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<1>
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Accession Number
2017015220
Title
Remote Ischemic Preconditioning Reduces Acute Kidney Injury after Cardiac
Surgery: A Systematic Review and Meta-analysis of Randomized Controlled
Trials.
Source
Anesthesia and Analgesia. 134(3) (pp 592-605), 2022. Date of Publication:
01 Mar 2022.
Author
Long Y.-Q.; Feng X.-M.; Shan X.-S.; Chen Q.-C.; Xia Z.; Ji F.-H.; Liu H.;
Peng K.
Institution
(Long, Shan, Chen, Ji, Peng) Department of Anesthesiology, First
Affiliated Hospital, Soochow University, 188 Shizi St, Jiangsu, Suzhou
215006, China
(Feng) Department of Anesthesiology, University of Utah Health, Salt Lake
City, UT, United States
(Feng) Transitional Residency Program, Intermountain Medical Center,
Murray, UT, United States
(Xia, Liu) Department of Anesthesiology and Pain Medicine, University of
California Davis Health, Sacramento, CA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Results from previous studies evaluating the effects of remote
ischemic preconditioning (RIPC) on morbidity and mortality after cardiac
surgery are inconsistent. This meta-analysis of randomized controlled
trials (RCTs) aims to determine whether RIPC improves cardiac and renal
outcomes in adults undergoing cardiac surgery. METHOD(S): PubMed,
EMBASE, and Cochrane Library were comprehensively searched to identify
RCTs comparing RIPC with control in cardiac surgery. The coprimary
outcomes were the incidence of postoperative myocardial infarction (MI)
and the incidence of postoperative acute kidney injury (AKI).
Meta-analyses were performed using a random-effect model. Subgroup
analyses were conducted according to volatile only anesthesia versus
propofol anesthesia with or without volatiles, high-risk patients versus
non-high-risk patients, and Acute Kidney Injury Network (AKIN) or Kidney
Disease Improving Global Outcomes (KDIGO) criteria versus other criteria
for AKI diagnosis. RESULT(S): A total of 79 RCTs with 10,814 patients
were included. While the incidence of postoperative MI did not differ
between the RIPC and control groups (8.2% vs 9.7%; risk ratio [RR] = 0.87,
95% confidence interval [CI], 0.76-1.01, P =.07, I2= 0%), RIPC
significantly reduced the incidence of postoperative AKI (22% vs 24.4%; RR
= 0.86, 95% CI, 0.77-0.97, P =.01, I2= 34%). The subgroup
analyses showed that RIPC was associated with a reduced incidence of MI in
non-high-risk patients, and that RIPC was associated with a reduced
incidence of AKI in volatile only anesthesia, in non-high-risk patients,
and in the studies using AKIN or KDIGO criteria for AKI diagnosis.
 CONCLUSION(S): This meta-analysis demonstrates that RIPC reduces the
incidence of AKI after cardiac surgery. This renoprotective effect of RIPC
is mainly evident during volatile only anesthesia, in non-high-risk
patients, and when AKIN or KDIGO criteria used for AKI
diagnosis. Copyright © 2022 Lippincott Williams and Wilkins. All
rights reserved.

<2>
Accession Number
2019735026
Title
Alirocumab and Cardiovascular Outcomes in Patients With Previous
Myocardial Infarction: Prespecified Subanalysis From ODYSSEY OUTCOMES.
Source
Canadian Journal of Cardiology. 38(10) (pp 1542-1549), 2022. Date of
Publication: October 2022.
Author
Chiang C.-E.; Schwartz G.G.; Elbez Y.; Szarek M.; Bhatt D.L.; Bittner
V.A.; Diaz R.; Erglis A.; Goodman S.G.; Hagstrom E.; Jukema J.W.;
Liberopoulos E.; Loy M.; Pordy R.; White H.D.; Simon T.; Steg P.G.
Institution
(Chiang) General Clinical Research Center, Division of Cardiology, Taipei
Veterans General Hospital and National Yang Ming Chiao Tung University,
Taipei, Taiwan (Republic of China)
(Schwartz) University of Colorado School of Medicine, Aurora, CO, United
States
(Elbez) Deepscover, Puteaux, France
(Szarek) State University of New York, Downstate School of Public Health,
Brooklyn, NY, United States
(Szarek) CPC Clinical Research and Division of Cardiology, University of
Colorado School of Medicine, Aurora, CO, United States
(Bhatt) Brigham and Women's Hospital Heart & Vascular Center, Boston, MA,
United States
(Bhatt) Harvard Medical School, Boston, MA, United States
(Bittner) Division of Cardiovascular Disease, University of Alabama at
Birmingham, Birmingham, AL, United States
(Diaz) Estudios Cardiologicos Latino America, Instituto Cardiovascular de
Rosario, Rosario, Argentina
(Erglis) Pauls Stradins Clinical University Hospital, University of
Latvia, Riga, Latvia
(Goodman) St. Michael's Hospital, University of Toronto, Toronto, ON,
Canada
(Goodman) Canadian VIGOUR Centre, University of Alberta, Edmonton, AB,
Canada
(Hagstrom) Department of Medical Sciences, and Uppsala Clinical Research
Centre, Uppsala University, Uppsala, Sweden
(Jukema) Department of Cardiology, Leiden University Medical Center, The
Netherlands, Leiden, Netherlands
(Liberopoulos) Faculty of Medicine, School of Health Sciences, University
of Ioannina, Ioannina, Greece
(Loy) Sanofi, Bridgewater Township, NJ, United States
(Pordy) Regeneron Pharmaceuticals, Tarrytown, NY, United States
(White) Green Lane Cardiovascular Services, Auckland City Hospital,
Auckland, New Zealand
(Simon) Sorbonne Universite, Assistance Publique-Hopitaux de Paris,
Hopital Saint Antoine, Paris, France
(Steg) Department of Cardiology, Universite de Paris, Paris, France
(Steg) Assistance Publique-Hopitaux de Paris, Hopital Bichat, Paris,
France
(Steg) FACT (French Alliance for Cardiovascular Trials), Paris, France
(Steg) INSERM U1148, Paris, France
(Steg) Imperial College, Royal Brompton Hospital, London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: After acute coronary syndrome (ACS), patients with a previous
myocardial infarction (MI) may be at particularly high risk for major
adverse cardiovascular events (MACE) and death. We studied the effects of
the PCSK9 inhibitor alirocumab in patients with recent ACS according to
previous history of MI. Method(s): The ODYSSEY OUTCOMES trial
compared alirocumab with placebo, beginning 1 to 12 months after ACS with
median 2.8-year follow-up. The primary MACE outcome comprised death from
coronary heart disease, nonfatal MI, fatal or nonfatal ischemic stroke,
and hospitalization for unstable angina. Of 18,924 patients, 3633 (19.2%)
had previous MI. Result(s): Patients with previous MI were older,
more likely male, with more cardiovascular risk factors and previous
events. With placebo, 4-year risks of MACE and death were higher among
those with vs without previous MI (20.5% vs 8.9%, P < 0.001; 7.4% vs 3.4%,
P < 0.001, respectively). Alirocumab reduced the risk of events regardless
of the presence or absence of a history of MI (MACE, adjusted hazard ratio
[aHR] 0.90, 95% confidence interval [CI], 0.78-1.05 vs 0.82, 0.73-0.92;
P<inf>interaction</inf> = 0.34; death, aHR 0.84; 95% CI, 0.64-1.08 vs
0.87, 0.72-1.05; P<inf>interaction</inf> = 0.81). Estimated absolute risk
reductions with alirocumab were numerically greater with vs without
previous MI (MACE, 1.91% vs 1.42%; death, 1.35% vs 0.41%).
 Conclusion(s): A previous history of MI places patients with recent
ACS at high risk for recurrent MACE and death. Alirocumab reduced the
relative risks of these events consistently in patients with or without
previous MI but with numerically greater absolute benefit in the former
subgroup. (ODYSSEY OUTCOMES: NCT01663402) Copyright © 2022 The
Authors

<3>
Accession Number
2019352187
Title
Different Antiplatelet Strategies for Radial Artery Protection After
Transradial Coronary Angiography-A Prospective Observational Cohort Study.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 913008. Date of Publication: 14 Jun 2022.
Author
Qin Z.; Yang X.; Cheng W.; Wang J.; Jin Z.
Institution
(Qin, Yang, Jin) Department of Cardiovascular, Beijing Tiantan Hospital,
Capital Medical University, Beijing, China
(Cheng, Wang) Department of Cardiology, Beijing Anzhen Hospital, Capital
Medical University, Beijing, China
Publisher
Frontiers Media S.A.
Abstract
Introduction: Radial artery occlusion (RAO) after transradial access is a
common thrombotic complication. A meta-analysis has proven that RAO
incidence in transradial coronary angiography (TRCA) settings was
significantly higher than that in percutaneous coronary intervention
settings. This prospective observational cohort aimed to evaluate radial
artery protection after TRCA with different antiplatelet strategies.
 Method(s): A total of 2,316 patients undergoing TRCA was enrolled and
divided into two groups: single-antiplatelet and dual-antiplatelet groups.
Radial artery patency was evaluated by ultrasound before, at 24 h, and 30
days after TRCA. The primary endpoint was RAO incidence at 30 days after
TRCA. Result(s): A total of 66 RAO was found on ultrasonography at
30-day follow-up (incidence: 2.8%). In the dual-antiplatelet group, the
rate of RAO was significantly lower compared with the single-antiplatelet
group (1.8 vs. 4.0%; odds ratio (OR): 0.41; 95% confidence interval (CI):
0.24-0.70; p = 0.001). The rate of self-recanalization in the
dual-antiplatelet group was significantly higher than that in the
single-antiplatelet group (73.68 vs. 44.12%, p < 0.001). However, there
was no statistical difference in delayed occlusion of radial artery
between the two groups (0.5 vs. 0.2%, p = 0.140). Unexpectedly, this study
also showed no significant difference in bleeding risk between the groups.
 Conclusion(s): Dual-antiplatelet therapy for 1 month after TRCA was
associated with a reduced risk of RAO and deemed safe. Copyright
© 2022 Qin, Yang, Cheng, Wang and Jin.

<4>
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Accession Number
2019315994
Title
Efficacy and Safety of Proton Pump Inhibitors in Patients with Coronary
Artery Diseases Receiving Oral Antiplatelet Agents and/or Anticoagulants:
A Systematic Review and Meta-Analysis.
Source
Journal of Cardiovascular Pharmacology. 80(1) (pp 1-12), 2022. Date of
Publication: 04 Jul 2022.
Author
Shang Y.-S.; Zhong P.-Y.; Ma Y.; Bai N.; Niu Y.; Wang Z.-L.
Institution
(Shang, Zhong, Ma, Bai, Niu) The First Clinical Medical College, Lanzhou
University, Lanzhou, China
(Wang) Department of Cardiology, The First Hospital of Lanzhou University,
No. 1, Donggang West Rd, Chengguan District, Gansu, Lanzhou 730000, China
Publisher
Lippincott Williams and Wilkins
Abstract
The purpose of this meta-analysis was to evaluate the efficacy and safety
of proton pump inhibitors (PPIs) plus antithrombotic strategy in patients
with coronary artery diseases compared with antithrombotic strategy alone.
We searched PubMed, EMBASE, Cochrane Library, and Chinese Biomedical
Medical Literature databases to retrieve randomized controlled trials
investigating PPIs combined with antithrombotic strategy in coronary
artery diseases. The primary efficacy outcome was major adverse
cardiovascular and cerebrovascular events (MACCE). The primary safety
outcome was gastrointestinal events. Secondary outcomes included all-cause
death, cardiovascular death, myocardial infarction, stent thrombosis,
significant bleeding from gastroduodenal lesions, and gastroduodenal
ulcer. Overall, 43,943 patients were enrolled from 19 trials. The
incidence of MACCE [relative risk (RR) 1.05; 95% confidence interval (CI)
0.96-1.15], all-cause death (RR 0.84; 95% CI 0.69-1.01), cardiovascular
death (RR 0.88; 95% CI 0.69-1.12), myocardial infarction (RR 0.98; 95% CI
0.88-1.09), stent thrombosis (RR 1.01; 95% CI 0.76-1.34), and
gastroduodenal ulcer (RR 0.40; 95% CI 0.13-1.29) did not increase
significantly in patients receiving PPIs compared with patients without
those. There were significant differences in the risk of gastrointestinal
events (RR 0.34; 95% CI 0.21-0.54) and significant bleeding from
gastroduodenal lesions (RR 0.09; 95% CI 0.03-0.28) between the 2 groups.
In patients with coronary artery diseases, PPIs plus antithrombotic
strategy could reduce the risk of gastrointestinal events and significant
bleeding from gastroduodenal lesions but may not affect the incidence of
MACCE, all-cause death, cardiovascular death, myocardial infarction, stent
thrombosis, and gastroduodenal ulcer (PROSPERO: CRD42021277899, date of
registration October 10, 2021). Copyright © 2022 Lippincott
Williams and Wilkins. All rights reserved.

<5>
Accession Number
2018346287
Title
Belatacept in Kidney Transplantation: What Are the True Benefits? A
Systematic Review.
Source
Frontiers in Medicine. 9 (no pagination), 2022. Article Number: 942665.
Date of Publication: 14 Jul 2022.
Author
Lombardi Y.; Francois H.
Institution
(Lombardi, Francois) Soins Intensifs Nephrologiques et Rein Aigu, Hopital
Tenon, Assistance Publique-Hopitaux de Paris, 4 rue de la Chine, Paris,
France
(Lombardi, Francois) Sorbonne Universite, Paris, France
(Francois) INSERM UMR_S 1155, Paris, France
Publisher
Frontiers Media S.A.
Abstract
The current gold standard to prevent allograft rejection for maintenance
immunosuppression in kidney transplantation currently consists in
glucocorticoids, an antiproliferative agent and a calcineurin inhibitor
(CNI), with better outcome for tacrolimus than cyclosporin. Although, CNI
drastically improved early graft survival, so far, CNI have failed to
significantly improve long-term survival mainly because of nephrotoxicity.
In addition, CNI carry several other side effects such as an increased
risk for cardiovascular events and for diabetes mellitus. Therefore,
seeking alternatives to CNI remains of paramount importance in kidney
transplantation. Belatacept is a fusion protein composed of the human IgG1
Fc fragment linked to the modified extracellular domain of cytotoxic T
lymphocyte-associated antigen 4. In kidney transplant recipients, pivotal
phase III randomized studies suggested clinical benefits of belatacept as
an initial maintenance regimen, as compared with cyclosporine, mainly on
kidney function. Recently, a randomized study also suggested a clinical
benefit on renal function of a conversion from a CNI-based to a
belatacept-based maintenance regimen in patients. However, conversion from
CNIs to belatacept is probably associated with an increased risk of
biopsy-proven acute rejection and should prompt close clinical
surveillance. On the other hand, other studies suggest a decrease in de
novo humoral transplant immunization. Belatacept is probably associated
with an increase in both risk and severity of some infectious diseases,
including EBV-linked post-transplantation lymphoproliferative disorders,
and with a decreased response to vaccines. Most studies on belatacept are
observational, retrospective, and non-comparative. Consequently,
high-quality data about the safety and efficacy profile of belatacept, as
compared with the current gold standard for maintenance regimens
(tacrolimus-based), is uncertain. Our review will therefore focus on the
most recent published data aiming at evaluating the evidence-based or the
"true" benefits and risks of belatacept-based regimens in kidney
transplantation. Copyright © 2022 Lombardi and Francois.

<6>
Accession Number
2005051033
Title
Outcomes of percutaneous temporary biventricular mechanical support: a
systematic review.
Source
Heart Failure Reviews. 27(3) (pp 879-890), 2022. Date of Publication: May
2022.
Author
Weber M.P.; O'Malley T.J.; Choi J.H.; Maynes E.J.; Prochno K.W.; Austin
M.A.; Wood C.T.; Patel S.; Morris R.J.; Massey H.T.; Tchantchaleishvili V.
Institution
(Weber, O'Malley, Choi, Maynes, Prochno, Austin, Wood, Patel, Morris,
Massey, Tchantchaleishvili) Division of Cardiac Surgery, Sidney Kimmel
Medical College, Thomas Jefferson University, 1025 Walnut St, Suite 607,
Philadelphia, PA 19107, United States
Publisher
Springer
Abstract
Percutaneous biventricular assist devices (BiVAD) are a recently developed
treatment option for severe cardiogenic shock. This systematic review
sought to identify indications and outcomes of patients placed on
percutaneous BiVAD support. An electronic search was performed to identify
all appropriate studies utilizing a percutaneous BiVAD configuration.
Fifteen studies comprising of 20 patients were identified. Individual
patient survival and outcomes data were combined for statistical analysis.
All 20 patients were supported with a microaxial LVAD, 12/20 (60%) of
those patients were supported with a microaxial (RMA) right ventricular
assist device (RVAD), and the remaining 8/20 (40%) patients were supported
with a centrifugal extracorporeal RVAD (RCF). All patients presented with
cardiogenic shock, and of these, 12/20 (60%) presented with a non-ischemic
etiology vs 8/20 (40%) with ischemic disease. For the RMA group, RVAD
support was significantly longer [RMA 5 (IQR 4-7) days vs RCF 1 (IQR 1-2)
days, p = 0.03]. Intravascular hemolysis post-BiVAD occurred in three
patients (27.3%) [RMA 3 (33.3%) vs RCF 0 (0%), p = 0.94]. Five patients
received a durable left ventricular assist device, one patient received a
total artificial heart, and one patient underwent a heart transplantation.
Estimated 30-day mortality was 15.0%, and 78.6% were discharged alive.
Both strategies for percutaneous BiVAD support appear to be viable options
for severe cardiogenic shock. Copyright © 2020, Springer
Science+Business Media, LLC, part of Springer Nature.

<7>
Accession Number
638878888
Title
Long-Term Evolocumab in Patients With Established Atherosclerotic
Cardiovascular Disease.
Source
Circulation. 146(15) (pp 1109-1119), 2022. Date of Publication: 11 Oct
2022.
Author
O'Donoghue M.L.; Giugliano R.P.; Wiviott S.D.; Atar D.; Keech A.; Kuder
J.F.; Im K.; Murphy S.A.; Flores-Arredondo J.H.; Lopez J.A.G.;
Elliott-Davey M.; Wang B.; Monsalvo M.L.; Abbasi S.; Sabatine M.S.
Institution
(O'Donoghue, Giugliano, Wiviott, Keech, Kuder, Im, Murphy, Sabatine) TIMI
Study Group, Division of Cardiovascular Medicine, Brigham and Women's
Hospital and Harvard Medical School, K.I., S.A.M., Boston, United States
(Atar) Department of Cardiology, Oslo University Hospital Ulleval, Norway
(Atar) Institute of Clinical Medicine, University of Oslo, Norway
(Flores-Arredondo, Lopez, Wang, Monsalvo, Abbasi) Global Development,
Amgen, Thousand Oaks, B.W.
(Elliott-Davey) Amgen Ltd, United Kingdom (M.E.-D.), Cambridge, United
Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: In FOURIER (Further Cardiovascular Outcomes Research With
PCSK9 Inhibition in Subjects With Elevated Risk), the proprotein
convertase subtilisin-kexin type 9 inhibitor evolocumab reduced
low-density lipoprotein cholesterol (LDL-C) and risk of cardiovascular
events and was safe and well tolerated over a median of 2.2 years of
follow-up. However, large-scale, long-term data are lacking.
 METHOD(S): The parent FOURIER trial randomized 27564 patients with
atherosclerotic cardiovascular disease and LDL-C >=70 mg/dL on statin to
evolocumab versus placebo. Patients completing FOURIER at participating
sites were eligible to receive evolocumab in 2 open-label extension
studies (FOURIER-OLE [FOURIER Open-Label Extension]) in the United States
and Europe; primary analyses were pooled across studies. The primary end
point was the incidence of adverse events. Lipid values and major adverse
cardiovascular events were prospectively collected. RESULT(S): A
total of 6635 patients were enrolled in FOURIER-OLE (3355 randomized to
evolocumab and 3280 to placebo in the parent study). Median follow-up in
FOURIER-OLE was 5.0 years; maximum exposure to evolocumab in parent plus
FOURIER-OLE was 8.4 years. At 12 weeks in FOURIER-OLE, median LDL-C was 30
mg/dL, and 63.2% of patients achieved LDL-C <40 mg/dL on evolocumab.
Incidences of serious adverse events, muscle-related events, new-onset
diabetes, hemorrhagic stroke, and neurocognitive events with evolocumab
long term did not exceed those for placebo-treated patients during the
parent study and did not increase over time. During the FOURIER-OLE
follow-up period, patients originally randomized in the parent trial to
evolocumab versus placebo had a 15% lower risk of cardiovascular death,
myocardial infarction, stroke, or hospitalization for unstable angina or
coronary revascularization (hazard ratio, 0.85 [95% CI, 0.75-0.96];
P=0.008); a 20% lower risk of cardiovascular death, myocardial infarction,
or stroke (hazard ratio, 0.80 [95% CI, 0.68-0.93]; P=0.003); and a 23%
lower risk of cardiovascular death (hazard ratio, 0.77 [95% CI,
0.60-0.99]; P=0.04). CONCLUSION(S): Long-term LDL-C lowering with
evolocumab was associated with persistently low rates of adverse events
for >8 years that did not exceed those observed in the original placebo
arm during the parent study and led to further reductions in
cardiovascular events compared with delayed treatment initiation.
REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifiers:
NCT02867813 and NCT03080935.

<8>
Accession Number
2018982962
Title
Comparison of the analgesic effect of inhaled lavender vs vanilla
essential oil for neonatal frenotomy: a randomized clinical trial
(NCT04867824).
Source
European Journal of Pediatrics. 181(11) (pp 3923-3929), 2022. Date of
Publication: November 2022.
Author
Maya-Enero S.; Fabregas-Mitjans M.; Llufriu-Marques R.M.; Candel-Pau J.;
Garcia-Garcia J.; Lopez-Vilchez M.A.
Institution
(Maya-Enero, Fabregas-Mitjans, Llufriu-Marques, Candel-Pau, Garcia-Garcia,
Lopez-Vilchez) Department of Neonatology, Service of Pediatrics, Hospital
del Mar, Parc de Salut Mar, Universitat Pompeu Fabra, Passeig Maritim
25-29, Barcelona 08003, Spain
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
It is necessary to treat neonatal pain because it may have short- and
long-term adverse effects. Frenotomy is a painful procedure where sucking,
a common strategy to relieve pain, cannot be used because the technique is
performed on the tongue. In a previous randomized clinical trial, we
demonstrated that inhaled lavender essential oil (LEO) reduced the signs
of pain during neonatal frenotomy. We aimed to find out whether inhaled
vanilla essential oil (VEO) is more effective in reducing pain during
frenotomy than LEO. Randomized clinical trial with neonates who underwent
a frenotomy for type 3 tongue-ties between May and October 2021. Pain was
assessed using pre and post-procedure heart rate (HR) and oxygen
saturation (SatO2), crying time, and NIPS score. Neonates were randomized
into "experimental" and "control" group. In both groups, we performed
swaddling, administered oral sucrose, and let the newborn suck for 2 min.
We placed a gauze pad with one drop of LEO (control group) or of VEO
(experimental group) under the neonate's nose for 2 min prior to and
during the frenotomy. We enrolled 142 neonates (71 per group). Both groups
showed similar NIPS scores (2.02 vs 2.38) and crying times (15.3 vs 18.7
s). We observed no differences in HR increase or in SatO2 decrease between
both groups. We observed no side effects in either of the groups.
 Conclusion(s): We observed no appreciable difference between LEO and
VEO; therefore, we cannot conclude which of them was more effective in
treating pain in neonates who underwent a frenotomy. Trial registration:
This clinical trial is registered with www.clinicaltrials.gov with
NCT04867824.What is Known:* Pain management is one of the most important
goals of neonatal care as it can have long-term neurodevelopmental
effects.* Lavender essential oil can help relieve pain due to its
sedative, antispasmodic, and anticolic properties.What is New:* Lavender
and vanilla essential oils are safe, beneficial, easy to use, and cheap in
relieving pain in neonates who undergo a frenotomy for type 3
tongue-ties. Copyright © 2022, The Author(s), under exclusive
licence to Springer-Verlag GmbH Germany, part of Springer Nature.

<9>
Accession Number
2017039819
Title
Outcomes of heart transplantation in cardiac amyloidosis: an updated
systematic review.
Source
Heart Failure Reviews. 27(6) (pp 2201-2209), 2022. Date of Publication:
November 2022.
Author
Lakhdar S.; Buttar C.; Nassar M.; Ciobanu C.; Patel R.; Munira M.S.
Institution
(Lakhdar, Nassar) Department of Medicine, Icahn School of Medicine at
Mount Sinai/NYC H+H/Queens, 82-68 164th St. Queens, New York, NY 11432,
United States
(Buttar) Department of Cardiology, Ochsner Medical Center, New Orleans,
LA, United States
(Ciobanu) St. Barnabas Hospital/Albert Einstein College of Medicine, New
York, NY, United States
(Patel, Munira) Division of Cardiology, Icahn School of Medicine at Mount
Sinai/NYC H+H/Queens, New York, NY, United States
(Munira) Division of Cardiology, Icahn School of Medicine at Mount Sinai,
New York, NY, United States
Publisher
Springer
Abstract
Cardiac amyloidosis is one of the most common infiltrative
cardiomyopathies that is characterized by the extracellular deposition of
misfolded fibrillar protein. Several studies have previously found that
patients with amyloid in the past have performed poorly after heart
transplantation. Recent advancements in treatments have been made that
have significantly improved outcomes in these patients. The study aimed to
evaluate the outcomes of heart transplantation in cardiac amyloidosis. We
systematically searched EMBASE, PubMed/MEDLINE, and Cochrane Library
databases on 30 December 2021 following the Preferred Reporting Items for
Systematic Reviews and Meta-analyses (PRISMA) guidelines. We identified 22
studies that examined 42,951 patients with cardiac amyloidosis of which
only 1,329 patients underwent isolated heart transplantation. Seven
studies reported individual patient data. The results of 123 patients have
been pooled for analysis. There were 70 male patients, 45 female patients,
and eight patients who did not report their gender. Among the types of
amyloids, 63 (51%) patients were found to have light chain amyloidosis
(AL) and 33 (27%) patients had transthyretin amyloidosis (ATTR). Only 41
patients (33.3%) reported a monoclonal component. There were 30 patients
with AL that underwent autologous hematopoietic stem cell transplant
(ASCT). The mean survival of 24 out of 30 patients was 4.33 years. In
addition, the reported data include 13 patients requiring intra-aortic
balloon pump (IABP), six with cardiac resynchronization therapy (CRT), and
four with implantable cardioverter defibrillator (ICD). With the current
advancements in treatments in combination with a multidisciplinary
approach and careful patient selection, patients undergoing heart
transplantation for amyloidosis may have encouraging results in the
current era. Further studies will be needed to evaluate the outcomes of
heart transplantation in amyloidosis patients now that several advances
have been made in the field. Copyright © 2022, The Author(s),
under exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature.

<10>
Accession Number
639224912
Title
Meta-Analysis on the Anesthetic Effects of Remifentanil plus
Dexmedetomidine versus Remifentanil Alone in Cardiac Surgery.
Source
Computational and mathematical methods in medicine. 2022 (pp 1077980),
2022. Date of Publication: 2022.
Author
Zeng X.-L.; Liao J.-H.; Zhong H.-S.; Yin X.-H.; Wang R.; Liang J.-P.;
Zhang Z.-S.
Institution
(Zeng, Yin, Wang) Department of Cardiology, Shenzhen University General
Hospital, Shenzhen, China
(Liao) Guangzhou Yujia Biotechnology Co., Ltd., Guangzhou, China
(Zhong) Cardiac Surgery Center, First Affiliated Hospital of Gannan
Medical University, Jiangxi, China
(Liang) Department of Radiology, Shenzhen Bao'an District Songgang
People's Hospital, Shenzhen, China
(Zhang) Department of Cardiology, Pingshan District People's Hospital of
Shenzhen, Pingshan General Hospital of Southern Medical University,
Shenzhen, Guangdong, China
Publisher
NLM (Medline)
Abstract
In this study, we performed a meta-analysis to investigate the anesthesia
effects of remifentanil plus dexmedetomidine versus remifentanil alone in
cardiac surgery. Literature search was performed on PubMed, Web of
Science, Embase, China Knowledge Infrastructure, Wanfang Data, and other
databases for relevant literature published in English or Chinese before
October 2021. A total of 17 studies, consisting of 1350 patients, were
included in this study. Of these, 10 studies showed that remifentanil plus
dexmedetomidine had a good anesthesia effect in cardiac surgery (OR =
3.61, 95% CI: 1.73, 7.52, P < 0.001), and 8 studies showed that the Ramsay
score test of anesthesia (SMD = 0.88; 95% CI: -0.77, 2.53; P < 0.001) in
the experimental group was better than that in the control group. In
addition, changes in the hemodynamic heart rate (SMD = -0.74; 95% CI:
-1.41, -0.07; P < 0.001) and mean arterial pressure (SMD = -0.18; 95% CI:
-0.72, 0.36; P < 0.001) of the two groups of anesthesia were counted in 17
studies, which also showed that the anesthesia effect of remifentanil plus
dexmedetomidine was good. Thus, remifentanil plus dexmedetomidine may be a
more promising option for cardiac surgery anesthesia than remifentanil
alone. Copyright © 2022 Xiao-Lin Zeng et al.

<11>
Accession Number
2020520250
Title
Research Progress on Coping Strategies of Cognitive Impairment after
Cardiac Surgery: A Systematic Review of Literature.
Source
Heart Surgery Forum. 25(1) (pp E118-E123), 2022. Date of Publication: 12
Jan 2022.
Author
Yan Y.; Sandeep B.; Ding W.; Ma C.; Peng S.; Xiao Z.
Institution
(Yan, Ding, Peng) Zunyi Medical University, Guizhou, Zunyi, China
(Sandeep, Ma) Department of Cardio-Thoracic Surgery, Chengdu Second
People's Hospital, Sichuan, Chengdu, China
(Xiao) Department of Cardio-Thoracic Surgery, Zunyi Medical University,
Chengdu Second People's Hospital, Sichuan, Chengdu, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Postoperative cognitive dysfunction (POCD) refers to a complication of
neurological dysfunction after surgery, including one or more changes that
are significantly lower than those before surgery. The purpose of this
study was to review the coping strategies and risk factors of POCD.
Systemic research was conducted searching Pubmed, Web of Science, MEDLINE,
and other websites with the keywords of cardiac surgery, cognitive
impairment, and POCD. Multiple factors have been associated with the
treatment of POCD, including anesthetic, choice of analgesic drugs,
anti-inflammatory drugs, erythropoietin, atherosclerosis, emotional
factors, surgical, and other factors. Targeted treatments are carried out
for risk factors that may affect POCD prevention, such as anesthetic drug
prevention, anti-inflammatory drug prevention, and intraoperative
prevention and other preventive measures are aimed at reducing the
incidence of POCD after cardiac surgery. Copyright © 2022 Forum
Multimedia Publishing, LLC.

<12>
Accession Number
2018182057
Title
Effects of Dexmedetomidine Pretreatment, Posttreatment, and Whole-Course
Pumping on Myocardial Damage during Cardiac Valve Replacement.
Source
International Heart Journal. 63(5) (pp 837-842), 2022. Date of
Publication: 2022.
Author
Gao S.; Ma G.; Zhou L.; Guan S.; Zhang J.
Institution
(Gao, Ma, Zhou, Guan) Department of Anesthesia, Tai'an City Central
Hospital, Tai'an, China
(Zhang) Taishan Sanatorium and Hospital of Shandong Province, Tai'an,
China
Publisher
International Heart Journal Association
Abstract
To compare the effects of dexmedetomidine (DEX) pretreatment,
posttreatment, and whole-course pumping on myocardial protection during
cardiac valve replacement. One hundred and twenty patients undergoing
cardiac valve replacement were randomly divided into the follow groups:
DEX pretreatment (D1 group), DEX posttreatment (D2 group), DEX
whole-course pumping (D3 group), and Control (C group). The concentrations
of cardiac troponin I (cTnI), malondialdehyde (MDA), tumor necrosis factor
alpha (TNF-alpha), rate of spontaneous heart rebound after aortic opening,
time to heart rebound, incidence of arrhythmia, and use of sufentanil and
vasoactive drugs were recorded. Compared with group C, the concentrations
of cTnI, MDA, and TNF-alpha in the D1, D2, and D3 groups were lower,
especially in the latter. The time to heart rebound was prolonged in all
three groups (P < 0.05). The rate of automatic rebound was increased (P <
0.05) while the incidence of arrhythmia was decreased (P < 0.05) in all
groups compared with group C. Group D3 had the highest rate of automatic
rebound and the lowest incidence of arrhythmia. Compared with groups C and
D2, the use of sufentanil and dopamine was lower in groups D1 and D3 (P <
0.05), especially in the latter. During cardiac valve replacement, DEX
pretreatment, posttreatment, and whole-course pumping could have
myocardial protective effects. The latter showed better
effects. Copyright © 2022, International Heart Journal
Association. All rights reserved.

<13>
Accession Number
2019429773
Title
A Randomized Pilot Study Assessing if SEDLine Monitoring During Induction
of Surgical Patients is Associated With Reduced Dosage of Administered
Induction Agents.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. (no pagination),
2022. Date of Publication: 2022.
Author
Krause M.; Nguyen A.; O'Brien O.; Khoche S.; Schmidt U.
Institution
(Krause, O'Brien, Khoche, Schmidt) Department of Anesthesiology,
University of California San Diego, San Diego, CA, United States
(Nguyen) Division of Critical Care Medicine, Providence Santa Rosa
Memorial Hospital, Santa Rosa, CA, United States
Publisher
SAGE Publications Inc.
Abstract
Background. Intubations, especially in emergent settings, carry a high
risk of hemodynamic instability with potentially catastrophic outcomes.
Weight-based dosing of induction drugs can be inappropriately high for
elective or emergent intubations and lead to hemodynamic instability. We
hypothesized that monitoring the patient state index of SEDLine monitors
(Masimo, Irvine, CA) would decrease the dose of induction drugs in the
operating room during elective intubations. Methods. In this randomized
study, SEDLine monitoring was provided to the intervention group but not
to the control group during the induction of anesthesia in the operating
room. Anesthesia providers in the intervention group were advised to
titrate induction drugs to a Patient State Index of <50 before proceeding
with intubation. The primary outcome was the induction dose of propofol
and etomidate per kilogram normalized to propofol dose equivalents.
Secondary outcomes included supplemental doses of ketamine, midazolam,
fentanyl, phenylephrine, and ephedrine per kg, time from induction to
intubation, administration of additional propofol or vasopressors after
induction, mean arterial pressure >= or <65 mmHg, and lowest mean arterial
pressure post-induction. Results. We found no significant difference in
propofol equivalents between groups (P =.41). Using a SEDLine decreased
the odds that a patient would require vasopressors during induction (odds
ratio of.39 [95% confidence interval,.15-.98]). Conclusion. SEDLine
monitoring during induction did not decrease dosing of the induction drugs
etomidate and propofol but decreased the odds of receiving vasopressors.
Further studies are warranted to assess the utility of processed
electroencephalography in emergent intubations outside of the operating
room. Copyright © The Author(s) 2022.

<14>
Accession Number
639224399
Title
Depth of anaesthesia and mortality after cardiac or noncardiac surgery: a
systematic review and meta-analysis of randomised controlled trials.
Source
British journal of anaesthesia. (no pagination), 2022. Date of
Publication: 06 Oct 2022.
Author
Payne T.; Braithwaite H.; McCulloch T.; Paleologos M.; Johnstone C.;
Wehrman J.; Taylor J.; Loadsman J.; Wang A.Y.; Sanders R.D.
Institution
(Payne, Loadsman) Central Clinical School Faculty of Medicine and Health,
The University of Sydney, Sydney, NSW, Australia; Department of
Anaesthetics, Royal Prince Alfred Hospital, Sydney Local Health District,
Sydney, NSW, Australia
(Braithwaite, McCulloch, Paleologos, Johnstone) Department of
Anaesthetics, Royal Prince Alfred Hospital, Sydney Local Health District,
NSW, Sydney, Australia
(Wehrman, Taylor) Central Clinical School Faculty of Medicine and Health,
University of Sydney, NSW, Sydney, Australia
(Wang) Department of Anaesthetics, Royal Prince Alfred Hospital, Sydney
Local Health District, Sydney, NSW, Australia; Northern Clinical School,
Faculty of Medicine and Health, The University of Sydney, NSW, Australia
(Sanders) Central Clinical School Faculty of Medicine and Health, The
University of Sydney, Sydney, NSW, Australia; Department of Anaesthetics,
Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW,
Australia; NHMRC Clinical Trials Centre, University of Sydney, New South
Wales, Australia; Institute of Academic Surgery, Royal Prince Alfred
Hospital, Sydney Local Health District, Sydney, NSW, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Recent randomised controlled trials have failed to show a
benefit in mortality by using processed electroencephalography (pEEG) to
guide lighter anaesthesia. We performed a meta-analysis of mortality data
from randomised trials of pEEG monitoring to assess the evidence of any
protective effect of pEEG-guided light anaesthesia compared with deep
anaesthesia in adults aged >=18 yr. METHOD(S): Our study followed the
Preferred Reporting Items for Systematic Reviews and Meta-analyses
(PRISMA) guidelines. In February 2022, we searched three databases
(Cochrane CENTRAL, OVID Medline, EMBASE) for RCTs of pEEG monitoring that
provided mortality data at 30 days, 90 days, and/or 1 yr or longer.
 RESULT(S): We included 16 articles from 12 RCTs with 48 827 total
participants. We observed no statistically significant mortality reduction
with light anaesthesia compared with deep anaesthesia in patients aged
>=18 yr when all studies were pooled (odds ratio [OR]=0.99; 95% confidence
interval (CI), 0.92-1.08). This result did not change significantly when
analysing mortality at 30 days, 90 days, 1 yr or longer. We observed no
mortality benefit for pEEG monitoring compared with usual care (OR=1.02;
95% CI, 0.89-1.18), targeting higher pEEG index values compared with lower
values (OR=0.89; 95% CI, 0.60-1.32), or low pEEG index value alerts
compared with no alerts (OR=1.02; 95% CI, 0.41-2.52). CONCLUSION(S):
pEEG-guided lighter anaesthesia does not appear to reduce the risk of
postoperative mortality. The absence of a plausible rationale for why
deeper anaesthesia should increase mortality has hampered appropriate
design of definitive clinical trials. CLINICAL TRIAL REGISTRATION:
CRD42022285195 (PROSPERO). Copyright © 2022 British Journal of
Anaesthesia. Published by Elsevier Ltd. All rights reserved.

<15>
Accession Number
639221773
Title
Prediction models for postoperative delirium after cardiac surgery:
Systematic review and critical appraisal.
Source
International journal of nursing studies. 136 (pp 104340), 2022. Date of
Publication: 06 Aug 2022.
Author
Cai S.; Li J.; Gao J.; Pan W.; Zhang Y.
Institution
(Cai, Li) Department of Nursing, Zhongshan Hospital, Fudan University,
Shanghai 200032, China; Department of Critical Care Medicine, Zhongshan
Hospital, Fudan University, Shanghai 200032, China; The Centre for
Critical Care Zhongshan Hospital: A Joanna Briggs Institute Center of
Excellence, China
(Gao) Center of Clinical Epidemiology and Evidence-based Medicine, Fudan
University, Shanghai 200032, China; Department of Nutrition, Zhongshan
Hospital, Fudan University, Shanghai 200032, China
(Pan, Zhang) Department of Nursing, Zhongshan Hospital, Fudan University,
Shanghai 200032, China; The Centre for Critical Care Zhongshan Hospital: A
Joanna Briggs Institute Center of Excellence, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Many studies have developed or validated prediction models to
estimate the risk of delirium after cardiac surgery, but the quality of
the model development and model applicability remain unknown.
 OBJECTIVE(S): To systematically review and critically evaluate
currently available prediction models for delirium after cardiac surgery.
DATA SOURCES: PubMed, EMBASE, and MEDLINE were systematically searched.
This systematic review was registered in PROSPERO (Registration ID:
CRD42021251226). STUDY SELECTION: Prospective or retrospective cohort
studies were considered eligible if they developed or validated prediction
models or scoring systems for delirium in the ICU. We included studies
involving adults (age >=18years) undergoing cardiac surgery and excluded
studies that did not validate a prediction model. DATA EXTRACTION: Data
extraction was independently performed by two authors using a standardized
data extraction form based on the Critical Appraisal and Data Extraction
for Systematic Reviews of Prediction Modeling Studies checklist. Quality
of the models was assessed with the Prediction Model Risk of Bias
Assessment Tool (PROBAST). DATA SYNTHESIS: Of 5469 screened studies, 13
studies described 10 prediction models. The postoperative delirium
incidence varied from 11.3% to 51.6%. The most frequently used predictors
were age and cognitive impairment. The reported areas under the curve or
C-statistics were between of 0.74 and 0.91 in the derivation set. The
reported AUCs in the external validation set were between 0.54 and 0.90.
All the studies had a high risk of bias, mainly owing to poor reporting of
the outcome domain and analysis domain; 10 studies were of high concern
regarding applicability. CONCLUSION(S): The current models for
predicting postoperative delirium in the ICU after cardiac surgery had a
high risk of bias according to the PROBAST. Future studies should focus on
improving current prediction models or developing new models with rigorous
methodology. Copyright © 2022. Published by Elsevier Ltd.

<16>
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.

<17>
Accession Number
2019662706
Title
Left ventricular assist device implantation via lateral thoracotomy: A
systematic review and meta-analysis.
Source
Journal of Heart and Lung Transplantation. 41(10) (pp 1440-1458), 2022.
Date of Publication: October 2022.
Author
Ribeiro R.V.P.; Lee J.; Elbatarny M.; Friedrich J.O.; Singh S.; Yau T.;
Yanagawa B.
Institution
(Ribeiro, Lee, Elbatarny, Yanagawa) Division of Cardiovascular Surgery,
St. Michael's Hospital, Toronto, ON, Canada
(Friedrich) Critical Care and Medicine Departments and Li Ka Shing
Knowledge Institute, St. Michael's Hospital, and Department of Medicine
and Interdepartmental Division of Critical Care, University of Toronto,
Toronto, ON, Canada
(Singh) Division of Cardiac Surgery, Trillium Health Partners, Toronto,
ON, Canada
(Yau) Division of Cardiac Surgery, Toronto General Hospital, Toronto, ON,
Canada
Publisher
Elsevier Inc.
Abstract
BACKGROUND: Left ventricular assist device (LVAD) implantation via lateral
thoracotomy can offer similar effectiveness to conventional approaches
with less perioperative adverse events. We performed a systematic review
and meta-analysis to determine the potential benefits of lateral
thoracotomy (LT) for LVAD implantation compared to median sternotomy.
 METHOD(S): We searched MEDLINE and Embase databases for studies
comparing continuous-flow LVAD implantation using LT with conventional
sternotomy. Main outcomes were perioperative mortality and complications.
 Result(s): Twenty-five observational studies enrolling 3072 patients
were included with a median follow-up of 10 months. Perioperative
mortality (30 day or in-hospital) was 7% (LT) and 14% (sternotomy);
however, mortality differences were no longer statistically significant in
matched/adjusted studies (RR:0.86; 95%CI:0.52-1.44; p = 0.58). LT was
associated with decreased need for blood product transfusions (mean
difference[MD]: -4.7; 95%CI: -7.2 to -2.3 units; p < 0.001), reoperation
for bleeding (RR:0.34; 95%CI:0.22-0.54; p < 0.001), postoperative RVAD
implantation (RR:0.53; 95%CI:0.36-0.77; p < 0.001), days requiring
inotropes (MD: -1.1; 95%CI: -2.1 to -0.03 inotrope days; p = 0.04), ICU
(MD: -3.3; 95%CI: -6.0 to -0.7 ICU days; p = 0.01), and hospital length of
stay (MD: -5.1; 95%CI: -10.1 to -0.1 hospital days; p = 0.04) in
matched/adjusted studies. Overall mortality during follow-up was
significantly lower for LT in unmatched/unadjusted studies but not
statistically significantly lower in matched/adjusted studies (Hazard
Ratio:0.82; 95%CI:0.59-1.14; p = 0.24). CONCLUSION(S): LVAD
implantation via LT was associated with significantly decreased need for
blood products, reoperation for bleeding, and postoperative RVAD
implantation. Furthermore, days on inotropic support were also lower,
likely contributing to the shorter length of stay. These findings support
greater use of a LT approach for carefully selected
patients. Copyright © 2022 International Society for Heart and
Lung Transplantation

<18>
Accession Number
2019352905
Title
An Updated Meta-Analysis of DOACs vs. VKAs in Atrial Fibrillation Patients
With Bioprosthetic Heart Valve.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 899906. Date of Publication: 17 Jun 2022.
Author
Cao Y.; Zheng Y.; Li S.; Liu F.; Xue Z.; Yin K.; Luo J.
Institution
(Cao) Department of Cardiology, Guizhou Provincial People's Hospital,
Guiyang, China
(Zheng, Li) Second Clinical Medical College, Nanchang University,
Nanchang, China
(Liu, Luo) Department of Cardiology, The Affiliated Ganzhou Hospital of
Nanchang University, Ganzhou, China
(Xue, Yin) Department of Critical Care Medicine, the First Affiliated
Hospital of Gannan Medical University, Ganzhou, China
Publisher
Frontiers Media S.A.
Abstract
Background: Current guidelines recommend the utilization of direct-acting
oral anticoagulants (DOACs) in patients with non-valvular atrial
fibrillation (AF). However, the optimal anticoagulation strategy for AF
patients with bioprosthetic heart valves (BPHV) remains controversial.
Therefore, we conducted this meta-analysis to explore the effect of DOACs
versus vitamin K antagonists (VKAs) in this population. Method(s): We
systematically searched the PubMed and Embase databases until November
2021 for studies reporting the effect of DOACs versus VKAs in AF patients
with BPHV. Adjusted risk ratios (RRs) and 95% confidence intervals (CIs)
were pooled using the random-effects model with an inverse variance
method. Result(s): We selected four randomized clinical trials and
seven observational studies (2236 DOAC- and 6403 VKAs-users). Regarding
the effectiveness outcomes, there were no significant differences between
DOACs and VKAs in stroke or systemic embolism (RR = 0.74, 95%CI:
0.50-1.08), ischemic stroke (RR = 1.08, 95%CI: 0.76-1.55), all-cause death
(RR = 0.98, 95%CI: 0.86-1.12), and cardiovascular death (RR = 0.85, 95%CI:
0.40-1.80). In terms of the safety outcomes, DOACs was associated with
lower risks of major bleeding (RR = 0.70, 95%CI: 0.59-0.82) and
intracranial bleeding (RR = 0.42, 95%CI: 0.26-0.70), but the risks of any
bleeding (RR = 0.85, 95%CI: 0.65-1.13) and gastrointestinal bleeding (RR =
0.92, 95%CI: 0.73-1.17) are not significantly different when compared with
VKAs. The subgroup analysis with follow-up as a covariate revealed that
the DOACs had lower risks of SSE (RR = 0.59, 95%CI: 0.37-0.94) and major
bleeding (RR = 0.69, 95%CI: 0.58-0.81) in patients with a mean follow-up
of more than 24 months, but no statistical differences were found in
patients with the follow-up less than 24 months (SSE: RR = 1.10, 95%CI:
0.92-1.32; major bleeding: RR = 0.91, 95%CI: 0.42-2.01).
 Conclusion(s): In AF with BPHV, patients on DOACs experienced a
reduced risk of major bleeding and intracranial bleeding compared with
VKAs, while the risks of stroke, cardiovascular death, and all-cause
mortality were similar. Copyright © 2022 Cao, Zheng, Li, Liu,
Xue, Yin and Luo.

<19>
Accession Number
2019352139
Title
Perioperative Myocardial Injury/Infarction After Non-cardiac Surgery in
Elderly Patients.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 910879. Date of Publication: 19 May 2022.
Author
Gao L.; Chen L.; He J.; Wang B.; Liu C.; Wang R.; Fan L.; Cheng R.
Institution
(Gao, He, Wang, Liu, Wang, Fan, Cheng) Department of Comprehensive
Surgery, General Hospital of Chinese People's Liberation Army and National
Clinical Research Center for Geriatric Disease, Beijing, China
(Chen) Department of Thoracic Surgery, General Hospital of Chinese
People's Liberation Army, Beijing, China
Publisher
Frontiers Media S.A.
Abstract
At present, we have entered an aging society. Many diseases suffered by
the elderly, such as malignant tumors, cardiovascular diseases, fractures,
surgical emergencies and so on, need surgical intervention. With the
improvement of Geriatrics, surgical minimally invasive technology and
anesthesia level, more and more elderly patients can safely undergo
surgery. Elderly surgical patients are often complicated with a variety of
chronic diseases, and the risk of postoperative myocardial
injury/infarction (PMI) is high. PMI is considered to be the increase of
cardiac troponin caused by perioperative ischemia, which mostly occurs
during operation or within 30 days after operation, which can increase the
risk of short-term and long-term death. Therefore, it is suggested to
screen troponin in elderly patients during perioperative period, timely
identify patients with postoperative myocardial injury and give
appropriate treatment, so as to improve the prognosis. The
pathophysiological mechanism of PMI is mainly due to the increase of
myocardial oxygen consumption and / the decrease of myocardial oxygen
supply. Preoperative and postoperative risk factors of myocardial injury
can be induced by mismatch of preoperative and postoperative oxygen
supply. The treatment strategy should first control the risk factors and
use the drugs recommended in the guidelines for treatment. Application of
cardiovascular drugs, such as antiplatelet beta- Receptor blockers,
statins and angiotensin converting enzyme inhibitors can effectively
improve postoperative myocardial ischemia. However, the risk of
perioperative bleeding should be fully considered before using
antiplatelet and anticoagulant drugs. This review is intended to describe
the epidemiology, diagnosis, pathophysiology, risk factors, prognosis and
treatment of postoperative myocardial infarction /injury. Copyright
© 2022 Gao, Chen, He, Wang, Liu, Wang, Fan and Cheng.

<20>
Accession Number
2019346767
Title
Factor XI Inhibitors for Prevention and Treatment of Venous
Thromboembolism: A Review on the Rationale and Update on Current Evidence.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 903029. Date of Publication: 12 May 2022.
Author
Nopp S.; Kraemmer D.; Ay C.
Institution
(Nopp, Kraemmer, Ay) Clinical Division of Hematology and Hemostaseology,
Department of Medicine I, Medical University of Vienna, Vienna, Austria
Publisher
Frontiers Media S.A.
Abstract
Although anticoagulation therapy has evolved from non-specific drugs
(i.e., heparins and vitamin K antagonists) to agents that directly target
specific coagulation factors (i.e., direct oral anticoagulants,
argatroban, fondaparinux), thrombosis remains a leading cause of death
worldwide. Direct oral anticoagulants (i.e., factor IIa- and factor
Xa-inhibitors) now dominate clinical practice because of their favorable
pharmacological profile and ease of use, particularly in venous
thromboembolism (VTE) treatment and stroke prevention in atrial
fibrillation. However, despite having a better safety profile than vitamin
K antagonists, their bleeding risk is not insignificant. This is true for
all currently available anticoagulants, and a high bleeding risk is
considered a contraindication to anticoagulation. As a result, ongoing
research focuses on developing future anticoagulants with an improved
safety profile. Several promising approaches to reduce the bleeding risk
involve targeting the intrinsic (or contact activation) pathway of
coagulation, with the ultimate goal of preventing thrombosis without
impairing hemostasis. Based on epidemiological data on hereditary factor
deficiencies and preclinical studies factor XI (FXI) emerged as the most
promising candidate target. In this review, we highlight unmet clinical
needs of anticoagulation therapy, outlay the rationale and evidence for
inhibiting FXI, discuss FXI inhibitors in current clinical trials, conduct
an exploratory meta-analysis on their efficacy and safety, and provide an
outlook on the potential clinical application of these novel
anticoagulants. Copyright © 2022 Nopp, Kraemmer and Ay.

<21>
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.

<22>
Accession Number
2019170935
Title
Fit, Female or Fifty-Is Cardiac Rehabilitation "Fit" for Purpose for All?
A Systematic Review and Meta-Analysis With Meta-Regression.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 764882. Date of Publication: 29 Mar 2022.
Author
Smith M.; Orchard J.; La Gerche A.; Gallagher R.; Fitzpatrick J.
Institution
(Smith) Australasian College of Sport and Exercise Physicians, Melbourne,
VIC, Australia
(Orchard) Agnes Ginges Centre for Molecular Cardiology, Centenary
Institute, The University of Sydney, Sydney, NSW, Australia
(La Gerche) Clinical Research Department, Baker Heart and Diabetes
Institute, Melbourne, VIC, Australia
(Gallagher) Faculty of Medicine and Health, The University of Sydney,
Sydney, NSW, Australia
(Fitzpatrick) Department of Physiotherapy, Centre for Health, Exercise and
Sports Medicine, Melbourne School of Health Sciences, Faculty of Medicine,
Dentistry and Health Sciences, University of Melbourne, Carlton, VIC,
Australia
Publisher
Frontiers Media S.A.
Abstract
Aims: Cardiac rehabilitation (CR) is an evidence-based intervention
promoting risk factor modification following coronary artery disease
events but the relative benefits for patient subgroups is not clear. This
review synthesizes the available evidence on the effectiveness of modern
CR programs and determines outcomes for age, sex and prior level of
fitness. Method(s): MEDLINE, CINAHL, and EMBASE were examined for RCT
and cohort studies involving exercise prescription or phase II or III CR
following Myocardial Infarction (MI), Percutaneous Coronary Intervention
(PCI) and cardiac surgery from January 2010 to February 2021. Outcomes
assessed included peakVO<inf>2</inf>max, 6-min walk test and Metabolic
Equivalent of Task. Meta-regression was used to determine CR impact for
change in fitness and age and sex influences. Result(s): The mean age
of study participants was 59.5 years and 82.7% were male. Females, younger
people and those of average or above cardiorespiratory fitness were
substantially under-represented in data and attendance, with 13% of study
groups with a mean age <55 years. At entry, 73% were below average for
fitness vs. age-matched normative values. Fitness improved across all
groups following CR with no evidence of sex or age independently affecting
outcomes. Conclusion(s): Modest improvements in fitness in all groups
were shown, but the benefits of CR can be far greater. A modern,
innovative approach to CR will likely lead to more substantial benefits.
This may require a "Precision Medicine" model which tailors exercise
prescription to different populations to ensure all CR participant's needs
are met. This will ensure that CR is more flexible and accessible for
all. Copyright © 2022 Smith, Orchard, La Gerche, Gallagher and
Fitzpatrick.

<23>
Accession Number
2020496320
Title
Mechanical Circulatory Support in Cardiovascular Surgical Patients: Single
Center Practice and Experience.
Source
Reviews in Cardiovascular Medicine. 23(9) (no pagination), 2022. Article
Number: 291. Date of Publication: September 2022.
Author
Han X.; Yao Y.-T.
Institution
(Han, Yao) Department of Anesthesiology, Fuwai Hospital, National Center
for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy
of Medical Sciences, Beijing 100037, China
(Han) Department of Anesthesiology, Lishui People's Hospital, Sixth
Affiliated Hospital of Wenzhou Medical University, First Affiliated
Hospital of Lishui University, Zhejiang, Lishui 323000, China
Publisher
IMR Press Limited
Abstract
Background: In view of the role of mechanical circulatory support in
patients with severe cardiac insufficiency during perioperative period, we
searched the relevant articles on mechanical circulatory support at Fuwai
Hospital, and analyzed the indications and complications of different
mechanical circulatory support methods. Method(s): Relevant studies
were identified by computerized searches of PubMed, Ovid, Embase, Cochrane
Library, Wanfang Data, VIP Data, Chinese BioMedical Literature & Retrieval
System (SinoMed), and China National Knowledge Infrastructure (CNKI),
using search words ("intra-aortic balloon counter pulsation" OR "IABP" OR
"extracorporeal membrane oxygenation" OR "ECMO" OR "ventricular assist
device" OR "VAD") AND ("Fuwai" OR "fuwai"). All studies concerning the
application of IABP, ECMO, and VAD at Fuwai Hospital were included,
exclusion criteria included: (1) studies published as review, case report
or abstract; (2) animal or cell studies; (3) duplicate publications; (4)
studies lacking information about outcomes of interest. Result(s): A
total of 36 literatures were selected for analysis. The specific
mechanical circulatory support methods of ECMO and VAD retrieved from the
studies were VA-ECMO and LVAD. The number of cases using IABP, ECMO, LVAD
was 1968, 972, 67; and the survival rate was 80.4%, 54.9%, 56.7%,
respectively. The major complications of IABP, ECMO and LVAD were
hemorrhage (1.2%, 35.9% and 14.5%), infection (3.7%, 12.7% and 9.7%),
acute kidney injury (9.1%, 29.6% and 6.5%), the secondary complications
were limb ischemia, neurological events, cardiovascular events and
thrombosis. Conclusion(s): The present study suggested that, IABP,
ECMO and VAD, either alone or in combination, were effective and safe
mechanical circulation support when managing cardiovascular surgical
patients with severe hemodynamic instability at Fuwai
Hospital. Copyright © 2022 The Author(s). Published by IMR Press.

<24>
Accession Number
2013254800
Title
Optimal Frequency for Changing Single-Use Enteral Delivery Sets in Infants
after Congenital Heart Surgery: A Randomized Controlled Trial.
Source
Journal of the American Nutrition Association. 41(2) (pp 140-148), 2022.
Date of Publication: 2022.
Author
Zhang L.; Shi H.; Li J.; Du N.; Chen X.; Wang J.; Gao X.; Si W.; Cui Y.
Institution
(Zhang, Du, Chen, Cui) Cardiac Intensive Care Unit, the Heart Center,
Guangzhou Women and Children Medical Center, Guangzhou Medical University,
Guangzhou, China
(Shi, Li, Si) Institute of Pediatrics, Guangzhou Women and Children
Medical Center, Guangzhou Medical University, Guangzhou, China
(Wang, Gao) Microbiology Laboratory, Guangzhou Women and Children Medical
Center, Guangzhou Medical University, Guangzhou, China
Publisher
Routledge
Abstract
Objective We aimed to assess the optimal frequency for changing single-use
enteral delivery sets during postoperative enteral feeding in infants with
congenital heart disease (CHD). Methods We enrolled 120 CHD infants who
were fed using an enteral nutrition pump directly connected to a milk
bottle with a single-use enteral delivery set in a four-arm randomized
controlled trial (ChiCTR2000039544). Patients were randomized into four
groups based on the replacement frequency of the enteral delivery set (6
h, 12 h, 18 h, and 24 h groups). The primary outcome was the percentage of
contaminated enteral delivery sets (overgrowth of microbiota and
colonization of pathogenic bacteria). Secondary outcomes included evidence
of infection, gastrointestinal tolerance, intestinal microflora dysbiosis,
and healthcare costs. Results The percentages of microbial overgrowth
detected in the 6 h, 12 h, 18 h, and 24 h groups were 6.7%, 30.0%, 46.7%,
and 80%, respectively (P < 0.001). Significant differences were observed
between the 6 h and 18 h groups (P < 0.001), the 6 h and 24 h groups (P <
0.001), and the 18 h and 24 h groups (P = 0.007). Meanwhile, pathogenic
bacterial colonization was detected in 0, 4, 6, and 11 delivery sets in
the 6 h, 12 h, 18 h, and 24 h groups, respectively (P = 0.002). No
difference in clinical symptoms was found among the four groups. The total
cost per patient in the 12 h group and the 18 h group was 340.2 RMB and
226.8 RMB, respectively. Conclusion Taking into consideration both
microbial overgrowth and cost-effectiveness, the results of this study
indicate that for children receiving continuous enteral feeding following
CHD surgery, the optimal frequency for changing the single-use enteral
delivery set when formula reconstituted from powder is used is 18
hours. Copyright © 2020 American College of Nutrition.

<25>
Accession Number
2019072124
Title
Are there differences in cardiothoracic surgery performed by trainees
versus fully trained surgeons?.
Source
Journal of Cardiac Surgery. 37(11) (pp 3776-3798), 2022. Date of
Publication: November 2022.
Author
Comanici M.; Salmasi M.Y.; Schulte K.L.; Raja S.G.; Attia R.Q.
Institution
(Comanici, Salmasi, Raja, Attia) Department of Cardiac Surgery, Harefield
Hospital, London, United Kingdom
(Comanici) Faculty of Medicine and Pharmacy, Dunarea de Jos University of
Galati, Galati, Romania
(Schulte) Department of Surgery, Sana Hospital Berlin Lichtenberg, Berlin,
Germany
Publisher
John Wiley and Sons Inc
Abstract
Objectives: We sought to assess the safety of training in cardiothoracic
surgery comparing outcomes of cases performed by trainees versus fully
trained surgeons. Method(s): EmBase, Scopus, PubMed, and OVID MEDLINE
were searched in August 2021 independently by two authors. A third author
arbitrated decisions to resolve disagreements. Inclusion criteria were
articles on cardiothoracic surgery reporting on outcomes for trainees.
Studies were assessed for appropriateness as per CBEM criteria. Eight
hundred and ninety-two results were obtained, 27 represented best evidence
(2-meta-analyses, 1-RCT, and 24 retrospective cohort studies).
 Result(s): In all 474,160 operative outcomes were assessed for
434,535 coronary artery bypass grafting (CABG) (431,329 on-pump vs. 3206
off-pump), 3090 AVR, 1740 MVR/repair, 26,433 mixed, 3565 congenital, and
4797 thoracic procedures. In all 398,058 cases were performed by trainees
and 75,943 by consultants. One hundred fifty-nine cases were
indeterminate. There were no statistically significant differences in the
patients' preoperative risk scores. All studies excluded extreme high-risk
patients in emergency setting, patients with poor left ventricular
function, and reoperation cases that were undertaken by consultants. There
were no differences in cardiopulmonary bypass and clamp times for CABG.
Times for valve replacement and repair cases were longer for trainees.
There were no differences in the postoperative outcomes including
perioperative myocardial infarction, resternotomy for bleeding, stroke,
renal failure, intensive therapy unit length of stay, and total length of
stay. One study reported no differences on angiographic graft patency at 1
year. There were no differences in in-hospital or midterm mortality out to
5-years. Discussion(s): Trainees can perform cardiothoracic surgery
in dedicated high-volume units with outcomes comparable to those of fully
trained surgeons. Copyright © 2022 Wiley Periodicals LLC.

<26>
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. 62(10) (pp 1973-1983), 2022. Date of Publication: October
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.

<27>
Accession Number
2018960497
Title
Adverse complications of frozen elephant trunk, do we have enough quality
data?.
Source
Journal of Cardiac Surgery. 37(11) (pp 3863-3864), 2022. Date of
Publication: November 2022.
Author
Howard C.; Al-Tawil M.; Geragotellis A.; Abdelhaliem A.
Institution
(Howard) Faculty of Biology, Medicine and Health, The University of
Manchester, Manchester, United Kingdom
(Al-Tawil) Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
(Geragotellis) Faculty of Health Sciences, University of Cape Town, Cape
Town, South Africa
(Abdelhaliem) Department of Vascular and Endovascular Surgery, Royal
Blackburn Teaching Hospital, Blackburn, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Frozen elephant trunk has in recent times become a mainstay
for total arch replacement in aortovascular surgery and is indicated to
treat a spectrum of complex aortic pathologies. However, despite
associated excellent postoperative results it is incredibly important to
recognize potential adverse complications such as negative aortic
remodeling, endoleak, and distal stent-graft induced new entry so that
outcomes can be further improved. Aim of the study: Below we provide
commentary on a recent article in the Journal of Cardiac Surgery
discussing the topic. Conclusion(s): Despite the fascinating outcomes
of this systematic review and meta-analysis the heterogeneity of the
literature regarding these adverse outcomes remains an issue which can
only be solved with large multicenter trials directly comparing graft
types as well as indications for surgery. Copyright © 2022 Wiley
Periodicals LLC.

<28>
Accession Number
2018148242
Title
Treatment of Amyloid Light Chain Cardiac Amyloidosis: Systematic Review
and Future Directions.
Source
Clinical Advances in Hematology and Oncology. 20(10) (pp 609-618), 2022.
Date of Publication: October 2022.
Author
Alsomali D.; Mohty D.; Grogan M.; Dispenzieri A.; Aljurf M.; Kumar S.;
Gertz M.A.; Hanbali A.; Hashmi S.K.
Institution
(Alsomali) Ministry of National Guard Af fairs, Jeddah, Saudi Arabia
(Mohty) Heart Center, King Faisal Specialist Hospital and Research Center,
Riyadh, Saudi Arabia
(Mohty) CHU Limoges, Hopital Dupuytren, Service Cardiologie and INSERM
1094, Faculte de medecine de Limoges, Limoges, France
(Mohty) Al Faisal University, Riyadh, Saudi Arabia
(Grogan) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Dispenzieri, Kumar, Gertz) Division of Hematology, Department of Internal
Medicine, Mayo Clinic, Rochester, MN, United States
(Aljurf, Hanbali) Oncology Center, King Faisal Specialist Hospital and
Research Center, Riyadh, Saudi Arabia
(Hashmi) Sheikh Shakhbout Medical City/Mayo Clinic, Abu Dhabi, United Arab
Emirates
Publisher
Millennium Medical Publishing, Inc.
Abstract
Background: Several treatment strategies for amyloid light chain cardiac
amyloidosis (AL-CA) have been described in the literature; however, there
is no consensus about the optimal approach to AL-CA. Objective(s): We
conducted this systematic review to summarize current evidence from
published studies about the safety and efficacy of various treatment
regimens for patients with AL-CA, mainly focusing on autologous stem cell
transplant (ASCT) and heart transplant. Method(s): An electronic
literature search of PubMed, Web of Science, Scopus, EBSCO, and CINAHL
Plus was conducted through December 2019 using the relevant keywords and
prespecified MeSH terminology. Records were screened, and eligible studies
were selected and narrative-ly discussed. Data on the hematologic and
cardiac responses as well as the safety of the treatment regimens were
extracted and synthesized narratively in the context of the systematic
review. Result(s): Thirty published articles were included in this
systematic review. The most commonly used first-line treatment in the
included studies was bortezomib-based therapy followed by high-dose
melphalan and ASCT, with recent evidence of improved outcome with the
addition of daratumumab. Heart transplant was found to extend survival for
selected patients who were not eligible for ASCT; however, it was found to
affect the patients' tolerance of further chemotherapy in some studies.
Published data on longterm outcomes with immunomodulatory agents were
scarce. Conclusion(s): Current evidence suggests several possible
regimens for the treatment of AL-CA. Effective treatment approaches for
AL-CA include induction therapy with bortezomib-based or
immunotherapy-based combinations in moderate/severe forms of cardiac
involvement, followed by high-dose melphalan and ASCT in eligible
patients, and heart transplant for selected severe cases. Therefore, we
highlight the necessity of conducting well-designed, randomized controlled
trials to provide evidence about the efficacy of these drugs with respect
to ASCT. Copyright © 2022, Millennium Medical Publishing, Inc..
All rights reserved.

<29>
Accession Number
2018145475
Title
Transcranial electric stimulation motor evoked potentials for cervical
spine intraoperative monitoring complications: systematic review and
illustrative case of cardiac arrest.
Source
European Spine Journal. 31(10) (pp 2723-2732), 2022. Date of Publication:
October 2022.
Author
Revilla-Pacheco F.; Watanabe S.; Rodriguez-Reyes J.; Sanchez-Torres C.;
Shkurovich-Bialik P.; Herrada-Pineda T.; Rodriguez-Salgado P.;
Franco-Granillo J.; Calderon-Juarez M.
Institution
(Revilla-Pacheco, Watanabe, Herrada-Pineda, Rodriguez-Salgado) Department
of Neurosurgery, ABC Medical Center, Mexico City, Mexico
(Rodriguez-Reyes, Sanchez-Torres) Department of Anesthesiology, ABC
Medical Center, Mexico City, Mexico
(Shkurovich-Bialik) Department of Neurophysiology, ABC Medical Center,
Mexico City, Mexico
(Franco-Granillo) Intensive Care Unit, ABC Medical Center, Mexico City,
Mexico
(Calderon-Juarez) Plan de Estudios Combinados en Medicina, Faculty of
Medicine, National Autonomous University of Mexico, Circuto Escolar 411A,
Coyoacan, Mexico City 04360, Mexico
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: We show a systematic review of known complications during
intraoperative neuromonitoring (IONM) using transcranial electric
stimulation motor evoked potentials (TES-MEP) on cervical spine surgery,
which provides a summary of the main findings. A rare complication during
this procedure, cardiac arrest by cardioinhibitory reflex, is also
described. Method(s): Findings of 523 scientific papers published
from 1995 onwards were reviewed in the following databases: CENTRAL,
Cochrane Library, Embase, Google Scholar, Ovid, LILACS, PubMed, and Web of
Science. This study evaluated only complications on cervical spine surgery
undergoing TES-MEP IONM. Result(s): The review of the literature
yielded 13 studies on the complications of TES-MEP IONM, from which three
were excluded. Five studies are case series; the rest are case reports.
Overall, 169 complications on 167 patients were reported in a total of
38,915 patients, a global prevalence of 0.43%. The most common
complication was tongue-bite in 129 cases, (76.3% of all complication
events). Tongue-bite had a prevalence of 0.33% (CI 95%, 0.28-0.39%) in all
patients on TES-MEP IONM. A relatively low prevalence of severe
complications was found: cardiac-arrhythmia, bradycardia and seizure, the
prevalence of this complications represents only one case in all the
sample. Alongside, we report the occurrence of cardiac arrest attributable
to TES-MEP IONM. Conclusion(s): This systematic review shows that
TES-MEP is a safe procedure with a very low prevalence of complications.
To our best knowledge, asystole is reported for the first time as a
complication during TES-MEP IONM. Copyright © 2022, The
Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part
of Springer Nature.

<30>
[Use Link to view the full text]
Accession Number
639209417
Title
Transcatheter Aortic Valve Replacement for Severe Symptomatic Aortic
Stenosis in Rheumatic Heart Disease: A Systematic Review.
Source
Cardiology in review. 30(6) (pp 318-323), 2022. Date of Publication: 01
Nov 2022.
Author
Fernandes A.D.F.; Fernandes G.C.; Grant J.; Knijnik L.; Cardoso R.; Cohen
M.G.; Ferreira A.C.; Alfonso C.E.
Institution
(Fernandes, Grant, Knijnik) From the Department of Internal Medicine,
University of Miami/Jackson Memorial Hospital, Miami, FL, Puerto Rico
(Fernandes) Division of Cardiology, University of Miami/ Jackson Memorial
Hospital, Miami, FL, Puerto Rico
(Cardoso) Division of Cardiology, Brigham and Women's Hospital, Boston,
MA, United States
(Cohen, Alfonso) Division of Cardiology, University of Miami, Miami, FL,
Puerto Rico
(Ferreira) Division of Cardiology, Jackson Memorial Hospital, Miami, FL,
Puerto Rico
Publisher
NLM (Medline)
Abstract
Transcatheter aortic valve replacement (TAVR) is well-established for
severe symptomatic aortic stenosis (AS), but its use in rheumatic heart
disease (RHD) has been limited. We systematically review the use of TAVR
for severe symptomatic AS in RHD. Pubmed, Embase, and Scopus were searched
for TAVR for symptomatic severe AS and proven or suspected RHD. Procedure
characteristics, efficacy, and safety endpoints were collected and all
definitions were based on the Valve Academic Research Consortium-2
(VARC-2) criteria. We included 3 case series and 12 case reports, with a
total of 43 patients. Mean age was 76 years, 75% were female, and 85% had
NYHA class III-IV symptoms. Follow up ranged from 1 to 29 months. Patients
were moderate to high risk, with Society of Thoracic Surgery score ranging
from 6.1% to 17.6%. The approach was transfemoral in 30 (83%) cases.
Procedural success occurred in 37 (86%) patients. Of the 7 patients with
periprocedural complications, 4 had valve dislodgement, 1 deployment
failure, 1 unplanned cardiopulmonary bypass, and 1 moderate aortic
regurgitation. Paravalvular leak was reported in 5 (11.6%) patients. Only
1 patient had heart block requiring pacemaker. Among 13 studies (23
patients), 30-day mortality was 0%. One case series with 19 patients had a
30-day, 1-year, 2-year, and 5-year mortality of 5%, 11%, 31%, and 48%,
respectively. TAVR appears feasible for selected patients with rheumatic
severe AS, albeit our results indicate a 14% incidence of device failure.
Future randomized clinical trials may clarify the role of TAVR in this
group. Copyright © 2021 Wolters Kluwer Health, Inc. All rights
reserved.

<31>
Accession Number
639214485
Title
Right displacement of trachea to reduce right bronchial misplacement of
left double lumen tube: a prospective, double-blind, randomized study.
Source
BMC anesthesiology. 22(1) (pp 312), 2022. Date of Publication: 06 Oct
2022.
Author
Guan J.; Zhu W.; Xiao X.; Huang Z.; Xing J.; Hei Z.; Zhang Y.; Yao W.
Institution
(Guan, Zhu, Xiao, Huang, Xing, Hei, Zhang, Yao) Department of
Anesthesiology, Third Affiliated Hospital of Sun Yat-Sen University,
Guangzhou 510630, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Misplacement of double-lumen endobronchial tubes (DLTs) during
bronchial intubation, especially when bronchoscopy guidance is not
applicable, threatens effective lung isolation and brings about airway
injury during reposition. We aimed to examine whether a novel maneuver
called right tracheal displacement (RTD) can reduce left-sided DLT
misplacement during first-attempt intubation without bronchoscopy
guidance. METHOD(S): Patients that underwent thoracic surgeries
requiring one-lung ventilation during November 2020 to January 2021 were
recruited and randomized into control and RTD group, with 54 cases in each
group. The primary outcomes included the incidence of DLT misplacement and
the time to complete desired bronchial intubation. The secondary outcomes
included mucosal injury, sore throat and hoarseness upon emergence and at
24 h post-operatively. RESULT(S): The incidence of DLT misplacement
in RTD group was significantly lower compared to control group (0% vs.
16.7%) The time to complete bronchial intubation was also significantly
shortened in RTD group compared to control (52.88+/-9.36 s vs.
63.04+/-20.02 s). The incidence of mucosal injury, sore throat and
hoarseness were comparable between two groups. CONCLUSION(S): RTD
maneuver can effectively improve the success rate of first-attempt proper
DLT positioning and shorten the time required by bronchial intubation.
TRIAL REGISTRATION: This prospective, double-blind, randomized study has
completed the registration of the Chinese Clinical Trial Center at
2/11/2020 with the registration number ChiCTR2000040212. It was conducted
from 26/11/2020 to 31/7/2021 in third affiliated hospital of Sun Yat-sen
university. Copyright © 2022. The Author(s).

<32>
Accession Number
2018167276
Title
Prophylactic low dose furosemide infusion effect on cardiac surgery
patients with renal dysfunction: A randomized controlled trial.
Source
Critical Care and Shock. 25(5) (pp 253-262), 2022. Date of Publication:
October 2022.
Author
Adriane P.; Hidayat J.; Sugiarto A.; Susilo A.R.
Institution
(Adriane, Hidayat, Sugiarto) Department of Anesthesiology and Intensive
Therapy, Medical Faculty, University of Indonesia, Jakarta, Indonesia
(Susilo) Department of Anesthesiology and Intensive Therapy, National
Cardiovascular Center Harapan Kita, Jakarta, Indonesia
Publisher
The Indonesian Foundation of Critical Care Medicine
Abstract
Objectives: Preoperative renal dysfunction in-creases the risk of
postoperative renal failure and mortality in cardiac surgery patients.
Stud-ies investigating the protective effect of furo-semide in cardiac
surgery were mostly conducted in patients with normal renal function. This
study aimed to evaluate the effect of prophylactic low-dose furosemide in
cardiac surgery patients with mild to moderate renal dys-function.
 Design(s): Double-blind randomized controlled trial. Setting(s):
This study was conducted at a cardiovascular surgery center. Patients and
participants: Eighty-seven patients of elective cardiac surgery with mild
to moderate renal dysfunction (estimated glomerular filtration rate [eGFR]
30-89 ml/min/1.73 m2). Intervention(s): Prophylactic
furosemide infusion (2 mg/h) or 0.9% NaCl infusion (2 ml/h) was
ad-ministered and continued for a total of 12 hours. Measurement and
results: We examined blood samples at 12, 24, 48, and 120 hours after
infusion started to measure the change in eGFR. A decrease in eGFR 320%
was considered a worsening of renal function, while 320% increase in eGFR
was recovering of renal function. We compared the requirement for
therapeutic furo-semide infusion and renal replacement therapy in both
groups. The incidence of decreasing eGFR at the 12th, 24th, and 48th-hour
was higher in the control compared to the furosemide group. Increasing
eGFR at the 120th-hour was the same in both groups. Subjects in the
furosemide group re-quired less administration of therapeutic furo-semide
infusion than the control group. Renal replacement therapy was needed more
in the furo-semide group than in the control group. Conclusion(s):
Low-dose furosemide infusion can reduce the incidence of worsening renal
function, and the need for therapeutic furosemide infu-sion, but does not
prevent the usage of renal replacement therapy. Copyright © 2022,
The Indonesian Foundation of Critical Care Medicine. All rights reserved.

<33>
Accession Number
2020555461
Title
Intraoperative identification of pulmonary nodules during minimally
invasive thoracic surgery: a narrative review.
Source
Quantitative Imaging in Medicine and Surgery. 12(11) (pp 5271-5287), 2022.
Date of Publication: November 2022.
Author
Tang L.; Zhang Y.; Wang Y.
Institution
(Tang) Department of Breast Surgery, China-Japan Union Hospital of Jilin
University, Changchun, China
(Zhang) Department of Radiology (Interventional), China-Japan Union
Hospital of Jilin University, Changchun, China
(Wang) Department of Thoracic Surgery, China-Japan Union Hospital of Jilin
University, Changchun, China
(Wang) Japan Union Hospital of Jilin University, 126 Xiantai Street,
Changchun 130033, China
Publisher
AME Publishing Company
Abstract
Background and Objective: The increasingly widespread application of
computed tomography (CT) in the screening and follow-up of patients with
lung disease has concomitantly increased the detection rate of pulmonary
nodules. Currently, minimally invasive thoracic surgery (MITS) has become
the preferred method of surgery for patients with pulmonary ground-glass
nodules (GGNs) due to its advantages minimal invasiveness and rapid
recovery. However, target nodule identification during MITS is sometimes
challenging due to the inherent characteristics of these nodules,
especially when they are small and distant from the pleura. This review
details the many methods used for the intraoperative localization of
pulmonary nodules. Method(s): Literature published in the Cochrane
Library, PubMed, ClinicalTrials, and China National Knowledge
Infrastructure from 1990 to 2022 were searched and analyzed to obtain a
comprehensive review of the different methods of identifying pulmonary
nodules. Literature related to animal testing were excluded. Key Content
and Findings: An overview of the recent progress in the clinical methods
for intraoperative localization of pulmonary nodules [including CT-guided
percutaneous placement of markers; bronchoscopy-guided placement of
markers; intraoperative ultrasonography; three-dimensional (3D) printing
technology; artificial intelligence (AI); and intraoperative molecular
imaging (IMI)] was conducted. The advantages and disadvantages, as well as
the complications associated with existing research methods, were
summarized to assist doctors in the development of optimized clinical
strategies. Conclusion(s): Clinicians can communicate with the
multidisciplinary team and select the appropriate positioning method
according to each patient's individual situation and the available support
of the equipment and technology of the institution. Certain non-invasive
and specific identification methods may have clinical potential in
pulmonary nodule localization in the future. Copyright ©
Quantitative Imaging in Medicine and Surgery. All rights reserved.

<34>
Accession Number
2020555050
Title
Thoracic surgery in Hong Kong.
Source
Journal of Thoracic Disease. 14(8) (pp 3075-3082), 2022. Date of
Publication: August 2022.
Author
Chang A.T.C.; Chan J.W.Y.; Lau R.W.H.; Ng C.S.H.
Institution
(Chang, Chan, Lau, Ng) Division of Cardiothoracic Surgery, Department of
Surgery, Prince of Wales Hospital, the Chinese University of Hong Kong,
Hong Kong
Publisher
AME Publishing Company
Abstract
In the era of modernized medicine, thoracic surgery has been focusing on
achieving minimally invasive surgery and providing a one-stop solution in
treating thoracic diseases. Particularly in the Asia population, where
patients are keen to have smaller wound and shorter hospital stay,
thoracic surgery in Hong Kong has evolved from the traditional open
thoracotomy approach to video-assisted thoracoscopic surgery (VATS). In
our institution, uniportal VATS for major lung resection was developed in
2012. While uniportal VATS has brought advantages into managing thoracic
pathologies, it also brought challenges like instrument fencing during
manipulation and suboptimal visualization angle. To improve the procedure
and its outcomes, novel techniques and equipment have been developed, for
example, double-hinged instruments, robotic assisted technology and
magnetic anchored and guided endoscopes (MAGS). With advanced medical
imaging nowadays, management of small lung nodules or ground glass opacity
(GGO) is in higher demand than ever before. Our hybrid operating room
(HOR) can incorporate instant and real-time imaging in lesion
localization, and provide treatment via VATS or electromagnetic navigated
bronchoscopic (ENB) ablation in a one-stop manner. This paper will review
the literature related to the historical development and clinical outcomes
of thoracic surgery in Hong Kong and discuss the future perspective of
ongoing development. Copyright © Journal of Thoracic Disease. All
rights reserved.

<35>
Accession Number
2020555047
Title
Anesthetic (r)evolution from the conventional concept to the minimally
invasive techniques in thoracic surgery-narrative review.
Source
Journal of Thoracic Disease. 14(8) (pp 3045-3060), 2022. Date of
Publication: August 2022.
Author
Szabo Z.; Fabo C.; Oszlanyi A.; Hawchar F.; Geczi T.; Lantos J.; Furak J.
Institution
(Szabo) Tritonlife Szeged Hospital, Szeged, Hungary
(Fabo, Hawchar) Department of Anesthesiology and Intensive Care,
University of Szeged, Szeged, Hungary
(Oszlanyi) Department of Cardiac Surgery, Zala County St. Raphael
Hospital, Zalaegerszeg, Hungary
(Geczi, Furak) Department of Surgery, University of Szeged, Szeged,
Hungary
(Lantos) Department of Neurology, Bacs-Kiskun County Hospital, Kecskemet,
Hungary
Publisher
AME Publishing Company
Abstract
Background and Objective: Thanks to the growing experience with the
non-intubated anesthetic and surgical techniques, most pulmonary
resections can now be performed by using minimally invasive techniques.
The conventional method, i.e., surgery on the intubated, ventilated
patient under general anesthesia with one-lung ventilation (OLV) was
considered necessary for the major thoracoscopic lung resections for all
patients. An adequate analgesic approach (regional or epidural anesthesia)
allows video-assisted thoracoscopy (VATS) to be performed in anesthetized
patients and thus the potential adverse effects related to general
anesthesia and mechanical OLV can be minimized. Method(s): Multiple
medical literature databases (PubMed, Google Scholar, Scopus) were
searched, using the terms [(non-intubated) OR (nonintubated) OR (tubeless)
OR (awake)] AND [(thoracoscopic surgery)] from 2004 to December 2021.
Thirty hundred and six scientific papers were collected. The editorials,
commentaries, letters, and papers were excluded, that focus on other than
the non-intubated (aka awake or tubeless) VATS technique, as well as the
full text scientific papers available in languages other than English. Key
Content and Findings: After reviewing the literature, we identified
"schools" with different techniques but with very similar results. Most of
the differences were in the anesthetic technique, oxygenation and
analgesia, however, the immunological results, and the qualitative
parameters (inpatient hospital care days, complication rate, mortality) of
the perioperative period showed great similarity, in addition, all three
schools identified the same risk factors (hypoxia, hypercapnia, airway
safety). The combination of spontaneous ventilation with double lumen tube
intubation, called VATS-spontaneous ventilation with intubation (SVI)
method seems to be suitable for reducing these risk factors, which may
serve as an alternative for patients not suitable for the non-intubated
technique in the near future. Conclusion(s): Based on the results,
non-intubated thoracic surgery appears to be an increasingly widespread,
safe procedure, that will be available to a wider range of patients as
experience expands and by the implication of the constantly evolving new
processes. Copyright © Journal of Thoracic Disease. All rights
reserved.

<36>
Accession Number
2020555046
Title
Management of perioperative bleeding risk in patients on antithrombotic
medications undergoing cardiac surgery-a systematic review.
Source
Journal of Thoracic Disease. 14(8) (pp 3030-3044), 2022. Date of
Publication: August 2022.
Author
Matejic-Spasic M.; Hassan K.; Thielmann M.; Geidel S.; Storey R.F.;
Schmoeckel M.; Adamson H.; Deliargyris E.N.; Wendt D.
Institution
(Matejic-Spasic, Adamson, Deliargyris, Wendt) CytoSorbents Inc., Monmouth
Junction, NJ, United States
(Hassan, Geidel, Schmoeckel) Department of Cardiac Surgery, Asklepios
Klinik St. Georg, Hamburg, Germany
(Thielmann, Wendt) Department of Thoracic and Cardiovascular Surgery,
Westgerman Heart and Vascular Center, Essen, Germany
(Storey) Department of Infection, Immunity and Cardiovascular Disease,
University of Sheffield, Sheffield, United Kingdom
Publisher
AME Publishing Company
Abstract
Background: Antithrombotic drugs increase the risk of bleeding, especially
in patients who need urgent surgery without an adequate wash-out period.
This review aims to evaluate perioperative bleeding complications in
patients on dual antiplatelet therapy (DAPT) or direct-acting oral
anticoagulants (DOACs) undergoing high-bleeding risk cardiovascular
surgery and to present currently available potential solutions to mitigate
antithrombotic therapy-related bleeding complications. Method(s): As
a first step, we searched for relevant articles, over the last 10 years,
in Medline (PubMed) and abstracted clinical information based on
pre-defined criteria for bleeding complications. In the next step, an
additional search evaluating potential solutions to mitigate bleeding
complications was performed. The literature screening and selection
process followed the principles derived from the PRISMA statement.
 Result(s): From all reviewed studies, a total of 19 articles could be
included evaluating the risk for bleeding in cardiac surgery related to
DAPT or DOACs and 10 papers evaluating antithrombotic drug reversal or
removal in the setting of cardiovascular surgery. Reported bleeding rates
ranged between 18% and 41%. The variability of the reported data is
remarkable. Idarucizumab is reported to provide optimal perioperative
hemostasis in up to 93% of patients. It has been observed that andexanet
alfa causes unresponsiveness to the anticoagulant effects of heparin.
Antithrombotic removal by intraoperative hemoadsorption is found to be
associated with a significant decrease in re-thoracotomy rate, overall
procedure duration, administered transfusion volumes, chest-tube drainage,
and length of hospitalization. Discussion(s): Bleeding complications
in patients treated with DAPT or DOACs in cardiac surgery are high. New
costly reversal agents are available but have not been sufficiently tested
in the cardio-surgical setting so far. Interestingly, bleeding-related
complications seem to be effectively reduced by applying innovative
intraoperative hemoadsorption techniques. Expected results from the
ongoing trials should provide better insights concerning the efficacy and
safety of several potential solutions. Currently, the variability of
reports and the deficit of high-quality studies in this specific setting
represent the major limitation for the unbiased conclusion of this
review. Copyright © Journal of Thoracic Disease. All rights
reserved.

<37>
Accession Number
2020515905
Title
Limb Remote Ischemic Preconditioning Applied During Sevoflurane Anesthesia
Does Not Protect the Lungs in Patients Undergoing Adult Heart Valve
Surgery.
Source
Heart Surgery Forum. 24(5) (pp E916-E924), 2021. Date of Publication: 08
Sep 2021.
Author
Li T.-Y.; Zeng Q.-S.; She S.-Z.
Institution
(Li) Department of Anesthesiology, The First Affiliated Hospital of
Nanchang University, Jiangxi, Nanchang, China
(Zeng) Department of Anesthesiology, Guangdong General Hospital,
Guangdong, Guangzhou, China
(She) Department of Anesthesiology, Guangzhou First People's Hospital,
Guangzhou, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: Two consistent overall cell protective preconditioning
treatments should provide more protection. We hypothesized that limb
remote ischemic preconditioning (RIPC, second preconditioning stimulus)
applied during sevoflurane inhalation (first preconditioning stimulus)
would provide more protection to the lungs of patients undergoing adult
heart valve surgery. Method(s): In this randomized,
placebo-controlled, double-blind trial, 50 patients were assigned to the
RIPC group or the placebo group (1:1). Patients in the RIPC group received
three 5-min cycles of 300 mmHg cuff inflation/deflation of the left-side
lower limb before aortic cross-clamping. Anesthesia consisted of opioids
and propofol for induction and sevoflurane for maintenance. The primary
end point was comparison of the postoperative arterial-alveolar oxygen
tension ratio (a/A ratio) between groups. Secondary end points included
comparisons of pulmonary variables, postoperative morbidity and mortality
and regional and systemic inflammatory cytokines between groups.
 Result(s): In the RIPC group, the a/A ratio and other pulmonary
variables exhibited no significant differences throughout the study period
compared with the placebo group. No significant differences in either
plasma or bronchoalveolar lavage levels of TNF- alpha were noted between
the groups at 10 min after anesthetic induction and 1 h after cross-clamp
release. The percentage of neutrophils at 12 h postoperation was
significantly increased in the RIPC group compared with the placebo group
(91.34+/-0.00 vs. 89.42+/-0.10, P = 0.023). Conclusion(s): Limb RIPC
applied during sevoflurane anesthesia did not provide additional
significant pulmonary protection following adult valvular cardiac surgery.
 Copyright © 2021 Forum Multimedia Publishing, LLC.

<38>
Accession Number
2020515899
Title
Relationship Between Cardiac Surgery and Acute Ischemic Stroke: An
Examination in Terms of Clinical, Radiological, and Functional Outcomes
and Possible Pathophysiological Mechanisms.
Source
Heart Surgery Forum. 24(4) (pp E713-E723), 2021. Date of Publication: 21
Jul 2021.
Author
Isik M.; Kozak H.H.; Gormus N.
Institution
(Isik, Gormus) Department of Cardiovascular Surgery, Meram Faculty of
Medicine, Necmettin Erbakan University, Konya, Turkey
(Kozak) Department of Neurology, Meram Faculty of Medicine, Necmettin
Erbakan University, Konya, Turkey
Publisher
Forum Multimedia Publishing LLC
Abstract
Aim: The aim is to discuss the clinical characteristics, time, anatomical
vascular distribution, radiological features, functional outcomes after
stroke and possible pathophysiological mechanisms of acute ischemic stroke
(AIS) that develop after cardiac surgery. Method(s): A total of 3,474
patients, who underwent cardiac surgery between 2015-2020, retrospectively
were analyzed. Forty-nine patients, who developed AIS and had brain CT and
diffusion MR images during hospitalization, were included in the study.
 Result(s): AIS distribution was at 53% CABG, 12.2% isolated mitral
valve, 8.1% isolated aortic valve, and 26.5% combined surgical procedures.
Patients with a <=2 days (P = 0.03) preop preparation time and body
surface area (BSA) of <1.85 m2 (P = 0.02) had a high discharge rate. While
newly developing AF was low in the early stroke group, it was higher in
the late stroke group (P = 0.02). A history of previous cerebrovascular
events was found in 3.3% of the patients. Postoperative new AIS was
detected in 7.8% of those with a history of cerebrovascular events. Total
anterior circulation infarction (TACI) case rate was 8.1%, partial
anterior circulation infarction (PACI) 12.2%, posterior circulation
infarction (POCI) 24.4%, cortical border zone infarction (CBZI) 30.6%,
combined POCI + CBZI 12.2%, multiple territorial infarcts (MTI) 10.2%, and
lacunar circulation infarction (LACI) rate was 2%. The modified Rankin
Scale means following AIS was 3.45. The worst Rankin score was 5.75 in
CABG+MVR cases; it was found to be 5 in the valve + ascending aorta case
and 5 in the five bypass cases. Conclusion(s): Calculation of
cerebrovascular reserve with extra/intracranial vascular imaging is
important in patients with multiple risk factors, whose association with
stroke has been determined before cardiac surgery. We believe that
cardiovascular surgery and neurology multidisciplinary prospective
randomized studies should be conducted to obtain pre-, peri- and
post-procedural risk calculation scales, according to cardiac surgery type
and to reshape surgical procedures accordingly. Copyright © 2021
Forum Multimedia Publishing, LLC.

<39>
Accession Number
2020515892
Title
Risk Factors Associated with an Increased Risk of Deep Sternal Wound
Infections in Patients After Coronary Artery Bypass Grafting and Heart
Defect Surgery.
Source
Heart Surgery Forum. 24(4) (pp E741-E745), 2021. Date of Publication: 21
Jul 2021.
Author
Vitartaite M.; Vaiciulyte D.; Vencloviene J.; Sirvinskas E.; Bukauskiene
R.; Jakuska P.; Vimantaite R.
Institution
(Vitartaite, Vaiciulyte) Faculty of Medicine, Medical Academy, Lithuanian
University of Health Sciences, Kaunas, Lithuania
(Vencloviene) Institute of Cardiology, Lithuanian University of Health
Sciences, Kaunas, Lithuania
(Sirvinskas, Bukauskiene, Jakuska) Lithuanian University of Health
Sciences Kaunas Clinics, Department of Cardiac, Thoracic and Vascular
Surgery, Kaunas, Lithuania
(Vimantaite) Lithuanian University of Health Sciences Kaunas Clinics,
Faculty of Nursing, Kaunas, Lithuania
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: Despite improvements over time with regard to morbidity,
mortality, and long-term survival, deep sternal wound infection (DSWI)
continues to be a major complication after open-heart surgery. This is why
it is important to identify possible risk factors for postoperative
development of DSWI in patients undergoing coronary artery bypass grafting
and valve replacement. The aim of this study was to identify the risk
factors for postoperative development of deep sternal wound infection in
patients after coronary artery bypass grafting and heart defect surgery at
the Department of Thoracic, Cardiac, and Vascular Surgery of the Hospital
of Lithuanian University of Health Sciences. Method(s): This
retrospective study analyzed 201 patients, who underwent coronary artery
bypass grafting and heart defect surgery between January 2017 and December
2018. The case group contained 45 patients, who had to be reoperated
because of deep sternal wound infection, and the control group consisted
of 156 randomly selected patients. For descriptive statistics, we used
means, median values, ranges, standard deviations, and 95% confidence
intervals, where appropriate. Categorical data were analyzed using the
chisquare or Fisher's exact test. Student T-test and Mann-Whitney used to
compare numerical variables. Logistic regression model adjusting for age
and gender was used to compare the risk of infection. A P-value of < 0.05
was considered to be statistically significant. SPSS 26.0 was used for
calculations. Result(s): Logistic regression analysis revealed that
independent risk factors for sternal wound infection were high BMI (odds
ratio [OR] 1.15, CI 1.06-1.24), preoperative CRP (OR 1.08, CI 1.01-1.16),
long duration of cardiopulmonary bypass (OR 1.02, CI 1.01-1.03),
intraoperative anemia (OR 0.97, CI 0.95-0.99), and postoperative CRP
concentration (OR 1.10; CI 1.05-1.16). Conclusion(s): Preoperative
assessment to identify obese individuals as being at risk and techniques
to minimize the duration of surgery and intraoperative blood loss may help
reduce postoperative deep sternal wound infections. Copyright ©
2021 Forum Multimedia Publishing, LLC.

<40>
Accession Number
2013258907
Title
Risk factors for delirium and cognitive decline following coronary artery
bypass grafting surgery: A systematic review and meta-analysis.
Source
Journal of the American Heart Association. 9(22) (no pagination), 2020.
Article Number: e017275. Date of Publication: 2020.
Author
Greaves D.; Psaltis P.J.; Davis D.H.J.; Ross T.J.; Ghezzi E.S.; Lampit A.;
Smith A.E.; Keage H.A.D.
Institution
(Greaves, Ross, Ghezzi, Smith, Keage) Cognitive Ageing and Impairment
Neurosciences Laboratory, Justice and Society Academic Unit, University of
South Australia, Adelaide, Australia
(Psaltis) Vascular Research Centre, Lifelong Health Theme, South
Australian Health and Medical Research Institute, Adelaide, Australia
(Psaltis) Adelaide Medical School, University of Adelaide, Adelaide,
Australia
(Psaltis) Department of Cardiology, Royal Adelaide Hospital, Central
Adelaide Local Health Network, Adelaide, Australia
(Davis) Medical Reasearch Council Unit for Lifelong Health and Ageing Unit
at UCL, London, United Kingdom
(Lampit) Academic Unit for Psychiatry of Old Age, Department of
Psychiatry, University of Melbourne, Melbourne, Australia
(Lampit) Department of Neurology, Charite-Universitatsmedizin Berlin,
Berlin, Germany
(Smith) Alliance for Research in Exercise, Nutrition and Activity, Allied
Health and Human Performance Academic Unit, University of South Australia,
Adelaide, Australia
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Coronary artery bypass grafting (CABG) is known to improve
heart function and quality of life, while rates of surgery-related
mortality are low. However, delirium and cognitive decline are common
complications. We sought to identify preoperative, intraoperative, and
postoperative risk or protective factors associated with delirium and
cognitive decline (across time) in patients undergoing CABG. METHODS AND
RESULTS: We conducted a systematic search of Medline, PsycINFO, EMBASE,
and Cochrane (March 26, 2019) for peer-reviewed, English publications
reporting post-CABG delirium or cognitive decline data, for at least one
risk factor. Random-effects meta-analyses estimated pooled odds ratio for
categorical data and mean difference or standardized mean difference for
continuous data. Ninety-seven studies, comprising data from 60 479
patients who underwent CABG, were included. Moderate to large and
statistically significant risk factors for delirium were as follows: (1)
preoperative cognitive impairment, depression, stroke history, and higher
European System for Cardiac Operative Risk Evaluation (EuroSCORE) score,
(2) intraoperative increase in intubation time, and (3) postoperative
presence of arrythmia and increased days in the intensive care unit;
higher preoperative cognitive performance was protective for delirium.
Moderate to large and statistically significant risk factors for acute
cognitive decline were as follows: (1) preoperative depression and older
age, (2) intraoperative increase in intubation time, and (3) postoperative
presence of delirium and increased days in the intensive care unit.
Presence of depression preoperatively was a moderate risk factor for
midterm (1-6 months) post-CABG cognitive decline. CONCLUSION(S): This
meta-analysis identified several key risk factors for delirium and
cognitive decline following CABG, most of which are nonmodifiable. Future
research should target preoperative risk factors, such as depression or
cognitive impairment, which are potentially modifiable. Copyright
© 2020 The Authors. Published on behalf of the American Heart
Association, Inc., by Wiley.

<41>
Accession Number
2020490626
Title
Patient values and preferences on transcatheter or surgical aortic valve
replacement therapy for aortic stenosis: a systematic review.
Source
BMJ Open. 6(9) (no pagination), 2016. Article Number: e014327. Date of
Publication: 2016.
Author
Lytvyn L.; Guyatt G.H.; Manja V.; Siemieniuk R.A.; Zhang Y.; Agoritsas T.;
Vandvik P.O.
Institution
(Lytvyn) Systematic Overviews Through Advancing Research Technology, Child
Health Evaluative Sciences, The Hospital for Sick Children Research
Institute, Toronto, ON, Canada
(Guyatt, Manja, Siemieniuk, Zhang, Agoritsas) Department of Clinical
Epidemiology & Biostatistics, McMaster University, Hamilton, ON, Canada
(Manja) Department of Internal Medicine, State University of New York at
Buffalo, Buffalo, NY, United States
(Manja) VA Western New York Healthcare System at Buffalo, Buffalo, NY,
United States
(Siemieniuk) Department of Medicine, University of Toronto, Toronto, ON,
Canada
(Agoritsas) Division of General Internal Medicine, Division of Clinical
Epidemiology, University Hospitals of Geneva, Geneva, Switzerland
(Vandvik) Faculty of Medicine, Institute of Health and Society, University
of Oslo, Oslo, Norway
(Vandvik) Department of Medicine, Innlandet Hospital Trust-Division,
Gjovik, Norway
Publisher
BMJ Publishing Group
Abstract
Objective: To investigate patients' values and preferences regarding
aortic valve replacement therapy for aortic stenosis. Setting(s):
Studies published after transcatheter aortic valve insertion (TAVI) became
available (2002). Participant(s): Adults with aortic stenosis who are
considering or have had valve replacement, either TAVI or via surgery
(surgical aortic valve replacement, SAVR). Outcome measures: We sought
quantitative measurements, or qualitative descriptions, of values and
preferences. When reported, we examined correlations between preferences
and objective (eg, ejection fraction) or subjective (eg, health-related
quality of life) measures of health. Result(s): We reviewed 1348
unique citations, of which 2 studies proved eligible. One study of
patients with severe aortic stenosis used a standard gamble study to
ascertain that the median hypothetical mortality risk patients were
willing to tolerate to achieve full health was 25% (IQR 25-50%). However,
there was considerable variability; for mortality risk levels defined by
current guidelines, 130 participants (30%) were willing to accept
low-to-intermediate risk (<=8%), 224 (51%) high risk (>8-50%) and 85 (19%)
a risk that guidelines would consider prohibitive (>50%). Study authors
did not, however, assess participants' understanding of the exercise,
resulting in a potential risk of bias. A second qualitative study of 15
patients identified the following factors that influence patients to
undergo assessment for TAVI: symptom burden; expectations; information
support; logistical barriers; facilitators; obligations and
responsibilities. The study was limited by serious risk of bias due to
authors' conflict of interest (5/9 authors industry-funded).
 Conclusion(s): Current evidence on patient values and preferences of
adults with aortic stenosis is very limited, and no studies have enrolled
patients deciding between TAVI and SAVR. On the basis of the data
available, there is evidence of variability in individual values and
preferences, highlighting the importance of well-informed and shared
decision-making with patients facing this decision. Trial registration
number: PROSPERO CRD42016041907. Copyright © 2016 BMJ Publishing
Group. All rights reserved.

<42>
Accession Number
2017999978
Title
Interdisciplinary and cross-sectoral perioperative care model in cardiac
surgery: implementation in the setting of minimally invasive heart valve
surgery (INCREASE)-study protocol for a randomized controlled trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 528. Date of
Publication: December 2022.
Author
Klotz S.G.R.; Ketels G.; Behrendt C.A.; Konig H.-H.; Kohlmann S.; Lowe B.;
Petersen J.; Stock S.; Vettorazzi E.; Zapf A.; Zastrow I.; Zollner C.;
Reichenspurner H.; Girdauskas E.
Institution
(Klotz, Ketels) Department of Physiotherapy, University Medical Center
Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany
(Behrendt) Research Group GermanVasc, Department of Vascular Medicine,
University Heart and Vascular Center, University Medical Center
Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany
(Konig) Department of Health Economics and Health Services Research,
University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg
20246, Germany
(Kohlmann, Lowe) Department of Psychosomatic Medicine and Psychotherapy,
University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg
20246, Germany
(Petersen, Reichenspurner) Department of Cardiovascular Surgery,
University Heart and Vascular Center, University Medical Center
Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany
(Stock, Girdauskas) Department of Cardiothoracic Surgery, University
Hospital Augsburg, Stenglinstr. 2, Augsburg 86156, Germany
(Vettorazzi, Zapf) Department of Medical Biometry and Epidemiology,
University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg
20246, Germany
(Zastrow) Department of Patient and Care Management, University Medical
Center Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany
(Zollner) Department of Anesthesiology, Center of Anesthesiology and
Intensive Care Medicine, University Medical Center Hamburg-Eppendorf,
Martinistr. 52, Hamburg 20246, Germany
Publisher
BioMed Central Ltd
Abstract
Background: Valvular heart diseases are frequent and increasing in
prevalence. Minimally invasive heart valve surgery embedded in an
interdisciplinary enhanced recovery after surgery (ERAS) program may have
potential benefits with regard to reduced length of stay and improved
patient reported outcomes. However, no prospective randomized data exist
regarding the superiority of ERAS program for the patients' outcome.
 Method(s): We aim to randomize (1:1) a total of 186 eligible patients
with minimally invasive heart valve surgery to an ERAS program vs.
standard treatment at two centers including the University Medical Center
Hamburg-Eppendorf, Germany, and the University Hospital Augsburg, Germany.
The intervention is composed out of pre-, peri-, and postoperative
components. The preoperative protocol aims at better preparation for the
operation with regard to physical activity, nutrition, and psychological
preparedness. Intraoperative anesthesiologic and surgical management are
trimmed to enable an early extubation. Patients will be transferred to a
specialized postoperative anesthesia care unit, where first mobilization
occurs 3 h after surgery. Transfer to low care ward will be at the next
day and discharge at the fifth day. Participants in the control group will
receive treatment as usual. Primary endpoints include functional discharge
at discharge and duration of in-hospital care during the first 12 months
after index surgery. Secondary outcomes include health-related quality of
life, health literacy, and level of physical activity. Discussion(s):
This is the first randomized controlled trial evaluating the effectiveness
of an ERAS process after minimally invasive heart valve surgery.
Interprofessional approach is the key factor of the ERAS process and
includes in particular surgical, anesthesiological, physiotherapeutic,
advanced nursing, and psychosocial components. A clinical implication
guideline will be developed facilitating the adoption of ERAS model in
other heart teams. Trial registration: The study has been registered in
ClinicalTrials.gov (NCT04977362 assigned July 27, 2021). Copyright
© 2022, The Author(s).

<43>
Accession Number
2019205920
Title
Long-Term Beta-Blocker Therapy in Patients With Stable Coronary Artery
Disease After Percutaneous Coronary Intervention.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 878003. Date of Publication: 17 May 2022.
Author
Lee S.-J.; Choi D.-W.; Kim C.; Suh Y.; Hong S.-J.; Ahn C.-M.; Kim J.-S.;
Kim B.-K.; Ko Y.-G.; Choi D.; Park E.-C.; Jang Y.; Nam C.-M.; Hong M.-K.
Institution
(Lee, Hong, Ahn, Kim, Kim, Ko, Choi, Hong) Severance Cardiovascular
Hospital, Yonsei University College of Medicine, Seoul, South Korea
(Choi, Park, Nam) Department of Preventive Medicine, Yonsei University
College of Medicine, Seoul, South Korea
(Choi) Cancer Big Data Center, National Cancer Control Institute, National
Cancer Center, Goyang, South Korea
(Kim) Seoul Hospital, Ewha Womans University College of Medicine, Seoul,
South Korea
(Suh) Myongji Hospital, Hanyang University College of Medicine, Goyang,
South Korea
(Jang) CHA Bundang Medical Center, CHA University College of Medicine,
Seongnam, South Korea
Publisher
Frontiers Media S.A.
Abstract
Background: It is unclear whether beta-blocker treatment is advantageous
in patients with stable coronary artery disease (CAD) who underwent
percutaneous coronary intervention (PCI). We evaluated the clinical impact
of long-term beta-blocker maintenance in patients with stable CAD after
PCI with drug-eluting stent (DES). Method(s): From a nationwide
cohort database, we identified the stable CAD patients without current or
prior history of myocardial infarction or heart failure who underwent DES
implantation. An intention-to-treat principle was used to analyze the
impact of beta-blocker treatment on long-term outcomes of major adverse
cardiovascular events (MACE) composed of cardiovascular death, myocardial
infarction, and hospitalization with heart failure. Result(s): After
stabilized inverse probability of treatment weighting, a total of 78,380
patients with stable CAD was enrolled; 45,746 patients with and 32,634
without beta-blocker treatment. At 5 years after PCI with a 6-month
quarantine period, the adjusted incidence of MACE was significantly higher
in patients treated with beta-blockers [10.0 vs. 9.1%; hazard ratio (HR)
1.11, 95% CI 1.06-1.16, p < 0.001] in an intention-to-treat analysis.
There was no significant difference in all-cause death between patients
treated with and without beta-blockers (8.1 vs. 8.2%; HR 0.99, 95% CI
0.94-1.04, p = 0.62). Statistical analysis with a time-varying Cox
regression and rank-preserving structure failure time model revealed
similar results to the intention-to-treat analysis. Conclusion(s):
Among patients with stable CAD undergoing DES implantation, long-term
maintenance with beta-blocker treatment might not be associated with
clinical outcome improvement. Trial Registration: ClinicalTrial.gov
(NCT04715594). Copyright © 2022 Lee, Choi, Kim, Suh, Hong, Ahn,
Kim, Kim, Ko, Choi, Park, Jang, Nam and Hong.

<44>
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.

<45>
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.

<46>
Accession Number
2019181783
Title
Association Between Familial Hypercholesterolemia and Risk of
Cardiovascular Events and Death in Different Cohorts: A Meta-Analysis of
1.1 Million Subjects.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 860196. Date of Publication: 21 Jun 2022.
Author
Yu Y.; Chen L.; Zhang H.; Fu Z.; Liu Q.; Zhao H.; Liu Y.; Chen Y.
Institution
(Yu, Chen) Medical College of Nankai University, Tianjing, China
(Yu, Chen, Zhang, Fu, Liu, Zhao, Liu, Chen) Department of Cardiology, The
Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
Publisher
Frontiers Media S.A.
Abstract
Background and Aims: The association of familial hypercholesterolemia (FH)
with risk of cardiovascular events (CVE) and death in different cohorts is
controversial. We aimed to assess the risk of CVE and death in patients
with FH in different cohorts, including CHD and ACS patients, White and
Asian, different diagnostic criteria. Method(s): We searched PubMed,
MEDLINE, and Web of Science electronic databases through May 2021 to
identify cohort studies of CVE and death in patients with FH.
 Result(s): We found 18 eligible studies with 1,139,788 participants,
including 34,261 patients. There were 31,287 ACS patients, of whom 2,338
were combined with FH. Randomized-effects meta-analysis showed that in
patients with FH, relative risk (RR) of CVE and death was 1.87 (95% CI
1.21-2.88), among which CVE was 2.14 (95%CI 1.26-3.64), all-cause of death
RR = 1.12 (95% CI 0.89-1.41), and cardiac death RR = 1.03 (95% CI
0.59-1.79). Risk of CVE and death in general population with FH was 2.85
(95% CI 0.72-11.21), hyperlipidemia population RR = 1.59 (95% CI
1.05-2.41), coronary heart disease patients (CHD) RR = 1.46 (95% CI
1.24-1.72), and acute coronary syndrome patients (ACS) RR = 1.71 (95% CI
1.19-2.46). Among ACS patients, the RR of CVE in patients with FH was 1.91
(95% CI 1.55-2.35), the RR of all-cause of death was 1.03 (95% CI
0.80-1.32), and the RR of cardiac death was 1.03 (95% CI 0.59-1.79). The
risk of CVE and death in ACS patients with FH in White was 1.69 (95% CI
1.09-2.64) and Asian 1.90 (95% CI 1.31-2.75). RR in patients with Dutch
Lipid Network criteria (DLCN) >=6 vs. <3 points was higher (RR = 2.24, 95%
CI 1.69-2.97). RR for long-term follow-up was 1.68 (95% CI 1.09-2.61) and
for short-term follow-up was 1.80 (95% CI 1.16-2.78). The results of the
overall population were similar, but RR for overall population during a
short-term follow-up was 1.49 (95% CI 0.81-2.73). We followed PRISMA
checklist to complete meta-analysis. Conclusion(s): The risk of CVE
and death was increased in patients with CHD, especially in patients with
ACS. DLCN >= 6 points was suggested for clinical diagnosis of FH. The risk
of long-term and short-term CVE and death increased in ACS patients with
FH. Registration Number: INPLASY2021110010. Copyright © 2022 Yu,
Chen, Zhang, Fu, Liu, Zhao, Liu and Chen.

<47>
Accession Number
2019171035
Title
Comparability of Heart Rate Turbulence Methodology: 15 Intervals Suffice
to Calculate Turbulence Slope - A Methodological Analysis Using PhysioNet
Data of 1074 Patients.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 793535. Date of Publication: 06 Apr 2022.
Author
Blesius V.; Scholzel C.; Ernst G.; Dominik A.
Institution
(Blesius, Scholzel, Dominik) Life Science Informatics Group, Department of
Mathematics, Natural Sciences and Informatics, Technische Hochschule
Mittelhessen (THM), University of Applied Sciences, Giessen, Germany
(Ernst) Department of Anaesthesiology, Kongsberg Hospital, Vestre Viken
Hospital Trust, Kongsberg, Norway
(Ernst) Psychological Institute, University of Oslo, Oslo, Norway
Publisher
Frontiers Media S.A.
Abstract
Heart rate turbulence (HRT) is a characteristic heart rate pattern
triggered by a ventricular premature contraction (VPC). It can be used to
assess autonomic function and health risk for various conditions, e.g.,
coronary artery disease or cardiomyopathy. While comparability is
essential for scientific analysis, especially for research focusing on
clinical application, the methodology of HRT still varies widely in the
literature. Particularly, the ECG measurement and parameter calculation of
HRT differs, including the calculation of turbulence slope (TS). In this
article, we focus on common variations in the number of intervals after
the VPC that are used to calculate TS (#TSRR) posing two questions: 1)
Does a change in #TSRR introduce noticeable changes in HRT parameter
values and classification? and 2) Do larger values of turbulence timing
(TT) enabled by a larger #TSRR still represent distinct HRT? We compiled a
free-access data set of 1,080 annotated long-term ECGs provided by
Physionet. HRT parameter values and risk classes were determined both with
#TSRR 15 and 20. A standard local tachogram was created by averaging the
tachograms of only the files with the best heart rate variability values.
The shape of this standard VPC sequence was compared to all VPC sequences
grouped by their TT value using dynamic time warping (DTW) in order to
identify HRT shapes. When calculated with different #TSRR, our results
show only a little difference between the number of files with enough
valid VPC sequences to calculate HRT (<1%) and files with different risk
classes (5 and 6% for HRT0-2 and HRTA-C, respectively). In the DTW
analysis, the difference between averaged sequences with a specific TT and
the standard sequence increased with increasing TT. Our analysis suggests
that HRT occurs in the early intervals after the VPC and TS calculated
from late intervals reflects common heart rate variability rather than a
distinct response to the VPC. Even though the differences in
classification are marginal, this can lead to problems in clinical
application and scientific research. Therefore, we recommend uniformly
using #TSRR 15 in HRT analysis. Copyright © 2022 Blesius,
Scholzel, Ernst and Dominik.

<48>
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.

<49>
Accession Number
2019169606
Title
Sex Difference Trend in 5-Year Mortality Among Patients With Coronary
Artery Disease: A 24,432 Chinese Cohort Study From 2007 to 2014.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 774365. Date of Publication: 12 Apr 2022.
Author
Huang H.; Lai W.; Li Q.; Wei H.; Remutula N.; Tuersun T.; Yang Z.; Bao K.;
Yan Z.; Wang B.; He Y.; Chen S.; Ou C.-Q.; Yang H.; Chen J.; Liu J.; Liu
Y.
Institution
(Huang, Lai, Li, Wang, He, Chen, Chen, Liu, Liu) Department of Cardiology,
Guangdong Cardiovascular Institute, Guangdong Provincial People's
Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
(Huang, Lai, Li, Wang, He, Chen, Chen, Liu, 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
(Huang, Chen, Liu) The Second School of Clinical Medicine, Southern
Medical University, Guangzhou, China
(Lai) Guangdong Provincial People's Hospital, School of Medicine, South
China University of Technology, Guangzhou, China
(Wei, Remutula, Tuersun, Yang) The First People's Hospital of Kashgar
Prefecture, Kashgar, China
(Yang, Yan, Ou) State Key Laboratory of Organ Failure Research, Department
of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease
Research, School of Public Health, Southern Medical University, Guangzhou,
China
(Bao) Department of Cardiology, Longyan First Affiliated Hospital of
Fujian Medical University, Longyan, China
Publisher
Frontiers Media S.A.
Abstract
Background: The sex difference trend of short-term mortality in coronary
artery disease (CAD) is narrowing, which has been reported in the previous
studies. However, no studies assess the sex difference temporal trends of
CAD mortality in China especially long-term mortality trend.
 Method(s): Based on the registry at Guangdong Provincial People's
Hospital which is the largest cardiovascular center in South China, this
retrospective cohort study included 24,432 hospitalized patients with CAD
confirmed by coronary angiography from January 2007 to December 2014.
Women and men were followed for 1-year and 5-year all-cause mortality.
 Result(s): From 2007 to 2014, 5-year age-standardized mortality
increased from 10.0 to 11.7% in men (p for trend < 0.001) and from 11.5 to
8.1% in women (p for trend = 0.99). The multivariable-adjusted hazard
ratios (95% CI), which compare women with men, were from 1.02 (0.39-2.67)
to 0.66 (0.39-1.12) for 1-year all-cause mortality and 1.23 (0.64-2.36) to
0.59 (0.44-0.79) for 5-year all-cause mortality (p for trend = 0.04).
 Conclusion(s): Our study found that the mortality risk among men and
women was similar in the 1-year prognosis of CAD, and there was no
significant downward trend. In the 5-year long-term prognosis of CAD, the
mortality risk among men continued to rise, while women had reached the
peak, which means that the mortality risk continues to be higher among men
than women. Copyright © 2022 Huang, Lai, Li, Wei, Remutula,
Tuersun, Yang, Bao, Yan, Wang, He, Chen, Ou, Yang, Chen, Liu and Liu.

<50>
Accession Number
2019169374
Title
Use of Cardiac Contractility Modulation as Bridge to Transplant in an
Obese Patient With Advanced Heart Failure: A Case Report.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 833143. Date of Publication: 16 Feb 2022.
Author
Masarone D.; Petraio A.; Fiorentino A.; Dellegrottaglie S.; Valente F.;
Ammendola E.; Nigro G.; Pacileo G.
Institution
(Masarone, Valente, Ammendola, Pacileo) Heart Failure Unit, Department of
Cardiology, AORN dei Colli, Monaldi Hospital, Naples, Italy
(Petraio) Heart Transplant Unit, Department of Cardiac Surgery and
Transplants, AORN dei Colli, Monaldi Hospital, Naples, Italy
(Fiorentino) Impulse Dynamics Germany, Frankfurt, Germany
(Dellegrottaglie) Division of Cardiology, Ospedale Accreditato Villa dei
Fiori, Naples, Italy
(Dellegrottaglie) Marie-Josee and Henry R. Kravis Center for
Cardiovascular Health, Zena and Michael A. Wiener Cardiovascular
Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Nigro) Department of Medical Translational Sciences, Monaldi Hospital,
University of Campania "Luigi Vanvitelli,", Naples, Italy
Publisher
Frontiers Media S.A.
Abstract
Cardiac contractility modulation (CCM) is a novel device-based therapy in
patients with heart failure with reduced ejection fraction (HFrEF). In
randomized clinical trials and real-life studies, CCM has been shown to
improve exercise tolerance and quality of life, reverse left ventricular
remodeling and reduce hospitalization in patients with HFrEF. In this case
report, we describe for the first time the use of CCM as a "bridge to
transplant" in a young obese patient with advanced heart failure due to
non-ischemic dilated cardiomyopathy. The patient had a poor quality of
life and frequent heart failure-related hospitalizations despite the
optimal medical therapy and, due to obesity, a suitable heart donor was
unlikely to be identified in the short term and due to severe obesity risk
of complications after implantation of a left ventricular assist device
(LVAD) was very high. Copyright © 2022 Masarone, Petraio,
Fiorentino, Dellegrottaglie, Valente, Ammendola, Nigro and Pacileo.

<51>
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.

<52>
Accession Number
2018411851
Title
Inhaled Pulmonary Vasodilators in COVID-19 Infection: A Systematic Review
and Meta-Analysis.
Source
Journal of Intensive Care Medicine. 37(10) (pp 1370-1382), 2022. Date of
Publication: October 2022.
Author
Khokher W.; Malhas S.-E.; Beran A.; Iftikhar S.; Burmeister C.; Mhanna M.;
Srour O.; Rashid R.; Kesireddy N.; Assaly R.
Institution
(Khokher, Malhas, Beran, Iftikhar, Burmeister, Mhanna, Srour, Kesireddy,
Assaly) Department of Internal Medicine, University of Toledo, Toledo, OH,
United States
(Rashid) Department of Internal Medicine, Mercy Catholic Medical Center,
Darby, PA, United States
(Assaly) Department of Pulmonary and Critical Care Medicine, University of
Toledo, Toledo, OH, United States
Publisher
SAGE Publications Inc.
Abstract
Introduction: Inhaled pulmonary vasodilators (IPVD) have been previously
studied in patients with non-coronavirus disease-19 (COVID-19) related
acute respiratory distress syndrome (ARDS). The use of IPVD has been shown
to improve the partial pressure of oxygen in arterial blood
(PaO<inf>2</inf>), reduce fraction of inspired oxygen (FiO<inf>2</inf>)
requirements, and ultimately increase PaO<inf>2</inf>/FiO<inf>2</inf>
(P/F) ratios in ARDS patients. However, the role of IPVD in COVID-19 ARDS
is still unclear. Therefore, we performed this meta-analysis to evaluate
the role of IPVD in COVID-19 patients. Method(s): Comprehensive
literature search of PubMed, Embase, Web of Science and Cochrane Library
databases from inception through April 22, 2022 was performed for all
published studies that utilized IPVD in COVID-19 ARDS patients. The single
arm studies and case series were combined for a 1-arm meta-analysis, and
the 2-arm studies were combined for a 2-arm meta-analysis. Primary
outcomes for the 1-arm and 2-arm meta-analyzes were change in pre- and
post-IPVD P/F ratios and mortality, respectively. Secondary outcomes for
the 1-arm meta-analysis were change in pre- and post-IPVD positive
end-expiratory pressure (PEEP) and lung compliance, and for the 2-arm
meta-analysis the secondary outcomes were need for endotracheal intubation
and hospital length of stay (LOS). Result(s): 13 single arm
retrospective studies and 5 case series involving 613 patients were
included in the 1-arm meta-analysis. 3 studies involving 640 patients were
included in the 2-arm meta-analysis. The pre-IPVD P/F ratios were
significantly lower compared to post-IPVD, but there was no significant
difference between pre- and post-IPVD PEEP and lung compliance. The
mortality rates, need for endotracheal intubation, and hospital LOS were
similar between the IPVD and standard therapy groups. Conclusion(s):
Although IPVD may improve oxygenation, our investigation showed no
benefits in terms of mortality compared to standard therapy alone.
However, randomized controlled trials are warranted to validate our
findings. Copyright © The Author(s) 2022.

<53>
Accession Number
2018390438
Title
Effects of Driving Pressure-Guided Ventilation on Postoperative Pulmonary
Complications in Prone-Positioned Patients Undergoing Spinal Surgery: A
Randomized Controlled Clinical Trial.
Source
Journal of Investigative Surgery. 35(10) (pp 1754-1760), 2022. Date of
Publication: 2022.
Author
Jin D.; Liu H.; Kong X.; Wei G.; Peng K.; Cheng H.; Ji F.
Institution
(Jin, Liu, Kong, Peng, Cheng, Ji) Department of Anesthesiology, The First
Affiliated Hospital of Soochow University, Suzhou, China
(Liu, Wei, Peng, Cheng, Ji) Institute of Anesthesiology, Soochow
University, Suzhou, China
Publisher
Taylor and Francis Ltd.
Abstract
Background: Prolonged spinal surgery in the prone position may lead to
postoperative pulmonary complications (PPCs). We aimed to compare the
effects of driving pressure-guided ventilation versus conventional
protective ventilation on postoperative pulmonary complications in
patients undergoing spinal surgery in the prone position. We hypothesized
that driving pressure-guided ventilation would be associated with a
decreased incidence of PPC. Method(s): We enrolled 78 patients into
this single-center, double-blind, randomized controlled trial. The driving
pressure (DP) group (n = 40) received a tidal volume of 6 ml/kg of
predicted body weight, individualized positive end-expiratory pressure
(PEEP) which produced the lowest driving pressure (plateau pressure-PEEP),
and a recruitment maneuver. The protective ventilation (PV) group (n = 38)
received the same tidal volume and recruitment maneuver but with a fixed
PEEP of 5 cm H<inf>2</inf>O. Our primary outcome was postoperative
pulmonary complications based on Lung Ultrasound Scores (LUS) at the end
of the surgery and the simplified Clinical Pulmonary Infection Score
(sCPIS) on postoperative days (POD) 1 and 3. Result(s): DP patients
had lower LUS and POD1 sCPIS than the PV group (p < 0.01). DP patients had
lower driving pressure during the surgery than PV patients (p < 0.01).
Perioperative arterial blood gases and hemodynamic parameters were
comparable between the two groups (p > 0.05). The visual pain score (VAS)
in postoperative days, drainage, and lengths of stay (LOS) were also
similar between the two groups (p > 0.05). Conclusion(s): Driving
pressure-guided ventilation during spinal surgery with a prolonged prone
patient position may reduce the incidence of early postoperative pulmonary
complications, compared with conventional protective
ventilation. Copyright © 2022 Taylor & Francis Group, LLC.

<54>
Accession Number
2018026763
Title
Reproducibility of quantitative coronary calcium scoring from PET/CT
attenuation maps: comparison to ECG-gated CT scans.
Source
European Journal of Nuclear Medicine and Molecular Imaging. 49(12) (pp
4122-4132), 2022. Date of Publication: October 2022.
Author
Pieszko K.; Shanbhag A.D.; Lemley M.; Hyun M.; Van Kriekinge S.; Otaki Y.;
Liang J.X.; Berman D.S.; Dey D.; Slomka P.J.
Institution
(Pieszko, Shanbhag, Lemley, Hyun, Van Kriekinge, Otaki, Liang, Berman,
Dey, Slomka) Departments of Medicine (Division of Artificial Intelligence
in Medicine), Imaging, and Biomedical Sciences, Cedars-Sinai Medical
Center, 8700 Beverly Blvd, Suite Metro 203, Los Angeles, CA 90048, United
States
(Pieszko) Department of Interventional Cardiology and Cardiac Surgery,
Collegium Medicum, University of Zielona Gora, Zielona Gora, Poland
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: We sought to evaluate inter-scan and inter-reader agreement of
coronary calcium (CAC) scores obtained from dedicated, ECG-gated CAC scans
(standard CAC scan) and ultra-low-dose, ungated computed tomography
attenuation correction (CTAC) scans obtained routinely during cardiac
PET/CT imaging. Method(s): From 2928 consecutive patients who
underwent same-day 82Rb cardiac PET/CT and gated CAC scan in
the same hybrid PET/CT scanning session, we have randomly selected 200
cases with no history of revascularization. Standard CAC scans and ungated
CTAC scans were scored by two readers using quantitative clinical
software. We assessed the agreement between readers and between two scan
protocols in 5 CAC categories (0, 1-10, 11-100, 101-400, and > 400) using
Cohen's Kappa and concordance. Result(s): Median age of patients was
70 (inter-quartile range: 63-77), and 46% were male. The inter-scan
concordance index and Cohen's Kappa for readers 1 and 2 were 0.69; 0.75
(0.69, 0.81) and 0.72; 0.8 (0.75, 0.85) respectively. The inter-reader
concordance index and Cohen's Kappa (95% confidence interval [CI]) was
higher for standard CAC scans: 0.9 and 0.92 (0.89, 0.96), respectively,
vs. for CTAC scans: 0.83 and 0.85 (0.79, 0.9) for CTAC scans (p = 0.02 for
difference in Kappa). Most discordant readings between two protocols
occurred for scans with low extent of calcification (CAC score < 100).
 Conclusion(s): CAC can be quantitatively assessed on PET CTAC maps
with good agreement with standard scans, however with limited sensitivity
for small lesions. CAC scoring of CTAC can be performed routinely without
modification of PET protocol and added radiation dose. Copyright
© 2022, The Author(s), under exclusive licence to Springer-Verlag
GmbH Germany, part of Springer Nature.

<55>
Accession Number
2015564616
Title
Serum cystatin C is associated with the prognosis in acute myocardial
infarction patients after coronary revascularization: a systematic review
and meta-analysis.
Source
BMC Cardiovascular Disorders. 22(1) (no pagination), 2022. Article Number:
156. Date of Publication: December 2022.
Author
Chen J.; Yang Y.; Dai C.; Wang Y.; Zeng R.; Liu Q.
Institution
(Liu) The Third Affiliated Hospital, Zhejiang Chinese Medical University,
Zhejiang, Hangzhou 310000, China
(Chen, Yang, Dai, Wang, Zeng, Liu) The First School of Clinical Medicine,
Zhejiang Chinese Medical University, Zhejiang, Hangzhou 310000, China
Publisher
BioMed Central Ltd
Abstract
Objective: Our study aimed to assess the association between serum
cystatin C levels and prognosis in acute myocardial infarction (AMI)
patients after coronary reconstructive surgery. Method(s): We
searched PubMed, Embase, and Cochrane Library up to January 21, 2022
without language restriction. Outcomes were major cardiovascular events
(MACEs) and mortality. The risk ratio (RR) and 95% confidence interval
(CI) were merged by random-effect models. Result(s): We included 8
studies with a total of 7,394 subjects in our meta-analysis. Our
meta-analysis showed that higher-level of serum cystatin C levels were
associated with higher risk of MACEs (RR = 2.52, 95% CI 1.63-3.89, P <
0.001) and mortality (RR = 2.64, 95% CI 1.66-4.19, P < 0.001) in AMI
patients after coronary revascularization. Subgroup analysis showed that
the serum cystatin C levels were associated with significantly higher risk
of MACEs (RR = 2.72, 95% CI 1.32-5.60, P = 0.006) and mortality (RR =
2.98, 95% CI 1.21-7.37, P = 0.020) in AMI patients after percutaneous
coronary intervention (PCI). However, in AMI patients after coronary
artery bypass surgery, there were no significantly higher risk of MACEs
(RR = 2.41, 95% CI 0.98-5.93, P = 0.05) and mortality (RR = 3.15, 95% CI
0.76-13.03, P = 0.10). Further subgroup analysis showed that this
significantly higher risk of MACEs and mortality did not change with the
study sample size, study population area or study follow-up time.
 Conclusion(s): The meta-analysis demonstrated that higher serum
cystatin C levels were associated with significantly higher risk of MACEs
and mortality in AMI patients after PCI. It is a biomarker for risk
stratification for predicting the prognosis in AMI patients after
PCI. Copyright © 2022, The Author(s).

<56>
Accession Number
2012315363
Title
In search of optimal cardioplegia for minimally invasive valve surgery.
Source
Perfusion (United Kingdom). 37(7) (pp 668-674), 2022. Date of Publication:
October 2022.
Author
Russell S.; Butt S.; Vohra H.A.
Institution
(Russell, Vohra) Department of Cardiac Surgery/Cardiovascular Sciences,
Bristol Heart Institute, University of Bristol, Bristol, United Kingdom
(Butt) Department of Perfusion Sciences, St George's Hospital, London,
United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Cardioplegic solutions are used in cardiac surgery to achieve controlled
cardiac arrest during operations, making surgery safer. Cardioplegia can
either be blood or crystalloid based, with perceived pros and cons of each
type. Whilst it is known that cardioplegia causes cardiac arrest, there is
debate over which cardioplegic solution provides the highest degree of
myocardial protection during arrest. Myocardial damage is measured
post-operatively by biomarkers such as serum TnT, TnI or CK-MB. It is
known that the outcomes of minimally invasive valve surgery are comparable
to full sternotomy valve operations. Despite there being a wide diversity
in use of different cardioplegic solutions across the world, this
comprehensive literature review found no superiority of one cardioplegic
solution over the other for myocardial protection during minimally
invasive valve procedures. Copyright © The Author(s) 2021.

<57>
Accession Number
2020333658
Title
Saffron and its active ingredients against human disorders: A literature
review on existing clinical evidence.
Source
Iranian Journal of Basic Medical Sciences. 26(8) (pp 913-933), 2022. Date
of Publication: August 2022.
Author
Omidkhoda S.F.; Hosseinzadeh H.
Institution
(Omidkhoda, Hosseinzadeh) Pharmaceutical Research Center, Pharmaceutical
Technology Institute, Mashhad University of Medical Sciences, Mashhad,
Iran, Islamic Republic of
(Hosseinzadeh) Department of Pharmacodynamics and Toxicology, School of
Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic
Republic of
(Hosseinzadeh) Department of Pharmacodynamics and Toxicology, School of
Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic
Republic of
Publisher
Mashhad University of Medical Sciences
Abstract
Saffron, the stigmas of Crocus sativus L., has been mentioned extensively
in the traditional reference texts as a herbal medicine. Many clinical
trials have been conducted on this valuable herbal substance and its main
constituents following numerous cellular and animal assessments. In the
present review, we have collected almost all of these clinical studies to
clarify how much knowledge has clinically been achieved in this field so
far and which scientific gaps are needed to be filled by more studies. A
comprehensive literature review was conducted through a two-round search.
First, we performed a general search for identifying the human disorders
against which saffron was studied. Then, we searched specifically for the
combination of saffron keywords and each disease name. Scientific
databases including Scopus, PubMed, and Web of science were used for this
search. Studies were collected through electronic databases from their
inception up to August 2021. The largest number of these clinical studies
represent the investigations into saffron efficacy in different
neurological and mental disorders, particularly depression. This substance
has clinically revealed significant protective effects against various
types of depression, age-related macular degeneration, and allergic
asthma. In some cases, such as sexual dysfunction, cognitive and metabolic
disorder, the effects of saffron are still clinically open to dispute, or
there are limited data on its positive influences. Overall, saffron and
its constituents have promising effects on human disorders; however, it
needs more clinical evidence or meta-analyses to be
confirmed. Copyright © 2022 Mashhad University of Medical
Sciences. All rights reserved.

<58>
Accession Number
2020411250
Title
Caudal epidural morphine versus intravenous morphine for postoperative
analgesia in pediatric cardiac surgery.
Source
Anaesthesia, Pain and Intensive Care. 26(4) (pp 514-522), 2022. Date of
Publication: August 2022.
Author
Nguyen T.D.; Ngo D.; Pham N.H.; Jantzen T.
Institution
(Nguyen) Department of Cardiovascular Anesthesia, Hue Central Hospital,
Hue City, Vietnam
(Ngo) Department of General Anesthesia, Hue Central Hospital, Hue City,
Vietnam
(Pham) Department of Abdominal Emergency and Pediatric Surgery, Hue
Central Hospital, Hue city, Vietnam
(Jantzen) Mecklenburg-Vorpommern, Parchim, Germany
Publisher
Faculty of Anaesthesia, Pain and Intensive Care, AFMS
Abstract
Background & objective: Traditionally, analgesia after heart surgery is
obtained with the use of intravenous opioids (particularly morphine).
Continuous infusion of narcotic analgesics results in a more constant
level of analgesia, but slow accumulation may cause excessive sedation.
The caudal epidural narcotics, alone or with local anesthetics have been
advocated following lower abdominal and thoracic surgery in children. We
compared the analgesic effect and safety of caudal epidural morphine (CEM)
after heart surgery with intravenous morphine infusion. Methodology: Sixty
children, aged 6 months to 5 y, undergoing elective cardiac surgery under
general anesthesia were enrolled in the study. The patients were randomly
allocated to one of the two groups to receive either 0.06 mg/kg CEM at
induction of anesthesia (study group or CEM group) or postoperative
morphine infusion at a rate of 0.025 mg/kg/h intravenously (control group
or PIVM group). Postoperative pain scores were assessed according to the
COMFORT behavior scale. Two patients were excluded from the study after
randomization and 58 patients completed the study. Result(s): Time
from pediatric intensive care unit (PICU) admission to the need of
intravenous morphine boluses was significantly longer in the CEM group
compared with the control group (16-20 h vs 38 min; P < 0.0001). In CEM
group, 68.97% of patients did not require additional morphine and the
total intravenous morphine consumption over the 48 h postoperatively was
lower (P < 0.0001). Moreover, the use of CEM resulted in earlier
extubation and earlier discharge from the PICU (P = 0.011). Over-sedation
was recorded in the control group on the first postoperative day. The
incidence of adverse events was low in both groups. Respiratory depression
was not seen in CEM group patients. Conclusion(s): A single dose of
morphine 0.06 mg/kg in caudal epidural, preoperatively in pediatric
cardiac surgery, had a significant intravenous morphine sparing effect as
compared to a postoperative morphine infusion at a rate of 0.025 mg/kg/h,
and was associated with a low incidence of adverse events after pediatric
cardiac surgery. Effective analgesia was achieved for 16-20 h after
surgery. Copyright © 2022 Faculty of Anaesthesia, Pain and
Intensive Care, AFMS. All rights reserved.

<59>
Accession Number
2020411238
Title
Analgesic efficacy of the erector spinae plane block using bupivacaine vs.
bupivacaine/magnesium sulphate in patients undergoing lumbar spine
surgery: a randomized, double-blinded comparative study.
Source
Anaesthesia, Pain and Intensive Care. 26(4) (pp 439-444), 2022. Date of
Publication: August 2022.
Author
Abdelbadie M.
Institution
(Abdelbadie) Department of Anesthesiology Surgical ICU and Pain
Management, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt
Publisher
Faculty of Anaesthesia, Pain and Intensive Care, AFMS
Abstract
Background & Objectives: Postoperative pain is one of the most troublesome
pains for the surgical patient, and is one of the causes of morbidity and
prolonged hospital stay. Opiates and non-steroidal anti-inflammatory drugs
have been routinely used across the world. Recent resurge of regional
anesthetic techniques offer some advantages, especially reduced
post-operative nausea and vomiting and less sedation. We compared the
efficacy of bupivacaine with a combination of bupivacaine/magnesium
sulphate for the Erector Spinae Plane (ESP) block in patients for
postoperative pain undergoing lumbar spinal fusion under general
anesthesia. Methodology: A total of 30 ASA-I and II patients, 20-60 y old,
who undergoing lumbar spinal fusion were enrolled. They were randomly
divided into two groups; Group B (n = 15) to receive bupivacaine 0.25
percent, 20 mL injected on each side to provide ESP block; and Group BMG
(n = 15): to receive 20 mL of 0.25 percent bupivacaine plus 500 mg
magnesium sulphate, injected on each side for ESP block. The parameters
measured included; the surgery time, non-invasive mean blood pressure
during surgery, postoperative heart rate at 1, 6, 12, and 24 h, The time
to first request for analgesics time after surgery referred to as the
postoperative period (h). Postoperative total analgesic (pethidine needed
per 24h) required and postoperative pain at rest and on moving, measured
with VAS (Visual Analogue Scale) at the 1st, 6th, 12th, and 24th h.
 Result(s): Both at rest and through moving the VAS (Visual Analogue
Scale) among both groups. No significant difference could be seen at the
first, sixth, twelfth, and twenty-fourth hours. The time to the first
request for analgesics was significantly prolonged in the Group BMG than
the Group B. The total analgesic need after surgery was significantly
lower in Group BMG than the Group B. Conclusion(s): The use of a
combination of bupivacaine plus magnesium for bilateral erector spinae
plane block after lumbar spinal fusion surgery is better in terms of
prolonged postoperative analgesia and reducing the opioid use as compared
to bupivacaine alone in patients undergoing lumbar spinal fusion under
general anesthesia. Copyright © 2022 Faculty of Anaesthesia, Pain
and Intensive Care, AFMS. All rights reserved.

<60>
Accession Number
2020394048
Title
Sleep apnea and recurrent heart failure hospitalizations after coronary
artery bypass grafting.
Source
Journal of Clinical Sleep Medicine. 17(12) (pp 2399-2407), 2021. Date of
Publication: 01 Dec 2021.
Author
Teo Y.H.; Tam W.W.; Koo C.-Y.; Aung A.-T.; Sia C.-H.; Wong R.C.C.; Kong
W.; Poh K.-K.; Kofidis T.; Kojodjojo P.; Lee C.-H.
Institution
(Teo, Kong, Poh, Kofidis, Lee) Yong Loo Lin School of Medicine, National
University of Singapore, Singapore, Singapore
(Tam, Kojodjojo) Alice Lee Centre for Nursing Studies, National University
of Singapore, Singapore, Singapore
(Koo, Aung, Sia, Wong, Kong, Poh, Lee) Department of Cardiology, National
University Heart Centre Singapore, Singapore, Singapore
(Kofidis) Department of Cardiac, Thoracic and Vascular Surgery, National
University Heart Centre, Singapore, Singapore
(Kofidis, Lee) Cardiovascular Research Institute, National University of
Singapore, Singapore, Singapore
(Kojodjojo) Division of Cardiology, Department of Medicine, Ng Teng Fong
General Hospital, Singapore, Singapore
Publisher
American Academy of Sleep Medicine
Abstract
Study Objectives: Sleep apnea is prevalent in patients undergoing coronary
artery bypass grafting (CABG). We investigated the relationship between
sleep apnea and recurrent heart failure hospitalizations in patients
undergoing nonurgent CABG. Method(s): Between November 2013 and
December 2018, 1,007 patients completed a sleep study prior to CABG and
were followed up until April 2020. Recurrent heart failure
hospitalizations were analyzed by Poisson, negative binomial,
Andersen-Gill, and joint frailty models, with partial and full adjustment
for covariates. Result(s): At an average follow-up of 3.3 years, the
number of patients with 0, 1, or >= 2 heart failure hospitalizations were
908 (90.2%), 62 (6.2%), and 37 (3.7%), respectively. The total number of
heart failure hospitalizations was 179, comprising 62 (35%) first and 117
(65%) repeat events. The numbers of heart failure hospitalizations for the
sleep apnea (n = 513, 50.9%) and nonsleep apnea groups were 127 and 52,
respectively. Negative binomial regression demonstrated that sleep apnea
was associated with recurrent heart failure hospitalizations (fully
adjusted rate ratio, 1.71; 95% confidence interval [CI], 1.12-2.62; P =
.013). Similar results were found in Poisson (1.63; 95% CI, 1.15-2.31; P =
.006), Andersen-Gill (1.66; 95% CI, 1.01-2.75; P = .047), and joint
frailty models (1.72; 95% CI, 1.00-3.01; P = .056) Conclusion(s): In
patients after CABG, repeat events accounted for two-thirds of heart
failure hospitalizations. Sleep apnea was independently associated with
recurrent heart failure hospitalizations. Copyright 2022 American
Academy of Sleep Medicine. All rights reserved.

<61>
Accession Number
2019265764
Title
Updates in the management of congenital heart disease in adult patients.
Source
Expert Review of Cardiovascular Therapy. 20(9) (pp 719-732), 2022. Date of
Publication: 2022.
Author
Massarella D.; Alonso-Gonzalez R.
Institution
(Massarella, Alonso-Gonzalez) Department of Cardiology, University Health
Network, Peter Munk Cardiac Centre, Toronto ACHD program, Toronto, ON,
Canada
Publisher
Taylor and Francis Ltd.
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. Copyright © 2022 Informa UK Limited,
trading as Taylor & Francis Group.

<62>
Accession Number
2019148550
Title
Clinical and echocardiographic predictors of the anterior mitral leaflet
repair failure.
Source
Journal of Cardiac Surgery. 37(11) (pp 3567-3574), 2022. Date of
Publication: November 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.

<63>
Accession Number
2019128828
Title
Techniques and pitfalls of coronary arterial reimplantation in anatomical
correction of transposition.
Source
Journal of Cardiac Surgery. 37(11) (pp 3813-3824), 2022. Date of
Publication: November 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.

<64>
Accession Number
2019072045
Title
Median sternotomy pain after cardiac surgery: To block, or not? A
systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. 37(11) (pp 3729-3742), 2022. Date of
Publication: November 2022.
Author
King M.; Stambulic T.; Hassan S.M.A.; Norman P.A.; Derry K.; Payne D.M.;
El Diasty M.
Institution
(King, Stambulic, Hassan) Queen's School of Medicine, Kingston, ON, Canada
(Norman) Kingston General Health Research Institute, Kingston, ON, Canada
(Derry) Department of Anesthesiology, Queen's University, Kingston, ON,
Canada
(Payne, El Diasty) Division of Cardiac Surgery, Queen's University,
Kingston, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: Inadequate pain control after median sternotomy leads to
reduced mobilization, increased respiratory complications, and longer
hospital stays. Typically, postoperative pain is controlled by opioid
analgesics that may have several adverse effects. Parasternal intercostal
block (PSB) has emerged as part of a multimodal strategy to control pain
after median sternotomy. However, the effectiveness of this intervention
on postoperative pain control and analgesic use has not been fully
established. Methods and Results: We conducted a meta-analysis to
assess the effect of PSB on postoperative pain and analgesic use in adult
cardiac surgery patients undergoing median sternotomy. PubMed, Embase,
Google Scholar, and the Cochrane database were searched with the following
search strategy: ([postoperative pain] or [pain relief] OR [analgesics] or
[analgesia] or [nerve block] or [regional block] or [local block] or
[regional anesthesia] or [local anesthetic] or [parasternal block] and
[sternotomy]) and (humans [filter]). Inclusion criteria were: patients who
underwent cardiac surgery via median sternotomy, age >18 and parasternal
block (continuous and single dose). Exclusion criteria were: noncardiac
surgery, nonparasternal nerve blocks, and the use of NSAIDS in parasternal
block. Quality assessment was performed by three independent reviewers via
the Cochrane risk of bias assessment tool. Of 1165 total citations, 18
were found to be relevant. Of these 18 citations, 7 citations (N = 2223
patients) reported postoperative pain scores in an extractable format and
11 citations (N = 2155 patients) reported postoperative opioid use in an
extractable format. For postoperative opioid use, morphine equivalent
doses were calculated for all studies and postoperative pain scores were
standardized to a 10-point visual analog scale for comparison between
studies; both these were reported as total opioid use or cumulative score
ranging from 24 to 72 h postoperative. All data analyses were run using a
random effects model, using a restricted maximum likelihood estimator, to
obtain summary standardized mean differences with 95% confidence interval
(CI's). For studies which only reported median and interquatile range
(IQR), the median was standard deviation was estimated by IQR/1.35.
Following median sternotomy both postoperative pain (SMD [95% CI] -0.49
[-0.92 to -0.06]) and postoperative morphine equivalent use (SMD [95% CI]
-1.68 [-3.11 to -0.25]) were significantly less in the PSB group.
 Conclusion(s): Our meta-analysis suggests that parasternal nerve
block significantly reduces postoperative pain and opioid
use. Copyright © 2022 Wiley Periodicals LLC.

<65>
Accession Number
2018846516
Title
Comparing mid-term outcomes of Cox-Maze procedure and pulmonary vein
isolation for atrial fibrillation after concomitant mitral valve surgery:
A systematic review.
Source
Journal of Cardiac Surgery. 37(11) (pp 3801-3810), 2022. Date of
Publication: November 2022.
Author
Sef D.; Trkulja V.; Raja S.G.; Hooper J.; Turina M.I.
Institution
(Sef, Raja) Department of Cardiac Surgery, Harefield Hospital, Royal
Brompton and Harefield Hospitals, Part of Guy's and St. Thomas' NHS
Foundation Trust, London, United Kingdom
(Trkulja) Department of Pharmacology, Zagreb University School of
Medicine, Zagreb, Croatia
(Hooper) Bristol Royal Infirmary, University Hospitals Bristol and Weston
NHS Foundation Trust, Bristol, United Kingdom
(Turina) University of Zurich, Zurich, Switzerland
Publisher
John Wiley and Sons Inc
Abstract
Background: Although concomitant pulmonary vein isolation (PVI) is used
more frequently than the Cox-Maze procedure, which is currently the gold
standard treatment for atrial fibrillation (AF), data on the comparative
effectiveness of the two procedures after concomitant mitral valve (MV)
surgery are still limited. Objective(s): We conducted a systematic
review to identify randomized controlled trials (RCTs) and observational
studies comparing the mid-term mortality and recurrence of AF after
concomitant Cox-Maze and PVI in patients with AF undergoing MV surgery
based on 12-month follow-up. Method(s): Medline, EMBASE databases,
and the Cochrane Library were searched from 1987 up to March 2022 for
studies comparing concomitant Cox-Maze and PVI. Additionally, a
meta-analysis of RCTs was performed to compare the mid-term clinical
outcomes between these two surgical ablation techniques. Result(s):
Three RCTs and three observational studies meeting the inclusion criteria
were included in this systematic review with 790 patients in total (532
concomitant Cox-Maze and 258 PVI during MV surgery). Most studies reported
that the concomitant Cox-Maze procedure was associated with higher freedom
from AF at 12-month follow-up than PVI. Regarding AF recurrence, estimates
pooled across the three RCTs indicated large heterogeneity and high
uncertainty. In the largest and highest quality RCT, 12-month AF
recurrence was higher in the PVI arm (risk ratio = 1.58, 95% CI:
0.91-2.73). In two out of three higher-quality observational studies,
12-month AF recurrence was higher in PVI than in the Cox-Maze arm
(estimated adjusted probabilities 11% vs. 8% and 35% vs. 17%,
respectively). RCTs demonstrated comparable 12-month mortality between
concomitant Cox-Maze and PVI, while observational studies demonstrated the
survival benefit of Cox-Maze. Conclusion(s): Concomitant Cox-Maze in
AF patients undergoing MV surgery is associated with better mid-term
freedom from AF when compared to PVI with comparable mid-term survival.
Large observational studies suggest that there might be a mid-term
survival benefit among patients after concomitant Cox-Maze. Further large
RCTs with longer standardized follow-up are required to clarify the
benefits of concomitant Cox-Maze in AF patients during MV
surgery. Copyright © 2022 The Authors. Journal of Cardiac Surgery
published by Wiley Periodicals LLC.

<66>
Accession Number
2018846459
Title
Commentary to: "Comparing midterm outcomes" of Cox-Maze procedure and
pulmonary vein isolation for atrial fibrillation after concomitant mitral
valve surgery: A "systematic review".
Source
Journal of Cardiac Surgery. 37(11) (pp 3811-3812), 2022. Date of
Publication: November 2022.
Author
Moscarelli M.; Fattouch K.
Institution
(Moscarelli, Fattouch) Deparment of Cardiovascular Surgery, Maria Eleonora
Hospital, GVM Care & Research, Palermo, Italy
Publisher
John Wiley and Sons Inc
Abstract
There is no solid evidence from the literature that compare Cox-Maze with
pulmonary vein isolation techniques for atrial fibrillation in the context
of concomitant mitral valve surgery. Although the first is perhaps more
effective and linked to higher freedom from atrial fibrillation, it is
more invasive compared to the pulmonary isolation. Copyright ©
2022 Wiley Periodicals LLC.

<67>
Accession Number
2018846168
Title
Renal outcomes in valve-in-valve transcatheter versus redo surgical aortic
valve replacement: A systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. 37(11) (pp 3743-3753), 2022. Date of
Publication: November 2022.
Author
Arjomandi Rad A.; Naruka V.; Vardanyan R.; Salmasi M.Y.; Tasoudis P.T.;
Kendall S.; Casula R.; Athanasiou T.
Institution
(Arjomandi Rad, Vardanyan) Department of Medicine, Imperial College
London, Faculty of Medicine, London, United Kingdom
(Naruka, Casula, Athanasiou) Department of Cardiothoracic Surgery,
Imperial College NHS Trust, Hammersmith Hospital, London, United Kingdom
(Salmasi, Athanasiou) Department of Surgery and Cancer, Imperial College
London, London, United Kingdom
(Tasoudis) Department of Cardiothoracic Surgery, University of Thessaly,
Biopolis, Larissa, Greece
(Kendall) Department of Cardiothoracic Surgery, James Cook University
Hospital, Middlesborough, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Postoperative acute kidney injury (AKI) and the requirement
for renal replacement therapy (RRT) remain common and significant
complications of both transcatheter valve-in-valve aortic valve
replacement (ViV-TAVR) and redo surgical aortic valve replacement (SAVR).
Nevertheless, the understanding of renal outcomes in the population
undergoing either redo SAVR or ViV-TAVR remains controversial.
 Method(s): A systematic database search with meta-analysis was
conducted of comparative original articles of ViV-TAVR versus redo SAVR in
EMBASE, MEDLINE, Cochrane database, and Google Scholar, from inception to
September 2021. Primary outcomes were AKI and RRT. Secondary outcomes were
stroke, major bleeding, pacemaker implantation rate, operative mortality,
and 30-day mortality. Result(s): Our search yielded 5435 relevant
studies. Eighteen studies met the inclusion criteria with a total of
11,198 patients. We found ViV-TAVR to be associated with lower rates of
AKI, postoperative RRT, major bleeding, pacemaker implantation, operative
mortality, and 30-day mortality. No significant difference was observed in
terms of stroke rate. The mean incidence of AKI in ViV-TAVR was 6.95%
(+/-6%) and in redo SAVR was 15.2% (+/-9.6%). For RRT, our data showed
that VIV-TAVR to be 1.48% (+/-1.46%) and redo SAVR to be 8.54% (+/-8.06%).
 Conclusion(s): Renoprotective strategies should be put into place to
prevent and reduce AKI incidence regardless of the treatment modality.
Patients undergoing re-intervention for the aortic valve constitute a
high-risk and frail population in which ViV-TAVR demonstrated it might be
a feasible option for carefully selected patients. Long-term follow-up
data and randomized control trials will be needed to evaluate mortality
and morbidity outcomes between these 2 treatments. Copyright ©
2022 The Authors. Journal of Cardiac Surgery published by Wiley
Periodicals LLC.

<68>
Accession Number
2018753365
Title
Machine learning to predict adverse outcomes after cardiac surgery: A
systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. 37(11) (pp 3838-3845), 2022. Date of
Publication: November 2022.
Author
Penny-Dimri J.C.; Bergmeir C.; Perry L.; Hayes L.; Bellomo R.; Smith J.A.
Institution
(Penny-Dimri, Smith) Department of Surgery, School of Clinical Sciences at
Monash Health, Monash University, Clayton, VIC, Australia
(Bergmeir) Department of Data Science and Artificial Intelligence, Faculty
of Information Technology, Monash University, Clayton, VIC, Australia
(Perry) Department of Anaesthesia and Pain Management, Royal Melbourne
Hospital, Melbourne, VIC, Australia
(Perry, Bellomo) Department of Critical Care, University of Melbourne,
Melbourne, VIC, Australia
(Hayes) Department of Anaesthesia, Barwon Health, Geelong, VIC, Australia
(Bellomo) Australian New Zealand Intensive Care Research Centre, Monash
University, Melbourne, VIC, Australia
(Bellomo) Department of Intensive Care, Royal Melbourne Hospital,
Melbourne, VIC, Australia
(Bellomo) Department of Intensive Care Research, Austin Hospital,
Melbourne, VIC, Australia
Publisher
John Wiley and Sons Inc
Abstract
Background: Machine learning (ML) models are promising tools for
predicting adverse postoperative outcomes in cardiac surgery, yet have not
translated to routine clinical use. We conducted a systematic review and
meta-analysis to assess the predictive performance of ML approaches.
 Method(s): We conducted an electronic search to find studies
assessing ML and traditional statistical models to predict postoperative
outcomes. Our primary outcome was the concordance (C-) index of
discriminative performance. Using a Bayesian meta-analytic approach we
pooled the C-indices with the 95% credible interval (CrI) across multiple
outcomes comparing ML methods to logistic regression (LR) and clinical
scoring tools. Additionally, we performed critical difference and
sensitivity analysis. Result(s): We identified 2792 references from
the search of which 51 met inclusion criteria. Two postoperative outcomes
were amenable for meta-analysis: 30-day mortality and in-hospital
mortality. For 30-day mortality, the pooled C-index and 95% CrI were 0.82
(0.79-0.85), 0.80 (0.77-0.84), 0.78 (0.74-0.82) for ML models, LR, and
scoring tools respectively. For in-hospital mortality, the pooled C-index
was 0.81 (0.78-0.84) and 0.79 (0.73-0.84) for ML models and LR,
respectively. There were no statistically significant results indicating
ML superiority over LR. Conclusion(s): In cardiac surgery patients,
for the prediction of mortality, current ML methods do not have greater
discriminative power over LR as measured by the C-index. Copyright
© 2022 The Authors. Journal of Cardiac Surgery published by Wiley
Periodicals LLC.

<69>
Accession Number
2018735532
Title
A survey of cardiac surgeons to evaluate the use of sutureless aortic
valve replacement in Canada.
Source
Journal of Cardiac Surgery. 37(11) (pp 3543-3549), 2022. Date of
Publication: November 2022.
Author
Makhdoum A.; Kim K.; Koziarz A.; Reza S.; Alsagheir A.; Pandey A.; Teoh
K.; Alhazzani W.; Lamy A.; Yanagawa B.; Belley-Cote E.P.; Whitlock R.
Institution
(Makhdoum, Kim, Reza, Alsagheir, Alhazzani, Lamy, Belley-Cote, Whitlock)
Population Research Health Institute, McMaster University, Hamilton,
Canada
(Makhdoum, Yanagawa) Division of Cardiac Surgery, St. Michael's Hospital,
University of Toronto, Toronto, Canada
(Kim) Department of Health Research Methodology, Evidence, and Impact,
McMaster University, Hamilton, ON, Canada
(Koziarz) Faculty of Medicine, University of Toronto, Toronto, ON, Canada
(Pandey) Department of Medicine, McMaster University, Hamilton, ON, Canada
(Teoh) Southlake Regional Health Sciences Centre, Newmarket, ON, Canada
(Alhazzani, Belley-Cote) Division of Critical Care, Department of
Medicine, McMaster University, Hamilton, ON, Canada
(Whitlock) Division of Cardiac Surgery, Department of Surgery, McMaster
University, Hamilton, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: Sutureless aortic valve replacement (SuAVR) is gaining
popularity for the treatment of aortic stenosis. We aimed to describe
Canadian cardiac surgeons' practice patterns and perceptions regarding
SuAVR. Method(s): Content experts (clinicians and methodologists)
developed the survey. Domains in the questionnaire include: respondent
characteristics, factors influencing the decision to implant a SuAVR,
barriers to SuAVR use, and interest in participating in a trial.
 Result(s): A total of 66 cardiac surgeons (median duration of
practice: 15 years; range 8-20 years) from 18 hospitals across Canada
responded to the survey for a response rate of 84%. Surgeons reported that
the following patient characteristics increased the likelihood they would
choose SuAVR: hostile root (73%), small annular size (55%), high Society
of Thoracic Surgery risk score (42%), older age (40%), to support
minimally invasive surgery (25%) and redo-operation (23%). The following
patient characteristics made surgeons less likely to pursue SuAVR: young
age (73%), low STS score (40%), and large annular size (30%). Reported
barriers to SuAVR use included: cost (33%), permanent pacemaker risk (27%)
and uncertain durability (12%). Of respondents, 73% were interested in
participating in a randomized controlled trial comparing SuAVR with
transcatheter aortic valve replacement. Conclusion(s): The primary
reasons for surgeons selecting SuAVR were high surgical risk and
anatomical challenges. Cost is a primary factor limiting SuAVR
use. Copyright © 2022 Wiley Periodicals LLC.

<70>
Accession Number
2018722852
Title
The evolving treatment of congenital heart disease in patient with Down
syndrome: Current state of knowledge.
Source
Journal of Cardiac Surgery. 37(11) (pp 3760-3768), 2022. Date of
Publication: November 2022.
Author
Alkattan H.N.; Ardah H.I.; Arifi A.A.; Yelbuz T.M.
Institution
(Alkattan, Arifi, Yelbuz) Department of Cardiac Sciences, Ministry of the
National Guard - Health Affairs, Riyadh, Saudi Arabia
(Alkattan, Ardah, Arifi, Yelbuz) Department of Cardiac Science, King
Abdulaziz Medical City, King Abdullah International Medical Research
Center, Riyadh, Saudi Arabia
(Alkattan, Ardah, Arifi, Yelbuz) Department of Cardiac Science, King
Abdulaziz Medical City, King Saud bin Abdulaziz University for Health
Sciences, Riyadh, Saudi Arabia
Publisher
John Wiley and Sons Inc
Abstract
Objectives: Children with Down syndrome are usually seen as not worthy of
high-risk cardiac surgery. Through this review, we try to show the results
of curative and palliative surgery for functional single ventricle
syndrome in patients with Down syndrome, as there is currently no standard
protocol for the treatment of this category of patients. Method(s):
An exhaustive search of all related published medical literature included
the following domains: Down syndrome and diagnosis, Down syndrome and
taxonomy, Down syndrome, and natural history, Down syndrome and
cardiovascular abnormalities, Down syndrome and pulmonary hypertension,
Down syndrome and institutionalization, Down syndrome and surgical repair,
Down syndrome, and single ventricle palliation, Down syndrome and Glenn,
Down syndrome, and Fontan. Result(s): 12 articles were included from
775 identified. Low-risk cardiac surgery procedure should be provided for
Down syndrome with a balanced ventricular septal defect. There is no
universal agreement about the surgical approach for Down syndrome with
unbalanced ventricular septal defects, but it can be performed at
relatively low risk. Conclusion(s): TCPC in Down syndrome patients
could be a relatively low-risk procedure if patients are prepared well and
their pulmonary vascular resistance is low. Randomized prospective studies
are required to show the long-term impact of TCPC palliation and develop a
better understanding of standardized care of these patients. Copyright
© 2022 Wiley Periodicals LLC.

<71>
Accession Number
2017692196
Title
Robotic cardiac surgery training during residency: Preparing residents for
the inevitable future.
Source
Laparoscopic, Endoscopic, and Robotic Surgery. 5(2) (pp 75-77), 2022. Date
of Publication: June 2022.
Author
Vinck E.E.; Smood B.; Barros L.; Palmen M.
Institution
(Vinck) Department of Cardiovascular Surgery, Cardio VID Clinic,
Pontifical Bolivarian University, Medellin, Colombia
(Smood) Department of Surgery, Division of Cardiothoracic Surgery,
University of Pennsylvania, PA, United States
(Barros) Department of Cardiovascular Surgery, Santa Casa of Sao Paulo,
Sao Paulo, Brazil
(Palmen) Department of Cardiothoracic Surgery, Leiden University Medical
Center, Leiden, Netherlands
Publisher
KeAi Communications Co.
Abstract
Unlike other surgical residency training programs including thoracic
surgery, robotic cardiac surgery skill training is minimal or absent in
residency curricula. A review was conducted to identify residents'
exposure to robotic cardiac surgery training based on databases including
PubMed, MEDLINE and Google Scholar. Published papers and cardiothoracic
surgical societies with robotic cardiac surgery training courses were
reviewed. Robotic cardiac surgery training for residents is almost
non-existent. Strategies to establish proper robotic cardiac surgical
training for residents include implementing simulation training,
implementing hour requirements and establishing wet/dry lab model training
in a progressive fashion. As robot-assisted cardiac surgery becomes
increasingly commonplace, it will be imperative to provide training for
residents with dedicated opportunities to develop their skills in robotic
cardiac surgery. Copyright © 2022 Zhejiang University

<72>
Accession Number
2017205988
Title
A physiology-based trigger score to guide perioperative transfusion of
allogeneic red blood cells: A multicentre randomised controlled trial.
Source
Transfusion Medicine. 32(5) (pp 375-382), 2022. Date of Publication:
October 2022.
Author
Lu K.; Huang Z.; Liang S.; Pan F.; Zhang C.; Wei J.; Wei H.; Wang Y.; Liao
R.; Huang A.; Huang Y.
Institution
(Lu, Liang, Wei, Huang) Department of Anesthesiology, The Third Affiliated
Hospital of Guangxi Medical University, Guangxi, Nanning, China
(Huang, Pan, Zhang) Department of Anesthesiology, Affiliated Hospital of
Youjiang Medical University for Nationalities, Guangxi, Baise, China
(Wei, Wang, Huang) Department of Anesthesiology, People's Hospital of
Guangxi Zhuang Autonomous Region, Guangxi, Nanning, China
(Liao) Department of Anesthesiology, West China Hospital, Sichuan
University, Sichuan, Chengdu, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Restrictive blood transfusion is recommended by major
guidelines for perioperative management, but requires objective assessment
at 7-10 g/dl haemoglobin (Hb). A scoring system that considers the
physiological needs of the heart may simply the practice and reduce
transfusion. Method(s): Patients (14-65 years of age) undergoing
non-cardiac surgery were randomised at a 1:1 ratio to a control group
versus a Perioperative Transfusion Trigger Score (POTTS) group. POTTS
(maximum of 10) was calculated as 6 plus the following: adrenaline
infusion rate (0 for no infusion, 1 for <=0.05
mug.kg-1.min-1, and 2 for higher rate),
FiO<inf>2</inf> to keep SpO<inf>2</inf> at >=95% (0 for <=35%, 1 for
36%-50%, and 2 for higher), core temperature (0 for <38degreeC, 1 for
38-40degreeC, and 2 for higher), and angina history (0 for no, 1 for
exertional, and 2 for resting). Transfusion is indicated when actual Hb is
lower than the calculated POTTS in individual patients. Transfusion in the
control group was based on the 2012 American Association for Blood Banks
(AABB) guideline. The primary outcome was the proportion of the patients
requiring transfusion of allogeneic red blood cells (RBCs) during the
perioperative period (until discharge from hospital), as assessed in the
intention-to-treat (ITT) population (all randomised subjects).
 Result(s): A total of 864 patients (mean age 44.4 years, 244 men and
620 women) were enrolled from December 2017 to January 2021 (433 in the
control and 431 in the POTTS group). Baseline Hb was 9.2 +/- 1.8 and 9.2
+/- 1.7 g/dl in the control and POTTS groups, respectively. In the ITT
analysis, the proportion of the patients receiving allogeneic RBCs was
43.9% (190/433) in the control group versus 36.9% (159/431) in the POTTS
group (p = 0.036). Lower rate of allogeneic RBCs transfusion in the POTTS
group was also evident in the per-protocol analysis (42.8% vs. 35.5%, p =
0.030). Transfusion volume was 4.0 (2.0, 6.0) and 3.5 (2.0, 5.5) units
(200 ml/unit) in the control and POTTS groups, respectively (p = 0.25).
The rate of severe postoperative complications (Clavien-Dindo grade IIIa
and higher) was 3.9% in the control group versus 1.2% in the POTTS group
(p = 0.010). Conclusion(s): Transfusion of allogeneic RBCs based on
the POTTS was safe and reduced the transfusion requirement in patients
undergoing non-cardiac surgery. Copyright © 2022 The Authors.
Transfusion Medicine published by John Wiley & Sons Ltd on behalf of
British Blood Transfusion Society.

<73>
Accession Number
639054079
Title
Cerebral Embolic Protection during Transcatheter Aortic-Valve Replacement.
Source
The New England journal of medicine. 387(14) (pp 1253-1263), 2022. Date of
Publication: 06 Oct 2022.
Author
Kapadia S.R.; Makkar R.; Leon M.; Abdel-Wahab M.; Waggoner T.; Massberg
S.; Rottbauer W.; Horr S.; Sondergaard L.; Karha J.; Gooley R.; Satler L.;
Stoler R.C.; Messe S.R.; Baron S.J.; Seeger J.; Kodali S.; Krishnaswamy
A.; Thourani V.H.; Harrington K.; Pocock S.; Modolo R.; Allocco D.J.;
Meredith I.T.; Linke A.
Institution
(Kapadia, Makkar, Leon, Abdel-Wahab, Waggoner, Massberg, Rottbauer, Horr,
Sondergaard, Karha, Gooley, Satler, Stoler, Messe, Baron, Seeger, Kodali,
Krishnaswamy, Thourani, Harrington, Pocock, Modolo, Allocco, Meredith,
Linke) From the Department of Cardiovascular Medicine (S.R.K.), Cleveland
Clinic Foundation (A.K.), Cleveland; Smidt Heart Institute, Cedars-Sinai
Medical Center, Los Angeles (R. Makkar); Columbia Interventional
Cardiovascular Care (M.L.), Columbia University Medical Center (S.K.), New
York; Leipzig Heart Center, University of Leipzig, Leipzig (M.A.-W.),
Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen and
German Center for Cardiovascular Research (DZHK), Munich Heart Alliance,
Munich (S.M.), Universitaetsklinikum Ulm, Ulm (W.R.), Medical Campus Lake
Constance, Friedrichshafen (J.S.), and the Clinic for Internal Medicine
and Cardiology, Technische Universitat Dresden, Herzzentrum, Dresden
(A.L.) - all in Germany; Pima Heart and Vascular, Tucson Medical Center
Healthcare, Tucson, AZ (T.W.); Centennial Medical Center, Nashville
(S.H.); Rigshospitalet, Copenhagen University Hospital, Copenhagen (L.
Sondergaard); Heart Hospital of Austin, Austin (J.K.), Baylor Heart and
Vascular Hospital, Dallas (R.C.S.), and Baylor Scott and White the Heart
Hospital-Plano, Plano (K.H.) - all in Texas; Monash Medical Centre,
Clayton, VIC, Australia (R.G.); Washington Hospital Center, Washington, DC
(L. Satler); the Department of Neurology, University of Pennsylvania,
Philadelphia (S.R.M.); Lahey Hospital and Medical Center, Burlington
(S.J.B.), and Boston Scientific, Marlborough (R. Modolo, D.J.A., I.T.M.) -
both in Massachusetts; Piedmont Heart Institute, Atlanta (V.H.T.); and the
London School of Hygiene and Tropical Medicine, London (S.P.)
Publisher
NLM (Medline)
Abstract
BACKGROUND: Transcatheter aortic-valve replacement (TAVR) for the
treatment of aortic stenosis can lead to embolization of debris. Capture
of debris by devices that provide cerebral embolic protection (CEP) may
reduce the risk of stroke. METHOD(S): We randomly assigned patients
with aortic stenosis in a 1:1 ratio to undergo transfemoral TAVR with CEP
(CEP group) or without CEP (control group). The primary end point was
stroke within 72 hours after TAVR or before discharge (whichever came
first) in the intention-to-treat population. Disabling stroke, death,
transient ischemic attack, delirium, major or minor vascular complications
at the CEP access site, and acute kidney injury were also assessed. A
neurology professional examined all the patients at baseline and after
TAVR. RESULT(S): A total of 3000 patients across North America,
Europe, and Australia underwent randomization; 1501 were assigned to the
CEP group and 1499 to the control group. A CEP device was successfully
deployed in 1406 of the 1489 patients (94.4%) in whom an attempt was made.
The incidence of stroke within 72 hours after TAVR or before discharge did
not differ significantly between the CEP group and the control group (2.3%
vs. 2.9%; difference, -0.6 percentage points; 95% confidence interval,
-1.7 to 0.5; P=0.30). Disabling stroke occurred in 0.5% of the patients in
the CEP group and in 1.3% of those in the control group. There were no
substantial differences between the CEP group and the control group in the
percentage of patients who died (0.5% vs. 0.3%); had a stroke, a transient
ischemic attack, or delirium (3.1% vs. 3.7%); or had acute kidney injury
(0.5% vs. 0.5%). One patient (0.1%) had a vascular complication at the CEP
access site. CONCLUSION(S): Among patients with aortic stenosis
undergoing transfemoral TAVR, the use of CEP did not have a significant
effect on the incidence of periprocedural stroke, but on the basis of the
95% confidence interval around this outcome, the results may not rule out
a benefit of CEP during TAVR. (Funded by Boston Scientific; PROTECTED TAVR
ClinicalTrials.gov number, NCT04149535.). Copyright © 2022
Massachusetts Medical Society.

<74>
Accession Number
639000786
Title
Is the world ready for the STICH 3.0 trial?.
Source
Current opinion in cardiology. 37(6) (pp 474-480), 2022. Date of
Publication: 01 Nov 2022.
Author
Vervoort D.; Jolicoeur M.E.; Marquis-Gravel G.; Fremes S.E.
Institution
(Vervoort, Fremes) Institute of Health Policy, Management and Evaluation
(Vervoort, Fremes) Division of Cardiac Surgery, University of Toronto,
Toronto, ON, Canada
(Jolicoeur, Marquis-Gravel) Montreal Heart Institute, University of
Montreal, Montreal, QC, Canada
(Fremes) Schulich Heart Centre, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, ON, Canada
Publisher
NLM (Medline)
Abstract
PURPOSE OF REVIEW: Coronary artery disease (CAD) is responsible for >50%
of heart failures cases. Patients with ischemic left ventricular systolic
dysfunction (iLVSD) are known to have poorer outcomes after percutaneous
coronary intervention (PCI) and coronary artery bypass grafting (CABG)
compared to patients with a normal ejection fraction. Nevertheless, <1% of
patients in coronary revascularization trials to date had iLVSD. The
purpose of this review is to describe coronary revascularization
modalities in patients with iLVSD and highlight the need for randomized
controlled trial evidence comparing these treatments in this patient
population. RECENT FINDINGS: Network meta-analytic findings of
observational studies suggest that PCI is associated with higher rates of
mortality, cardiac death, myocardial infarction, and repeat
revascularization but not stroke compared to CABG in iLVSD. In recent
years, outcomes for patients undergoing PCI have improved as a result of
advances in technologies and techniques. SUMMARY: The optimal coronary
revascularization modality in patients with iLVSD remains unknown. In
observational studies, CABG appears superior to PCI; however, direct
randomized evidence is absent and developments in PCI techniques have
improved post-PCI outcomes in recent years. The Surgical Treatment for
Ischemic Heart Failure 3.0 consortium of trials will seek to address the
clinical equipoise in coronary revascularization in patients with
iLVSD. Copyright © 2022 Wolters Kluwer Health, Inc. All rights
reserved.

<75>
Accession Number
639000111
Title
Effect of a balanced colloid on acute kidney injury in paediatric cardiac
surgery: A post hoc analysis of a randomised controlled trial.
Source
European journal of anaesthesiology. 39(11) (pp 895-897), 2022. Date of
Publication: 01 Nov 2022.
Author
Willems A.; Arend S.; Schmartz D.; Van der Linden P.
Institution
(Willems) From the Paediatric Intensive Care Unit, Department of Intensive
Care, Leiden University Medical Centre, Leiden, The Netherlands (AW),
Department of Anaesthesiology, University Hospital Brugmann and Queen
Fabiola University Children's Hospital, Brussels, Belgium (SA, DS, PVL)
Publisher
NLM (Medline)

<76>
Accession Number
638486265
Title
Early Peritoneal Dialysis and Postoperative Outcomes in Infants After
Pediatric Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Pediatric critical care medicine : a journal of the Society of Critical
Care Medicine and the World Federation of Pediatric Intensive and Critical
Care Societies. 23(10) (pp 793-800), 2022. Date of Publication: 01 Oct
2022.
Author
Namachivayam S.P.; Law S.; Millar J.; d'Udekem Y.
Institution
(Namachivayam, Law, Millar) Intensive Care Unit, The Royal Children's
Hospital, Melbourne, VIC, Australia
(Namachivayam, Millar) Clinical Sciences, Murdoch Children's Research
Institute, Melbourne, VIC, Australia
(Namachivayam) Department of Critical Care, University of Melbourne,
Melbourne, VIC, Australia
(Namachivayam, Law) Department of Pediatrics, Faculty of Medicine Siriraj
Hospital, Mahidol University, Bangkok, Thailand
(Namachivayam, Millar, d'Udekem) Department of Paediatrics, University of
Melbourne, Melbourne, VIC, Australia
(Namachivayam, d'Udekem) Cardiac Surgery, Children's National Heart
Institute, Children's National Hospital, Washington DC
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Peritoneal dialysis (PD) is used in several cardiac surgical
units after cardiac surgery, and early initiation of PD after surgery may
have the potential to influence postoperative outcomes. This systematic
review and meta-analysis aims to summarize the evidence for the
association between early PD after cardiac surgery and postoperative
outcomes. DATA SOURCES: MEDLINE, Embase, and PubMed from 1981 to November
1, 2021. STUDY SELECTION: Observational studies and randomized trials
reporting on early PD after pediatric cardiac surgery. DATA EXTRACTION:
Random-effects meta-analysis was used to estimate the pooled odds ratios
(ORs) and their 95% CIs for postoperative mortality and pooled mean
difference (MD) (95% CI) for duration of mechanical ventilation and ICU
length of stay. DATA SYNTHESIS: We identified nine studies from the
systematic review, and five were considered suitable for meta-analysis.
Early initiation of PD after cardiac surgery was associated with a
reduction in postoperative mortality (OR, 0.43 (95% CI, 0.23-0.80); number
of estimates = 4). Early commencement of PD shortened duration of
mechanical ventilation (MD [95% CI], -1.09 d [-1.86 to -0.33 d]; I2 =
56.1%; p = 0.06) and intensive care length of stay (MD [95% CI], -2.46 d
[-3.57 to -1.35 d]; I2 = 18.7%; p = 0.30], respectively. All three
estimates had broad 95% prediction intervals (crossing null) denoting
major heterogeneity between studies and wide range of possible study
estimates in similar future studies. Overall, studies reporting on the
effects of early PD included only a subset of infants undergoing cardiac
surgery (typically high-risk infants), so selection bias may be a major
issue in published studies. CONCLUSION(S): This review suggests that
early initiation of PD may be associated with beneficial postoperative
outcomes in infants after cardiac surgery. However, these results were
based on studies of varying qualities and risk of bias. Early
identification of high-risk infants after cardiac surgery is important so
that prevention or early mitigation strategies can be applied to this
cohort. Future prospective studies in high-risk populations are needed to
study the role of early PD in influencing postoperative
outcomes. Copyright © 2022 by the Society of Critical Care
Medicine and the World Federation of Pediatric Intensive and Critical Care
Societies.

<77>
Accession Number
2020485853
Title
Perioperative Anesthetic Management of the Pregnant Patient With
Congenital Heart Disease Undergoing Cardiac Intervention: A Systematic
Review.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2022.
Date of Publication: 2022.
Author
Zaleski K.L.; Blazey M.H.; Carabuena J.M.; Economy K.E.; Valente A.M.;
Nasr V.G.
Institution
(Zaleski, Nasr) Department of Anesthesiology, Critical Care, and Pain
Medicine-Boston Children's Hospital, Harvard Medical School, Boston, MA,
United States
(Blazey) Niagara Frontier Anesthesia, West Seneca, NY, United States
(Carabuena) Department of Anesthesiology, Perioperative and Pain
Medicine-Brigham and Women's Hospital, Harvard Medical School, Boston, MA,
United States
(Economy) Division of Maternal-Fetal Medicine, Brigham, and Women's
Hospital, Harvard Medical School, Boston, MA, United States
(Valente) Department of Cardiology, Boston Children's Hospital, Harvard
Medical School, Boston, MA, United States
Publisher
W.B. Saunders
Abstract
Maternal congenital heart disease is increasingly prevalent, and has been
associated with a significantly increased risk of maternal, obstetric, and
neonatal complications. For patients with CHD who require cardiac
interventions during pregnancy, there is little evidence-based guidance
with regard to optimal perioperative management. The periprocedural
management of pregnant patients with congenital heart disease requires
extensive planning and a multidisciplinary teams-based approach.
Anesthesia providers must not only be facile in the management of adult
congenital heart disease, but cognizant of the normal, but significant,
physiologic changes of pregnancy. Copyright © 2022 Elsevier Inc.

<78>
Accession Number
639202151
Title
'JOY TO BE HIDDEN, DISASTER NOT TO BE FOUND'- RARE CASE OF INTRA CARDIAC
LIPOMA IN A CHILD.
Source
Archives of Disease in Childhood. Conference: Royal College of Paediatrics
and Child Health Conference, RCPCH 2022. Liverpool United Kingdom.
107(Supplement 2) (pp A421-A422), 2022. Date of Publication: August 2022.
Author
Seenivasan A.; Dhelaria A.
Institution
(Seenivasan) Department of Paeditrics, East and North Hertfordshire NHS
Trust, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Aims Primary cardiac tumors in children although rare, are reported to be
increasing annually in recent years. Most of them are benign in nature
with the most common benign tumors being rhabdomyosarcoma, fibroma, and
myxomas. Intracardiac lipomas have been reported in a few pediatric
patients but none in the left atrium. We report a unique case of left
atrial lipoma. Methods A 9 years old boy previously fit and well was
referred due to increasing frequency of chest pain and a 'racing
heartbeat' soon after the chest pain. The events lasted for a few seconds
on a scale of 7 out of 10 and were random both at school and home. A
family history of congenital cardiac disease was mentioned in the first
cousin. Clinical examination was unremarkable. Baseline 12 lead
electrocardiogram (ECG) showed sinus arrhythmia with normal QTc and a left
axis deviation of 96 degrees. An echocardiogram showed situs solitus with
atrioventricular- ventriculo atrial concordance. A 1.6cm 3.6cm
hyper-echogenic, non-pedunculated mass was noted in the left atrial free
wall protruding into the left atrial cavity with fractional shortening of
30% and ejection fraction of 56%. Cardiac magnetic resonance imaging (MRI)
showed well-defined posterior mediastinal mass abutting the posterior left
atrial wall between the right and left-sided pulmonary veins typical for
lipoma. He was managed conservatively with regular outpatient follow-up
after discussion with the tertiary center. Results Cardiac lipomas are
rare benign tumors of the heart. They are usually asymptomatic and are
thus most often diagnosed on autopsies. The median age was 13 years. The
locations were in right AV grove, right ventricle, and central fibrous
body. They were located in different regions of the heart but none in the
left atrium.1 The diagnostic modality of choice is cardiac MRI. Treatment
guidelines have not yet been established due to the very low prevalence of
these tumors and no randomized clinical trials. The management is thus
guided by the patient's symptomatology.2 Although benign, these lipomas
can be aggressive causing signs of cardiac compromise. A surgical approach
is justified in symptomatic patients, to alleviate symptoms and to prevent
the progression of the disease. However, treatment in asymptomatic
patients poses a serious dilemma to the patient and the clinician as there
is no consensus to date. Conclusion Intracardiac lipomas can present from
being asymptomatic to aggressive cardiac failure or sudden cardiac arrest.
The importance of a 12-lead ECG and an echo should be emphasized in
children presenting with cardiac symptoCardiac MRI is diagnostic and
management depends on a decision by a joint specialist team along with
radiologists and cardiac surgeons. (Figure Presented).

<79>
Accession Number
639201985
Title
HARTMANN'S IS A SAFE AND COST EFFECTIVE ALTERNATIVE TO HAS FOR POST
OPERATIVE FLUID RESUSCITATION IN POST CARDIAC SURGERY INFANTS.
Source
Archives of Disease in Childhood. Conference: Royal College of Paediatrics
and Child Health Conference, RCPCH 2022. Liverpool United Kingdom.
107(Supplement 2) (pp A445-A446), 2022. Date of Publication: August 2022.
Author
Ramakrishnan S.; Kumar R.
Institution
(Ramakrishnan, Kumar) Leeds Teaching Hospitals NHS Trust, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Aims To determine safety and efficacy of changed fluid strategy in post
cardiac surgery infants. Methods This was a retrospective cohort study of
infants' <=90 days who underwent cardiac surgery in a tertiary PICU during
two different 12-month time intervals when the resuscitation fluid of
choice was changed. The null hypothesis was there is difference in length
of stay between HAS and Hartmann's group. A total of 146 infants were
included: 59 from 2016 to reflect the practice where 5%-HAS was
predominant resuscitation fluid (HAS group) and 87 from 2019 when the
practice of Hartman based resuscitation fluid (Hartmann's group) was
firmly established. Data were collected from electronic records regarding
patient demographics (age, weight), surgical parameters (RACHS, CPB, cross
clamp time, delayed chest closure) and postoperative clinical parameters
(acidosis/lactate on admission, day of chest closure in those who came to
the unit as open chest, blood products used per kg during the first and
second days and from 3rd to 7th day, resuscitation fluid received per kg
during the first and second days and from 3rd to 7th day of PICU stay,
inotropes on admission and during the first week, days spent in PICU, day
of extubation, any AKI during the stay, co-morbidities and any other
procedures undergone during the ICU stay) (table 1). The primary outcome
variables were length of PICU stay and day of chest closure. The groups
were compared in terms of demographics, RACHS and chest open cases.
Regression analysis was used to find association between the fluids/blood
products and the length of stay (figure 1). More number of ventilated days
correlated directly to longer stays in PICU. The Hartmann group found to
be having lesser days in PICU eventhough it was found to be statistically
similar in each group, rejecting null hypothesis. Results The two cohorts
were comparable in baseline characteristics. They were statistically
comparable in terms of RACHS category and distribution of chest open
cases. There were no significant difference between the two groups in
terms of length of stay in ICU, day of chest closure and prevalence of
AKI. Conclusion This retrospective study done as quality improvement
initiative to determine safety and efficacy of Hartman's as a predominant
resuscitation fluid shows that it can safely replace HAS and is
cost-effective. Therer was a trend towards prolonged PICU stay with use of
HAS, however it was not statistically significant. There was no
significant difference in delayed chest closure and incidence of AKI
between the two cohorts. The main limitaions are * Limitations inherent to
retrospective methodology * Quality of data/documentation * No specific
parameters/outcome for resuscitation fluid use * Potential variation in
practice over time. Recommendations Hartman's can be safely used as a cost
effective replacemnt for HAS in postoperative cardiac surgery fluid
resuscitation. Adequately powered multi-centre randomised controlled
trials are needed. (Table Presented).

<80>
Accession Number
2018968676
Title
Statins and Mortality of Patients After Transcatheter Aortic Valve
Implantation: A Systematic Review and Meta-analysis.
Source
Angiology. (no pagination), 2022. Date of Publication: 2022.
Author
Yarahmadi P.; Kabiri A.; Forouzannia S.M.; Yousefifard M.
Institution
(Yarahmadi, Forouzannia) School of Medicine, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Kabiri) School of Medicine, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Yousefifard) Physiology Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
Publisher
SAGE Publications Inc.
Abstract
While TAVI is widely used, optimal medical therapy to reduce the mortality
rate after transcatheter aortic valve implantation (TAVI) is still
unclear. We performed a systematic review and meta-analysis to evaluate
the impact of statins on mortality following TAVI. Present systematic
review of the literature was performed using Medline, Embase, Scopus, and
Web of Science; all studies reported all-cause mortality in patients who
underwent TAVI and received or did not receive statin therapy. Data were
analyzed using random-effects models. Seventeen articles (21 380 patients)
were included in the meta-analysis. Statin therapy was associated with a
reduction of all-cause mortality (Hazard ratio [HR] =.78, 95% Confidence
interval [CI].68-.89, P <.001). Moderate between-study heterogeneity was
observed (I2 = 45.2). High-intensity statin therapy was more
effective than low or moderate intensity statin therapy in reduction of
all-cause mortality (Risk ratio [RR] =.62, 95% CI 0.45-.85, P =.003,
I2 =.0). Statin therapy could reduce the mid-term all-cause
mortality rate following TAVI. However, all included studies were
observational and, therefore, randomized controlled trials are still
needed to assess the effect of statin therapy on mortality after
TAVI. Copyright © The Author(s) 2022.

<81>
Accession Number
639207254
Title
Early surgical intervention versus conservative management of asymptomatic
severe aortic stenosis: a systematic review and meta-analysis.
Source
Heart (British Cardiac Society). (no pagination), 2022. Date of
Publication: 05 Oct 2022.
Author
Costa G.N.F.; Cardoso J.F.L.; Oliveiros B.; Goncalves L.; Teixeira R.
Institution
(Costa, Goncalves, Teixeira) Servico de Cardiologia, Centro Hospitalar e
Universitario de Coimbra, Coimbra, Portugal
(Costa, Oliveiros, Goncalves, Teixeira) Faculty of Medicine, University of
Coimbra, Coimbra, Portugal
(Cardoso) Centro Hospitalar de Vila Nova de Gaia, Servico de Cirurgia
Cardio-toracica, Vila Nova de Gaia, Portugal
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Timing of intervention for patients with asymptomatic severe
aortic stenosis (AS) remains controversial. To compare the outcomes of
early aortic valve replacement (AVR) versus watchful waiting (WW) in
patients with asymptomatic severe AS. METHOD(S): We systematically
searched PubMed, Embase and Cochrane databases, in December 2021, for
studies comparing early AVR with WW in the treatment of asymptomatic
severe AS. Random-effects meta-analysis was performed. RESULT(S):
Twelve studies were included in which two were randomised clinical trials.
A total of 4130 patients were included, providing a 1092 pooled death
events. Our meta-analysis showed a significantly lower all-cause mortality
for the early AVR compared with WW group, although with a high amount of
heterogeneity between studies in the magnitude of the effect (pooled OR
0.40; 95% CI 0.35 to 0.45, p<0.01; I2=61%). An early surgery strategy
displayed a significantly lower cardiovascular mortality (pooled OR 0.33;
95% CI 0.19 to 0.56, p<0.01; I2=64%) and heart failure hospitalisation
(pooled OR 0.19; 95% CI 0.10 to 0.39, p<0.01, I2=7%). However, both groups
had similar rates of stroke (pooled OR 1.30; 95% CI 0.73 to 2.29, p=0.36,
I2=0%) and myocardial infarction (pooled OR 0.49; 95% CI 0.19 to 1.27,
p=0.14, I2= 0%). CONCLUSION(S): This study suggests that for patients
with asymptomatic severe AS an early surgical intervention compared with a
conservative WW strategy was associated with a lower heart failure
hospitalisation and a similar rate of stroke or myocardial infarction,
although with significant risk of bias. PROSPERO REGISTRATION NUMBER:
CRD42021291144. Copyright © Author(s) (or their employer(s))
2022. No commercial re-use. See rights and permissions. Published by BMJ.

<82>
Accession Number
639206678
Title
Outcomes of isolated tricuspid valve replacement: a systematic review and
meta-analysis of 5,316 patients from 35 studies.
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: 04 Oct 2022.
Author
Scotti A.; Sturla M.; Granada J.F.; Kodali S.K.; Coisne A.; Mangieri A.;
Godino C.; Ho E.; Goldberg Y.; Chau M.; Jorde U.P.; Garcia M.J.; Maisano
F.; Bapat V.N.; Ailawadi G.; Latib A.
Institution
(Scotti, Sturla, Granada, Coisne, Ho, Goldberg, Chau, Jorde, Garcia,
Latib) Montefiore-Einstein Center for Heart and Vascular Care, Montefiore
Medical Center, Albert Einstein College of Medicine, Bronx, NY, United
States
(Scotti, Granada, Coisne) Cardiovascular Research Foundation, New York,
NY, USA
(Kodali) Division of Cardiology, New York-Presbyterian Hospital/Columbia
University Irving Medical Center, New York, NY, USA
(Mangieri) Department of Biomedical Sciences, Humanitas University, Pieve
Emanuele, Italy and Cardio Center, Humanitas Research Hospital IRCCS,
Rozzano, Italy
(Godino, Maisano) Cardio-Thoracic-Vascular Department, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Bapat) Minneapolis Heart Institute, Abbott Northwestern Hospital,
Minneapolis, MN, United States
(Ailawadi) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, MI, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Transcatheter tricuspid valve replacement (TTVR) is rapidly
emerging as a therapeutic option amongst patients with secondary tricuspid
regurgitation. Historical data from surgical tricuspid valve replacement
(TVR) studies may serve as a benchmark for the development of TTVR trials.
AIMS: The aim of the study was to investigate the early and late outcomes
following isolated surgical TVR. METHOD(S): Multiple electronic
databases were searched to identify studies on isolated surgical TVR. The
prespecified primary endpoint was operative mortality; secondary endpoints
were early and late outcomes. Overall estimates of proportions and
incidence rates with 95% confidence intervals (CI) were calculated using
random-effects models. Multiple sensitivity analyses accounting for
baseline characteristics, country and the operative period were applied.
Results: A total of 35 studies (5,316 patients) were included in this
meta-analysis. The operative period ranged from 1974 to 2019. The overall
rate of operative mortality was 12% (95% CI: 9-15), with higher mortality
for patients who were operated on before 1995, who had prior cardiac
surgeries, or who had liver disease. The most frequent clinical events
were pacemaker implantation (10% [95% CI: 6-16]), bleeding (12% [95% CI:
8-17]), acute kidney injury (15% [95% CI: 9-24]) and respiratory
complications (15% [95% CI: 12-20]). At follow-up analysis of the
bioprosthetic TVR, there was an incidence rate per 100 person-years of 6
(95% CI: 2-13) for death and 8 (95% CI: 5-13) for recurrence of
significant tricuspid regurgitation. CONCLUSION(S): This
meta-analysis provides an overview of the historical clinical outcomes
following isolated surgical TVR. These findings can support the
development of future clinical trials in the tricuspid space by providing
thresholds for clinical outcomes.

<83>
Accession Number
639204823
Title
Data standards for transcatheter aortic valve implantation: the European
Unified Registries for Heart Care Evaluation and Randomised Trials
(EuroHeart).
Source
European heart journal. Quality of care & clinical outcomes. (no
pagination), 2022. Date of Publication: 04 Oct 2022.
Author
Aktaa S.; Batra G.; James S.K.; Blackman D.J.; Ludman P.F.; Mamas M.A.;
Abdel-Wahab M.; Angelini G.D.; Czerny M.; Delgado V.; De Luca G.;
Eustachio A.; Foldager D.; Hamm C.W.; Iung B.; Mangner N.; Mehilli J.;
Murphy G.J.; Mylotte D.; Parma R.; Petronio A.S.; Popescu B.A.;
Sondergaard L.; Teles R.C.; Sabate M.; Terkelsen C.J.; Testa L.; Wu J.;
Maggioni A.P.; Wallentin L.; Casadei B.; Gale C.P.
Institution
(Aktaa, Blackman, Gale) Leeds Institute of Cardiovascular and Metabolic
Medicine, University of Leeds, Leeds, United Kingdom
(Aktaa, Wu, Gale) Leeds Institute for Data Analytics, University of Leeds,
Leeds, United Kingdom
(Aktaa, Blackman, Gale) Department of Cardiology, Leeds Teaching Hospitals
NHS Trust, Leeds, United Kingdom
(Batra, James, Wallentin) Department of Medical Sciences, Cardiology and
Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
(Ludman) Institute of Cardiovascular Sciences, University of Birmingham
(Mamas) Keele Cardiovascular Research Group, Keele University, Stoke on
Trent, United Kingdom
(Abdel-Wahab) Heart Center Leipzig at University of Leipzig, Leipzig,
Germany
(Angelini) Bristol Heart Institute, Bristol University
(Czerny) Department of Cardiovascular Surgery, Faculty of Medicine,
Albert-Ludwigs-University of Freiburg, University Heart Center Freiburg,
Freiburg, Germany
(Delgado) Heart Institute; Department of Cardiology; Cardiovascular
Imaging Section; Hospital University Germans Trias i Pujol, Badalona,
Spain
(De Luca) Clinical and Experimental Cardiology Unit, AOU Sassari, Sassari,
Italy
(Eustachio) Cardiovascular Imaging Unit, San Raffaele Hospital,
Vita-Salute University, San Raffaele Milan, Milan, Italy
(Foldager) ESC Patient Forum, Denmark
(Hamm) Medical Clinic I, University of Giessen, Germany
(Hamm) Kerckhoff Heart Center, Bad Nauheim, Germany
(Iung) Cardiology Department, Bichat Hospital, Paris, France
(Mangner) Heart Centre Dresden, Department of Internal Medicine and
Cardiology, Technische Universitaet Dresden, Germany
(Mehilli) Landshut-Achdorf Hospital, Landshut, Germany
(Mehilli) Klinikum der Universitat Munchen,
Ludwig-Maximilians-Universitat, Germany. German Centre for Cardiovascular
Research (DZHK), partner site Munich Heart Alliance, Munich, Germany
(Murphy) University of Leicester NIHR Biomedical Research Unit, Leicester,
United Kingdom
(Mylotte) Department of Cardiology, University Hospital and National
University of Ireland Galway, Galway, Ireland
(Parma) Department of Cardiology and Structural Heart Diseases, Medical
University of Silesia, Katowice, Poland
(Petronio) Cardiothoracic and Vascular Dpt. University of Pisa, Italy
(Popescu) Department of Cardiology, University of Medicine and Pharmacy
"Carol Davila" -Euroecolab, Emergency Institute for Cardiovascular
Diseases "Prof. Dr C. C. Iliescu", Bucharest, Romania
(Sondergaard) Department of cardiology, Rigshospitalet, Copenhagen
University Hospital, Copenhagen, Denmark
(Teles) Hospital de Santa Cruz, CHLO, Nova Medical School, CEDOC, Lisbon,
Portugal
(Sabate) Department of Interventional Cardiology, Cardiovascular
Institute, Hospital Clinic, Institut d'Investigacions Biomediques August
Pi I Sunyer (IDIBAPS), Barcelona, Spain
(Terkelsen) Aarhus University Hospital & The Danish Heart Foundation,
Denmark
(Testa) IRCCS San Donato Hospital, Milan, Italy
(Wu) School of Dentistry, University of Leeds, Leeds, United Kingdom
(Maggioni) ANMCO Research Center-Heart Care Foundation, Florence, Italy
(Casadei) Division of Cardiovascular Medicine, NIHR Oxford Biomedical
Research Centre, University of Oxford, Oxford, United Kingdom
Publisher
NLM (Medline)
Abstract
AIMS: Standardized data definitions are necessary for the quantification
of quality of care and patient outcomes in observational studies and
randomised controlled trials (RCTs). The European Unified Registries for
Heart Care Evaluation and Randomised Trials (EuroHeart) project of the
European Society of Cardiology (ESC) aims to create pan-European data
standards for cardiovascular diseases and interventions, including
transcatheter aortic valve implantation (TAVI). METHODS AND RESULTS: We
followed the EuroHeart methodology for cardiovascular data standard
development. A Working Group of 29 members representing 12 countries was
established and included a patient representative, as well as experts in
the management of valvular heart disease from the European Association of
Percutaneous Cardiovascular Interventions (EAPCI), the European
Association of Cardiovascular Imaging (EACVI) and the Working Group on
Cardiovascular Surgery. We conducted a systematic review of the literature
and used a modified Delphi method to reach consensus on a final set of
variables. For each variable, the Working Group provided a definition,
permissible values and categorized the variable as mandatory (Level 1) or
additional (Level 2) based on its clinical importance and feasibility. In
total, 93 Level 1 and 113 Level 2 variables were selected, with the level
1 variables providing the dataset for registration of patients undergoing
TAVI on the EuroHeart IT platform. CONCLUSION(S): This document
provides details of the EuroHeart data standards for TAVI processes of
care and in-hospital outcomes. In the context of EuroHeart, this will
facilitate quality improvement, observational research, registry-based
RCTs and post-marketing surveillance of devices and
pharmacotherapies. Copyright © The Author(s) 2022. Published by
Oxford University Press on behalf of the European Society of Cardiology.

<84>
Accession Number
2020466213
Title
Immune checkpoint blockade for organ-transplant recipients with cancer: A
review.
Source
European Journal of Cancer. 175 (pp 326-335), 2022. Date of Publication:
November 2022.
Author
Runger A.; Schadendorf D.; Hauschild A.; Gebhardt C.
Institution
(Runger, Gebhardt) Department of Dermatology and Venereology, University
Hospital Hamburg-Eppendorf (UKE), Hamburg, Germany
(Schadendorf) Department of Dermatology, University Hospital Essen, Essen,
Germany
(Hauschild) Department of Dermatology, University Hospital
Schleswig-Holstein, Kiel, Germany
Publisher
Elsevier Ltd
Abstract
Clinical trials studying immune checkpoint inhibitors (ICIs) have excluded
immunocompromised patients, and little is known about the safety and
efficacy of immunotherapy for malignancies in this subset of patients.
Transplant organ recipients receiving ICIs face two distinct challenges:
First, immunotherapy may counteract immunosuppression and with that result
in transplant rejection. Second, immunosuppression may make immunotherapy
less effective. It remains unclear as to how commonly these seemingly
opposing treatment goals, immunosuppression for organ retention and immune
stimulation for effective immunotherapy, can be balanced to achieve
favourable outcomes. Given a lack of prospective clinical trials, we
reviewed the existing literature on this subject (case reports, case
series and previous reviews) and present here an updated analysis of
treatment outcomes from a total of 144 patients. This is, to our
knowledge, the most extensive review on this topic available today. We
found that an ideal outcome, meaning effective immunotherapy with retained
transplant was achieved in 30.8% of patients. The overall response rates
of immunotherapy were similar to non-immunocompromised cancer patients in
the reported cases, but publication bias may overestimate positive
outcomes. Contrary to expectation, tumour response rates were higher,
albeit not significantly, in patients who were able to retain their
transplanted organ, suggesting that it is possible to uncouple
immunosuppression and immune stimulation in these patients. One possible
strategy towards this goal may be to use mammalian target of rapamycin
(mTOR) inhibitors for immunosuppression, as patients whose
immunosuppressive regimen included an mTOR inhibitor had a 1.4-fold higher
rate of ideal outcomes (n.s.). Our data support a first line treatment
approach that aims for maintaining transplanted organs during ICI
treatment. Copyright © 2022 Elsevier Ltd

<85>
Accession Number
2014160428
Title
Dysphagia aortica.
Source
European Surgery - Acta Chirurgica Austriaca. 54(5) (pp 228-239), 2022.
Date of Publication: October 2022.
Author
Grimaldi S.; Milito P.; Lovece A.; Asti E.; Secchi F.; Bonavina L.
Institution
(Grimaldi, Milito, Lovece, Asti, Secchi, Bonavina) Department of
Biomedical Sciences for Health, Division of General and Foregut Surgery,
IRCCS Policlinico San Donato, University of Milan, Piazza Edmondo Malan,
San Donato Milanese, Milan 20097, Italy
(Secchi) Department of Radiology, IRCCS Policlinico San Donato, University
of Milan, Milan, Italy
Publisher
Springer Medizin
Abstract
Background: Dysphagia aortica is an umbrella term to describe swallowing
obstruction from external aortic compression secondary to a dilated,
tortuous, or aneurysmal aorta. We performed a systematic literature review
to clarify clinical features and outcomes of patients with dysphagia
aortica. Material(s) and Method(s): We searched PubMed, EMBASE, Web
of Science, and the Cochrane Library. The terms "aortic dysphagia,"
"dysphagia aortica," "dysphagia AND aortic aneurysm" were matched. We also
queried the prospectively updated database of our esophageal center to
identify patients with aortic dysphagia referred for diagnosis and
treatment over the past two decades. Result(s): A total of 57 studies
including 69 patients diagnosed with dysphagia aortica were identified,
and one patient from our center was added to the database. The mean age
was 72 years (range 22-98), and the male to female ratio 1.1:1. Of these
70 patients, the majority (n= 63, 90%) had an aortic aneurysm,
pseudoaneurysm, or dissection. Overall, 37 (53%) patients received an
operative treatment (81.1% a vascular procedure, 13.5% a digestive tract
procedure, 5.4% both procedures). Thoracic endovascular aortic repair
(TEVAR) accounted for 60% of all vascular procedures. The postoperative
mortality rate was 21.2% (n= 7/33). The mortality rate among patients
treated conservatively was 55% (n= 11/20). Twenty-six (45.6%) studies were
deemed at a high risk of bias. Conclusion(s): Dysphagia aortica is a
rare clinical entity with high morbidity and mortality rates and no
standardized management. Early recognition of dysphagia and a high
suspicion of aortoesophageal fistula may be lifesaving in this patient
population. Copyright © 2021, The Author(s).

<86>
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.

<87>
Accession Number
2020440574
Title
Primary left ventricular unloading with delayed reperfusion in patients
with anterior ST-elevation myocardial infarction: Rationale and design of
the STEMI-DTU randomized pivotal trial.
Source
American Heart Journal. 254 (pp 122-132), 2022. Date of Publication:
December 2022.
Author
Kapur N.K.; Kim R.J.; Moses J.W.; Stone G.W.; Udelson J.E.; Ben-Yehuda O.;
Redfors B.; Issever M.O.; Josephy N.; Polak S.J.; O'Neill W.W.
Institution
(Kapur, Udelson) Tufts Medical Center, Boston, MA
(Kim) Duke University Medical Center, Durham, NC
(Moses) Columbia University Irving Medical Center/NewYork-Presbyterian
Hospital, NY
(Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, NY
(Moses, Ben-Yehuda, Redfors, Issever) Cardiovascular Research Foundation,
NY
(Josephy, Polak) >Abiomed, Inc, Danvers, Massachusetts, United States
(Josephy) Massachusetts Institute of Technology, Cambridge, MA
(O'Neill) Henry Ford Hospital, Detroit, MI, United States
Publisher
Elsevier Inc.
Abstract
Background: Despite successful primary percutaneous coronary intervention
(PCI) in ST-elevation myocardial infarction (STEMI), myocardial salvage is
often suboptimal, resulting in large infarct size and increased rates of
heart failure and mortality. Unloading of the left ventricle (LV) before
primary PCI may reduce infarct size and improve prognosis. Study design
and objectives: STEMI-DTU (NCT03947619) is a prospective, randomized,
multicenter trial designed to compare mechanical LV unloading with the
Impella CP device for 30 minutes prior to primary PCI to primary PCI alone
without LV unloading. The trial aims to enroll approximately 668 subjects,
with a potential sample size adaptation, with anterior STEMI with a
primary end point of infarct size as a percent of LV mass evaluated by
cardiac magnetic resonance at 3-5 days after PCI. The key secondary
efficacy end point is a hierarchical composite of the 1-year rates of
cardiovascular mortality, cardiogenic shock >=24 hours after PCI, use of a
surgical left ventricular assist device or heart transplant, heart
failure, intra-cardiac defibrillator or chronic resynchronization therapy
placement, and infarct size at 3 to 5 days post-PCI. The key secondary
safety end point is Impella CP-related major bleeding or major vascular
complications within 30 days. Clinical follow-up is planned for 5 years.
 Conclusion(s): STEMI-DTU is a large-scale, prospective, randomized
trial evaluating whether mechanical unloading of the LV by the Impella CP
prior to primary PCI reduces infarct size and improves prognosis in
patients with STEMI compared to primary PCI alone without LV
unloading. Copyright © 2022

<88>
Accession Number
2020435410
Title
Neutrophil gelatinase-associated lipocalin (NGAL) in kidney injury - A
systematic review.
Source
Clinica Chimica Acta. 536 (pp 135-141), 2022. Date of Publication: 01 Nov
2022.
Author
Marakala V.
Institution
(Marakala) Department of Basic Medical Sciences, College of Medicine,
University of Bisha, Bisha 61922, Saudi Arabia
Publisher
Elsevier B.V.
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 Elsevier B.V.

<89>
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

<90>
Accession Number
2020227237
Title
Efficacy of comprehensive remote ischemic conditioning in elderly patients
with acute ST-segment elevation myocardial infarction underwent primary
percutaneous coronary intervention.
Source
Journal of Geriatric Cardiology. 19(6) (pp 435-444), 2022. Date of
Publication: 2022.
Author
Wang Y.-L.; Yang Q.; Hu C.-Y.; Chu Y.-Y.; Sun Z.; Zhao H.; Liu Z.
Institution
(Wang, Hu, Chu, Zhao, Liu) Department of Cardiology, Xuanwu Hospital,
Capital Medical University, Beijing, China
(Yang) Department of Radiology, Chaoyang Hospital, Capital Medical
University, Beijing, China
(Sun) Department of Radiology, Xuanwu Hospital, Capital Medical
University, Beijing, China
Publisher
Science Press
Abstract
BACKGROUND Remote ischemic conditioning (RIC) is used to protect against
myocardial injury. However, there is no adequate evidence for
comprehensive RIC in elderly patients with ST-segment elevation myocardial
infarction (STEMI). This study aimed to test whether comprehensive RIC,
started pre-primary percutaneous coronary intervention (PPCI) and repeated
daily on 1-30 days post-PPCI, can improve myocardial salvage index (SI),
left ventricular ejection fraction (LVEF), Kansas City Cardiomyopathy
Questionnaire Clinical Summary Score (KCCQ-CSS) and 6-min walk test
distance (6MWD) in elderly patients with acute STEMI during 12 months
follow-up. METHODS 328 consenting elderly patients were randomized to
receive standard PPCI plus comprehensive RIC (the treatment group) or
standard PPCI (the control group). SI at 5-7 days after PPCI, LVEF, left
ventricular end-diastolic volume index (LVEDVI), left ventricular
end-systolic volume index (LVESVI), KCCQ-CSS, 6MWD and adverse events
rates were measured and assessed. RESULTS SI was significantly higher in
the treatment group [interquartile range (IQR): 0.38-0.66, P = 0.037].
There were no significant differences in major adverse events at 12
months. Although the differences of LVEDVI, LVESVI and LVEF between the
treatment group and the control group did not reach statistical
significance at 6 months and 12 months, LVEF tended to be higher, LVEDVI
tended to be lower in the treatment group. The KCCQ-CSS was significantly
higher in the treatment group at 1 month (IQR: 46.5-87, P = 0.001) and 12
months (IQR: 55-93, P = 0.008). There was significant difference in 6MWD
between the treatment group and the control group (IQR: 258-360 vs. IQR:
250-345, P = 0.002) at 1 month and (IQR: 360-445 vs. IQR: 345-432, P =
0.035) at 12 months. A modest correlation was found between SI and LVEF (r
= 0.452, P < 0.01), KCCQ-CSS (r = 0.440, P < 0.01) and 6MWD (r = 0.384, P
< 0.01) respectively at 12 months. CONCLUSIONS The comprehensive RIC can
improve SI, KCCQ-CSS and 6MWD. It may be an adjunctive therapy to PPCI in
elderly patients with STEMI. Copyright © 2022 JGC All rights
reserved.

<91>
Accession Number
2020423582
Title
Inhaled Milrinone via HFNC as a Postextubation Cardiopulmonary Elixir:
Case Series and Review of Literature.
Source
Journal of Cardiac Critical Care. 6(2) (pp 126-130), 2022. Date of
Publication: 21 Sep 2022.
Author
Bansal N.; Magoon R.; Kalaiselvan J.; Shri I.; Kohli J.K.; Kashav R.C.
Institution
(Bansal, Magoon, Kalaiselvan, Shri, Kashav) Department of Cardiac
Anaesthesia, Atal Bihari Vajpayee Institute of Medical Sciences (ABVIMS),
Dr. Ram Manohar Lohia (RML) Hospital, Baba Kharak Singh Marg, New Delhi,
India
(Kohli) Department of Cardiac Anaesthesia, Dr. Ram Manohar Lohia (RML)
Hospital, Baba Kharak Singh Marg, New Delhi, India
Publisher
Thieme Medical and Scientific Publishers Pvt Ltd
Abstract
Pulmonary hypertension (PH) often complicates perioperative course
following pediatric cardiac surgery, often presenting unique challenges to
the attending cardiac anesthesiologist. Apart from difficult weaning from
cardiopulmonary bypass, PH can often compound weaning from mechanical
ventilation in this postoperative subset. From pathophysiological
standpoint, the former can be attributed to concurrent detrimental
cardiopulmonary consequences of PH as a multisystemic syndrome. Therefore,
with an objective to address the affected systems, that is, cardiac and
pulmonary simultaneously, we report combined use of inhaled milrinone (a
pulmonary vasodilator) through high-frequency nasal cannula (oxygen
reservoir and continuous positive airway pressure delivery device),
purported to complement each other's mechanism of action in the management
of PH, thereby hastening postoperative recovery. This article additionally
presents a nuanced perspective on the advantages of combining the
aforementioned therapies and hence proposing the same as a possible
postoperative cardiopulmonary elixir. Copyright © 2022. Official
Publication of The Simulation Society (TSS), accredited by International
Society of Cardiovascular Ultrasound (ISCU). All rights reserved.

<92>
Accession Number
2018442007
Title
Perioperative Hemodynamic Optimization in Patients at Risk for Delirium -
A Randomized-Controlled Trial.
Source
Frontiers in Medicine. 9 (no pagination), 2022. Article Number: 893459.
Date of Publication: 13 Jul 2022.
Author
Fuest K.E.; Servatius A.; Ulm B.; Schaller S.J.; Jungwirth B.; Blobner M.;
Schmid S.
Institution
(Fuest, Servatius, Ulm, Schaller, Jungwirth, Blobner, Schmid) Department
of Anesthesiology and Intensive Care, Technical University of Munich,
School of Medicine, Klinikum rechts der Isar, Munich, Germany
(Schaller) Department of Anesthesiology and Operative Intensive Care
Medicine, Charite - Universitatsmedizin Berlin, Freie Universitat Berlin,
Humboldt-Universitat zu Berlin and Berlin Institute of Health, Berlin,
Germany
(Jungwirth, Blobner, Schmid) Department of Anesthesiology and Intensive
Care Medicine, University Hospital Ulm, Ulm University, Ulm, Germany
Publisher
Frontiers Media S.A.
Abstract
Background: Post-operative delirium is common in elderly patients and
associated with increased morbidity and mortality. We evaluated in this
pilot study whether a perioperative goal-directed hemodynamic optimization
algorithm improves cerebral oxygenation and can reduce the incidence of
delirium. Material(s) and Method(s): Patients older than 70 years
with high risk for post-operative delirium undergoing elective non-cardiac
surgery were randomized to an intervention or control group. Patients in
the intervention group received a perioperative hemodynamic optimization
protocol based on uncalibrated pulse-contour analysis. Patients in the
control group were managed according to usual standard of care. Incidence
of delirium until day seven was assessed with confusion assessment method
(CAM) and chart review. Cerebral oxygenation was measured with
near-infrared spectroscopy. Result(s): Delirium was present in 13 of
85 (15%) patients in the intervention group and 18 of 87 (21%) in the
control group [risk difference -5.4%; 95% confidence interval, -16.8 to
6.1%; P = 0.47]. Intervention did not influence length of stay in hospital
or in-hospital mortality. Amounts of fluids and vasopressors applied, mean
arterial pressure, cardiac index, and near-infrared spectroscopy values
were comparable between groups. Conclusion(s): The hemodynamic
algorithm applied in high-risk non-cardiac surgery patients did not change
hemodynamic interventions, did not improve patient hemodynamics, and
failed to increase cerebral oxygenation. An effect on the incidence of
post-operative delirium could not be observed. Clinical Trial
Registration: [Clinicaltrials.gov], identifier
[NCT01827501]. Copyright © 2022 Fuest, Servatius, Ulm, Schaller,
Jungwirth, Blobner and Schmid.

<93>
Accession Number
2018288368
Title
Mortality and adverse events of hemoadsorption with CytoSorb in critically
ill patients: A systematic review and meta-analysis of randomized
controlled trials.
Source
Acta Anaesthesiologica Scandinavica. 66(9) (pp 1037-1050), 2022. Date of
Publication: October 2022.
Author
Heymann M.; Schorer R.; Putzu A.
Institution
(Heymann, Schorer, Putzu) Division of Anesthesiology, Department of Acute
Medicine, Geneva University Hospitals, Geneva, Switzerland
Publisher
John Wiley and Sons Inc
Abstract
Background: The effects and safety of extracorporeal hemoadsorption with
CytoSorb in critically ill patients with inflammatory conditions are
controversial. Method(s): We performed a systematic review with
meta-analysis and trial sequential analysis (TSA) of randomized-controlled
trials to assess the mortality and safety of CytoSorb therapy in
critically ill patients with inflammatory conditions. Electronic databases
were searched up to April 2022. The primary outcome was mortality at
longest follow-up and secondary outcomes included various adverse event
(AE) outcomes. Conflict of interest and funding of each trial were
assessed. We calculated relative risk (RR) and 95% confidence interval
(CI). Result(s): Fourteen published (n = 764) and 4 unpublished (n =
111) trials were included. Eight trials were performed in medical ICU
patients and 10 in complex cardiac surgery. Ten trials had significant
industrial funding or an author conflict of interest. Hemoadsorption with
CytoSorb was associated with higher mortality at latest follow-up (16
trials, n = 807, 120 of 402 [29.85%] patients in the CytoSorb group vs. 98
of 405 [24.20%] patients in the control group, RR = 1.24 [95% CI,
1.04-1.49], p =.02, [TSA-adjusted CI, 0.92-1.68]) and at 30-days or
in-hospital (11 trials, n = 727; RR = 1.41 [95% CI, 1.06-1.88], p =.02,
[TSA-adjusted CI, 0.44-4.62]). Only one trial reported the definition of
adverse event, while detailed results were reported in 3 trials; the risk
of adverse events was not higher with CytoSorb. Certainty of evidence
ranged from low to very low. Conclusion(s): Low certainty of evidence
showed that the use of CytoSorb might increase mortality in critically ill
patients with inflammatory conditions. Adverse events were frequent but
underreported and not systematically evaluated. Industrial funding and
conflict of interest were common. Considerable uncertainty about the
findings does not allow firm conclusions and suggests a need for
high-quality randomized trials to clarify mortality and adverse events
related to CytoSorb. Editorial Comment: Hemoadsorption with CytoSorb have
been used in critically ill patients despite lack of high quality data
from RCTs suggesting any patient-important benefits. The findings from
this systematic review and meta-analysis suggests an increased risk of
adverse events including mortality. With no apparent benefits and at the
same time risk of harm, use of hemoadsorption with CytoSorb in daily
clinical practice cannot be recommended at this time. Copyright ©
2022 The Authors. Acta Anaesthesiologica Scandinavica published by John
Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica
Foundation.

<94>
Accession Number
2019682889
Title
Outcomes of dexmedetomidine versus propofol sedation in critically ill
adults requiring mechanical ventilation: a systematic review and
meta-analysis of randomised controlled trials.
Source
British Journal of Anaesthesia. 129(4) (pp 515-526), 2022. Date of
Publication: October 2022.
Author
Heybati K.; Zhou F.; Ali S.; Deng J.; Mohananey D.; Villablanca P.;
Ramakrishna H.
Institution
(Heybati) Mayo Clinic Alix School of Medicine, Mayo Clinic - Rochester,
Rochester, MN, United States
(Zhou, Ali, Deng) Faculty of Health Sciences, McMaster University,
Hamilton, ON, Canada
(Ali) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Deng) Temerty Faculty of Medicine, University of Toronto, Toronto, ON,
Canada
(Mohananey) Department of Cardiology, Medical College of Wisconsin,
Milwaukee, WI, United States
(Villablanca) Department of Cardiology, Henry Ford Hospital, Detroit, MI,
United States
(Ramakrishna) Department of Anesthesiology and Perioperative Medicine,
Mayo Clinic - Rochester, Rochester, MN, United States
Publisher
Elsevier Ltd
Abstract
Background: Guidelines have recommended the use of dexmedetomidine or
propofol for sedation after cardiac surgery, and propofol monotherapy for
other patients. Further outcome data are required for these drugs.
 Method(s): This systematic review and meta-analysis was prospectively
registered on PROSPERO. The primary outcome was ICU length of stay.
Secondary outcomes included duration of mechanical ventilation, ICU
delirium, all-cause mortality, and haemodynamic effects. Intensive care
patients were analysed separately as cardiac surgical, medical/noncardiac
surgical, those with sepsis, and patients in neurocritical care. Subgroup
analyses based on age and dosage were conducted. Result(s): Forty-one
trials (N=3948) were included. Dexmedetomidine did not significantly
affect ICU length of stay across any ICU patient subtype when compared
with propofol, but it reduced the duration of mechanical ventilation (mean
difference -0.67 h; 95% confidence interval: -1.31 to -0.03 h; P=0.041;
low certainty) and the risk of ICU delirium (risk ratio 0.49; 95%
confidence interval: 0.29-0.87; P=0.019; high certainty) across cardiac
surgical patients. Dexmedetomidine was also associated with a greater risk
of bradycardia across a variety of ICU patients. Subgroup analyses
revealed that age might affect the incidence of haemodynamic side-effects
and mortality among cardiac surgical and medical/other surgical patients.
 Conclusion(s): Dexmedetomidine did not significantly impact ICU
length of stay compared with propofol, but it significantly reduced the
duration of mechanical ventilation and the risk of delirium in cardiac
surgical patients. It also significantly increased the risk of bradycardia
across ICU patient subsets. Copyright © 2022 British Journal of
Anaesthesia

<95>
Accession Number
2019540199
Title
Eicosapentaenoic Acid for Cardiovascular Events Reduction- Systematic
Review and Network Meta-Analysis of Randomized Controlled Trials: EPA and
cardiovascular outcomes.
Source
Journal of Cardiology. 80(5) (pp 416-422), 2022. Date of Publication:
November 2022.
Author
Yokoyama Y.; Kuno T.; Morita S.X.; Slipczuk L.; Takagi H.; Briasoulis A.;
Latib A.; Bangalore S.; Heffron S.P.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Bethlehem, PA, United States
(Kuno) Department of Medicine, Icahn School of Medicine at Mount Sinai,
Mount Sinai Beth Israel, New York, NY, United States
(Kuno, Slipczuk, Latib) Division of Cardiology, Montefiore Medical Center,
Albert Einstein College of Medicine, New York, NY, United States
(Morita) Division of Cardiology, Department of Medicine, Columbia
University Irving Medical Center/New York-Presbyterian Hospital, New York,
NY, United States
(Takagi) Department of Cardiovascular Surgery, Medical Center, Sunto-gun,
Shizuoka, Shizuoka, Japan
(Briasoulis) Division of Cardiovascular Diseases, University of Iowa
Hospitals and Clinics, Iowa City, IA, United States
(Bangalore, Heffron) Leon H. Charney Division of Cardiology, Department of
Medicine, NYU Grossman School of Medicine, New York, NY, United States
(Heffron) NYU Center for the Prevention of Cardiovascular Disease, New
York Langone Health, New York, NY, United States
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Background: Randomized clinical trials (RCTs) investigating the impact of
omega-3-fatty acid supplementation on cardiovascular events have largely
shown no benefit. However, there is debate about the benign nature of the
placebo in these trials. We aimed to conduct a network meta-analysis of
RCTs to compare the outcomes of omega-3 fatty acid supplementation to
various placebo oils. Method(s): MEDLINE and EMBASE were searched
through May, 2021 to identify RCTs investigating cardiovascular outcomes
with omega-3-fatty acid formulations [eicosapentaenoic acid (EPA),
decosahexanoic acid (DHA), or the combination] versus placebo or standard
of care controls. Result(s): Our analysis included 17 RCTs that
enrolled a total of 141,009 patients randomized to EPA (n=13,655), EPA+DHA
(n=56,908), mineral oil placebo (n=5,338), corn oil placebo (n =8,876),
olive oil placebo (n=41,009), and controls (no placebo oil; n=15,223).
Rates of cardiovascular death [hazard ratio (HR) (95% confidence interval,
CI) =0.80 (0.65-0.98); p =0.033], myocardial infarction [HR (95% CI) =0.73
(0.55-0.97); p=0.029] and stroke [HR (95% CI) =0.74 (0.58-0.94); p=0.014]
were significantly lower in those receiving EPA compared to those
receiving mineral oil, but were not different from rates in those
receiving other oils or controls. Rates of coronary revascularization were
significantly lower in those receiving EPA than in those receiving either
EPA+DHA, mineral oil, corn oil, or olive oil placebo, but not controls.
All-cause death was similar among all groups, but combined EPA+DHA was
associated with reduced risk of cardiovascular death compared to controls
[HR (95%CI): 0.83 (0.71-0.98)]. Conclusion(s): Our analyses
demonstrate that although EPA supplementation lowers risk of coronary
revascularization more than other oils, there may not be a benefit
relative to standard of care. Further, EPA reduces the risk of
cardiovascular events only in comparison to mineral oil and not when
compared with other placebo oils or controls. In contrast, combined
EPA+DHA was associated with reduced risk of cardiovascular death compared
to controls. Copyright © 2022 Elsevier Ltd

<96>
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.

<97>
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.

<98>
Accession Number
2018969711
Title
Impact of tight glycemic control and hypoglycemia after pediatric cardiac
surgery on neurodevelopmental outcomes at three years of age: Findings
from a randomized clinical trial.
Source
BMC Pediatrics. 22(1) (no pagination), 2022. Article Number: 531. Date of
Publication: December 2022.
Author
Sadhwani A.; Asaro L.A.; Goldberg C.S.; Ware J.; Butcher J.; Gaies M.;
Smith C.; Alexander J.L.; Wypij D.; Agus M.S.D.
Institution
(Sadhwani) Departments of Psychiatry and Behavioral Sciences, Boston
Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston,
MA 02115, United States
(Asaro, Wypij) Department of Cardiology, Boston Children's Hospital,
Boston, MA, United States
(Goldberg, Gaies, Smith) Division of Cardiology, C.S. Mott Children's
Hospital, Ann Arbor, MI, United States
(Goldberg, Butcher, Gaies) Department of Pediatrics, University of
Michigan Medical School, Ann Arbor, MI, United States
(Ware) Department of Medicine, Boston Children's Hospital and Harvard
Medical School, Boston, United States
(Butcher) Division of Pediatric Psychology, C.S. Mott Children's Hospital
and University of Michigan Medical School, Ann Arbor, MI, United States
(Alexander, Agus) Division of Medical Critical Care, Boston Children's
Hospital and Harvard Medical School, Boston, MA, United States
(Wypij) Department of Biostatistics, Harvard T.H. Chan School of Public
Health, Boston, MA, United States
Publisher
BioMed Central Ltd
Abstract
Background: Studies examining the impact of randomization As per standard
instruction, city is required for affiliations; however, this information
is missing in affiliation 6. Please check if the provided city is correct
and amend if necessary. to tight glycemic control (TGC) and resultant
hypoglycemia on later neurodevelopmental outcomes have produced mixed
results. Our study examined this association in children undergoing
cardiac surgery. Method(s): Participants who were enrolled in the
Safe Pediatric Euglycemia after Cardiac Surgery (SPECS) trial returned for
neurodevelopmental (ND) follow-up between 30 to 42.5 months of age. ND
outcomes were assessed using the Bayley Scales of Infant and Toddler
Development, Third Edition. ND scores were compared between the TGC and
standard care treatment groups and between patients with moderate to
severe and no to mild hypoglycemia. As a secondary analysis, to increase
sample size and power, we combined the three-year-old assessments with
previously collected assessments done at < 30 months of age to further
examine differences between groups longitudinally. Result(s): Among
the 269 participants who completed neurodevelopmental evaluation
(in-person testing or questionnaires) at three years of age (follow-up
rate, 31%), there were no statistically significant differences in ND
outcomes according to treatment group or hypoglycemia status. In the
combined analysis of all evaluations (from 9 to 42.5 months of age), we
found no treatment group differences. However, in these longitudinal
analyses, children who experienced moderate to severe hypoglycemia had
lower scores on the Bayley-III cognitive and motor domains compared to
children with no to mild hypoglycemia. Conclusion(s): For infants
undergoing cardiac surgery, there was no impact of tight glycemic control
on neurodevelopmental outcomes. Moderate to severe hypoglycemia was
associated with worse ND outcomes in longitudinal analyses. Trial
registration: ClinicalTrials.gov NCT00443599. Registered: November
2016. Copyright © 2022, The Author(s).

<99>
Accession Number
2018891930
Title
Mechanical Unloading of the Left Ventricle before Coronary Reperfusion in
Preclinical Models of Myocardial Infarction without Cardiogenic Shock: A
Meta-Analysis.
Source
Journal of Clinical Medicine. 11(16) (no pagination), 2022. Article
Number: 4913. Date of Publication: August 2022.
Author
Benenati S.; Crimi G.; Macchione A.; Giachero C.; Pescetelli F.; Balbi M.;
Porto I.; Vercellino M.
Institution
(Benenati, Porto) Cardiovascular Disease Chair, Department of Internal
Medicine (Di.M.I.), University of Genoa, Genoa 16132, Italy
(Crimi, Macchione, Giachero, Pescetelli, Balbi, Porto, Vercellino)
Cardiovascular Disease Unit, IRCCS Ospedale Policlinico San Martino, IRCCS
Italian Cardiology Network, Genova 16132, Italy
Publisher
MDPI
Abstract
Aim: to compare a conventional primary reperfusion strategy with a primary
unloading approach before reperfusion in preclinical studies.
 Method(s): we performed a meta-analysis of preclinical studies. The
primary endpoint was infarct size (IS). Secondary endpoints were left
ventricle end-diastolic pressure (LVEDP), mean arterial pressure (MAP),
heart rate (HR), cardiac output (CO). We calculated mean differences (MDs)
and associated 95% confidence intervals (CIs). Sensitivity and subgroup
analyses on the primary and secondary endpoints, as well as a
meta-regression on the primary endpoint using the year of publication as a
covariate, were also conducted. Result(s): 11 studies (n = 142) were
selected and entered in the meta-analysis. Primary unloading reduced IS
(MD -28.82, 95% CI -35.78 to -21.86, I2 96%, p < 0.01) and
LVEDP (MD -3.88, 95% CI -5.33 to -2.44, I2 56%, p = 0.02) and
increased MAP (MD 7.26, 95% CI 1.40 to 13.12, I2 43%, p < 0.01)
and HR (MD 5.26, 95% CI 1.97 to 8.55, I2 1%, p < 0.01), while
being neutral on CO (MD -0.11, 95% CI -0.95 to 0.72, I2 88%, p
= 0.79). Sensitivity and subgroup analyses showed, overall, consistent
results. The meta-regression on the primary endpoint demonstrated a
significant influence of the year of publication on effect estimate.
 Conclusion(s): in animal models of myocardial infarction, a primary
unloading significantly reduces IS and exerts beneficial hemodynamic
effects compared to a primary reperfusion. Copyright © 2022 by
the authors.

<100>
Accession Number
639170686
Title
Prediction model for delirium in patients with cardiovascular surgery:
development and validation.
Source
Journal of cardiothoracic surgery. 17(1) (pp 247), 2022. Date of
Publication: 01 Oct 2022.
Author
Xu Y.; Meng Y.; Qian X.; Wu H.; Liu Y.; Ji P.; Chen H.
Institution
(Xu, Meng, Qian, Wu, Liu, Ji) Departments of Cardiovascular Surgery
Intensive Care Unit, Affiliated Hospital of Nantong University, Nantong,
China
(Chen) School of Public Health, Nantong University, No.9 ,Sik Yuan Road,
Nantong, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: The aim of this study was to construct a nomogram model for
discriminating the risk of delirium in patients undergoing cardiovascular
surgery. METHOD(S): From January 2017 to June 2020, we collected data
from 838 patients who underwent cardiovascular surgery at the Affiliated
Hospital of Nantong University. Patients were randomly divided into a
training set and a validation set at a 5:5 ratio. A nomogram model was
established based on logistic regression. Discrimination and calibration
were used to evaluate the predictive performance of the model.
 RESULT(S): The incidence of delirium was 48.3%. A total of 389
patients were in the modelling group, and 449 patients were in the
verification group. Logistic regression analysis showed that CPB duration
(OR [Formula: see text] 1.004, 95% CI: 1.001-1.008, [Formula: see text]
0.018), postoperative serum sodium (OR [Formula: see text] 1.112, 95% CI:
1.049-1.178, [Formula: see text] 0.001), age (OR [Formula: see text]
1.027, 95% CI: 1.006-1.048, [Formula: see text] 0.011), and postoperative
MV (OR [Formula: see text] 1.019, 95% CI: 1.008-1.030, [Formula: see text]
0.001) were independent risk factors. The results showed that AUC[Formula:
see text] was 0.712 and that the 95% CI was 0.661-0.762. The
Hosmer-Lemeshow goodness of fit test showed that the predicted results of
the model were in good agreement with the actual situation ([Formula: see
text] 6.200, [Formula: see text] 0.625). The results of verification
showed that the AUC[Formula: see text] was 0.705, and the 95% CI was
0.657-0.752. The Hosmer-Lemeshow goodness of fit test results were
[Formula: see text] 8.653 and [Formula: see text] 0.372, indicating that
the predictive effect of the model is good. CONCLUSION(S): The
establishment of the model provides accurate and objective assessment
tools for medical staff to start preventing postoperative delirium in a
purposeful and focused manner when a patient enters the CSICU after
surgery. Copyright © 2022. The Author(s).

<101>
Accession Number
637530711
Title
Pacemaker implantation after sutureless or stented valve: results from a
controlled randomized trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 62(4) (no pagination),
2022. Date of Publication: 02 Sep 2022.
Author
Lorusso R.; Ravaux J.M.; Pollari F.; Folliguet T.A.; 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.; Fischlein T.
Institution
(Lorusso, Ravaux) Cardio-Thoracic Surgery Department, Heart & Vascular
Centre, Maastricht University Medical Center+ (MUMC+), Maastricht,
Netherlands
(Lorusso, Ravaux) Cardiovascular Research Institute Maastricht (CARIM),
Maastricht, Netherlands
(Pollari, Pfeiffer, Fischlein) Department of Cardiac Surgery,
Cardiovascular Center, Paracelsus Medical University-Klinikum Nurnberg,
Nuremberg, Germany
(Folliguet) Department of Cardiac Surgery & Transplantation, Assistance
Publique, Hopital Henri Mondor, Paris, France
(Kappert) Department of Cardiac Surgery, Dresden Heart Centre University
Hospital, Dresden University of Technology, Dresden, Germany
(Meuris, Rega) Cardiac Surgery Department, Universitaire Ziekenhuizen
Leuven, Leuven, Belgium
(Shrestha) Department of Thoracic and Cardiovascular Surgery, Hannover
Medical School, Hannover, Germany
(Roselli) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Bonaros) Department of Cardiac Surgery, Innsbruck Medical University,
Innsbruck, Austria
(Fabre) Department of Cardiac Surgery of Artois, Hospital Center of Lens,
Lens, France
(Fabre) Department of Cardiac Surgery, Bois Bernard Private Hospital,
Ramsay Generale de Sante, Lens, France
(Corbi) Department of Thoracic and Cardiovascular Surgery, Cardio-Vascular
Center, University Hospital of Poitiers, Poitiers, France
(Troise) Division of Cardiac Surgery, Poliambulanza Foundation, Brescia,
Italy
(Andreas) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Pinaud) Department of Cardiac Surgery, CHU d'Angers, University Hospital
Angers, Angers, France
(Kueri) Department of Cardiovascular Surgery, University Heart Center
Freiburg Bad Krozingen, Bad Krozingen, Germany
(Kueri) Department of Cardiovascular Surgery, University Heart Center,
Albert-Ludwigs-Universitat Freiburg, Bad Krozingen, Germany
(Tan) Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven,
Netherlands
(Voisine) Department of Surgery, Universite Laval, Quebec, QC, Canada
(Voisine) Division of Cardiac Surgery, Department of Cardiology, Institut
Universitaire de Cardiologie et de Pneumologie de Quebec (IUCPQ), Quebec,
QC, Canada
(Girdauskas) Department of Cardiovascular Surgery, University Heart and
Vascular Center Hamburg, Hamburg, Germany
(Rega) Division of Experimental Cardiac Surgery, Department of
Cardiovascular Sciences, University of Leuven, Leuven, Belgium
(Garcia-Puente) Department of Cardiac Surgery, Hospital Universitario
Virgen de la Arraixaca, Murcia, Spain
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Sutureless aortic valves demonstrated non-inferiority to
standard stented valves for major cardiovascular and cerebral events at 1
year after aortic valve replacement. We aim to assess the factors
correlating with permanent pacemaker implantation (PPI) in both cohorts.
 METHOD(S): PERSIST-AVR is a prospective, randomized, open-label
trial. Patients undergoing aortic valve replacement were randomized to
receive a sutureless aortic valve replacement (Su-AVR) or stented sutured
bioprosthesis (SAVR). Multivariable analysis was performed to identify
possible independent risk factors associated with PPI. A logistic
regression analysis was performed to estimate the risk of PPI associated
to different valve size. RESULT(S): The 2 groups (Su-AVR; n = 450,
SAVR n = 446) were well balanced in terms of preoperative risk factors.
Early PPI rates were 10.4% in the Su-AVR group and 3.1% in the SAVR. PPI
prevalence correlated with valve size XL (P = 0.0119) and preoperative
conduction disturbances (P = 0.0079) in the Su-AVR group. No predictors
were found in the SAVR cohort. Logistic regression analysis showed a
significantly higher risk for PPI with size XL compared to each individual
sutureless valve sizes [odds ratio (OR) 0.272 vs size S (95%confidence
interval 0.07-0.95), 0.334 vs size M (95% CI 0,16-0; 68), 0.408 vs size L
(95% CI 0,21-0.81)] but equivalent risk of PPI rates for all other
combination of valve sizes. CONCLUSION(S): Su-AVR is associated with
higher PPI rate as compared to SAVR. However, the increased PPI rate
appears to be size-dependent with significant higher rate only for size
XL. The combination of preoperative conduction disorder and a size XL can
lead to a higher probability of early PPI in Su-AVR. CLINICAL TRIAL
REGISTRATION NUMBER: NCT02673697. Copyright © The Author(s) 2022.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved.

<102>
Accession Number
2019845400
Title
Parasternal Intercostal Nerve Blocks in Patients Undergoing Cardiac
Surgery: Evidence Update and Technical Considerations.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(11) (pp 4173-4182),
2022. Date of Publication: November 2022.
Author
Schiavoni L.; Nenna A.; Cardetta F.; Pascarella G.; Costa F.; Chello M.;
Agro F.E.; Mattei A.
Institution
(Schiavoni, Pascarella, Costa, Agro, Mattei) Anesthesia, Intensive Care
and Pain Management, Universita Campus Bio-Medico di Roma, Rome, Italy
(Nenna, Cardetta, Chello) Cardiac Surgery, Universita Campus Bio-Medico di
Roma, Rome, Italy
Publisher
W.B. Saunders
Abstract
In the Enhanced Recovery After Surgery era, parasternal intercostal nerve
block has been proposed to improve pain control and reduce opioid use in
patients undergoing cardiac surgery. However current literature has
reported conflicting evidence about the effect of this multimodal pain
management, as procedural variations might pose a significant bias on
outcomes evaluation. In this setting, the infiltration of the parasternal
plane into 2 intercostal spaces, second and fifth, with a local anesthetic
spread under or above the costal plane with ultrasound guidance, seem to
be standardized in theory, but significant differences might be observed
in clinical practice. This narrative review summarizes and defines the
optimal techniques for parasternal plane blocks in patients undergoing
cardiac surgery with full median sternotomy, considering both
pectointercostal fascial block and transversus thoracic plane block. A
total of 10 randomized trials have been published, in adjunct to
observational studies, which are heterogeneous in terms of techniques,
methods, and outcomes. Parasternal block has been shown to reduce
perioperative opioid consumption and provide a more favorable analgesic
profile, with reduced postoperative opioid-related side effects. A trend
toward reduced intensive care unit stay or duration of mechanical
ventilation should be confirmed by adequately powered randomized trials or
registry studies. Differences in operative technique might impact outcomes
and, therefore, standardization of the procedure plays a pivotal role
before reporting specific outcomes. Parasternal plane blocks might
significantly improve outcomes of cardiac surgery with full median
sternotomy, and should be introduced comprehensively in Enhanced Recovery
After Surgery protocols. Copyright © 2022 Elsevier Inc.

<103>
Accession Number
2019788424
Title
Randomized controlled trial between conventional versus sutureless
bioprostheses for aortic valve replacement: Impact of mini and full
sternotomy access at 1-year follow-up.
Source
International Journal of Cardiology. 368 (pp 56-61), 2022. Date of
Publication: 01 Dec 2022.
Author
Fischlein T.; Caporali E.; 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.; Lorusso R.
Institution
(Fischlein, Pfeiffer) Klinikum Nurnberg, Cardiovascular Center, Paracelsus
Medical University, Nuremberg, Germany
(Caporali) Cardiology, Istituto Cardiocentro Ticino, EOC, Lugano,
Switzerland
(Caporali) Cardiac Surgery, Istituto Cardiocentro Ticino, EOC, Lugano,
Switzerland
(Folliguet) Department of Cardiac Surgery, Hopital Henri Mondor,
Universite Paris 12, Creteil, Paris, France
(Kappert) Herzzentrum Dresden GmbH Universitatsklinik, Dresden, Germany
(Meuris, Rega) UZ Gasthuisberg Leuven, University Hospital, Leuven,
Belgium
(Shrestha) Hannover Medical School, Hannover, Germany
(Roselli) Heart, Vascular and Thoracic Institute, Cleveland Clinic,
Cleveland, OH, United States
(Bonaros) Medical University of Innsbruck, Innsbruck, Austria
(Fabre) Lens Hospital and Bois Bernard Private Hospital, Lens, France
(Corbi) Poitiers University Hospital, Poitiers, France
(Troise) Cardiac Surgery, Poliambulanza Foundation Hospital, Brescia,
Italy
(Andreas) 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, Canada
(Girdauskas) University Heart Center Hamburg, Universitatsklinikum Hamburg
Eppendorf (UKE), Hamburg, Germany
(Garcia-Puente) University General Hospital Virgen de la Arrixaca, Murcia,
Spain
(Lorusso) Cardio-Thoracic Surgery Department, Heart and Vascular Center,
Maastricht University Medical Center (MUMC+), Cardiovascular Research
Institute Maastricht (CARIM), Maastricht, Netherlands
Publisher
Elsevier Ireland Ltd
Abstract
Background: The present study is a sub-analysis of the multicenter,
randomized PERSIST-AVR trial (PERceval Sutureless Implant versus Standard
Aortic Valve Replacement) comparing the in-hospital and 1-year results of
sutureless versus conventional stented bioprostheses in isolated surgical
aortic valve replacement (SAVR) within two different surgical approaches:
mini-sternotomy (MS) and full-sternotomy (FS). Method(s): A total of
819 patients (per-protocol population) underwent preoperative
randomization to sutureless or stented biological valve at 47 centers
worldwide. Sub-analysis on isolated SAVR was performed. Results were
compared between sutureless and stented within the two different surgical
approaches. Result(s): 285 patients were implanted with Perceval (67%
in MS) and 293 with stented valves (65% in MS). Sutureless group showed
significantly reduced surgical times both in FS and MS. In-hospital
results show no differences between Perceval and stented valves in FS,
while a lower incidence of new-onset of atrial fibrillation (3.7% vs
10.8%) with Perceval in MS. After 1-year, use of sutureless valve showed a
significant reduction of MACCE (5.2% vs 10.8%), stroke rate (1.0% vs
5.4%), new-onset of atrial fibrillation (4.2% vs 11.4%) and
re-hospitalizations (21.8 days vs 47.6 days), compared to stented valves
but presented higher rate of pacemaker implantation (11% vs 1.6%).
 Conclusion(s): Sutureless bioprosthesis showed significantly reduced
procedural times during isolated SAVR in both surgical approaches.
Patients with sutureless valves and MS access showed also better 1-year
outcome regarding MACCEs, stroke, re-hospitalization and new-onset atrial
fibrillation, but presented a higher rate of permanent pacemaker
implantation compared to patients with stented
bioprosthesis. Copyright © 2022 Elsevier B.V.

<104>
Accession Number
2019735493
Title
Geographic disparity in 10-year mortality after coronary artery
revascularization in the SYNTAXES trial.
Source
International Journal of Cardiology. 368 (pp 28-38), 2022. Date of
Publication: 01 Dec 2022.
Author
Kageyama S.; Serruys P.W.; Garg S.; Ninomiya K.; Masuda S.; Kotoku N.;
Colombo A.; Mack M.J.; Banning A.P.; Morice M.-C.; Witkowski A.; Curzen
N.; Burzotta F.; James S.; van Geuns R.-J.; Davierwala P.M.; Holmes D.R.;
Wood D.A.; McEvoy J.W.; Onuma Y.
Institution
(Kageyama, Serruys, Ninomiya, Masuda, Kotoku, McEvoy, Onuma) Department of
Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland
(Serruys, Wood) National Heart and Lung Institute, Imperial College
London, London, United Kingdom
(Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn,
United Kingdom
(Colombo) Department of Biomedical Sciences, Humanitas University, Pieve
Emanuele-Milan, Italy
(Mack) Department of Cardiothoracic Surgery, Baylor University Medical
Center, Dallas, TX, United States
(Banning) Department of Cardiology, John Radcliffe Hospital, Oxford
University Hospitals, Oxford, United Kingdom
(Morice) Departement of Cardiologie, Hopital prive Jacques Cartier,
Generale de Sante Massy, France
(Witkowski) Department of Interventional Cardiology and Angiology,
National Institute of Cardiology, Warsaw, Poland
(Curzen) Faculty of Medicine, University of Southampton, Southampton, &
Cardiothoracic Unit, University Hospital Southampton NHS Trust,
Southampton, United Kingdom
(Burzotta) Institute of Cardiology, Fondazione Policlinico Universitario
A. Gemelli IRCCS, Universita Cattolica del Sacro Cuore, Rome, Italy
(James) Department of Medical Sciences, Uppsala University, Sweden
(van Geuns) Department of Cardiology, Radboud University Medical Centre,
Nijmegen, Netherlands
(Davierwala) Department of Surgery, University of Toronto, Toronto, Canada
Division of Cardiovascular Surgery, Peter Munk Cardiac Centre, Toronto
General Hospital, Canada
(Davierwala) University Health Network, Toronto, ON, Canada
(Holmes) Department of Cardiovascular Diseases and Internal Medicine, Mayo
Clinic, Rochester, MN, United States
(Wood, McEvoy) National Institute of Prevention and Cardiovascular Health,
National University of Ireland, Galway, Ireland
(Colombo) Humanitas Clinical and Research Center IRCCS, Rozzano-Milan,
Italy
Publisher
Elsevier Ireland Ltd
Abstract
Aims: To investigate geographic disparity in long-term mortality following
revascularization in patients with complex coronary artery disease (CAD).
 Methods and Results: The SYNTAXES trial randomized 1800 patients with
three-vessel and/or left main CAD to percutaneous coronary intervention
(PCI) or coronary artery bypass grafting (CABG) and assessed their
survival at 10 years. Patients were stratified according to the region of
recruitment: North America (N-A, n = 245), Eastern Europe (E-E, n = 189),
Northern Europe (N-E, n = 425), Southern Europe (S-E, n = 263), and
Western Europe (W-E, n = 678), which also served as the reference group.
Compared to W-E, patients were younger in E-E (62 vs 65 years, p < 0.001),
and less frequently male in N-A (65.3% vs 79.6%, p < 0.001). Diabetes
(16.0% vs 25.4%, p < 0.001) and peripheral vascular disease (6.8% vs
10.9%, p = 0.025) were less frequent in N-E than W-E. Ejection fraction
was highest in W-E (62% vs 56%, p < 0.001). Compared to W-E, the mean
anatomic SYNTAX score was higher in S-E (29 vs 31, p = 0.008) and lower in
N-A (26, p < 0.001). Crude ten-year mortality was similar in N-A (31.6%),
and W-E (30.7%), and significantly lower in E-E (22.5%, p = 0.041), N-E
(21.9%, p = 0.003) and S-E (22.0%, p = 0.014). Compared to W-E, adjusted
mortality in N-E (HR 0.85, p = 0.019) and S-E (HR 0.72, p = 0.043) remain
significantly lower after adjustment for pre- and peri-procedural factors,
but no significant interaction (P<inf>interaction</inf> = 0.728) between
region and modality of revascularization was seen. Conclusion(s): In
the era of globalization, knowledge, and understanding of geographic
disparity are of paramount importance for the correct interpretation of
global studies. Copyright © 2022 Elsevier B.V.

<105>
Accession Number
2019734952
Title
A Comparative Study of Bilateral Erector Spinae Block Versus Intravenous
Dexmedetomidine for Perioperative Pain Management in Patients Undergoing
Off-Pump Coronary Artery Bypass Grafting - A Single-Blind Randomized
Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(11) (pp 4085-4092),
2022. Date of Publication: November 2022.
Author
Kodali V.R.K.; Shree S.; Prasad M.; Sambandam K.K.G.; Karthekeyan R.B.;
Vakamudi M.
Institution
(Kodali, Vakamudi) Department of Anaesthesiology, Sri Ramachandra
Institute of Higher Education and Research (SRIHER), Chennai, India
(Shree, Prasad, Sambandam, Karthekeyan) Department of Cardiac
Anaesthesiology, Sri Ramachandra Institute of Higher Education and
Research (SRIHER), Chennai, India
Publisher
W.B. Saunders
Abstract
Objective: Regional analgesia, along with general anesthesia, reduce
postoperative pain. In this study, the authors compared the erector spinae
plane (ESP) block having dexmedetomidine as an adjuvant with conventional
pain management along with intravenous dexmedetomidine. Design(s):
Prospective randomized single-blinded trial. Setting(s): Tertiary
care teaching hospital. Participant(s): All of the patients scheduled
for elective off-pump coronary artery bypass grafting with an ejection
fraction of >45%. Intervention(s): After obtaining institutional
ethical committee approval, 130 patients were randomized into Group E and
Group D. Group E patients received ESP block bilaterally with 25 mL of
bupivacaine plus 0.5 mug/kg of dexmedetomidine. The patients in Group D
received conventional intravenous analgesia, as well as a 0.7 mug/kg of
dexmedetomidine bolus, followed by a 0.3 mug/kg dexmedetomidine infusion
during surgery and continued postoperatively for 24 hours. Group E
patients received 8 mL/h of bupivacaine infusion bilaterally for 24 hours.
Measurements: The primary outcome assessed was pain scores in the
postoperative period. The secondary outcomes assessed were postoperative
rescue analgesic consumption, time to first rescue analgesia,
intraoperative fentanyl consumption, duration of mechanical ventilation,
and duration of intensive care unit (ICU) stay. Result(s): Both
groups were comparable in demographic characteristics. The postoperative
pain scores from 4 hours to 12 hours were lower in Group E compared with
Group D. The pain scores at 24 hours were not significantly different
between groups. Postoperative fentanyl consumption in Group E (99.23 +/-
50.19 mug) was significantly lower than in Group D (181.15 +/- 82.92 mug),
with a p value of 0.001. Time to first rescue analgesia was significantly
longer in Group E, with a median score of 8 hours when compared with that
of 4 hours in Group D, with a p value of 0.01. Intraoperative fentanyl
consumption was significantly lower in Group E (392.15 +/- 55.36 mug)
compared with Group D (604.00 +/- 131.87 mug; p = 0.001). There were no
significant differences in the duration of mechanical ventilation in both
groups. Duration of ICU stay was significantly lower in Group E (51.95 +/-
8.54 hours) when compared with Group D (59.06 +/- 8.68 hours) (p = 0.001).
 Conclusion(s): Erector spinae fascial plane blocks appeared to reduce
postoperative pain scores in off-pump coronary artery bypass graft
patients. Furthermore, ESP block was beneficial in terms of less
intraoperative and postoperative opioid consumption, longer time to first
rescue analgesia, and shorter ICU stay. Copyright © 2022 Elsevier
Inc.

<106>
Accession Number
2018962374
Title
Effect of ventilation mode on postoperative pulmonary complications
following lung resection surgery: a randomised controlled trial.
Source
Anaesthesia. 77(11) (pp 1219-1227), 2022. Date of Publication: November
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.

<107>
Accession Number
2016448775
Title
Coronary Stenting: Reflections on a 35-Year Journey.
Source
Canadian Journal of Cardiology. 38(10 Supplement 1) (pp S17-S29), 2022.
Date of Publication: October 2022.
Author
Strauss B.H.; Tanguay J.-F.; Picard F.; Doucet S.; Morice M.-C.;
Elbaz-Greener G.
Institution
(Strauss, Elbaz-Greener) Schulich Heart Program, Sunnybrook Health
Sciences Centre, Toronto, ON, Canada
(Strauss) University of Toronto, Toronto, ON, Canada
(Tanguay, Doucet) Montreal Heart Institute, University of Montreal,
Montreal, QC, Canada
(Picard) Cardiology Department, Assistance Publique-Hopitaux de Paris,
Paris, Hopital Cochin, France
(Morice) Department of Cardiology, Institut Hospitalier Jacques Cartier,
Ramsay Generale de Sante, Massy, France
(Elbaz-Greener) Department of Cardiology Hadassah Medical Center, Faculty
of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
Publisher
Elsevier Inc.
Abstract
Stenting was introduced as a therapy for coronary artery disease 35 years
ago, and is currently the most commonly performed minimally invasive
procedure globally. Percutaneous coronary revascularization, initially
with plain old balloon angioplasty and later with stenting, has
dramatically affected the outcomes of acute myocardial infarction and
acute coronary syndromes. Coronary stenting is probably the most
intensively studied therapy in medicine on the basis of the number of
randomized clinical trials for a broad range of indications. Continuous
improvements in stent materials, design, and coatings concurrent with
procedural innovations have truly been awe-inspiring. The story of
stenting is replete with high points and some low points, such as the
initial experience with stent thrombosis and restenosis, and the more
recent disappointment with bioabsorbable scaffolds. History has shown
rapid growth of stent use with expansion of indications followed by
contraction of some uses in response to clinical trial evidence in support
of bypass surgery or medical therapy. In this review we trace the
constantly evolving story of the coronary stent from the earliest
experience until the present time. Undoubtedly, future iterations of stent
design and materials will continue to move the stent story
forward. Copyright © 2021 Canadian Cardiovascular Society

<108>
Accession Number
2020486099
Title
Comparison Among Ultrasound-Guided Thoracic Paravertebral Block, Erector
Spinae Plane Block and Serratus Anterior Plane Block for Analgesia in
Thoracotomy for Lung Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2022.
Date of Publication: 2022.
Author
Das S.; Saha D.; Sen C.
Institution
(Das, Saha, Sen) Department of Cardiac Anaesthesiology, I.P.G.M.E&R and
S.S.K.M. Hospital, Kolkata, India
Publisher
W.B. Saunders
Abstract
Background: To compare the analgesic efficacy and safety of preoperative,
single-shot ultrasound-guided thoracic paravertebral block (TPVB), erector
spinae plane block (ESB), and serratus anterior plane block (SAPB) in
thoracotomy pain. Design(s): A prospective, randomized study.
 Setting(s): The cardiothoracic operating room and intensive care unit
of a tertiary-care hospital in India. Participant(s): Ninety adult
patients scheduled to undergo posterolateral thoracotomy for lung surgery
under general anesthesia were recruited and randomized into 3 equal
groups. Intervention(s): Preoperatively, the patients received
ultrasound-guided, single-shot nerve blocks within their respective
groups, as follows: Erector spinae plane block in the ESB group, Thoracic
paravertebral block in the TPVB group, and Serratus anterior plane block
in the SAPB group. Measurements and Results: The primary outcome measure,
the visual analog scale (VAS) score, was recorded postoperatively in the
intensive care unit at 0, 3, 6, 12, and 24 hours. The secondary outcome
measures were the time to first rescue analgesic, total rescue opioid dose
used, patient satisfaction at 24 hours, success of one-time attempt, and
occurrence of adverse events. Data were statistically analyzed and a
significant difference was found in the VAS score at all time points, the
time to rescue analgesic and total opioid dosage, and patient satisfaction
level (p < 0.05) among the groups with only 1 incidence of hypotension in
the TPVB group. From post hoc analysis, ESB was found to have better
analgesic efficacy compared with TPVB and SAPB. Serratus anterior plane
block was found to be least efficacious and shortest acting among the
three. Conclusion(s): The nerve blocks in decreasing order of
analgesic efficacy in relieving post-thoracotomy pain would be ESB, TPVB,
and SAPB. Copyright © 2022 Elsevier Inc.

<109>
Accession Number
639187367
Title
Unique Treatment of Duodenal Perforation in Middle Aged Female Patient
with Liver Transplant.
Source
American Journal of Transplantation. Conference: 2022 American Transplant
Congress, ATC 2022. Boston, MA United States. 22(Supplement 3) (pp
713-714), 2022. Date of Publication: June 2022.
Author
Elshebiny H.; Syed-Mohammed J.
Institution
(Elshebiny) Wayne State University, School of Medicine, Detroit, MI,
United States
(Syed-Mohammed) Henry Ford Health System, Detroit, MI, United States
Publisher
Blackwell Publishing Ltd
Abstract
Purpose: We describe a unique method of treatment of duodenal perforation
due to biliary stent using an over the scope clip-OTSC. Method(s): A
68 year old female with a history of hepatitis B induced cirrhosis, and
hepatic cancer was treated with a liver transplant. Postoperative course
indicated high liver function labs, and endoscope retrograde
echolangiopancreatography- ERCP showed an anastomotic biliary stricture,
and donor-recipient duct mismatch. Sphincterotomy and placement of a stent
treated the stricture. At night, the patient developed gastrointestinal-GI
symptoms and was found to have post-ERCP pancreatitis confirmed by
amylase=520IU/L. She was given IV fluid until the pancreatitis resolved. A
few days later, the patient visited the hospital again with worsening GI
pain, anorexia, and fever. Physical exam showed pain radiating from the
epigastrium to the right upper quadrant, back, and right flank area.
Computerized Topography(CT) scans demonstrated a large abscess collection
extending into the right paracolic gutter, and right perirenal fat with
the biliary stent(BS) extending through the second portion of the duodenum
into this collection, suggesting perforation of the duodenum due to the BS
inserted. After draining the abscess percutaneously, the patient underwent
esophagogastroendoscopy which showed the migration of the BS that resulted
in the perforation of the duodenal wall by the distal end of the stent.
The BS was removed, and the duodenal defect was closed with an OTSC. ERCP
was then performed with placement of a double pigtail BS for treatment of
patient's initial biliary anastomotic stricture. Result(s): After the
OTSC, the patient's symptoms improved and returned on a regular diet.
However, she later developed multiple cardiac abnormalities including
sinus tachycardia on both Lead II, V1. ECG has also shown dilated left
ventricle, ventricle failure, elevated Troponin I, and elevated pulmonary
artery pressure. Abdomen CT showed contrast within the duodenal cavity
concerning for persistent leak. The duodenal perforation was small,
however the presence of endoscopic over the scope mucosal clip was
identified and was believed to be maintaining a minor patency of the track
from duodenal to retroperitoneal abscess that had been drained for some
months by the biliary pigtail. Conclusion(s): Omental patch is the
common treatment for post-ERCP pancreatitis and an abdominal lavage, which
is a surgical procedure for treating perforated ulcers. In our case, the
duodenal perforation was closed using an OTSC (non-surgical). In a
retrospective study, it was found that using the OTSC offered a safer
treatment option for patients with non-variceal upper GI bleeding with
cardiovascular comorbidity. Another systematic review shows the OTSC
effectiveness of treatment for defects in the abdomen created by
endoscopic resections and stent fixation. We add to the research the case
of our patient, who did this procedure but developed cardiac symptoms.

<110>
Accession Number
639187253
Title
Estimating the Effect of Increased Donor Heart Ischemic Time on
Post-Transplant Survival Using Instrumental Variables.
Source
American Journal of Transplantation. Conference: 2022 American Transplant
Congress, ATC 2022. Boston, MA United States. 22(Supplement 3) (pp 834),
2022. Date of Publication: June 2022.
Author
Ran G.; Lazenby K.; Narang N.; Parker W.F.
Institution
(Ran, Lazenby) Pritzker School of Medicine, University of Chicago,
Chicago, IL, United States
(Narang) Department of Medicine, University of Illinois-Chicago, Chicago,
IL, United States
(Parker) Department of Medicine, University of Chicago, Chicago, IL,
United States
Publisher
Blackwell Publishing Ltd
Abstract
Purpose: Isolate the impact of organ ischemic time on post-transplant
survival using the recent change in heart allocation policy as a natural
experiment. Method(s): We examined heart transplants occurring prior
to (11/01/2016 - 10/31/2017) and after the policy change (11/01/2018 -
10/31/2019). The exposure of our interest is the receipt of a graft with
extended (>4 hours) cold ischemic time. Using an instrumental variable
(IV) model, we isolated the effect of graft ischemic time on one-year
post-transplant mortality by addressing bias from unobserved confounders.
We also controlled for observed characteristics of donors and transplant
recipients. Result(s): There were N = 3418 recipients in the
post-policy period compared with N = 3278 recipients in the pre-policy
period. Demographic variables (age, diagnosis, comorbidities) were similar
in both cohorts. An additional 10% of heart recipients post-policy change
received an organ with > 4 hours ischemic time compared to the pre-policy
period (15% pre vs. 25% post, F-value = 116). Without addressing
unobserved confounders, 1-year post-transplant survival was significantly
worse among those who received graft with prolonged ischemic time
(adjusted HR: 1.43, in green, P < 0.001). By using the policy period as an
instrument to eliminate unobserved confounders, we found no difference in
survival between those whose grafts sustained < 4 hours ischemic time and
those whose graft had longer ischemic time solely due to the policy change
(adjusted HR: 0.689, in blue, P = 0.73). Conclusion(s): For heart
transplant recipients who were "randomized" to grafts with > 4 hours of
ischemic time by changes in heart allocation policy, we found no effect on
survival within the first year of transplantation.

<111>
Accession Number
639181544
Title
Renal and cardiac effects of remote ischemic preconditioning in children
undergoing cardiopulmonary bypass surgery.
Source
Cardiology in the Young. Conference: 55th Annual Meeting of the
Association for European Paediatric and Congenital Cardiology, AEPC 2022.
Geneva Switzerland. 32(Supplement 2) (pp S47-S48), 2022. Date of
Publication: August 2022.
Author
Law Y.; Katz R.; Hsu C.; Hingorani S.; McMullan D.M.; Howard J.; Rong T.;
Michael R.; Jonathan H.
Institution
(Law, Hingorani, McMullan, Howard, Michael) Seattle Children's Hospital,
United States
(Katz, Hsu, Rong, Jonathan) University of Washington School of Medicine,
United States
Publisher
Cambridge University Press
Abstract
Background and Aim: Children undergoing cardiac surgery are at risk for
AKI and cardiac dysfunction affecting outcome. Improved surgical
techniques and post-operative care allow better outcomes in complex
repairs and at-risk patients. Opportunity exists in further protecting
multiple end organ function with remote ischemic preconditioning (RIPC)
given promising but mixed data in adults and children. Hypothesis: A
non-invasive technique of inducing reversible lower extremity ischemia
with inflation of pressure cuff lessens renal and myocardial injury.
 Method(s): A single center randomized, placebo controlled, double
blinded trial of RIPC in children undergoing cardiac surgery of RACHS-I
category 2 or greater. RIPC was performed in the operating room after
anesthesia and before sternotomy. Pre-speci-fied end points are change in
creatinine, eGFR, development of AKI, B-type natriuretic peptide and
Troponin I at 6, 12, 241 48, 72 hours post separation from bypass.
Secondary end points included select clinical outcomes. Result(s):
There were 45 in the RIPC and 39 patients in the control group: age was
3.5 and 3.8 years, respectively; 57 patients below 1 year of age; 35
patients below 1 month of age. There was no differ-ence between groups in
creatinine, cystatin C, eGFR at each time points. There was a trend for a
larger rate of decrease, especially for cystatin C (p = 0.042) in the RIPC
group but the magnitude was small. AKI was observed in 21 (54%) of control
and 16 (36%) of RIPC group (p = 0.094). Adjusting for baseline creatinine,
the odds ratio for AKI in in RIPC compared to control group was 0.31 (p =
0.037). Adjusted for clinical characteristics, the odds ratio was 0.34 (p
= 0 056). Peak troponin occurred at 6 hrs. Compared to control, the RIPC
group had a lower troponin at 6 hrs (p = 0.140). However, no difference in
other analyses of troponin and B*type natriuretic peptides between the
groups. Length of stay, all-cause mortality, systolic function by
echocardiography and composite clinical end points of advanced renal and
heart fail-ure were not different between groups. Conclusion(s):
There is suggestion of RIPC delivering renal protec-tion in an at-risk
pediatric population. Additional larger, higher risk population studies
will be required to fully determine its efficacy.

<112>
Accession Number
639181141
Title
Family-centered early motor intervention in infants with complex
congenital heart disease: Protocol for a randomized controlled pilot
trial.
Source
Cardiology in the Young. Conference: 55th Annual Meeting of the
Association for European Paediatric and Congenital Cardiology, AEPC 2022.
Geneva Switzerland. 32(Supplement 2) (pp S240), 2022. Date of Publication:
August 2022.
Author
Mitteregger E.; Dirks T.; Theiler M.; Kretschmar O.; Latal B.
Institution
(Mitteregger, Latal) Child Development Center, Children's Research Center,
University Children's Hospital Zurich, Switzerland
(Mitteregger, Latal) University of Zurich, Switzerland
(Dirks) Paediatric Physiotherapy, Groningen, Netherlands
(Theiler) Swiss Parents' Assoc. for the Child with Heart Disease
(Elternvereinigung fur das Herzkranke Kind), Switzerland
(Kretschmar) Department of Pediatric Cardiology, University Children's
Hospital Zurich, Switzerland
Publisher
Cambridge University Press
Abstract
Background and Aim: Children with congenital heart disease (CHD) are at
risk for developmental impairments. Motor developmental delay is the first
to become visible during the first year of life. Several studies have
investigated the neuromotor development in children with CHD. However,
only few interventional studies exist that aim to improve neuromotor
development in infants after open heart surgery within the first year of
life. Study results are inconclusive due to their low level of evidence.
The aim of our study is to conduct a tailored family centered early motor
intervention promoting motor development in infants with CHD.
 Method(s): This prospective, single centre randomized controlled
pilot study will investigate an early motor intervention compared to
standard of care for infants with CHD after open-heart surgery.
Participants will be 20 infants with CHD aged 3-5 months, who underwent
open heart surgery within the first months of life. Infants will be
randomly allocated to the intervention or control group. Infants assigned
to the intervention group will receive fam-ily-centered early motor
intervention for a duration of 3 months. The intervention promotes
infants' self-initiated motor activities, parents' attendance and active
involvement and support transac-tions between child, parents, and
therapist. Infants assigned to the control group will receive standard of
care. Specific assessments will measure infants' motor outcome and
parents' and infants' quality of life with a set of questionnaires at
baseline, post-treat-ment and at a follow-up at 12 months of age. The
primary out-come of this study is the Infants Motor Profile. Secondary
outcomes include the Alberta Infant Motor Scale and the Bayley Scales of
Infant and Toddler Development 3rd version. Parental questionnaires
evaluate socioeconomic status, parental physical and psychological
experience, parental empowerment, and parents' and infants' health related
quality of life. Result(s): This pilot study will be evaluated by
linear regression analyses to investigate between group, within subject
differences across treatment groups and associations between motor
develop-ment, and parents' and infants' health related quality of life.
 Conclusion(s): This protocol will provide a foundation for a
random-ized clinical trial for a family-centered early motor intervention
for infants after open heart surgery.

<113>
Accession Number
639180742
Title
Paediatric brain mri findings following congenital heart surgery: A
systematic review.
Source
Cardiology in the Young. Conference: 55th Annual Meeting of the
Association for European Paediatric and Congenital Cardiology, AEPC 2022.
Geneva Switzerland. 32(Supplement 2) (pp S90-S91), 2022. Date of
Publication: August 2022.
Author
Alablani F.; Asia Chan H.S.; Beishon L.; Patel N.; Almudayni A.; Bulock
F.; Chung E.M.
Institution
(Alablani, Asia Chan, Beishon) Cerebral Haemodynamics in Aging and Stroke
Medicine (CHIASM) Group, Department of Cardiovascular Sciences, University
of Leicester, Leicester LE2 7RH, United Kingdom
(Almudayni) College of Applied Medical Sciences, Prince Sattam Bin
Abdulaziz University, Kharj 11942, Saudi Arabia
(Patel) Department of Clinical Neuroscience, St George's, University of
London, London SW17 0RE, United Kingdom
(Bulock) University Hospitals of Leicester NHS Trust, Leicester LE1 5WW,
United Kingdom
(Chung) National Institute for Health Research Leicester Biomedical
Research Centre, Leicester LE5 4PW, United Kingdom
Publisher
Cambridge University Press
Abstract
Background and Aim: This systematic review aimed to establish the relative
incidence of new post-operative brain MRI findings fol-lowing paediatric
congenital cardiac surgery. Method(s): To distinguish perioperative
changes from pre-existing MR findings, our systematic search strategy
focused on identifying original research studies reporting both pre-and
post-surgery brain MRI scans. Patient demographics, study methods, and
brain MR findings were extracted. Result(s): Twenty-one eligible
publications, including two case-control, and one randomised controlled
trial were identified. Pre-existing brain MRI findings were noted in 43%
(513/1205) of neonates prior to surgery; mainly white matter injuries
(WMI). Surgery was performed at a median age of 8 days with comparison of
pre-and post-operative MR scans revealing addi-tional new post-operative
findings in 51% (550/1075) of patients; mainly WMI. Four studies adopted a
brain injury scoring system, but the majority did not indicate the
severity or time course of findings. In a sub-group analysis approximately
32% of patients with pre-existing lesions went on to develop additional
new lesions post-surgery. Pre-existing findings was not found to confer a
higher risk of acquiring brain lesions post-operatively. No evi-dence was
identified linking new MR findings with neurodeve-lopmental delay.
 Conclusion(s): This review and meta-analysis suggests that surgery
approximately doubles the number of patients with new brain lesions.

<114>
Accession Number
639180511
Title
A rare cardiac neoplasm: Case report of a cardiac angiosarcoma, review of
literature.
Source
Virchows Archiv. Conference: 34th European Congress of Pathology. Basel
Switzerland. 481(Supplement 1) (pp S203), 2022. Date of Publication:
September 2022.
Author
Balaban E.B.; Cikrikcioglu M.; Akgok Y.K.; Ketenci B.; Aker F.
Institution
(Balaban) Haydarpasa Numune Training and Research Hospital, Department of
Pathology, Turkey
Publisher
Springer
Abstract
Background & objectives: Primary cardiac malignancies are rare. Although
angiosarcomas are rare soft tissue tumours, they are the most common
primary cardiac malignancy. Method(s): In this study, we present a
case of primary cardiac angiosarcoma in a 24-year-old female patient. The
patient presented with complaints of chest pain and shortness of breath.
Following clinical and radiological evaluation, primary cardiac mass was
surgically removed. Result(s): Pathological examination revealed a
mesenchymal tumour with areas of haemorrhage and necrosis, solid and
vessel-like areas, composed of atypical cells. Immunohistochemical
examination showed diffuse and strong staining with CD31, ERG and FLI1.
With these findings, it was diagnosed as angiosarcoma. Although our case
was limited to the heart during surgery, lung and pleural metastases were
arisen in the postoperatively 5th month despite chemotherapy. Currently
she is in the postoperatively 10th month and her follow-up is continued.
 Conclusion(s): Cardiac angiosarcomas have a poor prognosis and a
fatal course, because they are metastatic at the time of diagnosis and
show rapid progression. Early diagnosis and surgical resection can improve
the survival.

<115>
[Use Link to view the full text]
Accession Number
2020554670
Title
Sugammadex for reversing neuromuscular blockages after lung surgery: A
systematic review and meta-analysis.
Source
Medicine (United States). 101(39) (pp E30876), 2022. Date of Publication:
30 Sep 2022.
Author
Yang J.-L.; Chen K.-B.; Shen M.-L.; Hsu W.-T.; Lai Y.-W.; Hsu C.-M.
Institution
(Yang, Chen, Hsu, Hsu) Department of Anesthesiology, China Medical
University Hospital, 40447 No.2, Yude Rd., North Dist., Taichung City
40447, Taiwan (Republic of China)
(Yang, Chen, Shen, Hsu, Lai, Hsu) Department of Anesthesiology, College of
Medicine, China Medical University, Taichung, Taiwan (Republic of China)
(Shen) Department of Anesthesiology, Taichung Tzu-Chi Hospital, Taichung,
Taiwan (Republic of China)
(Lai) Department of Nursing, China Medical University Hospital, Taichung,
Taiwan (Republic of China)
Publisher
Lippincott Williams and Wilkins
Abstract
Background: This study determined whether sugammadex was associated with a
lower risk of postoperative pulmonary complications and improved outcomes
in lung surgeries. Method(s): A systematic literature search was
conducted using PubMed, Embase, Web of Science, and the Cochrane Library
from January 2000 to March 2022. The characteristics of lung surgeries
using sugammadex treatment compared with control drugs and postoperative
outcomes were retrieved. The primary outcome was estimated through a
pooled odds ratio (OR) and its 95% confidence interval (CI) was identified
using a random-effects model. Result(s): From 465 citations, 7
studies with 453 patients receiving sugammadex and 452 patients receiving
a control were included. The risk of postoperative pulmonary complication
(PPCs) was lower in the sugammadex group than in the control group. Also,
it showed that the effect of sugammadex on PPCs in the subgroup analysis
was significantly assessed on the basis of atelectasis or non-atelectasis.
Furthermore, subgroup analysis based on the relationship between high body
mass index (BMI) and PPCs also showed that sugammadex had less occurrence
in both the high BMI (defined as BMI>=25) and low BMI groups. No
difference in length of hospital stay (LOS) between the two groups was
observed. Conclusion(s): This study observed that although reversing
neuromuscular blockages with sugammadex in patients undergoing thoracic
surgery recorded fewer PPCs and shorter extubation periods than
conventional reversal agents, no difference in LOS, postanaesthesia care
unit (PACU) stay length and chest tube insertion duration in both groups
was observed. Copyright © 2022 the Author(s).

<116>
Accession Number
2019398719
Title
Point-of-care platelet function testing for guided transfusion in
neurosurgical management of intracranial hemorrhage: a systematic review.
Source
European Journal of Medical Research. 27(1) (no pagination), 2022. Article
Number: 191. Date of Publication: December 2022.
Author
Xu F.W.X.; Lim N.-A.; Sim M.A.; Lean L.L.; Loh N.-H.W.; Ng K.T.; Chua
V.T.Y.; Chew S.T.H.; Ti L.K.
Institution
(Xu, Lim) Yong Loo Lin School of Medicine, National University of
Singapore, Singapore, Singapore
(Lean) Department of Anesthesia, Ng Teng Fong General Hospital, Singapore,
Singapore
(Ng) Department of Anesthesiology, Faculty of Medicine, University of
Malaya, Kuala Lumpur, Malaysia
(Sim, Chua, Chew) Department of Anesthesia, Singapore General Hospital,
Singapore, Singapore
(Loh, Chua, Ti) Department of Anesthesia, National University Hospital,
Singapore, Singapore
(Ti) Department of Anesthesia, Yong Loo Lin School of Medicine, National
University of Singapore, Singapore, Singapore
Publisher
BioMed Central Ltd
Abstract
Given the rising prevalence of antiplatelet therapy, rapid preoperative
identification of patients with bleeding diathesis is necessary for the
guidance of blood product administration. This is especially relevant in
neurosurgery for intracranial hemorrhage (ICH), where indiscriminate
transfusions may lead to further hemorrhagic or thromboembolic injury.
Point-of-care (POC) testing of platelet function is a promising solution
to this dilemma, as it has been proven effective in cardiac surgery.
However, to date, POC platelet function testing in neurosurgery has not
been extensively evaluated. This systematic review appraises the use of
POC platelet function test (PFT) in emergency neurosurgery in terms of its
impact on patient outcomes. A comprehensive search was conducted on four
electronic databases (Pubmed, MEDLINE, Embase, and Cochrane) for relevant
English language articles from their respective inceptions until 1 June
2022. We included all randomized controlled trials and cohort studies that
met the following inclusion criteria: (i) involved adult patients
undergoing neurosurgery for ICH; (ii) evaluated platelet function via POC
PFT; (iii) reported a change in perioperative blood loss; and/or (iv)
reported data on treatment-related adverse events and mortality.
Assessment of study quality was conducted using the Newcastle Ottawa
Quality Assessment Scale for Cohort Studies and Case-Control Studies, and
the JBI Critical Appraisal Checklist for Case Series. The search yielded
2,835 studies, of which seven observational studies comprising 849
patients met the inclusion criteria for this review. Overall, there is
evidence that the use of POC PFT to assess bleeding risk reduced bleeding
events, thromboembolic adverse outcomes, and the length of
hospitalization. However, there is currently insufficient evidence to
suggest that using POC PFT improves blood product use, functional outcomes
or mortality. Copyright © 2022, The Author(s).

<117>
Accession Number
2019346185
Title
Machine learning in predicting cardiac surgery-associated acute kidney
injury: A systemic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 951881. Date of Publication: 15 Sep 2022.
Author
Song Z.; Yang Z.; Hou M.; Shi X.
Institution
(Song, Yang, Hou) Qinghai University Medical School, Xining, China
(Hou, Shi) Qinghai University Affiliated Hospital Intensive Care Unit,
Xining, China
Publisher
Frontiers Media S.A.
Abstract
Background: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a
common complication following cardiac surgery. Early prediction of CSA-AKI
is of great significance for improving patients' prognoses. The aim of
this study is to systematically evaluate the predictive performance of
machine learning models for CSA-AKI. Method(s): Cochrane Library,
PubMed, EMBASE, and Web of Science were searched from inception to 18
March 2022. Risk of bias assessment was performed using PROBAST. Rsoftware
(version 4.1.1) was used to calculate the accuracy and C-index of CSA-AKI
prediction. The importance of CSA-AKI prediction was defined according to
the frequency of related factors in the models. Result(s): There were
38 eligible studies included, with a total of 255,943 patients and 60
machine learning models. The models mainly included Logistic Regression (n
= 34), Neural Net (n = 6), Support Vector Machine (n = 4), Random Forest
(n = 6), Extreme Gradient Boosting (n = 3), Decision Tree (n = 3),
Gradient Boosted Machine (n = 1), COX regression (n = 1), kappaNeural Net
(n = 1), and Naive Bayes (n = 1), of which 51 models with intact recording
in the training set and 17 in the validating set. Variables with the
highest predicting frequency included Logistic Regression, Neural Net,
Support Vector Machine, and Random Forest. The C-index and accuracy wer
0.76 (0.740, 0.780) and 0.72 (0.70, 0.73), respectively, in the training
set, and 0.79 (0.75, 0.83) and 0.73 (0.71, 0.74), respectively, in the
test set. Conclusion(s): The machine learning-based model is
effective for the early prediction of CSA-AKI. More machine learning
methods based on noninvasive or minimally invasive predictive indicators
are needed to improve the predictive performance and make accurate
predictions of CSA-AKI. Logistic regression remains currently the most
commonly applied model in CSA-AKI prediction, although it is not the one
with the best performance. There are other models that would be more
effective, such as NNET and XGBoost. Systematic review registration:
https://www.crd.york.ac.uk/; review registration ID:
CRD42022345259. Copyright © 2022 Song, Yang, Hou and Shi.

<118>
Accession Number
2019095688
Title
PRE-OPerative ECHOcardiograhy for prevention of cardiovascular events
after non-cardiac surgery in intermediate- and high-risk patients:
protocol for a low-interventional, mixed-cohort prospective study design
(PREOP-ECHO).
Source
Trials. 23(1) (no pagination), 2022. Article Number: 776. Date of
Publication: December 2022.
Author
Kim E.K.; Choi H.-M.; Choi E.-Y.; Lee H.S.; Park G.; Han D.W.; Lee S.-E.;
Park C.S.; Hwang J.-W.; Choi J.H.; Kim M.-N.; Kim H.-K.; Kim D.-H.; Shin
S.-H.; Sohn I.S.; Shin M.-S.; Na J.O.; Cho I.; Lee S.H.; Park Y.H.; Park
T.-H.; Kim K.H.; Cho G.-Y.; Jung H.O.; Park D.-G.; Hong J.Y.; Kang D.-H.
Institution
(Kim) Division of Cardiology, Department of Medicine, Cardiovascular
Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center,
Sungkyunkwan University School of Medicine, Seoul, South Korea
(Choi, Cho) Department of Cardiology, Cardiovascular Center, Seoul
National University Bundang Hospital, Seoul National University College of
Medicine, Gyeonggi-do, Seongnam, South Korea
(Choi) Division of Cardiology, Gangnam Severance Hospital, Yonsei
University College of Medicine, 211 Eonju-Ro, Gangnam-Gu, Seoul 06273,
South Korea
(Lee, Park) Biostatistics Collaboration Unit, Yonsei University College of
Medicine, Seoul, South Korea
(Han) Department of Anesthesiology and Pain Medicine, Yonsei University
College of Medicine, Seoul, South Korea
(Lee) Division of Cardiology, Department of Internal Medicine, Ewha Womans
University College of Medicine, Seoul, South Korea
(Park) Department of Cardiology, Bucheon St. Mary's Hospital, The Catholic
University College of Medicine, Bucheon, South Korea
(Hwang) Division of Cardiology, Department of Medicine, Ilsan Paik
Hospital, Inje University School of Medicine, Goyang, South Korea
(Choi) Division of Cardiology, Hallym University Dongtan Sacred Heart
Hospital, Hwaseong, South Korea
(Kim) Division of Cardiology, Korea University Anam Hospital, Seoul, South
Korea
(Kim) Division of Cardiology, Cardiovascular Center, Department of
Internal Medicine, Seoul National University College of Medicine, Seoul,
South Korea
(Kim, Kang) Department of Cardiology, Asan Medical Center, Ulsan
University College of Medicine, Seoul, South Korea
(Shin) Division of Cardiology, Inha University Medical Center, Incheon,
South Korea
(Sohn) Department of Cardiology, Cardiovascular Center, Kyung Hee
University Hospital at Gangdong, Seoul, South Korea
(Shin) Division of Cardiology, Department of Internal Medicine, Gil
Medical Center, Gachon University College of Medicine, Incheon, South
Korea
(Na) Cardiovascular Center, Korea University Guro Hospital, Seoul, South
Korea
(Cho) Division of Cardiology, Severance Cardiovascular Hospital, Yonsei
University College of Medicine, Seoul, South Korea
(Lee) Division of Cardiology, Department of Internal Medicine, Jeonbuk
National University Medical School, Jeonju, South Korea
(Park) Division of Cardiology, Department of Internal Medicine, Pusan
National University Yangsan Hospital, Yangsan, South Korea
(Park) Department of Cardiology, Dong-A University College of Medicine,
Busan, South Korea
(Kim) Department of Cardiovascular Medicine, Chonnam National University
Hospital, Gwangju, South Korea
(Jung) Division of Cardiology, Department of Internal Medicine, Seoul St.
Mary's Hospital, College of Medicine, The Catholic University of Korea,
Seoul, South Korea
(Park) Department of Internal Medicine, Kangdong Sacred Heart Hospital,
Hallym University, Seoul, South Korea
(Hong) Division of Cardiology, Hallym University Sacred Heart Hospital,
Hallym University College of Medicine, Anyang, South Korea
Publisher
BioMed Central Ltd
Abstract
Background: Cardiac evaluation using transthoracic echocardiography before
noncardiac surgery is common in real-world practice. However, evidence
supporting preoperative echocardiography is lacking. This study aims to
evaluate the additional benefit of preoperative echocardiography in
predicting postoperative cardiovascular events (CVE) in noncardiac
surgery. Method(s): This study is designed as a multicenter,
prospective study to assess the utility of preoperative echocardiography
in patients undergoing intermediate- or high-risk noncardiac surgery. This
trial comprises two studies: (1) a randomized controlled trial (RCT) for
patients undergoing intermediate-risk surgery with fewer than three
clinical risk factors from the revised cardiac risk index
(intermediate-risk group) and (2) a prospective cohort study for patients
undergoing intermediate-risk surgery with three or more clinical risk
factors, or who undergo high-risk surgery regardless of the number of
clinical risk factors (high-risk group). We hypothesize that the use of
preoperative echocardiography will reduce postoperative CVEs in patients
undergoing intermediate- to high-risk surgery through discovery of and
further intervention for unexpected cardiac abnormalities before elective
surgery. A total of 2330 and 2184 patients will be enrolled in the two
studies. The primary endpoint is a composite of all-cause death; aborted
sudden cardiac arrest; type I acute myocardial infarction; clinically
diagnosed unstable angina; stress-induced cardiomyopathy; lethal
arrhythmia, such as sustained ventricular tachycardia or ventricular
fibrillation; and/or newly diagnosed or acutely decompensated heart
failure within 30 days after surgery. Discussion(s): This study will
be the first large-scale prospective study examining the benefit of
preoperative echocardiography in predicting postoperative CVE. The
PREOP-ECHO trial will help doctors identify patients at risk of
postoperative CVE using echocardiography and thereby reduce postoperative
CVEs. Trial registration: The Clinical Research Information Service
KCT0006279 for RCT and KCT0006280 for prospective cohort study. Registered
on June 21, 2021. Copyright © 2022, The Author(s).

<119>
Accession Number
2020439435
Title
Intestinal microbiome changes in an infant with right atrial isomerism and
recurrent necrotizing enterocolitis: A case report and review of
literature.
Source
World Journal of Clinical Cases. 10(29) (pp 10583-10599), 2022. Date of
Publication: 16 Oct 2022.
Author
Kaplina A.; Zaikova E.; Ivanov A.; Volkova Y.; Alkhova T.; Nikiforov V.;
Latypov A.; Khavkina M.; Fedoseeva T.; Pervunina T.; Skorobogatova Y.;
Volkova S.; Ulyantsev V.; Kalinina O.; Sitkin S.; Petrova N.
Institution
(Kaplina, Fedoseeva, Petrova) Research Laboratory of Physiology and
Diseases of Newborns, Almazov National Medical Research Centre,
St.Petersburg 197341, Russian Federation
(Zaikova, Kalinina) Research Laboratory of Autoimmune and Autoinflammatory
Diseases, Almazov National Medical Research Centre, St.Petersburg 197341,
Russian Federation
(Ivanov, Ulyantsev) International Laboratory of Computer Technologies,
ITMO University, St.Petersburg 197101, Russian Federation
(Volkova, Latypov) Department of Cardiovascular Surgery for Children,
Almazov National Medical Research Centre, St.Petersburg 197341, Russian
Federation
(Alkhova) Department of Neonatal Physiology with an ICU Ward, Almazov
National Medical Research Centre, St.Petersburg 197341, Russian Federation
(Nikiforov) Pediatric Cardiac Intensive Care Unit, Almazov National
Medical Research Centre, St.Petersburg 197341, Russian Federation
(Khavkina) Neonatal and Preterm Special Care Unit (2nd Stage Care),
Almazov National Medical Research Centre, St.Petersburg 197341, Russian
Federation
(Pervunina) Institute of Perinatology and Pediatrics, Almazov National
Medical Research Centre, St.Petersburg 197341, Russian Federation
(Skorobogatova) Express Laboratory of Perinatal Centre, Almazov National
Medical Research Centre, St. Petersburg, St.Petersburg 197341, Russian
Federation
(Volkova) Clinical Diagnostic Laboratory, Almazov National Medical
Research Centre, St.Petersburg 197341, Russian Federation
(Sitkin) Epigenetics and Metagenomics Group, Institute of Perinatology and
Pediatrics, Almazov National Medical Research Centre, St.Petersburg
197341, Russian Federation
(Sitkin) Department of Internal Diseases, Gastroenterology and Dietetics,
North-Western State Medical University named after I.I. Mechnikov,
St.Petersburg 191015, Russian Federation
Publisher
Baishideng Publishing Group Inc
Abstract
Necrotizing enterocolitis (NEC) is a multifactorial disease that
predominantly affects premature neonates. Intestinal dysbiosis plays a
critical role in NEC pathogenesis in premature neonates. The main risk
factor for NEC in term infants is mesenteric hypoperfusion associated with
ductaldependent congenital heart disease (CHD) that eventually leads to
intestinal ischemia. The incidence of NEC in neonates with critical CHD is
6.8%-13%. However, the role of the intestinal microbiome in NEC
pathogenesis in infants with ductal-dependent CHD remains unclear. CASE
SUMMARY A male term neonate with right atrial isomerism underwent modified
Blalock-Taussig shunt placement on the 14th day of life and had persistent
mesenteric hypoperfusion after surgery. The patient had episodes of NEC
stage IIA on the 1st and 28th days after cardiac surgery. Fecal microbial
composition was analyzed before and after cardiac surgery by sequencing
region V4 of the 16S rRNA gene. Before surgery, species belonging to
genera Veillonella and Clostridia and class Gammaproteobacteria were
detected, Bifidobacteriaceae showed a low abundance. The first NEC episode
was associated with postoperative hemodynamic instability, intestinal
ischemiareperfusion injury during cardiopulmonary bypass, and a high
abundance of Clostridium paraputrificum (Clostridium sensu stricto I)
(56.1%). Antibacterial therapy after the first NEC episode resulted in
increased abundance of Gammaproteobacteria, decreased abundance of
Firmicutes, and low alpha diversity. These changes in the microbial
composition promoted the growth of Clostridium sensu stricto I (72.0%)
before the second NEC episode. CONCLUSION A high abundance of Clostridium
sensu stricto I and mesenteric hypoperfusion may have contributed to NEC
in the present case. Copyright © 2022 Baishideng Publishing Group
Inc. All rights reserved.

<120>
[Use Link to view the full text]
Accession Number
2020420650
Title
Intravenous lidocaine for the management of traumatic rib fractures: A
double-blind randomized controlled trial (INITIATE program of research).
Source
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, Ball) Department of Medicine
(Vogt) Department of Surgery
(Vogt, Priestap) Western University; Trauma Program, London Health
Sciences Centre, United Kingdom
(Parry, Ball) Office of Academic Military Medicine
(Ball) Department of Epidemiology and Biostatistics, Western University,
London, ON, Canada
Publisher
Lippincott Williams and Wilkins
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.
METHODS 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. RESULTS
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 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 © Wolters Kluwer Health, Inc. All rights
reserved.

<121>
Accession Number
2020486867
Title
Effect of Ventilation Strategy During Cardiopulmonary Bypass on Arterial
Oxygenation and Postoperative Pulmonary Complications After Pediatric
Cardiac Surgery: A Randomized Controlled Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2022.
Date of Publication: 2022.
Author
Elhaddad A.M.; Youssef M.F.; Ebad A.A.; Abdelsalam M.S.; Kamel M.M.
Institution
(Elhaddad, Youssef, Ebad, Abdelsalam, Kamel) Department of Anesthesia,
Kasr Alainy, Cairo University/Abo Elreesh Children's Hospital, via Al Kasr
Al Aini, Cairo Governorate, Old Cairo, Egypt
Publisher
W.B. Saunders
Abstract
Objectives: To compare the effects of 3 ventilation strategies during
cardiopulmonary bypass (CPB) on arterial oxygenation and postoperative
pulmonary complications (PPCs). Design(s): A prospective, randomized,
controlled study. Setting(s): A single-center tertiary teaching
hospital. Participant(s): One hundred twenty pediatric patients
undergoing elective repair of congenital acyanotic heart diseases with
CPB. Intervention(s): Patients were assigned randomly into 3 groups
according to ventilation strategy during CPB as follows: (1) no mechanical
ventilation (NOV), (2) continuous positive airway pressure (CPAP) of 5
cmH<inf>2</inf>O, (3) low tidal volume (LTV), pressure controlled
ventilation (PCV), respiratory rate (RR) 20-to-30/min, and peak
inspiratory pressure adjusted to keep tidal volume (Vt) 2 mL/kg.
 Measurements and Main Results: The PaO<inf>2</inf>/fraction of
inspired oxygen (F<inf>I</inf>O<inf>2</inf>) ratio and PaO<inf>2</inf>
were higher in the 5 minutes postbypass period in the LTV group but were
nonsignificant. The PaO<inf>2</inf>/F<inf>I</inf>O<inf>2</inf> ratio and
PaO<inf>2</inf> were significant after chest closure and 1 hour after
arrival to the intensive care unit with a higher
PaO<inf>2</inf>/F<inf>I</inf>O<inf>2</inf> ratio and PaO<inf>2</inf> in
the LTV group. Regarding the oxygenation index, the LTV group was superior
to the NOV group at the 3 time points, with lower values in the LTV group.
There were no significant differences in the predictive indices among the
3 groups, including the extubation time, and postoperative intensive care
unit stays days. The incidence of PPCs did not significantly differ among
the 3 groups. Conclusion(s): Maintaining ventilation during CPB was
associated with better oxygenation and did not reduce the incidence of
PPCs in pediatric patients undergoing cardiac surgery. Copyright
© 2022 Elsevier Inc.

<122>
Accession Number
2020398858
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: 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
(Lerman, Levi, Kornowski) Department of Cardiology, Rabin Medical Center,
Petah Tikva, Israel
(Lerman, Levi, Kornowski) The Faculty of Medicine, Tel Aviv University,
Tel Aviv, Israel
Publisher
Elsevier Ireland Ltd
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 Elsevier B.V.

<123>
Accession Number
2019386276
Title
Managing CHD in Tertiary NICU in Collaboration with a Cardiothoracic
Center.
Source
Pediatric Cardiology. (no pagination), 2022. Date of Publication: 2022.
Author
Chee Y.-H.; Dunning-Davies B.; Singh Y.; Yates R.; Kelsall W.
Institution
(Chee) Addenbrooke's Hospital, Paediatrics, Cambridge University Hospitals
NHS Foundation Trust, Cambridge, United Kingdom
(Dunning-Davies, Singh, Kelsall) Rosie Neonatal Unit, Cambridge University
Hospitals NHS Foundation Trust, Cambridge, United Kingdom
(Yates) Great Ormond Street Hospital, Paediatric Cardiology, London,
United Kingdom
Publisher
Springer
Abstract
Increasingly non-cardiac tertiary neonatal intensive care units (NCTNs)
manage newborns with CHD prior to planned transfer to specialist cardiac
surgical centres (SCSC). It improves patient flow in SCSCs, enables
families to be nearer home, and improves psychological well-being Parker
et al. (Evaluating models of care closer to home for children and young
people who are ill: a systematic review, 2011)<inf>.</inf> This practice
has gradually increased as the number of SCSCs has decreased. This study
examines the effectiveness of this expanding practice. The management
provided, length of stay in the NCTN and outcomes are described for one UK
NCTN situated at a significant distance from its SCSC. A retrospective
observational study of cardiac-related admissions to a NCTN between
January 2010 and December 2019 was conducted. 190 neonates were
identified: 41 had critical CHD; 64 had major CHD. The cohort includes
babies with a wide range of cardiac conditions and additional
complexities. 23.7% (n = 45) required transfer to a specialist center
after a period of stabilization and growth ranging from several hours to
132 days. 68% (n = 130) were discharged home or repatriated to a local
NICU. Of the remaining 15 babies, 13 were transferred to other specialties
including the hospice. Two died on NICU. The mortality was consistent with
the medical complexity of the group Best and Rankin (J Am Heart Assoc
5:e002846, 2016), Laas et al. (BMC Pediatr 17:124, 2017). 8.9% (n = 17)
died before age 2. Nine babies had care redirected due to an inoperable
cardiac condition or life-limiting comorbidities. Our study demonstrates a
complex neonatal cohort with CHD can be managed effectively in a NCTN,
supporting the current model of care. The NCTN studied was well supported
by pediatricians with expertise in cardiology alongside visiting pediatric
cardiologists. Copyright © 2022, The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature.

<124>
Accession Number
639192287
Title
Patient blood management and patient safety.
Source
Current opinion in anaesthesiology. (no pagination), 2022. Date of
Publication: 05 Oct 2022.
Author
Zacharowski K.; Zoller H.; Steinbicker A.U.
Institution
(Zacharowski, Steinbicker) Department of Anaesthesiology, Intensive Care
Medicine and Pain Therapy, University Hospital Frankfurt, Goethe
University Frankfurt, Germany
(Zoller) Department of Medicine I and Christian Doppler Laboratory on Iron
and Phosphate Biology, Medical University of Innsbruck, Innsbruck, Austria
Publisher
NLM (Medline)
Abstract
PURPOSE OF REVIEW: The particular fields within patient blood management
(PBM) and patient safety reviewed here include novel insights into
bleeding therapy, autologous cell salvage, and perioperative anemia
therapy. RECENT FINDING: World Health Organization has published that
implementation of PBM is important but has not yet been performed in all
hospitals. Two antibodies that mimic the function of FVIII, Emicizumab,
and Mim8 have been developed. Tranexamic acid (TXA) has been investigated
further in patients with hip surgery and shows reduction of bleeding.
Thrombocytopenia in patients undergoing cardiac surgery is a particular
concern that has been investigated in another trial. The use of autologous
cell salvage was updated in form of a review and meta-analysis. And last
but not least, intravenous iron in preoperative anemia therapy can reduce
the number of transfusions, but especially iron carboxymaltose can cause
hypophosphatemia. SUMMARY: PBM should be further implemented in more
hospitals. Emicizumab and Mim8 are indicated in acquired hemophilia or
hemophilia A with inhibitors. TXA was confirmed to reduce bleeding.
Autologous cell salvage is state of the art to reduce transfusion
requirements in major cardiac and noncardiac surgery. Serum phosphate
concentrations should be monitored after administration of intravenous
iron compounds. Copyright © 2022 Wolters Kluwer Health, Inc. All
rights reserved.

<125>
Accession Number
639189863
Title
Causes and Predictors of Heart Failure Hospitalizations Following
Transcatheter Aortic Valve Implantation: A Systematic Review and
Meta-Analysis.
Source
Current problems in cardiology. (pp 101428), 2022. Date of Publication:
30 Sep 2022.
Author
Yasmin F.; Aamir M.; Moeed A.; Iqbal K.; Iqbal A.; Asghar M.S.; Ullah W.;
Rajapreyar I.; Brailovsky Y.
Institution
(Yasmin, Moeed, Iqbal, Iqbal) Dow Medical College, Dow University of
Health Sciences, Karachi, Pakistan
(Aamir) Lehigh Valley Heart and Vascular Institute, Lehigh Valley Health
Network, Allentown, PA, United States
(Asghar) Division of Nephrology and Hypertension, Mayo Clinic, Rochester,
MN, United States
(Ullah, Rajapreyar, Brailovsky) Thomas Jefferson University Hospitals,
Philadelphia, PA, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Transcutaneous aortic valve implantation (TAVI) has
transformed the management of aortic stenosis (AS) and is increasingly
being used for patients with symptomatic, severe aortic stenosis who are
ineligible or at high risk for conventional cardiac surgery.
 METHOD(S): PUBMED, Google Scholar, and SCOPUS databases were searched
to identify studies reporting heart failure hospitalization after TAVI.
Major factors evaluated for HF hospitalization were age, comorbidities
such as hypertension, atrial fibrillation (AF), chronic pulmonary disease
including COPD, chronic kidney disease, baseline LVEF before the
procedure, NYHA symptom class, and society of thoracic surgeons (STS)
score. Hazard ratio (HR) with a 95% confidence interval were computed
using random-effects models. RESULT(S): A total of eight studies were
included comprising 77,745 patients who underwent TAVI for severe aortic
stenosis. The presence of diabetes mellitus (HR: 1.39, 95% CI [1.17,
1.66], chronic kidney disease (CKD) (HR: 1.39, 95% CI [1.31, 1.48], atrial
fibrillation (HR: 1.69, 95% CI [1.42, 2.01], chronic pulmonary disease
(HR: 1.33, 95% CI [1.12, 1.58], and a high STS score (HR: 1.07, 95% CI
[1.03, 1.11] were positive predictors of 1-year HF hospitalization after
TAVI. CONCLUSION(S): Patients with diabetes mellitus, AF, CKD,
chronic pulmonary disease, and a high STS score are at an increased risk
of heart failure hospitalization at 1-year of TAVI, whereas increasing
age, hypertension, LVEF <50%, and NYHA class III/IV symptoms did not
predict HF hospitalization. Careful follow-up after TAVI in high-risk
patients, with closer surveillance for HF particularly, is key to
preventing HF hospitalizations and death. Copyright © 2022.
Published by Elsevier Inc.

<126>
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.

<127>
Accession Number
2019182681
Title
Alprostadil vs. isosorbide dinitrate in ameliorating angina episodes in
patients with coronary slow flow phenomenon: A randomized controlled
trial.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 965364. Date of Publication: 08 Sep 2022.
Author
Zhang W.; Dai J.; Jiang Y.; Zheng X.; Xu K.; Yang X.; Wang X.; Hao Z.;
Zhao Y.; Wang D.; Jiang L.; Qiu X.; Shen L.; He B.
Institution
(Zhang, Dai, Shen, Jiang, Xu, Yang, Wang, Hao, Zhao, Wang, Jiang, Qiu,
Shen, He) Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao
Tong University, Shanghai, China
(Shen) Clinical Research Center, Shanghai Jiao Tong University, Shanghai,
China
(Zheng) Department of Cardiology, The First Affiliated Hospital of
Zhengzhou University, Zhengzhou, China
Publisher
Frontiers Media S.A.
Abstract
Background: The optimum therapy for coronary slow flow phenomenon (CSFP)
stays debatable. This study compared the effectiveness of alprostadil with
isosorbide dinitrate in alleviating angina episodes in CSFP patients.
 Method(s): In this prospective, randomized controlled study, 102
patients with CSFP without severe coronary artery stenosis that exhibited
stable angina were allocated randomly in a ratio of 1:1 to either the
alprostadil group (40 mug, three times per day, n = 51) or the isosorbide
dinitrate group (5 mg, three times per day, n = 51). Frequency of angina
events, intensity of suffering, and the Canadian Cardiovascular Society
(CCS) grading of angina pectoris were evaluated at baseline and one month
after. Additionally, the Seattle Angina Questionnaire (SAQ) was assessed.
 Result(s): Baseline characteristics were comparable between the two
groups. At 1-month follow-up, patients administered with alprostadil
experienced fewer angina episodes [episodes per week, 1 (2) vs. 2 (2), P <
0.001] and less pain intensity [self-evaluated pain score, 2 (3) vs. 3
(4), P < 0.001] than those with isosorbide dinitrate. In the alprostadil
group, 78.4% of patients were classified as CCS class I, significantly
higher than the 47.1% seen in the isosorbide dinitrate group (P = 0.001).
Furthermore, treatment of alprostadil led to a significant improvement in
the SAQ score (7.09 U, 95% CI: 4.22-9.96, P < 0.001) compared to
isosorbide dinitrate. Additionally, fewer patients suffered headaches when
receiving alprostadil (7.8% vs. 19.6%, P = 0.084). Conclusion(s):
Alprostadil was more effective in ameliorating angina symptoms in CSFP
patients than isosorbide dinitrate. Clinical trial registration:
[www.chictr.org.cn], identifier [ChiCTR2000033233]. Copyright ©
2022 Zhang, Dai, Shen, Jiang, Zheng, Xu, Yang, Wang, Hao, Zhao, Wang,
Jiang, Qiu, Shen and He.

<128>
Accession Number
2019182499
Title
Loss of m6A Methyltransferase METTL5 Promotes Cardiac
Hypertrophy Through Epitranscriptomic Control of SUZ12 Expression.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 852775. Date of Publication: 28 Feb 2022.
Author
Han Y.; Du T.; Guo S.; Wang L.; Dai G.; Long T.; Xu T.; Zhuang X.; Liu C.;
Li S.; Zhang D.; Liao X.; Dong Y.; Lui K.O.; Tan X.; Lin S.; Chen Y.;
Huang Z.-P.
Institution
(Han, Du, Guo, Wang, Long, Xu, Zhuang, Liu, Li, Liao, Dong, Lin, Chen,
Huang) Department of Cardiology, Center for Translational Medicine,
Institute of Precision Medicine, The First Affiliated Hospital, Sun
Yat-sen University, Guangzhou, China
(Han, Du, Dai, Long, Xu, Zhuang, Liu, Li, Liao, Dong, Chen, Huang) NHC Key
Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou,
China
(Zhang) Department of Nephrology, The First Affiliated Hospital, Sun
Yat-sen University, Guangzhou, China
(Lui) Department of Chemical Pathology, Li Ka Shing Institute of Health
Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital,
Shatin, Hong Kong
(Tan) School of Pharmaceutical Sciences, Center for Infectious Disease
Research, School of Medicine, Tsinghua University, Tsinghua-Peking Center
for Life Sciences, Beijing, China
Publisher
Frontiers Media S.A.
Abstract
Enhancement of protein synthesis from mRNA translation is one of the key
steps supporting cardiomyocyte hypertrophy during cardiac remodeling. The
methyltransferase-like5 (METTL5), which catalyzes m6A
modification of 18S rRNA at position A<inf>1832</inf>, has been shown to
regulate the efficiency of mRNA translation during the differentiation of
ES cells and the growth of cancer cells. It remains unknown whether and
how METTL5 regulates cardiac hypertrophy. In this study, we have generated
a mouse model, METTL5-cKO, with cardiac-specific depletion of METTL5 in
vivo. Loss function of METTL5 promotes pressure overload-induced
cardiomyocyte hypertrophy and adverse remodeling. The regulatory function
of METTL5 in hypertrophic growth of cardiomyocytes was further confirmed
with both gain- and loss-of-function approaches in primary cardiomyocytes.
Mechanically, METTL5 can modulate the mRNA translation of SUZ12, a core
component of PRC2 complex, and further regulate the transcriptomic shift
during cardiac hypertrophy. Altogether, our study may uncover an important
translational regulator of cardiac hypertrophy through m6A
modification. Copyright © 2022 Han, Du, Guo, Wang, Dai, Long, Xu,
Zhuang, Liu, Li, Zhang, Liao, Dong, Lui, Tan, Lin, Chen and Huang.

<129>
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.

<130>
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.

<131>
Accession Number
2019171065
Title
Isolated Coarctation of the Aorta: Current Concepts and Perspectives.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 817866. Date of Publication: 25 May 2022.
Author
Bhatt A.B.; Lantin-Hermoso M.R.; Daniels C.J.; Jaquiss R.; Landis B.J.;
Marino B.S.; Rathod R.H.; Vincent R.N.; Keller B.B.; Villafane J.
Institution
(Bhatt) Departments of Internal Medicine and Pediatrics and Division of
Cardiology, Harvard Medical School, Boston, MA, United States
(Lantin-Hermoso) Section of Cardiology, Department of Pediatrics, Baylor
College of Medicine, Houston, TX, United States
(Daniels) Departments of Pediatrics and Internal Medicine, The Ohio State
University Medical Center, Columbus, OH, United States
(Jaquiss) Department of Cardiovascular and Thoracic Surgery and Department
of Pediatrics, UT Southwestern Medical Center, Dallas, TX, United States
(Landis) Department of Pediatrics and Department of Medical and Molecular
Genetics, Indiana University School of Medicine, Indianapolis, IN, United
States
(Marino) Department of Pediatric Cardiology, Cleveland Clinic Children's,
Cleveland, OH, United States
(Rathod) Department of Pediatrics, Harvard Medical School, Boston, MA,
United States
(Vincent) Department of Pediatrics, New York Medical College, Valhalla,
NY, United States
(Keller, Villafane) Cincinnati Children's Heart Institute, Department of
Pediatrics, University of Cincinnati, Cincinnati, OH, United States
Publisher
Frontiers Media S.A.
Abstract
Current management of isolated CoA, localized narrowing of the aortic arch
in the absence of other congenital heart disease, is a success story with
improved prenatal diagnosis, high survival and improved understanding of
long-term complication. Isolated CoA has heterogenous presentations,
complex etiologic mechanisms, and progressive pathophysiologic changes
that influence outcome. End-to-end or extended end-to-end anastomosis are
the favored surgical approaches for isolated CoA in infants and
transcatheter intervention is favored for children and adults. Primary
stent placement is the procedure of choice in larger children and adults.
Most adults with treated isolated CoA thrive, have normal daily
activities, and undergo successful childbirth. Fetal echocardiography is
the cornerstone of prenatal counseling and genetic testing is recommended.
Advanced 3D imaging identifies aortic complications and myocardial
dysfunction and guides individualized therapies including re-intervention.
Adult CHD program enrollment is recommended. Longer follow-up data are
needed to determine the frequency and severity of aneurysm formation,
myocardial dysfunction, and whether childhood lifestyle modifications
reduce late-onset complications. Copyright © 2022 Bhatt,
Lantin-Hermoso, Daniels, Jaquiss, Landis, Marino, Rathod, Vincent, Keller
and Villafane.

<132>
Accession Number
2019169556
Title
2D Materials for Cardiac Tissue Repair and Regeneration.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 802551. Date of Publication: 11 Feb 2022.
Author
Gokce C.; Gurcan C.; Delogu L.G.; Yilmazer A.
Institution
(Gokce, Gurcan, Yilmazer) Department of Biomedical Engineering, Ankara
University, Ankara, Turkey
(Gurcan, Yilmazer) Stem Cell Institute, Ankara University, Ankara, Turkey
(Delogu) Department of Biomedical Sciences, University of Padua, Padua,
Italy
Publisher
Frontiers Media S.A.
Abstract
Cardiovascular diseases (CVDs) have a massive impact on human health. Due
to the limited regeneration capacity of adult heart tissue, CVDs are the
leading cause of death and disability worldwide. Even though there are
surgical and pharmacological treatments for CVDs, regenerative strategies
are the most promising approaches and have the potential to benefit
millions of people. As in any other tissue engineering approach, the
repair and regeneration of damaged cardiac tissues generally involve
scaffolds made up of biodegradable and biocompatible materials, cellular
components such as stem cells, and growth factors. This review provides an
overview of biomaterial-based tissue engineering approaches for CVDs with
a specific focus on the potential of 2D materials. It is essential to
consider both physicochemical and immunomodulatory properties for
evaluating the applicability of 2D materials in cardiac tissue repair and
regeneration. As new members of the 2D materials will be explored, they
will quickly become part of cardiac tissue engineering
technologies. Copyright © 2022 Gokce, Gurcan, Delogu and
Yilmazer.

<133>
Accession Number
2018968050
Title
Pentoxifylline Prevents Restenosis by Inhibiting Cell Proliferation via
p38MAPK Pathway in Rat Vein Graft Model.
Source
Cell Transplantation. 31 (no pagination), 2022. Date of Publication: 2022.
Author
Fan Y.; Ge J.
Institution
(Fan, Ge) Department of Cardiac Surgery, The First Affiliated Hospital of
USTC, Division of Life Sciences and Medicine, University of Science and
Technology of China, Hefei, China
Publisher
SAGE Publications Ltd
Abstract
Coronary artery bypass grafting remains the gold standard in the therapy
of advanced-stage patients. But the vein grafts are prone to restenosis or
failure. Pentoxifylline (PTX) is a methylxanthine derivative with a
function of inhibiting cell proliferation. We thus applied PTX locally to
the vein grafts to study its effect on the inhibition of graft restenosis
using a rat vein graft model. Morphometric results showed a significant
decrease in the thickness of vein grafts intimal and medial at day 28
after the bypass operation. Results from Western blot and
immunohistochemistry showed that PTX also significantly reduced the
proliferating cell nuclear antigen (PCNA), alpha-smooth muscle actin
(alpha-SMA) expression, and phosphorylation of p38 in vein grafts. These
results firstly discovered the positive role of PTX in preventing the vein
grafts restenosis and the mechanism may be inhibition of vascular smooth
muscle cells (VSMCs) proliferation via the p38MAPK pathway. Copyright
© The Author(s) 2022.

<134>
Accession Number
2018793370
Title
Mitral annular disjunction: A case series and review of the literature.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 976066. Date of Publication: 12 Aug 2022.
Author
Wu S.; Siegel R.J.
Institution
(Wu, Siegel) Cedars-Sinai Medical Center, Smidt Heart Institute, Los
Angeles, CA, United States
Publisher
Frontiers Media S.A.
Abstract
Mitral annular disjunction (MAD) is an abnormal displacement of the mitral
valve leaflet onto the left atrial wall and is commonly found in patients
with mitral valve prolapse (MVP). The diagnosis is usually made by
transthoracic echocardiography (TTE) although findings can be subtle and
further cardiac imaging may be necessary. MAD has been associated with a
risk of malignant ventricular arrhythmias and sudden cardiac death,
therefore recognition of this diagnosis and risk stratification are highly
important. In this review, we will discuss the diagnosis, clinical
implications, risk stratification and management of MAD based upon
currently available literature, as well as provide a series of cases
showing the heterogeneity in presentation and our experience with
management of this rare but potentially fatal entity. Copyright ©
2022 Wu and Siegel.

<135>
Accession Number
2018676625
Title
Incidence, risk factors, and outcomes in electroencephalographic seizures
after mechanical circulatory support: A systematic review and
meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 872005. Date of Publication: 03 Aug 2022.
Author
Li Q.; Shen J.; Lv H.; Liu Y.; Chen Y.; Zhou C.; Shi J.
Institution
(Li, Shen, Lv, Liu, Chen, Zhou, Shi) State Key Laboratory of
Cardiovascular Disease, Department of Anesthesiology, Fuwai Hospital,
National Center for Cardiovascular Diseases, Chinese Academy of Medical
Sciences and Peking Union Medical College, Beijing, China
Publisher
Frontiers Media S.A.
Abstract
Purpose: To estimate the overall incidence, risk factors, and clinical
outcomes of electroencephalographic (EEG) seizures for adults and children
after mechanical circulatory support (MCS). Method and measurements: This
systematic review and meta-analysis were carried out in accordance with
the PRISMA (Preferred Reporting Items for Systematic Review and
Meta-Analysis) guidance document. MEDLINE EMBASE and CENTRAL were
investigated for relevant studies. The related information was retrieved
by two independent reviewers and all analyses were conducted by STATA
(version 16.0; Stata Corporation, College Station, TX, United States).
 Result(s): Sixty studies including 36,191 adult and 55,475 pediatric
patients with MCS were enrolled for evaluation. The study showed that the
overall incidence of EEG seizures in adults was 2% (95%CI: 1-3%), in which
1% (95%CI: 1-2%) after cardiopulmonary bypass (CPB), and 3% (95%CI: 1-6%)
after extracorporeal membrane oxygenation (ECMO). For pediatrics patients,
the incidence of EEG seizures was 12% (95%CI: 11-14%), among which 12%
(9-15%) after CPB and 13% (11-15%) after ECMO. The major risk factors of
EEG seizures after MCS in adults were redo surgery (coefficient = 0.0436,
p = 0.044), and COPD (coefficient = 0.0749, p = 0.069). In addition, the
gestational week of CPB (coefficient = 0.0544, p = 0.080) and respiratory
failure of ECMO (coefficient = -0.262, p = 0.019) were also indicated to
be associated with EEG seizures in pediatrics. Conclusion(s): EEG
seizures after MCS were more common in pediatrics than in adults. In
addition, the incidence of EEG seizure after ECMO was higher than CPB both
in adults and children. It is expected that appropriate measures should be
taken to control modifiable risk factors, thus improving the prognosis and
increasing the long-term survival rate of MCS patients. Systematic Review
Registration: [https://www.crd.york.ac.uk/prospero], identifier
[CRD42021287288]. Copyright © 2022 Li, Shen, Lv, Liu, Chen, Zhou
and Shi.

<136>
Accession Number
2015431120
Title
Effect of high-flow nasal therapy on patient-centred outcomes in patients
at high risk of postoperative pulmonary complications after cardiac
surgery: a study protocol for a multicentre adaptive randomised controlled
trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 232. Date of
Publication: December 2022.
Author
Earwaker M.; Villar S.; Fox-Rushby J.; Duckworth M.; Dawson S.; Steele J.;
Chiu Y.-D.; Litton E.; Kunst G.; Murphy G.; Martinez G.; Zochios V.; Brown
V.; Brown G.; Klein A.
Institution
(Earwaker, Duckworth, Steele, Brown, Brown) Papworth Trials Unit
Collaboration, Royal Papworth Hospital, Cambridge, United Kingdom
(Villar, Dawson) MRC Biostatistics Unit, Cambridge University, Cambridge,
United Kingdom
(Fox-Rushby, Kunst) King's College London, London, United Kingdom
(Chiu, Martinez) Papworth Trials Unit, Royal Papworth Hospital, Cambridge,
United Kingdom
(Litton) Intensive Care Unit, Fiona Stanley Hospital, Perth, WA, Australia
(Murphy) University of Leicester, Leicester, United Kingdom
(Zochios) University Hospitals Birmingham, Birmingham, United Kingdom
(Klein) Department of Anaesthesia, Royal Papworth Hospital, Cambridge,
United Kingdom
Publisher
BioMed Central Ltd
Abstract
Background: High-flow nasal therapy is a non-invasive form of respiratory
support that delivers low-level, flow dependent positive airway pressure.
The device can be better tolerated by patients than alternatives such as
continuous positive airway pressure. The primary objective is to determine
if prophylactic high-flow nasal therapy after tracheal extubation can
result in an increase in the number of days alive and at home within the
first 90 days after surgery, when compared with standard oxygen therapy.
The co-primary objective is to estimate the incremental cost-effectiveness
and cost-utility of high-flow nasal therapy vs standard oxygen therapy at
90 days, from the view-point of the public sector, the health service and
patients. Method(s): This is an adaptive, multicentre, international
parallel-group, randomised controlled trial with embedded
cost-effectiveness analysis comparing the use of high-flow nasal therapy
with control in patients at high risk of respiratory complications
following cardiac surgery. Participants will be randomised before tracheal
extubation and allocated either high-flow nasal therapy or standard oxygen
therapy for a minimum of 16 h immediately post extubation. Participants
will be followed up until 90 days after surgery. The total sample size
needed to detect a 2-day increase in DAH90 with 90% power with an
intention to treat analysis is 850 patients. The adaptive design includes
an interim sample size re-estimation which will provide protection against
deviations from the original sample size assumptions made from the
single-centre pilot study and will allow for a maximum sample size
increase to 1152 patients. Discussion(s): Evidence to support routine
use of high-flow nasal therapy will inform the development of effective
enhanced recovery care bundles. Reducing complications should reduce
length of stay and re-admission to hospital and provide an important focus
for cost reduction. However; high-quality studies evaluating the clinical
and cost effectiveness of high-flow nasal therapy after cardiothoracic
surgery are lacking. Trial registration: The study has been registered
with ISRCTN (ISRCTN14092678, 13/05/2020) Clinicaltrials.gov Registration
Pending Copyright © 2022, The Author(s).

<137>
Accession Number
639076918
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: 22 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, The 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, Memorial Hermann Hospital, Houston,
United States
(Pijls) Department of Cardiology, Catharina Hospital, Eindhoven,
Netherlands
(Hakeem) Division of Cardiovascular Diseases and Hypertension, Robert Wood
Johnson Medical School, Rutgers University, New Brunswick, NJ, United
States
(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, United
States
(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 States
(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
American Medical Association
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.. Copyright © 2022 American
Medical Association. All rights reserved.

<138>
Accession Number
2019398873
Title
Role of advanced imaging techniques in cardiac surgery: Aortic dissection.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Paneitz D.C.; Hedgire S.; Jassar A.S.
Institution
(Paneitz, Jassar) Division of Cardiac Surgery, Harvard Medical School,
Massachusetts General Hospital, Boston, MA, United States
(Hedgire) Department of Radiology, Division of Cardiovascular Imaging,
Harvard Medical School, Massachusetts General Hospital, Boston, MA, United
States
Publisher
John Wiley and Sons Inc
Abstract
Background: Collaboration among cardiac surgeons and radiologists is
essential to fully leverage advanced imaging technologies and improve the
care of cardiac surgery patients. In this review, a cardiac surgeon and
cardiovascular radiologist discuss imaging pearls and considerations in
aortic dissection cases. Method(s): The surgeon and the radiologist
discuss imaging considerations in two aortic dissection cases.
 Result(s): It is essential to obtain and review all phases of a CTA
when diagnosing acute aortic pathology. Optimizing scan parameters and
careful multiplanar image review is necessary for adept interpretation.
Current CT technology allows ECG gating to eliminate motion artifact and
allow for dynamic assessment of the aortic pathology. Concurrent
evaluation of thoracic aorta and coronary arteries is feasible. A
systematic review of the scan using landmarks is critical for appropriate
diagnosis and reporting. As TEVAR is increasingly used for arch repair,
collaboration with radiologists is essential for preoperative planning in
redo cases. Conclusion(s): Collaboration among cardiac surgeons and
radiologists is mutually beneficial for surgeons, radiologists, and their
patients. Copyright © 2022 Wiley Periodicals LLC.

<139>
Accession Number
639174291
Title
Wavelet measured cerebral autoregulation and postoperative organ injury
following non-cardiac surgery.
Source
Journal of Neurosurgical Anesthesiology. Conference: 50th Annual Meeting
of the Society for Neuroscience in Anesthesiology and Critical Care, SNACC
2022. Seattle, WA United States. 34(4) (pp 507), 2022. Date of
Publication: October 2022.
Author
Highton D.; Saulov K.; Barras M.; Caney X.; Fanning J.; Scott I.; Sturgess
D.; White K.; Huth S.; Kearney A.; Oishi S.
Institution
(Highton) Princess Alexandra Hospital Southside Clinical Unit, University
of Queensland, Brisbane, QLD, Australia
(Saulov, Barras, Caney, Fanning, Scott, Sturgess, White, Huth, Oishi)
University of Queensland, Brisbane, QLD, Australia
(Kearney) Princess Alexandra Hospital, Brisbane, QLD, Australia
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Impaired tissue perfusion during non-cardiac surgery is
implicated in end-organ injury, morbidity and mortality. Cerebral
autoregulation (CA) describes dynamic vascular changes which maintain end
organ perfusion in the brain. The brain represents a unique opportunity to
measure intraoperative end-organ hemodynamic function. It has been
proposed that combination of hemodynamic compromise and impaired
autoregulatory function may contribute to end organ injury, and this has
already demonstrated an association between CA and organ injury following
cardiac surgery [1]. Non-cardiac surgery presents CA monitoring challenges
due to shorter operating length and smaller blood pressure variability. We
have previously demonstrated an advanced wavelet signal processing
technique which can measure CA from blood pressure and near infrared
spectroscopy (NIRS) cerebral oxygenation signals. We hypothesised that
wavelet measured CA would differ between patients with postoperative organ
injury. The aim of the study was to evaluate differences in CA between
patients with perioperative organ injury measured using a wavelet
technique. Method(s): Intraoperative monitoring data were analysed
from a randomised controlled trial of perioperative angiotensin axis
blocker administration. Data were gathered following ethical approval and
patient consent. Patients were included for analysis if they received
invasive arterial monitoring and cerebral oximetry. Blood pressure and
regional cerebral saturation (INVOS 5100C) were downloaded in real time
using ICM+ software during surgery. CA was evaluated using wavelet
semblance comparing the similarity of fluctuations in blood pressure and
cerebral oximetry [2]. Postoperative creatinine was measured daily for 5
days after surgery, and postoperative troponin was measured daily for 3
days after surgery. Kidney injury was defined as a rise of creatinine
>26.5 micromol/L, cardiac injury was defined as an elevated high
sensitivity troponin >22 ng/L. Wavelet semblance was compared between
groups using Student's t-test. Result(s): A total of 53 patients were
included in analysis. Mean age 66 (9.8) years, median ASA 3. Mean
semblance was 0.24 (0.13) in patients without a kidney injury and 0.35
(0.11) in patients with a kidney injury (P=0.03). Mean semblance was 0.24
(0.14) in patients without cardiac injury and 0.27 (0.11) in patients with
a cardiac injury (P=0.45). Conclusion(s): There was a significant
difference in wavelet measured CA between patients with a perioperative
kidney injury, although this did not meet significance for cardiac injury.
These results demonstrate the feasibility of wavelet/NIRS measured CA in
non-cardiac surgery. Further analysis in larger cohorts is required to
define the relationship between CA and hemodynamic targets, medication and
patient factors. However this technique has considerable future potential
as an intraoperative monitoring technique to define haemodynamic function.

<140>
Accession Number
2020527440
Title
Advanced Cardiovascular Imaging for the Diagnosis of Mycobacterium
chimaera Prosthetic Valve Infective Endocarditis After Open-heart Surgery:
A Contemporary Systematic Review.
Source
Current Problems in Cardiology. 47(12) (no pagination), 2022. Article
Number: 101392. Date of Publication: December 2022.
Author
Sanchez-Nadales A.; Diaz-Sierra A.; Mocadie M.; Asher C.; Gordon S.; Xu B.
Institution
(Sanchez-Nadales, Asher) Department of Cardiovascular Disease, Cleveland
Clinic Florida, Weston, FL
(Diaz-Sierra) Department of Medicine, Advocate Illinois Masonic Medical
Center, Chicago, IL
(Mocadie) Department of Infectious Diseases, University Hospitals,
Cleveland, OH
(Gordon) Department of Infectious Diseases, Cleveland Clinic, Cleveland,
OH
(Xu) Section of Cardiovascular Imaging, Robert and Suzanne Tomsich
Department of Cardiovascular Medicine, Sydell and Arnold Miller Family
Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH
Publisher
Elsevier Inc.
Abstract
Mycobacterium chimaera is an opportunistic and emerging pathogen, which
has been recognized to cause prosthetic valve infective endocarditis and
disseminated infection following open-chest cardiac surgery with certain
contaminated heater-cooler systems. Diagnostic evaluation of suspected
prosthetic valve infective endocarditis due to M chimaera is challenging
and requires a very high index of suspicion. This systematic review aims
to evaluate prosthetic valve infective endocarditis due to M chimaera.
Based on the current literature review, transesophageal echocardiography
and 18F-fluorodeoxyglucose positron emission tomography/computed
tomography are the most common imaging modalities used to establish the
diagnosis. Based on 22 published cases, the reported cases of M chimaera
endocarditis have occurred almost entirely in males. Within this cohort,
the patients developed endocarditis on average 2.7 years after exposure to
contaminated heater-cooler systems during cardiac surgery. M chimaera
infection is associated with significant morbidity and
mortality. Copyright © 2022 Elsevier Inc.

<141>
Accession Number
2019352496
Title
A nomogram to predict nosocomial infection in patients on venoarterial
extracorporeal membrane oxygenation after cardiac surgery.
Source
Perfusion (United Kingdom). (no pagination), 2022. Date of Publication:
2022.
Author
Li X.; Wang L.; Li C.; Wang X.; Hao X.; Du Z.; Xie H.; Yang F.; Wang H.;
Hou X.
Institution
(Li, Wang, Li, Wang, Hao, Du, Xie, Yang, Wang, Hou) Center for Cardiac
Intensive Care, Beijing Institute of Heart, Lung and Blood Vessel
Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing,
China
(Li) Department of intensive care unit, Aviation General Hospital of China
Medical University, Beijing, China
Publisher
SAGE Publications Ltd
Abstract
Introduction: After cardiac surgery, patients on venoarterial
extracorporeal membrane oxygenation (VA-ECMO) have a higher risk of
nosocomial infection in the intensive care unit (ICU). We aimed to
establish an intuitive nomogram to predict the probability of nosocomial
infection in patients on VA-ECMO after cardiac surgery. Method(s): We
included patients on VA-ECMO after cardiac surgery between January 2011
and December 2020 at a single center. We developed a nomogram based on
independent predictors identified using univariate and multivariate
logistic regression analyses. We selected the optimal model and assessed
its performance through internal validation and decision-curve analyses.
 Result(s): Overall, 503 patients were included; 363 and 140 patients
were randomly divided into development and validation sets, respectively.
Independent predictors derived from the development set to predict
nosocomial infection included older age, white blood cell (WBC) count
abnormality, ECMO environment in the ICU, and mechanical ventilation (MV)
duration, which were entered into the model to create the nomogram. The
model showed good discrimination, with areas under the curve (95%
confidence interval) of 0.743 (0.692-0.794) in the development set and
0.732 (0.643-0.820) in the validation set. The optimal cutoff probability
of the model was 0.457 in the development set (sensitivity, 0.683;
specificity, 0.719). The model showed qualified calibration in both the
development and validation sets (Hosmer-Lemeshow test, p >.05). The
threshold probabilities ranged from 0.20 to 0.70. Conclusion(s): For
adult patients receiving VA-ECMO treatment after cardiac surgery, a
nomogram-monitoring tool could be used in clinical practice to identify
patients with high-risk nosocomial infections and provide an early
warning. Copyright © The Author(s) 2022.

<142>
Accession Number
639174966
Title
Excess Re-intervention with Mitroflow Prosthesis for AVR: Ten-year
Outcomes of a Randomized Trial.
Source
The Annals of thoracic surgery. (no pagination), 2022. Date of
Publication: 29 Sep 2022.
Author
Cangut B.; Schaff H.V.; Suri R.M.; Greason K.L.; Stulak J.M.; Lahr B.D.;
Michelena H.I.; Daly R.C.; Dearani J.A.; Crestanello J.A.
Institution
(Cangut, Greason, Stulak, Daly, Dearani, Crestanello) Department of
Cardiovascular Surgery, Mayo Clinic, Rochester, MN, United States
(Schaff) Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN;
(Suri) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Lahr) Division of Biomedical Statistics and Informatics, Mayo Clinic
College of Medicine and Science, Rochester, MN, United States
(Michelena) Department of Cardiovascular Diseases, Mayo Clinic, Rochester,
MN, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Current bioprostheses are considered to have improved
durability and better hemodynamic performance compared to previous
designs, but there are limited comparative data on late outcomes.
 METHOD(S): From 2009 through 2011, 300 adults with severe aortic
valve stenosis undergoing aortic valve replacement (AVR) were randomized
to receive Edwards Magna, St.Jude Epic, or Sorin Mitroflow bioprosthesis
(n=100, n=101, n=99, respectively). Overall survival was analyzed using
Kaplan-Meier and Cox proportional hazards methods, whereas competing risk
analysis was used for all time-to-event outcomes. Serial echocardiographic
data were fitted with longitudinal models stratified by implant valve
size. RESULT(S): During median follow-up of 9.8 (interquartile range
[IQR], 8.7-10.2) years, 10-year survival was 50% for Magna group, 42% for
Epic group, and 41% for Mitroflow group (P=0.415). Cumulative risk of
stroke was 9% at 10 years, and rates were comparable for the three groups.
Indexed aortic valve area (AVAi), and mean gradients were similar between
three groups receiving 19 and 21mm valves, but in larger (>=23 mm)
prostheses, gradients were lower (P<0.001) and AVAi were higher in Magna
group (P<0.001). The 10-year risk of endocarditis differed by group
(P=0.033), with higher incidence in Mitroflow versus Magna group (7% vs.
0%, P=0.019). Late risk of re-interventions in Mitroflow group was 22%,
compared with 0% in Magna group (P<0.001) and 5% in Epic group (P=0.008).
 CONCLUSION(S): The Magna valve had the lowest gradients and largest
AVAi with larger implant sizes. The Mitroflow bioprosthesis is associated
with increased rate of re-intervention and possible increased risk of
infection compared to Magna and Epic valves. Copyright © 2022 The
Society of Thoracic Surgeons. Published by Elsevier Inc. All rights
reserved.

<143>
Accession Number
639171385
Title
Trends in the cost-effectiveness level of percutaneous coronary
intervention: Macro socioeconomic analysis and health technology
assessment.
Source
Journal of cardiology. (no pagination), 2022. Date of Publication: 28 Sep
2022.
Author
Takura T.; Komuro I.; Ono M.
Institution
(Takura) Department of Healthcare Economics and Health Policy, Graduate
School of Medicine, University of Tokyo, Tokyo, Japan
(Komuro) Department of Cardiovascular Medicine, Graduate School of
Medicine, University of Tokyo, Tokyo, Japan
(Ono) Department of Cardiac Surgery, University of Tokyo Hospital,
University of Tokyo, Tokyo, Japan
Publisher
NLM (Medline)
Abstract
Percutaneous coronary intervention (PCI), one of the most prevalent
techniques of revascularization, is a procedure that remarkably improves
treatment outcomes. However, it consumes large amounts of medical
resources and has resulted in an increased socioeconomic burden due to the
increasing number of target patients. In recent years, there have been
sporadic discussions, both in Japan and other countries, regarding the
optimization of interventions and the perspective of medical economics.
Based on this, previous studies on PCI-related cost-effectiveness were
reviewed in order to consider the current level of medical economics
regarding PCI. Using the databases MEDLINE and EMBASE, a survey involving
data from original articles and systematic reviews was conducted from
January 2010 to August 2022. Conditions were not imposed on the evidence
level due to the paucity of studies, although field studies were
prioritized over simulation studies. The macro medical economics of acute
myocardial infarction treatment, which is the primary target of PCI, were
generally at an average level when compared to those in other countries;
however, there is room for further improvement in Japan's performance.
Revascularization in a population with multivessel coronary artery disease
showed that coronary artery bypass graft surgery tended to be more
cost-effective than PCI in the long-term setting. However, it was
suggested that PCI may be more cost-effective in patients with SYNTAX
Score<=22 or left main artery disease. A cost-effectiveness report for
stable angina patients was not in favor of PCI over medical therapy.
Moreover, there were some reports showing the medical economic superiority
of early myocardial ischemia evaluation, and it was foreseen that active
selection of patients will contribute to the improvement of the overall
cost-effectiveness of PCI. In order to further improve the socioeconomic
significance of PCI in the future, it is necessary to aim for harmony
between clinical practice and health economics. Copyright © 2022.
Published by Elsevier Ltd.

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