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<1>
Accession Number
2020336182
Title
Sex Differences in 10-Year Outcomes Following STEMI: A Subanalysis From
the EXAMINATION-EXTEND Trial.
Source
JACC: Cardiovascular Interventions. 15(19) (pp 1965-1973), 2022. Date of
Publication: 10 Oct 2022.
Author
Gabani R.; Spione F.; Arevalos V.; Grima Sopesens N.; Ortega-Paz L.;
Gomez-Lara J.; Jimenez-Diaz V.; Jimenez M.; Jimenez-Quevedo P.; Diletti
R.; Pineda J.; Campo G.; Silvestro A.; Maristany J.; Flores X.; Oyarzabal
L.; Bastos-Fernandez G.; Iniguez A.; Serra A.; Escaned J.; Ielasi A.;
Tespili M.; Lenzen M.; Gonzalo N.; Bordes P.; Tebaldi M.; Biscaglia S.;
Al-Shaibani S.; Romaguera R.; Gomez-Hospital J.A.; Rodes-Cabau J.; Serruys
P.W.; Sabate M.; Brugaletta S.
Institution
(Gabani, Spione, Arevalos, Ortega-Paz, Rodes-Cabau, Sabate, Brugaletta)
Hospital Clinic, Cardiovascular Clinic Institute, Institut
d'Investigacions Biomediques August Pi i Sunyer, Barcelona, Spain
(Spione) Department of Advanced Biomedical Sciences, University of Naples,
Federico II, Naples, Italy
(Grima Sopesens) Faculty of Medicine, University of Barcelona, Barcelona,
Spain
(Ortega-Paz) Division of Cardiology, University of Florida College of
Medicine, Jacksonville, FL, United States
(Gomez-Lara, Oyarzabal, Romaguera, Gomez-Hospital) Hospital Universitari
de Bellvitge, Institut d'Investigacio Biomedica de Bellvitge, L'Hospitalet
de Llobregat, Spain
(Jimenez-Diaz, Bastos-Fernandez, Iniguez) Hospital Alvaro Cunqueiro, Vigo,
Spain
(Jimenez-Diaz, Bastos-Fernandez, Iniguez) Cardiovascular Research Group,
Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO,
Vigo, Spain
(Jimenez, Serra) University Hospital of Sant Pau, Barcelona, Spain
(Jimenez-Quevedo, Escaned, Gonzalo) University Hospital San Carlos,
Madrid, Spain
(Diletti, Lenzen, Al-Shaibani) Thoraxcenter, Rotterdam, Netherlands
(Pineda, Bordes) Hospital General of Alicante, Alicante, Spain
(Campo, Tebaldi, Biscaglia) Cardiology Unit, Azienda Ospedaliera
Universitaria di Ferrara, Cona, Italy
(Silvestro, Ielasi, Tespili) University Hospital Bolognini Seriate,
Bergamo, Italy
(Maristany) Hospital Son Dureta, Palma de Mallorca, Spain
(Flores) Hospital Universitario, A Coruna, Spain
(Serruys) International Center of Circulatory Health, Imperial College
London, London, United Kingdom
(Serruys) Department of Cardiology, National University of Ireland,
Galway, Ireland
(Sabate) CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
Publisher
Elsevier Inc.
Abstract
Background: Short-term outcomes following ST-segment elevation myocardial
infarction (STEMI) in women are worse than in men, with a higher mortality
rate. It is unknown whether sex plays a role in very long term outcomes.
 Objective(s): The aim of this study was to assess whether very long
term outcomes following STEMI treatment are influenced by sex.
 Method(s): EXAMINATION-EXTEND (10-Year Follow-Up of the EXAMINATION
Trial) was an investigator-driven 10-year follow-up of the EXAMINATION (A
Clinical Evaluation of Everolimus Eluting Coronary Stents in the Treatment
of Patients With ST-Segment Elevation Myocardial Infarction) trial, which
randomly 1:1 assigned 1,498 patients with STEMI to receive either
everolimus-eluting stents or bare-metal stents. The present study was a
subanalysis according to sex. The primary endpoint was the composite
patient-oriented endpoint (all-cause death, any myocardial infarction, or
any revascularization) at 10 years. Secondary endpoints were individual
components of the primary endpoint. All endpoints were adjusted for age.
 Result(s): Among 1,498 patients with STEMI, 254 (17%) were women.
Overall, women were older, with more arterial hypertension and less
smoking history than men. At 10 years, no difference was observed between
women and men for the patient-oriented composite endpoint (40.6% vs 34.2%;
adjusted HR: 1.14; 95% CI: 0.91-1.42; P = 0.259). There was a trend toward
higher all-cause death in women vs men (27.6% vs 19.4%; adjusted HR: 1.30;
95% CI: 0.99-1.71; P = 0.063), with no difference in cardiac death or
other endpoints. Conclusion(s): At very long term follow-up, there
were no differences in the combined patient-oriented endpoint between
women and men, with a trend toward higher all-cause death in women not
driven by cardiac death. The present findings underline the need for
focused personalized medicine in women after percutaneous
revascularization aimed at both cardiovascular and sex-specific risk
factor control and targeted treatment. (10-Years Follow-Up of the
EXAMINATION Trial [EXAMINAT10N]; NCT04462315) Copyright © 2022
American College of Cardiology Foundation

<2>
Accession Number
2017467724
Title
Retinopathy risk calculators in the prediction of sight-threatening
diabetic retinopathy in type 2 diabetes: A FIELD substudy.
Source
Diabetes Research and Clinical Practice. 186 (no pagination), 2022.
Article Number: 109835. Date of Publication: April 2022.
Author
Rao B.N.; Quinn N.; Januszewski A.S.; Peto T.; Brazionis L.; Aryal N.;
O'Connell R.L.; Li L.; Summanen P.; Scott R.; O'Day J.; Keech A.C.;
Jenkins A.J.
Institution
(Rao, Quinn, Januszewski, Aryal, O'Connell, Li, Keech, Jenkins) NHMRC
Clinical Trials Centre, The University of Sydney, Australia
(Rao) Faculty of Medicine, Nursing and Health Sciences, Monash University,
Australia
(Quinn, Peto, Jenkins) Centre for Public Health, Queens University,
Northern Ireland, Belfast, United Kingdom
(Brazionis, Jenkins) Department of Medicine, St. Vincent's Hospital
Campus, The University of Melbourne, Australia
(Summanen) Department of Ophthalmology, Helsinki University Hospital,
University of Helsinki, Finland
(Scott) Lipid and Diabetes Research Group, Christchurch Hospital,
Christchurch, New Zealand
(O'Day) Department of Ophthalmology, Royal Victorian Eye and Ear Hospital,
The University of Melbourne, Australia
Publisher
Elsevier Ireland Ltd
Abstract
Aims: To evaluate the risk algorithm by Aspelund et al. for predicting
sight-threatening diabetic retinopathy (STDR) in Type 2 diabetes (T2D),
and to develop a new STDR prediction model. Method(s): The Aspelund
et al. algorithm was used to calculate STDR risk from baseline variables
in 1012 participants in the Fenofibrate Intervention and Event Lowering in
Diabetes (FIELD) ophthalmological substudy, compared to on-trial STDR
status, and receiver operating characteristic analysis performed. Using
multivariable logistic regression, traditional risk factors and
fenofibrate allocation as STDR predictors were evaluated, with
bootstrap-based optimism-adjusted estimates of predictive performance
calculated. Result(s): STDR developed in 28 participants. The
Aspelund et al. algorithm predicted STDR at 2- and 5-years with area under
the curve (AUC) 0.86 (95% CI 0.77-0.94) and 0.86 (0.81-0.92),
respectively. In the second model STDR risk factors were any DR at
baseline (OR 24.0 [95% CI 5.53-104]), HbA1c (OR 1.95 [1.43-2.64]) and male
sex (OR 4.34 [1.32-14.3]), while fenofibrate (OR 0.13 [0.05-0.38]) was
protective. This model had excellent discriminatory ability (AUC = 0.89).
 Conclusion(s): The algorithm by Aspelund et al. predicts STDR well in
the FIELD ophthalmology substudy. Logistic regression analysis found DR at
baseline, male sex, and HbA1c were predictive of STDR and, fenofibrate was
protective. Copyright © 2022 Elsevier B.V.

<3>
Accession Number
2016340434
Title
Point-of-Care Ultrasound in the Evaluation of Patients with Left
Ventricular Assist Devices at the Emergency Department.
Source
Journal of Emergency Medicine. 62(3) (pp 348-355), 2022. Date of
Publication: March 2022.
Author
Pek J.H.; Teo L.Y.L.
Institution
(Pek) Department of Emergency Medicine, Sengkang General Hospital,
Singapore
(Teo) Department of Cardiology, National Heart Centre, Singapore
Publisher
Elsevier Inc.
Abstract
Background: Left ventricular assist devices (LVADs) can be used as a
bridging therapy for myocardial recovery or cardiac transplant, as well as
a destination therapy for long-term support in patients with advanced
heart failure. Patients with LVADs can present to the emergency department
(ED) for acute deterioration and emergency physicians (EPs) must be
equipped with the necessary knowledge and skill to treat this unique
population. Objective(s): This review describes the role of
point-of-care ultrasound (POCUS) in the evaluation of patients with LVADs
and illustrates how EPs can incorporate POCUS into the evaluation of these
patients in the ED. Discussion(s): The clinical applications for
which POCUS may be useful in patients with LVADs include hypotension or
shock, dyspnea, cardiac failure, dysrhythmia, syncope, and cardiac arrest.
The normal features of POCUS in patients with LVADs and the features of
POCUS associated with diseased states are presented. Conclusion(s):
Patients with LVADs have altered anatomy and physiology. Therefore, an
understanding of key modifications to standard POCUS views is necessary so
that EPs can use POCUS effectively in their evaluation of these
patients. Copyright © 2021 Elsevier Ltd

<4>
Accession Number
638475286
Title
Danhong injection improves elective percutaneous coronary intervention in
ua patients with blood stasis syndrome revealed by perioperative
metabolomics.
Source
World Journal of Traditional Chinese Medicine. 8(2) (pp 247-256), 2022.
Date of Publication: April-June 2022.
Author
Niu Q.; Xing W.-L.; Wang Y.-T.; Zhu Y.; Liu H.-X.
Institution
(Niu) Department of Critical Care Medicine, Zhuhai Hospital of Guangdong
Provincial Hospital of Traditional Chinese Medicine, Zhuhai, China
(Xing, Wang, Liu) Department of Cardiology, Beijing Hospital of
Traditional Chinese Medicine, Capital Medical University, Beijing, China
(Zhu) State Key Laboratory of Component-based Chinese Medicine, Tianjin
University of Traditional Chinese Medicine, Tianjin, China
Publisher
Wolters Kluwer Medknow Publications
Abstract
Objective: To observe the effect of Danhong injection (DHI) on
perioperative metabolomics of unstable angina pectoris (UA) with blood
stasis syndrome. Material(s) and Method(s): A prospective,
randomized, controlled, and single-blind clinical trial was conducted.
Sixty-one UA patients with traditional Chinese medicine blood stasis
syndrome undergoing elective percutaneous coronary intervention (PCI) were
randomly divided into the Danhong and control groups, and 10-healthy
volunteers were included as baseline. The Danhong group received western
medicine + DHI treatment, while the control group received western
medicine + saline. Nontargeted metabolomics was used to analyze the serum
metabolites of healthy volunteers in the Danhong and control groups before
and 5-days after PCI. Result(s): Before treatment, there was no
significant difference in serum metabolites between the Danhong and
control groups, but there was a significant difference between the two
groups and the healthy group. Differential metabolites were clustered
mainly in glycerophospholipid, sphingolipid, purine, and amino acid
groups, which were generated in their metabolic pathways. After 5-days of
PCI, the profiles of serum metabolites were significantly closer between
the Danhong-or control-Treated groups and that of the healthy group.
Furthermore, DHI treatment converted the serum metabolite profile more to
that of the healthy group than the control treatment. Conclusion(s):
The beneficial effect of DHI on patients with unstable angina is reflected
at the level of serum metabolic biomarkers. Copyright © World
Journal of Traditional Chinese Medicine.All rights reserved.

<5>
Accession Number
2018952546
Title
Dexmedetomidine and acute kidney injury following cardiac surgery in
pediatric patients-An updated systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 938790. Date of Publication: 24 Aug 2022.
Author
Wang H.; Zhang C.; Li Y.; Jia Y.; Yuan S.; Wang J.; Yan F.
Institution
(Wang, Li, Jia, Yuan, Wang, Yan) Department of Anesthesiology, Fuwai
Hospital, Chinese Academy of Medical Sciences and Peking Union Medical
College, Beijing, China
(Zhang) Department of Anesthesiology, Fuwai Hospital, Chinese Academy of
Medical Sciences, Shenzhen (Sun Yat-sen Cardiovascular Hospital,
Shenzhen), Shenzhen, China
Publisher
Frontiers Media S.A.
Abstract
Background: Acute kidney injury (AKI) is a common postoperative
complication in pediatric patients undergoing cardiac surgery and
associated with poor outcomes. Dexmedetomidine has the pharmacological
features of organ protection in cardiac surgery patients. The aim of this
meta-analysis is to investigate the effect of dexmedetomidine infusion on
the incidence of AKI after cardiac surgery in pediatric patients.
 Method(s): The databases of Pubmed, Embase, and Cochrane Library were
searched until April 24, 2022 following the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RevMan 5.3 was
used to perform statistical analyses. Result(s): Five relevant trials
with a total of 630 patients were included. The pooled result using
fixed-effects model with OR demonstrated significant difference in the
incidence of AKI between patients with dexmedetomidine and placebo (OR =
0.49, 95% CI: [0.33, 0.73], I2 = 0%, p for effect = 0.0004).
Subgroup analyses were performed based on congenital heart disease (CHD)
types and dexmedetomidine intervention time. Pooled results did not
demonstrate considerable difference in the incidence of AKI in pediatric
patients receiving intraoperative (OR = 0.53, 95% CI: [0.29, 0.99],
I2 = 0%, p for effect = 0.05) or postoperative dexmedetomidine
infusion (OR = 0.56, 95% CI: [0.31, 1.04], p for effect = 0.07), but a
significant difference in patients receiving combination of intra- and
postoperative dexmedetomidine infusion (OR = 0.27, 95% CI: [0.09, 0.77], p
for effect = 0.01). Besides, there was no significant difference in
duration of mechanical ventilation (SMD: -0.19, 95% CI: -0.46 to 0.08, p
for effect = 0.16; SMD: -0.16, 95% CI: -0.37 to 0.06, p for effect =
0.15), length of ICU (SMD: 0.02, 95% CI: -0.41 to 0.44, p for effect =
0.93) and hospital stay (SMD: 0.2, 95% CI: -0.13 to 0.54, p for effect =
0.23), and in-hospital mortality (OR = 1.26, 95% CI: 0.33-4.84, p for
effect = 0.73) after surgery according to the pooled results of the
secondary outcomes. Conclusion(s): Compared to placebo,
dexmedetomidine could significantly reduce the postoperative incidence of
AKI in pediatric patients undergoing cardiac surgery with cardiopulmonary
bypass (CPB), but the considerable difference was reflected in the
pediatric patients receiving combination of intra- and postoperative
dexmedetomidine infusion. Besides, there was no significant difference in
duration of mechanical ventilation, length of ICU and hospital stay, or
in-hospital mortality after surgery. Copyright © 2022 Wang,
Zhang, Li, Jia, Yuan, Wang and Yan.

<6>
Accession Number
2018952338
Title
Prognostic value of ventricular longitudinal strain in patients undergoing
transcatheter aortic valve replacement: A systematic review and
meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 965440. Date of Publication: 24 Aug 2022.
Author
Xiao Y.; Bi W.; Qiao W.; Wang X.; Li Y.; Ren W.
Institution
(Xiao, Bi, Qiao, Wang, Li, Ren) Department of Ultrasound, Shengjing
Hospital of China Medical University, Shenyang, China
Publisher
Frontiers Media S.A.
Abstract
Introduction: Strain obtained by speckle tracking echocardiography (STE)
can detect subclinical myocardial impairment due to myocardial fibrosis
(MF) and is considered a prognostic marker. Aortic stenosis (AS) is not
only a valve disease, but also a cardiomyopathy characterized by MF. The
purpose of this study was to systematically review and analyze ventricular
strain as a predictor of adverse outcomes in patients with AS undergoing
transcatheter aortic valve replacement (TAVR). Method(s): PubMed,
Embase, and the Cochrane library were searched for studies that
investigated the prognostic value of impaired ventricular strain on
patients with AS undergoing TAVR with all-cause mortality (ACM) and major
adverse cardiovascular events (MACE). Pooled odds ratios (ORs), hazard
ratios (HRs), and 95% confidence intervals (CIs) were calculated to assess
the role of left (LVLS) and right (RVLS) ventricular longitudinal strain
in the prognostic prediction of patients with AS undergoing TAVR.
Sensitivity and subgroup analysis was performed to assess heterogeneity.
 Result(s): Twelve studies were retrieved from 571 citations for
analysis. In total, 1,489 patients with a mean age of 82 years and
follow-up periods varying between 1 year and 8.5 years were included.
Meta-analysis showed the impaired LVLS from eight studies was associated
with an increased risk for combined ACM and MACE (OR: 1.08, 95% CI:
1-1.16; p = 0.037), and ACM alone (HR: 1.08, 95% CI: 1.01-1.16; p =
0.032). Impaired RVLS from four studies was associated with an increased
risk of combined ACM and MACE (OR: 1.08, 95% CI: 1.02-1.14; p < 0.01), and
ACM alone (HR: 1.07, 95% CI: 1.02-1.12; p < 0.01). Conclusion(s):
This meta-analysis demonstrated that ventricular strain, including LVLS
and RVLS, had a substantial prognostic value in ACM or combined ACM and
MACE, which could be used as a valid marker for risk stratification in
patients with AS undergoing TAVR. Copyright © 2022 Xiao, Bi,
Qiao, Wang, Li and Ren.

<7>
Accession Number
639088568
Title
Application of Propofol Target-Controlled Infusion for Optimized
Hemodynamic Status in ESRD Patients Receiving Arteriovenous Access
Surgery: A Randomized Controlled Trial.
Source
Medicina (Kaunas, Lithuania). 58(9) (no pagination), 2022. Date of
Publication: 01 Sep 2022.
Author
Chen P.-N.; Lu I.-C.; Huang T.-W.; Chen P.-C.; Lin W.-C.; Lu W.-L.; Tse J.
Institution
(Chen) Department of Anesthesiology, Yuan's General Hospital, Kaohsiung
802, Taiwan (Republic of China)
(Lu, Huang, Chen, Lin, Tse) Department of Anesthesiology, Kaohsiung
Medical University Hospital, Kaohsiung 807, Taiwan (Republic of China)
(Lu) Department of Anesthesiology, College of Medicine, Kaohsiung Medical
University, Kaohsiung 807, Taiwan (Republic of China)
(Lu, Lu) Department of Anesthesiology, Kaohsiung Municipal Siaogang
Hospital, Kaohsiung 812, Taiwan (Republic of China)
Publisher
NLM (Medline)
Abstract
Background and Objectives: End-stage renal disease (ESRD) is associated
with increased anesthetic risks such as cardiovascular events resulting in
higher perioperative mortality rates. This study investigated the
perioperative and postoperative outcomes in ESRD patients receiving
propofol target-controlled infusion with brachial plexus block during
arteriovenous (AV) access surgery. Material(s) and Method(s): We
recruited fifty consecutive patients scheduled to receive AV access
surgery. While all patients received general anesthesia combined with
ultrasound-guided brachial plexus block, the patients were randomly
assigned to one of two general anesthesia maintenance groups, with 23
receiving propofol target-controlled infusion (TCI) and 24 receiving
sevoflurane inhalation. We measured perioperative mean arterial pressure
(MAP), heart rate, and cardiac output and recorded postoperative pain
status and adverse events in both groups. Result(s): ESRD patients
receiving propofol TCI had significantly less reduction in blood pressure
than those receiving sevoflurane inhalation (p < 0.05) during AV access
surgery. Perioperative cardiac output and heart rate were similar in both
groups. Both groups reported relatively low postoperative pain score and a
low incidence of adverse events. Conclusion(s): Propofol TCI with
brachial plexus block can be used as an effective anesthesia regimen for
ESRD patients receiving AV access surgery. It can be used with less blood
pressure fluctuation than inhalational anesthesia.

<8>
Accession Number
639085852
Title
Transfusion practice in patients undergoing cardiac surgery in New
Zealand-impact of the TRICS III study (the TRICS TRIPS study).
Source
The New Zealand medical journal. 135(1562) (pp 34-47), 2022. Date of
Publication: 23 Sep 2022.
Author
Parke R.L.; Cavadino A.; McGuinness S.P.
Institution
(Parke) Nurse Senior Research Fellow, Associate Professor, Cardiothoracic
and Vascular Intensive Care Unit, Auckland City Hospital, Auckland, New
Zealand; Medical Research Institute of New Zealand, Wellington, New
Zealand; School of Nursing, University of Auckland, Auckland, New Zealand
(Cavadino) Biostatistician, School of Population Health, University of
Auckland, Auckland, New Zealand
(McGuinness) Intensive Care Consultant; Cardiothoracic and Vascular
Intensive Care Unit, Auckland City Hospital, Auckland, New Zealand;
Medical Research Institute of New Zealand, Wellington, New Zealand
Publisher
NLM (Medline)
Abstract
AIM: Cardiac surgery is the largest perioperative user of donated blood
products. There is significant uncertainty as to the optimal threshold for
RBC transfusion in patients undergoing cardiac surgery with little
evidence to guide practice. We wished to determine whether the results of
a large randomised controlled trial had changed practice. METHOD(S):
A prospective observational study of red blood cell (RBC) transfusions of
patients undergoing cardiac surgery utilising cardiopulmonary bypass was
undertaken as well as a cross-sectional self-administered online practice
survey of clinicians ordering red blood cell transfusions in all publicly
funded cardiac centres in New Zealand. RESULT(S): Significantly more
transfusions were administered to a pre-transfusion haemoglobin <75g/L and
thus considered in agreement with the restrictive arm of the TRICS III
study after completion of TRICS III study enrolment and before results
were known (T1)=44% when compared to after results were known (T2=56.7%,
p=0.01). Most respondents in the clinician survey had participated in the
TRICS III study. CONCLUSION(S): After the publication of the findings
of a large multi-national clinical trial, clinicians involved in the care
of cardiac surgery patients were more restrictive in their administration
of red blood cell transfusions than before the trial findings were
published. Copyright © PMA.

<9>
Accession Number
638468482
Title
Concomitant tricuspid annuloplasty in patients with mild to moderate
tricuspid valve regurgitation undergoing mitral valve surgery:
meta-analysis.
Source
The Journal of cardiovascular surgery. 63(5) (pp 624-631), 2022. Date of
Publication: 01 Oct 2022.
Author
Yokoyama Y.; Tsukagoshi J.; Takagi H.; Takayama H.; Kuno T.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Bethlehem, PA, United States
(Tsukagoshi) Department of Surgery, University of Texas Medical Branch,
Galveston, TX, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Takayama) Department of Surgery, Columbia University Medical Center, New
York, NY, USA
(Kuno) Department of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, New York, NY, USA -
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Clinical effects of concomitant tricuspid annuloplasty (TA)
in patients with mild to moderate tricuspid regurgitation at the time of
mitral valve surgery (MVS) remains indefinite. We aimed to perform a
meta-analysis to determine the long-term clinical and echocardiographic
effects of concomitant TA in patients undergoing MVS. EVIDENCE
ACQUISITION: MEDLINE and EMBASE were searched through January 2022 to
identify randomized controlled trials (RCT) and observational studies with
adjusted outcomes that investigated outcomes of concomitant TA versus
conservative management for mild to moderate tricuspid regurgitation in
patients undergoing MVS. EVIDENCE SYNTHESIS: Two RCT and 11 observational
studies included in the meta-analysis with a total of 3,953 patients
underwent MVS with (N.=1837) or without (N.=2166) concomitant TA. Mean
follow-up period ranged from 24 to 115.5 months. MVS with concomitant TA
was associated with all-cause mortality (hazard ratio [HR] 1.15; 95%
confidence interval [CI]: 0.81-1.55; P=0.34, I2=0%) compared with MVS
alone. Similarly, heart failure events (HR 0.74; 95% CI: 0.46-1.20;
P=0.22, I2=0%) as well as rates of tricuspid reoperation (HR 0.55; 95% CI:
0.27-1.10; P=0.09, I2=1%) were comparable between the groups. However, MVS
with concomitant TA was associated with a significant reduction in TR
progression (HR 0.30; 95% CI: 0.17-0.53; P<0.00001, I2=11%).
 CONCLUSION(S): Concomitant TA for patients undergoing MVS was
associated with similar long-term clinical outcomes compared to MVS alone.
However, concomitant TA was associated with a significant reduction in TR
progression. Longer follow-up is necessary to assess the effect on further
clinical outcomes.

<10>
Accession Number
2019243319
Title
Exercise training and cardiac autonomic function following coronary artery
bypass grafting: a systematic review and meta-analysis.
Source
Egyptian Heart Journal. 74(1) (no pagination), 2022. Article Number: 67.
Date of Publication: December 2022.
Author
Kushwaha P.; Moiz J.A.; Mujaddadi A.
Institution
(Kushwaha, Moiz, Mujaddadi) Centre for Physiotherapy and Rehabilitation
Sciences, Jamia Millia Islamia (A Central University), New Delhi 110025,
India
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Exercise training improves cardiac autonomic function is still
debatable in patients with coronary artery bypass grafting (CABG). The aim
of the present review is to assess the effect of exercise on CABG
patient's heart rate variability (HRV) and heart rate recovery (HRR)
parameters. Main body: Databases (PubMed, Web of Science and PEDro) were
accessed for systematic search from inception till May 2022. Eleven
potential studies were qualitatively analyzed by using PEDro and eight
studies were included in the quantitative synthesis. Meta-analysis was
conducted by using a random-effect model, inverse-variance approach
through which standardized mean differences (SMDs) were estimated. The
analysis of pooled data showed that exercise training improved HRV indices
of standard deviation of the R-R intervals (SDNN) [SMD 0.44, 95% CI 0.17,
0.71, p = 0.002], square root of the mean squared differences between
adjacent R-R intervals (RMSSD) [SMD 0.68, 95% CI 0.28, 1.08, p = 0.0008],
high frequency (HF) [SMD 0.58, 95% CI 0.18, 0.98, p = 0.005] and low
frequency-to-high frequency (LF/HF) ratio [SMD - 0.34, 95% CI - 0.65, -
0.02, p = 0.03]. Conclusion(s): Exercise training enhances cardiac
autonomic function in CABG patients. Owing to the methodological
inconsistencies in assessing HRV, the precise effect on autonomic function
still remains conflicted. Future high-quality trials are needed focusing
on precise methodological approach and incorporation of various types of
exercise training interventions will give clarity regarding autonomic
adaptations post-exercise training in CABG. Trial
registrationCRD42021230270, February 19, 2021. Copyright © 2022,
The Author(s).

<11>
Accession Number
2019220267
Title
Are Routine Chest X-rays Necessary following Thoracic Surgery? A
Systematic Literature Review and Meta-Analysis.
Source
Cancers. 14(18) (no pagination), 2022. Article Number: 4361. Date of
Publication: September 2022.
Author
Galata C.; Cascant Ortolano L.; Shafiei S.; Hetjens S.; Muller L.; Stauber
R.H.; Stamenovic D.; Roessner E.D.; Karampinis I.
Institution
(Galata, Shafiei, Stamenovic, Roessner, Karampinis) Division of Thoracic
Surgery, Academic Thoracic Center Mainz, University Medical Center Mainz,
Johannes Gutenberg University Mainz, Mainz 55122, Germany
(Cascant Ortolano) Departmental Library, University Medical Center Mainz,
Johannes Gutenberg University Mainz, Mainz 55122, Germany
(Hetjens) Institute of Medical Statistic and Biomathematics, University
Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University,
Mannheim 68167, Germany
(Muller) Clinic for Diagnostic and Interventional Radiology, University
Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz 55122,
Germany
(Stauber) Department of Otorhinolaryngology, Head and Neck Surgery,
Molecular and Cellular Oncology, University Medical Center Mainz, Johannes
Gutenberg University Mainz, Mainz 55122, Germany
Publisher
MDPI
Abstract
(1) Background: The number of chest X-rays that are performed in the
perioperative window of thoracic surgery varies. Many clinics X-ray
patients daily, while others only perform X-rays if there are clinical
concerns. The purpose of this study was to assess the evidence of
perioperative X-rays following thoracic surgery and estimate the clinical
value with regard to changes in patient care. (2) Methods: A systematic
literature research was conducted up until November 2021. Studies
reporting X-ray outcomes in adult patients undergoing general thoracic
surgery were included. (3) Results: In total, 11 studies (3841
patients/4784 X-rays) were included. The X-ray resulted in changes in
patient care in 488 cases (10.74%). In patients undergoing
mediastinoscopic lymphadenectomy or thoracoscopic sympathectomy,
postoperative X-ray never led to changes in patient care. (4)
 Conclusion(s): There are no data to recommend an X-ray before surgery
or to recommend daily X-rays. X-rays immediately after surgery seem to
rarely have any consequences. It is probably reasonable to keep requesting
X-rays after drain removal since they serve multiple purposes and alter
patient care in 7.30% of the cases. Copyright © 2022 by the
authors.

<12>
Accession Number
2019205878
Title
Comparing Clinical Outcomes on Oncology Patients With Severe Aortic
Stenosis Undergoing Transcatheter Aortic Valve Implantation: A Systematic
Review and Meta-Analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 890082. Date of Publication: 31 May 2022.
Author
Song Y.; Wang Y.; Wang Z.; Xu C.; Dou J.; Jiang T.
Institution
(Song, Wang, Wang, Xu, Dou, Jiang) Department of Cardiology, The First
Affiliated Hospital of Soochow University, Suzhou, China
(Song, Wang, Wang, Xu, Dou) Department of Medicine, Soochow University,
Suzhou, China
Publisher
Frontiers Media S.A.
Abstract
Objective: To compare the clinical outcomes of cancer and non-cancer
patients with severe aortic stenosis (AS) after transcatheter aortic valve
implantation (TAVI). Method(s): A computer-based search in PubMed,
EMbase, The Cochrane Library, CBM, CNKI, and Wanfang databases from their
date of inception to October 2021, together with reference screening, was
performed to identify eligible clinical trials. Two reviewers
independently screened the articles, extracted data, and evaluated their
quality. Review Manger 5.3 and Stata 12.0 software were used for
meta-analysis. Result(s): The selected 11 cohort studies contained
182,645 patients, including 36,283 patients with cancer and 146,362
patients without cancer. The results of the meta-analysis showed that the
30-day mortality [OR = 0.68, 95%CI (0.63,0.74), I2= 0, P <
0.00001] of patients with cancer in the AS group was lower than those in
the non-cancer group; 1-year mortality [OR = 1.49, 95%CI(1.19,1.88),
I2= 58%, P = 0.0006] and late mortality [OR = 1.52,
95%CI(1.26,1.84), I2= 55%, P < 0.0001] of patients with cancer
in the AS group was higher than those in the non-cancer group. The results
of the meta-analysis showed that the stroke [OR = 0.77, 95%CI (0.72,
0.82), I2= 0, P < 0.00001] and the acute kidney injury [OR =
0.78, 95%CI (0.68, 0.90), I2= 77%, P = 0.0005] of patients with
cancer in the AS group was lower than those in the non-cancer group. The
results of the meta-analysis showed no statistical difference in
cardiovascular mortality, bleeding events, myocardial infarction, vascular
complication, and device success rate. Conclusion(s): It is more
effective and safer in patients with cancer with severe AS who were
undergoing TAVI. However, compared with patients with no cancer, this is
still high in terms of long-term mortality, and further study of the role
of TAVI in patients with cancer with AS is necessary. Systematic Review
Registration: Identifier [INPLASY CRD: 202220009]. Copyright ©
2022 Song, Wang, Wang, Xu, Dou and Jiang.

<13>
Accession Number
2019205802
Title
Melatonin and Its Analogs for Prevention of Post-cardiac Surgery Delirium:
A Systematic Review and Meta-Analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 888211. Date of Publication: 18 May 2022.
Author
Han Y.; Tian Y.; Wu J.; Zhu X.; Wang W.; Zeng Z.; Qin Z.
Institution
(Han, Wang, Qin) Department of Anaesthesiology, Nanfang Hospital, Southern
Medical University, Guangzhou, China
(Tian, Zhu) Department of Anesthesiology, Guangdong Women and Children
Hospital, Guangzhou, China
(Wu, Zeng) Department of Critical Care Medicine, Nanfang Hospital,
Southern Medical University, Guangzhou, China
Publisher
Frontiers Media S.A.
Abstract
Background: The effectiveness of melatonin and its analogs in preventing
postoperative delirium (POD) following cardiac surgery is controversial.
The purpose of this systematic review and meta-analysis was to confirm the
benefits of melatonin and its analogs on delirium prevention in adults who
underwent cardiac surgery. Method(s): We systematically searched the
PubMed, Cochrane Library, Web of Science, Embase, and EBSCOhost databases,
the last search was performed in October 2021 and repeated before
publication. The controlled studies were included if investigated the
impact of melatonin and its analogs on POD in adults who underwent cardiac
surgery. The primary outcome was the incidence of delirium. The Stata
statistical software 17.0 was used to perform this study. Result(s):
This meta-analysis included eight randomized controlled trials (RCTs) and
two cohort studies with a total of 1,714 patients. The results showed that
melatonin and ramelteon administration were associated with a
significantly lower incidence of POD in adults who underwent cardiac
surgery (odds ratio [OR], 0.46; 95% confidence interval [CI], 0.29-0.74; P
= 0.001). The subgroup analyses confirmed that melatonin 3 mg (OR, 0.37;
95% CI, 0.18-0.76; P = 0.007) and 5 mg (OR, 0.34; 95% CI, 0.21-0.56; P <
0.001) significantly reduced the incidence of POD. Conclusion(s):
Melatonin at dosages of 5 and 3 mg considerably decreased the risk of
delirium in adults who underwent cardiac surgery, according to our
results. Cautious interpretation of our results is important owing to the
modest number of studies included in this meta-analysis and the
heterogeneity among them. Systematic Review Registration: PROSPERO
registration number: CRD42021246984. Copyright © 2022 Han, Tian,
Wu, Zhu, Wang, Zeng and Qin.

<14>
[Use Link to view the full text]
Accession Number
2020368902
Title
A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial of
Preoperative Antithrombin Supplementation in Patients at Risk for
Antithrombin Deficiency after Cardiac Surgery.
Source
Anesthesia and Analgesia. 135(4) (pp 757-768), 2022. Date of Publication:
01 Oct 2022.
Author
Moront M.G.; Woodward M.K.; Essandoh M.K.; Avery E.G.; Reece T.B.;
Brzezinski M.; Spiess B.; Shore-Lesserson L.; Chen J.; Henriquez W.;
Barcelo M.; Despotis G.; Karkouti K.; Levy J.H.; Ranucci M.; Mondou E.;
Kramer R.; Subramaniam K.; Nascimben L.; Fontes M.; Scavo V.; Sniecinski
R.; Lombard F.; Welsby I.; Milliken J.; Hazelrigg S.; Tibayan F.;
Rodriguez-Blanco Y.; Moainie S.; Moulton M.; Iribarne A.; Firstenberg M.;
Answini G.; Garrett E.; Beaver T.; Reda H.; Szeto W.
Institution
(Moront) Department of Cardiothoracic Sugery, Promedical Toledo Hospital,
Toledo, OH, United States
(Woodward, Chen, Henriquez, Barcelo, Mondou) Bioscience Research Group,
Grifols, Barcelona, Spain
(Essandoh) Department of Anesthesiology, Wexner Medical Center, The Ohio
State University, Columbus, OH, United States
(Avery) Department of Anesthesiology and Perioperative Medicine,
University Hospital Case Medical Center, Cleveland, OH, United States
(Reece) Department of Surgery, Division of Cardiothoracic Surgery,
University of Colorado, Aurora, CO, United States
(Brzezinski) Department of Anesthesiology and Perioperative Care,
University of California, San Francisco, CA, United States
(Brzezinski) San Francisco Veterans Affairs Health Care System, San
Francisco, CA, United States
(Spiess) Department of Anesthesiology, University of Florida, College of
Medicine, Gainesville, FL, United States
(Shore-Lesserson) Department of Anesthesiology, North Shore University
Hospital, New York, NY, United States
(Despotis) Departments of Pathology, Immunology and Anesthesiology,
Washington University, School of Medicine, St. Louis, MO, United States
(Karkouti) Department of Anesthesia and Pain Medicine, University of
Toronto, Toronto, ON, Canada
(Levy) Department of Anesthesiology and Critical Care, Duke University,
School of Medicine, Durham, NC, United States
(Ranucci) Department of Cardiothoracic and Vascular Anesthesia and
Intensive Care, IRCSS Policlinico San Donato, Milan, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Antithrombin (AT) activity is reduced during cardiac
operations with cardiopulmonary bypass (CPB), which is associated with
adverse outcomes. Preoperative AT supplementation, to achieve >58% and
<100% AT activity, may potentially reduce postoperative morbidity and
mortality in cardiac operations with CPB. This prospective, multicenter,
randomized, double-blind, placebo-controlled study was designed to
evaluate the safety and efficacy of preoperative treatment with AT
supplementation in patients at risk for low AT activity after undergoing
cardiac surgery with CPB. METHOD(S): A total of 425 adult patients
were randomized (1:1) to receive either a single dose of AT (n = 213) to
achieve an absolute increase of 20% above pretreatment AT activity or
placebo (n = 212) before surgery. The study duration was approximately 7
weeks. The primary efficacy end point was the percentage of patients with
any component of a major morbidity composite (postoperative mortality,
stroke, acute kidney injury [AKI], surgical reexploration, arterial or
venous thromboembolic events, prolonged mechanical ventilation, and
infection) in the 2 groups. Secondary end points included AT activity,
blood loss, transfusion requirements, duration of intensive care unit
(ICU), and hospital stays. Safety was also assessed. RESULT(S):
Overall, 399 patients (men, n = 300, 75.2%) with a mean (standard
deviation [SD]) age of 66.1 (11.7) years, with the majority undergoing
complex surgical procedures (n = 266, 67.9%), were analyzed. No
differences in the percentage of patients experiencing morbidity composite
outcomes between groups were observed (AT-treated 68/198 [34.3%] versus
placebo 58/194 [29.9%]; P =.332; relative risk, 1.15). After AT infusion,
AT activity was significantly higher in the AT group (108% [42-143])
versus placebo group (76% [40-110]), and lasted up to postoperative day 2.
At ICU, the frequency of patients with AT activity >=58% in the AT group
(81.5%) was significantly higher (P <.001) versus placebo group (43.2%).
Secondary end point analysis did not show any advantage of AT over placebo
group. There were significantly more patients with AKI (P <.001) in the AT
group (23/198; 11.6%) than in the placebo group (5/194, 2.6%). Safety
results showed no differences in treatment-emergent adverse events nor
bleeding events between groups. CONCLUSION(S): AT supplementation did
not attenuate adverse postoperative outcomes in our cohort of patients
undergoing cardiac surgery with CPB. Copyright © 2022 Lippincott
Williams and Wilkins. All rights reserved.

<15>
[Use Link to view the full text]
Accession Number
2020368901
Title
Society of Cardiovascular Anesthesiologists Clinical Practice Update for
Management of Acute Kidney Injury Associated with Cardiac Surgery.
Source
Anesthesia and Analgesia. 135(4) (pp 744-756), 2022. Date of Publication:
01 Oct 2022.
Author
Peng K.; McIlroy D.R.; Bollen B.A.; Billings F.T.; Zarbock A.; Popescu
W.M.; Fox A.A.; Shore-Lesserson L.; Zhou S.; Geube M.A.; Ji F.; Bhatia M.;
Schwann N.M.; Shaw A.D.; Liu H.
Institution
(Peng, Liu) Department of Anesthesiology and Pain Medicine, University of
California Davis Health, Sacramento, CA, United States
(Peng, Ji) First Affiliated Hospital of Soochow University, Suzhou, China
(McIlroy, Billings) Department of Anesthesiology, Vanderbilt University
Medical Center, Nashville, TN, United States
(Bollen) Department of Anesthesiology, The International Heart Institute
of Montana, Missoula, MT, United States
(Zarbock) Department of Anesthesiology and Intensive Care Medicine,
University Hospital of Muenster, Muenster, Germany
(Popescu) Department of Anesthesiology, Yale University, School of
Medicine, Easton, CT, United States
(Fox) Department of Anesthesiology and Pain Management, University of
Texas, Southwestern Medical Center, Dallas, TX, United States
(Shore-Lesserson) Department of Anesthesiology, Northwell Health,
Manhasset, NY, United States
(Zhou) Department of Anesthesiology, University of Texas Medical School,
Sugar Land, TX, United States
(Geube) Department of Cardiothoracic Anesthesiology, Cleveland Clinic,
Cleveland, OH, United States
(Bhatia) Department of Anesthesiology, University of North Carolina,
Chapel Hill, NC, United States
(Schwann) Department of Anesthesiology, Lehigh Valley Health Network,
Allentown, PA, United States
(Shaw) Department of Intensive Care and Resuscitation, Cleveland Clinic,
Cleveland, OH, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Cardiac surgery-associated acute kidney injury (CS-AKI) is common and is
associated with increased risk for postoperative morbidity and mortality.
Our recent survey of the Society of Cardiovascular Anesthesiologists (SCA)
membership showed 6 potentially renoprotective strategies for which
clinicians would most value an evidence-based review (ie, intraoperative
target blood pressure, choice of specific vasopressor agent, erythrocyte
transfusion threshold, use of alpha-2 agonists, goal-directed oxygen
delivery on cardiopulmonary bypass [CPB], and the "Kidney Disease
Improving Global Outcomes [KDIGO] bundle of care"). Thus, the SCA's
Continuing Practice Improvement Acute Kidney Injury Working Group aimed to
provide a practice update for each of these strategies in cardiac surgical
patients based on the evidence from randomized controlled trials (RCTs).
PubMed, EMBASE, and Cochrane library databases were comprehensively
searched for eligible studies from inception through February 2021, with
search results updated in August 2021. A total of 15 RCTs investigating
the effects of the above-mentioned strategies on CS-AKI were included for
meta-analysis. For each strategy, the level of evidence was assessed using
the Grading of Recommendations, Assessment, Development and Evaluation
(GRADE) methodology. Across the 6 potentially renoprotective strategies
evaluated, current evidence for their use was rated as "moderate," "low,"
or "very low." Based on eligible RCTs, our analysis suggested using
goal-directed oxygen delivery on CPB and the "KDIGO bundle of care" in
high-risk patients to prevent CS-AKI (moderate level of GRADE evidence).
Our results suggested considering the use of vasopressin in vasoplegic
shock patients to reduce CS-AKI (low level of GRADE evidence). The
decision to use a restrictive versus liberal strategy for perioperative
red cell transfusion should not be based on concerns for renal protection
(a moderate level of GRADE evidence). In addition, targeting a higher mean
arterial pressure during CPB, perioperative use of dopamine, and use of
dexmedetomidine did not reduce CS-AKI (a low or very low level of GRADE
evidence). This review will help clinicians provide evidence-based care,
targeting improved renal outcomes in adult patients undergoing cardiac
surgery. Copyright © 2022 Lippincott Williams and Wilkins. All
rights reserved.

<16>
Accession Number
639108512
Title
Yield of Dual Therapy With Statin and Ezetimibe in the Treat Stroke to
Target Trial.
Source
Stroke. (pp 101161STROKEAHA122039728), 2022. Date of Publication: 26 Sep
2022.
Author
Amarenco P.; Kim J.S.; Labreuche J.; Charles H.; Giroud M.; Lee B.-C.;
Lavallee P.C.; Mahagne M.-H.; Meseguer E.; Nighoghossian N.; Steg P.G.;
Vicaut E.; Bruckert E.
Institution
(Amarenco, Charles, Lavallee, Meseguer) APHP, Department of Neurology and
Stroke center, Bichat Hospital, INSERM LVTS-U1148, DHU FIRE, University of
Paris, H.C., P.C.L., France
(Amarenco) Population Health Research Institute, McMaster University,
Hamilton, Ontario, Canada (P.A.)
(Kim) Asan Medical Center, South Korea (J.S.K.), Seoul, South Korea
(Labreuche) Department of Biostatistics, CHU Lille
(Giroud) Department of Neurology, University Hospital of Dijon, Dijon
Stroke Registry, University of Burgundy, UBFC, EA 7460, Spain
(Lee) Department of Neurology, Hallym University Sacred Heart Hospital,
Anyang, China
(Mahagne) Stroke Unit, Pasteur Hospital, Nice, France
(Nighoghossian) Hospices Civils de Lyon, Department of Neurology and
Stroke Center, Lyon University, France
(Steg) Universite de Paris, INSERM LVTS-U1148, France
(Steg) AP-HP, Hopital Bichat, France
(Vicaut) APHP, Department of Biostatistics, Universite Paris-Diderot,
Fernand Widal hospital, Sorbonne-Paris Cite, Paris, United States
(Bruckert) APHP, Department of Endocrinology, Pitie-Salpetriere hospital,
Sorbonne University, Paris, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: In atherosclerotic stroke, lipid-lowering treatment with a
target LDL (low-density lipoprotein) cholesterol of <70 compared with
100+/-10 mg/dL reduced the risk of subsequent cardiovascular events. This
post hoc analysis explored the relative effects of the combination of
statin and ezetimibe (dual therapy) and statin monotherapy in achieving
the lower LDL cholesterol target and in reducing the risk of major
vascular events, as compared with the higher target group. METHOD(S):
Patients with ischemic stroke in the previous 3 months or transient
ischemic attack within the previous 15 days and evidence of
cerebrovascular or coronary artery atherosclerosis were randomly assigned
to a target LDL cholesterol of <70 or 100+/-10 mg/dL, using statin and/or
ezetimibe as needed. The primary outcome was the composite of ischemic
stroke, myocardial infarction, new symptoms requiring urgent coronary or
carotid revascularization, and vascular death. Cox regression model
including lipid-lowering therapy as a time varying variable, after
adjustment for randomization strategy, age, sex, index event (stroke or
transient ischemic attack), and time since the index event.
 RESULT(S): Among 2860 patients enrolled, patients who were on dual
therapy during the trial in the lower target group had a higher baseline
LDL cholesterol as compared to patients on statin monotherapy (141+/-38
versus 131+/-36, respectively, P<0.001). In patients on dual therapy and
on statin monotherapy, the achieved LDL cholesterol was 66.2 and 64.1
mg/dL respectively, and the primary outcome was reduced during dual
therapy as compared with the higher target group (HR, 0.60 [95% CI,
0.39-0.91]; P=0.016) but not during statin monotherapy (HR, 0.92 [95% CI,
0.70-1.20]; P=0.52), with no significant increase in intracranial
bleeding. CONCLUSION(S): In the TST trial (Treat Stroke to Target),
targeting an LDL cholesterol of < 70 mg/dL with a combination of statin
and ezetimibe compared with 100+/-10 mg/dL consistently reduced the risk
of subsequent stroke. REGISTRATION: URL: https://www. CLINICALTRIALS: gov;
Unique identifier: NCT01252875. URL: clinicaltrialsregister.eu; Unique
identifier: EUDRACT2009-A01280-57.

<17>
Accession Number
2018869605
Title
Effectiveness of rib fixation compared to pain medication alone on pain
control in patients with uncomplicated rib fractures: study protocol of a
pragmatic multicenter randomized controlled trial-the PAROS study (Pain
After Rib OSteosynthesis).
Source
Trials. 23(1) (no pagination), 2022. Article Number: 732. Date of
Publication: December 2022.
Author
Perentes J.Y.; Christodoulou M.; Abdelnour-Berchtold E.; Karenovics W.;
Gayet-Ageron A.; Gonzalez M.; Krueger T.; Triponez F.; Terrier P.; Bedat
B.
Institution
(Perentes, Abdelnour-Berchtold, Gonzalez, Krueger) Unit of Thoracic and
Endocrine Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne,
Switzerland
(Christodoulou) Unit of Thoracic and Endocrine Surgery, Hospital of
Valais, Sion, Switzerland
(Karenovics, Triponez, Terrier, Bedat) Unit of Thoracic and Endocrine
Surgery, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4,
Geneva 1205, Switzerland
(Gayet-Ageron) CRC & Division of Clinical-Epidemiology, Department of
Health and Community Medicine, University of Geneva & University Hospitals
of Geneva, Geneva, Switzerland
(Terrier) Haute-Ecole Arc Sante, HES-SO University of Applied Sciences and
Arts Western Switzerland, Neuchatel, Switzerland
Publisher
BioMed Central Ltd
Abstract
Background: Persistent pain and disability following rib fractures result
in a large psycho-socio-economic impact for health-care system. Benefits
of rib osteosynthesis are well documented in patients with flail chest
that necessitates invasive ventilation. In patients with uncomplicated and
simple rib fractures, indication for rib osteosynthesis is not clear. The
aim of this trial is to compare pain at 2 months after rib osteosynthesis
versus medical therapy. Method(s): This trial is a pragmatic
multicenter, randomized, superiority, controlled, two-arm, not-blinded,
trial that compares pain evolution between rib fixation and standard pain
medication versus standard pain medication alone in patients with
uncomplicated rib fractures. The study takes place in three hospitals of
Thoracic Surgery of Western Switzerland. Primary outcome is pain measured
by the brief pain inventory (BPI) questionnaire at 2 months post-surgery.
The study includes follow-up assessments at 1, 2, 3, 6, and 12 months
after discharge. To be able to detect at least 2 point-difference on the
BPI between both groups (standard deviation 2) with 90% power and
two-sided 5% type I error, 46 patients per group are required. Adjusting
for 10% drop-outs leads to 51 patients per group. Discussion(s):
Uncomplicated rib fractures have a significant medico-economic impact.
Surgical treatment with rib fixation could result in better clinical
recovery of patients with uncomplicated rib fractures. These improved
outcomes could include less acute and chronic pain, improved pulmonary
function and quality of life, and shorter return to work. Finally,
surgical treatment could then result in less financial costs. Trial
registration: ClinicalTrials.govNCT04745520. Registered on 8 February
2021. Copyright © 2022, The Author(s).

<18>
Accession Number
2018199925
Title
Lung transplantation and concomitant cardiac surgical procedures: A
systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. 37(10) (pp 3342-3352), 2022. Date of
Publication: October 2022.
Author
Meng E.; Jiang S.M.; Servito T.; Payne D.; El-Diasty M.
Institution
(Meng, Jiang, Servito, Payne, El-Diasty) Division of Cardiac Surgery,
Queen's University, Kingston, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: Lung transplantation is an effective treatment option for
end-stage lung diseases. In some cases, these patients may also have
underlying cardiac disease which may require surgical intervention before
or during transplantation. Concomitant cardiac surgery may often be
preferred, as reduced lung function precludes these patients from
pre-transplant surgery. Our meta-analysis sought to examine the impact of
lung transplantation paired with concomitant cardiac surgery on long-term
mortality. Method(s): We conducted a systematic review of the
MEDLINE, Embase, and Cochrane databases. Our primary outcome was overall
mortality. Secondary outcomes included length of stay (LOS) in hospital
and serious postoperative complication rates. We used a meta-analytic
model to determine the differences in the above outcomes between patients
who underwent lung transplantation with or without concomitant cardiac
surgery. Result(s): Out of the 1876 articles screened, 7 met our
pre-determined inclusion criteria. Lung transplantation with concomitant
cardiac surgery was not associated with increased mortality compared to
lung transplantation alone (hazard ratio = 1.02; 95% confidence interval
[CI] = 0.80-1.31; I2 = 0%; p =.99). LOS in hospital was not
significantly different between groups (standardized mean difference =
0.32; 95% CI = -0.91 to 1.55). Postoperative complication rates were also
reported but not analyzed due to missing data. Conclusion(s): There
was no significant difference in mortality rates in patients undergoing
lung transplantation with or without concomitant cardiac surgery at 1, 3,
and 5 years. However, postoperative complication rates were higher in the
concomitant group. The decision to perform concomitant procedures should
be tailored to each patient's clinical condition. Copyright ©
2022 Wiley Periodicals LLC.

<19>
Accession Number
2017687617
Title
Propofol Upregulates MicroRNA-30b to Inhibit Excessive Autophagy and
Apoptosis and Attenuates Ischemia/Reperfusion Injury in Vitro and in
Patients.
Source
Oxidative Medicine and Cellular Longevity. 2022 (no pagination), 2022.
Article Number: 2109891. Date of Publication: 2022.
Author
Lu Z.; Shen J.; Chen X.; Ruan Z.; Cai W.; Cai S.; Li M.; Yang Y.; Mo J.;
Mo G.; Lu Y.; Tang J.; Zhang L.
Institution
(Lu, Shen, Ruan, Cai, Cai, Li, Yang, Mo, Mo, Lu, Tang, Zhang) Department
of Anesthesiology, Affiliated Hospital of Guangdong Medical University,
Zhanjiang, Guangdong 524001, China
(Lu) Department of Anesthesiology, Hainan General Hospital, Hainan
Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311,
China
(Chen) Department of Oral and Maxillofacial Surgery, Hainan General
Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou,
Hainan 570311, China
Publisher
Hindawi Limited
Abstract
Evidence reveals that propofol protects cells via suppressing excessive
autophagy induced by hypoxia/reoxygenation (H/R). Previously, we found in
a genome-wide microRNA profile analysis that several autophagy-related
microRNAs were significantly altered during the process of H/R in the
presence or absence of propofol posthypoxia treatment (P-PostH), but how
these microRNAs work in P-PostH is still largely unknown. Here, we found
that one of these microRNAs, microRNA-30b (miR-30b), in human umbilical
vein endothelial cells (HUVECs) was downregulated by H/R treatment but
significantly upregulated by 100 M propofol after H/R treatment. miR-30b
showed similar changes in open heart surgery patients. By dual-luciferase
assay, we found that Beclin-1 is the direct target of miR-30b. This
conclusion was also supported by knockdown or overexpression of miR-30b.
Further studies showed that miR-30b inhibited H/R-induced autophagy
activation. Overexpression or knockdown of miR-30b regulated
autophagy-related protein gene expression in vitro. To clarify the
specific role of propofol in the inhibition of autophagy and distinguish
the induction of autophagy from the damage of autophagy flux, we used
bafilomycin A1. LC3-II levels were decreased in the group treated with
propofol combined with bafilomycin A1 compared with the group treated with
bafilomycin A1 alone after hypoxia and reoxygenation. Moreover, HUVECs
transfected with Ad-mCherry-GFP-LC3b confirmed the inhibitory effect of
miR-30b on autophagy flux. Finally, we found that miR-30b is able to
increase the cellular viability under the H/R condition, partially
mimicking the protective effect of propofol which suppressed autophagy via
enhancing miR-30b and targeting Beclin-1. Therefore, we concluded that
propofol upregulates miR-30b to repress excessive autophagy via targeting
Beclin-1 under H/R condition. Thus, our results revealed a novel mechanism
of the protective role of propofol during anesthesia. Clinical Trial
Registration Number. This trial is registered with ChiCTR-IPR-14005470.
The name of the trial register: Propofol Upregulates MicroRNA-30b to
Repress Beclin-1 and Inhibits Excessive Autophagy and
Apoptosis. Copyright © 2022 Zhiqi Lu et al.

<20>
Accession Number
2014783322
Title
Empagliflozin does not affect left ventricular diastolic function in
patients with type 2 diabetes mellitus and coronary artery disease:
insight from the EMPA-HEART CardioLink-6 randomized clinical trial.
Source
Acta Diabetologica. 59(4) (pp 575-578), 2022. Date of Publication: April
2022.
Author
Rai A.; Connelly K.A.; Verma S.; Mazer C.D.; Teoh H.; Ng M.-Y.; Roifman
I.; Quan A.; Pourafkari M.; Jimenez-Juan L.; Ramanan V.; Ge Y.; Deva D.P.;
Yan A.T.
Institution
(Rai, Pourafkari, Jimenez-Juan, Deva, Yan) Division of Cardiology,
Department of Medical Imaging, St Michael's Hospital, 30 Bond Street, Rm
6-030D, Toronto, ON M5B 1W8, Canada
(Rai, Connelly, Verma, Mazer, Roifman, Jimenez-Juan, Ge, Deva, Yan)
University of Toronto, Toronto, Canada
(Connelly, Verma, Ge, Yan) Terrence Donnelly Heart Center, St Michael's
Hospital, Toronto, Canada
(Connelly, Verma, Mazer, Teoh, Quan, Yan) Keenan Research Center, Li Ka
Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada
(Verma, Teoh, Quan) Division of Cardiac Surgery, St Michael's Hospital,
Toronto, Canada
(Mazer) Department of Anesthesia, St Michael's Hospital, Toronto, Canada
(Teoh) Division of Endocrinology and Metabolism, St Michael's Hospital,
Toronto, Canada
(Ng) Department of Diagnostic Radiology, HKU-Shenzhen Hospital and Li Ka
Shing Faculty of Medicine, The University of Hong Kong, Shenzhen, Hong
Kong
(Roifman, Ramanan) Schulich Heart Center, Sunnybrook Health Sciences
Center, Toronto, Canada
(Pourafkari) Queen's University, Kingston, Canada
Publisher
Springer-Verlag Italia s.r.l.

<21>
Accession Number
2014758406
Title
Nuclear Cardiac Imaging in the Interventional Suite.
Source
Current Cardiology Reports. 24(3) (pp 261-269), 2022. Date of Publication:
March 2022.
Author
Pickell Z.; Sinusas A.J.
Institution
(Pickell, Sinusas) Department of Medicine (Section of Cardiovascular
Medicine), Yale University School of Medicine, P.O. Box 208017, New Haven,
CT 06520, United States
(Sinusas) Department of Radiology & Biomedical Imaging, Yale University
School of Medicine, New Haven, CT, United States
(Sinusas) Department of Biomedical Engineering, Yale University, New
Haven, CT, United States
Publisher
Springer
Abstract
Purpose of Review: This review presents the current state of imaging
approaches that enable real-time molecular imaging in the interventional
suite and discusses the potential future use of integrated nuclear imaging
and fluoroscopy for intraprocedural guidance in the evaluation and
treatment of both cardiovascular and oncological diseases. Recent
Findings: Although there are no commercially available real-time hybrid
nuclear imaging devices that are approved for use in the interventional
suite, prototype open gantry hybrid nuclear imaging and x-ray c-arm
imaging systems and theranostic catheter for location radiotracer
detection are currently undergoing development and testing by multiple
groups. Summary: The integration of physiological and molecular
targeted nuclear imaging for real-time delivery of targeted theranostics
in the interventional laboratory may enable more personalized care for a
wide variety of cardiovascular procedures and improve patient
outcomes. Copyright © 2022, The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature.

<22>
Accession Number
2020336184
Title
Clinical Outcomes Following Isolated Orthotopic TTVI for Native Tricuspid
Valve Regurgitation: A Meta-Analysis.
Source
JACC: Cardiovascular Interventions. 15(19) (pp 1998-2000), 2022. Date of
Publication: 10 Oct 2022.
Author
Bansal A.; Agarwal S.; Hariri E.; Harb S.C.; Miyasaka R.; Reed G.W.; Puri
R.; Yun J.J.; Krishnaswamy A.; Kapadia S.R.
Publisher
Elsevier Inc.

<23>
Accession Number
2020239485
Title
Comparative efficacy of eight therapeutic methods in the treatment of left
main coronary artery disease: a Bayesian network meta-analysis protocol.
Source
BMJ Open. 12(9) (no pagination), 2022. Article Number: e058886. Date of
Publication: 06 Sep 2022.
Author
Hou B.; Chen M.; Li Q.; Huang W.; Wang L.
Institution
(Hou, Li, Huang, Wang) Inner Mongolia Medical University, Hohhot, China
(Chen) Bazhong Central Hospital, Sichuan, China
(Wang) Cardiothoracic Surgery Department, Inner Mongolia Baotou City
Central Hospital, Mongolia, Baotou, China
Publisher
BMJ Publishing Group
Abstract
Introduction As for coronary artery bypass grafting, although there are
many direct comparative studies on different minimally invasive methods
and traditional thoracotomy (off-pump/on-pump), there is still a lack of
further ranking and summary of the efficacy of all surgical methods for
left main coronary artery (LMCA) lesions. Combined with the current
controversial views, this study aims to introduce a planned network
meta-analysis (NMA) in detail, with a view to comparing the long-term
efficacy and safety of multiple therapeutic methods in the treatment of
patients with LMCA disease, and finally providing some reference bases for
the best selection of clinical schemes. Method and analysis PubMed,
Embase, Web of Science and The Cochrane Library databases will be
collected from inception to June 2022 to compare the efficacy of different
surgical methods in randomised controlled trials (RCTs) for LMCA disease.
Main outcome endpoints: major adverse cardiovascular events, including
mortality, myocardial infarction, stroke and revascularisation. Secondary
outcome endpoints: (1) operation-related time, (2) the amount of blood
transfusion, (3) complications including secondary thoracotomy,
postoperative new atrial fibrillation, wound infection, (4) physiological
score and psychological score, (5) time return to work and (6) total
hospitalisation costs. The methodological quality of included RCTs will be
assessed according to the Cochrane bias risk table. The Bayesian NMA will
be conducted by STATA V.16.0. Ethics and dissemination The essence of this
study is to summarise and analyse the original data without the approval
of the ethics committee. Our research does not involve ethical issues, and
the results will be published in peer-review journals. PROSPERO
registration number CRD42021274712. Copyright © Author(s) (or
their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial
re-use. See rights and permissions. Published by BMJ.

<24>
Accession Number
2020239163
Title
Risk and protective factors for atrial fibrillation after cardiac surgery
and valvular interventions: An umbrella review of meta-Analyses.
Source
Open Heart. 9(2) (no pagination), 2022. Article Number: e002074. Date of
Publication: 07 Sep 2022.
Author
Charitakis E.; Tsartsalis D.; Korela D.; Stratinaki M.; Vanky F.; Charitos
E.I.; Alfredsson J.; Karlsson L.O.; Foukarakis E.; Aggeli C.; Tsioufis C.;
Walfridsson H.; Dragioti E.
Institution
(Charitakis, Vanky, Alfredsson, Karlsson, Walfridsson) Department of
Cardiology and Department of Health, Medicine and Caring Sciences,
Linkoping University, Linkoping, Sweden
(Tsartsalis) Department of Emergency Medicine, Hippokration Hospital,
Athens, Greece
(Tsartsalis, Aggeli, Tsioufis) First Department of Cardiology,
Hippokration Hospital, Athens Medical School, Athens, Greece
(Korela, Stratinaki, Foukarakis) Department of Cardiology, Venizeleio
General Hospital, Heraklion, Greece
(Charitos) Department of Cardiac Surgery, Kerckhoff Hospital, Hessen,
Germany
(Dragioti) Pain and Rehabilitation Centre and Department of Health,
Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
Publisher
BMJ Publishing Group
Abstract
Objective Postoperative atrial fibrillation (POAF) is a common
complication affecting approximately one-Third of patients after cardiac
surgery and valvular interventions. This umbrella review systematically
appraises the epidemiological credibility of published meta-Analyses of
both observational and randomised controlled trials (RCT) to assess the
risk and protective factors of POAF. Methods Three databases were searched
up to June 2021. According to established criteria, evidence of
association was rated as convincing, highly suggestive, suggestive, weak
or not significant concerning observational studies and as high, moderate,
low or very low regarding RCTs. Results We identified 47 studies
(reporting 61 associations), 13 referring to observational studies and 34
to RCTs. Only the transfemoral transcatheter aortic valve replacement
(TAVR) approach was associated with the prevention of POAF and was
supported by convincing evidence from meta-Analyses of observational data.
Two other associations provided highly suggestive evidence, including
preoperative hypertension and neutrophil/lymphocyte ratio. Three
associations between protective factors and POAF presented a high level of
evidence in meta-Analyses, including RCTs. These associations included
atrial and biatrial pacing and performing a posterior pericardiotomy.
Nineteen associations were supported by moderate evidence, including use
of drugs such as amiodarone, b-blockers, glucocorticoids and statins and
the performance of TAVR compared with surgical aortic valve replacement.
Conclusions Our study provides evidence confirming the protective role of
amiodarone, b-blockers, atrial pacing and posterior pericardiotomy against
POAF as well as highlights the risk of untreated hypertension. Further
research is needed to assess the potential role of statins,
glucocorticoids and colchicine in the prevention of POAF. PROSPERO
registration number CRD42021268268. Copyright ©

<25>
Accession Number
2020159007
Title
Revisiting miRNA-21 as a Therapeutic Strategy for Myocardial Infarction: A
Systematic Review.
Source
Journal of Cardiovascular Pharmacology. 80(3) (pp 393-406), 2022. Date of
Publication: 28 Sep 2022.
Author
Sothivelr V.; Hasan M.Y.; Saffian S.M.; Zainalabidin S.; Ugusman A.;
Mahadi M.K.
Institution
(Sothivelr, Hasan, Mahadi) Centre for Drug and Herbal Development, Faculty
of Pharmacy, Universiti Kebangsaan, Malaysia
(Saffian) Centre for Quality Management of Medicine, Faculty of Pharmacy,
Universiti Kebangsaan, Malaysia
(Zainalabidin) Centre of Toxicology and Health Risk Study, Faculty of
Health Sciences, Universiti Kebangsaan, Malaysia
(Ugusman) Department of Physiology, Faculty of Medicine, Universiti
Kebangsaan, Malaysia
Publisher
Lippincott Williams and Wilkins
Abstract
Several types of cardiovascular cells use microRNA-21 (miR-21), which has
been linked to cardioprotection. In this study, we systematically reviewed
the results of published papers on the therapeutic effect of miR-21 for
myocardial infarction. Studies described the cardioprotective effects of
miR-21 to reduce infarct size by improving angiogenesis, antiapoptotic,
and anti-inflammatory mechanisms. Results suggest that cardioprotective
effects of miR-21 may work synergistically to prevent the deterioration of
cardiac function during postischemia. However, there are other results
that indicate that miR-21 positively regulates tissue fibrosis,
potentially worsening a postischemic injury. The dual functionalities of
miR-21 occur through the targeting of genes and signaling pathways, such
as PTEN, PDCD4, KBTBD7, NOS3, STRN, and Spry-1. This review provides
insights into the future advancement of safe miR-21-based genetic therapy
in the treatment of myocardial infarction. Copyright © 2022
Lippincott Williams and Wilkins. All rights reserved.

<26>
Accession Number
2019260540
Title
Aortic valve neocuspidization using autologous versus bovine pericardium:
Ozaki versus Batista.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Jubouri M.; Tan S.Z.C.P.; Mohammed I.; Bashir M.
Institution
(Jubouri) Hull York Medical School, University of York, York, United
Kingdom
(Tan) Barts and The London School of Medicine and Dentistry, Queen Mary
University of London, London, United Kingdom
(Mohammed) Institute of Cardiac and Aortic Disorders (ICAD), SRM
Institutes for Medical Science (SIMS Hospital), Tamil Nadu, Chennai, India
(Bashir) Vascular & Endovascular Surgery, Velindre University NHS Trust,
Health Education & Improvement Wales (HEIW), Cardiff, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: The average living age of the population is constantly
increasing and so is the incidence and prevalence of aortic valve disease.
Surgical aortic valve replacement (SAVR) is the current gold standard
treatment. Nevertheless, the use of prosthetic valves in SAVR is
associated with issues that impact patients' quality of life. Aortic valve
neocuspidization (AV Neo) offers a means to solve this dilemma by
minimizing foreign valve tissue. AV Neo can either be performed using
glutaraldehyde-treated autologous pericardium (Ozaki procedure) or bovine
pericardium (Batista procedure). Aim(s): This commentary aims to
discuss the recent study by Chan and colleagues which highlighted the
surgical approach, clinical outcomes, and limitations of the Ozaki
procedure, and compare this to the Batista procedure. Method(s): A
comprehensive literature search was performed using multiple electronic
databases including PubMed, Ovid, Embase, and Scopus to collate the
relevant research evidence. Result(s): Although the Ozaki procedure
can achieve favorable results whilst mainly avoiding the need for
life-long oral anticoagulation with mechanical valves, it still has
several limitations that may hinder results. AV Neo using
glutaraldehyde-treated bovine pericardium, developed by pioneer cardiac
surgeon Dr. Randas J. Vilela Batista, yields superior clinical outcomes to
Ozaki's, including excellent survival, lower complications, and minimal
need for reoperation as well as shorter operative times.
 Conclusion(s): AV Neo offers a means to perform SAVR whilst escaping
the prosthetic valve issues. However, the Batista procedure has shown
beyond doubt that it can be considered the superior approach for AV Neo
over the Ozaki procedure. Copyright © 2022 Wiley Periodicals LLC.

<27>
Accession Number
2019260475
Title
Understanding aortic valve repair through Ozaki procedure: A review of
literature evidence.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Chan J.; Basu A.; Di Scenza G.; Bartlett J.; Fan K.S.; Oo S.; Harkey A.
Institution
(Chan, Oo) Department of Cardiac Surgery, Bristol Heart Institute,
University of Bristol, Bristol, United Kingdom
(Basu, Di Scenza, Fan) Department of Medical Education, St George's
University of London, London, United Kingdom
(Bartlett) Department of Medical Education, Institute of Life Sciences,
Swansea University Medical School, Wales, Swansea, United Kingdom
(Harkey) Department of Cardiothoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Aortic valve neocuspidization (AV Neo) using
glutaraldehyde-treated autologous pericardium was first reported by Ozaki
et al. in 2007. This technique has become an alternative to tissue and
mechanical valve in selected patients as long-term anticoagulation is not
required and shows promising midterm results and durability.
 Method(s): A comprehensive search was performed on the major database
using the search terms "Ozaki technique" AND "Aortic Valve
Neocuspidization" AND "AV Neocuspidization" AND "Autologous pericardium"
AND "glutaraldehyde-treated autologous pericardium." Articles up to August
1st, 2021 were included in this study. Result(s): A total of nine
studies with a total of 1342 patients were included. The mean age was
67.36 and 54.23% were male. 66.32% and 23.92% of patients had aortic
stenosis and aortic regurgitation, respectively. 66% of patients had a
native tricuspid aortic valve (AV) and 31.37% of patients' native AV was
bicuspid. Three studies reported their experience performing AV Neo via
ministernotomy. Conclusion(s): AV Neo can be a suitable alternative
to surgical AV replacement in selected patients. The short- and midterm
outcomes are comparable without the need for long-term oral
anticoagulation. Long-term follow-up data are required for this novel
approach to be widely adopted. Copyright © 2022 Wiley Periodicals
LLC.

<28>
Accession Number
2016008520
Title
Multicenter randomized study evaluating the outcome of ganglionated plexi
ablation in maze procedure.
Source
General Thoracic and Cardiovascular Surgery. 70(10) (pp 908-915), 2022.
Date of Publication: October 2022.
Author
Sakamoto S.-I.; Ishii Y.; Otsuka T.; Mitsuno M.; Shimokawa T.; Isomura T.;
Yaku H.; Komiya T.; Matsumiya G.; Nitta T.
Institution
(Sakamoto, Ishii, Nitta) Department of Cardiovascular Surgery, Nippon
Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
(Otsuka) Department of Hygiene and Public Health, Nippon Medical School,
Tokyo, Japan
(Mitsuno) Department of Cardiovascular Surgery, Hyogo College of Medicine,
Hyogo, Japan
(Shimokawa) Department of Cardiovascular Surgery, Teikyo University,
Tokyo, Japan
(Isomura) Department of Cardiovascular Surgery, IMS Tokyo Katsushika
General Hospital, Tokyo, Japan
(Yaku) Department of Cardiovascular Surgery, Kyoto Prefectural University
of Medicine, Kyoto, Japan
(Komiya) Department of Cardiovascular Surgery, Kurashiki Central Hospital,
Okayama, Japan
(Matsumiya) Department of Cardiovascular Surgery, Chiba University
Graduate School of Medicine, Chiba, Japan
Publisher
Springer
Abstract
Objective: The benefit of adding ganglionated plexi ablation to the maze
procedure remains controversial. This study aims to compare the outcomes
of the maze procedure with and without ganglionated plexi ablation.
 Method(s): This multicenter randomized study included 74 patients
with atrial fibrillation associated with structural heart disease.
Patients were randomly allocated to the ganglionated plexi ablation group
(maze with ganglionated plexi ablation) or the maze group (maze without
ganglionated plexi ablation). The lesion sets in the maze procedure were
unified in all patients. High-frequency stimulation was applied to clearly
identify and perform ganglionated plexi ablation. Patients were followed
up for at least 6 months. The primary endpoint was a recurrence of atrial
fibrillation. Result(s): The intention-to-treat analysis included 69
patients (34 in the ganglionated plexi ablation group and 35 in the maze
group). No surgical mortality was observed in either group. After a mean
follow-up period of 16.3 +/- 7.9 months, 86.8% of patients in the
ganglionated plexi ablation group and 91.4% of those in the maze group did
not experience atrial fibrillation recurrence. Kaplan-Meier atrial
fibrillation-free curves showed no significant difference between the two
groups (P =.685). Cox proportional hazards regression analysis indicated
that left atrial dimension was the only risk factor for atrial
fibrillation recurrence (hazard ratio: 1.106, 95% confidence interval
1.017-1.024, P =.019). Conclusion(s): The addition of ganglionated
plexi ablation to the maze procedure does not improve early outcome when
treating atrial fibrillation associated with structural heart
disease. Copyright © 2022, The Author(s), under exclusive licence
to The Japanese Association for Thoracic Surgery.

<29>
Accession Number
2020319971
Title
Model for screening adult congenital heart disease surgery eligibility
with echocardiography parameters.
Source
Journal of Heart and Lung Transplantation. (no pagination), 2022. Date of
Publication: 2022.
Author
Zi-yang Y.; Hezhi L.; Nanshan X.; Yin Z.; Dongling L.; Hongwen F.; Caojin
Z.
Institution
(Zi-yang, Hezhi, Nanshan, Yin, Dongling, Hongwen, Caojin) Guangdong
Cardiovascular Institute, Guangdong Provincial People's Hospital,
Guangdong Academy of Medical Sciences, Guangdong, Guangzhou, China
(Zi-yang, Nanshan, Hongwen, Caojin) Southern Medical University, The
Second School of Clinical Medicine, Guangdong, Guangzhou, China
(Zi-yang, Nanshan, Yin, Caojin) Guangdong Provincial Key Laboratory of
South China Structural Heart Disease, Guangdong, Guangzhou, China
Publisher
Elsevier Inc.
Abstract
Objectives: This study aimed to screen for the eligibility of correction
in cases of adult congenital heart disease (CHD). Pulmonary to systemic
flow ratios (Qp/Qs) > 1.5 and pulmonary to systemic vascular resistance
ratios (Rp/Rs) < 1/3, acquired by right heart catheterization (RHC), are
two essential parameters. Nonetheless, performing RHC at every follow-up
is impractical and even harmful. Thus, it is important to establish a
model to predict Qp/Qs and Rp/Rs status before a RHC confirmation, using
echocardiography parameters. Method(s): A total of 1,785 patients
with adult CHD were enrolled and randomly assigned to the derivation or
validation groups. Echocardiogram parameters of the 974 patients in the
derivation group were considered candidate predictors for surgery
eligibility (Qp/Qs > 1.5 and Rp/Rs < 1/3). Binary logistic regression
analyses were performed to identify the independent predictors and
establish a scoring system. The scoring system was further examined in the
validation group using a receiver operating characteristic (ROC) analysis.
 Result(s): Estimated pulmonary artery systolic pressure, velocity
through the pulmonary valve, and diameters of the left and right atria
were identified as independent predictors. The area under the ROC curve of
the predictive value in the validation group and its pre- and
post-tricuspid valve malformation subgroups were 0.87 (95% confidence
interval [CI]: 0.84-0.90, p < 0.01), 0.86 (95% CI: 0.82-0.91, p < 0.01),
and 0.85 (95% CI: 0.79-0.90, p < 0.01), respectively. Conclusion(s):
This scoring system could augment flexibility and convenience for
pre-screening CHD patients' eligibility for surgery, before
RHC. Copyright © 2022 The Authors

<30>
Accession Number
2020319841
Title
Complete transcatheter versus surgical approach to aortic stenosis with
coronary artery disease: A systematic review and meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2022.
Date of Publication: 2022.
Author
Sakurai Y.; Yokoyama Y.; Fukuhara S.; Takagi H.; Kuno T.
Institution
(Sakurai) Department of Surgery, Marshall University Joan Edwards School
of Medicine, WVa
(Yokoyama) Department of Surgery, St Luke's University Health Network, Pa
(Fukuhara) Department of Cardiothoracic Surgery, University of Michigan,
Ann Arbor, Mich, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kuno) Division of Cardiology, Montefiore Medical Center, Albert Einstein
College of Medicine, Bronx, NY, United States
Publisher
Elsevier Inc.
Abstract
Objective: This meta-analysis aimed to evaluate outcomes of transcatheter
aortic valve replacement (TAVR) with percutaneous coronary intervention
(PCI) versus surgical aortic valve replacement (SAVR) with coronary artery
bypass grafting (CABG). Method(s): The MEDLINE, EMBASE, and Cochrane
Library databases were searched through November 2021 to identify studies
comparing TAVR + PCI and SAVR + CABG for severe aortic stenosis with
concurrent coronary artery disease. Outcomes of interest were all-cause
mortality, repeat coronary intervention, rehospitalization, myocardial
infarction, and stroke during follow-up, and 30-day periprocedural
outcomes. Result(s): Two randomized controlled trials and 6
observational studies including a total of 104,220 patients (TAVR + PCI, n
= 5004; SAVR + CABG, n = 99,216) were included. The weighted mean
follow-up period was 30.2 months. TAVR + PCI was associated with greater
all-cause mortality and coronary reintervention during follow-up period
(hazard ratio, 1.35; 95% confidence interval [CI], 1.11-1.65; P = .003,
hazard ratio, 4.14; 95% CI, 1.74-9.86; P = .001, respectively), 30-day
permanent pacemaker implantation rate (odds ratio [OR], 3.79; 95% CI,
1.61-8.95; P = .002), and periprocedural vascular complications (OR, 6.97;
95% CI, 1.85-26.30; P = .004). In contrast, TAVR + PCI was associated with
a lower rate of 30-day acute kidney injury (OR, 0.32; 95% CI, 0.20-0.50; P
= .0001). Rehospitalization, myocardial infarction, stroke during
follow-up, and other periprocedural outcomes including 30-day mortality
were similar in both groups. Conclusion(s): In patients with severe
aortic stenosis and coronary artery disease, TAVR + PCI was associated
with greater all-cause mortality at follow-up compared with SAVR + CABG.
Heart Team approach to assess TAVR candidacy remains
imperative. Copyright © 2022 The American Association for
Thoracic Surgery

<31>
Accession Number
639095014
Title
Performance of SHFM and MAGGIC risk scores to predict 1-year mortality in
patients on the waiting list for heart transplantation.
Source
Acta Cardiologica. Conference: 41st Annual Congress of the Belgian Society
of Cardiology. Brussels Belgium. 77(Supplement 1) (pp 20-21), 2022. Date
of Publication: 2022.
Author
Lejeune S.; Van Caenegem A.; Timmermans T.; Gurne O.; Mastrobuoni S.;
Poncelet A.; Van Caenegem O.; Pouleur A.-C.
Institution
(Lejeune, Van Caenegem, Timmermans, Gurne, Mastrobuoni, Poncelet, Van
Caenegem, Pouleur) Cliniques Universitaires Saint Luc, Bruxelles, Belgium
Publisher
Taylor and Francis Ltd.
Abstract
Background/Introduction: Currently, the decision to transplant patients
with end-stage heart failure (HF) is based on expert consensus and the
measure of exercise capacity. In the context of heart graft shortage, the
selection of patients for transplantation is critical. Risk scores have
been established to predict the prognosis of HF patients and may be useful
to prioritize patients on the transplant list. Purpose(s): To
evaluate the performance of the Seattle Heart Failure Model (SHFM) and the
Meta-analysis Global Group in Chronic Heart Failure (MAGGIC) score to
predict 1-year mortality in HF patients on the transplant list.
 Method(s): Patients enrolled on the transplant list in our centre
from 2007 to 2017 were included. Exclusion criteria were: high urgency
transplant, left ventricular assistance device, and previous heart
transplant. The endpoint was 1-year mortality. The performance of the
scores was assessed using the area under receiver operator curves (ROC
AUC). Result(s): In the final population of 121 patients (51 +/- 12
years, 78% men, LVEF 22 +/- 11% ), 10 (8%) patients died during the first
year after their inscription on the list, before reaching transplant. The
SHFM score had adequate discrimination regarding 1-year mortality (ROC AUC
=0.87, p<0.001). The MAGGIC score, however, performed poorly in this
specific population of advanced HF patients (ROC AUC 0.64, p=0.14) (Figure
1). Figure 2 shows the SHFM predicted 1-year survival plotted against the
Kaplan Meier curve of observed survival. Conclusion(s): The SHFM score
performs well to predict 1-year mortality in patients on the waiting list
for heart transplantation and may be valuable for patient selection.
Although easier to compute and validated in large cohorts of HF patients,
the MAGGIC score does not seem appropriate to predict 1-year mortality in
advanced HF patients waiting for heart transplantation. (Figure
Presented).

<32>
Accession Number
2019182223
Title
A Meta-Analysis of Early, Mid-term and Long-Term Mortality of On-Pump vs.
Off-Pump in Redo Coronary Artery Bypass Surgery.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 869987. Date of Publication: 25 Apr 2022.
Author
Zhang S.; Huang S.; Tiemuerniyazi X.; Song Y.; Feng W.
Institution
(Zhang, Huang, Tiemuerniyazi, Song, Feng) Department of Cardiac Surgery,
Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union
Medical College, Beijing, China
Publisher
Frontiers Media S.A.
Abstract
We aimed to compare the early, mid-term, and long-term mortality between
on-pump vs. off-pump redo coronary artery bypass grafting (CABG). We
conducted a systematic search for studies comparing clinical outcomes of
patients who underwent on-pump vs. off-pump redo CABG. We pooled the
relevant studies quantitatively to compare the early (perioperative
period, whether in hospital or within 30 days after discharge), mid-term
(>=1 year and <5 years), and long-term (>=5 year) mortality of on-pump vs.
off-pump redo CABG. A random-effect model was applied when there was high
heterogeneity (I2 > 50%) between studies. Otherwise, a
fixed-effect model was utilized. After systematic literature searching, 22
studies incorporating 5,197 individuals (3,215 in the on-pump group and
1,982 in the off-pump group) were identified. A pooled analysis
demonstrated that compared with off-pump redo CABG, on-pump redo CABG was
associated with higher early mortality (OR 2.11, 95%CI: 1.54-2.89, P <
0.00001). However, no significant difference was noted in mid-term
mortality (OR 1.12, 95%CI: 0.57-2.22, P = 0.74) and long-term mortality
(OR 1.12, 95%CI: 0.41-3.02, P = 0.83) between the two groups. In addition,
the complete revascularization rate was higher in the on-pump group than
the off-pump group (OR 2.61, 95%CI: 1.22-5.60, P = 0.01). In conclusion,
the off-pump technique is a safe and efficient alternative to the on-pump
technique, with early survival advantage and similar long-term mortality
to the on-pump technique in the setting of redo CABG, especially in
high-risk patients. Systematic Review Registration:
https://www.crd.york.ac.uk/PROSPERO/, identifier:
CRD42021244721. Copyright © 2022 Zhang, Huang, Tiemuerniyazi,
Song and Feng.

<33>
Accession Number
2020229413
Title
Pulmonary artery pathologies in Alagille syndrome: a meta-analysis.
Source
Postepy w Kardiologii Interwencyjnej. 18(2) (pp 111-117), 2022. Date of
Publication: 2022.
Author
Yuan S.-M.
Institution
(Yuan) Department of Cardiothoracic Surgery, The First Hospital of Putian,
Teaching Hospital, Fujian Medical University, Putian, China
Publisher
Termedia Publishing House Ltd.
Abstract
Alagille syndrome, caused by mutations in the gene encoding Jagged1
(JAG1), a ligand in the Notch signaling pathway, is an autosomal dominant
disorder with developmental abnormalities affecting the liver, heart,
eyes, face and skeleton. The aim of the present study is try to disclose
the clinical features, management and outcomes of pulmonary artery
stenosis associated with Alagille syndrome. By comprehensive literature
retrieval, 38 articles involving 401 patients were recruited for this
study. The pertinent variables closely related to pulmonary artery
stenosis in patients with Alagille syndrome were comprehensively analyzed
by following the PRISMA guidelines. The management of pulmonary artery
pathologies, especially a severe type of pulmonary artery stenosis in
Alagille syndrome, is a concerned matter. Publications of literature
retrieval of recent 3 decades were the study material of this article. The
pulmonary artery pathologies, especially the severe type of pulmonary
artery stenosis in Alagille syndrome, warrant surgical or interventional
treatments. After the procedures, the right ventricular to left
ventricular pressure ratio was reduced by 25%. There were no intergroup
differences in terms of recovery, reintervention and mortality rates
between interventionally and surgically treated patients. Transcatheter
treatment is preferable due to less trauma. Surgical treatment of
pulmonary artery stenosis can be performed currently with intracardiac
defect repair. Copyright © 2022 Termedia Publishing House Ltd..
All rights reserved.

<34>
Accession Number
2019217616
Title
Comparison of Transcatheter Aortic Valve Implantation Devices in Aortic
Stenosis: A Network Meta-Analysis of 42,105 Patients.
Source
Journal of Clinical Medicine. 11(18) (no pagination), 2022. Article
Number: 5299. Date of Publication: September 2022.
Author
Dogosh A.A.; Adawi A.; El Nasasra A.; Cafri C.; Barrett O.; Tsaban G.;
Barashi R.; Koifman E.
Institution
(Dogosh, Adawi, El Nasasra, Cafri, Barrett, Tsaban) Soroka Medical Center,
Heart Institute, Ben-Gurion University of the Negev, Beer Sheva 84101,
Israel
(Barashi, Koifman) Meir Medical Center, Tel Aviv University, Tel Aviv
6423906, Israel
Publisher
MDPI
Abstract
Background: In recent years, trans-catheter aortic valve implantation
(TAVI) has emerged as an excellent alternative to surgical aortic valve
replacement (SAVR). Currently, there are several approved devices on the
market, yet comparisons among them are scarce. We aimed to compare the
various devices via a network meta-analysis. Method(s): We performed
a network meta-analysis including randomized controlled trials (RCTs) and
propensity-matched studies that provide comparisons of either a single
TAVI with SAVR or two different TAVI devices and report clinical outcomes.
 Result(s): We included 12 RCT and 13 propensity-matched studies
comprising 42,105 patients, among whom 27,134 underwent TAVI using various
valve systems (Sapien & Sapien XT, Sapien 3, Corvalve, Evolut & Evolut
Pro, Acurate Neo, Portico). The mean follow-up time was 23.4 months.
Sapien 3 was superior over SAVR in the reduction of all-cause mortality
(OR = 0.53; 95%CrI 0.31-0.91), while no significant difference existed
between other devices and SAVR. Aortic regurgitation was more frequent
among TAVI devices compared to SAVR. There was no significant difference
between the various THVs and SAVR in cardiovascular mortality, myocardial
infarction, NYHA class III-IV, and endocarditis. Conclusion(s): Newer
generation TAVI devices, especially Sapien 3 and Evolut R/Pro are
associated with improved outcomes compared to SAVR and other devices of
the older generation. Copyright © 2022 by the authors.

<35>
Accession Number
2019217560
Title
The Analgesic Efficacy of the Single Erector Spinae Plane Block with
Intercostal Nerve Block Is Not Inferior to That of the Thoracic
Paravertebral Block with Intercostal Nerve Block in Video-Assisted
Thoracic Surgery.
Source
Journal of Clinical Medicine. 11(18) (no pagination), 2022. Article
Number: 5452. Date of Publication: September 2022.
Author
Kim S.; Song S.W.; Do H.; Hong J.; Byun C.S.; Park J.-H.
Institution
(Kim, Song, Do, Hong, Park) Department of Anesthesiology and Pain
Medicine, Wonju College of Medicine, Yonsei University, Wonju 26426, South
Korea
(Byun) Department of Thoracic and Cardiovascular Surgery, Wonju College of
Medicine, Yonsei University, Wonju 26426, South Korea
Publisher
MDPI
Abstract
This monocentric, single-blinded, randomized controlled noninferiority
trial investigated the analgesic efficacy of erector spinae plane block
(ESPB) combined with intercostal nerve block (ICNB) compared to that of
thoracic paravertebral block (PVB) with ICNB in 52 patients undergoing
video-assisted thoracic surgery (VATS). The endpoints included the
difference in visual analog scale (VAS) scores for pain (0-10, where 10 =
worst imaginable pain) in the postanesthetic care unit (PACU) and 24 and
48 h postoperatively between the ESPB and PVB groups. The secondary
endpoints included patient satisfaction (1-5, where 5 = extremely
satisfied) and total analgesic requirement in morphine milligram
equivalents (MME). Median VAS scores were not significantly different
between the groups (PACU: 2.0 (1.8, 5.3) vs. 2.0 (2.0, 4.0), p = 0.970; 24
h: 2.0 (0.8, 3.0) vs. 2.0 (1.0, 3.5), p = 0.993; 48 h: 1.0 (0.0, 3.5) vs.
1.0 (0.0, 5.0), p = 0.985). The upper limit of the 95% CI for the
differences (PACU: 1.428, 24 h: 1.052, 48 h: 1.176) was within the
predefined noninferiority margin of 2. Total doses of rescue analgesics
(110.24 +/- 103.64 vs. 118.40 +/- 93.52 MME, p = 0.767) and satisfaction
scores (3.5 (3.0, 4.0) vs. 4.0 (3.0, 5.0), p = 0.227) were similar. Thus,
the ESPB combined with ICNB may be an efficacious option after
VATS. Copyright © 2022 by the authors.

<36>
Accession Number
2019217456
Title
Can Quality Improvement Methodologies Derived from Manufacturing Industry
Improve Care in Cardiac Surgery? A Systematic Review.
Source
Journal of Clinical Medicine. 11(18) (no pagination), 2022. Article
Number: 5350. Date of Publication: September 2022.
Author
Hoefsmit P.C.; Schretlen S.; Burchell G.; van den Heuvel J.; Bonjer J.;
Dahele M.; Zandbergen R.
Institution
(Hoefsmit, Zandbergen) Department of Cardiothoracic Surgery, Amsterdam
University Medical Centre, Amsterdam 1081 HV, Netherlands
(Schretlen) Integrated Health Solutions, Medtronic Inc, Eindhoven 5616 VB,
Netherlands
(Burchell) Medical Library, Vrije Universiteit, Amsterdam 1081 HV,
Netherlands
(van den Heuvel) Department of Healthcare Management, University of
Amsterdam Business School, Amsterdam 1018 TV, Netherlands
(Bonjer, Zandbergen) Department of Surgery, Amsterdam University Medical
Centre, Amsterdam 1081 HV, Netherlands
(Dahele) Department of Radiation Oncology, Amsterdam University Medical
Centre, Amsterdam 1081 HV, Netherlands
Publisher
MDPI
Abstract
Objectives: Healthcare is required to be effectively organised to ensure
that growing, aging and medically more complex populations have timely
access to high-quality, affordable care. Cardiac surgery is no exception
to this, especially due to the competition for and demand on hospital
resources, such as operating rooms and intensive care capacity. This is
challenged more since the COVID-19 pandemic led to postponed care and
prolonged waiting lists. In other sectors, Quality Improvement
Methodologies (QIM) derived from the manufacturing industry have proven
effective in enabling more efficient utilisation of existing capacity and
resources and in improving the quality of care. We performed a systematic
review to evaluate the ability of such QIM to improve care in cardiac
surgery. Method(s): A literature search was performed in PubMed,
Embase, Clarivate Analytics/Web of Science Core Collection and Wiley/the
Cochrane Library according to the Preferred Reporting Items for Systematic
Reviews and Meta-Analysis methodology. Result(s): Ten articles were
identified. The following QIM were used: Lean, Toyota Production System,
Six Sigma, Lean Six Sigma, Root Cause Analysis, Kaizen and
Plan-Do-Study-Act. All reported one or more relevant improvements in
patient-related (e.g., infection rates, ventilation time, mortality,
adverse events, glycaemic control) and process-related outcomes (e.g.,
shorter waiting times, shorter transfer time and productivity). Elements
to enhance the success included: multidisciplinary team engagement, a
patient-oriented, data-driven approach, a sense of urgency and a focus on
sustainability. Conclusion(s): In all ten papers describing the
application of QIM initiatives to cardiac surgery, positive results, of
varying magnitude, were reported. While the consistency of the available
data is encouraging, the limited quantity and heterogenous quality of the
evidence base highlights that more rigorous evaluation, including how best
to employ manufacturing industry-derived QIM in cardiac surgery is
warranted. Copyright © 2022 by the authors.

<37>
Accession Number
2019205523
Title
Transcatheter Aortic Valve Implantation: A Report on Serbia's First
Systematic Program.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 882854. Date of Publication: 24 May 2022.
Author
Boljevic D.; Bojic M.; Farkic M.; Sagic D.; Topic D.; Kovacevic V.;
Lakcevic J.; Veljkovic S.; Dobric M.; Hinic S.; Ilijevski N.; Nikolic M.;
Kaludjerovic A.; Bunc M.; Nikolic A.
Institution
(Boljevic, Bojic, Farkic, Sagic, Topic, Kovacevic, Lakcevic, Veljkovic,
Dobric, Hinic, Ilijevski, Nikolic, Kaludjerovic, Nikolic) Dedinje
Cardiovascular Institute, Belgrade, Serbia
(Bojic) School of Medicine, University of Banja Luka, Banja Luka, Bosnia
and Herzegovina
(Sagic, Dobric, Ilijevski, Nikolic) School of Medicine, University of
Belgrade, Belgrade, Serbia
(Bunc) University Clinical Center Ljubljana, University of Ljubljana,
Ljubljana, Slovenia
Publisher
Frontiers Media S.A.
Abstract
Introduction: Severe aortic stenosis, a highly-common valve disease in the
elderly, has a poor prognosis if left untreated. To address the concern of
effective procedures for severe aortic stenosis, a systematic TAVI program
was established at the Dedinje Cardiovascular Institute (Belgrade,
Serbia). Method(s): Our cohort was composed of 56 patients (74+/-15
years old). The mean logistic EuroScore was 10.17%; the mean Society of
Thoracic Surgeons score was 3.22%. One third of the patients were
categorized as class III or IV of the New York Heart Association (NYHA).
The valves selected for use were either self-expandable or balloon
expandable (Evolut R, Medtronic; Acurate Neo, Boston Scientific and Myval,
Meril). The choice of valve type was made by the Institute's Structural
Heart Team, in accordance with the patient's native aortic valve, size and
calcification of ilio-femoral vessels, as well as the need for alternative
access. TAVI procedure was conducted according to current guidelines
provided by the European Society of Cardiology. Result(s): The
procedure success rate was 100%. Trans-femoral approach was achieved in
100% of patients; percutaneously in 87.5%, while a surgical cut was
necessary in 12.5%. No patient showed moderate or severe aortic
regurgitation after the procedure, although trace or mild regurgitation
was recorded in 30.3%. Permanent pacemaker was implanted in one patient
(1.78%), contrast induced acute kidney injury occured in one patient
(1.78%), no stroke was recorded, and three pseudo-aneurysms which required
surgical intervention occurred. Three patients required blood transfusions
(5.33%). A 30-day all-cause mortality rate was 1.78%. Conclusion(s):
The Dedinje Cardiovascular Institute spearheaded all efforts to establish
a TAVI program in Serbia. Our initial TAVI results are promising,
encouraging, and comparable with the results of previous large randomized
trials. This initial experience opens the door for further development
with a goal of our Institute to become a high-volume TAVI
center. Copyright © 2022 Boljevic, Bojic, Farkic, Sagic, Topic,
Kovacevic, Lakcevic, Veljkovic, Dobric, Hinic, Ilijevski, Nikolic,
Kaludjerovic, Bunc and Nikolic.

<38>
Accession Number
2019205445
Title
Pooled-Analysis of Association of Sievers Bicuspid Aortic Valve Morphology
With New Permanent Pacemaker and Conduction Abnormalities After
Transcatheter Aortic Valve Replacement.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 884911. Date of Publication: 26 May 2022.
Author
Zhang J.; Li X.; Xu F.; Chen Y.; Li C.
Institution
(Zhang, Xu, Chen, Li) Department of Emergency Medicine and Chest Pain
Center, Cheeloo College of Medicine, Qilu Hospital of Shandong University,
Jinan, China
(Zhang, Xu, Chen, Li) Key Laboratory of Emergency and Critical Care
Medicine of Shandong Province, Qilu Hospital of Shandong University,
Jinan, China
(Zhang, Xu, Chen, Li) Key Laboratory of Cardiovascular Remodeling and
Function Research, Qilu Hospital of Shandong University, Jinan, China
(Li) Department of Geriatrics, Qilu Hospital of Shandong University,
Jinan, China
Publisher
Frontiers Media S.A.
Abstract
Background: Studies on the association of Sievers bicuspid aortic valve
(BAV) morphology with conduction disorders after transcatheter aortic
valve replacement (TAVR) have not reached consensus. Method(s): We
here performed a pooled-analysis to explore whether Sievers type 1 BAV
morphology increased the risk of post-TAVR conduction abnormalities and
permanent pacemaker implantation (PPI) compared to type 0. Systematic
literature searches through EMBASE, Medline, and Cochrane databases were
concluded on 1 December 2021. The primary endpoint was post-TAVR new PPI
and pooled as risk ratios (RRs) and 95% confidence intervals (CIs).
Conduction abnormalities as the secondary endpoint were the composites of
post-TAVR PPI and/or new-onset high-degree of atrial-ventricle node block
and left-bundle branch block. Studies that reported incidence of outcomes
of interest in both type 1 and type 0 BAV morphology who underwent TAVR
for aortic stenosis were included. Result(s): Finally, nine studies
were included. Baseline characteristics were generally comparable, but
type 1 population was older with a higher surgical risk score compared to
type 0 BAV morphology. In the pooled-analysis type 1 BAV had significantly
higher risk of post-TAVR new-onset conduction abnormalities (RR = 1.68,
95%CI 1.09-2.60, p = 0.0195) and new PPI (RR = 1.97, 95%CI 1.29-2.99, p =
0.0016) compared to type 0. Random-effects univariate meta-regression
indicated that no significant association between baseline characteristics
and PPI. Conclusion(s): Sievers type 1 BAV morphology was associated
with increased risk of post-TAVR PPI and conduction abnormalities compared
to type 0. Dedicated cohort is warranted to further validate our
hypothesis. Copyright © 2022 Zhang, Li, Xu, Chen and Li.

<39>
Accession Number
2019182215
Title
Comparison of Four Machine Learning Techniques for Prediction of Intensive
Care Unit Length of Stay in Heart Transplantation Patients.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 863642. Date of Publication: 21 Jun 2022.
Author
Wang K.; Yan L.Z.; Li W.Z.; Jiang C.; Wang N.N.; Zheng Q.; Dong N.G.; Shi
J.W.
Institution
(Wang, Li, Zheng, Dong, Shi) Department of Cardiovascular Surgery, Union
Hospital, Tongji Medical College, Huazhong University of Science and
Technology, Wuhan, China
(Yan) Institute of Soil and Environmental Sciences, University of
Agriculture, Faisalabad, Pakistan
(Jiang) Department of Gastroenterology, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology, Wuhan, China
(Wang) Department of Nurse, Jianshi County People's Hospital, Enshi, China
Publisher
Frontiers Media S.A.
Abstract
Background: Post-operative heart transplantation patients often require
admission to an intensive care unit (ICU). Early prediction of the ICU
length of stay (ICU-LOS) of these patients is of great significance and
can guide treatment while reducing the mortality rate among patients.
However, conventional linear models have tended to perform worse than
non-linear models. Material(s) and Method(s): We collected the
clinical data of 365 patients from Wuhan Union Hospital who underwent
heart transplantation surgery between April 2017 and August 2020. The
patients were randomly divided into training data (N = 256) and test data
(N = 109) groups. 84 clinical features were collected for each patient.
Features were validated using the Least Absolute Shrinkage and Selection
Operator (LASSO) regression's fivefold cross-validation method. We
obtained Shapley Additive explanations (SHAP) values by executing package
"shap" to interpret model predictions. Four machine learning models and
logistic regression algorithms were developed. The area under the receiver
operating characteristic curve (AUC-ROC) was used to compare the
prediction performance of different models. Finally, for the convenience
of clinicians, an online web-server was established and can be freely
accessed via the website https://wuhanunion.shinyapps.io/PredictICUStay/.
 Result(s): In this study, 365 consecutive patients undergoing heart
transplantation surgery for moderate (NYHA grade 3) or severe (NYHA grade
4) heart failure were collected in Wuhan Union Hospital from 2017 to 2020.
The median age of the recipient patients was 47.2 years, while the median
age of the donors was 35.58 years. 330 (90.4%) of the donor patients were
men, and the average surgery duration was 260.06 min. Among this cohort,
47 (12.9%) had renal complications, 25 (6.8%) had hepatic complications,
11 (3%) had undergone chest re-exploration and 19 (5.2%) had undergone
extracorporeal membrane oxygenation (ECMO). The following six important
clinical features were selected using LASSO regression, and according to
the result of SHAP, the rank of importance was (1) the use of
extracorporeal membrane oxygenation (ECMO); (2) donor age; (3) the use of
an intra-aortic balloon pump (IABP); (4) length of surgery; (5) high
creatinine (Cr); and (6) the use of continuous renal replacement therapy
(CRRT). The eXtreme Gradient Boosting (XGBoost) algorithm presented
significantly better predictive performance (AUC-ROC = 0.88) than other
models [Accuracy: 0.87; sensitivity: 0.98; specificity: 0.51; positive
predictive value (PPV): 0.86; negative predictive value (NPV): 0.93].
 Conclusion(s): Using the XGBoost classifier with heart
transplantation patients can provide an accurate prediction of ICU-LOS,
which will not only improve the accuracy of clinical decision-making but
also contribute to the allocation and management of medical resources; it
is also a real-world example of precision medicine in
hospitals. Copyright © 2022 Wang, Yan, Li, Jiang, Wang, Zheng,
Dong and Shi.

<40>
Accession Number
2019182053
Title
Health and Well-Being in Surviving Congenital Heart Disease Patients: An
Umbrella Review With Synthesis of Best Evidence.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 870474. Date of Publication: 10 Jun 2022.
Author
Cocomello L.; Taylor K.; Caputo M.; Cornish R.P.; Lawlor D.A.
Institution
(Cocomello, Taylor, Cornish, Lawlor) MRC Integrative Epidemiology Unit,
Population Health Sciences, Bristol Medical School, University of Bristol,
Oakfield House, Bristol, United Kingdom
(Caputo) Bristol Heart Institute, Bristol, United Kingdom
Publisher
Frontiers Media S.A.
Abstract
Background: Advances in the management of congenital heart disease (CHD)
patients have enabled improvement in long-term survival even for those
with serious defects. Research priorities (for patients, families and
clinicians) have shifted from a focus on how to improve survival to
exploring long-term outcomes in patients with CHD. A comprehensive
appraisal of available evidence could inform best practice to maximize
health and well-being, and identify research gaps to direct further
research toward patient and clinical need. We aimed to critically appraise
all available published systematic reviews of health and well-being
outcomes in adult patients with CHD. Method(s): We conducted an
umbrella review, including any systematic reviews that assessed the
association of having vs. not having CHD with any long-term health
(physical or mental), social (e.g., education, occupation) or well-being
[e.g., quality of life (QoL)] outcome in adulthood (>=18-years).
 Result(s): Out of 1330 articles screened, we identified five
systematic reviews of associations of CHD with adult outcomes. All but one
(which studied QoL) explored health outcomes: one cardiovascular, two
mental, and one mortality after transplant. CHD patients had a higher risk
of stroke, coronary heart disease and heart failure, with the pooled
relative risk (RR) for any outcome of 3.12 (95% CI: 3.01 to 3.24), with
substantial heterogeneity (I2 = 99%) explained by the outcome
being studied (stronger association for heart failure) and geography
(stronger in Europe compared with other regions). CHD patients had a
higher risk of anxiety (OR = 2.58 (1.45 to 4.59)], and higher mean scores
for depression/anxiety symptoms (difference in means = -0.11 SD (-0.28 to
0.06), I2 = 94%)]. Compared with patients having a cardiac
transplant for other (non-CHD) diseases, CHD patients had higher
short-term mortality (RR at 30-days post-transplant = 2.18 [1.62 to
2.93)], with moderate heterogeneity (I2 = 41%) explained by
previous surgery (higher mortality with prior Fontan/Glenn operation). All
domains of QoL were lower in patients with Fontan's circulation than
non-CHD adults. Conclusion(s): Adults with CHD have poorer
cardiovascular, mental health and QoL outcomes, and higher short-term
mortality after transplant. The paucity of systematic reviews, in
particular for outcomes such as education, occupation and lifestyles,
highlights the need for this to be made a priority by funders and
researchers. Systematic Review Registration:
[www.crd.york.ac.uk/prospero], identifier [CRD42020175034]. Copyright
© 2022 Cocomello, Taylor, Caputo, Cornish and Lawlor.

<41>
Accession Number
639097495
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. Date of
Publication: 23 Sep 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
NLM (Medline)
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 1hour postoperatively and a shorter duration of stay in the PACU of
117min. 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 © American Society of Regional Anesthesia
& Pain Medicine 2022. No commercial re-use. See rights and permissions.
Published by BMJ.

<42>
Accession Number
639097456
Title
Neutrophil Gelatinase-Associated Lipocalin (NGAL) in kidney injury- A
systematic review.
Source
Clinica chimica acta; international journal of clinical chemistry. (no
pagination), 2022. Date of Publication: 20 Sep 2022.
Author
Marakala V.
Institution
(Marakala) Department of Basic Medical Sciences, College of Medicine,
University of Bisha, Kingdom of Saudi Arabia., Saudi Arabia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Neutrophil Gelatinase Associated Lipocalin (NGAL) is a
secretory protein of neutrophils that can be found both in plasma and
urine. Previous works have demonstrated a valuable marker for the early
detection of acute kidney injury. In this systematic review, we aimed to
assess whether NGAL could be helpful in the diagnosis and prognosis of
systemic diseases with kidney involvement. METHOD(S): MEDLINE,
PubMed, and EMBASE databases were searched for NGAL, described as a human
biomarker for diseases (total: 1690). Specifically, included studies
describing the use of NGAL for determining kidney injury outcomes and
other conditions associated with kidney dysfunction, including
cardiovascular diseases, cardiac surgery, and critically ill systemic
disorders. RESULT(S): A total of 24 validated studies were included
in the systemic review after applying the exclusion criteria. In all these
studies, NGAL appeared to have a predictive value irrespective of age,
from newborn to 78 years. The results indicate that NGAL levels can
accurately predict the outcome and severity of acute kidney injury occur
in several disease processes, including contrast-induced AKI during
cardiac surgery, kidney transplant rejection, chronic heart failure, and
systemic inflammation in critically ill patients, even though the
significance of NGAL is highly variable across studies. Very high plasma
NGAL levels were observed in the patients before the acute rejection of
the kidney, indicating the prognostic potential of the NGAL. Specifically,
the assays conducted before 72 hrs provided a significant predictive
value. CONCLUSION(S): Urinary and serum NGAL appears to be an
independent predictor of not only kidney complications but also
cardiovascular and liver-related diseases. The kidney is also involved in
pathogenesis. Copyright © 2022. Published by Elsevier B.V.

<43>
Accession Number
2020148905
Title
Rotational Atherectomy or Balloon-Based Techniques to Prepare Severely
Calcified Coronary Lesions.
Source
JACC: Cardiovascular Interventions. 15(18) (pp 1864-1874), 2022. Date of
Publication: 26 Sep 2022.
Author
Rheude T.; Fitzgerald S.; Allali A.; Mashayekhi K.; Gori T.; Cuculi F.;
Kufner S.; Hemetsberger R.; Sulimov D.S.; Rai H.; Ayoub M.; Bossard M.;
Xhepa E.; Fusaro M.; Toelg R.; Joner M.; Byrne R.A.; Richardt G.; Kastrati
A.; Cassese S.; Abdel-Wahab M.
Institution
(Rheude, Kufner, Xhepa, Fusaro, Joner, Kastrati, Cassese) Klinik fur Herz-
und Kreislauferkrankungen, Deutsches Herzzentrum Munchen, Munich, Germany
(Fitzgerald, Sulimov, Abdel-Wahab) Department of Cardiology, Heart Center
Leipzig at University of Leipzig, Leipzig, Germany
(Fitzgerald, Rai, Byrne) School of Pharmacy and Biomolecular Sciences,
RCSI University of Medicine and Health Sciences, Dublin, Ireland
(Allali, Toelg, Richardt) Heart Center, Segeberger Kliniken, Bad Segeberg,
Germany
(Mashayekhi, Ayoub) Division of Cardiology and Angiology II, University
Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany
(Gori) Medizinische Klinik und Poliklinik, Universitatsmedizin Mainz,
Mainz, Germany
(Cuculi, Bossard) Department of Cardiology, Kantonspital Luzern,
Switzerland
(Hemetsberger) Klinik fur Kardiologie und Angiologie,
Berufsgenossenschaftliches Universitatsklinikum Bergmannsheil Bochum,
Bochum, Germany
(Rai, Byrne) Cardiovascular Research Institute Dublin, Mater Private
Network, Dublin, Ireland
(Fusaro) Klinik fur Kardiologie und Angiologie, Zollernalb-Klinikum,
Albstadt, Germany
(Joner, Kastrati) DZHK (German Centre for Cardiovascular Research),
Partner site Munich Heart Alliance, Munich, Germany
Publisher
Elsevier Inc.
Abstract
Background: The comparative efficacy of percutaneous techniques for the
preparation of calcified lesions before stenting remains poorly studied.
 Objective(s): This study sought to compare the performance of
up-front rotational atherectomy (RA) or balloon-based techniques before
drug-eluting stent implantation in severely calcified coronary lesions as
assessed by angiography and optical coherence tomography (OCT).
 Method(s): Patient-level data from the PREPARE-CALC (Comparison of
Strategies to Prepare Severely Calcified Coronary Lesions) and ISAR-CALC
(Comparison of Strategies to Prepare Severely Calcified Coronary Lesions)
randomized trials were pooled. The primary endpoint was stent expansion as
assessed by OCT imaging. The secondary endpoints included stent
eccentricity, stent asymmetry, angiographic acute lumen gain, strategy
success and in-hospital occurrence of cardiac death, target vessel
myocardial infarction, and repeat revascularization. Result(s): Among
274 patients originally randomized, 200 participants with available OCT
data after lesion preparation with RA (n = 63), a modified balloon (MB, n
= 103), or a super high-pressure balloon (n = 34) before stenting were
analyzed. The use of RA versus MB or a super high-pressure balloon led to
comparable stent expansion (73.2% +/- 11.6% vs 70.8% +/- 13.6% vs 71.8%
+/- 12.2%, P = 0.49) and stent asymmetry (P = 0.83). Compared with RA or
MB, a super high-pressure balloon was associated with less stent
eccentricity (P = 0.03) with a numerically higher acute lumen gain, albeit
not significantly different (P = 0.08). Strategy success was more frequent
with RA versus MB (P = 0.002) and numerically more frequent with RA versus
a super high-pressure balloon (P = 0.06). Clinical outcomes did not differ
between groups. Conclusion(s): In patients with severely calcified
lesions undergoing drug-eluting stent implantation, lesion preparation
with RA, MB, or a super high-pressure balloon was associated with
comparable stent expansion. A super high-pressure balloon is associated
with less stent eccentricity, whereas strategy success is more frequent
with RA. Copyright © 2022 American College of Cardiology
Foundation

<44>
Accession Number
2020148769
Title
Apixaban and Valve Thrombosis After Transcatheter Aortic Valve
Replacement: The ATLANTIS-4D-CT Randomized Clinical Trial Substudy.
Source
JACC: Cardiovascular Interventions. 15(18) (pp 1794-1804), 2022. Date of
Publication: 26 Sep 2022.
Author
Montalescot G.; Redheuil A.; Vincent F.; Desch S.; De Benedictis M.;
Eltchaninoff H.; Trenk D.; Serfaty J.-M.; Charpentier E.; Bouazizi K.;
Prigent M.; Guedeney P.; Salloum T.; Berti S.; Cequier A.; Lefevre T.;
Leprince P.; Silvain J.; Van Belle E.; Neumann F.-J.; Portal J.-J.; Vicaut
E.; Collet J.-P.
Institution
(Montalescot, Guedeney, Salloum, Silvain, Collet) Sorbonne Universite,
ACTION Group, INSERM UMRS 1166, Hopital Pitie-Salpetriere (AP-HP),
Institut de Cardiologie, Paris, France
(Redheuil, Charpentier, Bouazizi, Prigent) Sorbonne Universite,
Laboratoire Imagerie Biomedicale, ICAN, ACTION Group, Hopital
Pitie-Salpetriere (AP-HP), Institut de Cardiologie, Paris, France
(Vincent, Van Belle) CHU Lille, Institut Coeur Poumon, Pole
Cardiovasculaire et Pulmonaire, ACTION Group, Inserm U1011, Institut
Pasteur de Lille, EGID, Universite de Lille, Lille, France
(Desch) Department of Internal Medicine/Cardiology, Heart Center Leipzig
at University of Leipzig, Leipzig, Germany
(De Benedictis) Azienda Ospedaliera Ordine Mauriziano di Torino, Torino,
Italy
(Eltchaninoff) Normandie Universite, UNIROUEN, U1096, CHU Rouen,
Departement de Cardiologie, FHU CARNAVAL, Rouen, France
(Trenk, Neumann) Division of Cardiology and Angiology II, University Heart
Centre Freiburg, Bad Krozingen, Germany
(Serfaty) Hopital Guillaume et Rene Laennec, Institut du Thorax-Clinique
Cardiologique, Unite d'Imagerie Cardiaque et Vasculaire Diagnostique,
Nantes, France
(Berti) Fondazione Toscana G. Monasterio, Ospedale del Cuore G.
Pasquinucci, Massa, Italy
(Cequier) Hospital Universitario de Bellvitge, University of Barcelona,
Heart Disease Institute, L'Hospitalet de Llobregat, Barcelona, Spain
(Lefevre) Hopital Prive Jacques Cartier, Institut Cardiovasculaire Paris
Sud, Massy, France
(Leprince) Sorbonne Universite, Hopital Pitie-Salpetriere (AP-HP),
Institut de Cardiologie, Chirurgie Cardiaque, Paris, France
(Portal, Vicaut) Unite de Recherche Clinique Lariboisiere St-Louis, ACTION
Group, Hopital St-Louis & Fernand Widal, Paris, France
Publisher
Elsevier Inc.
Abstract
Background: Subclinical obstructive valve thrombosis after transcatheter
aortic valve replacement (TAVR) is of uncertain frequency and clinical
impact. Objective(s): The aim of this study was to determine the
effects of apixaban vs standard of care on post-TAVR valve thrombosis
detected by 4-dimensional (4D) computed tomography. Method(s): The
randomized ATLANTIS (Anti-Thrombotic Strategy to Lower All Cardiovascular
and Neurologic Ischemic and Hemorrhagic Events After Trans-Aortic Valve
Implantation for Aortic Stenosis) trial demonstrated that apixaban 5 mg
twice daily was not superior to standard of care (vitamin K antagonists or
antiplatelet therapy) after successful TAVR and was associated with
similar safety but with more noncardiovascular deaths. Three months after
randomization, 4D computed tomography was proposed to all patients to
determine the percentage of patients with >=1 prosthetic valve leaflet
with grade 3 or 4 reduced leaflet motion or grade 3 or 4 hypoattenuated
leaflet thickening (the primary endpoint) in the intention-to-treat
population. Result(s): Seven hundred sixty-two participants had
complete multiphase datasets and were included in the 4D computed
tomographic analysis. The primary endpoint occurred in 33 (8.9%) and 51
(13.0%) patients in the apixaban and standard-of-care groups,
respectively. It was reduced with apixaban vs antiplatelet therapy (OR:
0.51; 95% CI: 0.30-0.86) but not vs vitamin K antagonists (OR: 1.80; 95%
CI: 0.62-5.25) (P<inf>interaction</inf> = 0.037). The composite of death,
myocardial infarction, any stroke, or systemic embolism at 1 year occurred
in 10.7% (n = 9 of 84) and 7.1% (n = 48 of 178) of patients with and
without subclinical valve thrombosis at 90 days, respectively (HR: 1.68;
95% CI: 0.82-3.44). Conclusion(s): Apixaban reduced subclinical
obstructive valve thrombosis in the majority of patients who underwent
TAVR without having an established indication for anticoagulation. This
study was not powered for clinical outcomes. (Anti-Thrombotic Strategy
After Trans-Aortic Valve Implantation for Aortic Stenosis [ATLANTIS];
NCT02664649) Copyright © 2022 American College of Cardiology
Foundation

<45>
Accession Number
2020113616
Title
Abbreviated Antiplatelet Therapy After Coronary Stenting in Patients With
Myocardial Infarction at High Bleeding Risk.
Source
Journal of the American College of Cardiology. 80(13) (pp 1220-1237),
2022. Date of Publication: 27 Sep 2022.
Author
Smits P.C.; Frigoli E.; Vranckx P.; Ozaki Y.; Morice M.-C.; Chevalier B.;
Onuma Y.; Windecker S.; Tonino P.A.L.; Roffi M.; Lesiak M.; Mahfoud F.;
Bartunek J.; Hildick-Smith D.; Colombo A.; Stankovic G.; Iniguez A.;
Schultz C.; Kornowski R.; Ong P.J.L.; Alasnag M.; Rodriguez A.E.; Paradies
V.; Kala P.; Kedev S.; Al Mafragi A.; Dewilde W.; Heg D.; Valgimigli M.
Institution
(Smits, Paradies) Department of Cardiology, Maasstad Hospital, Rotterdam,
Netherlands
(Frigoli, Heg) Clinical Trial Unit, University of Bern, Bern, Switzerland
(Vranckx) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Jessa Ziekenhuis, Hasselt, Belgium
(Vranckx) Faculty of Medicine and Life Sciences, Hasselt University,
Hasselt, Belgium
(Ozaki) Department of Cardiology, Fujita Health University School of
Medicine, Aichi, Toyoake, Japan
(Morice) Cardiovascular European Research Center (CERC), Massy, France
(Chevalier) Ramsay Generale de Sante, Interventional Cardiology
Department, Institut Cardiovasculaire Paris Sud, Massy, France
(Onuma) National University of Ireland, Galway, Ireland
(Windecker) Department of Cardiology, Bern University Hospital, Bern,
Switzerland
(Tonino) Department of Cardiology, Catharina Hospital, Eindhoven,
Netherlands
(Roffi) Division of Cardiology, Geneva University Hospitals, Geneva,
Switzerland
(Lesiak) 1st Department of Cardiology, University of Medical Sciences,
Poznan, Poland
(Mahfoud) Department of Cardiology, Angiology, Intensive Care Medicine,
Saarland University, Homburg, Germany
(Bartunek) Cardiovascular Center, OLV Hospital, Aalst, Belgium
(Hildick-Smith) Brighton and Sussex University Hospitals NHS Trust,
Brighton, United Kingdom
(Colombo) Department of Biomedical Sciences, Humanitas University, Pieve
Emanuele-Milan and Humanitas Clinical and Research Center IRCCS,
Rozzano-Milan, Italy
(Stankovic) Department of Cardiology, Clinical Center of Serbia, Faculty
of Medicine, University of Belgrade, Belgrade, Serbia
(Iniguez) Hospital Alvaro Cunqueiro, Vigo, Spain
(Schultz) Department of Cardiology, Royal Perth Hospital Campus,
University of Western Australia, Perth, WA, Australia
(Kornowski) Rabin Medical Center, Sackler School of Medicine, Tel Aviv
University, Tel Aviv, Israel
(Ong) Tan Tock Seng Hospital, Singapore
(Alasnag) Cardiac Center, King Fahad Armed Forces Hospital, Jeddah, Saudi
Arabia
(Rodriguez) Cardiac Unit Otamendi Hospital, Buenos Aires School of
Medicine Cardiovascular Research Center (CECI), Buenos Aires, Argentina
(Kala) University Hospital Brno, Brno, Czechia
(Kedev) University Clinic of Cardiology, Ss Cyril and Methodius
University, Skopje, North Macedonia
(Al Mafragi) Department of Cardiology, Zorgsaam Hospital, Terneuzen,
Netherlands
(Dewilde) Department of Cardiology, Imelda Hospital Bonheiden, Bonheiden,
Belgium
(Valgimigli) Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale,
Universita della Svizzera Italiana (USI), Lugano CH-6900, Switzerland
Publisher
Elsevier Inc.
Abstract
Background: The optimal duration of antiplatelet therapy (APT) after
coronary stenting in patients at high bleeding risk (HBR) presenting with
an acute coronary syndrome remains unclear. Objective(s): The
objective of this study was to investigate the safety and efficacy of an
abbreviated APT regimen after coronary stenting in an HBR population
presenting with acute or recent myocardial infarction. Method(s): In
the MASTER DAPT trial, 4,579 patients at HBR were randomized after 1 month
of dual APT (DAPT) to abbreviated (DAPT stopped and 11 months single APT
or 5 months in patients with oral anticoagulants) or nonabbreviated APT
(DAPT for minimum 3 months) strategies. Randomization was stratified by
acute or recent myocardial infarction at index procedure. Coprimary
outcomes at 335 days after randomization were net adverse clinical
outcomes events (NACE); major adverse cardiac and cerebral events (MACCE);
and type 2, 3, or 5 Bleeding Academic Research Consortium bleeding.
 Result(s): NACE and MACCE did not differ with abbreviated vs
nonabbreviated APT regimens in patients with an acute or recent myocardial
infarction (n = 1,780; HR: 0.83; 95% CI: 0.61-1.12 and HR: 0.86; 95% CI:
0.62-1.19, respectively) or without an acute or recent myocardial
infarction (n = 2,799; HR: 1.03; 95% CI: 0.77-1.38 and HR: 1.13; 95% CI:
0.80-1.59; P<inf>interaction</inf> = 0.31 and 0.25, respectively).
Bleeding Academic Research Consortium 2, 3, or 5 bleeding was
significantly reduced in patients with or without an acute or recent
myocardial infarction (HR: 0.65; 95% CI: 0.46-0.91 and HR: 0.71; 95% CI:
0.54-0.92; P<inf>interaction</inf> = 0.72) with abbreviated APT.
 Conclusion(s): A 1-month DAPT strategy in patients with HBR
presenting with an acute or recent myocardial infarction results in
similar NACE and MACCE rates and reduces bleedings compared with a
nonabbreviated DAPT strategy. (Management of High Bleeding Risk Patients
Post Bioresorbable Polymer Coated Stent Implantation With an Abbreviated
Versus Prolonged DAPT Regimen [MASTER DAPT]; NCT03023020) Copyright
© 2022 The Authors

<46>
Accession Number
2015324590
Title
Antiplatelet Therapy in Patients Undergoing Elective Percutaneous Coronary
Intervention.
Source
Current Cardiology Reports. 24(3) (pp 277-293), 2022. Date of Publication:
March 2022.
Author
Alkhalil M.; Dzavik V.; Bhatt D.L.; Mehran R.; Mehta S.R.
Institution
(Alkhalil, Dzavik) Division of Cardiology, Peter Munk Cardiac Centre,
Toronto General Hospital, Toronto, Canada
(Alkhalil) Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne,
United Kingdom
(Alkhalil) Translational and Clinical Research Institute, Newcastle
University, Newcastle-upon-Tyne, United Kingdom
(Bhatt) Brigham and Women's Hospital Heart and Vascular Center, Harvard
Medical School, Boston, MA, United States
(Mehran) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Mehta) Population Health Research Institute, McMaster University and
Hamilton Health Sciences, Hamilton, ON, Canada
Publisher
Springer
Abstract
Purpose of review: The evidence for use of dual antiplatelet therapy
(DAPT) for patients undergoing percutaneous coronary intervention (PCI) in
the elective setting is relatively sparse and is based on data from more
than two decades ago. We will review the evidence supporting the use of
DAPT with focus on stable patients undergoing elective PCI, including the
role of potent P<inf>2</inf>Y<inf>12</inf> inhibitors, modified DAPT
durations, and more recently, aspirin discontinuation. Recent findings:
Clopidogrel is the recommended P<inf>2</inf>Y<inf>12</inf> inhibitor in
the elective PCI setting. The benefit of more potent
P<inf>2</inf>Y<inf>12</inf> inhibitors such as ticagrelor or prasugrel in
stable patients is unproven, but their use might be reasonable in those
with high clinical or angiographic features of increased ischemic risk
without increased risk of bleeding. Moreover, extending DAPT beyond 12
months is associated with a reduction in ischemic events but also
increased bleeding. In contrast, shortening DAPT (3-6 months) reduces
bleeding compared with 1 year of treatment, but it is also probably
associated with increased ischemic events, mainly in higher-risk patients
undergoing complex PCI. Recently, early aspirin discontinuation at 3
months (and perhaps as early as 1 month) following PCI reduces bleeding,
with no evidence to suggest an increase in ischemic events. Summary:
Clopidogrel is the P<inf>2</inf>Y<inf>12</inf> inhibitor of choice, while
more data are required to support the use of more potent
P<inf>2</inf>Y<inf>12</inf> inhibitors in stable patients. The duration of
DAPT should be tailored to individual patient ischemic and bleeding risks.
New strategies, such as early aspirin discontinuation, are promising to
reduce bleeding risk without increase in ischemic risk. Copyright
© 2022, The Author(s), under exclusive licence to Springer
Science+Business Media, LLC, part of Springer Nature.

<47>
Accession Number
2020239493
Title
Intravenous ferric derisomaltose in iron-deficient patients undergoing
transcatheter aortic valve implantation due to severe aortic stenosis:
study protocol of the randomised controlled IIISAS trial.
Source
BMJ Open. 12(9) (no pagination), 2022. Article Number: e059546. Date of
Publication: 02 Sep 2022.
Author
Bardan S.; Kvaslerud A.B.; Andresen K.; Klove S.F.; Edvardsen T.;
Gullestad L.; Broch K.
Institution
(Bardan, Kvaslerud, Andresen, Edvardsen, Gullestad) Faculty of Medicine,
Institute for Clinical Medicine, University of Oslo, Oslo, Norway
(Kvaslerud, Andresen, Klove, Edvardsen, Gullestad, Broch) Department of
Cardiology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
(Kvaslerud, Gullestad) K.G. Jebsen Cardiac Research Center, Center for
Heart Failure Research, Faculty of Medicine, University of Oslo, Oslo,
Norway
Publisher
BMJ Publishing Group
Abstract
Introduction Iron deficiency is a prevalent comorbidity in patients with
severe aortic stenosis and may be associated with procedural and clinical
outcomes after transcatheter aortic valve implantation (TAVI). In the
Intravenous Iron Supplement for Iron Deficiency in Patients with Severe
Aortic Stenosis (IIISAS) trial, we aim to examine whether a single
administration of ferric derisomaltose can improve physical capacity after
TAVI. Methods and analysis This randomised, double-blind,
placebo-controlled trial aims to enrol 150 patients with iron deficiency
who are scheduled for TAVI due to severe aortic stenosis. The study drug
and matching placebo are administered approximately 3 months prior to
TAVI, and the patients are followed for 3 months after TAVI. Inclusion
criteria are iron deficiency, defined as serum ferritin<100 mug/L or
ferritin between 100 and 300 mug/L in combination with a transferrin
saturation<20% and written informed consent. Exclusion criteria include
haemoglobin<10 g/dL, red blood cell disorders, end-stage kidney failure,
intolerance to ferric derisomaltose, and ongoing infections. The primary
endpoint is the baseline-adjusted distance walked on a 6 min walk test
(6MWT) 3 months after TAVI. Secondary end points include quality of life,
New York Heart Association functional class (NYHA functional class), and
skeletal muscle strength. Ethics and dissemination Ethical approval was
obtained from the Regional Committee for Medical and Health Research of
South-Eastern Norway and The Norwegian Medicines Agency. Enrolment has
begun, and results are expected in 2022. The results of the IIISAS trial
will be disseminated by presentations at international and national
conferences and by publications in peer-reviewed journals. Trial
registration number NCT04206228 Copyright © Author(s) (or their
employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use.
See rights and permissions. Published by BMJ.

<48>
Accession Number
2018426224
Title
The current practice of transcatheter aortic valve replacement in China.
Source
Journal of Cardiac Surgery. 37(10) (pp 3168-3177), 2022. Date of
Publication: October 2022.
Author
Xie C.-M.; Yao Y.-T.
Institution
(Xie) Department of Anesthesiology, Fuwai Yunnan Cardiovascular Hospital,
Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming,
China
(Yao) Department of Anesthesiology, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College and Chinese Academy
of Medical Sciences, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
Objective: The purpose of this study is to summarize the current practice
and experience of transcatheter aortic valve replacement in China.
 Method(s): The relevant articles were identified through computerized
searches of the CNKI, WANFANG, VIP, and PubMed databases through February
1, 2022, using the search terms: "transcatheter aortic valve replacement,"
"transcatheter aortic valve implantation," "China.". Result(s): The
database searches identified 22 articles, 2092 patients, 57.65% were male,
with a mean age of 74.2 +/- 6.0 years, 71.51% of patients were classified
by New York Heart Association as class III/, Society of Thoracic Surgeons
score 8.4 +/- 4.1, mean left ventricular ejection fraction 52.8 +/- 14.2%,
mean transvalvular aortic pressure gradient 59.9 +/- 18.9 mmHg. The
overall procedural success rate was 97.85%, and 2.15% of patients were
converted to sternotomy, mainly due to transcatheter aortic bioprosthesis
dislocation. The most common vascular access approach was transfemoral
(1071 patients, 51.20%). General anesthesia (48.90%) was the commonly used
anesthesia technique. The incidence of postprocedural complications was as
follows: permanent pacemaker implantation (10.47%), bleeding events
(8.60%), mild paravalvular leakage (17.73%), moderate and severe
paravalvular leakage (4.16%), vascular complications (3.30%), stroke
(1.43%), respectively. The overall periprocedural period and
postprocedural 30-day mortality was 2.72%. Conclusion(s): Among
patients undergoing transcatheter aortic valve replacement in China,
device implantation success was achieved in 97.85% of cases. The most
common vascular access approach was transfemoral. General anesthesia was
the most commonly used anesthetic technique. Paravalvular leakage (458
patients, 21.89%) was the most common complication. Copyright ©
2022 Wiley Periodicals LLC.

<49>
Accession Number
639080895
Title
Prognostic Implications of Fractional Flow Reserve After Coronary
Stenting: A Systematic Review and Meta-analysis.
Source
JAMA network open. 5(9) (pp e2232842), 2022. Date of Publication: 01 Sep
2022.
Author
Hwang D.; Koo B.-K.; Zhang J.; Park J.; Yang S.; Kim M.; Yun J.P.; Lee
J.M.; Nam C.-W.; Shin E.-S.; Doh J.-H.; Chen S.-L.; Kakuta T.; Toth G.G.;
Piroth Z.; Johnson N.P.; Pijls N.H.J.; Hakeem A.; Uretsky B.F.; Hokama Y.;
Tanaka N.; Lim H.-S.; Ito T.; Matsuo A.; Azzalini L.; Leesar M.A.; Neleman
T.; van Mieghem N.M.; Diletti R.; Daemen J.; Collison D.; Collet C.; De
Bruyne B.
Institution
(Hwang, Koo, Park, Yang, Kim, Yun) Department of Internal Medicine and
Cardiovascular Center, Seoul National University Hospital, Seoul, South
Korea
(Zhang) Department of Cardiology, Second Affiliated Hospital, School of
Medicine, Zhejiang University, Hangzhou, China
(Lee) Division of Cardiology, Department of Internal Medicine, Heart
Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University
School of Medicine, Seoul, South Korea
(Nam) Department of Medicine, Keimyung University Dongsan Medical Center,
Daegu, South Korea
(Shin) Division of Cardiology, Ulsan Hospital, Ulsan, South Korea
(Doh) Department of Medicine, Inje University Ilsan Paik Hospital, Goyang,
South Korea
(Chen) Division of Cardiology, Nanjing First Hospital, Nanjing Medical
University, Nanjing, China
(Kakuta) Division of Cardiovascular Medicine, Tsuchiura Kyodo General
Hospital, Ibaraki, Japan
(Toth) University Heart Centre Graz, Medical University Graz, Austria
(Piroth) Gottsegen Hungarian Institute of Cardiology, Budapest, Hungary
(Johnson) Weatherhead PET Center For Preventing and Reversing
Atherosclerosis, Division of Cardiology, Department of Medicine,
University of Texas Medical School and Memorial Hermann Hospital, Houston,
United States
(Pijls) Department of Cardiology, Catharina Hospital, Eindhoven,
Netherlands
(Hakeem) Division of Cardiovascular Diseases & Hypertension, Robert Wood
Johnson Medical School, Rutgers University, New Brunswick, New Jersey
(Hakeem) National Institute of Cardiovascular Diseases, Karachi, Pakistan
(Uretsky) Central Arkansas VA Health System, Little Rock, AR, United
States
(Uretsky) University of Arkansas for Medical Sciences, Little Rock
(Hokama, Tanaka) Department of Cardiology, Tokyo Medical University
Hachioji Medical Center, Tokyo, Japan
(Lim) Department of Cardiology, Ajou University School of Medicine, Suwon,
South Korea
(Ito) Department of Cardiology, Nagoya City University Graduate School of
Medical Sciences, Nagoya, Japan
(Matsuo) Department of Cardiology, Kyoto Second Red Cross Hospital, Kyoto,
Japan
(Azzalini) Division of Cardiology, Department of Medicine, University of
Washington, Seattle, United States
(Leesar) Division of Cardiovascular Diseases, University of Alabama,
Birmingham, United Kingdom
(Neleman, van Mieghem, Diletti, Daemen) Department of Interventional
Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam,
Netherlands
(Collison) West of Scotland Regional Heart and Lung Centre, Golden Jubilee
National Hospital, Glasgow, United Kingdom
(Collet, De Bruyne) Cardiovascular Center Aalst, Aalst, Belgium
(De Bruyne) Department of Cardiology, University of Lausanne, Switzerland
Publisher
NLM (Medline)
Abstract
Importance: Fractional flow reserve (FFR) after percutaneous coronary
intervention (PCI) is generally considered to reflect residual disease.
Yet the clinical relevance of post-PCI FFR after drug-eluting stent (DES)
implantation remains unclear. Objective(s): To evaluate the clinical
relevance of post-PCI FFR measurement after DES implantation. Data
Sources: MEDLINE, Embase, and the Cochrane Central Register of Controlled
Trials were searched for relevant published articles from inception to
June 18, 2022. Study Selection: Published articles that reported post-PCI
FFR after DES implantation and its association with clinical outcomes were
included. Data Extraction and Synthesis: Patient-level data were collected
from the corresponding authors of 17 cohorts using a standardized
spreadsheet. Meta-estimates for primary and secondary outcomes were
analyzed per patient and using mixed-effects Cox proportional hazard
regression with registry identifiers included as a random effect. All
processes followed the Preferred Reporting Items for Systematic Review and
Meta-analysis of Individual Participant Data. Main Outcomes and
Measures: The primary outcome was target vessel failure (TVF) at 2 years,
a composite of cardiac death, target vessel myocardial infarction (TVMI),
and target vessel revascularization (TVR). The secondary outcome was a
composite of cardiac death or TVMI at 2 years. Result(s): Of 2268
articles identified, 29 studies met selection criteria. Of these, 28
articles from 17 cohorts provided data, including a total of 5277 patients
with 5869 vessels who underwent FFR measurement after DES implantation.
Mean (SD) age was 64.4 (10.1) years and 4141 patients (78.5%) were men.
Median (IQR) post-PCI FFR was 0.89 (0.84-0.94) and 690 vessels (11.8%) had
a post-PCI FFR of 0.80 or below. The cumulative incidence of TVF was 340
patients (7.2%), with cardiac death or TVMI occurring in 111 patients
(2.4%) at 2 years. Lower post-PCI FFR significantly increased the risk of
TVF (adjusted hazard ratio [HR] per 0.01 FFR decrease, 1.04; 95% CI,
1.02-1.05; P<.001). The risk of cardiac death or MI also increased
inversely with post-PCI FFR (adjusted HR, 1.03; 95% CI, 1.00-1.07,
P=.049). These associations were consistent regardless of age, sex, the
presence of hypertension or diabetes, and clinical diagnosis.
 Conclusions and Relevance: Reduced FFR after DES implantation was
common and associated with the risks of TVF and of cardiac death or TVMI.
These results indicate the prognostic value of post-PCI physiologic
assessment after DES implantation.

<50>
Accession Number
639078579
Title
Association of gestational diabetes mellitus with overall and type
specific cardiovascular and cerebrovascular diseases: systematic review
and meta-analysis.
Source
BMJ (Clinical research ed.). 378 (pp e070244), 2022. Date of Publication:
21 Sep 2022.
Author
Xie W.; Wang Y.; Xiao S.; Qiu L.; Yu Y.; Zhang Z.
Institution
(Xie, Zhang) Department of Rheumatology and Clinical Immunology, Peking
University First Hospital, Beijing 100034, China
(Wang, Yu) Department of Endocrinology, Peking University First Hospital,
Beijing, China
(Xiao) Department of Gastroenterology, Sichuan Provincial People's
Hospital, University of Electronic Science and Technology of China,
Chengdu, China
(Xiao) Department of Gastroenterology, Peking University Third Hospital,
Beijing, China
(Qiu) Department of Cardiology, Peking University First Hospital, Beijing,
China
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To quantify the risk of overall and type specific
cardiovascular and cerebrovascular diseases as well as venous
thromboembolism in women with a history of gestational diabetes mellitus.
DESIGN: Systematic review and meta-analyses. DATA SOURCES: PubMed, Embase,
and the Cochrane Library from inception to 1 November 2021 and updated on
26 May 2022. REVIEW METHODS: Observational studies reporting the
association between gestational diabetes mellitus and incident
cardiovascular and cerebrovascular diseases were eligible. Data, pooled by
random effects models, are presented as risk ratios (95% confidence
intervals). Certainty of evidence was appraised by the Grading of
Recommendations, Assessment, Development, and Evaluations. RESULT(S):
15 studies rated as moderate or serious risk of bias were included. Of
513324 women with gestational diabetes mellitus, 9507 had cardiovascular
and cerebrovascular disease. Of more than eight million control women
without gestational diabetes, 78895 had cardiovascular and cerebrovascular
disease. Compared with women without gestational diabetes mellitus, women
with a history of gestational diabetes mellitus showed a 45% increased
risk of overall cardiovascular and cerebrovascular diseases (risk ratio
1.45, 95% confidence interval 1.36 to 1.53), 72% for cardiovascular
diseases (1.72, 1.40 to 2.11), and 40% for cerebrovascular diseases (1.40,
1.29 to 1.51). Women with gestational diabetes mellitus showed increased
risks of incident coronary artery diseases (1.40, 1.18 to 1.65),
myocardial infarction (1.74, 1.37 to 2.20), heart failure (1.62, 1.29 to
2.05), angina pectoris (2.27, 1.79 to 2.87), cardiovascular procedures
(1.87, 1.34 to 2.62), stroke (1.45, 1.29 to 1.63), and ischaemic stroke
(1.49, 1.29 to 1.71). The risk of venous thromboembolism was observed to
increase by 28% in women with previous gestational diabetes mellitus
(1.28, 1.13 to 1.46). Subgroup analyses of cardiovascular and
cerebrovascular disease outcomes stratified by study characteristics and
adjustments showed significant differences by region (P=0.078), study
design (P=0.02), source of data (P=0.005), and study quality (P=0.04),
adjustment for smoking (P=0.03), body mass index (P=0.01), and
socioeconomic status (P=0.006), and comorbidities (P=0.05). The risk of
cardiovascular and cerebrovascular diseases was, however, attenuated but
remained significant when restricted to women who did not develop
subsequent overt diabetes (all gestational diabetes mellitus: 1.45, 1.33
to 1.59, gestational diabetes mellitus without subsequent diabetes: 1.09,
1.06 to 1.13). Certainty of evidence was judged as low or very low
quality. CONCLUSION(S): Gestational diabetes mellitus is associated
with increased risks of overall and type specific cardiovascular and
cerebrovascular diseases that cannot be solely attributed to conventional
cardiovascular risk factors or subsequent diabetes. Copyright ©
Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ.

<51>
Accession Number
638934090
Title
Direct Oral Anticoagulants Versus Antiplatelet Therapy After Transcatheter
Aortic Valve Replacement: A Meta-Analysis of Randomized Trials.
Source
Circulation. Cardiovascular interventions. 15(9) (pp e012194), 2022. Date
of Publication: 01 Sep 2022.
Author
Elbadawi A.; Dang A.T.; Sedhom R.; Hamed M.; Eid M.; Golwala H.; Goel
S.S.; Mamas M.A.; Elgendy I.Y.
Institution
(Elbadawi) Division of Cardiology' University of Texas Southwestern
Medical Center' Dallas (A.E.)
(Dang) Department of Internal Medicine, University of Texas Medical Branch
(Sedhom) Division of Cardiology' Loma Linda University Health' CA (R.S.)
(Hamed) Division of Internal Medicine, Florida Atlantic University
(Eid) Department of Internal Medicine, Lincoln Medical Center, NY, United
States
(Golwala) Division of Cardiology, Oregon Health and Science University
(Goel) Houston Methodist DeBakey Heart & Vascular Center
(Mamas) Keele Cardiovascular Research Group, Keele University, United
Kingdom (M.A.M.), United Kingdom
(Elgendy) Division of Cardiovascular Medicine, Gill Heart Institute,
University of Kentucky
Publisher
NLM (Medline)

<52>
Accession Number
638800934
Title
Preoperative P-wave parameters and risk of atrial fibrillation after
cardiac surgery: a meta-analysis of 20 201 patients.
Source
Interactive cardiovascular and thoracic surgery. 35(4) (no pagination),
2022. Date of Publication: 09 Sep 2022.
Author
Kawczynski M.J.; Van De Walle S.; Maesen B.; Isaacs A.; Zeemering S.;
Hermans B.; Vernooy K.; Maessen J.G.; Schotten U.; Bidar E.
Institution
(Kawczynski, Van De Walle, Maesen, Maessen, Bidar) Department of
Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University
Medical Centre, Maastricht, Netherlands
(Kawczynski, Maesen, Isaacs, Zeemering, Hermans, Maessen, Schotten, Bidar)
Department of Physiology, Maastricht University, Maastricht, Netherlands
(Zeemering, Hermans, Vernooy) Cardiovascular Research Institute Maastricht
(CARIM), Maastricht, Netherlands
(Vernooy) Department of Cardiology, Heart and Vascular Centre, Maastricht
University Medical Centre, Maastricht, Netherlands
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To evaluate the role of P-wave parameters, as defined on
preprocedural electrocardiography (ECG), in predicting atrial fibrillation
after cardiac surgery [postoperative atrial fibrillation (POAF)].
 METHOD(S): PubMed, Cochrane library and Embase were searched for
studies reporting on P-wave parameters and risk of POAF. Meta-analysis of
P-wave parameters reported by at least 5 different publications was
performed. In case of receiver operator characteristics (ROC-curve)
analysis in the original publications, an ROC meta-analysis was performed
to summarize the sensitivity and specificity. RESULT(S): Thirty-two
publications, with a total of 20 201 patients, contributed to the
meta-analysis. Increased P-wave duration, measured on conventional 12-lead
ECG (22 studies, Cohen's d=0.4, 95% confidence interval: 0.3-0.5,
P<0.0001) and signal-averaged ECG (12 studies, Cohen's d=0.8, 95%
confidence interval: 0.5-1.2, P<0.0001), was a predictor of POAF
independently from left atrial size. ROC meta-analysis for signal-averaged
ECG P-wave duration showed an overall sensitivity of 72% (95% confidence
interval: 65-78%) and specificity of 68% (95% confidence interval:
58-77%). Summary ROC curve had a moderate discriminative power with an
area under the curve of 0.76. There was substantial heterogeneity in the
meta-analyses for P-wave dispersion and PR-interval. CONCLUSION(S):
This meta-analysis shows that increased P-wave duration, measured on
conventional 12-lead ECG and signal-averaged ECG, predicted POAF in
patients undergoing cardiac surgery. Copyright © The Author(s)
2022. Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery.

<53>
Accession Number
637207161
Title
Intravenous lidocaine for the management of traumatic rib fractures: A
double-blind randomized controlled trial (INITIATE program of research).
Source
The journal of trauma and acute care surgery. 93(4) (pp 496-502), 2022.
Date of Publication: 01 Oct 2022.
Author
Patton P.; Vogt K.; Priestap F.; Parry N.; Ball I.M.
Institution
(Patton) From the Department of Medicine (P.P., I.M.B.), Department of
Surgery (K.V., N.P.), Western University; Trauma Program (K.V., F.P.,
N.P., I.M.B.), London Health Sciences Centre; Office of Academic Military
Medicine (N.P., I.M.B.), and Department of Epidemiology and Biostatistics
(I.M.B.), Western University, London, Ontario, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: Traumatic rib fractures (TRFs) are common with a 10% incidence
in all trauma patients and are associated with significant morbidity and
mortality. Adequate analgesia is paramount for preventing pulmonary
complications and death. Evidence exists for intravenous (IV) lidocaine's
effectiveness and safety in postoperative thoracic and abdominal surgery,
and we hypothesized that it would be effective in patients with TRFs.
 METHOD(S): We conducted a single-center, double-blind, randomized
control trial comparing IV lidocaine plus usual analgesics to placebo
infusion plus usual analgesics for 72 hours to 96 hours. Participants were
adult trauma patients diagnosed with two or more TRFs requiring hospital
admission. The primary outcome was mean pain score at rest and with
movement, as measured on the visual analog scale. Secondary outcomes
included patient satisfaction and opioid requirements (standardized total
morphine equivalents). The study was powered to detect a 20% reduction in
pain scores, which has been deemed clinically meaningful. RESULT(S):
Thirty-six patients were enrolled and randomized to IV lidocaine or
placebo. Comparison of the mean visual analog scale pain scores
demonstrated significant pain reduction with movement in the lidocaine
group compared with placebo (7.05 +/- 1.72 vs. 8.22 +/- 1.28, p = 0.042).
Although pain scores at rest were reduced in the lidocaine group, this
difference was not statistically significant (3.37 +/- 2.00 vs. 3.82 +/-
1.97; p = 0.519). Patient satisfaction was higher in the lidocaine group
than the placebo group, although this did not reach statistical
significance (8.3; interquartile range [IQR], 7.0-9.6 vs. 6.3; IQR,
5.2-7.1; p = 0.105). Total morphine equivalents were lower in the
lidocaine group than the placebo group, but this difference did not reach
statistical significance (167; IQR, 60-340 vs. 290; IQR 148-390; p =
0.194). CONCLUSION(S): These results demonstrate that lidocaine has a
beneficial analgesic effect in patients with TRFs. Future work is needed
to evaluate lidocaine's ability to reduce patient important consequences
of inadequate analgesia. LEVEL OF EVIDENCE: Therapeutic/Care Management;
Level II. Copyright © 2022 Wolters Kluwer Health, Inc. All rights
reserved.

<54>
Accession Number
2007403619
Title
Mechanical or biological heart valve for dialysis-dependent patients? A
meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 163(6) (pp 2057-2071.e12),
2022. Date of Publication: June 2022.
Author
Chi K.-Y.; Chiang M.-H.; Kang Y.-N.; Li S.-J.; Chan Y.-T.; Chen Y.-C.;
Wang S.-T.
Institution
(Chi) Department of Education, Center for Evidence-Based Medicine, Taipei
Medical University Hospital, Taipei, Taiwan (Republic of China)
(Chiang) School of Medicine, College of Medicine, Taipei Medical
University, Taipei, Taiwan (Republic of China)
(Kang) Evidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical
University, Taipei, Taiwan (Republic of China)
(Kang) Institute of Health Policy & Management, College of Public Health,
National Taiwan University, Taipei, Taiwan (Republic of China)
(Li) Cardiovascular Research Center, Wan Fang Hospital, Taipei Medical
University, Taipei, Taiwan (Republic of China)
(Li) Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
(Republic of China)
(Li) Division of Cardiovascular Surgery, Department of Surgery, Wan Fang
Hospital, Taipei Medical University, Taipei, Taiwan (Republic of China)
(Chan) Department of General Medicine, Shuang Ho Hospital, Taipei Medical
University, Taipei, Taiwan (Republic of China)
(Chen, Wang) Department of Family Medicine, Taipei Medical University
Hospital, Taipei, Taiwan (Republic of China)
(Chen, Wang) Department of Family Medicine, School of Medicine, College of
Medicine, Taipei Medical University, Taipei, Taiwan (Republic of China)
(Chen) School of Nutrition and Health Sciences, College of Nutrition,
Taipei Medical University, Taipei, Taiwan (Republic of China)
(Chen) Graduate Institute of Metabolism and Obesity Sciences, Taipei
Medical University, Taipei, Taiwan (Republic of China)
(Wang) Health Management Center, Taipei Medical University Hospital,
Taipei, Taiwan (Republic of China)
Publisher
Elsevier Inc.
Abstract
Objective: The optimal selection of prosthetic heart valve for
dialysis-dependent patients remains controversial. We investigated the
comparative effectiveness and safety of mechanical prosthesis (MP) and
bioprosthesis (BP) for these patients. Method(s): After the
systematic review, we included studies that involved patients on dialysis
undergoing aortic valve replacement or mitral valve replacement (MVR) and
reported comparative outcomes of MP and BP. Meta-analysis was performed
using random-effects model. We conducted a subgroup analysis based on the
valve position and postoperative international normalized ratio (INR),
which was extracted from either tables or methods of each study. A
meta-regression was used to examine the effects of study-level covariates.
 Result(s): We included 24 retrospective studies without
randomized-controlled trials, involving 10,164 participants (MP = 6934, BP
= 3230). Patients undergoing aortic valve replacement with MP exhibited a
better long-term survival effectiveness (hazard ratio, 0.64; 95%
confidence interval [CI], 0.47-0.86). Conversely, studies including MVR
demonstrated little difference in survival (hazard ratio, 0.90; 95% CI,
0.73-1.12). A meta-regression revealed that age had little effect on
long-term survival difference between MP and BP (beta = -0.0135, P =
.433). MP had a significantly greater bleeding risk than did BP when INR
was above 2.5 (incidence rate ratio, 10.58; 95% CI, 2.02-55.41). However,
when INR was below 2.5, bleeding events were comparable (incidence rate
ratio, 1.73; 95% CI, 0.78-3.82). The structural valve deterioration rate
was significantly lower in MP (risk ratio, 0.24; 95% CI, 0.14-0.44).
 Conclusion(s): MP is a reasonable choice for dialysis-dependent
patients without additional thromboembolic risk requiring aortic valve
replacement, for its better long-term survival, durability, and
noninferior bleeding risk compared with BP. Conversely, BP might be an
appropriate selection for patients with MVR, given its similar survival
rate and lower bleeding risk. Although our meta-regression demonstrates
little influence of age on long-term survival difference between MP and
BP, further studies stratifying patients based on age cut-off are
mandatory. Copyright © 2020 The American Association for Thoracic
Surgery. Elsevier Inc. This is an open access article under the CC
BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

<55>
Accession Number
2020333934
Title
The effectiveness of preoperative education interventions on improving
perioperative outcomes of adult patients undergoing cardiac surgery: a
systematic review and meta-analysis.
Source
European Journal of Cardiovascular Nursing. 21(6) (pp 521-536), 2022. Date
of Publication: 2022.
Author
Ng S.X.; Wang W.; Shen Q.; Toh Z.A.; He H.-G.
Institution
(Ng, Wang, Toh, He) Alice Lee Centre for Nursing Studies, Yong Loo Lin
School of Medicine, National University of Singapore, Clinical Research
Centre, Level 2, Block MD11, 10 Medical Drive, Singapore 117597, Singapore
(Ng, Wang, Toh, He) National University Health System, NUHS Tower Block,
1E Kent Ridge Rd, Singapore 119228, Singapore
(Shen) Department of Nursing, School of Medicine, Xiamen University, Alice
Lee Building, Room 220, Xiang An South Road, Xiang An District, Fujian
Province, Xiamen 361102, China
Publisher
Oxford University Press
Abstract
Background Cardiac surgeries pose as an emotional experience for patients.
Preoperative education is known to positively alter people's perceptions,
emotions, and mitigate surgical distress. However, this intervention's
effectiveness in improving perioperative outcomes among patients
undergoing cardiac surgery lacked rigorous statistical synthesis and
remains inconclusive. Aims The aim was to synthesize the effectiveness of
preoperative education on improving perioperative outcomes [anxiety,
depression, knowledge, pain intensity, pain interference with daily
activities, postoperative complications, length of hospitalization, length
of intensive care unit (ICU) stay, satisfaction with the intervention and
care, and health-related quality of life] among patients undergoing
cardiac surgery. Methods This systematic review and meta-analysis
conducted a comprehensive search of nine electronic databases (PubMed,
EMBASE, Scopus, MEDLINE, CINAHL, Cochrane CENTRAL, Web of Science,
PsycINFO, and ERIC) and grey literature for randomized controlled trials
examining the preoperative educational interventional effects on patients
undergoing cardiac surgery from inception to 31 December 2020. The
studies' quality was evaluated using Cochrane Risk-of-Bias Tool 1 (RoB1).
Meta-analyses via RevMan 5.4 software synthesized interventional effects.
Results Twenty-two trials involving 3167 participants were included.
Preoperative education had large significant effects on reducing
post-intervention preoperative anxiety (P = 0.02), length of ICU stay (P =
0.02), and improving knowledge (P < 0.00001), but small significant effect
sizes on lowering postoperative anxiety (P < 0.0001), depression (P =
0.03), and enhancing satisfaction (P = 0.04). Conclusions This review
indicates the feasibility of preoperative education in clinical use to
enhance health outcomes of patients undergoing cardiac surgery. Future
studies need to explore knowledge outcomes in-depth and more innovative
technologies in preoperative education delivery. Copyright Published
on behalf of the European Society of Cardiology. All rights reserved.
© The Author(s) 2021.

<56>
Accession Number
2020295675
Title
Papaverine Infusion Through Aortic Root before Cardiac Self-recovery in
Heart Valve Replacement with TiO2 Nanocrystalline Film Material.
Source
Cellular and Molecular Biology. 68(3) (pp 322-329), 2022. Date of
Publication: 2022.
Author
Tan X.; Li J.; Jin W.; Mei B.; He G.; Wang Y.; Wei S.; Lai Y.
Institution
(Tan, Li, Jin, Mei, He, Wang, Wei, Lai) Department of Cardiothoracic
Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong
637000, China
Publisher
Cellular and Molecular Biology Association
Abstract
This work was to investigate TiO2 nanocrystalline film material in heart
valve replacement (HVR) and the effect of papaverine infusion through the
aortic root before cardiac self-recovery during the HVR. TiO2
nanocrystalline films were prepared by radio frequency (RF) reactive
sputtering. The crystallization characteristics and surface morphology of
TiO2 nanocrystalline films were observed by X-ray diffraction and scanning
electron microscopy, and the anti-platelet adhesion and anti-coagulation
properties of the films were analyzed. 86 patients with heart valve
disease were selected and all underwent HVR. They were randomly divided
into a control group (routine treatment) and an experimental group
(papaverine perfusion through aortic root), with 43 cases in each group.
The rate of cardiac self-recovery and the dosage of dopamine were
observed. The results showed that the TiO2 nanocrystalline film was
composed of a large number of uniform particles, and the average particle
size was about 18.97 +/- 7.28 nm. The rate of cardiac self-recovery in the
experimental group was 97.67%, which was significantly higher than that in
the control group (67.44%) (P< 0.05). The dosage of epinephrine, dopamine,
and duration of cardiopulmonary bypass (CPB) assistance in the observation
group were less than those in the control group (P < 0.05). These results
indicated that TiO2 nanocrystalline film could be used in HVR, and
papaverine infusion through aortic root before HVR and myocardial
protection measures can significantly improve the rate of cardiac
self-recovery and promote postoperative recovery. Copyright ©
2022 by the C.M.B. Association. All rights reserved.

<57>
Accession Number
2020352745
Title
Vascular Closure Devices versus Manual Compression in Cardiac
Interventional Procedures: Systematic Review and Meta-Analysis.
Source
Cardiovascular Therapeutics. 2022 (no pagination), 2022. Article Number:
8569188. Date of Publication: 2022.
Author
Pang N.; Gao J.; Zhang B.; Guo M.; Zhang N.; Sun M.; Wang R.
Institution
(Pang, Gao, Guo, Zhang, Sun, Wang) Department of Cardiology, First
Hospital of Shanxi Medical University, Shanxi, Taiyuan, China
(Pang, Zhang) First Clinical Medical College, Shanxi Medical University,
Shanxi, Taiyuan, China
Publisher
Hindawi Limited
Abstract
Backgrounds. Manual compression (MC) and vascular closure device (VCD) are
two methods of vascular access site hemostasis after cardiac
interventional procedures. However, there is still controversial over the
use of them and a lack of comprehensive and systematic meta-analysis on
this issue. Methods. Original articles comparing VCD and MC in cardiac
interventional procedures were searched in PubMed, EMbase, Cochrane
Library, and Web of Science through April 2022. Efficacy, safety, patient
satisfaction, and other parameters were assessed between two groups.
Heterogeneity among studies was evaluated by I2 index and the Cochran Q
test, respectively. Publication bias was assessed using the funnel plot
and Egger's test. Results. A total of 32 studies were included after
screening with inclusion and exclusion criteria (33481 patients). This
meta-analysis found that VCD resulted in shorter time to hemostasis,
ambulation, and discharge (p<0.00001). In terms of vascular complication
risks, VCD group might be associated with a lower risk of major
complications (p=0.0001), but the analysis limited to randomized
controlled trials did not support this result (p=0.68). There was no
significant difference in total complication rates (p=0.08) and
bleeding-related complication rates (p=0.05) between the two groups.
Patient satisfaction was higher in VCD group (p=0.002). Meta-regression
analysis revealed no specific covariate as an influencing factor for above
results (p>0.05). Conclusions. Compared with MC, the use of VCDs
significantly shortens the time of hemostasis and allows earlier
ambulation and discharge, meanwhile without increase in vascular
complications. In addition, use of VCDs achieves higher patient
satisfaction and leads cost savings for patients and institutions.
 Copyright © 2022 Naidong Pang et al.

<58>
Accession Number
2020352702
Title
Influences of Antithrombotic Elastic Socks Combined with Air Pressure in
Reducing Lower Extremity Deep Venous Thrombosis for Patients Undergoing
Cardiothoracic Surgery.
Source
Computational and Mathematical Methods in Medicine. 2022 (no pagination),
2022. Article Number: 1338214. Date of Publication: 2022.
Author
Fu W.; Zhang Q.; Sun X.; Gu Y.
Institution
(Fu, Sun) Department of Thoracic Surgery, Affiliated Hospital of Nantong
University, Jiangsu, Nantong 226001, China
(Zhang) Department of Cardiovascular Surgery, Affiliated Hospital of
Nantong University, Jiangsu, Nantong 226001, China
(Gu) Department of Surgery, Affiliated Hospital of Nantong University,
Jiangsu, Nantong 226001, China
Publisher
Hindawi Limited
Abstract
This study was designed to investigate the application and therapeutic
effect of antithrombotic elastic socks combined with air pressure in the
prevention of lower extremity deep venous thrombosis in patients
undergoing cardiothoracic surgery. Sixty patients in cardiothoracic
surgery of our hospital from January 2019 to December 2020 were randomly
divided into a study group and control group. The control group was
treated with routine treatment intervention. Based on routine treatment
intervention, the study group was treated with antithrombotic elastic
socks combined with pneumatic treatment intervention. The activated
partial thromboplastin time (APTT), thrombin time (TT), femoral venous
blood flow velocity of both lower limbs, and the incidence of lower
extremity deep venous thrombosis (LEDVT), postoperative lower extremity
swelling, inflammatory factors, and satisfaction were measured. After
intervention, APTT (31.74+/-1.15 s) and TT (14.58+/-0.24 s) in the study
group were higher than those in the control group APTT (25.13+/-1.14 s)
and TT (12.14+/-0.23 s) (P<0.05). The left lower limb femoral vein blood
flow velocity and the right lower limb femoral vein blood flow velocity in
the study group were better than those in the control group (P<0.05). The
incidence of postoperative lower limb swelling and deep vein in the study
group was lower than that in the control group (P<0.05). Serum tumor
necrosis factor alpha and interleukin-6 concentrations in the study group
were lower than those in the control group (P<0.05). The satisfaction rate
of patients in the study group (93.33%) was significantly higher than that
in the control group (70.00%) (P<0.05). In conclusion, after
cardiothoracic surgery, antithrombotic elastic socks combined with air
pressure can significantly reduce the incidence of LEDVT by improving
patients' coagulation function, reducing inflammatory reaction. It is
worthy of popularization and application in relevant surgery.
 Copyright © 2022 Weihong Fu et al.

<59>
Accession Number
2020365441
Title
The role of optimism in manifesting recovery outcomes after coronary
artery bypass graft surgery: A systematic review.
Source
Journal of Psychosomatic Research. 162 (no pagination), 2022. Article
Number: 111044. Date of Publication: November 2022.
Author
Arsyi D.H.; Permana P.B.D.; Karim R.I.; Abdurachman
Institution
(Arsyi, Permana, Karim) Faculty of Medicine, Universitas Airlangga,
Mayjend. Prof. Dr. Moestopo Street no. 47, Surabaya, East Java 60132,
Indonesia
(Abdurachman) Department of Anatomy, Histology, and Pharmacology, Faculty
of Medicine, Universitas Airlangga, Mayjend. Prof. Dr. Moestopo Street no.
47, Surabaya, East Java 60132, Indonesia
Publisher
Elsevier Inc.
Abstract
Objective: Coronary artery bypass graft (CABG) is a major surgery
conducted in coronary heart disease management. Postoperative recovery is
a crucial process for patients undergoing CABG. This systematic review
evaluates current evidence regarding the association between trait
optimism and recovery outcomes in patients following coronary artery
bypass graft surgery. Method(s): This review followed the Preferred
Reporting Items of Systematic Review and Meta-Analysis (PRISMA) 2020
Guideline. The inclusion criteria focused on observational study that
examined study participants aged >=18 years old undergoing elective CABG
and measurement of trait optimism with validated methods (i.e. LOT, LOT-R)
and at least one recovery outcome. Studies in non-English languages and
duplicates were excluded. A systematic literature search was carried out
on PubMed, Scopus, and Web of Science electronic databases. Search results
were screened based on the eligibility criteria. The Newcastle-Ottawa
Scale was used to assess the quality of each included study.
 Result(s): The search yielded a total of 1853 articles, in which 7
articles fulfilled the eligibility criteria and were subsequently included
in the analysis. Measurement of trait optimism was conducted on 1276
patients who underwent a non-emergency/elective CABG. Optimism was
significantly associated with several categories of recovery, including
reduced rehospitalization rate, complications, pain, and physical symptoms
along with improved quality of life, rate of return to normal life, and
psychological status. Conclusion(s): Our review showed that trait
optimism was associated with recovery outcomes following CABG surgery.
However, the heterogeneity of recovery outcomes may hamper the clinical
benefit of trait optimism in CABG. (PROSPERO
CRD42022301882). Copyright © 2022 Elsevier Inc.

<60>
Accession Number
2020254339
Title
Treatment and outcomes of mechanical complications of acute myocardial
infarction during the Covid-19 era: A comparison with the pre-Covid-19
period. A systematic review and meta-analysis.
Source
Open Medicine (Poland). 17(1) (pp 1412-1416), 2022. Date of Publication:
01 Jan 2022.
Author
Spadaccio C.; Pisani A.; Salsano A.; Nenna A.; Fardman A.; D'Alessandro
D.; Santini F.; Gaudino M.F.L.; Sundt T.M.; Rose D.
Institution
(Spadaccio, D'Alessandro, Sundt) Cardiac Surgery, Massachusetts General
Hospital (MGH), Harvard Medical School, Boston, United States
(Pisani) Cardiac Surgery, Pineta Grande Hospital, Castel Volturno, Naples,
Italy
(Salsano, Santini) Division of Cardiac Surgery, Irccs Ospedale Policlinico
San Martino, Genoa, Italy
(Salsano, Santini) Disc Department, University of Genoa, L.go Rosanna
Benzi, 10, Genoa 16143, Italy
(Nenna) Division of Cardiac Surgery, Universita Campus Bio-Medico di Roma,
Rome, Italy
(Fardman) Lev Leviev Heart and Vascular Center, Sheba Medical Center, Tel
Hashomer, Israel
(Fardman) Sackler School of Medicine, Tel Aviv University, Tel Aviv,
Israel
(Gaudino) Cardiothoracic Surgery, Weill Cornell Medicine, New York, United
States
(Rose) Cardiac Surgery, Lancashire Cardiac Centre, Blackpool Victoria
Hospital, Blackpool, United Kingdom
Publisher
De Gruyter Open Ltd
Abstract
This study aims to compare treatments and outcomes of mechanical
complications of acute myocardial infarction (MI) during the Covid-19 and
in the pre-Covid-19 era. Electronic databases have been searched for MI
mechanical complications during the Covid-19 era and in the previous
period from January 1998 to January 2020 (pre-Covid-19 era), until October
2021. To perform a quantitative analysis of non-comparative series, a
meta-analysis of proportion has been conducted. Early mortality after
surgical treatment was 15.0% while it was significantly higher after
conservative treatment (62.4%) (P = 0.026). Early mortality after surgical
treatment was seemingly higher in the pre-Covid-19 era but the difference
did not reach statistical significance (15.0% vs 38.9%; P = 0.13).
Mortality in patients treated conservatively, or turned down for surgery,
was lower during the Covid-19 pandemic (62.4% vs 97.7%; P = 0.001). The
crude mean prevalence of the use rate of conservative or surgical
treatment across the studies during Covid-19 and in the pre-Covid-19 era
was comparable. The current increased incidence of MI mechanical
complications might be a consequence of delayed presentation or restricted
access to hospital facilities. Despite the general negative impact of
Covid-19 on cardiac surgery volumes and outcomes and the apparent increase
of the incidence of MI complications, the outcomes of their surgical and
clinical treatment seem not to have been affected during the pandemic.
 Copyright © 2022 Cristiano Spadaccio et al., published by De
Gruyter.

<61>
[Use Link to view the full text]
Accession Number
2020240861
Title
Catheter ablation for treatment of bradycardia-tachycardia syndrome: Is it
time to consider it the therapy of choice? A systematic review and
meta-analysis.
Source
Journal of Cardiovascular Medicine. 23(10) (pp 646-654), 2022. Date of
Publication: 01 Oct 2022.
Author
Magnano M.; Bissolino A.; Budano C.; Abdirashid M.; Devecchi C.; Oriente
D.; Matta M.; Occhetta E.; Gaita F.; Rametta F.
Institution
(Magnano, Abdirashid, Devecchi, Oriente, Matta, Occhetta, Rametta)
Cardiology Department, St. Andrea Hospital, Vercelli, Italy
(Bissolino, Budano, Gaita) Maria Pia Hospital, GVM Care & Research,
Torino, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
BackgroundAtrial fibrillation catheter ablation (AFCA) should be
considered as a strategy to avoid pacemaker (PM) implantation for patients
with bradycardia-tachycardia syndrome (BTS), but lack of evidence is
remarkable.MethodsOur aim was to conduct a random-effects model
meta-analysis on safety and efficacy data from controlled trials and
observational studies. We compared atrial fibrillation (AF) recurrence, AF
progression, procedural complication, additional procedure, cardiovascular
death, cardiovascular hospitalization, heart failure and stroke in
patients undergoing AFCA vs. PM implantation.ResultsPubMed/MEDLINE,
Cochrane Database and Google Scholar were screened, and four retrospective
studies were selected. A total of 776 patients (371 in the AFCA group, 405
in the PM group) were included. After a median follow-up of 67.5 months,
lower AF recurrence [odds ratio (OR) 0.06, confidence interval (CI)
0.02-0.18, I2= 82.42%, P < 0.001], AF progression (OR 0.12, CI
0.06-0.26, I2= 0%, P < 0.001), heart failure (OR 0.12, CI
0.04-0.34, I2= 0%, P < 0.001), and stroke (OR 0.30, CI
0.15-0.61, I2= 0%, P = 0.001) were observed in the AFCA group.
No differences were observed in cardiovascular death and hospitalization
(OR 0.48, CI 0.10-2.28, I2= 0%, P = 0.358 and OR 0.43, CI
0.14-1.29, I2= 87.52%, P = 0.134, respectively). Higher need
for additional procedures in the AFCA group was highlighted (OR 3.65, CI
1.51-8.84, I2= 53.75%, P < 0.001). PM implantation was avoided
in 91% of BTS patients undergoing AFCA.ConclusionsAFCA in BTS patients
seems to be more effective than PM implantation in reducing AF recurrence
and PM implantation may be waived in most BTS patients treated by AFCA.
Need for additional procedures in AFCA patients is balanced by long-term
benefit in clinical end points. Copyright © 2022 Lippincott
Williams and Wilkins. All rights reserved.

<62>
Accession Number
2020265852
Title
Use of Indocyanine Green Fluorescence Imaging in Thoracic and Esophageal
Surgery.
Source
Annals of Thoracic Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Ng C.S.-H.; Ong B.-H.; Chao Y.K.; Wright G.M.; Sekine Y.; Wong I.; Hao Z.;
Zhang G.; Chaturvedi H.; Thammineedi S.R.; Law S.; Kim H.K.
Institution
(Ng) Department of Surgery, The Chinese University of Hong Kong, Hong
Kong, Hong Kong
(Ong) Department of Cardiothoracic Surgery, National Heart Centre
Singapore, Singapore
(Chao) Division of Thoracic Surgery, Chang Gung Memorial Hospital-Linko,
Chang Gung University, Taoyuan, Taiwan (Republic of China)
(Wright) Department of Surgery, St. Vincent's Hospital, University of
Melbourne, Melbourne, VIC, Australia
(Sekine) Department of Thoracic Surgery, Yachiyo Medical Center, Tokyo
Women's Medical University, Yachiyo, Japan
(Wong, Law) Department of Surgery, School of Clinical Medicine, The
University of Hong Kong, Hong Kong, Hong Kong
(Hao) Department of Thoracic Surgery, The First Affiliated Hospital of
Guangzhou Medical University, Guangzhou, China
(Zhang) Department of Thoracic Surgery, The First Affiliated Hospital of
Xi'an Jiaotong University, Xi'an, China
(Chaturvedi) Department of Surgical Oncology, Max Hospital, New Delhi,
India
(Thammineedi) Department of Surgical Oncology, Basavatarakam Indo American
Cancer Hospital and Research Institute, Hyderabad, India
(Kim) Department of Thoracic and Cardiovascular Surgery, College of
Medicine, Korea University Guro Hospital, Seoul, South Korea
Publisher
Elsevier Inc.
Abstract
Background: Fluorescence imaging using indocyanine green in thoracic and
esophageal surgery is gaining popularity because of the potential to
facilitate surgical planning, to stage disease, and to reduce
postoperative complications. To optimize use of fluorescence imaging in
thoracic and esophageal surgery, an expert panel sought to establish a set
of recommendations at a consensus meeting. Method(s): The panel
included 12 experts in thoracic and upper gastrointestinal surgery from
Asia-Pacific countries. Before meeting, 7 focus areas were defined:
intersegmental plane identification for sublobar resections; pulmonary
nodule localization; lung tumor detection; bullous lesion detection;
lymphatic mapping of lung tumors; evaluation of gastric conduit perfusion;
and lymphatic mapping in esophageal surgical procedures. A literature
search of the PubMed database was conducted using keywords indocyanine
green, fluorescence, thoracic, surgery, and esophagectomy. At the meeting,
panelists addressed each focus area by discussing the most relevant
evidence and their clinical experiences. Consensus statements were derived
from the proceedings, followed by further discussions, revisions,
finalization, and unanimous agreement. Each statement was assigned a level
of evidence and a grade of recommendation. Result(s): A total of 9
consensus recommendations were established. Identification of the
intersegmental plane for sublobar resections, localization of pulmonary
nodules, lymphatic mapping in lung tumors, and assessment of gastric
conduit perfusion were applications of fluorescence imaging that have the
most robust current evidence. Conclusion(s): Based on best available
evidence and expert opinions, these consensus recommendations may
facilitate thoracic and esophageal surgery using fluorescence
imaging. Copyright © 2022 The Society of Thoracic Surgeons

<63>
Accession Number
2019180438
Title
Re-repair vs. Replacement for Failed Mitral Valve Repair: A Systemic
Review and Meta-Analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 868980. Date of Publication: 14 Jun 2022.
Author
Zhong Z.; Xu H.; Song W.; Liu S.
Institution
(Zhong, Xu, Song, Liu) Department of Cardiovascular Surgery, Fuwai
Hospital, Chinese Academy of Medical Science, Beijing, China
Publisher
Frontiers Media S.A.
Abstract
Objective: The objective of this study was to compare outcomes of
re-repair with those of mitral valve replacement (MVR) for failed initial
mitral valve repair (MVr). Method(s): We searched the Pubmed, Embase,
and Cochrane Library databases for studies that compared mitral valve
re-repair with MVR for the treatment of failed initial MVr. Data were
extracted by two independent investigators and subjected to a
meta-analysis. Odds ratio (OR), risk ratio (RR), hazard ratio (HR), ratio
difference (RD), mean difference (MD), and 95% confidence interval (CI)
were calculated with the Mantel-Haenszel and inverse-variance methods for
mode of repair failure, perioperative outcomes, and follow-up outcomes.
 Result(s): Eight retrospective cohort studies were included, with a
total of 938 patients, and mean/median follow-up ranged from 1.8 to 8.9
years. Pooled incidence of technical failure was 41% (RD: 0.41; 95% CI:
0.32 to 0.5; P = 0.00; I2 = 86%; 6 studies, 846 patients).
Pooled mitral valve re-repair rate was 36% (RD: 0.36; 95% CI: 0.26-0.46; P
= 0; I2 = 91%; 8 studies, 938 patients). Pooled data showed
significantly lower perioperative mortality (RR: 0.22; 95% CI: 07 to 0.66;
I2 = 0%; P = 0.008; 6 studies, 824 patients) and significantly
lower long-term mortality (HR:0.42; 95% CI: 0.3 to 0.58; I2 =
0%; P = 0; 7 studies, 903 patients) in the re-repair group compared with
MVR. Conclusion(s): Mitral valve re-repair was associated with better
immediate and sustained outcomes for failed MVr and should be recommended
if technically feasible. Copyright © 2022 Zhong, Xu, Song and
Liu.

<64>
Accession Number
2019907380
Title
The effect of different anesthesia techniques on cerebral oxygenation in
thoracic surgery.
Source
Cirugia y Cirujanos (English Edition). 90(Supplement 1) (pp 52-60), 2022.
Date of Publication: July 2022.
Author
Akdogan A.; Besir A.; Kutanis D.; Erturk E.; Tugcugil E.; Saylan S.
Institution
(Akdogan, Besir, Kutanis, Erturk, Tugcugil, Saylan) Department of
Anesthesiology and Intensive Care, Faculty of Medicine, Karadeniz
Technical University, Trabzon, Turkey
Publisher
Permanyer Publications
Abstract
Objective: One-lung ventilation may cause negative changes in the
oxygenation of cerebral tissue which results in post-operative cognitive
dysfunction. We compared the potential effects of total intravenous
anesthesia and inhalation general anesthesia techniques on cerebral tissue
oxygenation Material(s) and Method(s): In this prospective
double-blind trial, patients whose standard anesthesia induction was done
were randomly divided into two groups as group total intravenous
anesthesia using propofol (Group T, n = 30) and group inhalation general
anesthesia using sevoflurane (Group I, n = 30) based on anesthesia
maintenance. The intraoperative cerebral oxygen saturation and
pre-post-operative mini-mental status test scores of the patients were
monitored and recorded. Result(s): Baseline characteristics were
similar between the two groups. The decrease of cerebral oxygen saturation
more than 20% in total intravenous anesthesia group was significantly
higher than inhalation group (p < 0.05). In both groups, the mini-mental
status test values at the post-operative 3rd h were
significantly lower than the preoperative and post-operative
24th h values (p < 0.05). Conclusion(s): Inhalation
general anesthesia provided better cerebral tissue oxygenation in thoracic
surgery with one-lung ventilation compared to total intravenous
anesthesia. However, there was no significant correlation between the
presence of desaturation and post-operative cognitive
dysfunction Copyright © 2021 Academia Mexicana de Cirugia.
Published by Permanyer.

<65>
Accession Number
2019183894
Title
Effect of standardized vs. local preoperative enteral feeding practice on
the incidence of NEC in infants with duct dependent lesions: Protocol for
a randomized control trial.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 893764. Date of Publication: 08 Sep 2022.
Author
Seliga-Siwecka J.; Plotko A.; Wojcik-Sep A.; Bokiniec R.; Latka-Grot J.;
Zuk M.; Furmanczyk K.; Zielinski W.; Chrzanowska M.
Institution
(Seliga-Siwecka, Plotko, Wojcik-Sep, Bokiniec) Department of Neonatology
and Neonatal Intensive Care, Medical University of Warsaw, Warsaw, Poland
(Latka-Grot) Department of Neonatology, Children's Health Memorial
Institute, Warsaw, Poland
(Zuk) Cardiology Clinic, Children's Health Memorial Institute, Warsaw,
Poland
(Furmanczyk) Department of Applied Mathematics, Institute of Information
Technology, Warsaw University of Life Sciences, Warsaw, Poland
(Furmanczyk, Zielinski, Chrzanowska) Department of Prevention of
Environmental Hazards, Allergology and Immunology, Medical University of
Warsaw, Warsaw, Poland
(Zielinski, Chrzanowska) Department of Statistics and Econometrics,
Institute of Economics and Finance, Warsaw, University of Life Sciences,
Warsaw, Poland
Publisher
Frontiers Media S.A.
Abstract
Background: Infants with duct dependent heart lesions often require
invasive procedures during the neonatal or early infancy period. These
patients remain a challenge for pediatric cardiologists, neonatologists,
and intensive care unit personnel. A relevant portion of these infant
suffer from respiratory, cardiac failure and may develop NEC, which leads
to inadequate growth and nutrition, causing delayed or complicated cardiac
surgery. Method(s): This randomized control trial will recruit term
infants diagnosed with a duct dependant lesion within the first 72 h of
life. After obtaining written parental consent patients will be randomized
to either the physician led enteral feeding or protocol-based feeding
group. The intervention will continue up to 28 days of life or day of
cardiosurgical treatment, whichever comes first. The primary outcomes
include NEC and death related to NEC. Secondary outcomes include among
others, number of interrupted feedings, growth velocity, daily protein and
caloric intake, days to reach full enteral feeding and on mechanical
ventilation. Discussion(s): Our study will be the first randomized
control trial to evaluate if standard (as in healthy newborns) initiation
and advancement of enteral feeding is safe, improves short term outcomes
and does not increase the risk of NEC. If the studied feeding regime
proves to be intact, swift implementation and advancement of enteral
nutrition may become a recommendation. Trial registration: The study
protocol has been approved by the local ethical board. It is registered at
ClinicalTrials.gov NCT05117164. Copyright © 2022 Seliga-Siwecka,
Plotko, Wojcik-Sep, Bokiniec, Latka-Grot, Zuk, Furmanczyk, Zielinski and
Chrzanowska.

<66>
Accession Number
2019183885
Title
Long Term Follow-Up of Stereotactic Body Radiation Therapy for Refractory
Ventricular Tachycardia in Advanced Heart Failure Patients.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 849113. Date of Publication: 29 Apr 2022.
Author
Wight J.; Bigham T.; Schwartz A.; Zahid A.T.; Bhatia N.; Kiani S.; Shah
A.; Westerman S.; Higgins K.; Lloyd M.S.
Institution
(Wight, Bigham, Schwartz) School of Medicine, Emory University, Atlanta,
GA, United States
(Zahid) UChicago Medicine, Chicago, IL, United States
(Bhatia, Kiani, Shah, Westerman, Lloyd) Section of Cardiac
Electrophysiology, Emory University, Atlanta, GA, United States
(Higgins) Department of Radiation Oncology, Emory University, Atlanta, GA,
United States
Publisher
Frontiers Media S.A.
Abstract
Background: Initial studies of stereotactic body radiation therapy (SBRT)
for refractory ventricular tachycardia (VT) have demonstrated impressive
efficacy. Follow-up analyses have found mixed results and the role of SBRT
for refractory VT remains unclear. We performed palliative, cardiac radio
ablation in patients with ventricular tachycardia refractory to ablation
and medical management. Method(s): Arrhythmogenic regions were
targeted by combining computed tomography imaging with electrophysiologic
mapping with collaboration from a radiation oncologist,
electrophysiologist and cardiac imaging specialist. Patients were treated
with a single fraction 25 Gy. Total durations of VT, the quantity of
antitachycardia pacing (ATP) and shocks before and after treatment as
recorded by implantable cardioverter-defibrillators (ICDs) were analyzed.
Follow-up extended until most recent device interrogation unless
transplant, death or repeat ablation occurred sooner. Result(s):
Fourteen patients (age 50-78, four females) were treated and had an
average of two prior ablations. Nine had ACC/AHA Stage D heart failure and
three had left ventricular assist devices (LVAD). Two patients died
shortly after SBRT, one received a prompt heart transplant and another had
significant VT durations in the following months that were inaccurately
recorded by their device. Ten of the 14 patients remained with adequate
data post SBRT for analysis with an average follow-up duration of 216
days. Seven of those 10 patients had a decrease in VT post SBRT. Comparing
the 90 days before treatment to cumulative follow-up, patients had a 59%
reduction in VT, 39% reduction in ATP and a 60% reduction in shocks. Four
patients received repeat ablation following SBRT. Pneumonitis was the only
complication, occurring in four of the fourteen patients.
 Conclusion(s): SBRT may have value in advanced heart failure patients
with refractory VT acutely but the utility over long-term follow-up
appears modest. Prospective randomized data is needed to better clarify
the role of SBRT in managing refractory VT. Copyright © 2022
Wight, Bigham, Schwartz, Zahid, Bhatia, Kiani, Shah, Westerman, Higgins
and Lloyd.

<67>
Accession Number
2019180437
Title
Early vs. Delayed Initiation of Treatment With P2Y<inf>12</inf> Inhibitors
in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome: A
Systematic Review and Network Meta-Analysis of Randomized Controlled
Trials.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 862452. Date of Publication: 28 Apr 2022.
Author
Vicent L.; Diaz-Arocutipa C.; Tarantini G.; Mojoli M.; Hernandez A.V.;
Bueno H.
Institution
(Vicent, Bueno) Cardiology Department, Hospital Universitario 12 de
Octubre and Instituto de Investigacion Sanitaria Hospital, 12 de Octubre
(imas12), Madrid, Spain
(Vicent, Bueno) Centro de Investigacion Biomedica en Red Enfermedades
Cardiovasculares (CIBERCV), Madrid, Spain
(Diaz-Arocutipa, Hernandez) Vicerrectorado de Investigacion, Universidad
San Ignacio de Loyola, Lima, Peru
(Tarantini) Department of Cardiac, Thoracic and Vascular Sciences,
University of Padua Medical School, Padua, Italy
(Mojoli) Cardiology Department, Azienda Ospedaliera Friuli Occidentale,
Pordenone, Italy
(Hernandez) Health Outcomes, Policy, and Evidence Synthesis (HOPES) Group,
University of Connecticut School of Pharmacy, Storrs, CT, United States
(Bueno) Centro Nacional de Investigaciones Cardiovasculares (CNIC),
Madrid, Spain
(Bueno) Facultad de Medicina, Universidad Complutense de Madrid, Madrid,
Spain
Publisher
Frontiers Media S.A.
Abstract
Aims: Whether early or delayed dual antiplatelet therapy initiation is
better in patients with non-ST-segment elevation acute coronary syndrome
(NSTE-ACS) is unclear. We assessed the evidence for comparing the efficacy
and safety of early vs. delayed P2Y<inf>12</inf> inhibitor initiation in
NSTE-ACS. Method(s): The randomized controlled trials with available
comparisons between early and delayed initiation of P2Y<inf>12</inf>
inhibitors (clopidogrel, prasugrel, and ticagrelor) in patients with
NSTE-ACS until January 2021 were reviewed. The primary outcomes were
trial-defined major adverse cardiovascular events (MACEs) and bleeding.
Secondary outcomes were all-cause mortality, cardiovascular mortality,
myocardial infarction, stent thrombosis, urgent coronary
revascularization, and stroke. Frequentist random-effects network
meta-analyses were conducted, ranking best treatments per outcome with
p-scores. Result(s): A total of nine trials with intervention arms
including early and delayed initiation of clopidogrel (n = 5), prasugrel
(n = 8), or ticagrelor (n = 6) involving 40,096 patients were included.
Early prasugrel (hazard ratio [HR], 0.59; 95% confidence interval [95%CI],
0.40-0.87), delayed prasugrel (HR, 0.60; 95%CI 0.43-0.84), and early
ticagrelor (HR, 0.84; 95%CI, 0.74-0.96) significantly reduced MACE
compared with early clopidogrel, but increased bleeding risk. Delayed
prasugrel ranked as the best treatment to reduce MACE (p-score=0.80),
early prasugrel to reduce all-cause mortality, cardiovascular mortality,
stent thrombosis, and stroke, and delayed clopidogrel to reduce bleeding
(p-score = 0.84). The risk of bias was low for all trials.
 Conclusion(s): In patients with NSTE-ACS, delayed prasugrel
initiation was the most effective strategy to reduce MACE. Although early
prasugrel was the best option to reduce most secondary cardiovascular
outcomes, it was associated with the highest bleeding risk. The opposite
was found for delayed clopidogrel. Copyright © 2022 Vicent,
Diaz-Arocutipa, Tarantini, Mojoli, Hernandez and Bueno.

<68>
Accession Number
2019171425
Title
Prevalence and Mortality of Moderate or Severe Mitral Regurgitation Among
Patients Undergoing Percutaneous Coronary Intervention With or Without
Heart Failure: Results From CIN Study With 28,358 Patients.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 796447. Date of Publication: 03 Mar 2022.
Author
Huang H.; Liu J.; Bao K.; Huang X.; Huang D.; Wei H.; Remutula N.; Tuersun
T.; Lai W.; Li Q.; Wang B.; He Y.; Yang H.; Chen S.; Chen J.; Chen K.; Tan
N.; Wang X.; Chen L.; Liu Y.
Institution
(Huang, Liu, Lai, Li, Wang, He, Chen, Chen, Tan, Liu) Department of
Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention,
Guangdong Cardiovascular Institute, Guangdong Provincial People's
Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
(Bao, Chen, Chen) Department of Cardiology, Longyan First Hospital
Affiliated With Fujian Medical University, Longyan, China
(Huang, Huang) People's Hospital of Yangjiang, Yangjiang, China
(Wei, Remutula, Tuersun, Yang) Department of Cardiology, First People's
Hospital of Kashgar, Kashgar, China
(Lai, Chen, Tan, Liu) Guangdong Provincial People's Hospital, School of
Medicine, South China University of Technology, Guangzhou, China
(Wang) The First Affiliated Hospital, Sun Yat-sen University, Guangzhou,
China
(Wang) Department of Nuclear Medicine, The First Affiliated Hospital of
Sun Yat-sen University, Guangzhou, China
Publisher
Frontiers Media S.A.
Abstract
Aim: This study investigated the prevalence and mortality associated with
moderate or severe mitral regurgitation (MR) among patients undergoing
percutaneous coronary intervention (PCI), with or without heart failure
(HF). Method(s): We analyzed patients undergoing PCI without mitral
valve surgery from the Cardiorenal ImprovemeNt (CIN) study
(ClinicalTrials.gov NCT04407936). Patients without echocardiography to
determine MR occurrence or lacking follow-up death data were excluded.
Primary endpoints were 1-year and long-term all-cause mortality, with a
median follow-up time of 5 years (interquartile range: 3.1-7.6).
 Result(s): Of 28,358 patients undergoing PCI treatment [mean age:
62.7 +/- 10.7; women: 6,749 (25.6%)], 3,506 (12.4%) had moderate or severe
MR, and there was a higher rate of moderate or severe MR in HF group than
non-HF group (28.8 vs. 5.6%, respectively). Regardless of HF conditions,
patients with moderate or severe MR were older and had worse cardio-renal
function and significantly increased 1-year mortality [adjusted hazard
ratio (aHR): 1.82, 95% confidence interval (CI): 1.51-2.2], and long-term
mortality [aHR: 1.43, 95% CI: 1.3-1.58]. There was no significant
difference between patients with HF and those with non-HF (P for
interaction > 0.05). Conclusion(s): One-eighth of the patients
undergoing PCI had moderate or severe MR. Furthermore, one-third and
one-seventeenth experienced moderate or severe MR with worse cardiorenal
function in the HF and non-HF groups, and increased consistent mortality
risk. Further studies should explore the efficacy of mitral interventional
procedures for moderate or severe MR after PCI treatment, regardless of
HF. Copyright © 2022 Huang, Liu, Bao, Huang, Huang, Wei,
Remutula, Tuersun, Lai, Li, Wang, He, Yang, Chen, Chen, Chen, Tan, Wang,
Chen and Liu.

<69>
Accession Number
2019171102
Title
Effectiveness of Amiodarone in Preventing the Occurrence of Reperfusion
Ventricular Fibrillation After the Release of Aortic Cross-Clamp in
Open-Heart Surgery Patients: A Meta-Analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 821938. Date of Publication: 04 Feb 2022.
Author
He L.-M.; Zhang A.; Xiong B.
Institution
(He) Department of Cardiology, The First Affiliated Hospital, Chongqing
Medical University, Chongqing, China
(Zhang, Xiong) Department of Critical Care Medicine, The Second Affiliated
Hospital, Chongqing Medical University, Chongqing, China
Publisher
Frontiers Media S.A.
Abstract
Objective: To evaluate the efficiency of amiodarone in preventing the
occurrence of reperfusion ventricular fibrillation (RVF) after aortic
cross-clamp (ACC) release in patients undergoing open-heart surgery.
 Method(s): We searched the Web of Science, Cochrane Library, EMBASE,
and PubMed databases through January 2021 for relevant studies addressing
the efficacy of amiodarone in preventing RVF after ACC release in patients
undergoing cardiac surgery. A complete statistical analysis was performed
using RevMan 5.3. Risk ratios (RRs) and 95% confidence intervals (CIs)
were calculated to express the results of dichotomous outcomes using
random or fixed-effect models. The chi-square test and I2 test
were used to calculate heterogeneity. Result(s): Seven studies (856
enrolled patients; 311 in the amiodarone group, 268 in the lidocaine
group, and 277 in the placebo group) were selected for the meta-analysis.
The incidence of RVF was significantly decreased in the amiodarone group
compared to the placebo group (RR = 0.69, 95%CI: 0.50-0.94, P = 0.02).
However, amiodarone and lidocaine did not confer any significant
difference (RR = 0.98, 95%CI: 0.61-1.59, P = 0.94). The percentage of
patients requiring electric defibrillation counter shocks (DCSs) did not
confer any significant difference between patients administered amiodarone
and lidocaine or placebo (RR = 1.58, 95%CI: 0.29-8.74, P = 0.60; RR =
0.55, 95%CI: 0.27-1.10, P = 0.09; respectively). Conclusion(s):
Amiodarone is more effective than a placebo in preventing RVF after ACC
release in cardiac surgery. However, the amiodarone group required the
same number of electrical DCSs to terminate RVF as the lidocaine or
placebo groups. Copyright © 2022 He, Zhang and Xiong.

<70>
Accession Number
2019171040
Title
Prognostic Outcome of New-Onset Left Bundle Branch Block After
Transcatheter Aortic Valve Replacement in Patients With Aortic Stenosis: A
Systematic Review and Meta-Analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 842929. Date of Publication: 08 Apr 2022.
Author
Wang J.; Liu S.; Han X.; Chen Y.; Chen H.; Wan Z.; Song B.
Institution
(Wang, Han, Chen, Chen) The First Clinical Medical College of Lanzhou
University, Lanzhou University, Lanzhou, China
(Liu, Wan, Song) Department of Cardiovascular Surgery, First Hospital of
Lanzhou University, Lanzhou, China
Publisher
Frontiers Media S.A.
Abstract
Background: Left bundle branch block (LBBB) is a common complication of
the transcatheter aortic valve replacement (TAVR), and its impact on
prognosis is controversial. Method(s): A comprehensive electronic
search was conducted in databases (PubMed, Embase, Cochrane Library, and
The Web of Science), from the date of database establishment till March
2021, to screen for studies on new-onset LBBB after TAVR. We next
performed a meta-analysis to evaluate the effect of new-onset LBBB after
TAVR on patient prognosis, based on the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) statement. Result(s): A
total of 17 studies, including 9205 patients, were eligible for our
analysis. Patients with new-onset LBBB had elevated all-cause mortality
risk verses patients without new-onset LBBB, during all follow ups. The
relevant data are as follows: 30-day (RR:1.71; 95%CI:1.27-2.29; P <
0.001), 1-year (RR:1.31; 95%CI:1.12-1.52; P < 0.001), and 2-year (RR:1.31;
95%CI:1.09-1.56; P = 0.003) follow ups. Likewise, new-onset LBBB patients
also experienced increased cardiovascular mortality, compared to
non-new-onset LBBB patients, but only in the 1-year follow up (RR:1.49;
95%CI:1.23-1.82; P < 0.001). Hospitalization for heart failure was
dramatically elevated in patients with new-onset LBBB verses non-new-onset
LBBB, in all follow ups. The relevant data are as follows: 30-day
(RR:1.56; 95%CI:1.13-2.12; P = 0.007), 1-year (RR:1.35; 95%CI:1.08-1.68; P
= 0.007), and 2-year (RR:1.49; 95%CI:1.21-1.84; P < 0.001). Similarly,
new-onset LBBB patients had higher PPI risk than non-new-onset LBBB
patients, in all follow ups. The relevant data are as follows: 30-day
(RR:3.05; 95%CI:1.49-6.22; P = 0.002), 1-year (RR:2.15; 95%CI:1.52-3.03; P
< 0.001), and 2-year (RR:2.52; 95%CI:1.68-3.78; P < 0.001).
 Conclusion(s): Patients with new-onset LBBB have worse prognosis
after TAVR than those without new-onset LBBB. Recognition of the adverse
effects of post-TAVR new-onset LBBB can lead to the development of new
strategies that enhance clinical outcomes. Systematic Trial Registration:
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=197224,
identifier: 19722. Copyright © 2022 Wang, Liu, Han, Chen, Chen,
Wan and Song.

<71>
Accession Number
2019171036
Title
Patients With Bicuspid Aortic Stenosis Undergoing Transcatheter Aortic
Valve Replacement: A Systematic Review and Meta-Analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 794850. Date of Publication: 16 Mar 2022.
Author
Zhang Y.; Xiong T.-Y.; Li Y.-M.; Yao Y.-J.; He J.-J.; Yang H.-R.; Zhu
Z.-K.; Chen F.; Ou Y.; Wang X.; Liu Q.; Li X.; Li Y.-J.; Liao Y.-B.; Huang
F.-Y.; Zhao Z.-G.; Li Q.; Wei X.; Peng Y.; He S.; Wei J.-F.; Zhou W.-X.;
Zheng M.-X.; Bao Y.; Zhou X.; Tang H.; Meng W.; Feng Y.; Chen M.
Institution
(Zhang, Xiong, Li, Yao, He, Yang, Zhu, Chen, Ou, Wang, Liu, Li, Li, Liao,
Huang, Zhao, Li, Wei, Peng, He, Wei, Zhou, Zheng, Bao, Tang, Feng, Chen)
Department of Cardiology, West China Hospital, Sichuan University,
Chengdu, China
(Zhou) Department of Radiology, West China Hospital, Sichuan University,
Chengdu, China
(Meng) Department of Cardiovascular Surgery, West China Hospital, Sichuan
University, Chengdu, China
Publisher
Frontiers Media S.A.
Abstract
Objective: We sought to conduct a systematic review and meta-analysis of
clinical adverse events in patients undergoing transcatheter aortic valve
replacement (TAVR) with bicuspid aortic valve (BAV) vs. tricuspid aortic
valve (TAV) anatomy and the efficacy of balloon-expandable (BE) vs.
self-expanding (SE) valves in the BAV population. Comparisons
aforementioned will be made stratified into early- and new-generation
devices. Differences of prosthetic geometry on CT between patients with
BAV and TAV were presented. In addition, BAV morphological presentations
in included studies were summarized. Method(s): Observational studies
and a randomized controlled trial of patients with BAV undergoing TAVR
were included according to the Preferred Reporting Items for Systematic
Reviews and Meta-Analyses (PRISMA) guideline. Result(s): A total of
43 studies were included in the final analysis. In patients undergoing
TAVR, type 1 BAV was the most common phenotype and type 2 BAV accounted
for the least. Significant higher risks of conversion to surgical aortic
valve replacement (SAVR), the need of a second valve, a moderate or severe
paravalvular leakage (PVL), device failure, acute kidney injury (AKI), and
stroke were observed in patients with BAV than in patients with TAV during
hospitalization. BAV had a higher risk of new permanent pacemaker
implantation (PPI) both at hospitalization and a 30-day follow-up. Risk of
1-year mortality was significantly lower in patients with BAV than that
with TAV [odds ratio (OR) = 0.85, 95% CI 0.75-0.97, p = 0.01]. BE
transcatheter heart valves (THVs) had higher risks of annular rupture but
a lower risk of the need of a second valve and a new PPI than SE THVs.
Moreover, BE THV was less expanded and more elliptical in BAV than in TAV.
In general, the rates of clinical adverse events were lower in
new-generation THVs than in early-generation THVs in both BAV and TAV.
 Conclusion(s): Despite higher risks of conversion to SAVR, the need
of a second valve, moderate or severe PVL, device failure, AKI, stroke,
and new PPI, TAVR seems to be a viable option for selected patients with
severe bicuspid aortic stenosis (AS), which demonstrated a potential
benefit of 1-year survival, especially among lower surgical risk
population using new-generation devices. Larger randomized studies are
needed to guide patient selection and verified the durable performance of
THVs in the BAV population. Copyright © 2022 Zhang, Xiong, Li,
Yao, He, Yang, Zhu, Chen, Ou, Wang, Liu, Li, Li, Liao, Huang, Zhao, Li,
Wei, Peng, He, Wei, Zhou, Zheng, Bao, Zhou, Tang, Meng, Feng and Chen.

<72>
Accession Number
2019171029
Title
Meta-Analysis and Systematic Review of Coagulation Disbalances in
COVID-19: 41 Studies and 17,601 Patients.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 794092. Date of Publication: 11 Mar 2022.
Author
Len P.; Iskakova G.; Sautbayeva Z.; Kussanova A.; Tauekelova A.T.;
Sugralimova M.M.; Dautbaeva A.S.; Abdieva M.M.; Ponomarev E.D.; Tikhonov
A.; Bekbossynova M.S.; Barteneva N.S.
Institution
(Len, Iskakova, Sautbayeva, Kussanova, Tikhonov, Barteneva) School of
Sciences and Humanities, Nazarbayev University, Nur-Sultan, Kazakhstan
(Kussanova) Core Facilities, Nazarbayev University, Nur-Sultan, Kazakhstan
(Tauekelova, Sugralimova, Dautbaeva, Abdieva, Bekbossynova) National
Research Center for Cardiac Surgery, Nur-Sultan, Kazakhstan
(Ponomarev) School of Biomedical Sciences, The Chinese University of Hong
Kong, Hong Kong
(Barteneva) Harvard Medical School, Brigham and Women's Hospital, Boston,
MA, United States
Publisher
Frontiers Media S.A.
Abstract
Introduction: Coagulation parameters are important determinants for
COVID-19 infection. We conducted meta-analysis to assess the association
between early hemostatic parameters and infection severity.
 Method(s): Electronic search was made for papers that addressed
clinical characteristics of COVID-19 patients and disease severity.
Results were filtered using exclusion and inclusion criteria and then
pooled into a meta-analysis to estimate the standardized mean difference
(SMD) with 95% confidence interval (CI) for D-dimers, fibrinogen,
prothrombin time, platelet count (PLT), activated partial thromboplastin
time. To explore the heterogeneity and robustness of our fundings,
sensitivity and subgroup analyses were conducted. Publication bias was
assessed with contour-enhanced funnel plots and Egger's test by linear
regression. Coagulation parameters data from retrospective cohort study of
451 patients with COVID-19 at National Research Center for Cardiac Surgery
were included in meta-analysis of published studies. Result(s):
Overall, 41 original studies (17,601 patients) on SARS-CoV-2 were
included. For the two groups of patients, stratified by severity, we
identified that D-dimers, fibrinogen, activated partial thromboplastin
time, and prothrombin time were significantly higher in the severe group
[SMD 0.6985 with 95%CI (0.5155; 0.8815); SMD 0.661 with 95%CI (0.3387;
0.9833); SMD 0.2683 with 95%CI (0.1357; 0.4009); SMD 0.284 with 95%CI
(0.1472; 0.4208)]. In contrast, PLT was significantly lower in patients
with more severe cases of COVID-19 [SMD -0.1684 with 95%CI (-0.2826;
-0.0542)]. Neither the analysis by the leave-one-out method nor the
influence diagnostic have identified studies that solely cause significant
change in the effect size estimates. Subgroup analysis showed no
significant difference between articles originated from different
countries but revealed that severity assessment criteria might have
influence over estimated effect sizes for platelets and D-dimers.
Contour-enhanced funnel plots and the Egger's test for D-dimers and
fibrinogen revealed significant asymmetry that might be a sign of
publication bias. Conclusion(s): The hemostatic laboratory
parameters, with exception of platelets, are significantly elevated in
patients with severe COVID-19. The two variables with strongest
association to disease severity were D-dimers and fibrinogen levels.
Future research should aim outside conventional coagulation tests and
include analysis of clotting formation and platelet/platelet progenitors
characteristics. Copyright © 2022 Len, Iskakova, Sautbayeva,
Kussanova, Tauekelova, Sugralimova, Dautbaeva, Abdieva, Ponomarev,
Tikhonov, Bekbossynova and Barteneva.

<73>
Accession Number
2019170997
Title
Appropriate Timing of Coronary Artery Bypass Graft Surgery for Acute
Myocardial Infarction Patients: A Meta-Analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 794925. Date of Publication: 28 Mar 2022.
Author
Lang Q.; Qin C.; Meng W.
Institution
(Lang, Qin, Meng) Department of Cardiovascular Surgery, West China
Hospital, Sichuan University, Chengdu, China
Publisher
Frontiers Media S.A.
Abstract
Background: Currently, percutaneous coronary intervention (PCI) and
coronary artery bypass grafting (CABG) are commonly used in the treatment
of coronary atherosclerotic heart disease. But the optimal timing for CABG
after acute myocardial infarction (AMI) is still controversial. The
purpose of this article was to evaluate the optimal timing for CABG in
AMI. Method(s): We searched the PubMed, Embase, and Cochrane library
databases for documents that met the requirements. The primary outcome was
in-hospital mortality. The secondary outcomes were perioperative
myocardial infarction (MI) incidence and cerebrovascular accident
incidence. Result(s): The search strategy produced 1,742 studies, of
which 19 studies (including data from 113,984 participants) were included
in our analysis. In total, 14 studies compared CABG within 24 h with CABG
late 24 h after AMI and five studies compared CABG within 48 h with CABG
late 48 h after AMI. The OR of in-hospital mortality between early 24 h
CABG and late 24 h CABG group was 2.65 (95%CI: 1.96 to 3.58; P < 0.00001).
In the undefined ST segment elevation myocardial infarction (STEMI)/non-ST
segment elevation myocardial infarction (NSTEMI) subgroup, the mortality
in the early 24 h CABG group (OR: 3.88; 95%CI: 2.69 to 5.60; P < 0.00001)
was significantly higher than the late 24 h CABG group. Similarly, in the
STEMI subgroup, the mortality in the early 24 h CABG group (OR: 2.62; 95%
CI: 1.58 to 4.35; P = 0.0002) was significantly higher than that in the
late 24 h CABG group. However, the mortality of the early 24 h CABG group
(OR: 1.24; 95%CI: 0.83 to 1.85; P = 0.29) was not significantly different
from that of the late 24 h CABG group in the NSTEMI group. The OR of
in-hospital mortality between early 48 h CABG and late 48 h CABG group was
1.91 (95%CI: 1.11 to 3.29; P = 0.02). In the undefined STEMI/NSTEMI
subgroup, the mortality in the early 48 h CABG group (OR: 2.84; 95%CI:
1.31 to 6.14; P < 0.00001) was higher than the late 48 h CABG group. The
OR of perioperative MI and cerebrovascular accident between early CABG and
late CABG group were 1.38 (95%CI: 0.41 to 4.72; P = 0.60) and 1.31 (95%CI:
0.72 to 2.39; P = 0.38), respectively. Conclusion(s): The risk of
early CABG could be higher in STEMI patients, and CABG should be delayed
until 24 h later as far as possible. However, the timing of CABG does not
affect mortality in NSTEMI patients. There was no statistical difference
in perioperative MI and cerebrovascular accidents between early and late
CABG. Copyright © 2022 Lang, Qin and Meng.

<74>
Accession Number
2019170976
Title
Using Text Content From Coronary Catheterization Reports to Predict 5-Year
Mortality Among Patients Undergoing Coronary Angiography: A Deep Learning
Approach.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 800864. Date of Publication: 28 Feb 2022.
Author
Li Y.-H.; Lee I.-T.; Chen Y.-W.; Lin Y.-K.; Liu Y.-H.; Lai F.-P.
Institution
(Li, Lai) Department of Computer Science Information Engineering, National
Taiwan University, Taipei, Taiwan (Republic of China)
(Li, Lee) Division of Endocrinology and Metabolism, Department of Internal
Medicine, Taichung Veterans General Hospital, Taichung, Taiwan (Republic
of China)
(Lee) School of Medicine, National Yang-Ming University, Taipei, Taiwan
(Republic of China)
(Lee) School of Medicine, Chung Shan Medical University, Taichung, Taiwan
(Republic of China)
(Chen) Cardiovascular Center, Taichung Veterans General Hospital,
Taichung, Taiwan (Republic of China)
(Lin, Liu) Department of Computer Science, Columbia University, New York,
NY, United States
(Lai) Graduate Institute of Biomedical Electronics and Bioinformatics,
National Taiwan University, Taipei, Taiwan (Republic of China)
(Lai) Department of Electrical Engineering, National Taiwan University,
Taipei, Taiwan (Republic of China)
Publisher
Frontiers Media S.A.
Abstract
Background: Current predictive models for patients undergoing coronary
angiography have complex parameters which limit their clinical
application. Coronary catheterization reports that describe coronary
lesions and the corresponding interventions provide information of the
severity of the coronary artery disease and the completeness of the
revascularization. This information is relevant for predicting patient
prognosis. However, no predictive model has been constructed using the
text content from coronary catheterization reports before.
 Objective(s): To develop a deep learning model using text content
from coronary catheterization reports to predict 5-year all-cause
mortality and 5-year cardiovascular mortality for patients undergoing
coronary angiography and to compare the performance of the model to the
established clinical scores. Method(s): This retrospective cohort
study was conducted between January 1, 2006, and December 31, 2015.
Patients admitted for coronary angiography were enrolled and followed up
until August 2019. The main outcomes were 5-year all-cause mortality and
5-year cardiovascular mortality. In total, 11,576 coronary catheterization
reports were collected. BioBERT (bidirectional encoder representations
from transformers for biomedical text mining), which is a BERT-based model
in the biomedical domain, was utilized to construct the model. The area
under the receiver operating characteristic curve (AUC) was used to assess
model performance. We also compared our results to the residual SYNTAX
(SYNergy between PCI with TAXUS and Cardiac Surgery) score.
 Result(s): The dataset was divided into the training (60%),
validation (20%), and test (20%) sets. The mean age of the patients in
each dataset was 65.5 +/- 12.1, 65.4 +/- 11.2, and 65.6 +/- 11.2 years,
respectively. A total of 1,411 (12.2%) patients died, and 664 (5.8%)
patients died of cardiovascular causes within 5 years after coronary
angiography. The best of our models had an AUC of 0.822 (95% CI,
0.790-0.855) for 5-year all-cause mortality, and an AUC of 0.858 (95% CI,
0.816-0.900) for 5-year cardiovascular mortality. We randomly selected 300
patients who underwent percutaneous coronary intervention (PCI), and our
model outperformed the residual SYNTAX score in predicting 5-year
all-cause mortality (AUC, 0.867 [95% CI, 0.813-0.921] vs. 0.590 [95% CI,
0.503-0.684]) and 5-year cardiovascular mortality (AUC, 0.880 [95% CI,
0.873-0.925] vs. 0.649 [95% CI, 0.535-0.764]), respectively, after PCI
among these patients. Conclusion(s): We developed a predictive model
using text content from coronary catheterization reports to predict the
5-year mortality in patients undergoing coronary angiography. Since
interventional cardiologists routinely write reports after procedures, our
model can be easily implemented into the clinical setting. Copyright
© 2022 Li, Lee, Chen, Lin, Liu and Lai.

<75>
Accession Number
2019170847
Title
Perioperative Pain Management With Bilateral Pecto-intercostal Fascial
Block in Pediatric Patients Undergoing Open Cardiac Surgery.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 825945. Date of Publication: 22 Jun 2022.
Author
Zhang Y.; Min J.; Chen S.
Institution
(Zhang, Min, Chen) Department of Anesthesiology, First Affiliated Hospital
of Nanchang University, Nanchang, China
Publisher
Frontiers Media S.A.
Abstract
Purposes: Pediatric open cardiac surgical patients usually suffer from
acute pain after operation. The current work aimed to explore the impact
of bilateral PIFB in children suffering from open cardiac surgery.
 Method(s): This work randomized altogether 110 child patients as
bilateral PIFB (PIF) and non-nerve block (SAL) groups. This work adopted
post-operative pain at exercise and rest statuses as the primary endpoint,
whereas time-to-drain removal/extubation/initial defecation,
intraoperative/post-operative fentanyl use, and length of ICU and hospital
stay as the secondary endpoints. Result(s): MOPS were significantly
higher at 24-h post-operatively at coughing and rest statuses in SAL group
compared with PIF group. Meanwhile, PIF group exhibited markedly lower
intraoperative/post-operative fentanyl use amounts, as well as markedly
reduced time-to-extubation/initial flatus, and length of ICU/hospital
stay. Conclusion(s): Bilateral PIFB in pediatric open cardiac
surgical patients provide effective analgesia and lower the length of
hospital stay. Copyright © 2022 Zhang, Min and Chen.

<76>
Accession Number
2019170814
Title
A Partially Randomized Patient Preference Trial to Assess the Quality of
Life and Patency Rate After Minimally Invasive Cardiac Surgery-Coronary
Artery Bypass Grafting: Design and Rationale of the MICS-CABG PRPP Trial.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 804217. Date of Publication: 25 Apr 2022.
Author
Gong Y.; Wang X.; Li N.; Fu Y.; Zheng H.; Zheng Y.; Zhan S.; Ling Y.
Institution
(Gong, Fu, Zheng, Zheng, Ling) Department of Cardiac Surgery, Peking
University Third Hospital, Beijing, China
(Wang, Li, Zhan) Research Center of Clinical Epidemiology, Peking
University Third Hospital, Beijing, China
(Zhan) Department of Epidemiology and Biostatistics, School of Public
Health, Peking University, Beijing, China
Publisher
Frontiers Media S.A.
Abstract
Background: Minimally invasive cardiac surgery-coronary artery bypass
grafting (MICS-CABG) has emerged as a safe alternative to standard cardiac
surgery. However, treatment preferences can decrease the generalizability
of RCT results to the clinical population (i.e., reduce external validity)
and influence adherence to the treatment protocol and study outcomes
(i.e., reduce internal validity). However, this has not yet been properly
investigated in randomized trials with consideration of treatment
preferences. Study Design: In this study, patients with a preference
will be allocated to treatment strategies accordingly, whereas only those
patients without a distinct preference will be randomized. The randomized
trial is a 248-patient controlled, randomized, investigator-blinded trial.
It is designed to compare whether treatment with MICS-CABG is beneficial
in comparison to CABG. This study is aimed to establish the superiority
hypothesis for the physical component summary (PCS) accompanied by the
non-inferiority hypothesis for overall graft patency. Patients with no
treatment preference will be randomized in a 1:1 fashion to one of the two
treatment arms. The primary efficacy endpoints are the PCS score at 30
days after surgery and the overall patency rate of the grafts within 14
days after surgery. Secondary outcome measures include the PCS score and
patency rate at different time points. Safety endpoints include major
adverse cardiac and cerebrovascular events, complications, bleeding, wound
infection, death, etc. Conclusion(s): This trial will address
essential questions of the efficacy and safety of MICS-CABG. The study
will also address the impact of patients' preferences on external validity
and internal validity. Copyright © 2022 Gong, Wang, Li, Fu,
Zheng, Zheng, Zhan and Ling.

<77>
Accession Number
2019169738
Title
Hemodynamic Performance of Sutureless vs. Conventional Bioprostheses for
Aortic Valve Replacement: The 1-Year Core-Lab Results of the Randomized
PERSIST-AVR Trial.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 844876. Date of Publication: 18 Feb 2022.
Author
Fischlein T.; Caporali E.; Asch F.M.; Vogt F.; Pollari F.; Folliguet T.;
Kappert U.; Meuris B.; Shrestha M.L.; Roselli E.E.; Bonaros N.; Fabre O.;
Corbi P.; Troise G.; Andreas M.; Pinaud F.; Pfeiffer S.; Kueri S.; Tan E.;
Voisine P.; Girdauskas E.; Rega F.; Garcia-Puente J.; De Kerchove L.;
Lorusso R.
Institution
(Fischlein, Vogt, Pollari, Pfeiffer) Cardiac Surgery, Klinikum Nurnberg,
Paracelsus Medical University, Nuremberg, Germany
(Caporali) Department of Cardiology, Istituto Cardiocentro Ticino, Lugano,
Switzerland
(Caporali) Department of Cardiac Surgery, Istituto Cardiocentro Ticino,
Lugano, Switzerland
(Caporali, Lorusso) Department of Cardio-Thoracic Surgery, Heart and
Vascular Centre, Maastricht University Medical Centre (MUMC+), Maastricht,
Netherlands
(Asch) MedStar Health Research Institute, Washington Hospital Center,
Washington, DC, United States
(Folliguet) Cardiac Surgery Unit, Hopital Henri Mondor, Universite Paris
12, Creteil, France
(Kappert) Herzzentrum Dresden GmbH Universitatsklinik, Dresden, Germany
(Meuris, Rega) Cardiac Surgery Unit, UZ Gasthuisberg Leuven, Leuven,
Belgium
(Shrestha) Cardiothoracic and Vascular Surgery, Hannover Medical School,
Hannover, Germany
(Roselli) Heart, Vascular and Thoracic Institute, Cleveland Clinic,
Cleveland, OH, United States
(Bonaros) Department of Cardiac Surgery, Medical University of Innsbruck,
Innsbruck, Austria
(Fabre) Lens Hospital and Bois Bernard Private Hospital, Lens, France
(Corbi) Poitiers University Hospital, Poitiers, France
(Troise) Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
(Andreas) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Pinaud) Department of Cardiac Surgery, University Hospital Angers,
Angers, France
(Kueri) University Heart Center Freiburg, Bad Krozingen, Germany
(Tan) Catharina Ziekenhuis, Eindhoven, Netherlands
(Voisine) Division of Cardiac Surgery, Quebec Heart and Lung Institute,
Quebec, QC, Canada
(Girdauskas) University Heart Center Hamburg, Universitatsklinikum Hamburg
Eppendorf (UKE), Hamburg, Germany
(Garcia-Puente) University General Hospital Virgen de la Arrixaca, Murcia,
Spain
(De Kerchove) Cliniques Universitaires Saint-Luc (UCL), Bruxelles, Belgium
(Lorusso) Cardiac Surgery, Cardiovascular Research Institute Maastricht
(CARIM), Maastricht, Netherlands
Publisher
Frontiers Media S.A.
Abstract
Objective: Sutureless aortic valves are an effective option for aortic
valve replacement (AVR) showing non-inferiority to standard stented aortic
valves for major cardiovascular and cerebral events at 1-year. We report
the 1-year hemodynamic performance of the sutureless prostheses compared
with standard aortic valves, assessed by a dedicated echocardiographic
core lab. Method(s): Perceval Sutureless Implant vs. Standard Aortic
Valve Replacement (PERSIST-AVR) is a prospective, randomized, adaptive,
open-label trial. Patients undergoing AVR, as an isolated or combined
procedure, were randomized to receive a sutureless [sutureless aortic
valve replacement (Su-AVR)] (n = 407) or a stented sutured [surgical AVR
(SAVR)] (n = 412) bioprostheses. Site-reported echocardiographic
examinations were collected at 1 year. In addition, a subgroup of the
trial population (Su-AVR n = 71, SAVR = 82) had a complete
echocardiographic examination independently assessed by a Core Lab
(MedStar Health Research Institute, Washington D.C., USA) for the
evaluation of the hemodynamic performance. Result(s): The
site-reported hemodynamic data of stented valves and sutureless valves are
stable and comparable during follow-up, showing stable reduction of mean
and peak pressure gradients through one-year follow-up (mean: 12.1 +/- 6.2
vs. 11.5 +/- 4.6 mmHg; peak: 21.3 +/- 11.4 vs. 22.0 +/- 8.9 mmHg). These
results at 1-year are confirmed in the subgroup by the core-lab assessed
echocardiogram with an average mean and peak gradient of 12.8 +/- 5.7 and
21.5 +/- 9.1 mmHg for Su-AVR, and 13.4 +/- 7.7 and 23.0 +/- 13.0 mmHg for
SAVR. The valve effective orifice area was 1.3 +/- 0.4 and 1.4 +/- 0.4
cm2 at 1-year for Su-AVR and SAVR. These improvements are
observed across all valve sizes. At 1-year evaluation, 91.3% (n = 42) of
patients in Su-AVR and 82.3% in SAVR (n = 51) groups were free from
paravalvular leak (PVL). The rate of mild PVL was 4.3% (n = 2) in Su-AVR
and 12.9% (n = 8) in the SAVR group. A similar trend is observed for
central leak occurrence in both core-lab assessed echo groups.
 Conclusion(s): At 1-year of follow-up of a PERSIST-AVR patient
sub-group, the study showed comparable hemodynamic performance in the
sutureless and the stented-valve groups, confirmed by independent echo
core lab. Perceval sutureless prosthesis provides optimal sealing at the
annulus with equivalent PVL and central regurgitation extent rates
compared to sutured valves. Sutureless valves are therefore a reliable and
essential technology within the modern therapeutic possibilities to treat
aortic valve disease. Copyright © 2022 Fischlein, Caporali, Asch,
Vogt, Pollari, Folliguet, Kappert, Meuris, Shrestha, Roselli, Bonaros,
Fabre, Corbi, Troise, Andreas, Pinaud, Pfeiffer, Kueri, Tan, Voisine,
Girdauskas, Rega, Garcia-Puente, De Kerchove, Lorusso and on behalf of the
PERSIST-AVR Investigators.

<78>
Accession Number
2019169451
Title
Unravelling the Difference Between Men and Women in Post-CABG Survival.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 768972. Date of Publication: 13 Apr 2022.
Author
Schmidt A.F.; Haitjema S.; Sartipy U.; Holzmann M.J.; Malenka D.J.; Ross
C.S.; van Gilst W.; Rouleau J.L.; Meeder A.M.; Baker R.A.; Shiomi H.;
Kimura T.; Tran L.; Smith J.A.; Reid C.M.; Asselbergs F.W.; den Ruijter
H.M.
Institution
(Schmidt, Asselbergs) Department of Cardiology, Division Heart and Lungs,
University Medical Center Utrecht, Utrecht, Netherlands
(Schmidt, Asselbergs) Institute of Cardiovascular Science, Faculty of
Population Health, University College London, London, United Kingdom
(Haitjema) Department of Clinical Chemistry and Haematology, University
Medical Center Utrecht, Utrecht, Netherlands
(Sartipy) Department of Molecular Medicine and Surgery, Karolinska
Institutet, Stockholm, Sweden
(Sartipy) Department of Cardiothoracic Surgery, Karolinska University
Hospital, Stockholm, Sweden
(Holzmann) Department of Medicine, Functional Area of Emergency Medicine,
Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
(Malenka) The Geisel School of Medicine at Dartmouth, The Dartmouth
Institute for Health Policy and Clinical Practice, Lebanon, NH, United
States
(Ross) Department of Medicine, Heart and Vascular Center,
Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
(van Gilst) Department of Cardiology, University Medical Center Groningen,
University of Groningen, Groningen, Netherlands
(Rouleau) Montreal Heart Institute, University of Montreal, Montreal, QC,
Canada
(Meeder) Department of Anesthesiology, University Medical Center Utrecht,
Utrecht, Netherlands
(Baker) Quality and Outcomes, Cardiothoracic Surgical Unit, Flinders
Medical Centre, Adelaide, SA, Australia
(Baker) Perfusion Service, Cardiothoracic Surgical Unit, Flinders Medical
Centre, Adelaide, SA, Australia
(Baker) Department of Surgery, College of Medicine and Public Health,
Flinders University, Adelaide, SA, Australia
(Shiomi, Kimura) Department of Cardiovascular Medicine, Kyoto University
Graduate School of Medicine, Kyoto, Japan
(Tran, Reid) School of Public Health and Preventive Medicine, Monash
University, Melbourne, VIC, Australia
(Smith) Department of Surgery, School of Clinical Sciences at Monash
Health, Monash University, Clayton, VIC, Australia
(Smith) Department of Cardiothoracic Surgery, Monash Health, Clayton, VIC,
Australia
(Reid) School of Public Health, Curtin University, Perth, WA, Australia
(Asselbergs) Health Data Research UK, Institute of Health Informatics,
University College London, London, United Kingdom
(den Ruijter) Laboratory of Experimental Cardiology, University Medical
Center Utrecht, Utrecht, Netherlands
Publisher
Frontiers Media S.A.
Abstract
Objectives: Women have a worse prognosis after coronary artery bypass
grafting (CABG) surgery compared to men. We sought to quantify to what
extent this difference in post-CABG survival could be attributed to sex
itself, or whether this was mediated by difference between men and women
at the time of intervention. Additionally, we explored to what extent
these effects were homogenous across patient subgroups. Method(s):
Time to all-cause mortality was available for 102,263 CABG patients,
including 20,988 (21%) women, sourced through an individual participant
data meta-analysis of five cohort studies. Difference between men and
women in survival duration was assessed using Kaplan-Meier estimates, and
Cox's proportional hazards model. Result(s): During a median
follow-up of 5 years, 13,598 (13%) patients died, with women more likely
to die than men: female HR 1.20 (95%CI 1.16; 1.25). We found that
differences in patient characteristics at the time of CABG procedure
mediated this sex effect, and accounting for these resulted in a neutral
female HR 0.98 (95%CI 0.94; 1.02). Next we performed a priori defined
subgroup analyses of the five most prominent mediators: age, creatinine,
peripheral vascular disease, type 2 diabetes, and heart failure. We found
that women without peripheral vascular disease (PVD) or women aged 70+,
survived longer than men (interaction p-values 0.04 and 6 x
10-5, respectively), with an effect reversal in younger women.
 Conclusion(s): Sex differences in post-CABG survival were readily
explained by difference in patient characteristics and comorbidities.
Pre-planned analyses revealed patient subgroups (aged 70+, or without PVD)
of women that survived longer than men, and a subgroup of younger women
with comparatively poorer survival. Copyright © 2022 Schmidt,
Haitjema, Sartipy, Holzmann, Malenka, Ross, van Gilst, Rouleau, Meeder,
Baker, Shiomi, Kimura, Tran, Smith, Reid, Asselbergs and den Ruijter.

<79>
Accession Number
639092291
Title
Efficacy of prehabilitation prior to cardiac surgery: a systematic review
and meta-analysis.
Source
American journal of physical medicine & rehabilitation. (no pagination),
2022. Date of Publication: 23 Sep 2022.
Author
Steinmetz C.; Bjarnason-Wehrens B.; Walther T.; Schaffland T.F.; Walther
C.
Institution
(Steinmetz) Institute of Sports Science, Department Training Science,
Bundeswehr University Munich, Germany
(Bjarnason-Wehrens) Institute of Cardiology and Sports Medicine,
Department Preventive and Rehabilitative Sport and Exercise Medicine,
German Sport University Cologne, Germany
(Walther) Department of Cardiothoracic Surgery, University of Frankfurt,
Frankfurt am Main, Germany
(Schaffland) Methods Center Tubingen, University of Tubingen, Germany
(Walther) Cardiovascular Centrum Bethanien, Department of Cardiology,
Frankfurt am Main, Germany
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Patients awaiting cardiac surgery seem to benefit from
exercise-based-prehabilitation (EBPrehab) but the impact on different
perioperative outcomes compared to standard care is still unclear. DESIGN:
Eligible non-/randomized controlled studies investigating the impact of
EBPrehab in adults scheduled for elective cardiac surgery were searched on
16th december 2020 from electronic databases, including MEDLINE, CENTRAL
and CINAHL. The data were pooled and a meta-analysis was conducted.
 RESULT(S): Out of 1.490 abstracts six studies (n = 665) were included
into the review and meta-analysis. At post-intervention-interval and at
post-surgery-interval, 6-minute-walking-distance (6MWD) improved
significantly in EBPrehab-group compared to controls (mean difference (MD)
= 75.4 m, 95% CI, 13.7-137.1 m; p = 0.02 and 30.5 m, 95% CI, 8.5-52.6 m; p
= 0.007, respectively). Length of hospital stay (LOS) was significantly
shorter in EBPrehab-group (MD = -1.00 day, 95% CI, -1.78 to -0.23; p =
0.01). Participation in EBPrehab revealed a significant decrease in the
risk of postoperative atrial fibrillation (AF) in patients <=65 years
(risk ratio = 0.34, 95% CI, 0.14-0.83; p = 0.02). CONCLUSION(S): The
participation in EBPrehab significantly improves post-intervention and
post-surgery 6MWD, LOS and decreases the risk of postoperative AF in
patients <=65 years compared to controls. Copyright © 2022 The
Author(s). Published by Wolters Kluwer Health, Inc.

<80>
[Use Link to view the full text]
Accession Number
2019652672
Title
Heart Disease and Stroke Statistics-2022 Update: A Report from the
American Heart Association.
Source
Circulation. 145(8) (pp E153-E639), 2022. Date of Publication: 22 Feb
2022.
Author
Tsao C.W.; Aday A.W.; Almarzooq Z.I.; Alonso A.; Beaton A.Z.; Bittencourt
M.S.; Boehme A.K.; Buxton A.E.; Carson A.P.; Commodore-Mensah Y.; Elkind
M.S.V.; Evenson K.R.; Eze-Nliam C.; Ferguson J.F.; Generoso G.; Ho J.E.;
Kalani R.; Khan S.S.; Kissela B.M.; Knutson K.L.; Levine D.A.; Lewis T.T.;
Liu J.; Loop M.S.; Ma J.; Mussolino M.E.; Navaneethan S.D.; Perak A.M.;
Poudel R.; Rezk-Hanna M.; Roth G.A.; Schroeder E.B.; Shah S.H.; Thacker
E.L.; Vanwagner L.B.; Virani S.S.; Voecks J.H.; Wang N.-Y.; Yaffe K.;
Martin S.S.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The American Heart Association, in conjunction with the
National Institutes of Health, annually reports the most up-to-date
statistics related to heart disease, stroke, and cardiovascular risk
factors, including core health behaviors (smoking, physical activity,
diet, and weight) and health factors (cholesterol, blood pressure, and
glucose control) that contribute to cardiovascular health. The Statistical
Update presents the latest data on a range of major clinical heart and
circulatory disease conditions (including stroke, congenital heart
disease, rhythm disorders, subclinical atherosclerosis, coronary heart
disease, heart failure, valvular disease, venous disease, and peripheral
artery disease) and the associated outcomes (including quality of care,
procedures, and economic costs). Method(s): The American Heart
Association, through its Statistics Committee, continuously monitors and
evaluates sources of data on heart disease and stroke in the United States
to provide the most current information available in the annual
Statistical Update. The 2022 Statistical Update is the product of a full
year's worth of effort by dedicated volunteer clinicians and scientists,
committed government professionals, and American Heart Association staff
members. This year's edition includes data on the monitoring and benefits
of cardiovascular health in the population and an enhanced focus on social
determinants of health, adverse pregnancy outcomes, vascular contributions
to brain health, and the global burden of cardiovascular disease and
healthy life expectancy. Result(s): Each of the chapters in the
Statistical Update focuses on a different topic related to heart disease
and stroke statistics. Conclusion(s): The Statistical Update
represents a critical resource for the lay public, policymakers, media
professionals, clinicians, health care administrators, researchers, health
advocates, and others seeking the best available data on these factors and
conditions. Copyright © 2022 Lippincott Williams and Wilkins. All
rights reserved.

<81>
Accession Number
2019013771
Title
Association between sarcoidosis and cardiovascular Outcomes: A systematic
review and Meta-analysis.
Source
IJC Heart and Vasculature. 41 (no pagination), 2022. Article Number:
101073. Date of Publication: August 2022.
Author
Jaiswal V.; Peng Ang S.; Sarfraz Z.; Butey S.; Vinod Khandait H.; Song D.;
Ee Chia J.; Maroo D.; Hanif M.; Ghanim M.; Chand R.; Biswas M.
Institution
(Jaiswal) AMA School Of Medicine, Makati, Philippines
(Peng Ang) Department of Internal Medicine, Rutgers Health/Community
Medical Center, NJ, United States
(Sarfraz) Fatima Jinnah Medical University, Lahore, Pakistan
(Butey) Indira Gandhi Government Medical College, Nagpur, India
(Vinod Khandait, Chand) Department of Internal Medicine, Trinitas Regional
Medical Center, Elizabeth, NJ, United States
(Song) Department of Internal Medicine, Icahn School of Medicine at Mount
Sinai Hospital, NY, United States
(Ee Chia) School of Medicine, International Medical University, Kuala
Lumpur, Malaysia
(Maroo) Maulana Azad Medical College, New Delhi, India
(Hanif) Department of Internal Medicine, Suny Upstate Medical University,
NY, United States
(Ghanim) Henry Ford Healthcare System, Detroit, MI, United States
(Biswas) General Cardiology and Advanced Heart Failure, Wellspan
Cardiology, Lancaster, PA, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Sarcoidosis is a chronic inflammatory disorder of unknown
etiology associated with high morbidity and mortality. Its association
with cardiovascular outcomes is under-documented. Aim(s): The aim of
this study was to assess the adverse cardiovascular outcomes in patients
with sarcoidosis compared with that of non-sarcoidosis. Methodology:
Online databases including PubMed, Embase and Scopus were queried from
inception until March 2022. The outcomes assessed included all-cause
mortality (ACM) and incidence of ventricular tachycardia (VT), heart
failure (HF) and atrial arrhythmias (AA). Result(s): A total of 6
studies with 22,539,096 participants (42,763 Sarcoidosis, 22,496,354
Non-Sarcoidosis) were included in this analysis. The pooled prevalence of
sarcoidosis was 13.1% (95% CI 1% to 70%). The overall mean age was 47
years. The most common comorbidities were hypertension (12.7% vs 12.5%),
and diabetes mellitus (5.5% vs 4%) respectively. The pooled analysis of
primary endpoints showed that all-cause mortality (RR, 2.08; 95% CI: 1.17
to 3.08; p = 0.01) was significantly increased in sarcoidosis patients.
The pooled analysis of secondary endpoints showed that the incidence of VT
(RR, 15.3; 95% CI: 5.39 to 43.42); p < 0.001), HF (RR, 4.96; 95% CI: 2.02
to 12.14; p < 0.001) and AA (RR, 2.55; 95% CI: 1.47 to 4.44); p = 0.01)
were significantly higher with sarcoidosis respectively compared to
non-sarcoidosis. Conclusion(s): Incidence of VT, HF and AA was
significantly higher in patients with CS. Clinicians should be aware of
these adverse cardiovascular events associated with
sarcoidosis. Copyright © 2022 The Authors

<82>
Accession Number
2017940646
Title
The role of aromatherapy with lavender in reducing the anxiety of patients
with cardiovascular diseases: A systematic review of clinical trials.
Source
Journal of HerbMed Pharmacology. 11(2) (pp 182-187), 2022. Date of
Publication: 2022.
Author
Amin A.; Gavanrudi M.R.; Karami K.; Raziani Y.; Baharvand P.
Institution
(Amin) Cardiovascular Research Center, Lorestan University of Medical
Sciences, Khorramabad, Iran, Islamic Republic of
(Gavanrudi) Faculty of Pharmacy, Ayatollah Amoli Branch, Islamic Azad
University, Amol, Iran, Islamic Republic of
(Karami, Baharvand) Social Determinants of Health Research Center,
Lorestan University of Medical Sciences, Khorramabad, Iran, Islamic
Republic of
(Raziani) Department of Nursing, Komar University of Science and
Technology, Kurdistan Region, Sulaymaniyah, Iraq
Publisher
Nickan Research Institute
Abstract
Most studies have shown the positive effects of lavender inhalation in
decreasing anxiety in patients with cardiovascular diseases. We aimed to
systematically review the role of aromatherapy with lavender in these
patients. By PRISMA standards, we explored the studies on the role of
aromatherapy with lavender in reducing the anxiety of patients with
cardiovascular diseases in English databases through the words and terms
"aromatherapy", "lavender", "lavandula", "anxiety", "cardiovascular
diseases". Out of 16 647 papers, 12 papers up to January 2022 encountered
the inclusion criteria for involving in this systematic review. The
majority of studies (7 studies, 70%) were used Spielberger Standard
Questionnaire as a measurement scale for their studies. Lavender
aromatherapy was mostly used for myocardial infarction (3 studies, 30%)
and coronary artery bypass graft (CABG) surgery (3 studies, 30%) patients.
We concluded that aromatherapy with lavender essential oil significantly
ameliorated the anxiety signs in some cardiovascular diseases, e.g., CABG
surgery, myocardial infarction, and cardiac ischemia; however, more
studies are required in this field to obtain more specific
evidence. Copyright © 2022 Nickan Research Institute. All rights
reserved.

<83>
Accession Number
626247656
Title
Zingiber officinale roscoe reduces chest pain on patients undergoing
coronary angioplasty: A clinical trial.
Source
Journal of HerbMed Pharmacology. 8(1) (pp 47-50), 2019. Date of
Publication: 2019.
Author
Hasanvand A.; Ebrahimi Y.; Mohamadi A.; Nazari A.
Institution
(Hasanvand) Lorestan University of Medical Sciences, Khorramabad, Iran,
Islamic Republic of
(Ebrahimi) Department of Cardiology, Lorestan University of Medical
Sciences, Khorramabad, Iran, Islamic Republic of
(Mohamadi) Razi Herbal Medicines Research Center, Lorestan University of
Medical Sciences, Khorramabad, Iran, Islamic Republic of
(Nazari) Department of Physiology and Pharmacology, Lorestan University of
Medical Sciences, Khorramabad, Iran, Islamic Republic of
Publisher
Nickan Research Institute
Abstract
Introduction: Evidence from animal studies suggests that Zingiber
officinale (ginger) may help prevent ischemia-reperfusion injury (IRI) in
heart. The aim of the present study was to
investigatetheeffectofgingeroninducingpreconditioningonpatientsundergoinga
ngioplasty. Method(s): Thirty-four patients, referred for elective
angioplasty, were randomly divided into the control (17 patients) and
ginger groups (17 patients). Subjects in the experimental group were
provided 250 mg ginger powder in Zintoma capsules per day for 10 days,
whereas those in the control group received placebo. The patients
underwent percutaneous transluminal coronary angioplasty (PTCA) (One
45-second balloon inflation and 2 minutes reperfusion). Chest pain scores
were assessed immediately after angioplasty and cardiac injury biomarkers
were assessed 12 hours later. Result(s): The average pain score
during the balloon inflation in the ginger group was significantly lower
than the control group (2.1+/-1 versus 3.8+/-1.5, P=0.04). Troponin I was
elevated in both groups after angioplasty, but there was not any
significant difference between groups in this regard (P=0.12 and 0.10,
respectively). Conclusion(s): The use of ginger reduces chest pain
during coronary angioplasty but its effect on the release of biochemical
markers of myocardial damage is obscure. Copyright © 2019 Nickan
Research Institute. All Right Reserved.

<84>
Accession Number
2014753202
Title
Randomized controlled trial of an alternative drainage strategy vs routine
chest tube insertion for postoperative pain after thoracoscopic wedge
resection.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 27. Date
of Publication: December 2022.
Author
Wei S.; Zhang G.; Ma J.; Nong L.; Zhang J.; Zhong W.; Cui J.
Institution
(Wei) Department of Anaesthesiology, The First Affiliated Hospital of
Jinan University, Guangzhou 510632, China
(Zhang, Ma, Nong, Cui) Department of Anaesthesiology, Guangdong Provincial
People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou
510080, China
(Zhang, Zhong) Guangdong Lung Cancer Institute, Guangdong Provincial
People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou
510080, China
Publisher
BioMed Central Ltd
Abstract
Background: Thoracoscopic surgery has greatly alleviated the postoperative
pain of patients, but postsurgical acute and chronic pain still exists and
needs to be addressed. Indwelling drainage tubes are one of the leading
causes of postoperative pain after thoracic surgery. Therefore, the aim of
this study was to explore the effects of alternative drainage on acute and
chronic pain after video-assisted thoracoscopic surgery (VATS).
 Method(s): Ninety-two patients undergoing lung wedge resection were
selected and randomly assigned to the conventional chest tube (CT) group
and the 7-Fr central venous catheter (VC) group. Next, the numeric rating
scale (NRS) and pain DETECT questionnaire were applied to evaluate the
level and characteristics of postoperative pain. Result(s): NRS
scores of the VC group during hospitalization were significantly lower
than those of the CT group 6 h after surgery, at postoperative day 1, at
postoperative day 2, and at the moment of drainage tube removal. Moreover,
the number of postoperative salvage analgesics (such as nonsteroidal
anti-inflammatory drugs [(NSAIDs]) and postoperative hospitalization days
were notably reduced in the VC group compared with the CT group. However,
no significant difference was observed in terms of NRS pain scores between
the two groups of patients during the follow-up for chronic pain at 3
months and 6 months. Conclusion(s): In conclusion, a drainage
strategy using a 7-Fr central VC can effectively relieve perioperative
pain in selected patients undergoing VATS wedge resection, and this may
promote the rapid recovery of such patients after surgery. Trial
registration: ClinicalTrials.gov, NCT03230019. Registered July 23,
2017. Copyright © 2022, The Author(s).

<85>
Accession Number
2011473936
Title
The hemodynamic effects of warm versus room-temperature crystalloid fluid
bolus therapy in post-cardiac surgery patients.
Source
Perfusion (United Kingdom). 37(6) (pp 613-623), 2022. Date of Publication:
September 2022.
Author
Bitker L.; Cutuli S.L.; Yanase F.; Wilson A.; Osawa E.A.; Lucchetta L.;
Cioccari L.; Canet E.; Glassford N.; Eastwood G.M.; Bellomo R.
Institution
(Bitker, Cutuli, Yanase, Wilson, Osawa, Lucchetta, Cioccari, Canet,
Eastwood, Bellomo) Department of Intensive Care, Austin hospital,
Melbourne, Australia
(Bitker) Service de Medecine Intensive - Reanimation, hopital de la Croix
Rousse, Hospices Civils de Lyon, Lyon, France
(Cutuli) Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della
Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome,
Italy
(Cutuli) Universita Cattolica del Sacro Cuore, Facolta di Medicina e
Chirurgia "A. Gemelli", Rome, Italy
(Cioccari) Australian and New Zealand Intensive Care Research Centre
(ANZIC-RC), Melbourne, Australia
(Cioccari) Department of Intensive Care Medicine, Inselspital, Bern
University Hospital, University of Bern, Bern, Switzerland
(Glassford) Intensive Care Unit, Royal Melbourne Hospital, Melbourne
Health, Melbourne, Australia
(Glassford) School of Public Health and Preventive Medicine, Monash
University, Melbourne, Australia
(Glassford, Bellomo) Centre for Integrated Critical Care, Melbourne
Medical School, The University of Melbourne, Australia
(Bellomo) University of Melbourne, Parkville, VIC, Australia
Publisher
SAGE Publications Ltd
Abstract
Introduction: The contribution of fluid temperature to the effect of
crystalloid fluid bolus therapy (FBT) in post-cardiac surgery patients is
unknown. We evaluated the hemodynamic effects of FBT with fluid warmed to
40degreeC (warm FBT) versus room-temperature fluid. Method(s): In
this single centre prospective before-and-after study, we evaluated the
effects of 500 ml of warm versus room-temperature compound sodium lactate
administered over <30 minutes, in 50 cardiac surgery patients admitted to
ICU. We recorded hemodynamics continuous before and for 30 minutes after
the first FBT. We defined CI responsiveness (CI-R) as an CI increase >15%
of baseline immediately after FBT and effect dissipation if the CI
returned to <5% of baseline and MAP responsiveness as >10% increase and
dissipation as return to <3 mmHg of baseline. Result(s): Hypotension
(56%) and low CI (40%) typically triggered FBT. Temperature decreased
>0.3degreeC in 13 (52%) patients after room-temperature FBT versus 0 (0%)
after warm FBT (p < 0.01). CI and MAP responsiveness was similar (16 [64%]
versus 11 [44%], p = 0.15 and 15 [60%] versus 17 [68%], p = 0.77,
respectively). Among CI responders, CI increased more with
room-temperature FBT (+0.6 [IQR, 0.5-1.1] versus +0.5 [IQR, 0.4-0.6]
L/min/m2, p = 0.01). However, dissipation was more common after
room-temperature versus warm FBT (9/16 [56%] versus 1/11 [9%], p = 0.02).
 Conclusion(s): In postoperative cardiac surgery patients, warm FBT
preserved core temperature and induced smaller but more sustained CI
increases among responders. Fluid temperature appears to impact both core
temperature and the duration of CI response. Copyright © The
Author(s) 2021.

<86>
Accession Number
636033241
Title
Ventricular Assist Device Driveline Infections: A Systematic Review.
Source
Thoracic and Cardiovascular Surgeon. 70(6) (pp 493-504), 2022. Date of
Publication: 01 Sep 2022.
Author
Krzelj K.; Petricevic M.; Gasparovic H.; Biocina B.; McGiffin D.
Institution
(Krzelj, Gasparovic, Biocina) Department of Cardiac Surgery, University
Hospital Center Zagreb, Zagreb, Croatia
(Petricevic) Division of Health Studies, Department of Cardiac Surgery,
University of Split, University Hospital Center Zagreb, Zagreb, Croatia
(Gasparovic, Biocina) School of Medicine, University of Zagreb, Zagreb,
Croatia
(McGiffin) Department of Cardiothoracic Surgery and Transplantation,
Alfred Hospital, Melbourne, VIC, Australia
(McGiffin) Monash University, Clayton, VIC, Australia
Publisher
Georg Thieme Verlag
Abstract
Infection is the most common complication in patients undergoing
ventricular assist device (VAD) implantation. Driveline exit site (DLES)
infection is the most frequent VAD infection and is a significant cause of
adverse events in VAD patients, contributing to morbidity, even mortality,
and repetitive hospital readmissions. There are many risk factors for
driveline infection (DLI) including younger age, smaller constitution of
patients, obesity, exposed velour at the DLES, longer duration of device
support, lower cardiac index, higher heart failure score, DLES trauma, and
comorbidities such as diabetes mellitus, chronic kidney disease, and
depression. The incidence of DLI depends also on the device type. Numerous
measures to prevent DLI currently exist. Some of them are proven, whereas
the others remain controversial. Current recommendations on DLES care and
DLI management are predominantly based on expert consensus and clinical
experience of the certain centers. However, careful and uniform DLES care
including obligatory driveline immobilization, previously prepared sterile
dressing change kits, and continuous patient education are probably
crucial for prevention of DLI. Diagnosis and treatment of DLI are often
challenging because of certain immunological alterations in VAD patients
and microbial biofilm formation on the driveline surface areas. Although
there are many conservative and surgical methods described in the DLI
treatment, the only possible permanent solution for DLI resolution in VAD
patients is heart transplantation. This systematic review brings a
comprehensive synthesis of recent data on the prevention, diagnostic
workup, and conservative and surgical management of DLI in VAD
patients. Copyright © 2022 Georg Thieme Verlag. All rights
reserved.

<87>
Accession Number
2020161846
Title
Use of intraoperative haemostatic checklists on blood management in
patients undergoing cardiac surgery: A scoping review protocol.
Source
BMJ Open. 12(8) (no pagination), 2022. Article Number: e064098. Date of
Publication: 24 Aug 2022.
Author
Irabor B.E.; Kothari A.; Hong J.; Burnette-Chiang B.; Kent D.; Duhamel T.;
Arora R.C.
Institution
(Irabor) Cumming School of Medicine, University of Calgary, Calgary, AB,
Canada
(Kothari) Max Rady College of Medicine, University of Manitoba, Winnipeg,
MB, Canada
(Hong) Department of Cardiac Surgery, University of Manitoba Max Rady
College of Medicine, Winnipeg, MB, Canada
(Burnette-Chiang) Libraries and Cultural Resources, University of Calgary,
Calgary, AB, Canada
(Kent, Duhamel) Institute of Cardiovascular Sciences, St. Boniface
Hospital Albrechtsen Research Centre, Winnipeg, MB, Canada
(Duhamel) Faculty of Kinesiology and Recreation Management, University of
Manitoba, Winnipeg, MB, Canada
(Arora) Department of Surgery, Section of Cardiac Surgery, Max Rady
College of Medicine, University of Manitoba, Winnipeg, MB, Canada
Publisher
BMJ Publishing Group
Abstract
Introduction A major complication of cardiac surgery is bleeding which can
require surgical re-exploration and the transfusion of allogeneic blood
products. Re-operative procedures for bleeding have been associated with
higher rates of mortality and morbidity, therefore an intervention to
reduce this complication would be important. Previous investigation has
demonstrated that low-cost solutions, such as the use of an intraoperative
haemostatic checklist may result in the reduction of bleeding and
subsequent transfusion. The goals of this scoping review aim to assess the
efficacy of the use of intraoperative haemostatic checklists on blood
management in patients undergoing cardiac surgery. Specifically, the
objective is to understand if the use of intraoperative haemostatic
checklists has been associated with a reduction in bleeding and blood
product utilisation in patients undergoing non-emergent cardiac surgery.
Methods and analysis A scoping review of literature identifying randomised
control and observational trials, reporting on haemostatic checklists in
cardiac surgery, will be undertaken. The proposed review will be guided by
the methodological framework proposed by Arksey and O'Malley. A search
will be conducted for published and unpublished (grey) literature.
Published literature will be searched in the following electronic
databases: Scopus, MEDLINE, EMBASE and the Cochrane Library. Relevant grey
literature will be identified through conference abstracts. Outcomes
chosen are patient centred to ensure reduced bleeding and overall positive
experience that reduces complications intraoperatively. Ethics and
dissemination This study does not require ethical approval as the data
used are from available publications. Our dissemination strategy includes
peer-review publication, presentation at conferences and relevant
stakeholders. Copyright ©

<88>
[Use Link to view the full text]
Accession Number
2020240323
Title
Safety of Vitamin K in mechanical heart valve patients with
supratherapeutic INR: A systematic review and meta-analysis.
Source
Medicine (United States). 101(36) (pp E30388), 2022. Date of Publication:
09 Sep 2022.
Author
Sapapsap B.; Srisawat C.; Suthumpoung P.; Luengrungkiat O.; Leelakanok N.;
Saokaew S.; Kanchanasurakit S.
Institution
(Sapapsap, Leelakanok) Division of Clinical Pharmacy, Faculty of
Pharmaceutical Sciences, Burapha University, Chonburi, Thailand
(Srisawat) Division of Pharmaceutical Care, Department of Pharmacy,
Banphaeo General Hospital, Samut Sakhon, Thailand
(Suthumpoung) Division of Pharmaceutical Care, Department of Pharmacy,
Fort Khuncheangthammikkarat Hospital, Phayao, Thailand
(Luengrungkiat) Division of Pharmaceutical Care, Department of Pharmacy,
Wichaivej International Omnoi Hospital, Samutsakhon, Thailand
(Saokaew) Division of Social and Administration Pharmacy, Department of
Pharmaceutical Care, School of Pharmaceutical Sciences, University of
Phayao, Phayao, Thailand
(Saokaew, Kanchanasurakit) Center of Health Outcomes Research and
Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences,
University of Phayao, Phayao, Thailand
(Saokaew, Kanchanasurakit) Unit of Excellence on Clinical Outcomes
Research and Integration (UNICORN), School of Pharmaceutical Sciences,
University of Phayao, Phayao, Thailand
(Saokaew, Kanchanasurakit) Unit of Excellence on Herbal Medicine, School
of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand
(Saokaew) Biofunctional Molecule Exploratory Research Group, Biomedicine
Research Advancement Centre, School of Pharmacy, Monash University
Malaysia, Bandar Sunway, Selangor Darul Ehsan, Malaysia
(Saokaew) Novel Bacteria and Drug Discovery Research Group, Microbiome and
Bioresource Research Strength, Jeffrey Cheah School of Medicine and Health
Sciences, Monash University Malaysia, Bandar Sunway, Selangor Darul Ehsan,
Malaysia
(Kanchanasurakit) Division of Clinical Pharmacy, Department of
Pharmaceutical Care, School of Pharmaceutical Sciences, University of
Phayao, Phayao, Thailand
(Kanchanasurakit) Division of Pharmaceutical Care, Department of Pharmacy,
Phrae Hospital, Phrae, Thailand
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Patients who had mechanical heart valves and an international
normalized ratio (INR) of >5.0 should be managed by temporary cessation of
vitamin K antagonist. This study aimed to investigate the safety of
low-dose vitamin K1 in patients with mechanical heart valves who have
supratherapeutic INR. Method(s): CINAHL, Cochran Library, Clinical
trial.gov, OpenGrey, PubMed, ScienceDirect, and Scopus were systematically
searched from the inception up to October 2021 without language
restriction. Studies comparing the safety of low-dose vitamin K1 treatment
in patients with placebo or other anticoagulant reversal agents were
included. We used a random-effect model for the meta-analysis. Publication
bias was determined by a funnel plot with subsequent Begg's test and
Egger's test. Result(s): From 7529 retrieved studies, 3 randomized
control trials were included in the meta-analysis. Pooled data
demonstrated that low-dose vitamin K was not associated with
thromboembolism rate (risk ratio [RR] = 0.94; 95% CI: 0.19-4.55) major
bleeding rate (RR = 0.58; 95% CI: 0.07-4.82), and minor bleeding rate (RR
= 0.60; 95% CI: 0.07-5.09). Subgroup and sensitivity analysis demonstrated
the nonsignificant effect of low-dose vitamin K on the risk of
thromboembolism. Publication bias was not apparent, according to Begg's
test and Egger's test (P =.090 and 0.134, respectively).
 Conclusion(s): The current evidence does not support the role of
low-dose vitamin K as a trigger of thromboembolism in supratherapeutic INR
patients with mechanical heart valves. Nevertheless, more well-designed
studies with larger sample sizes are required to justify this research
question. Copyright © 2022 Lippincott Williams and Wilkins. All
rights reserved.

<89>
[Use Link to view the full text]
Accession Number
2020144164
Title
Letter by Condello Regarding Article, "Cytokine Hemadsorption During
Cardiac Surgery Versus Standard Surgical Care for Infective Endocarditis
(REMOVE): Results From a Multicenter Randomized Controlled Trial".
Source
Circulation. 146(10) (pp E138-E139), 2022. Date of Publication: 06 Sep
2022.
Author
Condello I.
Institution
(Condello) Department of Cardiac Surgery, Anthea Hospital, Gvm Care &
Research, Bari, Italy
Publisher
Lippincott Williams and Wilkins

<90>
Accession Number
2018988685
Title
The antimicrobial peptides secreted by the chromaffin cells of the adrenal
medulla link the neuroendocrine and immune systems: From basic to clinical
studies.
Source
Frontiers in Immunology. 13 (no pagination), 2022. Article Number: 977175.
Date of Publication: 25 Aug 2022.
Author
Scavello F.; Kharouf N.; Lavalle P.; Haikel Y.; Schneider F.;
Metz-Boutigue M.-H.
Institution
(Scavello, Kharouf, Lavalle, Haikel, Schneider, Metz-Boutigue) Department
of Biomaterials and Bioengineering, Institut National de la Sante et de la
Recherche Medicale (INSERM), Unite Mixte de recherche (UMR) S 1121,
Federation of Translational Medicine, Strasbourg University, Strasbourg,
France
(Scavello) IRCCS Humanitas Research Hospital, Milan, Italy
(Kharouf, Haikel) Department of Endodontics and Conservative Dentistry,
Faculty of Dental Medicine, University of Strasbourg, Strasbourg, France
(Schneider) Medecine Intensive-Reanimation, Hautepierre Hospital, Ho
Universitaires, Strasbourg, Federation of Translational Medicine, Faculty
of Medicine, University of Strasbourg, Strasbourg, France
Publisher
Frontiers Media S.A.
Abstract
The increasing resistance to antibiotic treatments highlights the need for
the development of new antimicrobial agents. Antimicrobial peptides (AMPs)
have been studied to be used in clinical settings for the treatment of
infections. Endogenous AMPs represent the first line defense of the innate
immune system against pathogens; they also positively interfere with
infection-associated inflammation. Interestingly, AMPs influence numerous
biological processes, such as the regulation of the microbiota, wound
healing, the induction of adaptive immunity, the regulation of
inflammation, and finally express anti-cancer and cytotoxic properties.
Numerous peptides identified in chromaffin secretory granules from the
adrenal medulla possess antimicrobial activity: they are released by
chromaffin cells during stress situations by exocytosis via the activation
of the hypothalamo-pituitary axis. The objective of the present review is
to develop complete informations including (i) the biological
characteristics of the AMPs produced after the natural processing of
chromogranins A and B, proenkephalin-A and free ubiquitin, (ii) the design
of innovative materials and (iii) the involvement of these AMPs in human
diseases. Some peptides are elective biomarkers for critical care
medicine, may play an important role in the protection of infections
(alone, or in combination with others or antibiotics), in the prevention
of nosocomial infections, in the regulation of intestinal mucosal dynamics
and of inflammation. They could play an important role for medical implant
functionalization, such as catheters, tracheal tubes or oral surgical
devices, in order to prevent infections after implantation and to promote
the healing of tissues. Copyright © 2022 Scavello, Kharouf,
Lavalle, Haikel, Schneider and Metz-Boutigue.

<91>
Accession Number
2018868444
Title
Cardiac magnetic resonance imaging versus computed tomography to guide
transcatheter aortic valve replacement: study protocol for a randomized
trial (TAVR-CMR).
Source
Trials. 23(1) (no pagination), 2022. Article Number: 726. Date of
Publication: December 2022.
Author
Klug G.; Reinstadler S.; Troger F.; Holzknecht M.; Reindl M.; Tiller C.;
Lechner I.; Fink P.; Pamminger M.; Kremser C.; Ulmer H.; Bauer A.; Metzler
B.; Mayr A.
Institution
(Klug, Reinstadler, Troger, Holzknecht, Reindl, Tiller, Lechner, Fink,
Bauer, Metzler) University Clinic of Internal Medicine III, Cardiology and
Angiology, Medical University of Innsbruck, Anichstrase 35, Innsbruck
6020, Austria
(Troger, Pamminger, Kremser, Mayr) University Clinic of Radiology, Medical
University of Innsbruck, Innsbruck, Austria
(Ulmer) Department for Medical Statistics, Informatics and Health Economy,
Medical University of Innsbruck, Innsbruck, Austria
Publisher
BioMed Central Ltd
Abstract
Background: The standard procedure for the planning of transcatheter
aortic valve replacement (TAVR) is the combination of echocardiography,
coronary angiography, and cardiovascular computed tomography (TAVR-CT) for
the exact determination of the aortic valve dimensions, valve size, and
implantation route. However, up to 80% of the patients undergoing TAVR
suffer from chronic renal insufficiency. Alternatives to reduce the need
for iodinated contrast agents are desirable. Cardiac magnetic resonance
(CMR) imaging recently has emerged as such an alternative. Therefore, we
aim to investigate, for the first time, the non-inferiority of TAVR-CMR to
TAVR-CT regarding efficacy and safety end-points. Method(s): This is
a prospective, randomized, open-label trial. It is planned to include 250
patients with symptomatic severe aortic stenosis scheduled for TAVR based
on a local heart-team decision. Patients will be randomized in a 1:1
fashion to receive a predefined TAVR-CMR protocol or to receive a standard
TAVR-CT protocol within 2 weeks after inclusion. Follow-up will be
performed at hospital discharge after TAVR and after 1 and 2 years. The
primary efficacy outcome is device implantation success at discharge. The
secondary endpoints are a combined safety endpoint and a combined clinical
efficacy endpoint at baseline and at 1 and 2 years, as well as a
comparison of imaging procedure related variables. Endpoint definitions
are based on the updated 2012 VARC-2 consensus document.
 Discussion(s): TAVR-CMR might be an alternative to TAVR-CT for
planning a TAVR procedure. If proven to be effective and safe, a broader
application of TAVR-CMR might reduce the incidence of acute kidney injury
after TAVR and thus improve outcomes. Trial registration: The trial is
registered at ClinicalTrials.gov (NCT03831087). The results will be
disseminated at scientific meetings and publication in peer-reviewed
journals. Copyright © 2022, The Author(s).

<92>
Accession Number
2018867080
Title
The application of 3D printing in preoperative planning for transcatheter
aortic valve replacement: a systematic review.
Source
BioMedical Engineering Online. 21(1) (no pagination), 2022. Article
Number: 59. Date of Publication: December 2022.
Author
Xenofontos P.; Zamani R.; Akrami M.
Institution
(Xenofontos, Zamani) Medical School, College of Medicine and Health,
Exeter, United Kingdom
(Akrami) Department of Engineering, College of Engineering, Mathematics,
and Physical Sciences, University of Exeter, Exeter, United Kingdom
Publisher
BioMed Central Ltd
Abstract
Background: Recently, transcatheter aortic valve replacement (TAVR) has
been suggested as a less invasive treatment compared to surgical aortic
valve replacement, for patients with severe aortic stenosis. Despite the
attention, persisting evidence suggests that several procedural
complications are more prevalent with the transcatheter approach.
Consequently, a systematic review was undertaken to evaluate the
application of three-dimensional (3D) printing in preoperative planning
for TAVR, as a means of predicting and subsequently, reducing the
incidence of adverse events. Method(s): MEDLINE, Web of Science and
Embase were searched to identify studies that utilised patient-specific 3D
printed models to predict or mitigate the risk of procedural
complications. Result(s): 13 of 219 papers met the inclusion criteria
of this review. The eligible studies have shown that 3D printing has most
commonly been used to predict the occurrence and severity of paravalvular
regurgitation, with relatively high accuracy. Studies have also explored
the usefulness of 3D printed anatomical models in reducing the incidence
of coronary artery obstruction, new-onset conduction disturbance and
aortic annular rapture. Conclusion(s): Patient-specific 3D models can
be used in pre-procedural planning for challenging cases, to help deliver
personalised treatment. However, the application of 3D printing is not
recommended for routine clinical practice, due to practicality
issues. Copyright © 2022, The Author(s).

<93>
Accession Number
2018866778
Title
Preoperative oral diazepam for intraoperative blood pressure stabilisation
in hypertensive patients undergoing vitrectomy under retrobulbar nerve
block anaesthesia: study protocol for a randomised controlled trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 723. Date of
Publication: December 2022.
Author
Qian T.; Gong Q.; Chen C.; Wu X.; Xue L.; Fan Y.; Wang W.; Zhang Z.; Cao
H.; Xu X.
Institution
(Qian, Gong, Chen, Wu, Xue, Fan, Wang, Zhang, Cao, Xu) Department of
Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University,
Shanghai, China
(Qian, Gong, Chen, Wu, Xue, Fan, Wang, Zhang, Cao, Xu) National Clinical
Research Center for Eye Diseases, Shanghai, China
(Qian, Gong, Chen, Wu, Xue, Fan, Wang, Zhang, Cao, Xu) Shanghai Key
Laboratory of Ocular Fundus Diseases, Shanghai, China
(Qian, Gong, Chen, Wu, Xue, Fan, Wang, Zhang, Cao, Xu) Shanghai
Engineering Center for Visual Science and Photomedicine, Shanghai, China
(Qian, Gong, Chen, Wu, Xue, Fan, Wang, Zhang, Cao, Xu) Shanghai
Engineering Center for Precise Diagnosis and Treatment of Eye Disease,
Shanghai, China
Publisher
BioMed Central Ltd
Abstract
Background: As a type of local anaesthesia, retrobulbar nerve block is
often used in vitrectomy, with patients remaining conscious during the
operation. The increase in systolic blood pressure (SBP) caused by tension
and fear during the operation-especially in patients with a history of
hypertension-can negatively impact the safety of the procedure, resulting
in suprachoroidal haemorrhage or retinal haemorrhage. Diazepam has a
sedative effect and can relieve tension during surgery. This study aims to
evaluate the efficacy and safety of diazepam for intraoperative BP
stabilisation in hypertensive patients under retrobulbar anaesthesia
during surgery. Method(s): This single-centre, double-blind,
randomised controlled and parallel clinical trial will include 180
hypertensive patients who will undergo vitrectomy with nerve block
anaesthesia. Study participants will be randomly allocated in a 1:1 ratio
to intervention (patients receiving oral diazepam before the operation)
and control (patients receiving oral placebo before the operation) groups.
The primary outcome is the effective rate of intraoperative BP control
(systolic BP during operation maintained at <160mmHg at all timepoints).
The secondary outcomes are the proportion of patients with SBP >=180 mmHg
at any timepoint from operation to 1 h post-operation, the change of mean
systolic blood pressure and mean heart rate during operation from
baseline, as well as the number of patients with intraoperative and
post-operative adverse reactions within 12 weeks of surgery. The logistic
regression model will be performed to compare the outcomes.
 Discussion(s): This study will evaluate the efficacy and safety of
diazepam for intraoperative BP stabilisation in hypertensive patients
under nerve block anaesthesia during surgery. The results of this trial
will reveal whether diazepam has a significant effect on intraoperative BP
stability in patients with a history of hypertension who require
vitrectomy. If the results of this trial are significant, a large-scale
multi-centre clinical trial can be designed. Trial registration: Chinese
Clinical Trial Registry (ChiCTR) ChiCTR2100041772. Registered on 5 January
2021. Copyright © 2022, The Author(s).

<94>
Accession Number
2018727633
Title
Intraoperative respiratory and hemodynamic strategies for reducing nausea,
vomiting, and pain after surgery: Systematic review and meta-analysis.
Source
Acta Anaesthesiologica Scandinavica. 66(9) (pp 1051-1060), 2022. Date of
Publication: October 2022.
Author
Holst J.M.; Klitholm M.P.; Henriksen J.; Vallentin M.F.; Jessen M.K.;
Bolther M.; Holmberg M.J.; Hoybye M.; Lind P.C.; Granfeldt A.; Andersen
L.W.
Institution
(Holst, Klitholm, Henriksen, Bolther, Lind, Granfeldt, Andersen)
Department of Anesthesiology and Intensive Care, Aarhus University
Hospital, Aarhus, Denmark
(Vallentin, Jessen, Holmberg, Hoybye, Lind, Granfeldt, Andersen)
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
(Vallentin, Andersen) Prehospital Emergency Medical Services, Central
Denmark Region, Aarhus, Denmark
(Jessen, Holmberg, Hoybye, Andersen) Research Center for Emergency
Medicine, Aarhus University Hospital, Aarhus, Denmark
(Holmberg) Department of Anesthesiology and Intensive Care, Randers
Regional Hospital, Randers, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Background: Despite improved medical treatment strategies, postoperative
pain, nausea, and vomiting remain major challenges. This systematic review
investigated the relationship between perioperative respiratory and
hemodynamic interventions and postoperative pain, nausea, and vomiting.
 Method(s): PubMed and Embase were searched on March 8, 2021 for
randomized clinical trials investigating the effect of perioperative
respiratory or hemodynamic interventions in adults undergoing non-cardiac
surgery. Investigators reviewed trials for relevance, extracted data, and
assessed risk of bias. Meta-analyses were performed when feasible. GRADE
was used to assess the certainty of the evidence. Result(s): This
review included 65 original trials; of these 48% had pain, nausea, and/or
vomiting as the primary focus. No reduction of postoperative pain was
found in meta-analyses when comparing recruitment maneuvers with no
recruitment, high (80%) to low (30%) fraction of oxygen, low (5-7 ml/kg)
to high (9-12 ml/kg) tidal volume, or goal-directed hemodynamic therapy to
standard care. In the meta-analysis comparing recruitment maneuvers with
no recruitment maneuvers, patients undergoing laparoscopic gynecological
surgery had less shoulder pain 24 h postoperatively (mean difference in
the numeric rating scale from 0 to 10: -1.1, 95% CI: -1.7, -0.5). In
meta-analyses, comparing high to low fraction of inspired oxygen and
goal-directed hemodynamic therapy to standard care in patients undergoing
abdominal surgery, the risk of postoperative nausea and vomiting was
reduced (odds ratio: 0.45, 95% CI: 0.24, 0.87 and 0.48, 95% CI: 0.27,
0.85). The certainty in the evidence was mostly very low to low. The
results should be considered exploratory given the lack of prespecified
hypotheses and corresponding risk of Type 1 errors. Conclusion(s):
There is limited evidence regarding the impact of intraoperative
respiratory and hemodynamic interventions on postoperative pain or nausea
and vomiting. More definitive trials are needed to guide clinical care
within this area. Copyright © 2022 The Authors. Acta
Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on
behalf of Acta Anaesthesiologica Scandinavica Foundation.

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

<96>
Accession Number
2018645278
Title
Anti-factor X activity levels with continuous intravenous infusion and
subcutaneous administration of enoxaparin after coronary artery bypass
grafting: A randomized clinical trial.
Source
Acta Anaesthesiologica Scandinavica. 66(9) (pp 1083-1090), 2022. Date of
Publication: October 2022.
Author
Parviainen M.K.; Vahtera A.; Anas N.; Tahtinen J.; Huhtala H.; Kuitunen
A.; Jarvela K.
Institution
(Parviainen, Jarvela) Tampere University Heart Hospital Tampere, Tampere,
Finland
(Vahtera, Anas, Tahtinen, Kuitunen) Tampere University Hospital, Tampere,
Finland
(Huhtala) Faculty of Social Sciences, Tampere University, Tampere, Finland
(Kuitunen) Faculty of Medicine and Health Sciences, Tampere University,
Tampere, Finland
(Jarvela) Finnish Cardiovascular Research Center Tampere, Tampere
University, Tampere, Finland
Publisher
John Wiley and Sons Inc
Abstract
Background: Low-molecular-weight heparin enoxaparin is widely used in
pharmacological thromboprophylaxis after coronary artery bypass grafting
(CABG). The aim of this study was to compare anti-factor X activity
(anti-Xa) levels when the thromboprophylactic dose of enoxaparin was
provided after CABG, with two different administration routes: continuous
intravenous infusion (CIV) and subcutaneous bolus (SCB) injection. We
hypothesized that the current standard method of SCB administration might
lead to lower anti-Xa levels than recommended in other patient groups, due
to reduced bioavailability. Method(s): In this prospective,
randomized, controlled clinical trial, 40 patients scheduled for elective
CABG were randomized to receive 40 mg of enoxaparin per day either as CIV
or SCB for 72 h. Enoxaparin was initiated 6-10 h after CABG. Anti-Xa
levels were measured 12-14 times during the study period. The primary
outcome, that is, the maximum anti-Xa concentration over 0-24 h
(C<inf>max0-24h</inf>), was calculated from these measured values.
Secondary outcomes were C<inf>max25-72h</inf> and the trough concentration
of anti-Xa after 72 h of enoxaparin initiation (C<inf>72h</inf>).
 Result(s): Twenty patients were randomized to the CIV-group and 19 to
the SCB-group. The median anti-Xa C<inf>max0-24h</inf> was significantly
lower in the CIV-group than in the SCB-group: 0.15 [interquartile range
(IQR) 0.13-0.19] IU/ml versus 0.25 (IQR 0.18-0.32) IU/ml, p <.005. The
median anti-Xa C<inf>max25-72h</inf> was 0.12 (IQR, 0.1-0.17) IU/ml versus
0.23 (IQR 0.19-0.31) IU/ml, respectively, p <.005. At 72 h, there was no
difference between the groups in their anti-Xa levels. Conclusion(s):
In this low-risk CABG patient population, SCB administration of a
thromboprophylactic dose of enoxaparin provided anti-Xa levels that are
considered sufficient for thromboprophylaxis in other patient groups. CIV
administration resulted in lower anti-Xa levels compared to the SCB
route. Copyright © 2022 Acta Anaesthesiologica Scandinavica
Foundation.

<97>
Accession Number
2018512710
Title
Negative-Pressure Wound Therapy for Prevention of Sternal Wound Infection
after Adult Cardiac Surgery: Systematic Review and Meta-Analysis.
Source
Journal of Clinical Medicine. 11(15) (no pagination), 2022. Article
Number: 4268. Date of Publication: August 2022.
Author
Biancari F.; Santoro G.; Provenzano F.; Savarese L.; Iorio F.; Giordano
S.; Zebele C.; Speziale G.
Institution
(Biancari, Santoro, Provenzano, Savarese, Iorio, Giordano, Zebele) Clinica
Montevergine, GVM Care Research, Mercogliano 83013, Italy
(Biancari) Heart and Lung Center, Helsinki University Hospital, University
of Helsinki, Helsinki 00029, Finland
(Speziale) Anthea Hospital, GVM Care Research, Bari 70124, Italy
Publisher
MDPI
Abstract
The results of current studies are not conclusive on the efficacy of
incisional negative-pressure wound therapy (NPWT) for the prevention of
sternal wound infection (SWI) after adult cardiac surgery. A systematic
review of the literature was performed through PubMed, Scopus and Google
to identify studies which investigated the efficacy of NPWT to prevent SWI
after adult cardiac surgery. Available data were pooled using RevMan and
Meta-analyst with random effect models. Out of 191 studies retrieved from
the literature, ten fulfilled the inclusion criteria and were included in
this analysis. The quality of these studies was judged fair for three of
them and poor for seven studies. Only one study was powered to address the
efficacy of NPWT for the prevention of postoperative SWI. Pooled analysis
of these studies showed that NPWT was associated with lower risk of any
SWI (4.5% vs. 9.0%, RR 0.54, 95% CI 0.34-0.84, I2 48%),
superficial SWI (3.8% vs. 4.4%, RR 0.63, 95% CI 0.29-1.36, I2
65%), and deep SWI (1.8% vs. 4.7%, RR 0.46, 95% CI 0.26-0.74,
I2 0%), but such a difference was not statistically significant
for superficial SWI. When only randomized and alternating allocated
studies were included, NPWT was associated with a significantly lower risk
of any SWI (3.3% vs. 16.5%, RR 0.22, 95% CI 0.08-0.62, I2 0%),
superficial SWI (2.6% vs. 12.4%, RR 0.21, 95% CI 0.06-0.69, I2
0%), and deep SWI (1.2% vs. 4.8%, RR 0.17, 95% CI 0.03-0.95, I2
0%). This pooled analysis showed that NPWT may prevent postoperative SWI
after adult cardiac surgery. NPWT is expected to be particularly useful in
patients at risk for surgical site infection and may significantly reduce
the burden of resources needed to treat such a complication. However, the
methodology of the available studies was judged as poor for most of them.
Further studies are needed to obtain conclusive results on the potential
benefits of this preventative strategy. Copyright © 2022 by the
authors.

<98>
Accession Number
2018357125
Title
The use of sutureless and rapid-deployment aortic valve prosthesis in
patients with bicuspid aortic valve: A focused review.
Source
Journal of Cardiac Surgery. 37(10) (pp 3355-3362), 2022. Date of
Publication: October 2022.
Author
King M.; Stambulic T.; Payne D.; Fernandez A.L.; El-Diasty M.
Institution
(King, Stambulic) Queen's School of Medicine, Kingston, ON, Canada
(Payne, El-Diasty) Division of Cardiac Surgery, Queen's University,
Kingston, ON, Canada
(Fernandez) Cardiac Surgery Department, University of Santiago de
Compostela, Santiago, Spain
Publisher
John Wiley and Sons Inc
Abstract
Objective: The objective of this scoping review is to describe the
postoperative outcomes and complications of patients with bicuspid aortic
valve (BAV) treated with sutureless or rapid-deployment prosthesis.
 Background(s): The use of sutureless and rapid-deployment prostheses
is generally avoided in patients with BAV due to anatomical concerns and
the elevated risk of para-prosthetic leaks. Multiple studies have reported
the use of these prostheses into patients with BAV with varying degrees of
success. The focus of this review is to consolidate the current available
evidence on this topic. Method(s): A scoping review was conducted
using a comprehensive search strategy in multiple databases (Medline,
Embase, Cochrane Central Register of Controlled Clinical Trials) for
relevant articles. All abstracts and full texts were screened by two
independent reviewers according to predefined inclusion and exclusion
criteria. Thirteen articles, including case reports and case series were
ultimately included for analysis. Result(s): Of 1052 total citations,
44 underwent full text review and 13 (4 case reports, 6 retrospective
analyses, and 3 prospective analyses) were included in the scoping review.
Across all 13 studies, a total of 314 patients with BAV were used for data
analysis. In sutureless and rapid-deployment prostheses, the mean
postoperative aortic valvular gradients were less than 15 mmHg in all
studies with mean postoperative aortic valvular areas all greater than 1.3
cm.2 There were 186 total complications for an overall
complication rate of 59%. Individual complications included new onset
atrial fibrillation (n = 65), required pacemaker insertion (n = 24),
intraprosthetic aortic regurgitation (n = 20), new onset atrioventricular
block (n = 18), and new onset paravalvular leakage (n = 10).
 Conclusion(s): The use of sutureless and rapid deployment prostheses
in patients with BAV showed comparable intraoperative and implantation
success rates to patients without BAV. Postoperative complications from
using these prostheses in patients with BAV included new onset atrial
fibrillation, intraprosthetic aortic regurgitation, new onset
atrioventricular block, and required pacemaker insertion. Various
techniques have been described to minimize these complications in patients
with BAV receiving sutureless or rapid deployment
prostheses. Copyright © 2022 Wiley Periodicals LLC.

<99>
Accession Number
2018222019
Title
Standardized Aortic Valve Neocuspidization for Treatment of Aortic Valve
Diseases.
Source
Annals of Thoracic Surgery. 114(4) (pp 1108-1117), 2022. Date of
Publication: October 2022.
Author
Amabile A.; Krane M.; Dufendach K.; Baird C.W.; Ganjoo N.; Eckstein F.S.;
Albertini A.; Gruber P.J.; Mumtaz M.A.; Bacha E.A.; Benedetto U.; Chikwe
J.; Geirsson A.; Holfeld J.; Iida Y.; Lange R.; Morell V.O.; Chu D.
Institution
(Amabile, Krane, Geirsson) Division of Cardiac Surgery, Department of
Surgery, Yale University School of Medicine, New Haven, Connecticut
(Dufendach, Ganjoo, Morell, Chu) Division of Cardiac Surgery, Department
of Cardiothoracic Surgery, University of Pittsburgh School of Medicine,
Pittsburgh, Pennsylvania
(Mumtaz, Morell, Chu) University of Pittsburgh Medical Center Heart and
Vascular Institute, Pittsburgh, Pennsylvania
(Baird) Department of Cardiac Surgery, Boston Children's Hospital, Harvard
Medical School, Boston, Massachusetts
(Eckstein) Department of Cardiac Surgery, University Hospital Basel,
University of Basel, Switzerland
(Albertini) Cardiovascular Surgery Department, Maria Cecilia Hospital GVM
Care and Research, Cotignola, Revenna, Italy
(Gruber, Bacha) Division of Cardiac, Thoracic, and Vascular Surgery,
Section of Pediatric and Congenital Heart Surgery, Columbia University
Medical Center/New York-Presbyterian Hospital, New York, New York
(Benedetto) Department of Cardiac Surgery, University Chieti-Pescara,
Chieti, Italy
(Chikwe) Department of Cardiac Surgery, Cedars-Sinai Medical Center, Smidt
Heart Institute, Los Angeles, California
(Holfeld) Department of Cardiac Surgery, Innsbruck Medical University,
Innsbruck, Austria
(Iida) Department of Cardiovascular Surgery, Saiseikai Yokohamashi Tobu
Hospital, Yokohama, Japan
(Lange) Department of Cardiovascular Surgery, German Heart Center, Munich,
Germany
Publisher
Elsevier Inc.
Abstract
Background: Aortic valve replacement is the traditional surgical treatment
for aortic valve diseases, yet standardized aortic valve neocuspidization
(AVNeo) is a promising alternative that is gaining popularity. The purpose
of this article is to review the available published literature of AVNeo
using glutaraldehyde-treated autologous pericardium, also known as the
Ozaki procedure, including indications, outcomes, potential benefits, and
modes of failure for the reconstructed valve. Method(s): A
comprehensive literature search was performed using keywords related to
aortic valve repair, AVNeo, or Ozaki procedure. All articles describing
performance of AVNeo were reviewed. Result(s): Reported early
mortality after AVNeo varies from 0% to 5.88%. The largest cohort of
patients in the literature includes 850 patients with an inhospital
mortality rate of 1.88%. Cumulative incidence of aortic valve reoperation
was 4.2% in the largest series. Reoperation was uncommon and mainly due to
infective endocarditis or degeneration of the reconstructed valve (most
commonly due to aortic valve regurgitation, rather than stenosis).
 Conclusion(s): Aortic valve neocuspidization is a versatile and
standardized alternative to aortic valve replacement with a biological
prosthesis. Early to midterm outcomes from a number of centers are
excellent and demonstrate the safety and durability of the procedure.
Long-term outcomes and clinical trial data are necessary to determine
which patients benefit the most from this procedure. Copyright ©
2022 The Society of Thoracic Surgeons

<100>
Accession Number
2016336132
Title
Management of venous ulceration (interventional treatments) with
perspectives from a recent metaanalysis and recommendations.
Source
Phlebolymphology. 28(3) (pp 119-127), 2021. Date of Publication: 2021.
Author
Neaume N.
Institution
(Neaume) Clinique Pasteur, Toulouse, France
Publisher
Les Laboratoires Seriver
Abstract
Venous leg ulcers still affect about 1% of the adult population despite
recent advances in chronic venous insufficiency treatment, and they
represent a significant public health cost, estimated at between 1% and 2%
of the annual health budget of Western European countries. Venous leg
ulcers may be treated conservatively, with compression bandaging and wound
care, medically, surgically, or with a combination of approaches,
depending on the severity of the ulcer and available resources. The
randomized trial of early endovenous ablation in venous ulceration
demonstrated that early removal of a superficial venous reflux in patients
with leg ulcer, combined with appropriate elastic compression, reduces
healing time and increases time to recurrence without ulcer, assessed at
1-year follow-up. Thus, current National Institute for Health and Care
Excellence (NICE) clinical guidelines recommend early endovenous treatment
in patients with venous ulcers. However, the relative benefit or
indications for use of these interventional treatments (surgery, thermal
ablation, nonthermal nontumescent techniques, subfascial endoscopic
perforator surgery [SEPS], valvuloplasty, and stenting) remain to be
definitively shown. Copyright © LLS SAS. All rights reserved.

<101>
Accession Number
2014376279
Title
Preventive use of ascorbic acid for atrial fibrillation after coronary
artery bypass graft surgery.
Source
Heart Surgery Forum. 21(5) (pp E415-E417), 2018. Date of Publication: 06
Nov 2018.
Author
Mirmohammadsadeghi M.; Mirmohammadsadeghi A.; Mahmoudian M.
Institution
(Mirmohammadsadeghi, Mirmohammadsadeghi) Department of Cardiovascular
Surgery, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic
Republic of
(Mahmoudian) Islamic Azad University, Najafabad Branch, Isfahan, Iran,
Islamic Republic of
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: Atrial fibrillation is one of the most frequent complications
and a major risk of morbidity and mortality after cardiac surgery.
Antioxidants such as vitamin C are used for prevention of this arrhythmia.
Different results of studies have been reported, but most of them have
shown efficiency of vitamin C in prophylaxis of postoperative AF. We tried
to examine this efficacy with larger sample size. Method(s): Three
hundred and fourteen on pump coronary artery bypass graft surgery alone.
Patients were divided into two groups: The intervention group received
vitamin C (N = 160) and the control group did not receive any (N = 154).
Intervention group was administered two grams of vitamin C intravenously
(IV) 24 hours preoperatively, 500 mg every 12 hours IV for 48 hours in
ICU, and 500 mg every 12 hours PO for 48 hours in ward. Continuous
monitoring in ICU and three times a day ECG was used for AF detection. The
two groups were compared. Result(s): The two groups were matched in
terms of age, sex, LA size, ejection fraction, functional class, and TSH
level. Of the patients, 244 were male. Mean age was 62 years (40-84 years)
in both groups. M/F ratio was four in both groups. Functional class and
ejection fraction were the same in both groups. There was no mean TSH
level difference. AF occurrence in vitamin C group was 7.6 % and in
control group was 7.8 %. There was no difference in ICU or hospital stay.
 Conclusion(s): Prophylactic use of vitamin C does not further reduce
postoperative atrial fibrillation in on pump CABG patients. Copyright
© 2018 Forum Multimedia Publishing, LLC.

<102>
Accession Number
2015360070
Title
A Randomized Pilot Trial Assessing the Role of Human Fibrinogen
Concentrate in Decreasing Cryoprecipitate Use and Blood Loss in Infants
Undergoing Cardiopulmonary Bypass.
Source
Pediatric Cardiology. 43(7) (pp 1444-1454), 2022. Date of Publication:
October 2022.
Author
Tirotta C.F.; Lagueruela R.G.; Gupta A.; Salyakina D.; Aguero D.; Ojito
J.; Kubes K.; Hannan R.; Burke R.P.
Institution
(Tirotta, Lagueruela, Aguero, Ojito, Kubes, Hannan, Burke) The Heart
Program, Nicklaus Children's Hospital, Miami, FL, United States
(Gupta, Salyakina) Nicklaus Children's Health System Research Institute,
Miami, FL, United States
(Tirotta, Lagueruela) Dept. Anesthesiology, The Heart Program, Nicklaus
Children's Hospital, 3100 SW 62nd Avenue, Miami, FL 33155, United States
Publisher
Springer
Abstract
The objective of this study was to determine whether treatment with human
fibrinogen concentrate decreases the need for component blood therapy and
blood loss in neonate and infant patients undergoing cardiopulmonary
bypass. Pediatric patients (N = 30) undergoing elective cardiac surgery
were randomized to receive human fibrinogen concentrate or placebo
following cardiopulmonary bypass termination. The primary endpoint was the
amount of cryoprecipitate administered. Secondary endpoints included
estimated blood loss during the 24 h post-surgery; perioperative blood
product transfusion; effects of fibrinogen infusion on global hemostasis,
measured by laboratory testing and rotational thromboelastometry; and
adverse events. No clinically significant differences were identified in
baseline characteristics between groups. A significantly lower volume of
cryoprecipitate was administered to the treatment group during the
perioperative period [median (interquartile range) 0.0 (0.0-0.0) cc/kg vs
12.0 (8.2-14.3) cc/kg; P < 0.0001] versus placebo. No difference was
observed between treatment groups in blood loss, laboratory coagulation
tests, use of other blood components, or incidence of adverse events.
FIBTEM amplitude of maximum clot firmness values was significantly higher
among patients treated with human fibrinogen concentrate versus placebo (P
<= 0.0001). No significant differences were observed in post-drug HEPTEM,
INTEM, and EXTEM results. Human fibrinogen concentrate (70 mg/kg)
administered after the termination of cardiopulmonary bypass reduced the
need for transfusion with cryoprecipitate in a neonate and infant patient
population. ClinicalTrials.gov identifier: NCT02822599. Copyright
© 2022, The Author(s).

<103>
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.

<104>
Accession Number
638831806
Title
Effect of a Decision Aid on Agreement between Patient Preferences and
Repair Type for Abdominal Aortic Aneurysm: A Randomized Clinical Trial.
Source
JAMA Surgery. 157(9) (pp E222935), 2022. Date of Publication: September
2022.
Author
Eid M.A.; Barry M.J.; Tang G.L.; Henke P.K.; Johanning J.M.; Tzeng E.;
Scali S.T.; Stone D.H.; Suckow B.D.; Lee E.S.; Arya S.; Brooke B.S.;
Nelson P.R.; Spangler E.L.; Murebee L.; Dosluoglu H.H.; Raffetto J.D.;
Kougais P.; Brewster L.P.; Alabi O.; Dardik A.; Halpern V.J.; O'Connell
J.B.; Ihnat D.M.; Zhou W.; Sirovich B.E.; Metha K.; Moore K.O.; Voorhees
A.; Goodney P.P.
Institution
(Eid, Stone, Suckow, Sirovich, Metha, Moore, Voorhees, Goodney) Department
of Surgery and VA Outcomes Group, White River Junction VA Medical Center,
White River Junction, VT, United States
(Eid, Stone, Suckow, Sirovich, Metha, Goodney) Geisel School of Medicine
at Dartmouth, Hanover, NH, United States
(Barry) Massachusetts General Hospital, Center for Shared Decision Making,
Boston, United States
(Tang) Seattle VA Medical Center, Seattle, WA, United States
(Henke) Ann Arbor VA Medical Center, Ann Arbor, MI, United States
(Johanning) Omaha VA Medical Center, Omaha, NE, United States
(Tzeng) Pittsburgh VA Medical Center, Pittsburgh, PA, United States
(Scali) Gainesville VA Medical Center, Gainesville, FL, United States
(Lee) Sacramento VA Medical Center, Mather, CA, United States
(Arya) Palo Alto VA Medical Center, Palo Alto, CA, United States
(Brooke) Salt Lake City VA, Salt Lake City, UT, United States
(Nelson) Muskogee VA Medical Center, Muskogee, OK, United States
(Spangler) Birmingham VA, Birmingham, AL, United States
(Murebee) Durham VA Medical Center, Durham, NC, United States
(Dosluoglu) Buffalo VA Medical Center, Buffalo, NY, United States
(Raffetto) West Roxbury VA, Boston, MA, United States
(Kougais) Houston VA Medical Center, Houston, TX, United States
(Brewster, Alabi) Atlanta VA Medical Center, Atlanta, GA, United States
(Dardik) West Haven VA Medical Center, West Haven, CT, United States
(Halpern) Phoenix VA Medical Center, Phoenix, AZ, United States
(O'Connell) Los Angeles VA Medical Center, Los Angeles, CA, United States
(Ihnat) Minneapolis VA Medical Center, Minneapolis, MN, United States
(Zhou) Tucson VA Medical Center, Tucson, AZ, United States
Publisher
American Medical Association
Abstract
Importance: Patients with abdominal aortic aneurysm (AAA) can choose open
repair or endovascular repair (EVAR). While EVAR is less invasive, it
requires lifelong surveillance and more frequent aneurysm-related
reinterventions than open repair. A decision aid may help patients receive
their preferred type of AAA repair. Objective(s): To determine the
effect of a decision aid on agreement between patient preference for AAA
repair type and the repair type they receive. Design, Setting, and
Participant(s): In this cluster randomized trial, 235 patients were
randomized at 22 VA vascular surgery clinics. All patients had AAAs
greater than 5.0 cm in diameter and were candidates for both open repair
and EVAR. Data were collected from August 2017 to December 2020, and data
were analyzed from December 2020 to June 2021. Intervention(s):
Presurgical consultation using a decision aid vs usual care. Main
Outcomes and Measures: The primary outcome was the proportion of patients
who had agreement between their preference and their repair type, measured
using chi2analyses, kappa statistics, and adjusted odds ratios.
 Result(s): Of 235 included patients, 234 (99.6%) were male, and the
mean (SD) age was 73 (5.9) years. A total of 126 patients were enrolled in
the decision aid group, and 109 were enrolled in the control group. Within
2 years after enrollment, 192 (81.7%) underwent repair. Patients were
similar between the decision aid and control groups by age, sex, aneurysm
size, iliac artery involvement, and Charlson Comorbidity Index score.
Patients preferred EVAR over open repair in both groups (96 of 122 [79%]
in the decision aid group; 81 of 106 [76%] in the control group; P =.60).
Patients in the decision aid group were more likely to receive their
preferred repair type than patients in the control group (95% agreement
[93 of 98] vs 86% agreement [81 of 94]; P =.03), and kappa statistics were
higher in the decision aid group (kappa = 0.78; 95% CI, 0.60-0.95)
compared with the control group (kappa = 0.53; 95% CI, 0.32-0.74).
Adjusted models confirmed this association (odds ratio of agreement in the
decision aid group relative to control group, 2.93; 95% CI, 1.10-7.70).
 Conclusions and Relevance: Patients exposed to a decision aid were
more likely to receive their preferred AAA repair type, suggesting that
decision aids can help better align patient preferences and treatments in
major cardiovascular procedures. Trial Registration: ClinicalTrials.gov
Identifier: NCT03115346. Copyright © 2022 American Medical
Association. All rights reserved.

<105>
Accession Number
638461760
Title
Prothrombin Complex Concentrate vs Plasma for Post-Cardiopulmonary Bypass
Coagulopathy and Bleeding: A Randomized Clinical Trial.
Source
JAMA Surgery. 157(9) (pp 757-764), 2022. Date of Publication: September
2022.
Author
Smith M.M.; Schroeder D.R.; Nelson J.A.; Mauermann W.J.; Welsby I.J.;
Pochettino A.; Montonye B.L.; Assawakawintip C.; Nuttall G.A.
Institution
(Smith, Nelson, Mauermann, Nuttall) Department of Anesthesiology and
Perioperative Medicine, Mayo Clinic, College of Medicine and Science,
Rochester, MN, United States
(Schroeder) Department of Biomedical Statistics and Informatics, Mayo
Clinic, College of Medicine and Science, Rochester, MN, United States
(Welsby) Department of Anesthesiology, Duke University, Medical Center,
Durham, NC, United States
(Pochettino) Division of Cardiovascular Surgery, Department of Surgery,
Mayo Clinic, College of Medicine and Science, Rochester, MN, United States
(Montonye) Anesthesia Clinical Research Unit, Mayo Clinic College of
Medicine and Science, Rochester, MN, United States
(Assawakawintip) Department of Anesthesiology, Wetchakarunrasm Hospital,
Bangkok, Thailand
Publisher
American Medical Association
Abstract
Importance: Post-cardiopulmonary bypass (CPB) coagulopathy and bleeding
are among the most common reasons for blood product transfusion in
surgical practices. Current retrospective data suggest lower transfusion
rates and blood loss in patients receiving prothrombin complex concentrate
(PCC) compared with plasma after cardiac surgery. Objective(s): To
analyze perioperative bleeding and transfusion outcomes in patients
undergoing cardiac surgery who develop microvascular bleeding and receive
treatment with either PCC or plasma. Design, Setting, and
Participant(s): A single-institution, prospective, randomized clinical
trial performed at a high-volume cardiac surgical center. Patients were
aged 18 years or older and undergoing cardiac surgery with CPB. Patients
undergoing complex cardiac surgical procedures (eg, aortic replacement
surgery, multiple procedures, or repeated sternotomy) were preferentially
targeted for enrollment. During the study period, 756 patients were
approached for enrollment, and 553 patients were randomized. Of the 553
randomized patients, 100 patients met criteria for study intervention.
 Intervention(s): Patients with excessive microvascular bleeding, a
prothombin time (PT) greater than 16.6 seconds, and an international
normalized ratio (INR) greater than 1.6 were randomized to receive
treatment with either PCC or plasma. The PCC dose was 15 IU/kg or closest
standardized dose; the plasma dose was a suggested volume of 10 to 15
mL/kg rounded to the nearest unit. Main Outcomes and Measures: The
primary outcome was postoperative bleeding (chest tube output) from the
initial postsurgical intensive care unit admission through midnight on
postoperative day 1. Secondary outcomes were PT/INR, rates of
intraoperative red blood cell (RBC) transfusion after treatment, avoidance
of allogeneic transfusion from the intraoperative period to the end of
postoperative day 1, postoperative bleeding, and adverse events.
 Result(s): One hundred patients (mean [SD] age, 66.8 [13.7] years; 61
[61.0%] male; and 1 [1.0%] Black, 1 [1.0%] Hispanic, and 98 [98.0%] White)
received the study intervention (49 plasma and 51 PCC). There was no
significant difference in chest tube output between the plasma and PCC
groups (median [IQR], 1022 [799-1575] mL vs 937 [708-1443] mL). After
treatment, patients in the PCC arm had a greater improvement in PT (effect
estimate, -1.37 seconds [95% CI, -1.91 to -0.84]; P <.001) and INR (effect
estimate, -0.12 [95% CI, -0.16 to -0.07]; P <.001). Fewer patients in the
PCC group required intraoperative RBC transfusion after treatment (7 of 51
patients [13.7%] vs 15 of 49 patients [30.6%]; P =.04); total
intraoperative transfusion rates were not significantly different between
groups. Seven (13.7%) of 51 patients receiving PCCs avoided allogeneic
transfusion from the intraoperative period to the end of postoperative day
1 vs none of those receiving plasma. There were no significant differences
in postoperative bleeding, transfusions, or adverse events.
 Conclusions and Relevance: The results of this study suggest a
similar overall safety and efficacy profile for PCCs compared with plasma
in this clinical context, with fewer posttreatment intraoperative RBC
transfusions, improved PT/INR correction, and higher likelihood of
allogeneic transfusion avoidance in patients receiving PCCs. Trial
Registration: ClinicalTrials.gov Identifier: NCT02557672. Copyright
© 2022 American Medical Association. All rights reserved.

<106>
Accession Number
2020336153
Title
Prediction of Death or HF Hospitalization in Patients With Severe FMR: The
COAPT Risk Score.
Source
JACC: Cardiovascular Interventions. 15(19) (pp 1893-1905), 2022. Date of
Publication: 10 Oct 2022.
Author
Shah N.; Madhavan M.V.; Gray W.A.; Brener S.J.; Ahmad Y.; Lindenfeld J.;
Abraham W.T.; Grayburn P.A.; Kar S.; Lim D.S.; Mishell J.M.; Whisenant
B.K.; Zhang Z.; Redfors B.; Mack M.J.; Stone G.W.
Institution
(Shah) East Carolina University, Greenville, NC, United States
(Madhavan, Ahmad, Redfors) NewYork-Presbyterian Hospital/Columbia
University Irving Medical Center, New York, NY, United States
(Madhavan, Zhang, Redfors) Clinical Trials Center, Cardiovascular Research
Foundation, New York, NY, United States
(Gray) Lankenau Heart Institute, Wynnewood, PA, United States
(Brener) NewYork-Presbyterian Hospital/Brooklyn Methodist Hospital,
Brooklyn, NY, United States
(Ahmad) Imperial College London, London, United Kingdom
(Lindenfeld) Vanderbilt Heart and Vascular Institute, Nashville, TN,
United States
(Abraham) The Ohio State University, Columbus, OH, United States
(Grayburn, Mack) Baylor Scott & White Heart Hospital, Plano, TX, United
States
(Kar) Center for Advanced Cardiac and Vascular Interventions, Los Angeles,
CA, United States
(Lim) University of Virginia, Charlottesville, VA, United States
(Mishell) Kaiser Permanente-San Francisco Hospital, San Francisco, CA,
United States
(Whisenant) Intermountain Medical Center, Murray, UT, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: There are limited data on the predictors of death or heart
failure hospitalization (HFH) in patients with heart failure (HF) with
functional mitral regurgitation (FMR). Objective(s): The aim of this
study was to develop a predictive risk score using the COAPT
(Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy
for Heart Failure Patients With Functional Mitral Regurgitation) trial
database. Method(s): In COAPT, 614 symptomatic patients with HF and
moderate to severe or severe FMR were randomized to MitraClip implantation
plus guideline-directed medical therapy (GDMT) or GDMT alone. A risk score
for the 2-year rate of death or HFH was generated from Cox proportional
hazards models. The predictive value of the model was assessed using the
area under the curve of receiver-operating characteristic plots.
Kaplan-Meier curves were generated to estimate the proportion of patients
experiencing death or HFH across quartiles of risk. Result(s): During
2-year follow-up, 201 patients (64.4%) in the GDMT-alone group and 133
patients (44.0%) in the MitraClip group experienced death or HFH (P <
0.001). A risk score containing 4 clinical variables (New York Heart
Association functional class, chronic obstructive pulmonary disease,
atrial fibrillation or flutter, and chronic kidney disease) and 4
echocardiographic variables (left ventricular ejection fraction, left
ventricular end-systolic dimension, right ventricular systolic pressure,
and tricuspid regurgitation) in addition to MitraClip treatment was
generated. The area under the curve of the risk score model was 0.74, and
excellent calibration was present. The relative benefit of MitraClip
therapy in reducing the 2-year hazard of death or HFH was consistent
across the range of baseline risk. Conclusion(s): A simple risk score
of clinical, echocardiographic, and treatment variables may provide useful
prognostication in patients with HF and severe FMR. Copyright ©
2022 American College of Cardiology Foundation

<107>
Accession Number
2020319624
Title
Early surgery vs conservative management among asymptomatic aortic
stenosis: A systematic review and meta-analysis.
Source
IJC Heart and Vasculature. 43 (no pagination), 2022. Article Number:
101125. Date of Publication: December 2022.
Author
Jaiswal V.; Khan N.; Jaiswal A.; Dagar M.; Joshi A.; Huang H.; Naz H.;
Attia A.M.; Ghanim M.; Baburaj A.; Song D.
Institution
(Jaiswal, Joshi) Department of Cardiovascular Research, Larkin Community
Hospital, FL, United States
(Khan) Jinnah Sindh Medical University, Karachi, Pakistan
(Jaiswal) Department of Geriatric Medicine, All India Institute of Medical
Science, New Delhi, India
(Dagar) Himalayan Institute of Medical Science, Dehradun, India
(Huang) University of Medicine and Health Science, Royal College of
Surgeons in Ireland, Dublin, Ireland
(Naz) Fatima Jinnah Medical University, Pakistan
(Attia) Faculty of Medicine, Cairo University, Cairo, Egypt
(Ghanim) Henry Ford Healthcare System, Detroit, MI, United States
(Baburaj) Center for Public Health, Queen's University, Belfast, United
Kingdom
(Song) Department of Internal Medicine, Icahn School of Medicine at Mount
Sinai - Elmhurst Hospital Center, NY, United States
Publisher
Elsevier Ireland Ltd
Abstract
Introduction: Although aortic valve replacement in severe symptomatic
Aortic Stenosis (AS) are clearly outlined, the role of surgical
intervention in asymptomatic severe AS remains unclear with limited
evidence. The aim of our meta-analysis is to evaluate the efficacy and
safety of early surgical aortic valve repair compared to conservative
management. Method(s): A systematic literature search was performed
in PubMed, Scopus, Embase and Cochrane databases for studies comparing the
early surgery versus conservative management among asymptomatic aortic
stenosis patients. Unadjusted odds ratios (OR) were pooled using a
random-effect model, and a p-value of < 0.05 was considered statistically
significant. Result(s): A total of 5 articles (3 observational
studies and 2 randomized controlled trials) were included. At a median
followup of 4.1 years, here were significantly lower odds of all-cause
mortality [OR = 0.30 (95 %CI:0.17-0.53), p < 0.0001], cardiovascular
mortality [OR = 0.35 (95 %CI:(0.17-0.72), p = 0.005], and sudden cardiac
death (OR = 0.36 (95 %CI: 0.15-0.89), p = 0.03) among early surgery group
compared with conservative care. There was no significant difference
between incidence of major bleeding, clinical thromboembolic events,
hospitalization due to heart failure, stroke and myocardial infarction
between the conservative care groups and early surgery.
 Conclusion(s): Among asymptomatic patients with AS, early surgery
shows better outcomes in reducing all-cause mortality and cardiovascular
mortality compared with conservative management approaches. Copyright
© 2022

<108>
Accession Number
2019169488
Title
Vitamin C May Improve Left Ventricular Ejection Fraction: A Meta-Analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 789729. Date of Publication: 25 Feb 2022.
Author
Hemila H.; Chalker E.; de Man A.M.E.
Institution
(Hemila) Department of Public Health, University of Helsinki, Helsinki,
Finland
(Chalker) Biological Data Science Institute, Australian National
University, Canberra, ACT, Australia
(de Man) Department of Intensive Care Medicine, Amsterdam University
Medical Centers, Amsterdam, Netherlands
Publisher
Frontiers Media S.A.
Abstract
Background: Vitamin C deprivation can lead to fatigue, dyspnea, oedema and
chest pain, which are also symptoms of heart failure (HF). In animal
studies vitamin C has improved contractility and mechanical efficiency of
the heart. Compared with healthy people, patients with HF have lower
vitamin C levels, which are not explained by differences in dietary intake
levels, and more severe HF seems to be associated with lower plasma
vitamin C levels. This meta-analysis looks at the effect of vitamin C on
left ventricular ejection fraction (LVEF). Method(s): We searched for
trials reporting the effects of vitamin C on LVEF. We assessed the quality
of the trials, and pooled selected trials using the inverse variance,
fixed effect options. We used meta-regression to examine the association
between the effect of vitamin C on LVEF level and the baseline LVEF level.
 Result(s): We identified 15 trials, three of which were excluded from
our meta-analysis. In six cardiac trials with 246 patients, vitamin C
increased LVEF on average by 12.0% (95% CI 8.1-15.9%; P < 0.001). In six
non-cardiac trials including 177 participants, vitamin C increased LVEF on
average by 5.3% (95% CI 2.0-8.5%; P = 0.001). In meta-regression analysis
we found that the effect of vitamin C was larger in trials with the lowest
baseline LVEF levels with P = 0.001 for the test of slope. The
meta-regression line crossed the null effect level at a baseline LVEF
level close to 70%, with progressively greater benefit from vitamin C with
lower LVEF levels. Some of the included trials had methodological
limitations. In a sensitivity analysis including only the four most
methodologically sound cardiac trials, the effect of vitamin C was not
substantially changed. Conclusion(s): In this meta-analysis, vitamin
C increased LVEF in both cardiac and non-cardiac patients, with a strong
negative association between the size of the vitamin C effect and the
baseline LVEF. Further research on vitamin C and HF should be carried out,
particularly in patients who have low LVEF together with low vitamin C
intake or low plasma levels. Different dosages and different routes of
administration should be compared. Copyright © 2022 Hemila,
Chalker and de Man.

<109>
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.

<110>
Accession Number
2019169363
Title
Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention
for Multivessel Coronary Artery Disease: A One-Stage Meta-Analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 822228. Date of Publication: 25 Mar 2022.
Author
Chew N.W.S.; Koh J.H.; Ng C.H.; Tan D.J.H.; Yong J.N.; Lin C.; Lim
O.Z.-H.; Chin Y.H.; Lim D.M.W.; Chan K.H.; Loh P.-H.; Low A.; Lee C.-H.;
Tan H.-C.; Chan M.
Institution
(Chew, Chan, Loh, Low, Lee, Tan, Chan) Department of Cardiology, National
University Heart Centre, Singapore, Singapore
(Koh, Ng, Tan, Yong, Lin, Lim, Chin, Lim, Chan, Loh, Low, Lee, Tan, Chan)
School of Medicine, National University of Singapore, Singapore, Singapore
Publisher
Frontiers Media S.A.
Abstract
Background and Aims: Data are emerging on 10-year mortality comparing
coronary artery bypass grafting (CABG) and percutaneous coronary
intervention (PCI) with stenting for multivessel disease (MVD) without
left main (LM) involvement. We conducted an updated two-stage
meta-analysis using reconstructed individual patient data to compare
long-term mortality between CABG and PCI for patients with MVD without
significant LM coronary disease. Method(s): Medline and Embase
databases were searched for articles comparing CABG with PCI for MVD. A
two-stage meta-analysis was conducted using reconstructed patient level
survival data for all-cause mortality with subgroups by SYNTAX score. The
shared-frailty and stratified Cox models were fitted to compare survival
endpoints. Result(s): We screened 1,496 studies and included six
randomized controlled trials with 7,181 patients. PCI was associated with
greater 10-year all-cause mortality risk (HR: 1.282, CI: 1.118-1.469, p <
0.001) compared with CABG. In patients with low SYNTAX score, 10-year
all-cause mortality after PCI was comparable to CABG (HR: 1.102,
0.822-1.479, p = 0.516). However, in patients with moderate to high SYNTAX
score, 10-year all-cause mortality was significantly higher after PCI
compared with CABG (HR: 1.444, 1.122-1.858, p < 0.001; HR: 1.856,
1.380-2.497, p < 0.001, respectively). Conclusion(s): This updated
reconstructed individual patient-data meta-analysis revealed a sustained
lower cumulative all-cause mortality of CABG over PCI for multivessel
disease without LM involvement. Copyright © 2022 Chew, Koh, Ng,
Tan, Yong, Lin, Lim, Chin, Lim, Chan, Loh, Low, Lee, Tan and Chan.

<111>
Accession Number
2019168537
Title
Impact of 3D Rigid Ring Annuloplasty for Tricuspid Regurgitation: A
Systematic Review and Meta-Analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 725968. Date of Publication: 08 Mar 2022.
Author
You T.; Ma Y.-H.; Yi K.; Gao J.; Xu J.-G.; Xu X.-M.; He S.-E.; Wang W.; Ji
M.
Institution
(You, Yi) Department of Cardiovascular Surgery, Gansu Provincial Hospital,
Lanzhou, China
(You, Ma, Yi, Gao, Xu, He, Wang, Ji) Gansu International Scientific and
Technological Cooperation Base of Diagnosis and Treatment of Congenital
Heart Disease, Lanzhou, China
(Ma) Department of Neurosurgery, West China Hospital of Sichuan
University, Chengdu, China
(Gao, Xu, Wang, Ji) The First Clinical Medical College of Lanzhou
University, Lanzhou, China
(Xu) Evidence-Based Medicine Center, School of Basic Medical Sciences,
Lanzhou University, Lanzhou, China
(He) The Second Clinical Medical College of Lanzhou University, Lanzhou,
China
Publisher
Frontiers Media S.A.
Abstract
Background: Tricuspid annuloplasty (TAP) is accepted as the standard
technique for correcting tricuspid regurgitation (TR). We conducted the
present study to provide an overview of the contemporary results of 3D
rigid ring annuloplasty for TR. Method(s): A systematic literature
search was carried out in eight databases to collect all relevant studies
on the three-dimensional (3D) rigid ring annuloplasty treatment of TR
published before October 1, 2020. The main outcomes of interest were
postoperative TR grade, perioperative mortality, and recurrent TR.
 Result(s): A total of eight studies were included, all of which were
retrospective observational studies. Rigid 3D rings were compared with
flexible bands, and there was no difference in perioperative mortality
[odds ratio (OR) = 1.02; 95% CI (0.52, 2.02); p = 0.95], late mortality
[OR = 0.99; 95% CI (0.28, 3.50); p = 0.98], or recurrent TR [OR = 0.59;
95% CI (0.29, 1.21); p = 0.15]. The postoperative TR grade associated with
3D rigid rings was 0.12 lower [mean difference (MD) = -0.12; 95% CI
(-0.22, -0.01); p = 0.03], which indicated that 3D rigid rings result in
better postoperative outcomes than flexible bands. Compared with suture
annuloplasty, the postoperative TR grade of the 3D rigid ring group was
0.51 lower [MD = -0.51; 95% CI (-0.59, -0.43); p < 0.05]. Within the 5
years of follow-up, patients who underwent 3D rigid ring annuloplasty had
lower TR recurrence [OR = 0.26; 95% CI (0.13, 0.50); p < 0.05].
 Conclusion(s): Compared with suture annuloplasty, 3D rigid rings
present early advantages. The 3D rigid rings provide an acceptable
short-term effect similar to that of the flexible bands, and a significant
difference between these approaches was not discovered. However, the
conclusion was based on the limited, short-term data available at the time
of the study. Further research on the long-term effects of 3D rigid ring
annuloplasty for TR is clearly needed. Systematic Review Registration:
https://inplasy.com/inplasy-2021-3-0105/, identifier:
202130105. Copyright © 2022 You, Ma, Yi, Gao, Xu, Xu, He, Wang
and Ji.

<112>
Accession Number
2019168270
Title
Ultrasound-guided, continuous erector spinae plane (ESP) block in
minimally invasive thoracic surgery-comparing programmed intermittent
bolus (PIB) vs continuous infusion on quality of recovery and
postoperative respiratory function: a double-blinded randomised controlled
trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 792. Date of
Publication: December 2022.
Author
Eochagain A.N.; Moorthy A.; O'Gara A.; Buggy D.J.
Institution
(Eochagain, Moorthy, Buggy) Division of Anaesthesiology & Perioperative
Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
(Moorthy, Buggy) School of Medicine, University College, Dublin, Ireland
(O'Gara) Department of Anaesthesia and Pain Medicine, St James's
University Hospital, Dublin, Ireland
Publisher
BioMed Central Ltd
Abstract
Background: Minimally invasive thoracic surgery (MITS) has been shown to
reduce postoperative pain and contribute to better postoperative quality
of life as compared to open thoracic surgery (Bendixen et al., Lancet
Oncol 17:836-44, 2016). However, it still causes significant
post-operative pain. Regional anaesthesia techniques including fascial
plane blocks such as the erector spinae plane block (ESP) have been shown
to contribute to post-operative pain control after MITS (Finnerty et al.,
Br J Anaesth 125:802-10, 2020). Case reports relating to ESP catheters
have described improved quality of pain relief using programmed
intermittent boluses (PIB) instead of continuous infusion (Bendixen et
al., Lancet Oncol 17:836-44, 2016). It is suggested that larger, repeated
bolus dose may provide superior pain relief, possibly because of improved
spread of the local anaesthetic medications (Ilfeld and Gabriel, Reg
Anesth Pain Med 44:285-86, 2019). Evidence for improved spread of local
anaesthetic may be found in one study which demonstrated that PIB
increased the spread of local anaesthetic medication compared to
continuous infusions for continuous paravertebral blocks, which are
another type of regional anaesthesia technique for the chest wall (Hida et
al., Reg Anesth Pain Med 44:326-32, 2019). Similarly, regarding labour
epidural analgesia, the weight of evidence is in favour of PIB providing
better pain relief compared with continuous infusion (Onuoha, Anesthesiol
Clin 35:1-14, 2017). Since fascial plane blocks, such as ESP, rely on the
spread of local anaesthetic medication between muscle layers of the chest
wall, intermittent boluses may be particularly useful for this group of
blocks. However, until recently, pumps capable of providing automated
boluses in addition to patient-controlled boluses were not widely
available. To best of our knowledge, there are no randomised controlled
trials comparing continuous infusion versus intermittent bolus strategies
for erector spinae plane block for MITS in terms of patient centred
outcomes such as quality of recovery. Method(s): This trial will be a
prospective, double-blinded, randomised controlled superiority trial. A
total of 60 eligible patients will be randomly assigned to receive an
intermittent bolus regime of local anaesthetic vs a continuous infusion of
local anaesthetic. The medication will be delivered via an
ultrasound-guided erector spinae plane block catheter which will be
inserted by an anaesthesiologist while the patient is under general
anaesthetic before their MITS surgery begins. The primary outcome being
measured is the Quality of Recovery (QoR-15) score between the two groups
24 h after surgery. Secondary outcomes include respiratory testing of
maximal inspiratory volume measured with a calibrated incentive
spirometer, area under the curve for Verbal Rating Score for pain at rest
and on deep inspiration versus time over 48 h, total opioid consumption
over 48 h, QoR-15 score at 48 h and time to first mobilisation.
 Discussion(s): Despite surgical advancements in thoracic surgery,
severe acute post-operative pain following MITS is still prevalent. This
study will provide new knowledge and possible recommendations about the
efficacy of programmed intermittent bolus regimen of local anaesthetic vs
a continuous infusion of local anaesthetic via an ultrasound-guided
erector spinae plane catheter for patients undergoing MITS. Trial
registration: This trial was pre-registered on ClinicalTrials.gov
Identifier: NCT05181371. Registered on 6 January 2022. All item from the
World Health Organization Trial Registration Data set have been
included. Copyright © 2022, The Author(s).

<113>
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.

<114>
Accession Number
2019147269
Title
Neuroprotective effect of remote ischemic preconditioning in patients
undergoing cardiac surgery: A randomized controlled trial.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 952033. Date of Publication: 06 Sep 2022.
Author
Zhu S.; Zheng Z.; Lv W.; Ouyang P.; Han J.; Zhang J.; Dong H.; Lei C.
Institution
(Zhu, Zheng, Lv, Ouyang, Dong, Lei) Department of Anesthesiology and
Perioperative Medicine, Xijing Hospital, Air Force Medical University,
Xi'an, China
(Han) Department of Anesthesiology, Tianjin Chest Hospital, Tianjin, China
(Zhang) Department of Anesthesiology and Perioperative Medicine, Henan
Provincial People's Hospital, People's Hospital of Zhengzhou University,
Zhengzhou, China
Publisher
Frontiers Media S.A.
Abstract
Background: The neuroprotective effect of remote ischemic preconditioning
(RIPC) in patients undergoing elective cardiopulmonary bypass
(CPB)-assisted coronary artery bypass graft (CABG) or valvular cardiac
surgery remains unclear. Method(s): A randomized, double-blind,
placebo-controlled superior clinical trial was conducted in patients
undergoing elective on-pump coronary artery bypass surgery or valve
surgery. Before anesthesia induction, patients were randomly assigned to
RIPC (three 5-min cycles of inflation and deflation of blood pressure cuff
on the upper limb) or the control group. The primary endpoint was the
changes in S-100 calcium-binding protein beta (S100-beta) levels at 6 h
postoperatively. Secondary endpoints included changes in Neuron-specific
enolase (NSE), Mini-mental State Examination (MMSE), and Montreal
Cognitive Assessment (MoCA) levels. Result(s): A total of 120
patients [mean age, 48.7 years; 36 women (34.3%)] were randomized at three
cardiac surgery centers in China. One hundred and five patients were
included in the modified intent-to-treat analysis (52 in the RIPC group
and 53 in the control group). The primary result demonstrated that at 6 h
after surgery, S100-beta levels were lower in the RIPC group than in the
control group (50.75; 95% confidence interval, 67.08 to 64.40 pg/ml vs.
70.48; 95% CI, 56.84 to 84.10 pg/ml, P = 0.036). Compared to the control
group, the concentrations of S100-beta at 24 h and 72 h and the
concentration of NSE at 6 h, 24 h, and 72 h postoperatively were
significantly lower in the RIPC group. However, neither the MMSE nor the
MoCA revealed significant between-group differences in postoperative
cognitive performance at 7 days, 3 months, and 6 months after surgery.
 Conclusion(s): In patients undergoing CPB-assisted cardiac surgery,
RIPC attenuated brain damage as indicated with the decreased release of
brain damage biomarker S100-beta and NSE. Clinical trial registration:
[ClinicalTrials.gov], identifier [NCT01231789]. Copyright © 2022
Zhu, Zheng, Lv, Ouyang, Han, Zhang, Dong and Lei.

<115>
Accession Number
2019076107
Title
Effect of low-dose dexmedetomidine on sleep quality in postoperative
patients with mechanical ventilation in the intensive care unit: A pilot
randomized trial.
Source
Frontiers in Medicine. 9 (no pagination), 2022. Article Number: 931084.
Date of Publication: 31 Aug 2022.
Author
Sun Y.-M.; Zhu S.-N.; Zhang C.; Li S.-L.; Wang D.-X.
Institution
(Sun, Li) Department of Critical Care Medicine, Peking University First
Hospital, Beijing, China
(Zhu) Department of Biostatistics, Peking University First Hospital,
Beijing, China
(Zhang) Department of Respiratory and Critical Care Medicine, Peking
University First Hospital, Beijing, China
(Wang) Departments of Anesthesiology and Critical Care Medicine, Peking
University First Hospital, Beijing, China
(Wang) Outcomes Research Consortium, Cleveland Clinic, Cleveland, OH,
United States
Publisher
Frontiers Media S.A.
Abstract
Background: Sleep disturbances are prevalent in patients requiring
invasive mechanical ventilation in the intensive care unit (ICU) and are
associated with worse outcomes. Sedative-dose dexmedetomidine may improve
sleep quality in this patient population but is associated with adverse
events. Herein, we tested the effect of low-dose dexmedetomidine infusion
on nighttime sleep quality in postoperative ICU patients with invasive
ventilation. Method(s): In this pilot randomized trial, 80 adult
patients who were admitted to the ICU after non-cardiac surgery and
required invasive mechanical ventilation were randomized to receive either
low-dose dexmedetomidine (0.1 to 0.2 mug/kg/h, n = 40) or placebo (n = 40)
for up to 72 h. The primary endpoint was overall subjective sleep quality
measured using the Richards-Campbell Sleep Questionnaire (score ranges
from 0 to 100, with a higher score indicating better quality) in the night
of surgery. Secondary outcomes included sleep structure parameters
monitored with polysomnography from 9:00 PM on the day of surgery to the
next 6:00 AM. Result(s): All 80 patients were included in the
intention-to-treat analysis. The overall subjective sleep quality was
median 52 (interquartile 20, 66) with placebo vs. 61 (27, 79) with
dexmedetomidine, and the difference was not statistically significant
(median difference 8; 95% CI: -2, 22; P = 0.120). Among 68 patients
included in sleep structure analysis, those in the dexmedetomidine group
tended to have longer total sleep time [median difference 54 min (95% CI:
-4, 120); P = 0.061], higher sleep efficiency [median difference 10.0%
(95% CI: -0.8%, 22.3%); P = 0.060], lower percentage of stage N1 sleep
[median difference -3.9% (95% CI: -11.8%, 0.5%); P = 0.090], higher
percentage of stage N3 sleep [median difference 0.0% (95% CI: 0.0%, 0.4%);
P = 0.057], and lower arousal index [median difference -0.9 (95% CI -2.2,
0.1); P = 0.091] but not statistically significant. There were no
differences between the two groups regarding the incidence of adverse
events. Conclusion(s): Among patients admitted to the ICU after
surgery with intubation and mechanical ventilation, low-dose
dexmedetomidine infusion did not significantly improve the sleep quality
pattern, although there were trends of improvement. Our findings support
the conduct of a large randomized trial to investigate the effect of
low-dose dexmedetomidine in this patient population. Clinical trial
registration: ClinicalTrial.gov, identifier: NCT03335527. Copyright
© 2022 Sun, Zhu, Zhang, Li and Wang.

<116>
Accession Number
2019075273
Title
Flurbiprofen used in one-lung ventilation improves intraoperative regional
cerebral oxygen saturation and reduces the incidence of postoperative
delirium.
Source
Frontiers in Psychiatry. 13 (no pagination), 2022. Article Number: 889637.
Date of Publication: 31 Aug 2022.
Author
Shen L.; Chen J.-Q.; Yang X.-L.; Hu J.-C.; Gao W.; Chai X.-Q.; Wang D.
Institution
(Shen) Department of Anesthesiology, Anhui Provincial Hospital Affiliated
to Anhui Medical University, Hefei, China
(Shen, Chen, Yang, Hu, Gao, Chai, Wang) Pain Clinic, Department of
Anesthesiology, First Affiliated Hospital of USTC, Division of Life
Sciences and Medicine, University of Science and Technology of China
(USTC), Hefei, China
Publisher
Frontiers Media S.A.
Abstract
Background: We previously demonstrated that flurbiprofen increased
arterial oxygen partial pressure and reduced intrapulmonary shunts. The
present study aims to investigate whether flurbiprofen improves
intraoperative regional cerebral oxygen saturation (rScO<inf>2</inf>) and
reduces the incidence of postoperative delirium (POD) in elderly patients
undergoing one-lung ventilation (OLV). Method(s): One hundred and
twenty patients undergoing thoracoscopic lobectomy were randomly assigned
to the flurbiprofen-treated group (n = 60) and the control-treated group
(n = 60). Flurbiprofen was intravenously administered 20 minutes before
skin incision. The rScO<inf>2</inf> and partial pressure of arterial
oxygen (PaO<inf>2</inf>) were recorded during the surgery, and POD was
measured by the Confusion Assessment Method (CAM) within 5 days after
surgery. The study was registered in the Chinese Clinical Trial Registry
with the number ChiCTR1800020032. Result(s): Compared with the
control group, treatment with flurbiprofen significantly improved the mean
value of intraoperative rScO<inf>2</inf> as well as the PaO<inf>2</inf>
value (P < 0.05, both) and significantly reduced the baseline values of
the rScO<inf>2</inf> area under threshold (AUT) (P < 0.01) at 15, 30, and
60 min after OLV in the flurbiprofen-treated group. After surgery, the POD
incidence in the flurbiprofen-treated group was significantly decreased
compared with that in the control group (P < 0.05). Conclusion(s):
Treatment with flurbiprofen may improve rScO<inf>2</inf> and reduce the
incidence of POD in elderly patients undergoing thoracoscopic one-lung
ventilation surgery for lung cancer. Clinical trial registration:
http://www.chictr.org/cn/, identifier ChiCTR1800020032. Copyright
© 2022 Shen, Chen, Yang, Hu, Gao, Chai and Wang.

<117>
Accession Number
2019168364
Title
Factor eight inhibiting bypass activity for refractory bleeding in acute
type A aortic dissection repair: A propensity-matched analysis.
Source
Transfusion. (no pagination), 2022. Date of Publication: 2022.
Author
Pupovac S.S.; Levine R.; Giammarino A.T.; Scheinerman S.J.; Hartman A.R.;
Brinster D.R.; Hemli J.M.
Institution
(Pupovac, Hartman) Department of Cardiovascular and Thoracic Surgery,
North Shore University Hospital/Northwell Health, Manhasset, NY, United
States
(Levine) Department of Hematology and Oncology, Lenox Hill
Hospital/Northwell Health, New York, NY, United States
(Giammarino, Scheinerman, Brinster, Hemli) Department of Cardiovascular
and Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, NY,
United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Perioperative bleeding and transfusion have been associated
with adverse outcomes after cardiac surgery. The use of factor eight
inhibiting bypass activity (FEIBA) in managing bleeding after repair of
acute Stanford type A aortic dissection (ATAAD) has not previously been
evaluated. We report our experience in utilizing FEIBA in ATAAD repair.
Study Design and Methods: A retrospective review was undertaken of all
consecutive patients who underwent repair of ATAAD between July 2014 and
December 2019. Patients were divided into two groups, dependent upon
whether or not they received FEIBA intraoperatively: "FEIBA" (n = 112)
versus "no FEIBA" (n = 119). From this, 53 propensity-matched pairs of
patients were analyzed with respect to transfusion requirements and
short-term clinical outcomes. Result(s): Thirty-day mortality for the
entire cohort was 11.7% (27 deaths), not significantly different between
patient groups. Those patients who received FEIBA demonstrated reduced
transfusion requirements for all types of blood products in the first 48 h
after surgery as compared with the "no FEIBA" cases, including red blood
cells, platelets, plasma, and cryoprecipitate (p <.0001). There was no
significant difference in major postoperative morbidity between the two
groups. The FEIBA cohort did not demonstrate an increased incidence of
thrombotic complications (stroke, deep venous thrombosis, pulmonary
thromboembolism). Discussion(s): When used as rescue therapy for
refractory bleeding following repair of ATAAD, FEIBA appears to be
effective in decreasing postoperative transfusion requirements whilst not
negatively impacting clinical outcomes. These findings should prompt
further investigation and validation via larger, multi-center, randomized
trials. Copyright © 2022 AABB.

<118>
Accession Number
2019148550
Title
Clinical and echocardiographic predictors of the anterior mitral leaflet
repair failure.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Stojanovic I.; Okiljevic B.R.; Radojicic Z.; Novakovic A.; Kaitovic M.;
Tomic S.
Institution
(Stojanovic, Okiljevic, Kaitovic) Clinic for Cardiac Surgery, Institute
for Cardiovascular Diseases "Dedinje", Belgrade, Serbia
(Radojicic) Faculty of Organizational Science, University of Belgrade,
Belgrade, Serbia
(Novakovic) Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
(Tomic) Clinic for Cardiology, Institute for Cardiovascular Diseases
"Dedinje", Belgrade, Serbia
Publisher
John Wiley and Sons Inc
Abstract
Background: Anterior mitral leaflet prolapse repair is a highly effective
procedure, but despite excellent operative results still has an inferior
long-term durability when compared to posterior leaflet repair.
 Method(s): We analysed mitral repair durability in 74 consecutive
patients operated for anterior leaflet prolapse between 2010 and 2021.
Their pre- and postoperative clinical, echocardiographic data and repair
durability as well, were compared with 74 randomly assigned posterior
leaflet prolapse patients who underwent valve repair during the same
period. Result(s): While groups were of similar age, patients with
anterior leaflet prolapse had an inferior preoperative status in terms of
functional reserve, atrial fibrillation, operative risk, ejection fraction
and had more dilated left heart chambers as well. 1, 5, and 10-year
freedom from repair failure was 87.1 +/- 4.6%, 79.8 +/- 6.5% and 50.7 +/-
12.5% in the anterior, and 98.5 +/- 1.5% respectively in the posterior
leaflet group. Atrial fibrilation (hazard ratio [HR] 5.365; 95%;
confidence interval [CI] 1.093-26.324 p =.038) and left ventricle
end-systolic diameter (HR 1.160 95%; CI 1.037-1.299 p =.010) independently
predicted anterior leaflet repair failure. Receiver Operating Curve
analysis established left ventricle end-systolic diameter <=42 mm as a
cut-off value associated with improved anterior leaflet repair durability.
Accordingly, 10-year repair durability in a subset of patients, with
preserved left ventricle end-systolic diameter (<=42 mm) was 86.4 +/-
7.8%. Conclusion(s): Better long-term repair durability in patients
with anterior mitral leaflet prolapse and preserved sinus rhytm and
left-ventricle diameters justifies early reconstructive
approach. Copyright © 2022 Wiley Periodicals LLC.

<119>
Accession Number
2018968990
Title
Long-term results after simultaneous carotid and coronary
revascularisation.
Source
Asian Cardiovascular and Thoracic Annals. (no pagination), 2022. Date of
Publication: 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.

<120>
Accession Number
2018964118
Title
Health-related quality of life after restrictive versus liberal RBC
transfusion for cardiac surgery: Sub-study from a randomized clinical
trial.
Source
Transfusion. (no pagination), 2022. Date of Publication: 2022.
Author
Hu R.T.; Royse A.G.; Royse C.; Scott D.A.; Bowyer A.; Boggett S.; Summers
P.; Mazer C.D.
Institution
(Hu, Royse, Royse, Scott, Bowyer, Boggett) Department of Surgery,
University of Melbourne, Parkville, VIC, Australia
(Hu) Department of Anaesthesia, Austin Health, Heidelberg, VIC, Australia
(Royse, Royse, Bowyer) Department of Anaesthesia and Pain Management,
Royal Melbourne Hospital, Parkville, VIC, Australia
(Royse) Outcomes Research Consortium, The Cleveland Clinic, Cleveland, OH,
United States
(Scott) Department of Anaesthesia and Acute Pain Medicine, St Vincent's
Hospital Melbourne, Fitzroy, VIC, Australia
(Summers) Statistical Consulting Centre, University of Melbourne,
Parkville, VIC, Australia
(Summers) Melbourne Disability Institute, University of Melbourne,
Parkville, VIC, Australia
(Summers) Centre for Health Analytics, Murdoch Children's Research
Institute, Royal Children's Hospital, Parkville, VIC, Australia
(Mazer) Department of Anaesthesia, St. Michael's Hospital, University of
Toronto, Toronto, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: Transfusion Requirements in Cardiac Surgery III (TRICS III), a
multi-center randomized controlled trial, demonstrated clinical
non-inferiority for restrictive versus liberal RBC transfusion for
patients undergoing cardiac surgery. However, it is uncertain if
transfusion strategy affects long-term health-related quality of life
(HRQOL). Study Design and Methods: In this planned sub-study of Australian
patients in TRICS III, we sought to determine the non-inferiority of
restrictive versus liberal transfusion strategy on long-term HRQOL and to
describe clinical outcomes 24 months postoperatively. The restrictive
strategy involved transfusing RBCs when hemoglobin was <7.5 g/dl; the
transfusion triggers in the liberal group were: <9.5 g/L intraoperatively,
<9.5 g/L in intensive care, or <8.5 g/dl on the ward. HRQOL assessments
were performed using the 36-item short form survey version 2 (SF-36v2).
Primary outcome was non-inferiority of summary measures of SF-36v2 at 12
months, (non-inferiority margin: -0.25 effect size; restrictive minus
liberal scores). Secondary outcomes included non-inferiority of HRQOL at
18 and 24 months. Result(s): Six hundred seventeen Australian
patients received allocated randomization; HRQOL data were available for
208/311 in restrictive and 217/306 in liberal group. After multiple
imputation, non-inferiority of restrictive transfusion at 12 months was
not demonstrated for HRQOL, and the estimates were directionally in favor
of liberal transfusion. Non-inferiority also could not be concluded at 18
and 24 months. Sensitivity analyses supported these results. There were no
differences in quality-adjusted life years or composite clinical outcomes
up to 24 months after surgery. Discussion(s): The non-inferiority of
a restrictive compared to a liberal transfusion strategy was not
established for long-term HRQOL in this dataset. Copyright © 2022
AABB.

<121>
Accession Number
2018962374
Title
Effect of ventilation mode on postoperative pulmonary complications
following lung resection surgery: a randomised controlled trial.
Source
Anaesthesia. (no pagination), 2022. Date of Publication: 2022.
Author
Li X.-F.; Jin L.; Yang J.-M.; Luo Q.-S.; Liu H.-M.; Yu H.
Institution
(Li, Liu, Yu) Department of Anaesthesiology, West China Hospital of
Sichuan University, Chengdu, China
(Jin, Yang, Luo) Department of Anaesthesiology, Leshan People's Hospital,
Leshan, China
Publisher
John Wiley and Sons Inc
Abstract
The effect of intra-operative mechanical ventilation modes on pulmonary
outcomes after thoracic surgery with one-lung ventilation has not been
well established. We evaluated the impact of three common ventilation
modes on postoperative pulmonary complications in patients undergoing lung
resection surgery. In this two-centre randomised controlled trial, 1224
adults scheduled for lung resection surgery with one-lung ventilation were
randomised to one of three groups: volume-controlled ventilation;
pressure-controlled ventilation; and pressure-control with volume
guaranteed ventilation. Enhanced recovery after surgery pathways and
lung-protective ventilation protocols were implemented in all groups. The
primary outcome was a composite of postoperative pulmonary complications
within the first seven postoperative days. The outcome occurred in 270
(22%), with 87 (21%) in the volume control group, 89 (22%) in the pressure
control group and 94 (23%) in the pressure-control with volume guaranteed
group (p = 0.831). The secondary outcomes also did not differ across study
groups. In patients undergoing lung resection surgery with one-lung
ventilation, the choice of ventilation mode did not influence the risk of
developing postoperative pulmonary complications. This is the first
randomised controlled trial examining the effect of three ventilation
modes on pulmonary outcomes in patients undergoing lung resection
surgery. Copyright © 2022 Association of Anaesthetists.

<122>
Accession Number
639081235
Title
Meta-analysis of short- and long-term clinical outcomes of the
self-expanding Evolut R/pro valve versus the balloon-expandable Sapien 3
valve for transcatheter aortic valve implantation.
Source
International journal of cardiology. (no pagination), 2022. Date of
Publication: 18 Sep 2022.
Author
Lerman T.T.; Levi A.; Kornowski R.
Institution
(Lerman) Department of Internal Medicine F-Recanati, Beilinson Hospital,
Rabin Medical Center, Petah Tikva, Israel; Department of Cardiology, Rabin
Medical Center, Petah Tikva, Israel; The Faculty of Medicine, Tel Aviv
University, Tel Aviv, Israel
(Levi, Kornowski) Department of Cardiology, Rabin Medical Center, Petah
Tikva, Israel; The Faculty of Medicine, Tel Aviv University, Tel Aviv,
Israel
Publisher
NLM (Medline)
Abstract
BACKGROUND: The Evolut R/Pro and the Sapien 3 are the most commonly valve
systems used today for transcatheter aortic valve implantation (TAVI).
However, there is a still uncertainty regarding the efficacy and safety
comparison of these two valves. METHOD(S): We conducted a systematic
review and meta-analysis of randomized controlled trials (RCTs) and
observational studies comparing the Evolut R/Pro versus the Sapien 3. The
primary outcome was all-cause mortality (short and long-term). The
secondary outcomes were stroke, bleeding, permanent pacemaker implantation
(PPI), acute kidney injury (AKI), major vascular complication, device
success, moderate- severe aortic regurgitation (AR), and pressure
gradients. RESULT(S): Twenty-one publications totaling 35,248
patients were included in the analysis. Evolut R/Pro was associated with
higher risk of short-term all-cause mortality (OR=1.31;95% CI 1.15-1.49,
p<0.001) and a trend of higher long-term mortality (OR=1.07;95% CI
1.00-1.16, p=0.06). The Evolut R/Pro was associated with higher risk of
PPI and AR and lower risk for bleeding, major vascular complication, and
pressure gradients. There was no significant difference between the groups
regarding the risk of stroke, AKI and device success. CONCLUSION(S):
The Evolut R/Pro valve system compared to the Sapien 3 is associated with
higher risk of short-term mortality, significant AR and PPI while
providing the advantage of lower risk of bleeding, major vascular
complication, and lower residual transvalvular gradients. Copyright
© 2022. Published by Elsevier B.V.

<123>
Accession Number
2017565871
Title
A Randomized Clinical Trial of Perfusion Modalities in Pediatric
Congenital Heart Surgery Patients.
Source
Annals of Thoracic Surgery. 114(4) (pp 1404-1411), 2022. Date of
Publication: October 2022.
Author
Undar A.; Patel K.; Holcomb R.M.; Clark J.B.; Ceneviva G.D.; Young C.A.;
Spear D.; Kunselman A.R.; Thomas N.J.; Myers J.L.
Institution
(Undar, Patel, Holcomb, Clark, Ceneviva, Young, Spear, Kunselman, Thomas,
Myers) Departments of Pediatrics, Penn State Hershey Pediatric
Cardiovascular Research Center, Hershey, Pennsylvania
(Undar, Patel, Holcomb, Clark, Myers) Department of Surgery, Penn State
Hershey Pediatric Cardiovascular Research Center, Hershey, Pennsylvania
(Undar) Department of Biomedical Engineering, Penn State Hershey Pediatric
Cardiovascular Research Center, Hershey, Pennsylvania
(Ceneviva, Young, Spear) Division of Pediatric Critical Care Medicine,
Penn State Health Children's Hospital, Penn State College of Medicine,
Hershey, Pennsylvania
(Kunselman, Thomas) Department of Public Health Sciences, Penn State
Health Children's Hospital, Penn State College of Medicine, Hershey,
Pennsylvania
Publisher
Elsevier Inc.
Abstract
Background: The objective of this randomized clinical trial was to
investigate the effects of perfusion modalities on cerebral hemodynamics,
vital organ injury, quantified by the Pediatric Logistic Organ
Dysfunction-2 (PELOD-2) Score, and clinical outcomes in risk-stratified
congenital cardiac surgery patients. Method(s): This randomized
clinical trial included 159 consecutive congenital cardiac surgery
patients in whom pulsatile (n = 83) or nonpulsatile (n = 76) perfusion was
used. Cerebral hemodynamics were assessed using transcranial Doppler
ultrasound. Multiple organ injury was quantified using the PELOD-2 score
at 24, 48, and 72 hours. Clinical outcomes, including intubation time,
intensive care unit length of stay (LOS), hospital LOS, and mortality,
were also evaluated. Result(s): The Pulsatility Index at the middle
cerebral artery and in the arterial line during aortic cross-clamping was
consistently better maintained in the pulsatile group. Demographics and
cardiopulmonary bypass characteristics were similar between the 2 groups.
While risk stratification with The Society of Thoracic Surgeons-European
Association for Cardio-Thoracic Surgery (STAT) Mortality Categories was
similar between the groups, Mortality Categories 1 to 3 demonstrated more
patients than Mortality Categories 4 and 5. There were no differences in
clinical outcomes between the groups. The PELOD-2 scores showed a
progressive improvement from 24 hours to 72 hours, but the results were
not statistically different between the groups. Conclusion(s): The
Pulsatillity Index for the pulsatile group demonstrated a more physiologic
pattern compared with the nonpulsatile group. While pulsatile perfusion
did not increase plasma-free hemoglobin levels or microemboli delivery, it
also did not demonstrate any improvements in clinical outcomes or PELOD-2
scores, suggesting that while pulsatile perfusion is a safe method, it not
a "magic bullet" for congenital cardiac operations. Copyright ©
2022 The Society of Thoracic Surgeons

<124>
Accession Number
2016693209
Title
Vaptans for oedematous and hyponatraemic disorders in childhood: A
systematic literature review.
Source
British Journal of Clinical Pharmacology. 88(10) (pp 4474-4480), 2022.
Date of Publication: October 2022.
Author
Piffer A.; Bianchetti M.G.; Leoni-Foglia C.; Simonetti G.D.; Milani G.P.;
Lava S.A.G.
Institution
(Piffer, Leoni-Foglia, Simonetti) Pediatric Institute of Southern
Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
(Bianchetti) Family Medicine, Faculty of Biomedical Sciences, Universita
della Svizzera Italiana, Lugano, Switzerland
(Bianchetti, Simonetti) Faculty of Biomedical Sciences, Universita della
Svizzera Italiana, Lugano, Switzerland
(Milani) Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore
Policlinico, Milan, Italy
(Milani) Department of Clinical Sciences and Community Health, Universita
degli Studi di Milano, Milan, Italy
(Lava) Pediatric Cardiology Unit, Department of Pediatrics, Centre
Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne,
Switzerland
(Lava) Heart Failure and Transplantation, Department of Pediatric
Cardiology, Great Ormond Street Hospital, London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Aims: The aim of this study was to systematically review the use of
vaptans (nonpeptide vasopressin receptor antagonists) in children.
 Method(s): Through a database search (Web of Science, the National
Library of Medicine, Excerpta Medica), we identified case series and case
reports and extracted clinical and laboratory data. Result(s):
Twenty-six articles, published since 2008, reported on 226 patients. Among
115 children with hyponatraemic (n = 63) and oedematous disorders (n =
52), a 48 hour course of tolvaptan with an initial dose of 0.38 +/- 0.27
mg/kg was administered in 106 cases, while intravenous conivaptan was
reported in nine cases. An increase (P <.02) in urine output was shown in
both oedematous (from 3.2 +/- 2.0 to 5.3 +/- 6.7 mL/kg/day) and
hyponatraemic (from 3.0 +/- 1.5 to 4.4 +/- 2.3 mL/kg/day) patients. In
these latter, sodium increased from 125 +/- 6 to 133 +/- 6 mmol/L (P
<.0001). The increase in sodium level correlated with its basal value, but
not with the administered vaptan dose. Among 111 children undergoing
cardiac surgery, after tolvaptan 0.21 +/- 0.01 mg/kg/day, mostly combined
with conventional diuretics, an increase in diuresis by 41 +/- 4% was seen
within 24 hours (P <.0001). Similarly, a single add-on dose of tolvaptan
0.45 mg/kg allowed a reduced additional intravenous furosemide
administration (0.26 +/- 0.23 vs 0.62 +/- 0.48 mg/kg, P <.005). Side
effects were rarely reported, and included excessive thirst and xerostomia
in seven, skin rash in one and elevated aminotransferases in one
patient(s). Conclusion(s): Vaptans appear to be safe for oedematous
and hyponatraemic disorders also in children. Although they increase
diuresis and natraemia, no superiority to traditional diuretics and sodium
supplements has been demonstrated. Reported side effects are rare and
non-serious. Copyright © 2022 British Pharmacological Society.

<125>
[Use Link to view the full text]
Accession Number
2020144007
Title
Prophylactic effect of intravenous lidocaine against cognitive deficit
after cardiac surgery: A PRISMA-compliant meta-analysis and trial
sequential analysis.
Source
Medicine (United States). 101(35) (pp E30476), 2022. Date of Publication:
02 Sep 2022.
Author
Hung K.-C.; Ho C.-N.; Liu W.-C.; Yew M.; Chang Y.-J.; Lin Y.-T.; Hung
I.-Y.; Chen J.-Y.; Huang P.-W.; Sun C.-K.
Institution
(Hung, Ho, Liu, Yew, Chang, Lin, Hung, Chen) Department of Anesthesiology,
Chi Mei Medical Center, Tainan city, Taiwan (Republic of China)
(Huang) Department of Emergency Medicine, Show Chwan Memorial Hospital,
Changhua city, Taiwan (Republic of China)
(Sun) Department of Emergency Medicine, E-Da Hospital, Kaohsiung city,
Taiwan (Republic of China)
(Sun) College of Medicine, I-Shou University, Kaohsiung city, Taiwan
(Republic of China)
Publisher
Lippincott Williams and Wilkins
Abstract
Background: This study aimed at providing an updated evidence of the
association between intraoperative lidocaine and risk of postcardiac
surgery cognitive deficit. Method(s): Randomized clinical trials
(RCTs) investigating effects of intravenous lidocaine against cognitive
deficit in adults undergoing cardiac surgeries were retrieved from the
EMBASE, MEDLINE, Google scholar, and Cochrane controlled trials register
databases from inception till May 2021. Risk of cognitive deficit was the
primary endpoint, while secondary endpoints were length of stay (LOS) in
intensive care unit/hospital. Impact of individual studies and cumulative
evidence reliability were evaluated with sensitivity analyses and trial
sequential analysis, respectively. Result(s): Six RCTs involving 963
patients published from 1999 to 2019 were included. In early postoperative
period (i.e., 2 weeks), the use of intravenous lidocaine (overall
incidence = 14.8%) was associated with a lower risk of cognitive deficit
compared to that with placebo (overall incidence = 33.1%) (relative risk =
0.49, 95% confidence interval: 0.32-0.75). However, sensitivity analysis
and trial sequential analysis signified insufficient evidence to arrive at
a firm conclusion. In the late postoperative period (i.e., 6-10 weeks),
perioperative intravenous lidocaine (overall incidence = 37.9%) did not
reduce the risk of cognitive deficit (relative risk = 0.99, 95% confidence
interval: 0.84) compared to the placebo (overall incidence = 38.6%).
Intravenous lidocaine was associated with a shortened LOS in intensive
care unit/hospital with weak evidence. Conclusion(s): Our results
indicated a prophylactic effect of intravenous lidocaine against cognitive
deficit only at the early postoperative period despite insufficient
evidence. Further large-scale studies are warranted to assess its use for
the prevention of cognitive deficit and enhancement of recovery (e.g.,
LOS). Copyright © 2022 Lippincott Williams and Wilkins. All
rights reserved.

<126>
Accession Number
2018867478
Title
Cardiovascular risk factors, exercise capacity and health literacy in
patients with chronic ischaemic heart disease and type 2 diabetes mellitus
in Germany: Baseline characteristics of the Lifestyle Intervention in
Chronic Ischaemic Heart Disease and Type 2 Diabetes study.
Source
Diabetes and Vascular Disease Research. 19(4) (no pagination), 2022. Date
of Publication: July 2022.
Author
Dinges S.M.T.; Krotz J.; Gass F.; Treitschke J.; Fegers-Wustrow I.;
Geisberger M.; Esefeld K.; von Korn P.; Duvinage A.; Edelmann F.; Wolfram
O.; Brandts J.; Winzer E.B.; Wolfarth B.; Freigang F.; Neubauer S.;
Nebling T.; Hackenberg B.; Amelung V.; Mueller S.; Halle M.
Institution
(Dinges, Gass, Treitschke, Fegers-Wustrow, Geisberger, Esefeld, von Korn,
Duvinage, Mueller, Halle) Department of Prevention and Sports Medicine,
University Hospital Klinikum Rechts der Isar, Technical University of
Munich, Munich, Germany
(Dinges, Gass, Fegers-Wustrow, Esefeld, von Korn, Duvinage, Mueller,
Halle) DZHK (German Centre for Cardiovascular Research), Partner Site
Munich Heart Alliance, Munich, Germany
(Krotz, Freigang, Amelung) Institute for Applied Healthcare Research GmbH
(inav), Berlin, Germany
(Edelmann) Department of Internal Medicine and Cardiology, Charite
Universitatsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany
(Edelmann) German Centre for Cardiovascular Research (DZHK), Partner Site
Berlin, Berlin, Germany
(Wolfram) Department of Cardiology and Angiology, University Hospital
Magdeburg, Magdeburg, Germany
(Brandts) Department of Medicine I, University Hospital Aachen, Aachen,
Germany
(Winzer) Heart Centre Dresden, University Hospital, Technische Universitat
Dresden, Dresden, Germany
(Wolfarth) Department of Sports Medicine, Humboldt University and Charite
University School of Medicine, Berlin, Germany
(Neubauer, Nebling) Techniker Krankenkasse, Hamburg, Germany
(Hackenberg) IDS Diagnostic Systems GmbH, Bonn, Germany
Publisher
SAGE Publications Ltd
Abstract
Background: Lifestyle interventions are a cornerstone in the treatment of
chronic ischaemic heart disease (CIHD) and type 2 diabetes mellitus
(T2DM). This study aimed at identifying differences in clinical
characteristics between categories of the common lifestyle intervention
targets BMI, exercise capacity (peak VO<inf>2</inf>) and health literacy
(HL). Method(s): Cross-sectional baseline characteristics of patients
enrolled in the LeIKD trial (Clinicaltrials.gov NCT03835923) are presented
in total, grouped by BMI, %-predicted peak VO<inf>2</inf> and HL
(HLS-EU-Q16), and compared to other clinical trials with similar
populations. Result(s): Among 499 patients (68.3+/-7.7 years; 16.2%
female; HbA1c, 6.9+/-0.9%), baseline characteristics were similar to other
trials and revealed insufficient treatment of several risk factors (LDL-C
92+/-34 mg/dl; BMI, 30.1+/-4.8 kg/m2; 69.6% with peak
VO<inf>2</inf><90% predicted). Patients with lower peak VO<inf>2</inf>
showed significantly higher (p < 0.05) CIHD and T2DM disease severity
(HbA1c, CIHD symptoms, coronary artery bypass graft). Obese patients had a
significantly higher prevalence of hypertension and higher triglyceride
levels, whereas in patients with low HL both quality of life components
(physical, mental) were significantly reduced. Conclusion(s): In
patients with CIHD and T2DM, peak VO2, BMI and HL are important indicators
of disease severity, risk factor burden and quality of life, which
reinforces the relevance of lifestyle interventions. Copyright ©
The Author(s) 2022.

<127>
Accession Number
2018861352
Title
The effect of percutaneouS vs. cutdoWn accEss in patients after
Endovascular aorTic repair (SWEET): Study protocol for a single-blind,
single-center, randomized controlled trial.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 966251. Date of Publication: 19 Aug 2022.
Author
Zhou Y.; Wang J.; Zhao J.; Yuan D.; Weng C.; Wang T.; Huang B.
Institution
(Zhou, Wang, Zhao, Yuan, Weng, Wang, Huang) Department of Vascular
Surgery, West China Hospital, Sichuan University, Chengdu, China
(Zhou) West China School of Medicine, West China Hospital, Sichuan
University, Chengdu, China
Publisher
Frontiers Media S.A.
Abstract
Background: Endovascular abdominal aortic repair (EVAR) and thoracic
endovascular aortic repair (TEVAR) have become the first-line treatment
for aortic diseases, but current evidence is uncertain regarding whether a
percutaneous approach has better outcomes than cutdown access, especially
for patient-centered outcomes (PCOs). This study is designed to compare
these outcomes of percutaneous access vs. cutdown access after
endovascular aortic repair. Method(s): The SWEET study is a
randomized, controlled, single-blind, single-center non-inferiority trial
with two parallel groups in two cohorts respectively. After eligibility
screening, subjects who meet the inclusion criteria will be divided into
Cohort EVAR or Cohort TEVAR according to clinic interviews. And then
participants in two cohorts will be randomly allocated to either
intervention groups receiving percutaneous access endovascular repair or
controlled groups receiving cutdown access endovascular repair separately.
Primary clinician-reported outcome (ClinRO) is access-related
complication, and primary patient-centered outcome (PCO) is time back to
normal life. Follow-up will be conducted at 2 weeks, 1 month, 3 months
postoperatively. Discussion(s): The choice of either percutaneous or
cutdown access may not greatly affect the success of EVAR or TEVAR
procedures, but can influence the quality of life and patient-centered
experience. Given the very low evidence for ClinROs and few data for PCOs,
comparison of the percutaneous vs. cutdown access EVAR and TEVAR is
essential for both patient-centered care and clinical decision making in
endovascular aortic repair. Trial registration: Chinese Clinical Trial
Registry ChiCTR2100053161 (registered on 13th November,
2021). Copyright © 2022 Zhou, Wang, Zhao, Yuan, Weng, Wang and
Huang.

<128>
Accession Number
2018149385
Title
Safety and efficacy of transcatheter aortic valve implantation in stenotic
bicuspid aortic valve compared to tricuspid aortic valve: a systematic
review and meta-analysis.
Source
Expert Review of Cardiovascular Therapy. 20(7) (pp 581-588), 2022. Date of
Publication: 2022.
Author
Zghouzi M.; Osman H.; Ullah W.; Suleiman A.-R.; Razvi P.; Abdalrazzak M.;
Rabbat F.; Alraiyes M.; Sattar Y.; Bagur R.; Paul T.; Matetic A.; Mamas
M.A.; Lakkis N.; Alraies M.C.
Institution
(Zghouzi, Osman, Razvi) Department of Internal Medicine, Detroit Medical
Center, Detroit, MI, United States
(Ullah) Thomas Jefferson University, Philadelphia, PA, United States
(Suleiman, Abdalrazzak) Division of Cardiology, Wayne State University
School of Medicine, Detroit, MI, United States
(Rabbat) Division of Cardiolog, Internal medicine, Baptist hospital,
Miami, FL, United States
(Alraiyes) Division of Cardiology, Vernon Hills High School, Vernon Hills,
IL, United States
(Sattar) Division of cardiology, West Virginia University, Morgantown, WV,
United States
(Bagur) Division of Cardiology, London Health Sciences Centre, Western
University, London, ON, Canada
(Paul) Department of Medical Education, University of Tennessee at
Nashville, Nashville, TN, United States
(Matetic, Mamas) Keele Cardiovascular Research Group, Centre for Prognosis
Research, Keele University, Stoke-on-Trent, United Kingdom
(Lakkis, Alraies) Division of cardiology, Wayne State University/Detroit
Medical Center, Detroit, MI, United States
Publisher
Taylor and Francis Ltd.
Abstract
Background: Transcatheter aortic valve implantation (TAVI) has emerged as
a safe and effective alternative to surgical replacement for tricuspid
aortic valve (TAV) stenosis. However, utilization of TAVI for aortic
stenosis in bicuspid aortic valve (BAV) compared to TAV remains
controversial. Method(s): We queried online databases with various
keywords to identify relevant articles. We compared major cardiovascular
events and procedural outcomes using a random effect model to calculate
odds ratios (OR). Result(s): We included a total of 22 studies
comprising 189,693 patients (BAV 12,669 vs. TAV 177,024). In the pooled
analysis, there were no difference in TAVI for BAV vs. TAV for all-cause
mortality, cardiovascular mortality, myocardial infarction (MI), vascular
complications, acute kidney injury (AKI), coronary occlusion, annulus
rupture, and reintervention/reoperation between the groups. The incidence
of stroke (OR 1.24; 95% CI 1.1-1.39), paravalvular leak (PVLR) (OR 1.42;
95% CI 1.26-1.61), and the need for pacemaker (OR 1.15; 95% CI 1.06-1.26)
was less in the TAV group compared to the BAV group, while incidence of
life-threatening bleeding was higher in the TAV group. Subgroup analysis
mirrored pooled outcomes except for all-cause mortality.
 Conclusion(s): The use of TAVI for the treatment of aortic stenosis
in selective BAV appears to be safe and effective. Copyright ©
2022 Informa UK Limited, trading as Taylor & Francis Group.

<129>
Accession Number
2019572525
Title
Balloon- vs Self-Expanding Valve Systems for Failed Small Surgical Aortic
Valve Bioprostheses.
Source
Journal of the American College of Cardiology. 80(7) (pp 681-693), 2022.
Date of Publication: 16 Aug 2022.
Author
Rodes-Cabau J.; Abbas A.E.; Serra V.; Vilalta V.; Nombela-Franco L.;
Regueiro A.; Al-Azizi K.M.; Iskander A.; Conradi L.; Forcillo J.; Lilly
S.; Calabuig A.; Fernandez-Nofrerias E.; Mohammadi S.; Panagides V.;
Pelletier-Beaumont E.; Pibarot P.
Institution
(Rodes-Cabau, Mohammadi, Panagides, Pelletier-Beaumont, Pibarot) Quebec
Heart and Lung Institute, Laval University, Quebec City, QC, Canada
(Abbas) Beaumont Hospital, Royal Oak, MI, United States
(Serra, Calabuig) Hospital Universitari Vall d'Hebron, Barcelona, Spain
(Vilalta, Fernandez-Nofrerias) Hospital Universitari Germans Trias i
Pujol, Badalona, Spain
(Nombela-Franco) Cardiovascular Institute, Hospital Clinico San Carlos,
IdISSC, Madrid, Spain
(Regueiro) Hospital Clinic Barcelona, Barcelona, Spain
(Al-Azizi) Baylor Scott and White The Heart Hospital Plano, Plano, TX,
United States
(Iskander) SJH Cardiology Associates, Syracuse, NY, United States
(Conradi) University Heart and Vascular Center, Hamburg, Germany
(Forcillo) Centre Hospitalier Universitaire de Montreal, Montreal, QC,
Canada
(Lilly) OSU Heart and Vascular Research Organization, Richard M Ross
Hospital, Columbus, OH, United States
Publisher
Elsevier Inc.
Abstract
Background: Data comparing valve systems in the valve-in-valve
transcatheter aortic valve replacement (ViV-TAVR) field have been obtained
from retrospective studies. Objective(s): The purpose of this study
was to compare the hemodynamic results between the balloon-expandable
valve (BEV) SAPIEN (3/ULTRA, Edwards Lifesciences) and self-expanding
valve (SEV) Evolut (R/PRO/PRO+, Medtronic) in ViV-TAVR. Method(s):
Patients with a failed small (<=23 mm) surgical valve were randomized to
receive a BEV or an SEV. The primary endpoint was valve hemodynamics
(maximal/mean residual gradients, severe prosthesis patient mismatch
[PPM], or moderate-severe aortic regurgitation) at 30 days as evaluated by
Doppler echocardiography. Result(s): A total of 102 patients were
randomized, and of these, 98 patients finally underwent a ViV-TAVR
procedure (BEV: n = 46, SEV: n = 52). The procedure was successful in all
cases, with no differences in clinical outcomes at 30 days between groups
(no death or stroke events). Patients in the SEV group exhibited lower
mean and maximal transvalvular gradient values (15 +/- 8 mm Hg vs 23 +/- 8
mm Hg; P < 0.001; 28 +/- 16 mm Hg vs 40 +/- 13 mm Hg, P < 0.001), and a
tendency toward a lower rate of severe PPM (44% vs 64%; P = 0.07). There
were no cases of moderate-severe aortic regurgitation. In total, 55
consecutive patients (SEV: n = 27; BEV: n = 28) underwent invasive valve
hemodynamic evaluation during the procedure, with no differences in mean
and peak transvalvular gradients between both groups (P = 0.41 and P =
0.70, respectively). Conclusion(s): In patients with small failed
aortic bioprostheses, ViV-TAVR with an SEV was associated with improved
valve hemodynamics as evaluated by echocardiography. There were no
differences between groups in intraprocedural invasive valve hemodynamics
and 30-day clinical outcomes (Comparison of the Balloon-Expandable Edwards
Valve and Self-Expandable CoreValve Evolut R or Evolut PRO System for the
Treatment of Small, Severely Dysfunctional Surgical Aortic Bioprostheses.
The 'LYTEN' Trial; NCT03520101) Copyright © 2022 American College
of Cardiology Foundation

<130>
Accession Number
2016545459
Title
The early and long-term outcomes of coronary artery bypass grafting added
to aortic valve replacement compared to isolated aortic valve replacement
in elderly patients: a systematic review and meta-analysis.
Source
Heart and Vessels. 37(10) (pp 1647-1661), 2022. Date of Publication:
October 2022.
Author
D'Alessandro S.; Tuttolomondo D.; Singh G.; Hernandez-Vaquero D.; Pattuzzi
C.; Gallingani A.; Maestri F.; Nicolini F.; Formica F.
Institution
(D'Alessandro) Cardiac Surgery Unit, San Gerardo Hospital, Monza, Italy
(Tuttolomondo) Cardiology Unit, University Hospital of Parma, Parma, Italy
(Singh) Department of Critical Care Medicine and Division of Cardiac
Surgery, Mazankowski Alberta Heart Institute, University of Alberta,
Edmonton, AB, Canada
(Hernandez-Vaquero) Cardiac Surgery Department, Hospital Universitario
Central de Asturias, Oviedo, Spain
(Pattuzzi, Gallingani, Maestri, Nicolini, Formica) Cardiac Surgery Unit,
University Hospital of Parma, Parma, Italy
(Nicolini, Formica) Department of Medicine and Surgery, University of
Parma, Parma, Italy
(Formica) UOC Cardiochirurgia, Azienda Ospedaliera Universitaria di Parma,
Via A. Gramsci, 14, Parma 43126, Italy
Publisher
Springer
Abstract
In aged population, the early and long-term outcomes of coronary
revascularization (CABG) added to surgical aortic valve replacement (SAVR)
compared to isolated SAVR (i-SAVR) are conflicting. To address this
limitation, a meta-analysis comparing the early and late outcomes of SAVR
plus CABG with i-SAVR was performed. Electronic databases from January
2000 to November 2021 were screened. Studies reporting early-term and
long-term comparison between the two treatments in patients over 75 years
were analyzed. The primary endpoints were in-hospital/30-day mortality and
overall long-term survival. The pooled odd ratio (OR) and hazard ratio
(HR) with 95% confidence interval (CI) were calculated for in-early
outcome and long-term survival, respectively. Random-effect model was used
in all analyses. Forty-four retrospective observational studies reporting
on 74,560 patients (i-SAVR = 36,062; SAVR + CABG = 38,498) were included
for comparison. The pooled analysis revealed that i-SAVR was significantly
associated with lower rate of early mortality compared to SAVR plus CABG
(OR = 0.70, 95% CI 0.66-0.75; p < 0.0001) and with lower incidence of
postoperative acute renal failure (OR = 0.65; 95% CI 0.50-0.91; p = 0.02),
need for dialysis (OR = 0.65; 95% CI 0.50-0.86; p = 0.002) and prolonged
mechanical ventilation (OR = 0.57; 95% CI 0.42-0.77; p < 0.0001).
Twenty-two studies reported data of long-term follow-up. No differences
were reported between the two groups in long-term survival (HR = 0.95; 95%
CI 0.87-1.03; p = 0.23). CABG added to SAVR is associated with worse early
outcomes in terms of early mortality, postoperative acute renal failure,
and prolonged mechanical ventilation. Long-term survival was comparable
between the two treatments. Copyright © 2022, The Author(s).

<131>
Accession Number
638829264
Title
High-dose adenosine versus saline-induced cardioplegic arrest in coronary
artery bypass grafting: A randomized double-blind clinical feasibility
trial.
Source
Scandinavian journal of surgery : SJS : official organ for the Finnish
Surgical Society and the Scandinavian Surgical Society. 111(3) (pp 3-10),
2022. Date of Publication: 01 Sep 2022.
Author
Mattila M.S.; Jarvela K.M.; Rinne T.T.; Nikus K.C.; Rantanen M.J.;
Siltanen J.A.A.; Helea J.-J.; Laurikka J.O.
Institution
(Mattila) Heart Hospital Tampere University Hospital PL 2000 33521 Tampere
Finland, Finland
(Jarvela, Rantanen) Heart Hospital, Tampere University Hospital, Tampere,
Finland
(Rinne) Tampere University Hospital, Tampere, Finland
(Nikus, Laurikka) Heart Hospital, Tampere University Hospital, Finland
Faculty of Medicine and Health Technology, Tampere University, Tampere,
Finland
(Siltanen, Helea) Faculty of Medicine and Health Technology, Tampere
University, Tampere, Finland
Publisher
NLM (Medline)
Abstract
BACKGROUND AND OBJECTIVE: In this clinical trial, we evaluated if a
short-acting nucleoside, adenosine, as a high-dose bolus injection with
blood cardioplegia induces faster arrest and provides better myocardial
performance in patients after bypass surgery for coronary artery disease.
 METHOD(S): Forty-three patients scheduled for elective or urgent
coronary artery bypass grafting were prospectively recruited in two-arm
1:1 randomized parallel groups to either receive 20 mg of adenosine (in 21
patients) or saline (in 22 patients) into the aortic root during the first
potassium-enriched blood cardioplegia infusion. The main outcomes of the
study were ventricular myocardial performance measured with cardiac index,
right ventricular stroke work index, and left ventricular stroke work
index at predefined time points and time to asystole after a single bolus
injection of adenosine. Conventional myocardial biomarkers were compared
between the two groups at predefined time points as secondary endpoints.
Electrocardiographic data and other ad hoc clinical outcomes were compared
between the groups. RESULT(S): Compared with saline, adenosine
reduced the time to asystole (68 (95% confidence interval (95% CI) =
37-100) versus 150 (95% CI = 100-210) seconds, p = 0.005). With myocardial
performance, the results were inconclusive, since right ventricular stroke
work index recovered better in the adenosine group (p = 0.008), but there
were no significant overall differences in cardiac index and left
ventricular stroke work index between the groups. Only the
post-cardiopulmonary bypass cardiac index was better in the adenosine
group (2.3 (95% CI = 2.2-2.5) versus 2.1 (95% CI = 1.9-2.2) L/min/m2, p =
0.016). There were no significant differences between the groups in
cardiac biomarker values. CONCLUSION(S): A high dose adenosine bolus
at the beginning of the first cardioplegia infusion resulted in
significantly faster asystole in coronary artery bypass grafting patients
but enhanced only partially the ventricular performance.EudraCT number:
2014-001382-26.
https://www.clinicaltrialsregister.eu/ctr-search/trial/2014-001382-26/FI.

<132>
Accession Number
2018024153
Title
Effect of Continuous Infusion of Intravenous Nefopam on Postoperative
Opioid Consumption After Video-assisted Thoracic Surgery: A Double-blind
Randomized Controlled Trial.
Source
Pain Physician. 25(6) (pp 491-500), 2022. Date of Publication:
September/October 2022.
Author
Yoon S.; Lee H.B.; Na K.J.; Park S.; Bahk J.; Lee H.-J.
Institution
(Yoon, Lee, Bahk, Lee) Department of Anesthesiology and Pain Medicine,
Seoul National University Hospital, Seoul, South Korea
(Yoon, Bahk, Lee) Department of Anesthesiology and Pain Medicine, Seoul
National University College of Medicine, Seoul, South Korea
(Na, Park) Department of Thoracic and Cardiovascular Surgery, Seoul
National University Hospital, Seoul, South Korea
(Na, Park) Department of Thoracic and Cardiovascular Surgery, Seoul
National University College of Medicine, Seoul, South Korea
Publisher
American Society of Interventional Pain Physicians
Abstract
Background: Although nefopam has been reported to have opioid-sparing and
analgesic effects in postsurgical patients, its effectiveness in
video-assisted thoracoscopic surgery (VATS) is unknown. Objective(s):
This study aimed to investigate the opioid-sparing and analgesic effects
of perioperative nefopam infusion for lung resection. Study Design:
Double-blinded randomized controlled trial. Setting(s): Operating
room, postoperative recovery room, and ward at a single tertiary
university hospital. Method(s): Ninety patients scheduled for
elective VATS for lung resection were randomized to either the nefopam
(group N) or control group (group C). Group N received 20 mg nefopam over
30 minutes immediately after the induction of anesthesia. Nefopam was
administered continuously for 24 hours postoperative, using a dual-channel
elastomeric infusion pump combined with fentanyl-based intravenous
patient-controlled analgesia. Group C received the same volume of normal
saline as nefopam solution administered in the same manner. The primary
outcome measure was fentanyl consumption for the first postoperative 24
hours. The secondary outcome measures were the cumulative fentanyl
consumption during the first postoperative 48 hours, pain intensity at
rest and during coughing evaluated using an 11-point numeric rating scale,
quality of recovery at postoperative time points 24 hours and 48 hours,
and the occurrence of analgesic-related side effects during the first
postoperative 24 hours and postoperative 24 to 48 hour period. Variables
related to chronic postsurgical pain (CPSP) were also investigated by
telephone interviews with patients at 3 months postoperative. This
prospective randomized trial was approved by the appropriate institutional
review board and was registered in the ClinicalTrials.gov registry.
 Result(s): A total of 83 patients were enrolled. Group N showed
significantly lower fentanyl consumption during the first postoperative 24
hours and 48 hours (24 hours: median difference:-270 microg [95%CI,-400
to-150 microg], P < 0.001); 48 hours: median difference:-365 microg [95%
CI:-610 to-140 microg], P < 0.001). Group N also showed a significantly
lower pain score during coughing at 24 hours postoperative (median
difference,-1 [corrected 95% CI:-2.5 to 0], adjusted P = 0.040). However,
there were no significant between-group differences in the postoperative
quality of recovery, occurrence of analgesic-related side effects, length
of hospital stay, and occurrence of CPSP. Limitation(s): Despite the
significant opioid-sparing effect of perioperative nefopam infusion, it
would have been difficult to observe significant improvements in other
postoperative outcomes owing to the modest sample size.
 Conclusion(s): Perioperative nefopam infusion using a dual-channel
elastomeric infusion pump has a significant opioid-sparing effect in
patients undergoing VATS for lung resection. Therefore, it could be a
feasible option for multimodal analgesia in these patients. Copyright
© 2022, American Society of Interventional Pain Physicians. All
rights reserved.

<133>
Accession Number
2019128828
Title
Techniques and pitfalls of coronary arterial reimplantation in anatomical
correction of transposition.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Chowdhury U.K.; Anderson R.H.; Spicer D.E.; Sankhyan L.K.; George N.;
Pandey N.N.; Goja S.; Chandhirasekar B.
Institution
(Chowdhury, George, Pandey, Goja, Chandhirasekar) Cardiothoracic Centre,
All India Institute of Medical Sciences, New Delhi, India
(Anderson) Institute of Biomedical Sciences, Newcastle University,
Newcastle-upon-Tyne, United Kingdom
(Spicer) Heart Institute, Johns Hopkins All Children's Hospital, St.
Petersburg, FL, United States
(Spicer) Department of Pediatric Cardiology, University of Florida,
Gainesville, FL, United States
(Sankhyan) Cardiothoracic Centre, All India Institute of Medical Sciences,
Bilaspur, India
Publisher
John Wiley and Sons Inc
Abstract
Background and aim: We assessed the anatomical variations in coronary
arterial patterns relative to the techniques of reimplantation in the
setting of the arterial switch operation, relating the variations to
influences on outcomes. Method(s): We reviewed pertinent published
investigations, assessing events reported following varied surgical
techniques for reimplantation of the coronary arteries in the setting of
the arterial switch procedure. Result(s): The prevalence of reported
adverse events, subsequent to reimplantation, varied from 2% to 11%, with
a bimodal presentation of high early and low late incidence. The
intramural pattern continues to contribute to mortality, with some reports
of 28% fatality. The presence of abnormal course relative to the arterial
pedicles in the setting of single sinus origin was associated with a
three-fold increase in mortality. Abnormal looping with bisinusal origin
of arteries was not associated with increased risk. Conclusion(s):
The techniques of transfer of the coronary arteries can be individually
adapted to cater for the anatomical variations. Cardiac surgeons,
therefore, need to be familiar with the myriad creative options available
to achieve successful repair when there is challenging anatomy. Long-term
follow-up will be required to affirm the superiority of any specific
individual technique. Detailed multiplanar computed-tomographic scanning
can now reveal all the variants, and elucidate the mechanisms of late
complications. Coronary angioplasty or surgical revascularization may be
considered in selected cases subsequent to the switch
procedure. Copyright © 2022 Wiley Periodicals LLC.

<134>
Accession Number
639064336
Title
Permanent pacemaker implantation and left bundle branch block with
self-expanding valves - a SCOPE 2 subanalysis.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
(no pagination), 2022. Date of Publication: 21 Sep 2022.
Author
Pellegrini C.; Garot P.; Morice M.-C.; Tamburino C.; Bleiziffer S.; Thiele
H.; Scholtz S.; Schramm R.; Cockburn J.; Cunnington M.; Wolf A.; Barbanti
M.; Tchetche D.; Pagnotta P.; Gilard M.; Bedogni F.; Van Belle E.;
Vasa-Nicotera M.; Chieffo A.; Bogaerts K.; Hengstenberg C.; Capodanno D.;
Joner M.
Institution
(Pellegrini, Joner) Klinik fur Herz- und Kreislauferkrankungen, Deutsches
Herzzentrum Munchen, Technical University Munich, Munich, Germany
(Garot, Morice) Institut Cardiovasculaire Paris-Sud, Hopital Prive Jacques
Cartier, Massy, France
(Tamburino, Capodanno) Division of Cardiology, Azienda Ospedaliero
Universitaria Policlinico "G.Rodolico - S. Marco" - University of Catania,
Catania, Italy
(Bleiziffer, Schramm) Department of Thoracic and Cardiovascular Surgery,
Heart and Diabetes Center North Rhine-Westphalia, University Hospital,
Ruhr-University Bochum, Bad Oeynhausen, Germany
(Thiele) Department of Cardiology, Heart Center Leipzig at University of
Leipzig, Leipzig, Germany
(Scholtz) Department of Interventional Cardiology, Heart and Diabetes
Center North Rhine-Westphalia, Bad Oeynhausen, Germany
(Cockburn) Department of Cardiology, Brighton & Sussex University
Hospitals NHS Trust, Brighton, United Kingdom
(Cunnington) Department of Cardiology, Leeds General Infirmary, Leeds
Teaching Hospitals NHS Trust, Leeds, United Kingdom
(Wolf) Department of Interventional Cardiology, Elisabeth Hospital Essen,
Essen, Germany
(Barbanti) Department of Cardio-Thoracic-Vascular diseases and
transplantation, Catania, Italy
(Tchetche) Groupe CardioVasculaire Interventionnel, Clinique Pasteur,
Toulouse, France
(Pagnotta) Department of Cardiovascular Medicine, Humanitas Clinical and
Research Center, Milano, Italy
(Gilard) Department of Cardiology, Brest University Hospital, Brest,
France
(Bedogni) Cardiology Department, IRCCS Policlinico San Donato, Milano,
Italy
(Van Belle) Department of Cardiology, University Hospital, Lille, France
(Vasa-Nicotera) Department of Cardiology, Goethe University Hospital
Frankfurt, Frankfurt am Main, Germany
(Chieffo) Interventional Cardiology Unit, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Bogaerts) KU Leuven, Faculty of Medicine, I-BioStat, Leuven, Belgium and
UHasselt, I-BioStat, Hasselt, Belgium
(Hengstenberg) Department of Internal Medicine II, Medical University of
Vienna, Vienna, Austria
(Joner) Deutsches Zentrum fur Herz- und Kreislauf-Forschung (DZHK) e.V.
(German Center for Cardiovascular Research), Partner Site Munich Heart
Alliance, Munich, Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: No detailed data on left bundle branch block (LBBB) and
permanent pacemaker implantation (PPI) exist from randomised clinical
trials comparing the ACURATE neo and CoreValve Evolut devices. AIMS: Our
aim was to assess the incidence and impact of new LBBB and PPI with
self-expanding prostheses from a powered randomised comparison.
 METHOD(S): From the SCOPE 2 trial, 648 patients with no previous
pacemaker were analysed for PPI at 30 days, and 426 patients without
previous LBBB were adopted for analysis of LBBB at 30 days. Results: At 30
days, 16.5% of patients required PPI; rates were higher in CoreValve
Evolut compared to ACURATE neo recipients (21.0% vs 12.3%; p=0.004).
Previous right bundle branch block (odds ratio [OR] 6.11, 95% confidence
interval [CI]: 3.19-11.73; p<0.001) was associated with an increased risk
of PPI at 30 days, whereas the use of the ACURATE neo (OR 0.50, 95% CI:
0.31-0.81; p=0.005) was associated with a decreased risk. One-year
mortality was similar in patients with and without new PPI. A total of
9.4% of patients developed persistent LBBB at 30 days, with higher
incidences in CoreValve Evolut recipients (13.4% vs 5.5%; p=0.007). New
LBBB at 30 days was associated with lower ejection fraction at 1 year
(65.7%+/-11.0 vs 69.1%+/-7.6; p=0.041). CONCLUSION(S): New LBBB and
PPI rates were lower in ACURATE neo compared to CoreValve Evolut
recipients. The ACURATE neo valve was associated with a lower risk of PPI
at 30 days. No effect on 1-year mortality was determined for PPI at 30
days, while LBBB at 30 days was associated with reduced ejection fraction
at 1 year.

<135>
Accession Number
639063713
Title
Updates in the management of congenital heart disease in adult patients.
Source
Expert review of cardiovascular therapy. (no pagination), 2022. Date of
Publication: 21 Sep 2022.
Author
Massarella D.; Alonso-Gonzalez R.
Institution
(Massarella, Alonso-Gonzalez) Peter Munk Cardiac Centre, Toronto ACHD
program, University Health Network, Toronto, ON, Canada
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Adults with congenital heart disease represent a highly
diverse, ever-growing population. Optimal approaches to management of
problems such as arrhythmia, sudden cardiac death, heart failure,
transplant, application of advanced therapies and unrepaired shunt lesions
are incompletely established. Efforts to strengthen our understanding of
these complex clinical challenges and inform evidence-based practices are
ongoing. AREAS COVERED: This narrative review summarizes evidence
underpinning current approaches to congenital heart disease management
while highlighting areas requiring further investigation. A search of
literature published in 'Medline,' 'EMBASE,' and 'PubMed' using search
terms 'congenital heart disease', 'arrhythmia', 'sudden cardiac death',
'heart failure', 'heart transplant', 'advanced heart failure therapy',
'ventricular assist device (VAD)', 'mechanical circulatory support (MSC)',
'intracardiac shunt' and combinations thereof was undertaken. EXPERT
OPINION: Application of novel technologies in the diagnosis and management
of arrhythmia has and will continue to improve outcomes in this
population. Sudden death remains a prevalent problem with many persistent
unknowns. Heart failure is a leading cause of morbidity and mortality.
Improved access to specialist care, advanced therapies and cardiac
transplant is needed. The emerging field of cardio-obstetrics will
continue to define state of the art care for the reproductive health of
women with heart disease.

<136>
Accession Number
639063212
Title
Transcatheter Edge-to-Edge Repair in Patients with Severe Mitral
Regurgitation and Cardiogenic Shock: TVT Registry Analysis.
Source
Journal of the American College of Cardiology. (no pagination), 2022.
Date of Publication: 13 Sep 2022.
Author
Simard T.; Vemulapalli S.; Jung R.G.; Vekstein A.; Stebbins A.; Holmes
D.R.; Czarnecki A.; Hibbert B.; Alkhouli M.
Institution
(Simard, Holmes, Alkhouli) Department of Cardiovascular Disease, Mayo
Clinic, Rochester, MN, United States
(Vemulapalli, Vekstein, Stebbins) Department of Medicine, Duke University,
Durham, North Carolina; Duke Clinical Research Institute, Duke University
School of Medicine, Durham, North Carolina
(Jung, Hibbert) University of Ottawa Heart Institute, Ottawa, ON, Canada
(Czarnecki) Sunnybrook Health Sciences Centre, Toronto, ON, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: Data on the efficacy of transcatheter edge-to-edge repair
(TEER) in patients with cardiogenic shock (CS) are limited.
 OBJECTIVE(S): We investigated the characteristics and outcomes of
consecutive patients with significant MR and CS who underwent TEER.
 METHOD(S): The STS/ACC/TVT Registry was assessed from November 22,
2013, to December 31, 2021. CS was defined as [i] CS, [ii] inotrope-use or
[iii] mechanical circulatory support prior to TEER. Device success was
defined as MR reduction of >1 grade and a final MR grade<2+. The primary
outcome was the impact of device success on 1-year mortality or heart
failure (HF) re-admissions. Cox proportional hazards model were used to
report the risk-adjusted association between device success and 1-year
outcomes. RESULT(S): A total of 3,797 patients met the inclusion
criteria. Mean age was 73.0+/-11.9 and 59.5% were male. Mean STS-score (MV
repair) was 14.9+/-15.3. MR etiology was degenerative (53.4%) and
functional (27.5%). Device success was achieved in 3,249(85.6%) patients
given successful achievement of [i] final MR grade <2+(88.2%) and [ii] MR
reduction >1 absolute grade(91.4%). At one-year after TEER, device success
was associated with significantly lower all-cause mortality (34.6%
vs.55.5%, adjusted-HR 0.49,95%CI 0.41-0.59,p<0.001), and a composite of
mortality or HF admissions (29.6% vs. 45.2%, adjusted HR 0.51,95%CI
0.42-0.62,p<0.001). CONCLUSION(S): Successful MR reduction is
achievable in most patients with CS and is associated with significantly
lower mortality and HF hospitalization at 1-year. Randomized trials
assessing TEER in CS are needed to establish this potential therapeutic
approach. CONDENSED ABSTRACT: We examined the role of transcatheter
edge-to-edge repair (TEER) in patients with cardiogenic shock and mitral
regurgitation (MR). We identified 3,797 patients with cardiogenic shock
who underwent TEER between 2013-2021 in the STS/ACC/TVT registry. Mean age
was 73.0+/-11.9 and 59.5% were males. Mean STS was 14.9+/-15.3. Device
success (defined as MR reduction of >1 grade and a final MR <2+) was
achieved in 3,249 patients (85.6%). At one-year, device success was
associated with lower all-cause mortality (34.6% vs.55.5%,adjusted-HR
0.49,95%CI 0.41-0.58, p<0.001), and a composite of mortality and HF
admissions (29.6% vs. 45.2%, adjusted HR 0.51,95%CI 0.42-0.62,
p<0.001). Copyright © 2022. Published by Elsevier Inc.

<137>
Accession Number
639063043
Title
Cardiac Magnetic Resonance Imaging for the Diagnosis of Infective
Endocarditis in the COVID-19 Era.
Source
Current problems in cardiology. (pp 101396), 2022. Date of Publication:
17 Sep 2022.
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) Ohio State University Wexner Medical Center, Columbus,
OH, United States
(Patel, Ciricillo, Haddad, Khokher, Patel) University of Toledo College of
Medicine and Life Sciences, Toledo, OH, USA
(Mhanna) Division of Cardiology, Department of Medicine, University of
Iowa, Iowa City, IA, United States
(Malas, Kammeyer) University of Toledo College of Medicine and Life
Sciences, Toledo, OH, USA; ProMedica Toledo Hospital, Toledo, OH, USA
Publisher
NLM (Medline)
Abstract
INTRODUCTION: 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). METHOD(S): 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. RESULT(S): 7 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
nondiagnostic, but patients were treated empirically. There was no
difference in antibiotic duration or outcomes over 1 year.
 CONCLUSION(S): 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.
Published by Elsevier Inc.

<138>
Accession Number
639059531
Title
Individualised flow-controlled ventilation versus pressure-controlled
ventilation in a porcine model of thoracic surgery requiring one-lung
ventilation: A laboratory study.
Source
European journal of anaesthesiology. (no pagination), 2022. Date of
Publication: 21 Sep 2022.
Author
Spraider P.; Martini J.; Abram J.; Putzer G.; Ranalter M.; Mathis S.; Hell
T.; Barnes T.; Enk D.
Institution
(Spraider) From the Department of Anaesthesia and Intensive Care Medicine,
Medical University Innsbruck, GP, Department of Mathematics, Faculty of
Mathematics, Computer Science and Physics, University of Innsbruck,
University of Greenwich, Faculty of Medicine, University of Munster,
Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: Flow-controlled ventilation (FCV) enables precise
determination of dynamic compliance due to a continuous flow coupled with
direct tracheal pressure measurement. Thus, pressure settings can be
adjusted accordingly in an individualised approach. OBJECTIVE(S): The
aim of this study was to compare gas exchange of individualised FCV to
pressure-controlled ventilation (PCV) in a porcine model of simulated
thoracic surgery requiring one-lung ventilation (OLV). DESIGN: Controlled
interventional trial conducted on 16 domestic pigs. SETTING: Animal
operating facility at the Medical University of Innsbruck. INTERVENTIONS:
Thoracic surgery was simulated with left-sided thoracotomy and subsequent
collapse of the lung over a period of three hours. When using FCV,
ventilation was performed with compliance-guided pressure settings. When
using PCV, end-expiratory pressure was adapted to achieve best compliance
with peak pressure adjusted to achieve a tidal volume of 6 ml kg-1 during
OLV. MAIN OUTCOME MEASURES: Gas exchange was assessed by the Horowitz
index (= PaO2/FIO2) and CO2 removal by the PaCO2 value in relation to
required respiratory minute volume. RESULT(S): In the FCV group (n =
8) normocapnia could be maintained throughout the OLV trial despite a
significantly lower respiratory minute volume compared to the PCV group (n
= 8) (8.0 vs. 11.6, 95% confidence interval, CI -4.5 to -2.7 l min-1; P <
0.001), whereas permissive hypercapnia had to be accepted in PCV (PaCO2
5.68 vs. 6.89, 95% CI -1.7 to -0.7 kPa; P < 0.001). The Horowitz index was
comparable in both groups but calculated mechanical power was
significantly lower in FCV (7.5 vs. 22.0, 95% CI -17.2 to -11.8 J min-1; P
< 0.001). CONCLUSION(S): In this porcine study FCV maintained
normocapnia during OLV, whereas permissive hypercapnia had to be accepted
in PCV despite a substantially higher minute volume. Reducing exposure of
the lungs to mechanical power applied by the ventilator in FCV offers a
possible advantage for this mode of ventilation in terms of lung
protection. Copyright © 2022 European Society of Anaesthesiology
and Intensive Care. Unauthorized reproduction of this article is
prohibited.

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