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<1>
Accession Number
2015447311
Title
"Heart in DRESS": Cardiac Manifestations, Treatment and Outcome of
Patients with Drug Reaction with Eosinophilia and Systemic Symptoms
Syndrome: A Systematic Review.
Source
Journal of Clinical Medicine. 11(3) (no pagination), 2022. Article Number:
704. Date of Publication: February-1 2022.
Author
Radovanovic M.; Jevtic D.; Calvin A.D.; Petrovic M.; Paulson M.; Rueda
Prada L.; Sprecher L.; Savic I.; Dumic I.
Institution
(Radovanovic, Calvin, Paulson, Rueda Prada, Sprecher, Dumic) Mayo Clinic
Alix School of Medicine, Rochester, MN 55905, United States
(Radovanovic, Paulson, Rueda Prada, Sprecher, Dumic) Department of
Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, United
States
(Jevtic, Savic) School of Medicine, University of Belgrade, Belgrade
11000, Serbia
(Calvin) Department of Cardiovascular Medicine, Mayo Clinic Health System,
Eau Claire, WI 54703, United States
(Petrovic) Icahn School of Medicine at Mount Sinai, New York, NY 10029,
United States
Publisher
MDPI
Abstract
Cardiac involvement in drug reaction with eosinophilia and systemic
symptoms (DS) is rare but associated with high mortality. The aim of this
research was to systematically review case reports by PRISMA guidelines in
order to synthetize the knowledge of cardiac manifestations of DS. We
identified 42 cases from 36 case reports. Women were two times more
affected than men. Two-thirds of patients had cardiac manifestation in the
initial phase of the disease, while in one-third of cases cardiac
manifestations developed later (mean time of 70 +/- 63 days). The most
common inciting medications were minocycline (19%) and allopurinol (12%).
In 17% of patients, the heart was the only internal organ affected, while
the majority (83%) had at least one additional organ involved, most
commonly the liver and the kidneys. Dyspnea (55%), cardiogenic shock
(43%), chest pain (38%), and tachycardia (33%) were the most common
cardiac signs and symptoms reported. Patients frequently had an abnormal
ECG (71.4%), and a decrease in left ventricular ejection fraction was the
most common echocardiographic finding (45%). Endomyocardial biopsy or
histological examination at autopsy was performed in 52.4%, with the
predominant finding being fulminant eosinophilic myocarditis with acute
necrosis in 70% of those biopsied. All patients received immunosuppressive
therapy with intravenous steroids, while non-responders were more likely
to have received IVIG, cyclosporine, mycophenolate, and other
steroid-sparing agents (60%). Gender and degree of left ventricular
systolic dysfunction were not associated with outcomes, but short latency
between drug exposure and the first DRESS symptom onset (<15 days) and
older age (above 65 years) was associated with death. This underscores the
potential importance of heightened awareness and early
treatment.<br/>Copyright &#xa9; 2022 by the authors. Licensee MDPI, Basel,
Switzerland.

<2>
Accession Number
2021075164
Title
The Effect of Valvular Heart Disease on Maternal and Fetal Outcome of
Pregnancy in Young Pregnant Females.
Source
Pakistan Journal of Medical and Health Sciences. 16(9) (pp 386-390), 2022.
Date of Publication: September 2022.
Author
Altaf A.; Faiz S.; Badalyan S.S.; Khan R.; Yahya S.
Institution
(Altaf, Faiz) Mohi-ud-Din Islamic Medical College, AJK, Mirpur, Pakistan
(Badalyan) First Moscow State, Medical University, Moscow, Russian
Federation
(Khan) Ganjju Khan Medical College, Swabi, Pakistan
(Yahya) Hazrat Bari Imam Srkar Medical and Dental College, Islamabad,
Pakistan
Publisher
Lahore Medical And Dental College
Abstract
Objective: The objective of this study is to determine the effect of
valvular heart disease on maternal and fetal outcomes of pregnancy in
young pregnant females Study design: Retrospective study Methodology: A
retrospective study was conducted to get an analysis of 321 healthy women
and 312 women with valvular heart disease who received care at a tertiary
care hospital during the same time period and compared the results of
their pregnancies. The chi (2)-test was used for statistical analysis,
with a significance set at 0.05. <br/>Result(s): n comparison to women in
the control group, women with valvular heart disease had significantly
higher rates of congestive heart failure (5.1 percent vs. 0 percent,
P0.001), mortality (0.64% [two women] vs. 0 percent), and surgical
interventions during pregnancy (13.4 percent (balloon mitral valvotomy)
vs. 0.6 percent [ovarian cystectomy Additionally, the perinatal outcome
was worse in the valvular heart disease group than in the control group,
with higher preterm delivery rates (48.3 percent vs. 20.5 percent), lower
birth weights (2434+/-599 g vs. 2653+/-542 g; P0.001), and a higher
incidence of APGAR scores below 8 (8.3 percent vs. 4 percent; P0.01).
Additionally, the rate of instrumental delivery increased (9.9 percent vs.
3.4 percent). The proportion of cesarean deliveries, however, was
comparable across the two groups. <br/>Conclusion(s): In conclusion, there
is a substantial link between valvular heart disease and maternal and
neonatal mortality. Close fetal and maternal monitoring are required, and
valvular stenosis should be repaired before conception. To avoid
difficulties for both the mother and the fetus, balloon valvuloplasty
should be taken into consideration in cases of severe stenosis during the
second trimester of pregnancy. The hospitals that deal with heart illness
and pregnancy should create practical recommendations.<br/>Copyright
&#xa9; 2022 Lahore Medical And Dental College. All rights reserved.

<3>
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Accession Number
2021013239
Title
Five-Year Results of Coronary Artery Bypass Grafting with or Without
Carotid Endarterectomy in Patients with Asymptomatic Carotid Artery
Stenosis: CABACS RCT.
Source
Stroke. 53(11) (pp 3270-3277), 2022. Date of Publication: 01 Nov 2022.
Author
Knipp S.C.; Holst T.; Bilbilis K.; Von Velsen O.; Ose C.; Diener H.-C.;
Jakob H.; Ruhparwar A.; Jockel K.-H.; Weimar C.; Beyersdorf F.; Breuer M.;
Dahm M.; Diegeler A.; Kowalski A.; Martens S.; Mohr F.-W.; Moritz A.;
Ondrasek J.; Reiter B.; Roth P.; Seipelt R.; Siggelkow M.; Steinhoff G.;
Stock U.; Wilhelmi M.; Wimmer-Greinecker G.
Institution
(Knipp, Jakob, Ruhparwar) Department of Thoracic and Cardiovascular
Surgery, University Hospital Essen, Germany
(Holst) Department of Cardiac Surgery, Medical Faculty and University
Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Germany
(Bilbilis, Von Velsen, Ose, Jockel) Center for Clinical Trials Essen
(ZKSE), C/o Institute for Medical Informatics, Biometry and Epidemiology
(IMIBE), University Hospital Essen, Germany
(Diener, Jockel, Weimar) Institute for Medical Informatics, Biometry and
Epidemiology (IMIBE), University Hospital Essen, Germany
(Weimar) BDH Clinic Elzach GmbH, Germany
(Beyersdorf) Klinik fur Herz-und Gefaschirurgie, Universitats-Herzzentrum
Freiburg-Bad Krozingen, Freiburg, Germany
(Breuer) Klinik fur Herz-und Thoraxchirurgie, Universitatsklinikum Jena,
Jena, Germany
(Dahm) Klinik fur Thorax-, Herz-und Gefaschirurgie, Westpfalz-Klinikum,
Kaiserslautern, Germany
(Diegeler) Herz-und Gefasklinik, Klinik fur Kardiochirurgie, Bad Neustadt
An der Saale
(Kowalski, Siggelkow) Klinik fur Herz-und Gefaschirurgie,
Universitatsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
(Martens) Klinik fur Herzchirurgie, Universitatsklinikum Munster, Munster,
Germany
(Mohr) Klinik fur Herzchirurgie, Herzzentrum Leipzig GmbH,
Universitatsklinik, Leipzig, Germany
(Moritz, Stock) Klinik fur Thorax-, Herz-und Thorakale Gefaschirurgie,
Johann Wolfgang Goethe-Universitat Frankfurt, Frankfurt, Germany
(Ondrasek) Centrum Kardiovaskularni A Transplantacni Chirurgie, Brno,
Czechia
(Reiter) Klinik und Poliklinik fur Herz-und Gefaschirurgie, Universitares
Herzzentrum Hamburg, Hamburg, Germany
(Roth) Herz-, Kinderherz-und Gefaschirurgie, Universitatsklinikum Giesen
und Marburg, Giessen, Germany
(Seipelt) Abteilung fur Thorax-, Herz und Gefaschirurgie,
Universitatsmedizin Gottingen, Gottingen, Germany
(Steinhoff) Klinik und Poliklinik fur Herzchirurgie, Universitat Rostock,
Rostock, Germany
(Wilhelmi) Klinik fur Herz-, Thorax-, Transplantations-und Gefaschirurgie,
Medizinische Hochschule Hannover, Hannover, Germany
(Wimmer-Greinecker) Klinik fur Herz-Thorax-Chirurgie, Herz-und
Gefaszentrum Bad Bevensen, Bad Bevensen, Germany
Publisher
Wolters Kluwer Health
Abstract
Background: In patients with coronary artery disease and concomitant
asymptomatic severe carotid stenosis, combined simultaneous coronary
artery bypass grafting (CABG) and carotid endarterectomy (CEA) has been
widely performed despite lack of evidence from randomized trials. We
recently showed that the risk of stroke or death within 30 days was higher
following CABG+CEA compared with CABG alone. Here, we report long-term
outcomes following CABG with versus without CEA. <br/>Method(s): The
CABACS (Coronary Artery Bypass Graft Surgery in Patients With Asymptomatic
Carotid Stenosis Study) is a randomized, controlled, multicenter, open
trial. Patients with asymptomatic severe (>=70%) carotid stenosis
undergoing CABG were allocated either CABG+CEA or CABG alone, and
follow-up was 5 years. Major secondary end points included nonfatal stroke
or death, any death and any nonfatal stroke. Due to low recruitment, the
study was stopped prematurely after randomization of 127 patients in 17
centers. <br/>Result(s): By 5 years, the rate of stroke or death did not
significantly differ between groups (CABG+CEA 40.6% [95% CI, 0.285-0.536],
CABG alone 35.0% [95% CI, 0.231-0.484]; P=0.58). Higher albeit
statistically nonsignificant rates of nonfatal strokes occurred at any
time following CABG+CEA versus CABG alone (1 year: 19.3% versus 7.1%,
P=0.09; 5 years: 29.4% versus 18.8%, P=0.25). All-cause mortality up to 5
years was similar in both groups (CABG+CEA: 25.4% versus CABG alone:
23.3%, hazard ratio, 1.148 [95% CI, 0.560-2.353]; P=0.71). Subgroup
analyses did not reveal any significant effect of age, sex, preoperative
modified Rankin Scale and center on outcome events. <br/>Conclusion(s):
During 5-years follow-up, combined simultaneous CABG+CEA was associated
with a higher albeit statistically nonsignificant rate of stroke or death
compared with CABG alone. This was mainly due to a nonsignificantly higher
perioperative risk following CABG+CEA. Since the power of our study was
not sufficient, no significant effect of either procedure could be
observed at any time during follow-up. Registration: URL:
http://www.controlled-trials.com; Unique identifier:
ISRCTN13486906.<br/>Copyright &#xa9; 2022 Lippincott Williams and Wilkins.
All rights reserved.

<4>
Accession Number
2020979795
Title
Neuroprotection role of cooling helmet on neuron specific enolase (NSE)
and post-surgery delirium levels in open heart surgery patients: a
randomized controlled trial.
Source
Anaesthesia, Pain and Intensive Care. 26(5) (pp 588-594), 2022. Date of
Publication: 01 Oct 2022.
Author
Adji M.P.; Hidayat J.K.; Heriwardito A.
Institution
(Adji, Hidayat, Heriwardito) Department of Anesthesiology and Intensive
Care, Universitas Indonesia, Jakarta, Indonesia
Publisher
Faculty of Anaesthesia, Pain and Intensive Care, AFMS
Abstract
Background & objective: This study aims to assess the effect of cooling
helmet during surgery on neuron specific enolase (NSE) and delirium levels
following open heart surgery patients with cardiopulmonary bypass (CPB)
using a heart-lung machine. Methodology: This double-blind randomized
clinical trial took place from October to December 2021 in a tertiary care
hospital. The research used a modified cooling helmet to decrease brain
temperature. Inclusion criteria were adult patients who were scheduled for
open heart surgery with CPB. The subjects were randomized into two groups:
patients with the cooling helmet on as the treatment group (n = 12) and
the patients with the non-cooling helmet on as the control group (n = 13).
The differences between NSE and delirium levels in both groups were
assessed at specific times. <br/>Result(s): NSE levels in the treatment
group were lower than the control group (7.13 +/- 7.63 vs. 12.49 +/- 6.81;
P < 0.05). Regarding the delirium, no statistically significant difference
was found in both groups (P > 0.05). <br/>Conclusion(s): The hypothermia
effect of the cooling helmet is associated with a decrease of neuron
specific enolase levels, but it did not significantly correlate to prevent
the delirium after open heart surgery patients with the cardiopulmonary
bypass machine.<br/>Copyright &#xa9; 2022 Faculty of Anaesthesia, Pain and
Intensive Care, AFMS. All rights reserved.

<5>
Accession Number
2019977492
Title
Dynamic parameters for fluid responsiveness in mechanically ventilated
children: A systematic review.
Source
Frontiers in Pediatrics. 10 (no pagination), 2022. Article Number:
1010600. Date of Publication: 21 Oct 2022.
Author
Yenjabog P.; Kanchongkittiphon W.; Chutipongtanate S.; Lertbunrian R.;
Ungprasert P.
Institution
(Yenjabog, Lertbunrian) Division of Pediatric Critical Care, Department of
Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University,
Bangkok, Thailand
(Kanchongkittiphon) Division of Allergy and Immunology, Department of
Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University,
Bangkok, Thailand
(Chutipongtanate) Pediatric Translational Research Unit, Department of
Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University,
Bangkok, Thailand
(Chutipongtanate) Department of Clinical Epidemiology and Biostatistics,
Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital,
Mahidol University, Bangkok, Thailand
(Chutipongtanate) Chakri Naruebodindra Medical Institute, Faculty of
Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand
(Ungprasert) Department of Rheumatic and Immunologic Diseases, Cleveland
Clinic, Cleveland, OH, United States
Publisher
Frontiers Media S.A.
Abstract
Objective: Fluid administration is the initial step of treatment of
unstable pediatric patients. Evaluation of fluid responsiveness is crucial
in mechanically ventilated children to avoid fluid overload, which
increases mortality. We aim to review and compare the diagnostic
performance of dynamically hemodynamic parameters for predicting fluid
responsiveness in mechanically ventilated children. <br/>Design(s): A
systematic review was performed using four electronic databases, including
PubMed, EMBASE, Scopus, and Central, for published articles from 1 January
2010 to 31 December 2020. Studies were included if they described
diagnostic performance of dynamic parameters after fluid challenge was
performed in mechanically ventilated children. <br/>Setting(s): Pediatric
intensive and cardiac intensive care unit, and operative room.
<br/>Patient(s): Children aged 1 month to 18 years old who were under
mechanical ventilation and required an intravenous fluid challenge.
<br/>Measurements and Main Results: Twenty-seven studies were included in
the systematic review, which included 1,005 participants and 1,138 fluid
challenges. Respiratory variation in aortic peak velocity was reliable
among dynamic parameters for predicting fluid responsiveness in
mechanically ventilated children. All studies of respiratory variation in
aortic peak velocity showed that the area under the receiver operating
characteristic curve ranged from 0.71 to 1.00, and the cutoff value for
determining fluid responsiveness ranged from 7% to 20%. Dynamic parameters
based on arterial blood pressure (pulse pressure variation and stroke
volume variation) were also used in children undergoing congenital heart
surgery. The plethysmography variability index was used in children
undergoing neurological and general surgery, including the pediatric
intensive care patients. <br/>Conclusion(s): The respiratory variation in
aortic peak velocity exhibited a promising diagnostic performance across
all populations in predicting fluid responsiveness in mechanically
ventilated children. High sensitivity is advantageous in non-cardiac
surgical patients and the pediatric intensive care unit because early
fluid resuscitation improves survival in these patients. Furthermore, high
specificity is beneficial in congenital heart surgery because fluid
overload is particularly detrimental in this group of patients. Systematic
Review Registration:
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=206400<br/
>Copyright 2022 Yenjabog, Kanchongkittiphon, Chutipongtanate, Lertbunrian
and Ungprasert.

<6>
Accession Number
2019950583
Title
Use of a Video Laryngoscope to Reduce Complications of Transesophageal
Echocardiography Probe Insertion: A Multicenter Randomized Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(12) (pp 4289-4295),
2022. Date of Publication: December 2022.
Author
Borde D.; C K.; Jasapara A.; Shetty V.; Juvekar N.; Desurkar V.; Gaidu J.;
Joshi P.; Asegaonkar B.; KP U.; V V.; Joshi S.; Koshy T.
Institution
(Borde, Joshi, Asegaonkar) Department of Cardiac Anesthesia, Ozone
Anesthesia Group, Maharashtra, Aurangabad, India
(C) Department of Cardiac Anesthesia, Madras Medical Mission, Tamilnadu,
Chennai, India
(Jasapara, Shetty) Department of Cardiac Anesthesia, Fortis Hospitals,
Maharashtra, MulundMumbai, India
(Juvekar, Desurkar, Gaidu) Department of Cardiac Anesthesia, Deenanath
Maneshkar Hospital, Maharashtra, Pune, India
(KP, V, Koshy) Department of Cardiac Anesthesia, Sree Chitra Tirunal
Institute of Medical Sciences and Technology, Kerala, Trivandrum, India
(Joshi) Department of Cardiac Anesthesia, Narayana Institute of Cardiac
Sciences, Karnataka, Bengaluru, India
Publisher
W.B. Saunders
Abstract
Objective: The objective of this multicenter study was to test the
hypothesis of whether the use of a video laryngoscope (VL) reduces
complications related to transesophageal echocardiography (TEE) probe
insertion. <br/>Design(s): A multicenter randomized control study.
<br/>Setting(s): At 5 tertiary care level hospitals. <br/>Participant(s):
Three hundred sixty-three adult patients undergoing elective cardiac
surgery. <br/>Intervention(s): The patients were randomized into 2
groups-the conventional group (C group; n = 177) and the VL group (n =
186) for TEE probe insertion. <br/>Measurements and Main Results: The
primary endpoint of the study was the incidence of oropharyngeal injury,
which was defined as blood at the tip of the TEE probe at the end of
surgery and/or evidence of injury on VL examination at the end of surgery.
The secondary endpoints of the study were the number of attempts required
for successful TEE probe insertion and the relation between the esophageal
inlet and the larynx. There was a higher incidence of injuries in the C
group (n = 26; 14.7%) compared to the VL group (n = 14; 7.5%; p = 0.029).
The number of attempts for probe insertion was significantly lower in the
VL group (p = 0.0023). The most common relation between the esophageal
inlet and the larynx was posterolateral (n = 88; 47%), followed by
posterior (n = 77; 41%) and lateral (n = 21;12%). <br/>Conclusion(s): The
use of VL was associated with a lesser incidence of injury compared to the
conventional technique, and its use for this purpose is recommended. The
use of VL for probe insertion resulted in fewer attempts compared with the
conventional technique. Significant variations do exist in the relation
between the esophageal inlet and the larynx, and direct visualization with
VL may contribute to better safety.<br/>Copyright &#xa9; 2022 Elsevier
Inc.

<7>
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Accession Number
635468146
Title
Neuromuscular and Clinical Recovery in Thoracic Surgical Patients Reversed
with Neostigmine or Sugammadex.
Source
Anesthesia and Analgesia. 133(2) (pp 435-444), 2021. Date of Publication:
01 Aug 2021.
Author
Murphy G.S.; Avram M.J.; Greenberg S.B.; Bilimoria S.; Benson J.; Maher
C.E.; Teister K.J.; Szokol J.W.
Institution
(Murphy, Greenberg, Bilimoria, Benson, Maher, Teister, Szokol) Department
of Anesthesiology, NorthShore University HealthSystem, 2650 Ridge Ave,
Evanston, IL 60201, United States
(Avram) Department of Anesthesiology, Northwestern University Feinberg
School of Medicine, Chicago, IL, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Patients undergoing thoracoscopic procedures may be at
high-risk for incomplete neuromuscular recovery and associated
complications. The aim of this clinical investigation was to assess the
incidence of postoperative residual neuromuscular blockade in adult
thoracic surgical patients administered neostigmine or sugammadex when
optimal dosing and reversal strategies for these agents were used. The
effect of choice of reversal agent on hypoxemic events and signs and
symptoms of muscle weakness were also determined. Additionally, operative
conditions in each group were graded by surgeons performing the
procedures. <br/>METHOD(S): Two hundred patients undergoing thoracoscopic
surgical procedures were enrolled in this nonrandomized controlled trial.
One hundred consecutive patients maintained at moderate levels of
neuromuscular blockade were reversed with neostigmine (neostigmine group)
followed by 100 consecutive patients given sugammadex to antagonize deeper
levels of neuromuscular blockade (sugammadex group). Anesthetic and
neuromuscular management were standardized. Surgeons rated operative
conditions at the conclusion of the procedure on a 4-point scale (grade 1
= excellent to grade 4 = poor). Train-of-four ratios were measured
immediately before extubation and at PACU admission (primary outcomes).
Postoperatively, patients were assessed for adverse respiratory events and
11 signs and 16 symptoms of muscle weakness. <br/>RESULT(S): The 2 groups
were similar in intraoperative management characteristics. The percentage
of patients with residual neuromuscular blockade, defined as a normalized
train-of-four ratio <0.9, was significantly greater in the neostigmine
group than the sugammadex group at both tracheal extubation (80% vs 6%,
respectively, P <.0001) and PACU admission (61% vs 1%, respectively, P
<.0001). Patients in the neostigmine group had less optimal operative
conditions (median score 2 [good] versus 1 [excellent] in the sugammadex
group; P <.0001), and more symptoms of muscle weakness were present in
these subjects (median number [interquartile range] 4 [1-8] vs 1 [0-2] in
the sugammadex group, P <.0001). No differences between groups in adverse
airway events were observed. <br/>CONCLUSION(S): Despite the application
of strategies documented to reduce the risk of residual neuromuscular
blockade, a high percentage of thoracoscopic patients whose neuromuscular
blockade was reversed with neostigmine were admitted to the PACU with
clinical evidence of residual paralysis. In contrast, muscle weakness was
rarely observed in patients whose neuromuscular blockade was antagonized
with sugammadex.<br/>Copyright &#xa9; 2021 Lippincott Williams and
Wilkins. All rights reserved.

<8>
Accession Number
633654983
Title
Retrograde Autologous Priming in Cardiac Surgery: Results From a
Systematic Review and Meta-analysis.
Source
Anesthesia and Analgesia. 132(1) (pp 100-107), 2021. Date of Publication:
01 Jan 2021.
Author
Hensley N.B.; Gyi R.; Zorrilla-Vaca A.; Choi C.W.; Lawton J.S.; Brown
C.H.; Frank S.M.; Grant M.C.; Cho B.C.
Institution
(Hensley, Frank, Grant) Department of Anesthesiology/Critical Care
Medicine, Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD 21287,
United States
(Gyi, Brown, Cho) Department of Anesthesiology/Critical Care Medicine,
Johns Hopkins University, School of Medicine, Baltimore, MD, United States
(Zorrilla-Vaca) Universidad del Valle School of Medicine Cali, Colombia
(Choi, Lawton) Division of Cardiac Surgery, Johns Hopkins University
School of Medicine, Baltimore, MD, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Retrograde autologous priming (RAP) before cardiopulmonary
bypass (CPB) may minimize allogeneic red cell transfusion. We conducted a
systematic review of the literature to examine the impact of RAP on
perioperative allogeneic red cell transfusions in cardiac surgical
patients. <br/>METHOD(S): This study involved a systematic review and
meta-analysis of randomized controlled trials (RCTs) and observational
studies evaluating the use of RAP in cardiac surgery involving CPB. The
primary outcome was intraoperative allogeneic red cell transfusion.
Secondary outcomes included whole hospital allogeneic transfusions and
adverse events such as acute kidney injury (AKI) and stroke.
<br/>RESULT(S): A total of 11 RCTs (n = 1337 patients) were included,
comparing RAP patients (n = 674) to control (n = 663). In addition, 10
observational studies (n = 2327) were included, comparing RAP patients (n
= 1257) to control (n = 1070). Overall, RAP was associated with a
significantly reduced incidence of intraoperative red cell transfusion (n
= 18 studies; odds ratio [OR] = 0.34; 95% confidence interval [CI],
0.22-0.55, P <.001) compared to controls. This effect was seen among RCTs
(n = 10 studies; OR = 0.19; 95% CI, 0.08-0.45, P <.001) and observational
studies (n = 8 studies; OR = 0.66; 95% CI, 0.50-0.87, P =.004) in
isolation. RAP was also associated with a significantly reduced incidence
of whole hospital red cell transfusion (n = 5 studies; OR = 0.28; 95% CI,
0.19-0.41, P <.001). Among the studies that reported AKI and stroke
outcomes, there was no statistically significant increased odds of AKI or
stroke in either RAP or control patients. <br/>CONCLUSION(S): Based on the
pooled results of the available literature, RAP is associated with a
significant reduction in intraoperative and whole hospital allogeneic red
cell transfusion. Use of RAP may prevent hemodilution of cardiac surgical
patients and thus, lessen transfusions. Additional high-quality
prospective studies are necessary to determine the ideal priming volume
necessary to confer the greatest benefit without incurring organ injury
(Anesth Analg 2021;132:100?7).<br/>Copyright &#xa9; 2020 International
Anesthesia Research Society

<9>
Accession Number
2021158825
Title
Late outcomes of valve-in-valve transcatheter aortic valve implantation
versus re-replacement: Meta-analysis of reconstructed time-to-event data.
Source
International Journal of Cardiology. (no pagination), 2022. Date of
Publication: 2022.
Author
Sa M.P.; Van den Eynde J.; Simonato M.; Hirji S.; Erten O.; Jacquemyn X.;
Tasoudis P.; Dokollari A.; Sicouri S.; Weymann A.; Ruhparwar A.; Arora R.;
Clavel M.-A.; Pibarot P.; Ramlawi B.
Institution
(Sa, Ramlawi) Department of Cardiothoracic Surgery, Lankenau Heart
Institute, Lankenau Medical Center, Main Line Health, Wynnewood, PA,
United States
(Sa, Erten, Tasoudis, Dokollari, Sicouri, Ramlawi) Department of
Cardiothoracic Surgery Research, Lankenau Institute for Medical Research,
PA, United States
(Van den Eynde, Jacquemyn) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Simonato) Yale School of Medicine, New Haven, CT, United States
(Hirji) Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Weymann, Ruhparwar) Department of Thoracic and Cardiovascular Surgery,
West German Heart and Vascular Center Essen, University Hospital of Essen,
University of Duisburg-Essen, Essen, Germany
(Arora) Department of Surgery, Section of Cardiac Surgery, Max Rady
College of Medicine, University of Manitoba, Winnipeg, MB, Canada
(Clavel, Pibarot) Centre de Recherche de l'Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Quebec City, Quebec, Canada
(Clavel, Pibarot) Department of Medicine, Faculty of Medicine, Universite
Laval, Quebec City, Quebec, Canada
Publisher
Elsevier Ireland Ltd
Abstract
Aims: To evaluate all-cause mortality in ViV-TAVI versus redo SAVR in
patients with failed bioprostheses. <br/>Method(s): Study-level
meta-analysis of reconstructed time-to-event data from Kaplan-Meier curves
of non-randomized studies published by September 30, 2021. <br/>Result(s):
Ten studies met our eligibility criteria and included a total of 3345
patients (1676 patients underwent ViV-TAVI and 1669 patients underwent
redo SAVR). Pooling all the studies, ViV-TAVI showed a lower risk of
all-cause mortality in the first 44 days [hazard ratio (HR) 0.67, 95%
confidence interval (CI) 0.49-0.93, P = 0.017], with an HR reversal after
197 days favoring redo SAVR (HR 1.53; 95% CI 1.22-1.93; P < 0.001).
Pooling only the matched populations (1143 pairs), ViV-TAVI showed a lower
risk of all-cause mortality in the first 55 days [hazard ratio (HR) 0.63,
95% confidence interval (CI) 0.45-0.89, P < 0.001], with a reversal HR
after 212 days favoring redo SAVR (HR 1.57; 95% CI 1.22-2.03; P < 0.001).
The Cox regression model showed a statistically significant association of
prosthesis-patient mismatch (PPM) with all-cause mortality during
follow-up for ViV-TAVI (HR 1.03 per percentage increase in the study- and
treatment arm-level proportion of PPM, 95% 1.02-1.05, P < 0.001).
<br/>Conclusion(s): ViV-TAVI is associated with a strong protective effect
immediately after the procedure in comparison with redo SAVR, however,
this initial advantage reverses over time and redo SAVR seems to be a
protective factor for all-cause mortality after 6 months. Considering that
these results are the fruit of pooling data from observational studies,
they should be interpreted with caution and trials are
warranted.<br/>Copyright &#xa9; 2022 Elsevier B.V.

<10>
Accession Number
2020878218
Title
The role of duloxetine in reducing opioid consumption after thoracotomy: a
prospective, randomized, double-blinded, placebo-controlled pilot trial.
Source
Minerva Anestesiologica. 88(10) (pp 780-788), 2022. Date of Publication:
October 2022.
Author
Abdelghafar E.M.; Othman A.H.; Elrawas M.M.; Kilany A.M.; Shaker E.H.
Institution
(Abdelghafar, Elrawas, Shaker) Department of Anesthesia and Pain
Management, National Cancer Institute, Cairo University, Cairo, Egypt
(Othman) Department of Anesthesia, ICU and Pain Relief, South Egypt Cancer
Institute, Assiut University, Assiut, Egypt
(Kilany) Department of Research on Children with Special Needs, National
Research Center, Cairo, Egypt
Publisher
Edizioni Minerva Medica
Abstract
BACKGROUND: Exploration of the thoracic cavity through a thoracotomy
incision for thoracic malignancies is accompanied by severe, excruciating
acute postoperative pain. The objective of this study is to evaluate the
efficacy of perioperative duloxetine when given as part of a multimodal
analgesia in reducing the dose of opioids needed to treat acute
postoperative pain after thoracotomy. <br/>METHOD(S): Sixty patients
scheduled for thoracotomy were randomly assigned to one of two treatment
groups. The duloxetine group (D) received duloxetine 60 mg orally two
hours before the surgical procedure and 24 hours after surgery, and the
placebo group (P) received oral equivalent placebo capsules during the
same time schedule. The primary outcome was the postoperative consumption
of narcotics. Secondary outcome measures were assessment of postoperative
pain scores (VAS) during rest, walking and coughing, hemodynamic variables
and development of any side effects. <br/>RESULT(S): Total dose of
morphine needed to treat postoperative pain in first 48 hours,
intraoperative isoflurane concentrations, intra- and postoperative
epidural infusion rates all were significantly lower in group D (P<0.001).
Postoperative pain at rest (VAS-R) was significantly less frequent in
group D compared to group P at all-time intervals so as during walking
(VAS-W) (P<0.001). While during cough (VAS-C), it was comparable at all
time point except at 12 hours which was significantly low in group D
(P<0.001). The intra-, postoperative mean blood pressure and development
of side effects were comparable between the two groups.
<br/>CONCLUSION(S): Oral duloxetine used perioperatively during thoracic
surgery may play an important role as multimodal analgesia for acute
postoperative pain without any added side effects.<br/>Copyright &#xa9;
2022 EDIZIONI MINERVA MEDICA.

<11>
Accession Number
2020094910
Title
Opioid-Free Anaesthesia Effectiveness in Thoracic Surgery-Objective
Measurement with a Skin Conductance Algesimeter: A Randomized Controlled
Trial.
Source
International Journal of Environmental Research and Public Health. 19(21)
(no pagination), 2022. Article Number: 14358. Date of Publication:
November 2022.
Author
Sadowska D.; Bialka S.; Palaczynski P.; Czyzewski D.; Smereka J.;
Szelka-Urbanczyk A.; Misiolek H.
Institution
(Sadowska) Clinical Department of Internal Medicine, Dermatology and
Allergology, Faculty of Medical Sciences in Zabrze, Medical University of
Silesia, Katowice 40-055, Poland
(Bialka, Palaczynski, Szelka-Urbanczyk, Misiolek) Department of
Anaesthesiology and Intensive Care, Faculty of Medical Sciences in Zabrze,
Medical University of Silesia, Katowice 40-055, Poland
(Czyzewski) Department of Thoracic Surgery, Faculty of Medical Sciences in
Zabrze, Medical University of Silesia, Katowice 40-055, Poland
(Smereka) Department of Emergency Medical Service, Wroclaw Medical
University, Wroclaw 50-367, Poland
Publisher
MDPI
Abstract
Background: Chest surgery is associated with significant pain, and potent
opioid medications are the primary medications used for pain relief.
Opioid-free anaesthesia (OFA) combined with regional anaesthesia is
promoted as an alternative in patients with an opioid contraindication.
<br/>Method(s): Objective: To assess the efficacy of OFA combined with a
paravertebral block in pain treatment during video-assisted thoracic
surgery. <br/>Design(s): A randomized, open-label study. <br/>Setting(s):
A single university hospital between December 2015 and March 2018.
<br/>Participant(s): Sixty-six patients scheduled for elective
video-assisted thoracic surgery were randomized into two groups. Of these,
16 were subsequently excluded from the analysis. <br/>Intervention(s): OFA
combined with a paravertebral block with 0.5% bupivacaine in the OFA
group; typical general anaesthesia with opioids in the control group.
<br/>Main Outcome Measure(s): Intraoperative nociceptive intensity
measured with a skin conductance algesimeter (SCA) and traditional
intraoperative monitoring. <br/>Result(s): Higher mean blood pressure was
observed in the control group before induction and during intubation (p =
0.0189 and p = 0.0095). During chest opening and pleural drainage, higher
SCA indications were obtained in the control group (p = 0.0036 and p =
0.0253), while in the OFA group, the SCA values were higher during
intubation (p = 0.0325). SCA during surgery showed more stable values in
the OFA group. Pearson analysis revealed a positive correlation between
the SCA indications and mean blood pressure in both groups.
<br/>Conclusion(s): OFA combined with a paravertebral block provides
effective nociception control during video-assisted thoracic surgery and
can be an alternative for general anaesthesia with opioids. OFA provides a
stable nociception response during general anaesthesia, as measured by
SCA.<br/>Copyright &#xa9; 2022 by the authors.

<12>
Accession Number
639506426
Title
Endothelialization and Inflammatory Reactions After Intracardiac Device
Implantation.
Source
Advances in Experimental Medicine and Biology. 1401 (pp 1-22), 2022. Date
of Publication: 2022.
Author
Edlinger C.; Paar V.; Kheder S.H.; Krizanic F.; Lalou E.; Boxhammer E.;
Butter C.; Dworok V.; Bannehr M.; Hoppe U.C.; Kopp K.; Lichtenauer M.
Institution
(Edlinger, Lalou, Butter, Dworok, Bannehr) Department of Cardiology, Heart
Center Brandenburg, Bernau/Berlin, Germany
(Edlinger, Kheder, Lalou, Butter, Dworok, Bannehr) Brandenburg Medical
School (MHB) "Theodor Fontane", Neuruppin, Germany
(Edlinger, Paar, Boxhammer, Hoppe, Kopp, Lichtenauer) Department of
Internal Medicine II, Division of Cardiology, Paracelsus Medical
University of Salzburg, Salzburg, Austria
(Krizanic) Department of Cardiology, Caritas Clinic Pankow, Berlin,
Germany
Publisher
Springer
Abstract
Background: Due to the advances in catheter-based interventional
techniques, a wide range of heart diseases can now be treated with a
purely interventional approach. Little is yet known regarding biological
effects at the intracardiac implantation site or the effects on
endothelialization and vascular inflammation in an in vivo environment.
Detailed knowledge of ongoing vascular response, the process of
endothelialization, and possible systemic inflammatory reactions after
implantation is crucial for the clinical routine, since implants usually
remain in the body for a lifetime. <br/>Method(s): For this narrative
review, we conducted an extensive profound PubMed analysis of the current
literature on the endothelialization processes of intracardially implanted
devices, such as persistent foramen ovale (PFO) occluders, atrial septal
defect (ASD) occluders, left atrial appendage (LAA) occluders,
transcatheter aortic valve implantations (TAVIs), and leadless pacemakers.
Additionally, the known biological activities of common metallic and
synthetic components of intracardiac devices in an "in vivo" setting have
been evaluated. <br/>Result(s): Nitinol, an alloy of nickel and titanium,
is by far the most commonly used material found in intracardiac devices.
Although allergies to both components are known, implantation can be
performed safely in the vast majority of patients. Depending on the device
used, endothelialization can be expected within a time frame of 3-6
months. For those patients with a known allergy, gold coating may be
considered as a viable alternative. <br/>Conclusion(s): Based on our
analysis, we conclude that the vast majority of devices are made of a
material that is both safe to implant and nontoxic in long-term treatment
according to the current knowledge. The literature on the respective
duration of endothelialization of individual devices however is highly
divergent.<br/>Copyright &#xa9; 2022, Springer Nature Switzerland AG.

<13>
Accession Number
639511334
Title
Fate of iatrogenic atrial septal defects following mitral transcatheter
edge-to-edge repair - a subanalysis of the MITHRAS trial.
Source
The international journal of cardiovascular imaging. (no pagination),
2022. Date of Publication: 13 Nov 2022.
Author
Blazek S.; Unterhuber M.; Rommel K.-P.; Kresoja K.-P.; Kister T.; Besler
C.; Fengler K.; Rosch S.; Daehnert I.; Thiele H.; Lurz P.; von Roeder M.
Institution
(Blazek, Unterhuber, Rommel, Kresoja, Kister, Besler, Fengler, Rosch,
Thiele, Lurz, von Roeder) Department of Internal Medicine/Cardiology,
Heart Center Leipzig at Leipzig University, Struempellstrasse 39, Leipzig
04289, Germany
(Rosch, Thiele, Lurz) Leipzig Heart Institute, Leipzig, Germany
(Daehnert) Department of Pediatric Cardiology, Heart Center Leipzig at
Leipzig University, Leipzig, Germany
Publisher
NLM (Medline)
Abstract
Persisting iatrogenic atrial septal defects (iASD) after transcatheter
mitral edge-to-edge repair (M-TEER) are associated with impaired outcomes.
We investigated the natural history of relevant iASDs with left-to-right
shunting post-M-TEER, predictors of spontaneous closure of iASD between 1
and 6 months post-M-TEER, and outcomes (heart failure [HF]
hospitalization) in patients with spontaneous closure versus those with
persistent iASD 6 months post-M-TEER. Patients with a relevant iASD
1-month post-M-TEER, who were treated conservatively in the randomized
controlled MITHRAS trial, underwent clinical follow-up including
transesophageal echocardiography 6 months post-M-TEER. Overall, 36
patients (median 77 [interquartile range 65-81] years; 36% women)
completed the 6-months follow-up. Six (17%) patients had a spontaneous
closure of the iASD. The eccentricity index of the iASD 1-month after
M-TEER was the strongest predictor for spontaneous closure (Odds ratio
3.78; 95% confidence interval 1.26-11.33, p=0.01) and an eccentricity
index of<1.9 provided a sensitivity of 77% at a specificity of 83% for
iASD persistence (Area under the curve 0.83, p<0.001) within 6-months post
M-TEER.At follow-up, a numerical difference in the endpoint of HF
hospitalization between the spontaneous closure and the residual shunt
group (0% vs. 20%, p=0.25) was observed. The eccentricity of the iASD was
the strongest predictor for spontaneous closure at 1-months and an
eccentricity index of<1.9 is associated with a high persistence rate for 6
month after M-TEER. Clinical Trial Registration ClinicalTrials.gov
https://clinicaltrials.gov/ct2/show/NCT03024268 Identifier: NCT03024268. a
(red) is reflecting the mayor lengthwise dimension and b (blue) the mayor
oblique dimension. The eccentricity index is calculated by dividing a
through b. (Open circle) is depicting an example for a round iASD and
(Open rhombus) an example for an eccentric iASD 1 month after
M-TEER.<br/>Copyright &#xa9; 2022. The Author(s).

<14>
Accession Number
2015002102
Title
Colchicine may become a new cornerstone therapy for coronary artery
disease: a meta-analysis of randomized controlled trials.
Source
Clinical Rheumatology. 41(6) (pp 1873-1887), 2022. Date of Publication:
June 2022.
Author
Zhang H.; Chen Y.; Li M.; Luo W.; Liu Y.; Fu Y.; Xia H.; Xu C.; Jiang Y.;
Wu Y.
Institution
(Chen, Zhang, Chen, Li, Luo, Liu, Fu, Xia, Xu, Wu) Department of
Cardiovascular Medicine, Donghu District, The Second Affiliated Hospital
of Nanchang University, No. 1, Minde Road, Jiangxi, Nanchang 330006, China
(Jiang) Department of Cardiovascular Medicine, Donghu District, The First
Affiliated Hospital of Nanchang University, No. 17, Yongzhengwai Road,
Jiangxi, Nanchang 330006, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: Colchicine is an ancient anti-inflammatory drug. In recent years,
an increasing number of studies have shown that colchicine improves the
prognosis of patients with coronary artery disease (CAD), while other
studies have reported the opposite. The aim of this study was to evaluate
the relative efficacy and safety of colchicine in treating CAD.
<br/>Method(s): PubMed, EMBASE, the Cochrane Library, and
ClinicalTrials.gov were searched from inception to 20 October 2020 for
randomized controlled trials (RCTs) comparing colchicine and placebo in
patients with CAD. The primary outcomes were the primary composite
outcomes of cardiovascular death, myocardial infarction (MI), ischemic
stroke, or ischemia-driven coronary revascularization after colchicine
administration. The secondary outcomes were cardiovascular death, death
from any cause, noncardiac death, MI, ischemic stroke, coronary
revascularization, gastrointestinal (GI) symptoms, and the different
effects of colchicine in acute and chronic CAD. We assessed the pooled
odds ratio (OR) of all-cause and cardiovascular mortality for CAD in
fixed-effects models, the pooled risk ratio (RR) of the primary composite
outcomes, MI, ischemic stroke, and ischemia-driven coronary
revascularization in fixed-effects models and the pooled RR of GI symptoms
in random-effects models. The Cochrane risk of bias tool was used to
assess the risk of bias in the included RCTs. <br/>Finding(s): Eleven of
the 894 identified studies (n = 12,899 patients) were included (6501
subjects in the colchicine group; 6389 subjects in the control group). The
colchicine group had significantly lower pooled RRs of the primary
composite outcomes (0.73, 95% confidence interval (CI) 0.64-0.84, P <
0.0001), MI (0.77, 95% CI 0.64-0.92, P = 0.004), ischemic stroke (0.47,
95% CI 0.30-0.76, P = 0.002), and ischemia-driven coronary
revascularization (0.77, 95% CI 0.66-0.89, P = 0.0007), while the pooled
RR of adverse GI events (2.15 95% CI 1.40-3.31, P = 0.0005) was
significantly higher. Colchicine had a lower pooled RR of ischemic stroke
(0.28, 95% CI 0.12-0.65, P = 0.003) for patients with acute compared with
chronic CAD. Implications: Colchicine treatment significantly decreased
the risk of primary cardiovascular composite outcomes, MI, ischemic
stroke, and ischemia-driven coronary revascularization in CAD patients but
increased adverse GI events. There was no significant difference in
all-cause mortality, cardiovascular mortality, and non-cardiovascular
death between the colchicine and control groups. Colchicine performs
better in acute CAD patients with ischemic stroke than chronic CAD
patients. Colchicine might be a new treatment for patients with
CAD.<br/>Copyright &#xa9; 2022, International League of Associations for
Rheumatology (ILAR).

<15>
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.<br/>Copyright &#xa9; 2022 Zhejiang University

<16>
Accession Number
2017089479
Title
Therapeutic Potential of Electromyostimulation (EMS) in Critically Ill
Patients-A Systematic Review.
Source
Frontiers in Physiology. 13 (no pagination), 2022. Article Number: 865437.
Date of Publication: 09 May 2022.
Author
Balke M.; Teschler M.; Schafer H.; Pape P.; Mooren F.C.; Schmitz B.
Institution
(Balke, Pape) St. Marien Hospital Cologne, Department of Early
Rehabilitation, Cologne, Germany
(Balke, Teschler, Schafer, Mooren, Schmitz) Department of Rehabilitation
Sciences, Faculty of Health, University of Witten/Herdecke, Witten,
Germany
(Teschler, Schafer, Mooren, Schmitz) DRV Clinic Konigsfeld, Center for
Medical Rehabilitation, Ennepetal, Germany
Publisher
Frontiers Media S.A.
Abstract
Ample evidence exists that intensive care unit (ICU) treatment and
invasive ventilation induce a transient or permanent decline in muscle
mass and function. The functional deficit is often called ICU-acquired
weakness with critical illness polyneuropathy (CIP) and/or myopathy (CIM)
being the major underlying causes. Histopathological studies in ICU
patients indicate loss of myosin filaments, muscle fiber necrosis, atrophy
of both muscle fiber types as well as axonal degeneration. Besides medical
prevention of risk factors such as sepsis, hyperglycemia and pneumonia,
treatment is limited to early passive and active mobilization and one
third of CIP/CIM patients discharged from ICU never regain their
pre-hospitalization constitution. Electromyostimulation [EMS, also termed
neuromuscular electrical stimulation (NMES)] is known to improve strength
and function of healthy and already atrophied muscle, and may increase
muscle blood flow and induce angiogenesis as well as beneficial systemic
vascular adaptations. This systematic review aimed to investigate evidence
from randomized controlled trails (RCTs) on the efficacy of EMS to improve
the condition of critically ill patients treated on ICU. A systematic
search of the literature was conducted using PubMed (Medline), CENTRAL
(including Embase and CINAHL), and Google Scholar. Out of 1,917 identified
records, 26 articles (1,312 patients) fulfilled the eligibility criteria
of investigating at least one functional measure including muscle
function, functional independence, or weaning outcomes using a RCT design
in critically ill ICU patients. A qualitative approach was used, and
results were structured by 1) stimulated muscles/muscle area (quadriceps
muscle only; two to four leg muscle groups; legs and arms; chest and
abdomen) and 2) treatment duration (<=10 days, >10 days). Stimulation
parameters (impulse frequency, pulse width, intensity, duty cycle) were
also collected and the net EMS treatment time was calculated. A high grade
of heterogeneity between studies was detected with major cofactors being
the analyzed patient group and selected outcome variable. The overall
efficacy of EMS was inconclusive and neither treatment duration,
stimulation site or net EMS treatment time had clear effects on study
outcomes. Based on our findings, we provide practical recommendations and
suggestions for future studies investigating the therapeutic efficacy of
EMS in critically ill patients. Systematic Review Registration:
[https://www.crd.york.ac.uk/prospero/], identifier
[CRD42021262287].<br/>Copyright &#xa9; 2022 Balke, Teschler, Schafer,
Pape, Mooren and Schmitz.

<17>
Accession Number
2018221467
Title
A clinical profile of infective endocarditis in patients with recent
COVID-19: A systematic review.
Source
American Journal of the Medical Sciences. 364(1) (pp 16-22), 2022. Date of
Publication: July 2022.
Author
Quintero-Martinez J.A.; Hindy J.-R.; Mahmood M.; Gerberi D.J.; DeSimone
D.C.; Baddour L.M.
Institution
(Quintero-Martinez, Hindy, Mahmood, DeSimone, Baddour) Division of
Infectious Diseases, Departments of Medicine and Cardiovascular Diseases,
Mayo Clinic College of Medicine and Science, 200 First St. SW, Rochester,
MN 55905, United States
(Gerberi) Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, United States
Publisher
Elsevier B.V.
Abstract
Background: Coronavirus disease 2019 (COVID-19) can progress to
cardiovascular complications which are linked to higher in-hospital
mortality rates. Infective endocarditis (IE) can develop in patients with
recent COVID-19 infections, however, characterization of IE following
COVID-19 infection has been lacking. To better characterize this disease,
we performed a systematic review with descriptive analysis of the clinical
features and outcomes of these patients. <br/>Method(s): Our search was
conducted in 8 databases for all published reports of probable or definite
IE in patients with a prior COVID-19 confirmed diagnosis. After ensuring
an appropriate inclusion of the articles, we extracted data related to
clinical characteristics, modified duke criteria, microbiology, outcomes,
and procedures. <br/>Result(s): Searches generated a total of 323
published reports, and 20 articles met our inclusion criteria. The mean
age of patients was 52.2 +/- 16.9 years and 76.2% were males.
Staphylococcus aureus was isolated in 8 (38.1%) patients, Enterococcus
faecalis in 3 patients (14.3%) and Streptococcus mitis/oralis in 2 (9.5%)
patients. The mean time interval between COVID-19 and IE diagnoses was
16.7 +/- 15 days. Six (28.6%) patients required critical care due to IE, 7
patients (33.3%) underwent IE-related cardiac surgery and 5 patients
(23.8%) died during their IE hospitalization. <br/>Conclusion(s): Our
systematic review provides a profile of clinical features and outcomes of
patients with a prior COVID-19 infection diagnosis who subsequently
developed IE. Due to the ongoing COVID-19 pandemic, it is essential that
clinicians appreciate the possibility of IE as a unique complication of
COVID-19 infection.<br/>Copyright &#xa9; 2022 Southern Society for
Clinical Investigation

<18>
Accession Number
2018000128
Title
Randomized trial of conventional versus radiofrequency needle transseptal
puncture for cryoballoon ablation: the CRYO-LATS trial.
Source
Journal of Interventional Cardiac Electrophysiology. 65(2) (pp 481-489),
2022. Date of Publication: November 2022.
Author
Andrade J.G.; Macle L.; Bennett M.T.; Hawkins N.M.; Essebag V.; Champagne
J.; Roux J.-F.; Makanjee B.; Tang A.; Skanes A.; Khaykin Y.; Morillo C.;
Jolly U.; Lockwood E.; Amit G.; Angaran P.; Sapp J.; Wardell S.; Wells
G.A.; Verma A.; Deyell M.W.
Institution
(Andrade, Bennett, Hawkins, Deyell) University of British Columbia,
Vancouver, Canada
(Andrade, Hawkins, Deyell) Center for Cardiovascular Innovation, 2775
Laurel St, Vancouver, BC V5Z 1M9, Canada
(Andrade, Macle) Montreal Heart Institute, Universite de Montreal,
Montreal, Canada
(Essebag, Verma) McGill University Health Centre, Montreal, Canada
(Essebag) Hopital Sacre-Coeur de Montreal, Montreal, Canada
(Champagne) Universite Laval, QC, Canada
(Roux) Universite de Sherbrooke, Sherbrooke, Canada
(Makanjee) Rouge Valley Centenary Hospital, Ajax, Canada
(Tang, Skanes) University of Western Ontario, London, Canada
(Khaykin) Southlake Regional Health Center, Newmarket, Canada
(Morillo) Libin Cardiovascular Institute, University of Calgary, Calgary,
Canada
(Jolly) St. Mary's Hospital, Kitchener, Canada
(Lockwood) Royal Alexandra Hospital, Edmonton, Canada
(Amit) McMaster University, Hamilton, Canada
(Angaran) St. Michael's Hospital, University of Toronto, Toronto, Canada
(Sapp) Dalhousie University, Halifax, Canada
(Wardell) University of Saskatchewan, Saskatoon, Canada
(Wells) University of Ottawa Heart Institute, Ottawa, Canada
Publisher
Springer
Abstract
Background: Transseptal puncture to achieve left atrial access is
necessary for many cardiac procedures, including atrial fibrillation
ablation. More recently, there has been an increasing need for left atrial
access using large caliber sheaths, which increases risk of perforation
associated with the initial advancement into the left atrium. We compared
the effectiveness of a radiofrequency needle-based transseptal system
versus conventional needle for transseptal access. <br/>Method(s): This
prospective controlled trial randomized 161 patients with symptomatic
paroxysmal atrial fibrillation undergoing cryoballoon pulmonary vein
isolation to transseptal access with a commercially available transseptal
system (radiofrequency needle plus stiff pigtail wire; RF + Pigtail group)
versus conventional transseptal access (standard group). The primary
outcome was time required for left atrial access. Secondary outcomes
included failure of the assigned transseptal system, radiation exposure,
and complications. <br/>Result(s): The median transseptal puncture time
was significantly shorter using the radiofrequency needle plus stiff
pigtail wire transseptal system compared with conventional transseptal
(840 +/- 323 vs. 956 +/- 407 s, P = 0.0489). Compared to conventional
transseptal puncture, fewer transseptal attempts were required (1.0 +/-
0.5 RF applications vs. 1.3 +/- 0.8 mechanical punctures, P = 0.0123) and
the fluoroscopy time was significantly shorter (72.0 [IQR 48.0, 129.0] vs.
93.0 [IQR 60.0, 171.0] s, P = 0.0490) with the radiofrequency needle plus
stiff pigtail wire transseptal system. Failure to achieve transseptal LA
access with the assigned system was rarely observed (1.3% vs. 5.7%, P =
0.2192). There were no procedural complications observed with either
system. <br/>Conclusion(s): The use of a radiofrequency needle plus stiff
pigtail wire resulted in shorter time to left atrial access and reduced
fluoroscopy time compared to left atrial access using conventional
transseptal equipment. Trial registration: ClinicalTrials.gov identifier
NCT03199703.<br/>Copyright &#xa9; 2022, The Author(s).

<19>
Accession Number
2020668456
Title
Using Music for the Prevention of Delirium in Patients After Coronary
Artery Bypass Graft Surgery: A Randomized Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 36(12) (pp 4341-4346),
2022. Date of Publication: December 2022.
Author
Esfahanian F.; Mirmohammadsadeghi A.; Gholami H.; Neshat S.; Mansouri M.;
Sadeghi M.; Bathaie S.R.; Heidari Z.; Mirmohammadsadeghi M.
Institution
(Esfahanian, Gholami, Neshat, Bathaie) School of Medicine, Isfahan
University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Mansouri) Cardiac Anesthesia Research Center, Department of
Anesthesiology, Isfahan University of Medical Sciences, Isfahan, Iran,
Islamic Republic of
(Sadeghi) Cardiac Rehabilitation Research Center, Isfahan Cardiovascular
Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran,
Islamic Republic of
(Heidari) School of Health, Isfahan University of Medical Sciences,
Isfahan, Iran, Islamic Republic of
(Mirmohammadsadeghi, Mirmohammadsadeghi) Chamran Cardiovascular Medical
and Research Hospital, Isfahan University of Medical Sciences, Isfahan,
Iran, Islamic Republic of
Publisher
W.B. Saunders
Abstract
Objective: The aim was to evaluate the effect of music on preventing
delirium after coronary artery bypass grafting, to analyze vital signs and
blood gas parameters, and to determine risk factors affecting delirium.
<br/>Design(s): A randomized clinical trial. <br/>Setting(s): A
single-center, tertiary hospital. <br/>Participant(s): In total, 200
patients who underwent coronary artery bypass grafting surgery from April
2020 to April 2021. <br/>Intervention(s): A one-hour session of new-age
music was administered twice a day postoperatively for 7 days using a
headphone. Delirium was assessed using the Confusion Assessment Method for
the Intensive Care Unit before and after each session. Vital signs and
blood gas parameters were compared to evaluate the effect of music. All
assessments were conducted blindly by a different researcher.
<br/>Measurements and Main Results: Twelve participants who were
delirium-positive were in the control group, and there were 3 in the case
group, which suggested a statistically significant effect of music in
preventing delirium (p = 0.016). The mean age of patients was 64.7 +/- 7.9
years old in the control group and 62.2 +/- 7.5 years old in the case
group. There was a significant difference among the control and case
groups in terms of the surgery time; surgery time in the control group was
significantly lower than in the case group (242.4 +/- 42.3 v 261.6 +/-
48.9, respectively; p = 0.03 < 0.05). Blood pressure and heart rate in the
case group were lower, similar to the respiratory rate and venous blood
gas parameters; Blood pressure differences were not statistically
significant (p > 0.05); <br/>Conclusion(s): Relaxation music, including
bird, water, and wind, significantly prevents delirium after coronary
artery bypass grafting.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<20>
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. 36(12) (pp 4386-4392),
2022. Date of Publication: December 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. <br/>Design(s): A prospective, randomized study.
<br/>Setting(s): The cardiothoracic operating room and intensive care unit
of a tertiary-care hospital in India. <br/>Participant(s): Ninety adult
patients scheduled to undergo posterolateral thoracotomy for lung surgery
under general anesthesia were recruited and randomized into 3 equal
groups. <br/>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. <br/>Conclusion(s): The nerve blocks in decreasing order of
analgesic efficacy in relieving post-thoracotomy pain would be ESB, TPVB,
and SAPB.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<21>
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. 36(12) (pp 4357-4363),
2022. Date of Publication: December 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). <br/>Design(s): A prospective, randomized,
controlled study. <br/>Setting(s): A single-center tertiary teaching
hospital. <br/>Participant(s): One hundred twenty pediatric patients
undergoing elective repair of congenital acyanotic heart diseases with
CPB. <br/>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.
<br/>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. <br/>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.<br/>Copyright
&#xa9; 2022 Elsevier Inc.

<22>
Accession Number
2020021418
Title
Impact of sleep disordered breathing on postoperative atrial fibrillation
in patients who underwent cardiac surgery: a meta-analysis.
Source
Annals of Medicine. 54(1) (pp 3177-3188), 2022. Date of Publication: 2022.
Author
Chen Z.; Zhang R.; Hu X.; Wan C.; Shen Y.; Qin J.; Gao L.; Zhu J.
Institution
(Chen) West China School of Medicine/West China Hospital of Sichuan
University and West China Tianfu Hospital of Sichuan University, Chengdu,
China
(Zhang) Information Center, West China Hospital of Sichuan University,
Chengdu, China
(Hu, Wan, Shen, Qin, Gao, Zhu) Department of Respiratory and Critical Care
Medicine, West China Hospital of Sichuan University, Chengdu, China
Publisher
Taylor and Francis Ltd.
Abstract
Objective: An increasing number of studies suggest that sleep disordered
breathing (SDB) may be associated with postoperative atrial fibrillation
(POAF), but these studies present discrepant results. Thus, this
meta-analysis aimed to synthesize the data associating SDB with POAF in
patients who underwent cardiac surgery. <br/>Method(s): A literature
search was performed in the Scopus, PubMed, Web of Science, EMBASE,
CENTRAL, Weipu, Wanfang Data, and China National Knowledge Infrastructure
databases before August 2022. Data were extracted, and the strength of the
relationship between SDB and the risk of POAF was evaluated using odds
ratio (OR) and 95% confidence intervals (CIs). All statistical analysis
was carried out using the Stata 12.0 software. <br/>Result(s): A total of
24 studies with 660,685 subjects were included in current meta-analysis.
SDB was significantly associated with the risk of POAF in the patients who
underwent cardiac surgery (OR = 1.49; 95% CI, 1.30-1.70; p <.001). Next
subgroup analysis revealed that such association may be increased in the
group with medical equipment-measured SDB (OR = 2.27; 95% CI, 1.59-3.23; p
<.001), prospective studies (OR = 2.17; 95% CI, 1.55-3.03; p <.001),
patients without a previous history of atrial fibrillation (OR = 2.04; 95%
CI, 1.47-2.82; p <.001), and patients who received a coronary artery
bypass graft (OR = 2.10; 95% CI, 1.45-3.05; p <.001). No publication bias
was identified. <br/>Conclusion(s): The results of meta-analysis support
that SDB may be associated with an increased risk of POAF in patients who
had undergone cardiac surgery, and these results should be confirmed in
more rigorously designed studies.KEY MESSAGES Patients with SDB who
underwent cardiac surgery showed increased risk of POAF. The relationship
between SDB and POAF should be explained with caution with the
consideration of various covariate. The effect of pre-treatment of SDB on
POAF should be examined in future.<br/>Copyright &#xa9; 2022 The
Author(s). Published by Informa UK Limited, trading as Taylor & Francis
Group.

<23>
[Use Link to view the full text]
Accession Number
639486204
Title
Ischemia-free organ transplantation - a review.
Source
Current opinion in organ transplantation. 27(4) (pp 300-304), 2022. Date
of Publication: 01 Aug 2022.
Author
Guo Z.; Luo T.; Mo R.; Zhao Q.; He X.
Institution
(Guo, Luo, Mo, Zhao, He) Organ Transplant Center, First Affiliated
Hospital, Sun Yat-sen University
(Guo, Luo, Mo, Zhao, He) Guangdong Provincial Key Laboratory of Organ
Donation and Transplant Immunology
(Guo, Luo, Mo, Zhao, He) Guangdong Provincial International Cooperation
Base of Science and Technology, Guangzhou, China
Publisher
NLM (Medline)
Abstract
PURPOSE OF REVIEW: Organ transplantation is one of the miracles in
medicine in the 20th century. However, in the current practice, all the
donor organs suffer from ischemia/reperfusion injury (IRI), which
compromise transplant outcomes and limits organ availability. Continuous
efforts have been made in organ machine perfusion to ameliorate IRI. In
2017, ischemia-free organ transplantation (IFOT) was first proposed with
the aim of complete avoidance of IRI in organ transplantation. The purpose
of this review is to highlight the latest progresses in IFOT. RECENT
FINDINGS: The feasibility of IFOT has been validated in liver, kidney, and
heart transplantation. The results of the first nonrandomized controlled
study demonstrate that ischemia-free liver transplantation (IFLT) may
improve transplant outcomes and increase organ availability. Furthermore,
laboratory results, including the absence of the characteristic
pathological changes, gene transcription and metabolic reprogramming, as
well as sterile inflammation activation in IFLT grafts, suggest the
virtual avoidance of graft IRI in IFLT. SUMMARY: IFOT might change the
current practice by abrogating graft IRI. IFOT also provides a unique
model to investigate the interaction between allograft IRI and rejection.
The next steps will be to simplify the technique, make long-distance
transportation possible and evaluate cost-effectiveness.<br/>Copyright
&#xa9; 2022 The Author(s). Published by Wolters Kluwer Health, Inc.

<24>
Accession Number
635205998
Title
Return to work after coronary artery bypass grafting and aortic valve
replacement surgery: A scoping review.
Source
Scandinavian journal of caring sciences. 36(4) (pp 893-909), 2022. Date of
Publication: 01 Dec 2022.
Author
Mortensen M.; Sandvik R.K.N.M.; Svendsen OS.; Haaverstad R.; Moi A.L.
Institution
(Mortensen, Sandvik, Moi) Department of Health and Caring Sciences,
Western Norway University of Applied Sciences, Bergen, Norway
(Svendsen) Department of Anaesthesia and Intensive Care, Haukeland
University Hospital, Bergen, Norway
(Haaverstad) Section of Cardiothoracic Surgery, Department of Heart
Disease, Haukeland University Hospital, Bergen, Norway
(Haaverstad) Department of Clinical Science, Faculty of Medicine,
University of Bergen, Bergen, Norway
(Moi) Department of Plastic, Hand and Reconstructive Surgery, National
Burn Centre, Haukeland University Hospital, Bergen, Norway
Publisher
NLM (Medline)
Abstract
BACKGROUND: Coronary artery bypass grafting surgery and aortic valve
replacement surgery are essential treatment options for people suffering
from angina pectoris or aortic valve disease. Surgery aims to prolong life
expectancy, improve quality of life, and facilitate participation in
society for the individuals afflicted. The aim of this review was to
explore the literature on work participation in patients following
coronary artery bypass grafting or aortic valve replacement surgery, and
to identify demographic and clinical characteristics associated with
returning to work. <br/>METHOD(S): A scoping review framework of Arksey
and O'Malley was chosen. Four electronic databases: Medline, CINAHL,
Embase, and Google Scholar were searched for studies in English, Swedish,
Danish or Norwegian between January 1988 and January 2020. A blinded
selection of articles was performed. The data were then charted and
summarized by descriptive numerical analyses and categorized into themes.
<br/>RESULT(S): Forty-five out of 432 articles were included in the final
full-text analysis. Absence from work following coronary artery bypass
graft grafting or aortic valve replacement surgery lasted on average 30
weeks, whereas 34% of the patients never returned to work. Being female,
suffering from pre-existing depression, having limited secondary
education, or low income were associated with decreased return to work
rates. Previous employment was a decisive factor for returning to work
after surgery. Data on return to work after aortic valve replacement were
scarce. <br/>CONCLUSION(S): A significant number of patients never return
to work following coronary artery bypass grafting or aortic valve surgery,
and the time interval until work return is longer than expected. Failure
to resume work represents a threat to the patients' finances and quality
of life. Nurses are in a unique position to assess work-related issues and
have an active part in the multi-disciplinary facilitation of tailored
occupational counselling after cardiac surgery.<br/>Copyright &#xa9; 2021
The Authors. Scandinavian Journal of Caring Sciences published by John
Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

<25>
Accession Number
2020983839
Title
Hospitalizations and Mortality in Patients With Secondary Mitral
Regurgitation and Heart Failure: The COAPT Trial.
Source
Journal of the American College of Cardiology. 80(20) (pp 1857-1868),
2022. Date of Publication: 15 Nov 2022.
Author
Giustino G.; Camaj A.; Kapadia S.R.; Kar S.; Abraham W.T.; Lindenfeld J.;
Lim D.S.; Grayburn P.A.; Cohen D.J.; Redfors B.; Zhou Z.; Pocock S.J.;
Asch F.M.; Mack M.J.; Stone G.W.
Institution
(Giustino, Camaj, Stone) The Zena and Michael A. Wiener Cardiovascular
Institute Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Kapadia) Cleveland Clinic, Cleveland, OH, United States
(Kar) Los Robles Regional Medical Center, Thousand Oaks, CA, United States
(Kar) Bakersfield Heart Hospital, Bakersfield, CA, United States
(Abraham) Division of Cardiovascular Medicine, The Ohio State University
Medical Center, Columbus, OH, United States
(Lindenfeld) Advanced Heart Failure and Cardiac Transplantation Section,
Vanderbilt Heart and Vascular Institute, Nashville, TN, United States
(Lim) Division of Cardiology, University of Virginia, Charlottesville, VA,
United States
(Grayburn) Baylor University Medical Center, Baylor Heart and Vascular
Institute, Dallas, TX, United States
(Cohen) St Francis Hospital, Roslyn, NY, United States
(Cohen, Redfors, Zhou) Clinical Trials Center Cardiovascular Research
Foundation, New York, NY, United States
(Pocock) London School of Hygiene and Tropical Medicine, London, United
Kingdom
(Asch) MedStar Health Research Institute, Washington, DC, United States
(Asch) Georgetown University, Washington, DC, United States
(Mack) Baylor Scott and White Health, Plano, TX, United States
Publisher
Elsevier Inc.
Abstract
Background: The impact of transcatheter edge-to-edge repair (TEER) on the
rate and prognostic impact of hospitalizations in patients with heart
failure (HF) and severe secondary mitral regurgitation is unknown.
<br/>Objective(s): This study sought to evaluate the effect of the
MitraClip percutaneous edge-to edge repair system on fatal and nonfatal
hospitalizations and their relationship with mortality in the COAPT
(Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy
for Heart Failure Patients With Functional Mitral Regurgitation) trial.
<br/>Method(s): Patients with HF (n = 614) with severe secondary mitral
regurgitation were randomized to TEER plus guideline-directed medical
therapy (GDMT) versus GDMT alone. Hospitalizations were classified as
fatal if death occurred during that hospitalization or nonfatal if the
patient was discharged alive. <br/>Result(s): At 2 years, TEER treatment,
compared with GDMT alone, resulted in lower time-to-first-event rates of
any heart failure hospitalization (HFH) (34.8% vs 56.4%; HR: 0.51; 95% CI:
0.39-0.66) and fatal HFH (6.5% vs 12.6%; HR: 0.47; 95% CI: 0.26-0.85).
TEER also resulted in lower rates of all-cause nonfatal and fatal
hospitalizations. During the 2-year follow-up period, patients who
underwent TEER spent an average of 2 more months alive and out of the
hospital than did patients treated with GDMT alone (581 +/- 27 days vs 519
+/- 26 days; P = 0.002). All HFHs (adjusted HR: 6.37; 95% CI: 4.63-8.78)
and nonfatal HFHs (adjusted HR: 1.78; 95% CI: 1.27-2.49) were consistently
independently associated with increased 2-year mortality in both the TEER
and GDMT groups (P<inf>interaction</inf> = 0.34 and 0.39, respectively).
<br/>Conclusion(s): In the COAPT trial, compared with GDMT alone, patients
with HF and severe secondary mitral regurgitation undergoing TEER with the
percutaneous edge-to edge repair system had lower 2-year rates of fatal
and nonfatal all-cause hospitalizations and HFH and spent more time alive
and out of the hospital. HFHs were strongly associated with mortality,
irrespective of treatment. (Cardiovascular Outcomes Assessment of the
MitraClip Percutaneous Therapy for Heart Failure Patients With Functional
Mitral Regurgitation [The COAPT Trial] and COAPT CAS [COAPT];
NCT01626079)<br/>Copyright &#xa9; 2022 American College of Cardiology
Foundation

<26>
Accession Number
639493986
Title
Personality changes following heart transplants: can epigenetics explain
these transformations?.
Source
European Psychiatry. Conference: 27th European Congress of Psychiatry, EPA
2019. Warsaw Poland. 56(Supplement 1) (pp S568), 2019. Date of
Publication: April 2019.
Author
Liester M.
Institution
(Liester, Liester) University of Colorado, School of Medicine, Psychiatry,
Monument, United States
Publisher
Cambridge University Press
Abstract
Background and aims.- Personality changes following heart transplants have
been reported for decades. Recent advances in the field of epigenetics may
explain how such transformations occur. We investigated the possible
relationship between personality changes following heart transplants and
epigenetic mechanisms. Methods.- We began our research by reviewing a 1999
article by Pearsall examining personality changes in ten heart transplant
recipients. We then conducted a PubMed search using the terms 'heart
transplant,' 'memory,' 'cellular memory,' 'epigenetics' and 'epigenetic
memory.' All retrieved articles were screened and relevant abstracts were
selected for more detailed evaluation. Biographies of all articles were
searched for additional references. Articles and books selected were those
that evaluated the association between heart transplants and
cellular/epigenetic memory. Results.- Heart transplant recipients report
personality changes including altered preferences (e.g. music, foods,
activities, sexual orientation, etc.) and behaviors (e.g. change in eating
patterns, change in sexual behaviors, change in laugh) that mimic their
donor's preferences. They also describe experiencing memories from their
donor's life (e.g. donor's name, events related to donor's death, etc.).
Epigenetic modifications of chromatin produce cellular memory. Animal and
human studies have demonstrated memories can be transmitted between
individuals via epigenetic modifications. We hypothesize epigenetic
mechanisms are responsible for the personality changes that occur
following heart transplants. Conclusions.- Epigenetic processes are known
to play a role inmemory and learning. The discovery that memories can be
transferred from one individual to another via epigenetic modifications
provides a mechanism for the transfer of memories, as well as other
personality traits, from heart transplant donors to recipients.

<27>
Accession Number
2021164716
Title
A Practical Approach to Left Main Coronary Artery Disease: JACC
State-of-the-Art Review.
Source
Journal of the American College of Cardiology. 80(22) (pp 2119-2134),
2022. Date of Publication: 29 Nov 2022.
Author
Davidson L.J.; Cleveland J.C.; Welt F.G.; Anwaruddin S.; Bonow R.O.;
Firstenberg M.S.; Gaudino M.F.; Gersh B.J.; Grubb K.J.; Kirtane A.J.;
Tamis-Holland J.E.; Truesdell A.G.; Windecker S.; Taha R.A.; Malaisrie
S.C.
Institution
(Davidson, Bonow, Taha, Malaisrie) Divisions of Cardiology and Cardiac
Surgery, Northwestern University, Chicago, IL, United States
(Cleveland) Department of Cardiothoracic Surgery, University of Colorado,
Aurora, CO, United States
(Welt) Department of Cardiovascular Medicine, University of Utah, Salt
Lake City, UT, United States
(Anwaruddin) Department of Cardiology & Interventional Cardiology, St.
Vincent Hospital, Worcester, MA, United States
(Firstenberg) Department of Cardiothoracic Surgery, St. Elizabeth Medical
Center, Appleton, WI, United States
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
(Gersh) Department of Cardiovascular Medicine, Mayo Clinic College of
Medicine and Science, Rochester, MN, United States
(Grubb) Department of Surgery, Division of Cardiothoracic Surgery, Emory
University, Atlanta, GA, United States
(Kirtane) Division of Cardiology and the Cardiovascular Research
Foundation, Columbia University Irving Medical Center/NewYork-Presbyterian
Hospital, New York, NY, United States
(Tamis-Holland) Department of Cardiology, Mount Sinai, New York, NY,
United States
(Truesdell) Department of Interventional Cardiology, Virginia Heart and
the Inova Heart and Vascular Institute, Falls Church, VA, United States
(Windecker) Department of Cardiology, Bern University Hospital,
Inselspital, Bern, Switzerland
Publisher
Elsevier Inc.
Abstract
The treatment of left main (LM) coronary artery disease (CAD) requires
complex decision-making. Recent clinical practice guidelines provide
clinicians with guidance; however, decisions regarding treatment for
individual patients can still be difficult. The American College of
Cardiology's Cardiac Surgery Team and Interventional Council joined
together to develop a practical approach to the treatment of LM CAD,
taking into account randomized clinical trial, meta-analyses, and clinical
practice guidelines. The various presentations of LM CAD based on anatomy
and physiology are presented. Recognizing the complexity of LM CAD, which
rarely presents isolated and is often in combination with multivessel
disease, a treatment algorithm with medical therapy alone or in
conjunction with percutaneous coronary intervention or coronary artery
bypass grafting is proposed. A heart team approach is recommended that
accounts for clinical, procedural, operator, and institutional factors,
and features shared decision-making that meets the needs and preferences
of each patient and their specific clinical situation.<br/>Copyright
&#xa9; 2022

<28>
Accession Number
2021123513
Title
Treatment of advanced heart failure in adults with congenital heart
disease: a narrative review and clinical cases.
Source
Cardiovascular Diagnosis and Therapy. 12(5) (pp 727-743), 2022. Date of
Publication: October 2022.
Author
Sinning C.; Huntgeburth M.; Fukushima N.; Tompkins R.; Huh J.; Tataneo S.;
Diller G.-P.; Chen Y.-S.; Zengin E.; Magnussen C.; Kaemmerer A.-S.; Cho
Y.H.; Blankenberg S.; Rickers C.; Harig F.; Weyand M.; Hubler M.; von
Kodolitsch Y.; Oto O.; Zuckermann A.; Kirchhof P.; Baumgartner H.;
Reichenspurner H.; Kobashigawa J.; Kaemmerer H.; Niwa K.
Institution
(Sinning, Zengin, Magnussen, Blankenberg, von Kodolitsch, Kirchhof)
Department of Cardiology, University Heart and Vascular Centre Hamburg,
Hamburg, Germany
(Sinning, Magnussen, Blankenberg, Kirchhof) German Centre of
Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel, Lubeck, Germany
(Huntgeburth, Kaemmerer) Department of Congenital Heart Disease and
Pediatric Cardiology, German Heart Center Munich, Technical University
Munich, Munich, Germany
(Fukushima) Department of Transplant Medicine, National Cerebral and
Cardiovascular Center, Osaka University, Osaka, Japan
(Tompkins) The Guerin Family Congenital Heart Program, Cedars-Sinai Heart
Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Huh) Department of Pediatrics, Heart Vascular Stroke Institute, Samsung
Medical Center, Sungkyunkwan University School of Medicine, Seoul, South
Korea
(Tataneo) Section of Adult Congenital Heart Disease, Chiba Cerebral and
Cardiovascular Center, Chiba, Ichihara, Japan
(Diller, Baumgartner) Division of Adult Congenital and Valvular Heart
Disease, Department of Cardiovascular Medicine, University Hospital
Muenster, Germany
(Chen) Department of Cardiovascular Surgery, National Taiwan University
Hospital, Taipei, Taiwan (Republic of China)
(Kaemmerer, Harig, Weyand) Department of Cardiac Surgery,
Friedrich-Alexander University, Erlangen, Nurnberg, Germany
(Cho) Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan
University, Seoul, South Korea
(Rickers) Adult Congenital Heart Disease Section, University Heart &
Vascular Center Hamburg, Hamburg, Germany
(Hubler) Department of Pediatric Cardiac Surgery, University Heart &
Vascular Center Hamburg, Hamburg, Germany
(Oto) Dokuz Eylul University Hospital air Esref Cad, Izmir, Turkey
(Zuckermann) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Kirchhof) Institute of Cardiovacsular Sciences and SWBH and UHB NHS
Trusts, Birmingham, United Kingdom
(Reichenspurner) Department of Cardiovascular Surgery, University Heart
and Vascular Center Hamburg, Hamburg, Germany
(Kobashigawa) Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, United
States
(Niwa) Department of Cardiology, Cardiovascular Center, St. Luke's
International Hospital, Tokyo, Japan
Publisher
AME Publishing Company
Abstract
Background and Objective: The number of adults with congenital heart
disease (ACHD) is increasing worldwide. Almost all congenital cardiac
lesions can be successfully treated due to the progress in neonatal
surgery and pediatric cardiology with a high likelihood of surviving until
adulthood. However, ACHD frequently develop sequelae related to the
initial cardiac anomaly. Heart failure (HF) is one of the most common
complications associated with a high morbidity and mortality.
<br/>Method(s): The authors did search the PubMed database regarding
relevant content covering publications up to March 2022. Relevant
manuscripts were classified according to the impact factor of the journal,
being a guideline manuscript, a position paper by a society or a
comprehensive review of the current literature. Key Content and Findings:
Optimal HF treatment remains an unmet need in ACHD. In particular,
advanced HF therapy with cardiac resynchronization therapy, ventricular
assist devices or organ transplantation is still very different and more
specific in ACHD compared to non-ACHD. This review aims to compile
international views and evidence from the literatures on the treatment of
advanced HF in ACHD. Current challenges, but also the success of different
treatment strategies in ACHD are illustrated by clinical cases.
<br/>Conclusion(s): The main finding of the review is that data is still
scarce regarding ACHD with advanced HF and international efforts to
collect data regarding these patients needed to improve the current
standard of care.<br/>Copyright &#xa9; Cardiovascular Diagnosis and
Therapy. All rights reserved.

<29>
Accession Number
2020025012
Title
Antithrombotic Treatment and Its Association with Outcome in a Multicenter
Cohort of Transcatheter Edge-to-Edge Mitral Valve Repair Patients.
Source
Journal of Cardiovascular Development and Disease. 9(11) (no pagination),
2022. Article Number: 366. Date of Publication: November 2022.
Author
Waechter C.; Ausbuettel F.; Chatzis G.; Cheko J.; Fischer D.; Nef H.;
Barth S.; Halbfass P.; Deneke T.; Mueller J.; Kerber S.; Divchev D.;
Schieffer B.; Luesebrink U.
Institution
(Waechter, Ausbuettel, Chatzis, Cheko, Mueller, Divchev, Schieffer,
Luesebrink) Department of Cardiology, University Hospital Marburg,
Baldingerstrase, Marburg 35043, Germany
(Fischer, Nef) Department of Cardiology, Cardiovascular Center
Rotenburg/Fulda, Heinz-Meise-Strase 100, Rotenburg an der Fulda 36199,
Germany
(Nef) Department of Cardiology, University Hospital Giessen, Klinikstrase
33, Giessen 35392, Germany
(Barth, Halbfass, Deneke, Mueller, Kerber) Department of Cardiology,
Cardiovascular Center Bad Neustadt/Saale, Von-Guttenberg-Strase 11, Bad
Neustadt an der Saale 97616, Germany
Publisher
MDPI
Abstract
Transcatheter edge-to-edge mitral valve repair (TEER) has become
established as a safe and efficacious therapy for severe mitral
regurgitation (MR) in high-risk patients. Despite its widespread use,
postprocedural antithrombotic therapy (ATT) still to date is based on
local expertise rather than evidence. In a multicenter, observational
cohort study, 646 consecutive patients undergoing TEER were enrolled; 609
patients were successfully treated and antithrombotic therapy analyzed;
449 patients (73.7%) were previously treated with oral anticoagulants
(OAC) due to the high prevalence of atrial fibrillation (459/609, 75.4%).
Postprocedural ATT in patients previously treated with OAC consisted of no
additional, additional single (SAPT) or dual antiplatelet therapy (DAPT)
in 146/449 (33.6%), 248/449 (55.2%) and 55/449 (12.2%), respectively.
There were 234/449 (52.1%) patients treated with vitamin-k antagonists
(VKA) and 215/449 (47.9%) with nonvitamin-k antagonist oral anticoagulants
(NOAC). One hundred sixty patients (26.3%) had no prior indication for OAC
and were predominantly treated with DAPT (132/160, 82.5%). Use of SAPT
(17/160, 10.6%) and no APT (11/160, 6.9%) was marginal. No statistically
significant differences in terms of in-hospital mortality or the rate of
major adverse cardiac and cerebrovascular events (MACCE) between the
different antithrombotic therapy regimens were observed. Multiple Cox
regression analysis showed a statistically significant decreased risk for
all-cause mortality after a median follow-up of 419 days for OAC
monotherapy (HR 0.6, 95%-CI 0.5-0.9, p = 0.04). This study provides
evidence for a more favorable long-term outcome of OAC monotherapy in
patients with an indication for OAC and reiterates the urgent need for
randomized controlled trials on the optimal antithrombotic treatment of
TEER patients.<br/>Copyright &#xa9; 2022 by the authors.

<30>
Accession Number
2021159430
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: 2022.
Author
Takura T.; Komuro I.; Ono M.
Institution
(Takura) Department of Healthcare Economics and Health Policy, Graduate
School of Medicine, The University of Tokyo, Tokyo, Japan
(Komuro) Department of Cardiovascular Medicine, Graduate School of
Medicine, The University of Tokyo, Tokyo, Japan
(Ono) Department of Cardiac Surgery, University of Tokyo Hospital, The
University of Tokyo, Tokyo, Japan
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
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.<br/>Copyright &#xa9; 2022
The Authors

<31>
Accession Number
2021131199
Title
External applicability of the Effect of ticagrelor on Health Outcomes in
diabEtes Mellitus patients Intervention Study (THEMIS) trial: An analysis
of patients with diabetes and coronary artery disease in the REduction of
Atherothrombosis for Continued Health (REACH) registry.
Source
International Journal of Cardiology. (no pagination), 2022. Date of
Publication: 2022.
Author
Abtan J.; Bhatt D.L.; Elbez Y.; Ducrocq G.; Goto S.; Smith S.C.; Ohman
E.M.; Eagle K.A.; Fox K.; Harrington R.A.; Leiter L.A.; Mehta S.R.; Simon
T.; Petrov I.; Sinnaeve P.R.; Pais P.; Lev E.; Bueno H.; Wilson P.; Steg
P.G.
Institution
(Abtan, Elbez, Ducrocq, Steg) FACT (French Alliance for Cardiovascular
clinical Trials), Universite de Paris, Hopital Bichat (Assistance Publique
- Hopitaux de Paris) and INSERM U-1148, all in Paris, France
(Abtan, Bhatt) Brigham and Women's Hospital Heart & Vascular Center,
Harvard Medical School, Boston, MA, United States
(Goto) Department of Medicine (Cardiology), Tokai University School of
Medicine, Kanagawa, Isehara, Japan
(Smith) Division of Cardiology, Department of Medicine, University of
North Carolina, Chapel Hill, United States
(Ohman) Division of Cardiology, Department of Medicine, Duke University
School of Medicine, Durham, North Carolina, Duke Clinical Research
Institute, Durham, NC, United States
(Eagle) University of Michigan Cardiovascular Center, Ann Arbor, United
States
(Fox, Steg) National Heart and Lung Institute, Imperial College, London,
United Kingdom
(Fox) Institute of Cardiovascular Medicine and Science, Royal Brompton
Hospital, London, United Kingdom
(Harrington) Stanford Center for Clinical Research, Department of
Medicine, Stanford University, California, United States
(Leiter) Division of Endocrinology and Metabolism, Li Ka Shing Knowledge
Institute, St Michael's Hospital, University ot Toronto, ON, Canada
(Mehta) Population Health Research Institute and Department of Medicine,
McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
(Simon) Plateforme de Recherche Clinique de l'Est Parisien
(URCEST-CRCEST-CRB), Saint-Antoine Hospital, AP-HP, Paris, France
(Petrov) University Hospital Acibadem City Clinic Sofia, Sofia University
St. Kliment Ohridski, Bulgaria
(Sinnaeve) Department of Cardiovascular Medicine, University Hospitals
Leuven, Belgium
(Pais) Division of Clinical Research and Training, St. John's Research
Institute, Bangalore, India
(Lev) Department of Cardiology, Rabin Medical Center, Petach Tikva,
Department of Cardiology, Assuta Ashdod University Hospital, Ashdod,
Faculty of Medicine, Ben Gurion University, all in, Be'er Sheva, Israel
(Bueno) Cardiology Department, Hospital Universitario 12 de Octubre,
Centro Nacional de Investigaciones Cardiovasculares, CIBER de enfermedades
CardioVasculares (CIBERCV), Madrid, Spain
(Wilson) Mayo Clinic, Rochester, MN, United States
Publisher
Elsevier Ireland Ltd
Abstract
Aims: THEMIS is a double-blind, randomized trial of 19,220 patients with
diabetes mellitus and stable coronary artery disease (CAD) comparing
ticagrelor to placebo, in addition to aspirin. The present study aimed to
describe the proportion of patients eligible and reasons for ineligibility
for THEMIS within a population of patients with diabetes and CAD included
in the Reduction of Atherothrombosis for Continued Health (REACH)
registry. <br/>Methods and Results: The THEMIS eligibility criteria were
applied to REACH patients. THEMIS included patients >=50 years with type 2
diabetes and stable CAD as determined by either a history of previous
percutaneous coronary intervention, coronary artery bypass grafting, or
documentation of angiographic stenosis of >=50% of at least one coronary
artery. Patients with prior myocardial infarction or stroke were excluded.
In REACH, 10,156 patients had stable CAD and diabetes. Of these, 6515
(64.1%) patients had at least one exclusion criteria. From the remaining
population, 784 patients did not meet inclusion criteria (7.7%) mainly due
to absence of aspirin treatment (7.2%), yielding a 'THEMIS-eligible
population' of 2857 patients (28.1% of patients with diabetes and stable
CAD). The main reasons for exclusion were a history of myocardial
infarction (53.1%), use of oral anticoagulation (14.5%), or history of
stroke (12.9%). Among the 4208 patients with diabetes and a previous PCI,
1196 patients (28.4%) were eligible for inclusion in the THEMIS-PCI
substudy. <br/>Conclusion(s): In a population of patients with diabetes
and stable coronary artery disease, a sizeable proportion appear to be
'THEMIS eligible.' Clinical trial registration:
http://www.clinicaltrials.gov identifier: NCT01991795<br/>Copyright &#xa9;
2022 The Author(s)

<32>
Accession Number
2020105208
Title
Autologous CD133 + Cells and Laser Revascularization in patients with
severe Ischemic Cardiomyopathy.
Source
Stem Cell Reviews and Reports. (no pagination), 2022. Date of
Publication: 2022.
Author
Abdel-Latif A.; Ahmed T.; Leung S.W.; Alnabelsi T.; Tarhuni W.; Sekela
M.E.
Institution
(Abdel-Latif, Ahmed, Leung, Alnabelsi) Department of Cardiovascular
Medicine, Division of Cardiology, University of Kentucky, Lexington, KY,
United States
(Abdel-Latif) Department of Cardiovascular Medicine, Division of
Cardiology, University of Michigan, Ann Arbor, MI, United States
(Tarhuni) Department of Internal Medicine, Division of Cardiology,
Canadian Cardiac Research Center, University of Saskatchewan, Saskatoon,
SK, Canada
(Sekela) Department of Cardiothoracic Surgery, University of Kentucky,
Lexington, KY, United States
(Sekela) Heart Transplant, Division of Cardiothoracic Surgery, University
of Kentucky, Lexington, KY, United States
Publisher
Springer
Abstract
Objective: We tested the hypothesis that targeted TMLR combined with
intramyocardial injection of autologous CD 133⁺ progenitor
cells is safe and feasible in patients with chronic ischemic
cardiomyopathy (ICM) and no revascularization options. <br/>Method(s):
Eight male patients (age 62 +/- 2.4 years) with multivessel severe
ischemic heart disease and no revascularization options were enrolled.
Autologous CD 133 + endothelial progenitor cells were derived and purified
from the bone marrow on the day of surgery using the clinical-grade closed
CliniMACS system. Using a lateral thoracotomy approach, TMLR was
performed, followed by transmyocardial transplantation of purified CD133 +
cells (mean number of transplanted cells: 12.5 x 10⁶) in the
region surrounding the TMLR sites. These sites were selected based on
ischemia on pre-procedure perfusion imaging. We performed clinical and
myocardial perfusion imaging pre-procedure and then at 6- and 12-month
follow-up. <br/>Result(s): No major complications or death occurred during
the procedure or during the peri-operative hospital stay. One patient died
of cardiac cause 6 months post-procedure. There was a reported short-term
improvement in anginal and heart failure symptoms and a modest reduction
in the ischemic score as assessed by perfusion imaging.
<br/>Conclusion(s): Our phase 1 clinical study examining the combination
therapy of targeted transmyocardial laser revascularization therapy and
autologous CD133 + endothelial progenitor cells in patients with chronic
ICM and no revascularization options demonstrates the feasibility and
short-term safety of this combined approach and warrants future larger
phase 2 randomized clinical studies.<br/>Copyright &#xa9; 2022, The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature.

<33>
Accession Number
639504546
Title
Systematic review on oncologic outcomes on adjuvant endovesical treatment
for non-muscle invasive bladder cancer in patients with solid organ
transplant.
Source
World journal of urology. (no pagination), 2022. Date of Publication: 11
Nov 2022.
Author
Simonet M.; Dominguez Gutierrez A.; Territo A.; Prudhomme T.; Campi R.;
Andras I.; Baboudjian M.; Hevia V.; Boissier R.
Institution
(Simonet, Baboudjian, Boissier) Department of Urology and Renal
Transplantation, Urology, University Hospital La Conception, Aix-Marseille
University, Marseille, France
(Dominguez Gutierrez, Hevia) Urology Department, Hospital Universitario
Ramon y Cajal, Madrid, Spain
(Territo) Oncology and Renal Transplant Units, Puigvert's Foundation,
Barcelona, Spain
(Prudhomme) Department of Urology, Rangueil University Hospital, Toulouse,
France
(Campi) Department of Urology, Florence University Hospital, Florence,
Italy
(Andras) Department of Urology, Iuliu Hatieganu University of Medicine and
Pharmacy, Cluj-Napoca, Romania
(Boissier) Department of Urology and Kidney Transplantation, Aix-Marseille
University, Conception Academic Hospital, APHM147 Boulevard Baille,
Marseille 13005, France
Publisher
NLM (Medline)
Abstract
PURPOSE: Urothelial carcinoma has a higher incidence in renal transplanted
patients according to several registries (relative riskx3), and the global
prognosis is inferior to the general population. The potential impact of
immunosuppressive therapy on the feasibility, efficacy, and complications
of endovesical treatment, especially Bacillus Calmette-Guerin, has a low
level of evidence. We performed a systematic review that aimed to assess
the morbidity and oncological outcomes of adjuvant endovesical treatment
in solid organ transplanted patients. <br/>METHOD(S): Medline was searched
up to December 2021 for all relevant publications reporting oncologic
outcomes of endovesical treatment in solid organ transplanted patients
with NMIBC. Data were synthesized in light of methodological and clinical
heterogeneity. <br/>RESULT(S): Twenty-three retrospective studies
enrolling 238 patients were included: 206 (96%) kidney transplants, 5 (2%)
liver transplants, and 2 (1%) heart transplants. Concerning staging: 25%
were pTa, 62% were pT1, and 22% were CIS. 140/238 (59%) patients did not
receive adjuvant treatment, 50/238 (21%) received mitomycin C, 4/238 (2%)
received epirubicin, and 46/238 (19%) received BCG. Disease-free survival
reached 35% with TURBT only vs. 47% with endovesical treatment (Chi-square
test p=0.08 OR 1.2 [0.98-1.53]). The complication rate of endovesical
treatment was 12% and was all minor (Clavien-Dindo I). <br/>CONCLUSION(S):
In solid organ transplanted patients under immunosuppressive treatment,
both endovesical chemotherapy and BCG are safe, but the level of evidence
concerning efficacy in comparison with the general population is low.
According to these results, adjuvant treatment should be proposed for NMIC
in transplanted patients as in the general population.<br/>Copyright
&#xa9; 2022. The Author(s), under exclusive licence to Springer-Verlag
GmbH Germany, part of Springer Nature.

<34>
Accession Number
639504271
Title
The Prognostic Value of Elevated Neutrophil-Lymphocyte Ratio for Cardiac
Surgery Associated Acute Kidney Injury: A Systematic Review and
Meta-Analysis.
Source
Acta anaesthesiologica Scandinavica. (no pagination), 2022. Date of
Publication: 11 Nov 2022.
Author
Wheatley J.; Liu Z.; Loth J.; Plummer M.P.; Penny-Dimri J.C.; Segal R.;
Smith J.; Perry L.A.
Institution
(Wheatley) Department of Anaesthesia, Perioperative Medicine and Pain
Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia
(Wheatley) Department of Intensive Care Medicine, Royal Melbourne
Hospital, Parkville, Australia
(Liu, Loth, Segal, Perry) Department of Anaesthesia, Royal Melbourne
Hospital, Parkville, Australia
(Liu, Plummer, Segal, Perry) Department of Critical Care, Melbourne
Medical School, Faculty of Medicine, Dentistry and Health Sciences,
University of Melbourne, Parkville, Australia
(Plummer) Department of Intensive Care Medicine, Royal Adelaide Hospital,
Adelaide, Australia
(Penny-Dimri, Smith) Department of Surgery (School of Clinical Sciences at
Monash Health), Monash University, Department of Cardiothoracic Surgery,
Monash Health, Clayton, Australia
Publisher
NLM (Medline)
Abstract
BACKGROUND: Patients undergoing cardiac surgery are at significant risk of
developing postoperative acute kidney injury. Neutrophil-lymphocyte ratio
is a widely available inflammatory biomarker which may be of prognostic
value in this setting. <br/>METHOD(S): We conducted a systematic review
and meta-analysis of studies reporting associations between perioperative
neutrophil-lymphocyte ratio with postoperative acute kidney injury. We
searched Medline, Embase, and the Cochrane Library, without language
restriction, from inception to May 2022 for relevant studies. We
meta-analysed the reported odds ratios with 95% confidence intervals for
both elevated preoperative and postoperative neutrophil-lymphocyte ratio
with risk of postoperative acute kidney injury and need for renal
replacement therapy. We conducted a meta-regression to explore inter-study
statistical heterogeneity. <br/>RESULT(S): Twelve studies involving 10,724
participants undergoing cardiac surgery were included, with eight studies
being deemed at high risk of bias using PROBAST modelling. We found
statistically significant associations between elevated preoperative
neutrophil-lymphocyte ratio and postoperative acute kidney injury (odds
ratio 1.45, 95% confidence interval 1.18-1.77), as well as postoperative
need for renal replacement therapy (odds ratio 2.37, 95% confidence
interval 1.50-3.72). Post-operative neutrophil-lymphocyte ratio
measurements were not of prognostic significance. <br/>CONCLUSION(S):
Elevated preoperative neutrophil-lymphocyte ratio is a reliable
inflammatory biomarker for predicting acute kidney injury following
cardiac surgery. This article is protected by copyright. All rights
reserved.

<35>
Accession Number
639503985
Title
High-Sensitivity Cardiac Troponin I and T Kinetics Differ following
Coronary Bypass Surgery: A Systematic Review and Meta-Analysis.
Source
Clinical chemistry. (no pagination), 2022. Date of Publication: 11 Nov
2022.
Author
Denessen E.J.; Heuts S.; Daemen J.H.; van Doorn W.P.; Vroemen W.H.; Sels
J.-W.; Segers P.; Van't Hof A.W.; Maessen J.G.; Bekers O.; Van Der Horst
I.C.; Mingels A.M.
Institution
(Denessen, van Doorn, Vroemen, Bekers, Mingels) Central Diagnostic
Laboratory, Maastricht University Medical Center+, Maastricht, Netherlands
(Denessen, van Doorn, Sels, Van't Hof, Maessen, Bekers, Van Der Horst,
Mingels) Cardiovascular Research Institute Maastricht (CARIM), Maastricht
University, Maastricht, Netherlands
(Heuts, Segers, Maessen) Department of Cardiothoracic Surgery, Maastricht
University Medical Center+, Maastricht, Netherlands
(Daemen) Department of Surgery, Division of General Thoracic Surgery,
Zuyderland Medical Center, Heerlen, Netherlands
(Sels, Van Der Horst) Department of Intensive Care Medicine, Maastricht
University Medical Center+, Maastricht, Netherlands
(Sels, Van't Hof) Department of Cardiology, Maastricht University Medical
Center+, Maastricht, Netherlands
(Van't Hof) Department of Cardiology, Zuyderland Medical Center, Heerlen,
Netherlands
Publisher
NLM (Medline)
Abstract
BACKGROUND: Cardiac troponin I and T are both used for diagnosing
myocardial infarction (MI) after coronary artery bypass grafting (CABG),
also known as type 5 MI (MI-5). Different MI-5 definitions have been
formulated, using multiples of the 99th percentile upper reference limit
(10x, 35x, or 70x URL), with or without supporting evidence. These
definitions are arbitrarily chosen based on conventional assays and do not
differentiate between troponin I and T. We therefore investigated the
kinetics of high-sensitivity cardiac troponin I (hs-cTnI) and T (hs-cTnT)
following CABG. <br/>METHOD(S): A systematic search was applied to MEDLINE
and EMBASE databases including the search terms "coronary artery bypass
grafting" AND "high-sensitivity cardiac troponin." Studies reporting
hs-cTnI or hs-cTnT on at least 2 different time points were included.
Troponin concentrations were extracted and normalized to the
assay-specific URL. <br/>RESULT(S): For hs-cTnI and hs-cTnT, 17 (n = 1661
patients) and 15 studies (n = 2646 patients) were included, respectively.
Preoperative hs-cTnI was 6.1x URL (95% confidence intervals: 4.9-7.2) and
hs-cTnT 1.2x URL (0.9-1.4). Mean peak was reached 6-8 h postoperatively
(126x URL, 99-153 and 45x URL, 29-61, respectively). Subanalysis of
hs-cTnI illustrated assay-specific peak heights and kinetics, while
subanalysis of surgical strategies revealed 3-fold higher hs-cTnI than
hs-cTnT for on-pump CABG and 5-fold for off-pump CABG. <br/>CONCLUSION(S):
Postoperative hs-cTnI and hs-cTnT following CABG surpass most current
diagnostic cutoff values. hs-cTnI was almost 3-fold higher than hs-cTnT,
and appeared to be highly dependent on the assay used and surgical
strategy. There is a need for assay-specific hs-cTnI and hs-cTnT cutoff
values for accurate, timely identification of MI-5.<br/>Copyright @
American Association for Clinical Chemistry 2022.

<36>
Accession Number
639503298
Title
Bayesian Meta-analysis of Direct Oral Anticoagulation Versus Vitamin K
Antagonists With or Without Concomitant Antiplatelet After Transcatheter
Aortic Valve Implantation in Patients With Anticoagulation Indication.
Source
Angiology. (pp 33197221121616), 2022. Date of Publication: 10 Nov 2022.
Author
Lee G.S.J.; Tay H.S.E.; Teo V.X.Y.; Goh R.S.J.; Chong B.; Chan S.P.; Tay
E.; Lim Y.; Yip J.; Chew N.W.S.; Kuntjoro I.
Institution
(Lee, Tay, Teo, Goh, Chong, Chan, Lim, Yip, Kuntjoro) Yong Loo Lin School
of Medicine, 63751National University of Singapore, Singapore
(Chan, Tay, Lim, Yip, Chew, Kuntjoro) Department of Cardiology, National
University Health System, 375583National University Heart Centre,
Singapore
Publisher
NLM (Medline)
Abstract
Patients undergoing transcatheter aortic valve implantation (TAVI)
commonly have co-morbidities requiring anticoagulation. However, the
optimal post-procedural anticoagulation regimen is not well-established.
This meta-analysis investigates safety and efficacy outcomes of direct
oral anticoagulants (DOACs) and Vitamin K Antagonist (VKA), with or
without concomitant antiplatelet therapy. We searched EMBASE and MEDLINE
for appropriate studies. Subgroup analyses were performed for
anticoagulant monotherapy and combined therapy with antiplatelet agents.
Eleven studies (6359 patients) were included. Overall, there were no
differences between DOACs and VKA for all-cause mortality (Odds Ratio
[OR]: .69; Credible Interval [CrI]: .40-1.06), cardiovascular-related
mortality (OR: .76; Crl: .13-3.47), bleeding (OR: .95; CrI: .75-1.17),
stroke (OR: 1.04; CrI: .65-1.63), myocardial infarction (OR: 1.51; CrI:
.55-3.84), and valve thrombosis (OR: .29; CrI: .01-3.54). For DOACs vs VKA
monotherapy subgroup, there were no differences in outcomes. For the
combined therapy subgroup, there was decreased odds of all-cause mortality
in the DOACs group compared with the VKA group (OR: .13; CrI: .02-.65),
but no differences for bleeding and stroke. DOACs and VKA have similar
safety and efficacy profiles for post-TAVI patients with anticoagulation
indication. However, if concomitant antiplatelet therapy is required,
DOACs were more favorable than VKA for all-cause mortality.

<37>
Accession Number
639503041
Title
Re: EJCTS-2022-100615R3 - Evaluation of Rhomboid Intercostal and
Subserratus Plane Block Under Direct Vision For Postoperative Analgesia in
Thoracic Surgeries: A Prospective, Randomized Controlled Trial, Thoracic
non-oncologic, Original Article.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2022.
Date of Publication: 11 Nov 2022.
Author
West D.
Institution
(West) Consultant Thoracic Surgeon, University Hospitals Bristol and
Weston
Publisher
NLM (Medline)

<38>
Accession Number
639497581
Title
Cardioprotective Effects of Glucose-Insulin-Potassium Infusion in Patients
Undergoing Cardiac Surgery: a Systematic Review and Meta-Analysis.
Source
Seminars in thoracic and cardiovascular surgery. (no pagination), 2022.
Date of Publication: 07 Nov 2022.
Author
Hagerman A.; Schorer R.; Putzu A.; Keli-Barcelos G.; Licker M.
Institution
(Hagerman, Schorer, Putzu, Keli-Barcelos) Dept. of Acute Medicine, Geneva
University Hospitals, Geneva, Switzerland
(Licker) University of Geneva, Faculty of Medicine, Geneva, Switzerland
Publisher
NLM (Medline)
Abstract
The infusion of glucose-insulin-potassium (GIK) has yielded conflicting
results in terms of cardioprotective effects. We conducted a meta-analysis
to examine the impact of perioperative GIK infusion in early outcome after
cardiac surgery. Randomized controlled trials (RCTs) were eligible if they
examined the efficacy of GIK infusion in adults undergoing cardiac
surgery. The main study endpoint was postoperative myocardial infarction
(MI) and secondary outcomes were hemodynamics, any complications and
hospital resources utilization. Subgroup analyses explored the impact of
the type of surgery, GIK composition and timing of administration. Odds
ratio (OR) or mean difference (MD) with 95% confidence interval (CI) were
calculated with a random-effects model. Fifty-three studies (n=6,129) met
the inclusion criteria. Perioperative GIK infusion was effective in
reducing MI (k=32 OR 0.66[0.48, 0.89] p=0.0069), acute kidney injury (k=7
OR 0.57[0.4, 0.82] p=0.0023) and hospital length of stay (k=19 MD
-0.89[-1.63, -0.16] days p=0.0175). Postoperatively, the GIK-treated group
presented higher cardiac index (k=14 MD 0.43[0.29, 0.57] L/min p<0.0001)
and lesser hyperglycemia (k=20 MD -30[-47, -13] mg/dL p=0.0005) than in
the usual care group. The GIK-associated protection for MI was effective
when insulin infusion rate exceeded 2 mUI/kg/min and after coronary artery
bypass surgery. Certainty of evidence was low given imprecision of the
effect estimate, heterogeneity in outcome definition and risk of bias.
Perioperative GIK infusion is associated with improved early outcome and
reduced hospital resource utilization after cardiac surgery. Supporting
evidence is heterogenous and further research is needed to standardize the
optimal timing and composition of GIK solutions.<br/>Copyright &#xa9; 2022
The Author(s). Published by Elsevier Inc. All rights reserved.

<39>
Accession Number
2017848294
Title
Design and methods for the training in exercise activities and motion for
growth (TEAM 4 growth) trial: A randomized controlled trial.
Source
International Journal of Cardiology. 359 (pp 28-34), 2022. Date of
Publication: 15 Jul 2022.
Author
Lambert L.M.; Pemberton V.L.; Trachtenberg F.L.; Uzark K.; Woodard F.;
Teng J.E.; Bainton J.; Clarke S.; Justice L.; Meador M.R.; Riggins J.;
Suhre M.; Sylvester D.; Butler S.; Miller T.A.
Institution
(Lambert) Division of Pediatric Cardiothoracic Surgery, University of
Utah, Salt Lake City, UT, United States
(Pemberton) Division of Cardiovascular Sciences, National Heart, Lung, and
Blood Institute, NIH, Bethesda, MD, United States
(Trachtenberg, Teng) HealthCore Inc., Watertown, MA, United States
(Uzark) Division of Cardiology, C.S. Mott Children's Hospital, Ann Arbor,
MI, United States
(Woodard) Division of Pediatric Cardiology, Medical University of South
Carolina, Charleston, SC, United States
(Bainton) Division of Cardiology, The Hospital for Sick Children,
University of Toronto, Toronto, ON, Canada
(Clarke) Division of Cardiology, Emory University School of Medicine,
Children's Healthcare of Atlanta, Atlanta, GA, United States
(Justice, Suhre) Division of Cardiology, Cincinnati Children's Hospital
Medical Center, Cincinnati, OH, United States
(Meador) Division of Cardiology Pediatric Anesthesiology, Texas Children's
Hospital, Baylor College of Medicine, Houston, TX, United States
(Riggins) Division of Cardiovascular Surgery, Riley Hospital for Children
at IU Health, Indianapolis, IN, United States
(Sylvester) Division of Cardiology, The Children's Hospital of
Philadelphia, Perelman School of Medicine, Philadelphia, PA, United States
(Butler) Department of Psychiatry, Children's Hospital Boston, Boston, MA,
United States
(Miller) Division of Cardiology, Maine Medical Center, Portland, ME,
United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Growth is often impaired in infants with congenital heart
disease. Poor growth has been associated with worse neurodevelopment,
abnormal behavioral state, and longer time to hospital discharge.
Nutritional interventions, drug therapy, and surgical palliation have
varying degrees of success enhancing growth. Passive range of motion
(PROM) improves somatic growth in preterm infants and is safe and feasible
in infants with hypoplastic left heart syndrome (HLHS), after their first
palliative surgery (Norwood procedure). <br/>Method(s): This multicenter,
Phase III randomized control trial of a 21-day PROM exercise or standard
of care evaluates growth in infants with HLHS after the Norwood procedure.
Growth (weight-, height- and head circumference-for-age z-scores) will be
compared at 4 months of age or at the pre-superior cavopulmonary
connection evaluation visit, whichever comes first. Secondary outcomes
include neonatal neurobehavioral patterns, neurodevelopmental assessment,
and bone mineral density. Eligibility include diagnosis of HLHS or other
single right ventricle anomaly, birth at >=37 weeks gestation and Norwood
procedure at <30 days of age, and family consent. Infants with known
chromosomal or recognizable phenotypic syndromes associated with growth
failure, listed for transplant, or expected to be discharged within 14
days of screening are excluded. <br/>Conclusion(s): The TEAM 4 Growth
trial will make an important contribution to understanding the role of
PROM on growth, neurobehavior, neurodevelopment, and BMD in infants with
complex cardiac anomalies, who are at high risk for growth failure and
developmental concerns.<br/>Copyright &#xa9; 2022 Elsevier B.V.

<40>
Accession Number
2015929588
Title
The effects of vitamin D supplementation on postoperative atrial
fibrillation after coronary artery bypass grafting in patients with
vitamin D deficiency.
Source
Journal of Cardiac Surgery. 37(7) (pp 2219-2224), 2022. Date of
Publication: July 2022.
Author
Talasaz A.H.; Salehiomran A.; Heidary Z.; Gholami K.; Aryannejad H.;
Jalali A.; Daei M.
Institution
(Talasaz, Salehiomran, Aryannejad, Jalali) Tehran Heart Center, Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Heidary) Department of Clinical Pharmacy, Faculty of Pharmacy, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Gholami) Department of Clinical Pharmacy, School of Pharmacy, Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Daei) Department of Clinical Pharmacy, Faculty of Pharmacy, Alborz
University of Medical Sciences, Alborz, Iran, Islamic Republic of
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Postoperative atrial fibrillation (POAF) as a common
complication of coronary artery bypass grafting (CABG) surgery is
associated with increased mortality and morbidity rates. Vitamin D
deficiency increases the prevalence of POAF; however, the effects of
vitamin D supplementation on the incidence of POAF have not yet been
completely elucidated. <br/>Method(s): In this prospective, open-label,
randomized clinical trial the level of 25-hydroxy vitamin D (25(OH) D) was
measured in patients undergoing CABG surgery. Patients with vitamin D
insufficiency (defined as 25(OH) D level < 30 ng/ml) were included and
randomly assigned to control group to receive either the general standard
of care (Group A) or to study group to receive the general standard of
care plus oral vitamin D<inf>3</inf>, 600,000 IU 5 days before surgery
(Group B). The primary outcome of our study was the occurrence of POAF
during the first 5 days after CABG surgery. <br/>Result(s): Totally, 93
patients in group B and 103 patients in group A completed the study. The
occurrence of POAF was significantly lower in group B as compared to group
A (9.68% vs. 20.39%, p =.038). The length of intensive care unit (ICU)
stay and hospital stay were reduced in group B patients (2.21 vs. 3.86
days, p <.001 and 7.40 vs. 9.58 days, p =.022, respectively).
<br/>Conclusion(s): Our study demonstrated that vitamin D supplementation
reduces the incidence of POAF, duration of ICU, and hospital stay
following CABG surgery.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<41>
[Use Link to view the full text]
Accession Number
2018383954
Title
Amiodarone with or without N -Acetylcysteine for the Prevention of Atrial
Fibrillation after Thoracic Surgery: A Double-blind, Randomized Trial.
Source
Anesthesiology. 136(6) (pp 916-926), 2022. Date of Publication: 01 Jun
2022.
Author
Amar D.; Zhang H.; Chung M.K.; Tan K.S.; Desiderio D.; Park B.J.; Pedoto
A.; Roistacher N.; Isbell J.M.; Molena D.; Milne G.L.; Meyers B.F.;
Fischer G.W.; Rusch V.W.; Jones D.R.
Institution
(Amar) Department of Anesthesiology and Critical Care Medicine, Memorial
Sloan Kettering Cancer Center, Weill Cornell Medical College, New York,
United States
(Chung) Department of Cardiovascular Medicine, Heart, Vascular and
Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States
(Tan) Department of Epidemiology and Biostatistics, Memorial Sloan
Kettering Cancer Center, New York, NY, United States
(Roistacher) Department of Medicine, Memorial Sloan Kettering Cancer
Center, New York, NY, United States
(Milne) Department of Medicine, Division of Clinical Pharmacology,
Vanderbilt University Medical Center, Nashville, TN, United States
(Meyers) Department of Surgery, Washington University Medical Center, St.
Louis, MO, United States
(Fischer) Department of Anesthesiology and Critical Care Medicine,
Memorial Sloan Kettering Cancer Center, New York, NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Postoperative atrial fibrillation may identify patients at
risk of subsequent atrial fibrillation, with its greater risk of stroke.
This study hypothesized that N-acetylcysteine mitigates inflammation and
oxidative stress to reduce the incidence of postoperative atrial
fibrillation. <br/>Method(s): In this double-blind, placebo-controlled
trial, patients at high risk of postoperative atrial fibrillation
scheduled to undergo major thoracic surgery were randomized to
N-acetylcysteine plus amiodarone or placebo plus amiodarone. On arrival to
the postanesthesia care unit, N-acetylcysteine or placebo intravenous
bolus (50 mg/kg) and then continuous infusion (100 mg/kg over the course
of 48 h) was administered plus intravenous amiodarone (bolus of 150 mg and
then continuous infusion of 2 g over the course of 48 h). The primary
outcome was sustained atrial fibrillation longer than 30 s by telemetry
(first 72 h) or symptoms requiring intervention and confirmed by
electrocardiography within 7 days of surgery. Systemic markers of
inflammation (interleukin-6, interleukin-8, tumor necrosis factor alpha,
C-reactive protein) and oxidative stress (F<inf>2</inf>-isoprostane
prostaglandin F<inf>2alpha</inf>; isofuran) were assessed immediately
after surgery and on postoperative day 2. Patients were telephoned monthly
to assess the occurrence of atrial fibrillation in the first year.
<br/>Result(s): Among 154 patients included, postoperative atrial
fibrillation occurred in 15 of 78 who received N-acetylcysteine (19%) and
13 of 76 who received placebo (17%; odds ratio, 1.24; 95.1% CI, 0.53 to
2.88; P = 0.615). The trial was stopped at the interim analysis because of
futility. Of the 28 patients with postoperative atrial fibrillation, 3
(11%) were discharged in atrial fibrillation. Regardless of treatment at 1
yr, 7 of 28 patients with postoperative atrial fibrillation (25%) had
recurrent episodes of atrial fibrillation. Inflammatory and oxidative
stress markers were similar between groups. <br/>Conclusion(s): Dual
therapy comprising N-acetylcysteine plus amiodarone did not reduce the
incidence of postoperative atrial fibrillation or markers of inflammation
and oxidative stress early after major thoracic surgery, compared with
amiodarone alone. Recurrent atrial fibrillation episodes are common among
patients with postoperative atrial fibrillation within 1 yr of major
thoracic surgery.<br/>Copyright &#xa9; 2022 Lippincott Williams and
Wilkins. All rights reserved.

<42>
Accession Number
2018196260
Title
Segmentation Algorithm-Based Safety Analysis of Cardiac Computed
Tomography Angiography to Evaluate Doctor-Nurse-Patient Integrated Nursing
Management for Cardiac Interventional Surgery.
Source
Computational and Mathematical Methods in Medicine. 2022 (no pagination),
2022. Article Number: 2148566. Date of Publication: 2022.
Author
Zhang A.; Chen Q.
Institution
(Zhang) Intervention Section, South Hospital Of Chenzhou First People's
Hospital, Hunan, Chenzhou 423000, China
(Chen) Operation Room, South Hospital Of Chenzhou First People's Hospital,
Hunan, Chenzhou 423000, China
Publisher
Hindawi Limited
Abstract
To deeply analyze the influences of doctor-nurse-patient integrated
nursing management on cardiac interventional surgery, 120 patients with
coronary heart disease undergoing cardiac interventional therapy were
selected as the subjects and randomly divided into two groups, 60 cases in
each group. The experimental group used the doctor-nurse-patient
integrated nursing, while the control group adopted the routine nursing.
The Hessian matrix enhanced filter segmentation algorithm was used to
process the cardiac computed tomography angiography (CTA) images of
patients to assess the algorithm performance and the safety of nursing
methods. The results showed that the Jaccard, Dice, sensitivity, and
specificity of cardiac CTA images of patients with coronary heart disease
processed by Hessian matrix enhanced filter segmentation algorithm were
0.86, 0.93, 0.94, and 0.95, respectively; the disease self-management
ability score and quality of life score of patients in the experimental
group after nursing intervention were significantly better than those
before nursing intervention, with significant differences (P<0.05). The
number of cases with adverse vascular events in the experimental group was
3 cases, which was obviously lower than that in the control group (15
cases). The diagnostic accuracy of the two groups of patients after
segmentation algorithm processing was 0.87 and 0.88, respectively, which
was apparently superior than the diagnostic accuracy of conventional CTA
(0.58 and 0.61). In summary, cardiac CTA evaluation of
doctor-nurse-patient integrated nursing management cardiac interventional
surgery based on segmentation algorithm had good safety and was worthy of
further promotion in clinical cardiac interventional
surgery.<br/>Copyright &#xa9; 2022 Aiqiong Zhang and Qiuxiang Chen.

<43>
[Use Link to view the full text]
Accession Number
2021013237
Title
Yield of Dual Therapy with Statin and Ezetimibe in the Treat Stroke to
Target Trial.
Source
Stroke. 53(11) (pp 3260-3267), 2022. Date of Publication: 01 Nov 2022.
Author
Amarenco P.; Kim J.S.; Labreuche J.; Charles H.; Giroud M.; Lee B.-C.;
Lavallee P.C.; Mahagne M.-H.; Meseguer E.; Nighoghossian N.; Steg P.G.;
Vicaut E.; Bruckert E.
Institution
(Amarenco, Charles, Lavallee, Meseguer) APHP, Department of Neurology and
Stroke Center, Bichat Hospital, INSERM LVTS-U1148, DHU FIRE, University of
Paris, France
(Amarenco) Population Health Research Institute, McMaster University,
Hamilton, ON, Canada
(Kim) Asan Medical Center, Seoul, South Korea
(Labreuche) CHU Lille, Department of Biostatistics, France
(Giroud) Department of Neurology, University Hospital of Dijon, Dijon
Stroke Registry, EA 7460, University of Burgundy, UBFC, France
(Lee) Department of Neurology, Hallym University Sacred Heart Hospital,
Anyang, South Korea
(Mahagne) Stroke Unit, Pasteur Hospital, Nice, France
(Nighoghossian) Hospices Civils de Lyon, Department of Neurology and
Stroke Center, Lyon University, France
(Steg) Universite de Paris, INSERM LVTS-U1148, France
(Steg) AP-HP, Hopital Bichat, France
(Vicaut) APHP, Department of Biostatistics, Universite Paris-Diderot,
Sorbonne-Paris Cite, Fernand Widal Hospital, Paris, France
(Bruckert) APHP, Department of Endocrinology, Pitie-Salpetriere Hospital,
Sorbonne University, Paris, France
Publisher
Wolters Kluwer Health
Abstract
Background: In atherosclerotic stroke, lipid-lowering treatment with a
target LDL (low-density lipoprotein) cholesterol of <70 compared with
100+/-10 mg/dL reduced the risk of subsequent cardiovascular events. This
post hoc analysis explored the relative effects of the combination of
statin and ezetimibe (dual therapy) and statin monotherapy in achieving
the lower LDL cholesterol target and in reducing the risk of major
vascular events, as compared with the higher target group. <br/>Method(s):
Patients with ischemic stroke in the previous 3 months or transient
ischemic attack within the previous 15 days and evidence of
cerebrovascular or coronary artery atherosclerosis were randomly assigned
to a target LDL cholesterol of <70 or 100+/-10 mg/dL, using statin and/or
ezetimibe as needed. The primary outcome was the composite of ischemic
stroke, myocardial infarction, new symptoms requiring urgent coronary or
carotid revascularization, and vascular death. Cox regression model
including lipid-lowering therapy as a time varying variable, after
adjustment for randomization strategy, age, sex, index event (stroke or
transient ischemic attack), and time since the index event.
<br/>Result(s): Among 2860 patients enrolled, patients who were on dual
therapy during the trial in the lower target group had a higher baseline
LDL cholesterol as compared to patients on statin monotherapy (141+/-38
versus 131+/-36, respectively, P<0.001). In patients on dual therapy and
on statin monotherapy, the achieved LDL cholesterol was 66.2 and 64.1
mg/dL respectively, and the primary outcome was reduced during dual
therapy as compared with the higher target group (HR, 0.60 [95% CI,
0.39-0.91]; P=0.016) but not during statin monotherapy (HR, 0.92 [95% CI,
0.70-1.20]; P=0.52), with no significant increase in intracranial
bleeding. <br/>Conclusion(s): In the TST trial (Treat Stroke to Target),
targeting an LDL cholesterol of < 70 mg/dL with a combination of statin
and ezetimibe compared with 100+/-10 mg/dL consistently reduced the risk
of subsequent stroke. Registration: URL: https://www.clinicaltrials.gov;
Unique identifier: NCT01252875. URL: clinicaltrialsregister.eu; Unique
identifier: EUDRACT2009-A01280-57.<br/>Copyright &#xa9; 2022 Lippincott
Williams and Wilkins. All rights reserved.

<44>
Accession Number
2020209124
Title
Pathophysiology of Coronary Microvascular Dysfunction.
Source
Circulation Journal. 86(9) (pp 1319-1328), 2022. Date of Publication:
2022.
Author
Crea F.; Montone R.A.; Rinaldi R.
Institution
(Crea, Montone) Department of Cardiovascular Medicine, Fondazione
Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
(Crea, Rinaldi) Department of Cardiovascular and Pulmonary Sciences,
Catholic University of the Sacred Heart, Rome, Italy
Publisher
Japanese Circulation Society
Abstract
Ischemic heart disease (IHD) is commonly recognized as the consequence of
coronary atherosclerosis and obstructive coronary artery disease (CAD).
However, a significant number of patients may present angina or myocardial
infarction even in the absence of any significant coronary artery stenosis
and impairment of the coronary microcirculation has been increasingly
implicated as a relevant cause of IHD. The term "coronary microvascular
dysfunction" (CMD) encompasses several pathogenic mechanisms resulting in
functional and/or structural changes in the coronary microcirculation and
determining angina and myocardial ischemia in patients with angina without
obstructive CAD ("primary" microvascular angina), as well as in several
other conditions, including obstructive CAD, cardiomyopathies, Takotsubo
syndrome and heart failure, especially the phenotype with preserved
ejection fraction. The pathogenesis of CMD is complex and involves the
combination of functional and structural alterations leading to impaired
coronary blood flow and resulting in myocardial ischemia. In the absence
of therapies specifically targeting CMD, attention has been focused on the
role of modifiable risk factors. Here, we provide updated evidence
regarding the pathophysiological mechanisms underlying CMD, with a
particular focus on the role of cardiovascular risk factors and
comorbidities. Moreover, we discuss the specific pathogenic mechanisms of
CMD across the different cardiovascular diseases, aiming to pave the way
for further research and the development of novel strategies for a
precision medicine approach.<br/>Copyright &#xa9; 2022 Japanese
Circulation Society. All rights reserved.

<45>
Accession Number
2015177334
Title
Effects of changes in position, positive end-expiratory pressure and mean
arterial pressure on renal, portal and hepatic Doppler ultrasound
perfusion indices: a randomized crossover study in cardiac surgery
patients.
Source
Journal of Clinical Monitoring and Computing. 36(6) (pp 1841-1850), 2022.
Date of Publication: December 2022.
Author
Hermansen J.L.; Norskov J.; Juhl-Olsen P.
Institution
(Hermansen, Norskov, Juhl-Olsen) Department of Cardiothoracic- and
Vascular Surgery, Anaesthesia Section, Aarhus University Hospital, Palle
Juul-Jensens, Boulevard 99, Aarhus 8200, Denmark
(Hermansen, Juhl-Olsen) Department of Clinical Medicine, Aarhus
University, Palle Juul-Jensens Boulevard 82, Aarhus 8200, Denmark
Publisher
Springer Science and Business Media B.V.
Abstract
Point-of-care ultrasound perfusion indices can be used for detection of
AKI and venous congestion. Patients in the postoperative- and intensive
care units are frequently exposed to alternating treatment and loading
conditions. We aimed to study the effects of changes in preload (patient
positioning), positive end-expiratory pressure (PEEP) and afterload
(phenylephrine) on renal, portal and hepatic ultrasound indices. We
hypothesized that renal resistive index was not influenced by changes in
PEEP and patient positioning. This was a single-site, randomized,
crossover study. Patients above 18 years scheduled for elective open-heart
surgery at Aarhus University Hospital, Denmark, were available for
inclusion. Patients were randomized to a sequence of six combinations of
PEEP and position in addition to an increase in mean arterial pressure by
phenylephrine. Thirty-one patients participated in the study. Resistive
index was influenced by positional change (P = 0.007), but not by change
in PEEP (P = 0.50) (Table 1). Renal venous stasis index and portal
pulsatility fraction increased in the raised legs position (P <= 0.019),
but not with increases in PEEP. Renal venous flow pattern and hepatic
venous flow pattern were affected by position (P <= 0.019), but not by
PEEP. None of the ultrasound indices were significantly changed by
infusion of phenylephrine. Doppler perfusion indices were significantly
affected by changes in preload, but not by changes in PEEP or afterload.
Although the changes in the Doppler ultrasound indices were significant,
they were small in absolute numbers. Therefore, from a clinical
perspective, the ultrasound indices were robust. Trial registration
Registered at clinicaltrials.com, first posted online June 5th 2020,
identifier: NCT04419662.<br/>Copyright &#xa9; 2022, The Author(s), under
exclusive licence to Springer Nature B.V.

<46>
[Use Link to view the full text]
Accession Number
635476134
Title
Prevention of Cardiac Surgery-Associated Acute Kidney Injury by
Implementing the KDIGO Guidelines in High-Risk Patients Identified by
Biomarkers: The PrevAKI-Multicenter Randomized Controlled Trial.
Source
Anesthesia and Analgesia. 133(2) (pp 292-302), 2021. Date of Publication:
01 Aug 2021.
Author
Zarbock A.; Kullmar M.; Ostermann M.; Lucchese G.; Baig K.; Cennamo A.;
Rajani R.; McCorkell S.; Arndt C.; Wulf H.; Irqsusi M.; Monaco F.; Di
Prima A.L.; Garcia Alvarez M.; Italiano S.; Miralles Bagan J.; Kunst G.;
Nair S.; L'Acqua C.; Hoste E.; Vandenberghe W.; Honore P.M.; Kellum J.A.;
Forni L.G.; Grieshaber P.; Massoth C.; Weiss R.; Gerss J.; Wempe C.;
Meersch M.
Institution
(Zarbock, Kullmar, Massoth, Weiss, Wempe, Meersch) Department of
Anesthesiology Intensive Care and Pain Medicine, University Hospital
Munster, Albert-Schweitzer-Campus 1, Munster 48149, Germany
(Ostermann, Lucchese, Baig, Cennamo, Rajani, McCorkell) Department of
Critical Care, Guy's & St Thomas' National Health Service Foundation
Hospital, London, United Kingdom
(Arndt, Wulf) Department of Anesthesiology and Intensive Care Medicine,
United Kingdom
(Irqsusi) Department of Cardiac Surgery, University Hospital Marburg,
Marburg, Germany
(Monaco, Di Prima) Department of Anesthesia and Intensive Care, Istituto
di Ricovero e Cura A Carattere Scientifico San Raffaele Scientific
Institute, Milan, Italy
(Garcia Alvarez, Italiano, Miralles Bagan) Department of Anesthesiology,
Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
(Kunst, Nair) Department of Anesthetics, King's College Hospital, Denmark
Hill, London, United Kingdom
(L'Acqua) Department of Anesthesia and Critical Care, Centro Cardiologico
Monzino Istituto di Ricovero e Cura A Carattere Scientifico, Milan, Italy
(Hoste, Vandenberghe) Department of Intensive Care Medicine, University
Hospital Gent, Gent, Belgium
(Honore) Department of Intensive Care, CHU Brugmann University Hospital,
Brussels, Belgium
(Kellum) Center for Critical Care Nephrology, Department of Critical Care
Medicine, University of Pittsburgh, Pittsburgh, PA, United States
(Forni) Department of Intensive Care Medicine, Royal Surrey County
Hospital & Faculty of Health Sciences, University of Surrey, Guildford,
United Kingdom
(Grieshaber) Department of Cardiac Surgery, University Hospital Giessen,
Giessen, Germany
(Gerss) Institute of Biostatistics and Clinical Research, University of
Munster, Munster, Germany
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Prospective, single-center trials have shown that the
implementation of the Kidney Disease: Improving Global Outcomes (KDIGO)
recommendations in high-risk patients significantly reduced the
development of acute kidney injury (AKI) after surgery. We sought to
evaluate the feasibility of implementing a bundle of supportive measures
based on the KDIGO guideline in high-risk patients undergoing cardiac
surgery in a multicenter setting in preparation for a large definitive
trial. <br/>METHOD(S): In this multicenter, multinational, randomized
controlled trial, we examined the adherence to the KDIGO bundle consisting
of optimization of volume status and hemodynamics, functional hemodynamic
monitoring, avoidance of nephrotoxic drugs, and prevention of
hyperglycemia in high-risk patients identified by the urinary biomarkers
tissue inhibitor of metalloproteinases-2 [TIMP-2] and insulin growth
factor-binding protein 7 [IGFBP7] after cardiac surgery. The primary end
point was the adherence to the bundle protocol and was evaluated by the
percentage of compliant patients with a 95% confidence interval (CI)
according to Clopper-Pearson. Secondary end points included the
development and severity of AKI. <br/>RESULT(S): In total, 278 patients
were included in the final analysis. In the intervention group, 65.4% of
patients received the complete bundle as compared to 4.2% in the control
group (absolute risk reduction [ARR] 61.2 [95% CI, 52.6-69.9]; P <.001).
AKI rates were statistically not different in both groups (46.3%
intervention versus 41.5% control group; ARR -4.8% [95% CI, -16.4 to 6.9];
P =.423). However, the occurrence of moderate and severe AKI was
significantly lower in the intervention group as compared to the control
group (14.0% vs 23.9%; ARR 10.0% [95% CI, 0.9-19.1]; P =.034). There were
no significant effects on other specified secondary outcomes.
<br/>CONCLUSION(S): Implementation of a KDIGO-derived treatment bundle is
feasible in a multinational setting. Furthermore, moderate to severe AKI
was significantly reduced in the intervention group.<br/>Copyright &#xa9;
2021 Lippincott Williams and Wilkins. All rights reserved.

<47>
Accession Number
2021034738
Title
Efficacy of maintaining low-tidal volume mechanical ventilation as
compared to resting lung strategy during coronary artery bypass graft
cardiopulmonary bypass surgery: A post-hoc analysis of the MECANO trial.
Source
Journal of Clinical Anesthesia. 84 (no pagination), 2023. Article Number:
110991. Date of Publication: February 2023.
Author
Boussion K.; Tremey B.; Gibert H.; Koune J.-D.L.; Aubert S.; Balcon L.;
Nguyen L.S.
Institution
(Boussion, Tremey, Gibert, Koune, Aubert, Balcon, Nguyen) Research and
Innovation Group, Groupe Hospitalier Ambroise Pare-Hartmann, 25-27
boulevard Victor Hugo, Neuilly-sur-Seine, France
Publisher
Elsevier Inc.
Abstract
Study objective: To compare a low-tidal-volume with positive
end-expiratory pressure strategy (VENT strategy) to a
resting-lung-strategy (i.e., no-ventilation (noV) strategy) during
cardiopulmonary bypass for coronary artery bypass graft surgery on the
incidence of postoperative pulmonary complications. <br/>Design(s):
Post-hoc analysis of the MECANO trial which was a prospective
single-center, blind, randomized, parallel-group controlled trial.
<br/>Setting(s): Tertiary care cardiac surgery center. <br/>Patient(s):
Patients who underwent isolated on-pump coronary bypass surgery were
randomized either to VENT or noV group. <br/>Intervention(s): During the
cardiopulmonary bypass phase of the cardiac surgery procedure, mechanical
ventilation in the VENT group consisted of a tidal volume of 3 mL/kg, a
respiratory rate of 5 per minute and a positive end-expiratory pressure of
5 cmH<inf>2</inf>O. Patients in the noV group received no ventilation
during this phase. Measurements: Primary composite outcome combining
death, early respiratory failure, ventilation support beyond day 2 and
reintubation. <br/>Main Result(s): In this post-hoc analysis, we retained
725 patients who underwent isolated CABG surgery, from the 1501 patients
included in the original study. There were 352 in the VENT group and 373
patients in the noV group. Post-hoc comparison yielded no differences in
baseline characteristics between these two groups. The primary outcome
occurred less frequently in the VENT group than in the noV group, with 44
(12.5%) and 76 (20.4%) respectively (odds-ratio (OR) = 0.56 (0.37-0.84), p
= 0.004). There were fewer early respiratory dysfunctions and prolonged
respiratory support in the VENT group (respectively, OR = 0.34 (0.12-0.96)
p = 0.033 and OR = 0.51 (0.27-0.94) p = 0.029). Complications related to
mechanical ventilation were similar in the two groups. <br/>Conclusion(s):
In this post-hoc analysis, maintaining low-tidal ventilation compared to a
resting-lung strategy was associated with fewer pulmonary postoperative
complications in patients who underwent isolated CABG
procedures.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<48>
Accession Number
2021033566
Title
The effectiveness of positive airway pressure therapy in reducing
postoperative adverse outcomes in surgical patients with obstructive sleep
apnea: A systematic review and meta-analysis.
Source
Journal of Clinical Anesthesia. 84 (no pagination), 2023. Article Number:
110993. Date of Publication: February 2023.
Author
Berezin L.; Nagappa M.; Poorzargar K.; Saripella A.; Ariaratnam J.; Butris
N.; Englesakis M.; Chung F.
Institution
(Berezin, Poorzargar, Saripella, Ariaratnam, Butris, Chung) Department of
Anesthesia and Pain Management, Toronto Western Hospital, University
Health Network, University of Toronto, Toronto, ON, Canada
(Nagappa, Chung) Department of Anesthesia & Perioperative Medicine, London
Health Sciences Centre and St. Joseph Healthcare, Schulich School of
Medicine and Dentistry, Western University, London, ON, Canada
(Poorzargar, Butris) Institute of Medical Science, University of Toronto,
ON, Canada
(Englesakis) Library & Information Services, University Health Network,
Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Importance: Obstructive sleep apnea (OSA) is prevalent in surgical
patients and is associated with an increased risk of adverse perioperative
events. Study objective: To determine the effectiveness of positive airway
pressure (PAP) therapy in reducing the risk of postoperative complications
in patients with OSA undergoing surgery. <br/>Design(s): Systematic review
and meta-analysis searching Medline and other databases from inception to
October 17, 2021. The search terms included: "positive airway pressure,"
"surgery," "post-operative," and "obstructive sleep apnea." The inclusion
criteria were: 1) adult patients with OSA undergoing surgery; (2) patients
using preoperative and/or postoperative PAP; (3) at least one
postoperative outcome reported; (4) control group (patients with OSA
undergoing surgery without preoperative and/or postoperative PAP therapy);
and (5) English language articles. <br/>Patient(s): Twenty-seven studies
included 30,514 OSA patients undergoing non-cardiac surgery and 837 OSA
patients undergoing cardiac surgery. <br/>Intervention(s): PAP therapy
Main results: In patients with OSA undergoing non-cardiac surgery, PAP
therapy was associated with a decreased risk of postoperative respiratory
complications (2.3% vs 3.6%; RR: 0.72, 95% CI: 0.51-1.00, asymptotic P =
0.05) and unplanned ICU admission (0.12% vs 4.1%; RR: 0.44, 95% CI:
0.19-0.99, asymptotic P = 0.05). No significant differences were found for
all-cause complications (11.6% vs 14.4%; RR: 0.89, 95% CI: 0.74-1.06, P =
0.18), postoperative cardiac and neurological complications, in-hospital
length of stay, and in-hospital mortality between the two groups. In
patients with OSA undergoing cardiac surgery, PAP therapy was associated
with decreased postoperative cardiac complications (33.7% vs 50%; RR:
0.63, 95% CI: 0.51-0.77, P < 0.0001), and postoperative atrial
fibrillation (40.1% vs 66.7%; RR: 0.59, 95% CI 0.45-0.77, P < 0.0001).
<br/>Conclusion(s): In patients with OSA undergoing non-cardiac surgery,
PAP therapy was associated with a 28% reduction in the risk of
postoperative respiratory complications and 56% reduction in unplanned ICU
admission. In patients with OSA undergoing cardiac surgery, PAP therapy
decreased the risk of postoperative cardiac complications and atrial
fibrillation by 37% and 41%, respectively.<br/>Copyright &#xa9; 2022

<49>
Accession Number
2019051770
Title
Staged Versus Synchronous Carotid Endarterectomy and Coronary Artery
Bypass Grafting: A Meta-Analysis and Systematic Review.
Source
Annals of Vascular Surgery. 86 (pp 428-439), 2022. Date of Publication:
October 2022.
Author
Peng C.; Yang Y.-F.; Zhao Y.; Yang X.-Y.
Institution
(Peng, Yang, Zhao, Yang) Department of Neurosurgery, Tianjin Medical
University General Hospital, Tianjin, China
Publisher
Elsevier Inc.
Abstract
Background: There are several treatment options for patients with
concomitant carotid and coronary artery disease, and it is difficult to
identify an optimal treatment strategy that has consensus. Here, we
performed a meta-analysis to compare the early and long-term outcomes of
staged and synchronous carotid endarterectomy and coronary artery bypass
grafting approaches. <br/>Method(s): We performed a meta-analysis that
compared staged and synchronous carotid endarterectomy and coronary artery
bypass grafting approaches between July 1976 and September 2021. PubMed,
EMBASE, and the Cochrane Library were systematically searched for related
articles. <br/>Result(s): Nineteen studies were identified with a total of
39,269 and 30,066 patients in the synchronous and staged groups,
respectively. Early mortality was lower in the staged group than in the
synchronous group (odds ratio OR 1.256, 95% confidence interval CI
1.006-1.569, P= P < 0.05, I² = 54.5%), and stroke rates were
significantly higher in the synchronous group (OR 1.356, 95% CI
1.232-1.493, P < 0.05, I² = 33.3%). The rate of myocardial
ischemia was significantly higher in the staged group than in the
synchronous group (OR 0.757, 95% CI 0.635-0.903, P < 0.05, I² =
51.5%), and this meta-analysis also showed a significantly higher risk of
transient ischemic attacks (TIAs) in the synchronous group (OR 1.335, 95%
CI 1.055-1.688, P < 0.05, I² = 0.00%). The secondary outcomes,
including the rate of reoperation, were significantly lower for the staged
procedure than for the synchronous procedure (OR 1.177, 95% CI
1.052-1.318, P < 0.05, I² = 4.2%), and the rate of wound
infection was significantly higher in the synchronous group than in the
staged group (OR 0.457, 95% CI 0.403-0.519, P < 0.05, I² =
0.0%). There was no significant difference in the rate of cardiac
arrhythmia between the two groups (OR 0.544, 95% CI 0.265-1.117, P > 0.05,
I² = 12.7%). There was also no statistical significance in the
long-term results regarding the incidence of stroke, myocardial ischemia,
and mortality between the synchronous and staged groups (P > 0.05).
<br/>Conclusion(s): Patients treated with the synchronous approach had a
significantly higher risk of early mortality, stroke, TIA, wound
infection, and reoperation and a lower risk of myocardial ischemia than
those treated with the staged approach. There was no significant
difference in the long-term results between the 2 groups.<br/>Copyright
&#xa9; 2022 Elsevier Inc.

<50>
Accession Number
2020044664
Title
Heart transplantation in end-stage heart failure secondary to cardiac
sarcoidosis: an updated systematic review.
Source
Heart Failure Reviews. (no pagination), 2022. Date of Publication: 2022.
Author
Buttar C.; Lakhdar S.; Pavankumar T.; Guzman-Perez L.; Mahmood K.; Collura
G.
Institution
(Buttar) Department of Cardiology, Tulane Hospital, New Orleans, LA,
United States
(Lakhdar, Pavankumar) Department of Cardiology, Ochsner Medical Center,
New Orleans, LA, United States
(Guzman-Perez) Department of Medicine, Icahn School of Medicine at Mount
Sinai/NYC H+H/Queens, Queens, NY, United States
(Mahmood) Department of Heart Failure and Transplant, Icahn School of
Medicine at Mount Sinai, New York, NY, United States
(Collura) Division of Cardiology, Icahn School of Medicine at Mount Sinai,
NYC H+H/Queens, Queens, NY, United States
Publisher
Springer
Abstract
The prevalence of cardiac sarcoidosis is increasing with improved cardiac
imaging and may lead to severe heart failure, cardiomyopathy, and
arrhythmias that warrant heart transplant consideration. This study aimed
to evaluate the outcomes of heart transplantation in sarcoidosis. We
systematically searched PubMed/MEDLINE, EMBASE and Cochrane Library
following the Preferred Reporting Items for Systematic Reviews and
Meta-analysis (PRISMA) guidelines. We identified 15 articles that examined
patients with cardiac sarcoidosis. The study aimed to evaluate the
outcomes of heart transplantation in cardiac sarcoidosis. We
systematically searched EMBASE, PubMed/MEDLINE, and Cochrane Library
following the Preferred Reporting Items for Systematic Reviews and
Meta-analyses (PRISMA) guidelines. We identified 15 studies that examined
1075 patients with cardiac sarcoidosis who underwent heart
transplantation. A total of five studies reported individual patient data.
Forty-two patients have been pooled for further analysis. There were 22
male patients, 14 female patients, and 7 patients whose gender was not
reported. Among these patients, 10 patients had concomitant pulmonary
sarcoidosis at the time of diagnosis. The mean survival was reported for
all 42 patients. The mean survival in months was 71.4 months, with a range
of 2 days to 288 months. Three patients died of graft failure, 2 patients
from septic shock, 2 patients from pneumonia, 1 patient from cervical
cancer, and 1 patient from sudden cardiac death. One patient developed a
malignant arrythmia in the setting of CMV myocarditis post-heart
transplant. Sarcoidosis recurrence after heart transplant was reported in
3 of 30 patients.Patients with cardiac sarcoidosis have shown to have
favorable outcomes after heart transplant. Despite these outcomes, some
centers still hesitate to pursue heart transplant for CS patients.
Carefully selected patients with advanced-stage heart failure due to
cardiac sarcoidosis have encouraging outcomes after transplantation.
Further studies will be needed to evaluate the outcomes of heart
transplantation in sarcoidosis.<br/>Copyright &#xa9; 2022, The Author(s),
under exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature.

<51>
Accession Number
2020010524
Title
Coronary artery bypass surgery for acute coronary syndrome: A network
meta-analysis of on-pump cardioplegic arrest, off-pump, and on-pump
beating heart strategies.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Hwang B.; Williams M.L.; Tian D.H.; Yan T.D.; Misfeld M.
Institution
(Hwang) School of Medicine, University of New South Wales, Sydney,
Australia
(Hwang, Williams, Tian, Yan) The Collaborative Research (CORE) Group,
Macquarie University, Sydney, Australia
(Williams) Department of Cardiothoracic Surgery, Dunedin Hospital,
Dunedin, New Zealand
(Yan, Misfeld) Department of Cardiothoracic Surgery, Royal Prince Alfred
Hospital, Sydney, Australia
Publisher
John Wiley and Sons Inc
Abstract
Background: Coronary artery bypass grafting (CABG) in the setting of an
acute coronary syndrome is a high-risk procedure, and the best strategy
for myocardial revascularisation remains debated. This study compares the
30-day mortality benefit of on-pump CABG (ONCAB), off-pump CABG (OPCAB),
and on-pump beating heart CABG (OnBHCAB) strategies. <br/>Method(s): A
systematic search of three electronic databases was conducted for studies
comparing ONCAB with OPCAB or OnBHCAB in patients with acute coronary
syndrome (ACS). The primary outcome, 30-day mortality, was compared using
a Bayesian hierarchical network meta-analysis (NMA). A random effects
consistency model was applied, and direct and indirect comparisons were
made to determine the relative effectiveness of each strategy on
postoperative outcomes. <br/>Result(s): One randomised controlled trial
and eighteen observational studies fulfilling the inclusion criteria were
identified. A total of 4320, 5559, and 1962 patients underwent ONCAB,
OPCAB, and OnBHCAB respectively. NMA showed that OPCAB had the highest
probability of ranking as the most effective treatment in terms of 30-day
mortality (odds ratio [OR], 0.50; 95% credible interval [CrI], 0.23-1.00),
followed by OnBHCAB (OR, 0.62; 95% CrI, 0.20-1.57), however the 95% CrI
crossed or included unity. A subgroup NMA of nine studies assessing only
acute myocardial infarction (AMI) patients demonstrated a 72% reduction in
likelihood of 30-day mortality after OPCAB (CrI, 0.07-0.83). No
significant increase in rate of stroke, renal dysfunction or length of
intensive care unit stay was found for either strategy.
<br/>Conclusion(s): Although no single best surgical revascularisation
approach in ACS patients was identified, the significant mortality benefit
with OPCAB seen with AMI suggests high acuity patients may benefit most
from avoiding further myocardial injury associated with cardiopulmonary
bypass and cardioplegic arrest.<br/>Copyright &#xa9; 2022 The Authors.
Journal of Cardiac Surgery published by Wiley Periodicals LLC.

<52>
Accession Number
639483200
Title
Effect of TAVR Approach and Other Baseline Factors on the Incidence of
Acute Kidney Injury: A Systematic Review and Meta-Analysis.
Source
Journal of interventional cardiology. 2022 (pp 3380605), 2022. Date of
Publication: 2022.
Author
Alzu'bi H.; Rmilah A.A.; Haq I.-U.; Kheiri B.; Al-Abdouh A.; Hasan B.;
Elsekaily O.; Jaber S.; Qaisi I.; Yagmour A.; Dajani H.; Ahmed A.; Ahmed
Elhag; Kashani K.; Deshmukh A.
Institution
(Alzu'bi, Rmilah, Elsekaily, Ahmed, Deshmukh) Department of Cardiovascular
Medicine, Mayo Clinic, Rochester, MN, United States
(Haq) Department of Internal Medicine, Mayo Clinic, Rochester, MN, United
States
(Kheiri) Knight Cardiovascular Institute, Oregon Health & Science
University, Portland, OR, USA
(Al-Abdouh) Department of Medicine, Ascension Saint Agnes Hospital,
Baltimore, MD, United States
(Hasan) Evidence-Based Practice Research Program, Mayo Clinic, Rochester,
MN, United States
(Jaber, Ahmed Elhag) Department of Internal Medicine, Dr. Sulaiman Al
Habib Hospital, Riyadh, Saudi Arabia
(Qaisi, Dajani) An-Najah National University School of Medicine, State of
Palestine, Nablus
(Yagmour) State of Palestine, Al Quds University School of Medicine,
Hebron, United States
(Kashani) Division of Nephrology and Hypertension, Mayo Clinic, Rochester,
MN, United States
Publisher
NLM (Medline)
Abstract
Background: Acute kidney injury (AKI) is a well-known complication
following a transcatheter aortic valve replacement (TAVR) and is
associated with higher morbidity and mortality. <br/>Objective(s): We aim
to compare the risk of developing AKI after transfemoral (TF), transapical
(TA), and transaortic (TAo) approaches following TAVR. <br/>Method(s): We
searched Medline and EMBASE databases from January 2009 to January 2021.
We included studies that evaluated the risk of AKI based on different TAVR
approaches. After extracting each study's data, we calculated the risk
ratio and 95% confidence intervals using RevMan software 5.4. Publication
bias was assessed by the forest plot. <br/>Result(s): Thirty-six (36)
studies, consisting of 70,406 patients undergoing TAVR were included.
Thirty-five studies compared TF to TA, and only seven investigations
compared TF to TAo. AKI was documented in 4,857 out of 50,395 (9.6%)
patients that underwent TF TAVR compared to 3,155 out of 19,721 (16%)
patients who underwent TA-TAVR, with a risk ratio of 0.49 (95% CI,
0.36-0.66; p < 0.00001). Likewise, 273 patients developed AKI out of the
1,840 patients (14.8%) that underwent TF-TAVR in contrast to 67 patients
out of the 421 patients (15.9%) that underwent TAo-TAVR, with a risk ratio
of 0.51 (95% CI, 0.27-0.98; p=0.04). There was no significant risk when we
compared TA to TAo approaches, with a risk ratio of 0.89 (95% CI,
0.29-2.75; p=0.84). <br/>Conclusion(s): The risk of post-TAVR AKI is
significantly lower in patients who underwent TF-TAVR than those who
underwent TA-TAVR or TAo-TAVR.<br/>Copyright &#xa9; 2022 Hossam Alzu'bi et
al.

<53>
[Use Link to view the full text]
Accession Number
631846339
Title
Use of Coagulation Point-of-Care Tests in the Management of
Anticoagulation and Bleeding in Pediatric Cardiac Surgery: A Systematic
Review.
Source
Anesthesia and Analgesia. 130(6) (pp 1594-1604), 2020. Date of
Publication: 01 Jun 2020.
Author
Bianchi P.; Beccaris C.; Norbert M.; Dunlop B.; Ranucci M.
Institution
(Bianchi) Department of Anesthesia and Intensive Care, Royal Brompton and
Harefield NHS Foundation Trust, London, United Kingdom
(Beccaris) Great Ormond Street Hospital NHS Foundation Trust, Cardiac
Intensive Care Unit, London, United Kingdom
(Norbert, Dunlop) Brunel University, London, United Kingdom
(Ranucci) Department of Cardiothoracic, Vascular Anesthesia and Intensive
Care, IRCCS Policlinico San Donato, Milan, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
Bleeding and coagulation management are essential aspects in the
management of neonates and children undergoing cardiac surgery. The use of
point-of-care tests (POCTs) in a pediatric setting is not as widely used
as in the adult setting. This systematic review aims to summarize the
evidence showed by the literature regarding the use of POCTs in children
undergoing cardiac surgery. We included all studies examining the
pediatric population (<18 years old) undergoing cardiac surgery in which
the coagulation profile was assessed with POCTs. Three electronic
databases (PubMed, Embase, and the Cochrane Controlled Clinical Trials
register) were searched. Tests involved were heparin effect tests,
viscoelastic tests, and platelet function tests. Due to the wide
heterogeneity of the patients and tests studied, a formal meta-analysis
was impossible, and the results are therefore presented through a
systematic review. Eighty articles were found, of which 47 are presented
in this review. At present, literature data are too weak to define POCTs
as a "gold standard"for the treatment of perioperative bleeding in
pediatric cardiac surgery. Nevertheless, introduction of POCTs into
postoperative algorithms has shown to improve bleeding management, patient
outcome, and cost efficiency. <br/>Copyright &#xa9; 2019 International
Anesthesia Research Society.

<54>
Accession Number
2021123352
Title
Thoracic surgery in the Netherlands.
Source
Journal of Thoracic Disease. 14(10) (pp 4173-4186), 2022. Date of
Publication: October 2022.
Author
Laven I.E.W.G.; Daemen J.H.T.; Jansen Y.J.L.; Janssen N.; Franssen
A.J.P.M.; Heuts S.; Maessen J.G.; van den Broek F.J.C.; Hulsewe K.W.E.;
Vissers Y.L.J.; de Loos E.R.
Institution
(Laven, Daemen, Jansen, Janssen, Franssen, Hulsewe, Vissers, de Loos)
Department of Surgery, Division of General Thoracic Surgery, Zuyderland
Medical Center, Heerlen, Netherlands
(Heuts, Maessen) Department of Cardiothoracic Surgery, Maastricht
University Medical Center, Maastricht, Netherlands
(Maessen) Cardiovascular Research Institute Maastricht (CARIM), Maastricht
University, Maastricht, Netherlands
(van den Broek) Department of Surgery, Maxima Medical Center, Veldhoven,
Eindhoven, Netherlands
Publisher
AME Publishing Company
Abstract
The purpose of this article, part of the Thoracic Surgery Worldwide
series, is to provide a descriptive review of how thoracic surgery is
organized in the Netherlands. General information is provided on the Dutch
healthcare system, as well as on how Dutch thoracic surgeons are organized
and trained. Additionally, this study provides information on our national
quality surveillance system, an overview of the most common thoracic
surgeries performed in our country, and details of academic research
conducted by Dutch medical specialists. Furthermore, we discuss current
challenges and future perspectives. In the Netherlands general thoracic
surgical procedures are performed by approximately 110 general thoracic
surgeons and 25 of the 135 cardiothoracic surgeons. Dutch thoracic
surgeons provide minimally invasive lung surgery, chest wall surgery,
thymic and mediastinal surgery, and surgical diagnosis and treatment of
pleural disorders. Some recently published data on hospital mortality and
postoperative adverse events of thoracic surgeries are reported.
Furthermore, the structure of the thoracic surgical education and training
program is discussed, highlighting the particular structure of two
educational programs for thoracic surgery via a general thoracic and
cardiothoracic surgery program. To assure high-quality surgical care, the
Netherlands has a well-structured national quality surveillance system,
involving frequent site visits and mandatory participation in the national
lung cancer surgery registry for all hospitals. In terms of academic
research, the Netherlands ranked 14th worldwide on number of clinical
trials conducted across all medical disciplines in 2021. Furthermore,
several thoracic-related (inter-)national multicenter randomized trials
which are currently performed and initiated by Dutch hospital research
groups are mentioned. Finally, future challenges and advances of Dutch
thoracic surgery are addressed, including the implementation of lung
cancer screening, imbalanced labor market, and centralization of
care.<br/>Copyright &#xa9; 2022 AME Publishing Company. All rights
reserved.

<55>
Accession Number
2021123331
Title
A randomized comparison between the VivaSight double-lumen tube and
standard double-lumen tube intubation in thoracic surgery patients.
Source
Journal of Thoracic Disease. 14(10) (pp 3903-3914), 2022. Date of
Publication: October 2022.
Author
Palaczynski P.; Misiolek H.; Bialka S.; Owczarek A.J.; Gola W.; Szarpak
L.; Smereka J.
Institution
(Palaczynski, Misiolek, Bialka) Department of Anaesthesiology and Critical
Care, Faculty of Medical Sciences in Zabrze, Medical University of
Silesia, Katowice, Poland
(Owczarek) Health Promotion and Obesity Management Unit, Department of
Pathophysiology, Faculty of Medical Sciences in Katowice, Medical
University of Silesia, Katowice, Poland
(Gola) Faculty of Medicine and Health Sciences, Jan Kochanowski
University, Kielce, Poland
(Szarpak) Henry J. N. Taub Department of Emergency Medicine, Baylor
College of Medicine, Houston, TX, United States
(Szarpak) Institute of Outcomes Research, Maria Sklodowska-Curie Medical
Academy, Warsaw, Poland
(Smereka) Department of Emergency Medical Service, Faculty of Health
Sciences, Wroclaw Medical University, Wroclaw, Poland
Publisher
AME Publishing Company
Abstract
Background: Thoracic surgery often demands separation of ventilation
between the lungs. It is achieved with double-lumen tubes (DLTs), video
double-lumen tubes (VDLTs) or bronchial blockers. We tested the hypothesis
that intubation with the VivaSight double-lumen tube would be easier and
faster than with a standard DLT. <br/>Method(s): Seventy-one adult
patients undergoing thoracic procedures that required general anaesthesia
and one-lung ventilation (OLV) were enrolled in this randomized,
prospective study. Patients were randomly assigned to procedure of
intubation with a standard DLT or VDLT. The collected data included:
Patients' demographics, surgery information, anthropometric tests used for
difficult intubation prediction, specifics of intubation procedure, tube
placement, fiberoptic bronchoscopy (FOB) use, lung separation, trachea
temperature, and reported complications of intubation. <br/>Result(s): For
DLTs compared to video-double lumen tubes, intubation time was
significantly longer (125 vs. 44 s; P<0.001), intubation graded harder
(P<0.05) and FOB use was more prevalent [8 (20.5%) vs. 0; P<0.05].
<br/>Conclusion(s): The use of VDLTs when compared with standard-double
lumen tubes offers reduced intubation time and is relatively easier. Also,
the reduced need for fibreoptic bronchoscopy may improve the
cost-effectiveness of VDLT use. In addition, constant visualization of the
airways during the procedure allows to quickly correct or even prevent the
tube malposition.<br/>Copyright &#xa9; 2022 AME Publishing Company. All
rights reserved.

<56>
[Use Link to view the full text]
Accession Number
2021104192
Title
Prophylactic Use of Antifibrinolytics During Pediatric Cardiac Surgery
With Cardiopulmonary Bypass on Postoperative Bleeding and Transfusion: A
Systematic Review and Meta-Analysis.
Source
Pediatric Critical Care Medicine. 23(11) (pp E517-E529), 2022. Date of
Publication: 01 Nov 2022.
Author
Schertz K.; Karam O.; Demetres M.; Mayadunna S.; Faraoni D.; Nellis M.E.
Institution
(Schertz) Department of Pediatrics, New York-Presbyterian/Weill Cornell
Medicine, New York, NY, United States
(Karam) Pediatric Critical Care Medicine, Yale School of Medicine, New
Haven, CT, United States
(Demetres) Samuel J. Wood Library & C.V. Starr Biomedical Information
Center, Weill Cornell Medicine, New York, NY, United States
(Mayadunna, Faraoni, Nellis) Wagner College, New York, NY, United States
(Mayadunna) Arthur S. Keats Division of Pediatric Cardiovascular
Anesthesia Department of Anesthesiology, Perioperative and Pain Medicine
Texas Children's Hospital, Baylor College of Medicine, Houston, TX, United
States
(Faraoni) Weill Cornell Medicine, Division of Pediatric Critical Care,
Department of Pediatrics, New York, NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives: To determine the effect of intraoperative antifibrinolytics,
including tranexamic acid (TXA), aminocaproic acid (EACA), or aprotinin,
on bleeding in children undergoing cardiac surgery with cardiopulmonary
bypass (CPB). <br/>Data Sources: Relevant articles were systematically
searched from Ovid MEDLINE, Ovid EMBASE, CINAHL, Cochrane Library, and Web
of Science to November 15, 2021. Study Selection: Abstracts were screened,
and full texts were reviewed using predetermined inclusion and exclusion
criteria using the Preferred Reporting Items for Systematic Reviews and
Meta-analyses reporting guideline. <br/>Data Extraction: A standardized
data extraction tool was used. <br/>Data Synthesis: Sixty-eight studies
including 28,735 patients were analyzed. TXA compared with placebo
resulted in a mean decrease in chest tube output of 9.1 mL/kg (95% CI,
6.0-12.3 mL/kg), I²equals to 65.2%, p value of less than 0.001,
platelet requirement of 2.9 mL/kg (95% CI, 0.1-5.8 mL/kg),
I²=72.5%, p value less than 0.001 and plasma requirement of 4.0
mL/kg (95% CI, 0.6-7.2 mL/kg), I²equals to 94.5%, p value less
than0.001. Aprotinin compared with placebo resulted in a mean decrease in
chest tube output of 4.3 mL/kg (2.4-6.2 mL/kg), I²equals to
66.3%, p value of less than 0.001, platelet transfusion of 4.6 mL/kg (95%
CI, 0.6-8.6 mL/kg), I²equals to 93.6%, p value of less than
0.001, and plasma transfusion of 7.7 mL/kg (95% CI, 2.1-13.2 mL/kg),
I²equals to 95.3%, p value of less than 0.001. EACA compared
with placebo resulted in a mean decrease in chest tube output of 9.2 mL/kg
(2.3-21.0 mL/kg), I²equals to 96.4%, p value of less than
0.001, RBC transfusion of 7.2 mL/kg (95% CI, 2.4-12.1 mL/kg),
I²equals to 94.5%, p value equals to 0.002, and platelet
transfusion of 10.7 mL/kg (95% CI, 2.9-18.5 mL/kg), I²equals to
0%, p value of less than 0.001. No statistical difference was observed in
chest tube output when TXA was compared with aprotinin. Subgroup analysis
of cyanotic patients showed a significant decrease in chest tube output,
platelet requirement, and plasma requirement for patients receiving
aprotinin. Overall, the quality of evidence was moderate.
<br/>Conclusion(s): Antifibrinolytics are effective at decreasing blood
loss and blood product requirement in children undergoing cardiac surgery
with CPB although the quality of evidence is only moderate.<br/>Copyright
&#xa9; 2022 Lippincott Williams and Wilkins. All rights reserved.

<57>
Accession Number
2021072918
Title
Topical antibiotic prophylaxis for surgical wound infections in clean and
clean-contaminated surgery: a systematic review and meta-analysis.
Source
BJS Open. 5(6) (no pagination), 2021. Article Number: zrab125. Date of
Publication: 01 Nov 2021.
Author
Chen P.-J.; Hua Y.-M.; Toh H.S.; Lee M.-C.
Institution
(Chen) Department of Emergency Medicine, Chi Mei Medical Center, Tainan,
Taiwan (Republic of China)
(Hua, Lee) Department of Pharmacy, Chi Mei Medical Center, Tainan, Taiwan
(Republic of China)
(Toh) Department of Intensive Care Medicine, Chi Mei Medical Center,
Tainan, Taiwan (Republic of China)
(Toh) Institute of Clinical Medicine, College of Medicine, National Cheng
Kung University, Tainan, Taiwan (Republic of China)
(Toh) Department of Health and Nutrition, Chia Nan University of Pharmacy
& Science, Tainan, Taiwan (Republic of China)
(Lee) Department of Public Health, College of Medicine, National Cheng
Kung University, Tainan, Taiwan (Republic of China)
Publisher
Oxford University Press
Abstract
Background: Topical antibiotics are widely prescribed as prophylaxis for
surgical site infection (SSI). Despite giving high drug concentrations at
local wound sites, their efficacy remains controversial. This study is a
systematic review and meta-analysis designed to compare the efficacy and
safety of topical antibiotics with non-antibiotic agents in preventing
SSI. <br/>Method(s): Randomized controlled trials (RCTs) comparing topical
antibiotics in patients with clean and clean-contaminated postsurgical
wounds were included. Relevant trials published before 30 September 2020,
were searched in the PubMed, Embase, and Cochrane databases, without
language restrictions. The primary outcome was the incidence of SSIs,
presented as the event rate. The secondary outcome was the incidence of
contact dermatitis (safety outcome). Data were synthesized using the
random-effects model, with the results expressed as risk ratio (RR) with
95 per cent confidence intervals (c.i.). <br/>Result(s): Thirteen RCTs
were included. The incidence of SSIs and contact dermatitis showed no
significant difference between topical antibiotics and non-antibiotic
agents (RR 0.89, 95 per cent c.i. 0.59 to 1.32 (P = 0.56, I2 = 48 per
cent); and RR 2.79, 95 per cent c.i. 0.51 to 15.19 (P = 0.24, I2 = 0 per
cent), respectively). In the subgroup analyses, a reduction in SSIs was
also not observed in dermatological (RR 0.77, 95 per cent c.i. 0.39 to
1.55; P = 0.46, I2 = 65 per cent), ocular (RR 0.08, 95 per cent c.i. 0.00
to 1.52; P = 0.09), spinal (RR 1.34, 95 per cent c.i. 0.65 to 2.77; P =
0.43, I2 = 0 per cent), orthopaedic (RR 0.69, 95 per cent c.i. 0.37 to
1.29; P = 0.25, I2 = 0 per cent), or cardiothoracic surgeries (RR 1.60, 95
per cent c.i. 0.79 to 3.25; P = 0.19). <br/>Conclusion(s): Given the
current evidence, the routine application of topical antibiotics to
surgical wounds did not reduce the incidence of SSI. Further trials are
needed to assess their effectiveness in high-risk surgeries or in selected
patient groups. <br/>Copyright &#xa9; 2022 The Author(s).

<58>
Accession Number
2021072878
Title
Association of intraoperative hypotension with postoperative morbidity and
mortality: systematic review and meta-analysis.
Source
BJS Open. 5(1) (no pagination), 2021. Article Number: zraa018. Date of
Publication: 01 Jan 2021.
Author
Wijnberge M.; Schenk J.; Bulle E.; Vlaar A.P.; Maheshwari K.; Hollmann
M.W.; Binnekade J.M.; Geerts B.F.; Veelo D.P.
Institution
(Wijnberge, Schenk, Bulle, Hollmann, Geerts, Veelo) Department of
Anaesthesiology, Amsterdam University Medical Centre, Amsterdam,
Netherlands
(Wijnberge, Bulle, Vlaar, Binnekade) Department of Intensive Care,
Amsterdam University Medical Centre, Amsterdam, Netherlands
(Wijnberge, Vlaar, Hollmann) Laboratory of Experimental Intensive Care and
Anaesthesiology, Amsterdam University Medical Centre, Amsterdam,
Netherlands
(Maheshwari) Department of General Anaesthesiology, Outcomes Research,
Anaesthesiology Institute, Cleveland Clinic, Cleveland, OH, United States
Publisher
Oxford University Press
Abstract
Background: Intraoperative hypotension, with varying definitions in
literature, may be associated with postoperative complications. The aim of
this meta-analysis was to assess the association of intraoperative
hypotension with postoperative morbidity and mortality. <br/>Method(s):
MEDLINE, Embase and Cochrane databases were searched for studies published
between January 1990 and August 2018. The primary endpoints were
postoperative overall morbidity and mortality. Secondary endpoints were
postoperative cardiac outcomes, acute kidney injury, stroke, delirium,
surgical outcomes and combined outcomes. Subgroup analyses, sensitivity
analyses and a meta-regression were performed to test the robustness of
the results and to explore heterogeneity. <br/>Result(s): The search
identified 2931 studies, of which 29 were included in the meta-analysis,
consisting of 130 862 patients. Intraoperative hypotension was associated
with an increased risk of morbidity (odds ratio (OR) 2.08, 95 per cent
confidence interval 1.56 to 2.77) and mortality (OR 1.94, 1.32 to 2.84).
In the secondary analyses, intraoperative hypotension was associated with
cardiac complications (OR 2.44, 1.52 to 3.93) and acute kidney injury (OR
2.69, 1.31 to 5.55). Overall heterogeneity was high, with an I2 value of
88 per cent. When hypotension severity, outcome severity and study
population variables were added to the meta-regression, heterogeneity was
reduced to 50 per cent. <br/>Conclusion(s): Intraoperative hypotension
during non-cardiac surgery is associated with postoperative cardiac and
renal morbidity, and mortality. A universally accepted standard definition
of hypotension would facilitate further research into this topic.
<br/>Copyright &#xa9; 2021 The Author(s).

<59>
Accession Number
2020032629
Title
Unmet Needs in TAVR: Conduction Disturbances and Management of Coronary
Artery Disease.
Source
Journal of Clinical Medicine. 11(21) (no pagination), 2022. Article
Number: 6256. Date of Publication: November 2022.
Author
Auffret V.; Ridard C.; Salerno N.; Sorrentino S.
Institution
(Auffret, Ridard) CHU Rennes Service de Cardiologie, Universite de Rennes
1, Inserm LTSI U1099, Rennes 35000, France
(Ridard) Vivalto Sante, Centre Hospitalier Prive St-Gregoire, St-Gregoire
35760, France
(Salerno, Sorrentino) Department of Medical and Surgical Sciences,
Division of Cardiology, Magna Graecia University, Catanzaro 88100, Italy
Publisher
MDPI
Abstract
Over the past two decades, transcatheter aortic valve replacement (TAVR)
swiftly evolved from a disrupting technology towards mainstream therapy in
the field of severe symptomatic aortic stenosis. A series of randomized
evaluations established its role in treating severe aortic stenosis
patients across all surgical risk categories, paving the way for an
extension of its indications to younger low-risk patients with a longer
life expectancy. Therefore, managing comorbidities and limiting procedural
complications, which may affect long-term outcomes, is of paramount
importance. Among those, new-onset conduction disturbances and concomitant
coronary artery disease remain two of the most debated issues. In the
present review, we will discuss the incidence, prognostic impact, and
unmet needs of patients with post-TAVR new-onset conduction disturbances
and the ongoing challenges posed by the management of concomitant coronary
artery disease.<br/>Copyright &#xa9; 2022 by the authors.

<60>
Accession Number
2019916807
Title
Association between periprocedural myocardial injury and long-term
all-cause mortality in patients undergoing transcatheter aortic valve
replacement: a systematic review and meta-analysis.
Source
Scandinavian Cardiovascular Journal. 56(1) (pp 387-393), 2022. Date of
Publication: 2022.
Author
Han Y.; Wang C.; Chen W.
Institution
(Chen, Han, Wang, Chen) The Key Laboratory of Cardiovascular Remodeling
and Function Research, Chinese Ministry of Education, Chinese National
Health Commission and Chinese Academy of Medical Sciences, The State and
Shandong Province Joint Key Laboratory of Translational Cardiovascular
Medicine, Department of Cardiology, Qilu Hospital of Shandong University,
Jinan, China
Publisher
Taylor and Francis Ltd.
Abstract
Objective. The purpose of this meta-analysis was to investigate the effect
of periprocedural myocardial injury (PPMI) on long-term all-cause
mortality in patients undergoing transcatheter aortic valve replacement
(TAVR) and to explore potential factors associated with mortality risk.
Design. The PubMed, Embase, and Cochrane Library databases were searched
up to April 2022. Studies reporting the effect of PPMI on the risk of
long-term all-cause mortality were included. The summary odds ratio (OR)
was calculated using a random effects model. Additionally, meta-regression
and subgroup analyses were conducted according to specific research
characteristics to explore sources of heterogeneity. Results. Fourteen
studies involving 6,415 patients who underwent TAVR showed that the
occurrence of PPMI was associated with a higher risk of long-term
mortality. Subgroup analysis showed that in the group of aged >=82 years,
men accounted for less than 50%, coronary artery disease patients
accounted for more than 50%, and the proportion of patients with chronic
kidney disease accounted for more than 60%, the proportion of patients
with atria fibrillation accounted for less than 30%, and the Society of
Thoracic Surgeons predicted risk of mortality score was >8 points,
patients with PPMI had higher long-term all-cause mortality than those
without PPMI. Conclusions. Among the patients who underwent TAVR, those
who developed PPMI had higher long-term all-cause mortality.<br/>Copyright
&#xa9; 2022 The Author(s). Published by Informa UK Limited, trading as
Taylor & Francis Group.

<61>
Accession Number
2020996058
Title
The Fried Frailty Phenotype in Patients Undergoing Cardiac Surgery: A
Systematic Review and Meta-Analysis.
Source
Heart Surgery Forum. 25(5) (pp E652-E659), 2022. Date of Publication:
2022.
Author
Nguyenhuy M.; Chang J.; Xu R.; Virk S.; Saxena A.
Institution
(Nguyenhuy) Western Hospital, Melbourne, Footscray, VIC, Australia
(Chang) The Royal Melbourne Hospital, Melbourne, Parkville, VIC, Australia
(Xu) The University of Melbourne, Melbourne, Parkville, VIC, Australia
(Virk) Department of Cardiology, Concord Repatriation General Hospital,
Concord West, NSW, Australia
(Saxena) Department of Cardiothoracic Surgery and Transplantation, Fiona
Stanley Hospital, Murdoch, WA, Australia
Publisher
Forum Multimedia Publishing LLC
Abstract
Objective: Frailty is an increasingly recognized marker of poor surgical
outcomes in cardiac surgery. Frailty first was described in the seminal
"Fried" paper, which constitutes the longest-standing and most
well-recognized definition. This study aimed to assess the impact of the
Fried and modified Fried frailty classifications on patient outcomes
following cardiac surgery. <br/>Method(s): The PUBMED, MEDLINE, and EMBASE
databases were searched from January 2000 until August 2021 for studies
evaluating postoperative outcomes using the Fried or modified Fried
frailty indexes in open cardiac surgical procedures. Primary outcomes were
one-year survival and postoperative quality of life. Secondary outcomes
included postoperative complications, intensive care unit (ICU) length of
stay (LOS), total hospital LOS, and institutional discharge.
<br/>Result(s): Eight eligible studies were identified. Meta-analysis
identified that frailty was associated with an increased risk of one-year
mortality (Risk Ratio [RR]:2.23;95% confidence interval [CI]1.17-4.23),
postoperative complications (RR 1.78;95% CI 1.27 - 2.50), ICU LOS (Mean
difference [MD] 21.2 hours;95% CI 8.42 - 33.94), hospital LOS (MD 3.29
days; 95% CI 2.19 - 4.94), and institutional discharge (RR 3.29;95% CI
2.19 - 4.94). A narrative review of quality of life suggested an
improvement following surgery, with frail patients demonstrating a greater
improvement from baseline over non-frail patients. <br/>Conclusion(s):
Frailty is associated with a higher degree of surgical morbidity, and
frail patients are twice as likely to experience mortality within one-year
post-operatively. Despite this, quality of life also improves dramatically
in frail patients. Frailty, in itself, does not constitute a
contraindication to cardiac surgery.<br/>Copyright &#xa9; 2022 Forum
Multimedia Publishing, LLC.

<62>
Accession Number
2020996041
Title
Efficacy of Intraoperative Low Dose Intravenous Amiodarone in
Pharmacologic Cardioversion in Patients with Preoperative Atrial
Fibrillation Presenting for Mitral Valve Replacement Surgery Randomized
Control Trial.
Source
Heart Surgery Forum. 25(4) (pp E564-E570), 2022. Date of Publication:
2022.
Author
Kamal F.; Al Jawad M.A.; Gamal M.
Institution
(Kamal) Department of Anesthesiology, Ain Shams University, Cairo, Egypt
(Al Jawad, Gamal) Department of Cardiothoracic Surgery, Ain Shams
University, Cairo, Egypt
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: Atrial fibrillation (AF) is the most common form of
dysrhythmia observed in the clinical field, causing multiple morbidities,
such as thromboembolic complications. Hence, the maintenance of sinus
rhythm is superior to rate control. This study tests the efficacy of
single- and low-dose amiodarone on the persistence of AF after surgery
before transfer to the intensive care unit. <br/>Method(s): A
double-blinded, randomized controlled trial assessed 113 patients who
underwent mitral valve surgery with preoperative chronic AF. Patients were
divided into two groups: the control group (N = 55) who received 50 mL of
5% dextrose over 10 min after general anesthesia induction, and the
amiodarone group (N = 58) who received 1 mg/kg of amiodarone diluted in 50
mL of 5% dextrose over 10 min shortly after anesthesia induction.
<br/>Result(s): The amiodarone group had a statistically significant
successful conversion of preoperative AF to normal sinus rhythm in 40
patients (72.73%). The control group demonstrated spontaneous conversion
from AF to a normal sinus rhythm in seven patients (12.73%). The sinus
rhythm was maintained in 60% of patients (36), as four patients reverted
to AF during the hospital stay despite the initial normal sinus rhythm
after the operation. In contrast, 53 (96.36%) patients in the control
group were discharged from the hospital with a controlled rate of AF. In
addition, low-dose amiodarone caused a statistically significant reduction
in heart rates at 10, 30, and 60 min after declamping, extended throughout
the first 24 h with mean heart rates of 97.233+/-7.311, 99.509+/-8.482,
and 97.940+/-7.715 bpm, respectively. In comparison, the control group had
heart rates of 115.382+/-7.547, 115.055+/-13.919, and 113.618+/-8.765 bpm
at these times. The mean postoperative heart rate at the end of the first
24 h was 97.793+/-7.189 bpm in the amiodarone group and 113.036+/-9.737
bpm in the control group. No mortality or need for mechanical support was
recorded in either group. <br/>Conclusion(s): Single and low-dose
intraoperative intravenous amiodarone during mitral valve surgery may be
practical to aid in pharmacological cardioversion of patients with
preoperative chronic AF presenting for mitral valve surgery.<br/>Copyright
&#xa9; 2022 Forum Multimedia Publishing, LLC.

<63>
Accession Number
2020996019
Title
Comparative Efficacy of Local and General Anesthesia for Transcatheter
Aortic Valve Implantation: A Meta-Analysis and Systematic Review.
Source
Heart Surgery Forum. 25(3) (pp E364-E373), 2022. Date of Publication:
2022.
Author
Gao L.; Jin B.; Chao C.; Wang B.; Zhang X.; Shen J.
Institution
(Gao, Shen) Department of Anesthesiology, The Third Affiliated Hospital of
Soochow University, Changzhou 213000, China
(Jin) NO.971 Hospital of The People's Liberation Army Navy, China
(Chao, Wang, Zhang) Department of Cardiothoracic Surgery, The Third
Affiliated Hospital of Soochow University, Changzhou 213000, China
Publisher
Forum Multimedia Publishing LLC
Abstract
Background: This meta-analysis aimed to compare the potential effects of
local anesthesia (LA) and general anesthesia (GA) for transcatheter aortic
valve implantation (TAVI). Measurements: All relevant studies were
searched from Pubmed, EMbase, Web of Science, and the Cochrane Library
(January 1, 2016, to June 1, 2021). The main outcomes of this literature
meta-analysis were 30-day mortality, procedural time, new pacemaker
implantation, total stay in the hospital, use of the vasoactive drug, and
intra-and postoperative complications and emergencies, including
conversion to open, myocardial infarction, pulmonary complication,
vascular complication, renal injury/failure, stroke, transesophageal
echocardiography, life-threatening/major bleeding, cardiac tamponade, and
emergency PCI. Pooled risk ratio (RR) and mean difference (MD) together
with a 95% confidence interval (CI) were calculated. <br/>Result(s): A
total of 17 studies, including 20938 patients, in the final analysis,
fulfilled the inclusion criteria. Intra-and postoperative complications
(myocardial infarction, vascular complication, renal injury/failure,
stroke, and cardiac tamponade) undergoing TAVI in severe AS patients under
GA do not offer a significant difference compared with LA. No differences
were observed between LA and GA for new pacemaker implantation, total stay
in the hospital, transesophageal echocardiography, and emergency PCI. LA
has lower mortality compared with GA (RR 0.69, P = 0.600), pulmonary
complications (RR 0.54, P = 0.278), life-threatening/major bleeding (RR
0.85, P = 0.855), and lower times of conversion to open (RR 0.22, P =
0.746). LA has many advantages, including a shorter procedure duration
(MD=-0.38, P = 0.000) and reduction of the use of the vasoactive drug (RR
0.57, P = 0.000). <br/>Conclusion(s): For TAVI, both LA with or without
sedation and GA are feasible and safe. LA appears a feasible alternative
to GA for AS patients undergoing TAVI.<br/>Copyright &#xa9; 2022 Forum
Multimedia Publishing, LLC.

<64>
Accession Number
2020016012
Title
Effects of Melatonin on Cardiac Injury and Inflammatory Biomarkers in
Patients Undergoing Coronary Artery Bypass Graft Surgery: a Meta-analysis.
Source
Cardiology and Therapy. (no pagination), 2022. Date of Publication: 2022.
Author
Farshidianfar M.; Ardekani A.; Tabrizi R.; Lankarani K.B.; Taherifard E.;
Abdollahi A.; Azizi A.; Akbari M.
Institution
(Farshidianfar, Ardekani, Lankarani, Azizi, Akbari) Health Policy Research
Center, Institute of Health, Shiraz University of Medical Sciences,
Shiraz, Iran, Islamic Republic of
(Farshidianfar) Department of Medical Sciences, Islamic Azad University,
Mashhad, Iran, Islamic Republic of
(Tabrizi) Noncommunicable Diseases Research Center, Fasa University of
Medical Sciences, Fasa, Iran, Islamic Republic of
(Tabrizi) Clinical Research Development Unit, Valiasr Hospital, Fasa
University of Medical Sciences, Fasa, Iran, Islamic Republic of
(Ardekani, Taherifard) School of Medicine, Shiraz University of Medical
Sciences, Shiraz, Iran, Islamic Republic of
(Abdollahi) Student Research Committee, Shiraz University of Medical
Sciences, Shiraz, Iran, Islamic Republic of
(Azizi) School of Pharmacy, Kerman University of Medical Sciences, Kerman,
Iran, Islamic Republic of
(Tabrizi) USERN Office, Fasa University of Medical Sciences, Fasa, Iran,
Islamic Republic of
Publisher
Adis
Abstract
Introduction: The antiinflammatory and antioxidative effects of melatonin
have been established in recent years. Several studies indicate that
oxidative stress and inflammation are key drivers of post-coronary artery
bypass graft (CABG) surgery complications. In the present study, we aimed
to investigate the effects of melatonin on cardiac injury and inflammatory
biomarkers in CABG candidates. <br/>Method(s): Embase, Medline/PubMed, Web
of Science, Scopus, and the Cochrane library were searched up to 5 June
2022. All randomized controlled trials examining cardiac injury and
inflammatory biomarkers of CABG patients who received melatonin were
included. The random-effects model was utilized to perform the analysis.
<br/>Result(s): A total of 947 citations were retrieved through database
searches. Finally, five articles (six trials with 342 patients) were
included after the screening. Melatonin supplementation led to a
significant reduction in cardiac troponin I (CTnI) [weighted mean
difference(WMD): -2.28 ng/ml; 95% CI -2.87, -1.69; P < 0.01;
I²: 91.25%] and high sensitivity-C reactive protein (hs-CRP)
levels (WMD: -0.62 mg/L; 95% CI -0.73, -0.5; P < 0.01; I²:
99.98%) in patients undergoing CABG surgery. We found a nonsignificant
decrease in creatine kinase isoenzyme muscle/brain (CK-MB) levels (WMD:
-2.87 ng/ml; 95% CI -5.97, 0.23; P = 0.07; I²: 99.98%) after
melatonin supplementation. No publication bias was found according to
Egger's test. <br/>Conclusion(s): Melatonin supplementation may be useful
in reducing cardiac injury and inflammatory biomarkers in CABG candidates.
Future studies should investigate the clinical significance of these
findings.<br/>Copyright &#xa9; 2022, The Author(s).

<65>
Accession Number
2019987069
Title
Furosemide does not reduce the incidence of postoperative acute kidney
injury in adult patients undergoing cardiac surgery: A PRISMA-compliant
systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Xie C.-M.; Yao Y.-T.; Yang K.; Shen M.-Q.; He L.-X.; Dai Z.
Institution
(Xie, Yang, Shen, He, Dai) Department of Anesthesiology, Fuwai Yunnan
Cardiovascular Hospital, Affiliated Cardiovascular Hospital of Kunming
Medical University, Kunming, China
(Yao) Department of Anesthesiology, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College and Chinese Academy
of Medical Sciences, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
Objective: Acute kidney injury (AKI) is a common complication of cardiac
surgical patients, the occurrence of which is multifactorial. Furosemide
is the most common loop diuretic and widely used in cardiac surgery to
reduce fluid overload, increase tubular flow and urine output. It remains
unknown whether furosemide affects the incidence or prognosis of cardiac
surgery-induced acute kidney injury (CS-AKI). Therefore, the current study
was performed to address this question. <br/>Method(s): PubMed, Embase,
Scopus, Cochrane Library, and Web of Science databases were searched for
relevant studies. Primary outcomes of interest included postoperative
CS-AKI incidence, need for renal replacement therapy (RRT) rate. Secondary
outcomes of interest included postoperative serum creatinine (Scr) and
blood urea nitrogen (BUN) levels, postoperative mechanical ventilation
duration (MVD), length of stay (LOS) in intensive care unit (ICU) and in
hospital, and mortality. The odds ratio (OR) and/or the weighted mean
difference (WMD) with 95% confidence interval (CI) were used to pool the
data. <br/>Result(s): Database search yielded six studies including 566
adult patients, and 283 patients were allocated into Group Furosemide and
283 into Group Control (Placebo). Heterogeneity between studies was deemed
acceptable, and the publication bias was low. Meta-analysis suggested that
furosemide administration in adult cardiac surgical patients had no effect
on CS-AKI incidence (n = 4 trials; OR = 0.92; 95% CI: 0.37-2.30; p =.86;
I² = 57%) and need for RRT rate (n = 2 trials; OR = 4.13; 95%
CI: 0.44-38.51; p =.21; I² = 0%). Diversely, furosemide
administration in adult cardiac surgical patients significantly decreased
postoperative BUN level (n = 3 trials; WMD = 0.71; 95% CI: 0.10-1.33; p
=.02; I² = 0%), postoperative MVD (n = 2 trials; WMD = -3.13;
95% CI: -3.78 to -2.49; p <.00001; I² = 0%) and postoperative
LOS in ICU (n = 3 trials; WMD = -0.47; 95% CI: -0.76 to -0.18; p =.001;
I² = 0%). However, it had no significant impact on
postoperative Scr level, postoperative LOS in hospital, and postoperative
mortality. <br/>Conclusion(s): This meta-analysis suggested that
furosemide administration in adult cardiac surgical patients had no
significant effect on CS-AKI incidence, need for RRT rate, postoperative
Scr level, LOS in hospital and mortality, but could reduce postoperative
BUN level, MVD, and LOS in ICU. As only a limited number of studies were
included, these results should be interpreted carefully and cautiously.
Future high-quality randomized controlled trials are needed to define the
role of furosemide in CS-AKI prevention and management.<br/>Copyright
&#xa9; 2022 Wiley Periodicals LLC.

<66>
Accession Number
639486763
Title
Cognitive function and delirium following sevoflurane or propofol
anesthesia for valve replacement surgery: A multicenter randomized
controlled trial.
Source
The Kaohsiung journal of medical sciences. (no pagination), 2022. Date of
Publication: 10 Nov 2022.
Author
Duan G.-Y.; Duan Z.-X.; Chen H.; Chen F.; Du Z.-Y.; Chen L.-Y.; Lu K.-Z.;
Zuo Z.-Y.; Li H.
Institution
(Duan, Duan, Chen, Chen, Chen, Du, Li) Department of Anesthesiology,
Second Affiliated Hospital of Army Military Medical University, Chongqing,
China
(Chen) Department of Anesthesiology, Field Surgery Center, Army Medical
University, Chongqing, China
(Lu) Department of Anesthesiology, First Affiliated Hospital of Army
Medical University, Chongqing, China
(Zuo) Department of Anesthesiology, University of Virginia,
Charlottesville, VA, United States
Publisher
NLM (Medline)
Abstract
Cognitive dysfunction is a common postoperative neurological complication
in patients undergoing valve replacement surgery. This study aimed to
compare the effects of sevoflurane versus propofol-based total intravenous
anesthesia on the incidence of cognitive dysfunction following valve
replacement surgery. This multicenter, randomized, controlled
double-blinded study was conducted in three teaching hospitals in China.
Patients receiving on-pump valve replacement surgery were enrolled.
Stratified block randomization was used to randomly assign patients 1:1 to
receive sevoflurane (1.0-1.5 MAC) or propofol (2.0-3.0 mg/kg/h) for
anesthesia maintenance. The primary outcome was the incidence of cognitive
dysfunction assessed by four cognitive tests before, as well as 7-14days
after surgery. Patients were randomly assigned to receive sevoflurane
anesthesia (n = 144) or propofol-based total intravenous anesthesia (n =
145). The incidence of postoperative cognitive dysfunction in the
sevoflurane anesthesia group (31.9%) was significantly lower than that in
the total intravenous anesthesia group (43.4%; relative risk 0.61, 95%
confidence interval [CI]: 0.38-0.97, p = 0.044). There was no difference
in the incidence of delirium between patients receiving sevoflurane and
total intravenous anesthesia (27.8% [35/144] vs. 25.9% [35/145], 1.10, 95%
CI: 0.64 to 1.90, p = 0.736). There was a significant difference in the
Katz Index on day 3 after surgery (3 [0.9) vs. 3 (1.0], 0.095, 95% CI:
0.05 to 0.43, p = 0.012). No difference was observed in other outcomes
between the two groups. For patients undergoing on-pump valve replacement
surgery, sevoflurane anesthesia had a smaller effect on cognitive function
and independence in daily life activities compared with propofol
anesthesia.<br/>Copyright &#xa9; 2022 The Authors. The Kaohsiung Journal
of Medical Sciences published by John Wiley & Sons Australia, Ltd on
behalf of Kaohsiung Medical University.

<67>
Accession Number
639485109
Title
Efficacy and safety of degludec U100 versus glargine U300 for the early
postoperative management of patients with type 2 diabetes mellitus
undergoing coronary artery bypass graft surgery: a non-inferiority
randomized trial.
Source
Diabetic medicine : a journal of the British Diabetic Association. (pp
e15002), 2022. Date of Publication: 10 Nov 2022.
Author
Shafi Kuchay M.; Mathew A.; Mishra M.; Parvathi S.; Kaur P.; Wasir J.S.;
Gill H.K.; Jain R.; Gagneja S.; Kohli C.; Kumari P.; Singh M.K.; Mishra
S.K.
Institution
(Shafi Kuchay, Mathew, Mishra, Kaur, Wasir, Gill, Jain, Gagneja, Kohli,
Kumari, Mishra) Division of Endocrinology and Diabetes, Medanta-The
Medicity Hospital, Haryana, India
(Parvathi, Singh) Department of Clinical Research and Studies, Medanta-The
Medicity Hospital, Haryana, India
Publisher
NLM (Medline)
Abstract
AIMS: To compare the efficacy and safety of degludec U100 versus glargine
U300 for the early postoperative management of patients with type 2
diabetes mellitus (T2D) undergoing coronary artery bypass graft (CABG)
surgery. MATERIAL AND METHODS: A total of 239 patients were randomly
assigned (1:1) to receive a basal-bolus regimen in the early postoperative
period using degludec U100 (n =122) or glargine U300 (n =117) as basal and
glulisine before meals. The primary outcome was mean differences between
groups in their daily BG concentrations. The major safety outcome was the
occurrence of hypoglycemia. <br/>RESULT(S): There were no differences in
mean daily BG concentrations (157 vs. 162 mg/dL), mean percentage of
readings within target BG of 70-180 mg/dL (74% vs. 73%), daily basal
insulin dose (19 vs. 21 units/day), length of stay (median [IQR]: 9 vs.
9days), or hospital complications (21.3% vs. 21.4%) between treatment
groups. There were no differences in the proportion of patients with BG
<70 mg/dL (15.6% vs. 23.1%) or <54 mg/dL (1.6% vs. 4.3%) between
degludec-100 and glargine-300 groups. <br/>CONCLUSION(S): Treatment with
degludec U100 is as effective and safe as glargine U300 for the early
postoperative hospital management of patients with T2D undergoing
CABG.<br/>Copyright This article is protected by copyright. All rights
reserved.

<68>
Accession Number
639482367
Title
Sternotomy Wound Infiltration With Liposomal Versus Plain Bupivacaine for
Postoperative Analgesia After Elective Cardiac Surgery.
Source
Journal of cardiothoracic and vascular anesthesia. (no pagination), 2022.
Date of Publication: 12 Oct 2022.
Author
Subramaniam K.; Sciortino C.M.; Boisen M.L.; La Colla L.; Dickson A.;
Nowakowski E.; Prangley K.; Ruppert K.M.
Institution
(Subramaniam, Boisen, La Colla, Dickson, Nowakowski, Prangley) Department
of Anesthesiology and Perioperative Medicine, University of Pittsburgh,
Pittsburgh, PA, United States
(Sciortino) Sentara Mid-Atlantic Cardiothoracic Surgeons, Sentara Medical
Group, Norfolk, VA, United States
(Ruppert) Department of Anesthesiology and Perioperative Medicine,
University of Pittsburgh, Pittsburgh, PA; Department of Epidemiology,
University of Pittsburgh, Pittsburgh PA
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Poor pain control after cardiac surgery can be associated with
postoperative complications, longer recovery, and development of chronic
pain. The authors hypothesized that adding liposomal bupivacaine (LB) to
plain bupivacaine (PB) will provide better and long-lasting analgesia when
used for wound infiltration in median sternotomy. STUDY DESIGN:
Prospective, randomized, and double-blinded clinical trial. SETTING:
Single institution, tertiary care university hospital. PARTICIPANTS: Adult
patients who underwent elective cardiac surgery through median sternotomy.
INTERVENTIONS: A single surgeon performed wound infiltration of LB plus PB
or PB into the sternotomy wound, chest, and mediastinal tube sites.
MEASUREMENTS AND MAIN RESULTS: Patients were followed up for 72 hours for
pain scores, opioid consumption, and adverse events. Sixty patients
completed the study for analysis (LB group [n = 29], PB group [n = 31]).
Patient characteristics, procedural variables, and pain scores measured at
specific intervals from 4 hours until 72 hours postoperatively did not
reveal any significant differences between the groups. Mixed-model
regression showed that the trend of mean pain scores at movement in the LB
group was significantly (p = 0.01) lower compared with the PB group.
Opioid consumption over 72 hours was not significantly different between
the 2 groups (oral morphine equivalents; median [interquartile range], 139
[73, 212] mg in LB v 105 [54, 188] mg in PB, p = 0.29). Recovery
characteristics and adverse events were comparable. <br/>CONCLUSION(S): LB
added to PB for sternotomy wound infiltration during elective cardiac
surgery did not significantly improve the quality of postoperative
analgesia.<br/>Copyright &#xa9; 2022 Elsevier Inc. All rights reserved.

<69>
Accession Number
639482091
Title
COMPETENCE Trial: The EVAHEART 2 continuous flow left ventricular assist
device.
Source
The Journal of heart and lung transplantation : the official publication
of the International Society for Heart Transplantation. (no pagination),
2022. Date of Publication: 19 Oct 2022.
Author
Allen S.R.; Slaughter M.S.; Ahmed M.M.; Bartoli C.R.; Dhingra R.; Egnaczyk
G.F.; Gulati S.K.; Kiernan M.S.; Mahr C.; Meyer D.M.; Motomura T.; Ono M.;
Ravichandran A.; Shafii A.; Smith J.; Soleimani B.; Toyoda Y.; Yarboro
L.T.; Dowling R.D.
Institution
(Allen, Soleimani) Penn State Health, Milton S. Hershey Medical Center,
Hershey, PA, United States
(Slaughter) University of Louisville, Louisville, KY, United States
(Ahmed) University of Florida, Gainesville, FL, Puerto Rico
(Bartoli) Geisinger Medical Center, Danville, PA, United States
(Dhingra, Smith) University of Wisconsin Hospitals and Clinics, Madison,
WI, United States
(Egnaczyk, Dowling) Christ Hospital, Cincinnati, OH, United States
(Gulati) Atrium Health Sanger Heart and Vascular Institute, Charlotte,
North Carolina
(Kiernan) Tufts Medical Center, Boston, MA, United States
(Mahr) University of Washington, Seattle, WA, United States
(Meyer) Baylor Scott and White, Dallas, TX, United States
(Motomura) Inc, Houston, TX, United States
(Ono) Methodist Healthcare, San Antonio, TX, United States
(Ravichandran) Saint Vincent Health, Indianapolis, IN, United States
(Shafii) Baylor College of Medicine St. Luke's Medical Center, Houston,
TX, United States
(Toyoda) Temple University Medical Center, Philadelphia, PA, United States
(Yarboro) University of Virginia, Charlottesville, VA, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Continuous flow left ventricular assist devices have improved
outcomes in patients with end-stage heart failure that require mechanical
circulatory support. Current devices have an adverse event profile that
has hindered widespread application. The EVAHEART2 left ventricular assist
device (EVA2) has design features such as large blood gaps, lower pump
speeds and an inflow cannula that does not protrude into the left
ventricle that may mitigate the adverse events currently seen with other
continuous flow devices. <br/>METHOD(S): A prospective, multi-center
randomized non-inferiority study, COMPETENCE Trial, is underway to assess
non-inferiority of the EVA2 to the HeartMate 3 LVAS when used for the
treatment of refractory advanced heart failure. The primary end-point is a
composite of the individual primary outcomes: Survival to cardiac
transplant or device explant for recovery; Free from disabling stroke;
Free from severe Right Heart Failure after implantation of original
device. Randomization is in a 2:1 (EVA2:HM3) ratio. <br/>RESULT(S): The
first patient was enrolled into the COMPETENCE Trial in December of 2020,
and 25 subjects (16 EVA2 and 9 HM3) are currently enrolled. Enrollment of
a safety cohort is projected to be completed by third quarter of 2022 at
which time an interim analysis will be performed. Short-term cohort (92
EVA2 subjects) and long-term cohort is expected to be completed by the end
of 2023 and 2024, respectively. <br/>CONCLUSION(S): Contemporary risk
scores were therapy responsive in FREEDOM-EV and early improvements
predicted subsequent outcomes. This post hoc analysis suggests that risk
scores may be a surrogate for clinical worsening.<br/>Copyright &#xa9;
2022 International Society for Heart and Lung Transplantation. Published
by Elsevier Inc. All rights reserved.

<70>
Accession Number
2021024494
Title
Pulmonary hypertension and associated outcomes in noncardiac surgery: A
systematic review and meta-analysis.
Source
Heart and Lung. 58 (pp 21-27), 2023. Date of Publication: 01 Mar 2023.
Author
Binbraik Y.; Wang M.K.; Riekki T.; Conen D.; Marcucci M.; Borges F.K.;
Hambly N.; Devereaux P.J.
Institution
(Binbraik, Wang, Conen, Marcucci, Borges, Hambly, Devereaux) Department of
Medicine, McMaster University, Hamilton, ON, Canada
(Binbraik) Cardiac Sciences Department, King Saud University, Riyadh,
Saudi Arabia
(Wang, Conen, Marcucci, Borges, Devereaux) Department of Health Research
Methods, Evidence, Impact, McMaster University, Hamilton, ON, Canada
(Wang, Conen, Marcucci, Borges, Devereaux) Population Health Research
Institute, Hamilton, ON, Canada
(Riekki) Department of Anesthesia, McMaster University, Hamilton, ON,
Canada
(Hambly) Firestone Institute for Respiratory Health, Hamilton, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Some studies suggest that patients with pulmonary hypertension
(PH) may be at higher risk of complications and death after noncardiac
surgery. However, the magnitude of these associations is unclear.
<br/>Objective(s): To determine the associations between PH and adverse
outcomes after noncardiac surgery. <br/>Method(s): We searched PUBMED and
EMBASE for studies published from January 1970 to April 2022. We included
studies that reported the association between PH and one or more outcomes
of interest occurring after noncardiac surgery. Data were pooled using
random-effects models and reported as summary odds ratios (ORs) with 95%
confidence intervals (CIs). <br/>Result(s): Eighteen studies met
eligibility criteria (n=18,214,760). PH was independently associated with
mortality (adjusted odds ratio [OR] 2.09; 95% CI, 1.51-2.90;
I²=98%; 8 studies). PH was associated with a higher unadjusted
risk of deep venous thrombosis (OR 4.02; 95% CI, 2.14-7.54;
I²=85%; 3 studies), pulmonary embolism (OR 4.16; 95% CI,
3.23-5.36; I²=69%; 7 studies), myocardial infarction (OR 1.49;
95% CI, 1.44-1.54; I²=0%; 5 studies), congestive heart failure
or cardiogenic shock (OR 3.37; 95% CI, 1.73-6.60; I²=34%; 5
studies), length of hospital stay (mean difference 1.97 days; 95% CI,
0.81-3.12; I²=99%; 5 studies), and delayed extubation (OR 5.98;
95% CI, 1.70-21.02; I²=3%; 3 studies). PH was associated with
lower unadjusted risk of postoperative stroke (OR 0.93; 95% CI, 0.88-0.98;
I²=0%; 3 studies). <br/>Conclusion(s): PH is a predictor of
morbidity and mortality after noncardiac surgery. High quality studies are
needed to determine effective strategies for reducing postoperative
complications in this population.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<71>
Accession Number
2021006524
Title
P2Y12 Inhibitors Monotherapy in Patients Undergoing Complex vs Non-Complex
Percutaneous Coronary Intervention: A Meta-Analysis of Randomized Trials.
Source
American Heart Journal. 255 (pp 71-81), 2023. Date of Publication: January
2023.
Author
Oliva A.; Castiello D.S.; Franzone A.; Condorelli G.; Colombo A.; Esposito
G.; Stefanini G.G.; Piccolo R.
Institution
(Oliva, Condorelli, Colombo, Stefanini) Department of Biomedical Sciences,
Humanitas University, Milan, Pieve Emanuele, Italy
(Oliva, Condorelli, Colombo, Stefanini) Cardio Center, IRCCS Humanitas
Research Hospital, Milan, Rozzano, Italy
(Castiello, Franzone, Esposito, Piccolo) Department of Advanced Biomedical
Sciences, University of Naples Federico II, Napoli, Naples, Italy
Publisher
Elsevier Inc.
Abstract
Background: Monotherapy with P2Y12 inhibitors (P2Y12i) is emerging as
alternative strategy to dual antiplatelet therapy (DAPT) after
percutaneous coronary intervention (PCI). However, early withdrawal of
aspirin as part of P2Y12i monotherapy regimens may pose concerns in
high-risk patients, such as those undergoing complex PCI. Our aim was to
evaluate the efficacy and safety of P2Y12i monotherapy after a short
course of DAPT (1-3-month) compared with standard DAPT (>=12-month)
according to PCI complexity. <br/>Method(s): We performed a meta-analysis
of randomized trials using random effects models to combine hazard ratios
(HRs) with 95% confidence intervals (CIs). Within-trial interactions were
pooled to estimate heterogeneity between complex and noncomplex PCI
strata. The study protocol was registered in the PROSPERO
(CRD42021291027). <br/>Result(s): We identified 5 trials including 31,627
patients, of whom 8,328 (26.3%) underwent complex PCI. P2Y12i monotherapy
compared with standard DAPT was associated with a similar risk of
all-cause death, stent thrombosis, and stroke, with no evidence for
interaction between complex and noncomplex PCI. We found heterogeneity in
the treatment effect of P2Y12i monotherapy vs standard DAPT with respect
to myocardial infarction (P-interaction = 0.027). Compared with standard
DAPT, P2Y12i monotherapy decreased the risk of myocardial infarction in
complex PCI (HR 0.77, 95%CI 0.60-0.99, P =.042), but not in noncomplex PCI
patients (HR 1.09, 95%CI 0.90-1.30, P =.382). The risk of major bleeding
was significantly reduced by P2Y12i monotherapy with a consistent
treatment effect (P-interaction = 0.699) in both complex and noncomplex
PCI strata. <br/>Conclusion(s): Patients undergoing complex PCI may derive
more benefit and less harm from P2Y12i monotherapy after early aspirin
withdrawal compared with standard DAPT.<br/>Copyright &#xa9; 2022 Elsevier
Inc.

<72>
[Use Link to view the full text]
Accession Number
2021013036
Title
Feasibility of selective coronary angiography and percutaneous coronary
intervention following self-expanding transcatheter aortic valve
replacement: a systematic review and meta-analysis.
Source
Coronary Artery Disease. 33(8) (pp 678-681), 2022. Date of Publication: 01
Dec 2022.
Author
Gin J.H.; Castles A.; Koshy A.N.; Yudi M.B.
Institution
(Gin, Castles, Koshy, Yudi) Department of Cardiology, Austin Health,
United States
(Castles, Koshy, Yudi) Department of Medicine, The University of
Melbourne, Melbourne, VIC, Australia
Publisher
Lippincott Williams and Wilkins

<73>
[Use Link to view the full text]
Accession Number
2021013031
Title
A systematic review and meta-analysis of coronary artery disease and
revascularization in lung transplant patients.
Source
Coronary Artery Disease. 33(8) (pp 661-669), 2022. Date of Publication: 01
Dec 2022.
Author
Fialka N.M.; Bozso S.J.; El-Andari R.; Kang J.J.H.; Laing B.; Meyer S.R.;
Nagendran J.
Institution
(Fialka, El-Andari) Faculty of Medicine and Dentistry, Canada
(Bozso, Kang, Meyer, Nagendran, Nagendran) Division of Cardiac Surgery,
Department of Surgery, Canada
(Laing) Department of Surgery, University of Alberta, Edmonton, AB, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Coronary artery disease (CAD) is common in candidates for lung
transplantation (LTx) and has historically been considered a relative
contraindication to transplantation. We look to review the outcomes of LTx
in patients with CAD and determine the optimum revascularization strategy
in LTx candidates. PubMed, Medline and Web of Science were systematically
searched by three authors for articles comparing the outcomes of LTx in
patients with CAD and receiving coronary revascularization. In total 1668
articles were screened and 12 were included in this review.Preexisting CAD
in LTx recipients was not associated with significantly increased
postoperative morbidity or mortality. The pooled estimates of mortality
rate at 1, 3 and 5 years indicated significantly inferior survival in LTx
recipients with a prior history of coronary artery bypass grafting (CABG)
[odds ratio (OR), 1.84; 95% confidence interval (CI), 1.53-2.22; P <
0.00001; I²= 0%; OR, 1.52; 95% CI, 1.21-1.91; P = 0.0003;
I²= 0%; OR, 1.62; 95% CI, 1.13-2.33; P = 0.008; I²=
71%, respectively). However, contemporary literature suggests that
survival rates in LTx recipients with CAD that received revascularization
either by percutaneous coronary intervention (PCI), previous or
concomitant CABG, are similar to patients who did not receive
revascularization. Trends in postoperative morbidity favored CABG in the
rates of myocardial infarction and repeat revascularization, whereas rates
of stroke favored PCI. The composite results of this study support the
consideration of patients with CAD or previous coronary revascularization
for LTx. Prospective, randomized controlled trials with consistent patient
populations and outcomes reporting are required to fully elucidate the
optimum revascularization strategy in LTx candidates.<br/>Copyright &#xa9;
2022 Lippincott Williams and Wilkins. All rights reserved.

<74>
[Use Link to view the full text]
Accession Number
2021013024
Title
Vascular healing responses to paclitaxel coated balloons or everolimus
eluting stents for the treatment of in-stent restenosis. Insights from
optical coherence tomography.
Source
Coronary Artery Disease. 33(8) (pp 609-617), 2022. Date of Publication: 01
Dec 2022.
Author
McInerney A.; Salazar C.; Perez-Vizcayno M.J.; Jimenez-Quevedo P.;
Jimenez-Valero S.; Brugaletta S.; Romaguera R.; Nombela-Franco L.;
Travieso-Gonzalez A.; Jeronimo-Baza A.; Tirado-Conte G.; Fernandez-Ortiz
A.; Escaned J.; Alfonso F.; MacAya C.; Gonzalo N.
Institution
(McInerney, Salazar, Perez-Vizcayno, Jimenez-Quevedo, Nombela-Franco,
Travieso-Gonzalez, Jeronimo-Baza, Tirado-Conte, Fernandez-Ortiz, Escaned,
MacAya, Gonzalo) Departamento de Cardiologia Intervencionista, Hospital
Universitario Clinico San Carlos, IdISSC, Universidad Complutense, Spain
(Perez-Vizcayno) Fundacion Interhospitalaria Para la Investigacion
Cardiovascular (FIC), Spain
(Jimenez-Valero) Departamento de Cardiologia Intervencionista, Hospital
Universitario la Paz, Madrid, Spain
(Brugaletta) Departamento de Cardiologia Intervencionista, Hospital
Universitario Clinic, Barcelona, Spain
(Romaguera) Departamento de Cardiologia Intervencionista, Hospital
Universitario Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
(Alfonso) Departamento de Cardiologia Intervencionista, Hospital
Universitario de la Princesa, Madrid, Spain
Publisher
Lippincott Williams and Wilkins
Abstract
Background Treatment of in-stent restenosis (ISR) remains a significant
challenge. Current options include repeat stenting or drug-coated
balloons. However, there is a paucity of data regarding vascular healing
after these strategies. We, aimed to compare optical coherence tomography
(OCT)-based vessel healing after treatment with paclitaxel-coated balloons
(PCB) or everolimus-eluting stents (EES). Methods An OCT substudy
(baseline and 6-9 months) of patients from RIBS IV and RIBS V, two
prospective multicenter, randomized controlled clinical trials comparing
PCB vs. EES in patients with ISR was performed. Results Sixty-four
patients were included (30 PCB and 34 EES). There were no differences in
the baseline or angiographic characteristics between groups. Both groups
had the same proportion of drug-eluting and bare-metal stent (BMS) ISR.
Baseline OCT analysis did not show differences in the qualitative
characteristics of the ISR nor the restenotic tissue burden. Follow-up OCT
showed a larger mean lumen area in the EES group (6.03 +/- 1.5 vs. 5.24
+/- 1.3 mm²; P = 0.043) but no difference in angiographic
restenosis (P = 0.66). Percentage tissue coverage was higher with PCB vs.
EES (26 +/- 13 vs. 19 +/- 11%; P = 0.031). EES-treated ISR more frequently
had uncovered struts at follow-up [21 (72%) vs. 12 (44%); P = 0.034].
Tissue covering struts more frequently had a high backscatter structure
after PCB [21 (78%) vs. 16 (55%); P = 0.07]. Conclusions Compared with
EES, ISR treated with PCB demonstrated more strut coverage with mainly
high backscattering tissue. Larger OCT-defined neointimal proliferation in
PCB-treated ISR did not translate into higher angiographic restenosis
rates.<br/>Copyright &#xa9; 2022 Lippincott Williams and Wilkins. All
rights reserved.

<75>
Accession Number
639308728
Title
Non-invasive positive pressure ventilation for central sleep apnoea in
adults.
Source
Cochrane Database of Systematic Reviews. 2022(10) (no pagination), 2022.
Article Number: CD012889. Date of Publication: 24 Oct 2022.
Author
Pinto A.C.P.N.; Rocha A.; Pachito D.V.; Drager L.F.; Lorenzi-Filho G.
Institution
(Pinto) Cochrane Brazil, Health Technology Assessment Center, Sao Paulo,
Brazil
(Pinto) Biological and Health Sciences Department, Federal University of
Amapa, Amapa, Brazil
(Pinto) Post-graduation program in Evidence-based Health, Department of
Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil
(Rocha) Cochrane Brazil, Nucleo de Avaliacao de Tecnologias em Saude, Sao
Paulo, Brazil
(Pachito) Prossono, Sao Paulo, Brazil
(Drager) Unidade de Hipertensao, Disciplina de Nefrologia, Hospital das
Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao
Paulo, Brazil
(Drager) Unidade de Hipertensao, Instituto do Coracao (InCor), Hospital
das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo,
Sao Paulo, Brazil
(Drager) Cardiology Center, Hospital Sirio Libanes, Sao Paulo, Brazil
(Lorenzi-Filho) Laboratorio de Sono, Divisao de Pneumologia, Instituto do
Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina,
Universidade de Sao Paulo, Sao Paulo, Brazil
Publisher
John Wiley and Sons Ltd
Abstract
Background: Central sleep apnoea (CSA) is characterised by abnormal
patterns of ventilation during sleep due to a dysfunctional drive to
breathe. Consequently, people with CSA may present poor sleep quality,
sleep fragmentation, inattention, fatigue, daytime sleepiness, and reduced
quality of life. <br/>Objective(s): To assess the effectiveness and safety
of non-invasive positive pressure ventilation (NIPV) for the treatment of
adults with CSA. <br/>Search Method(s): We searched the Cochrane Central
Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and Scopus on 6
September 2021. We applied no restrictions on language of publication. We
also searched clinical trials registries for ongoing and unpublished
studies, and scanned the reference lists of included studies to identify
additional studies. <br/>Selection Criteria: We included randomised
controlled trials (RCTs) reported in full text, those published as
abstract only, and unpublished data. <br/>Data Collection and Analysis:
Two review authors independently selected studies for inclusion, extracted
data, and assessed risk of bias of the included studies using the Cochrane
risk of bias tool version 1.0, and the certainty of the evidence using the
GRADE approach. In the case of disagreement, a third review author was
consulted. <br/>Main Result(s): We included 15 RCTs with a total of 1936
participants, ranging from 10 to 1325 participants. All studies had
important methodological limitations. We assessed most studies (11
studies) as at high risk of bias for at least one domain, and all studies
as at unclear risk of bias for at least two domains. The trials included
participants aged > 18 years old, of which 70% to 100% were men, who were
followed from one week to 60 months. The included studies assessed the
effects of different modes of NIPV and CSA. Most participants had CSA
associated with chronic heart failure. Because CSA encompasses a variety
of causes and underlying clinical conditions, data were carefully
analysed, and different conditions and populations were not pooled. The
findings for the primary outcomes for the seven evaluated comparisons are
presented below. Continuous positive airway pressure (CPAP) plus best
supportive care versus best supportive care in CSA associated with chronic
heart failure. In the short term, CPAP plus best supportive care may
reduce central apnoea hypopnoea index (AHI) (mean difference (MD) -14.60,
95% confidence interval (CI) -20.11 to -9.09; 1 study; 205 participants).
However, CPAP plus best supportive care may result in little to no
difference in cardiovascular mortality compared to best supportive care
alone. The evidence for the effect of CPAP plus best supportive care on
all-cause mortality is very uncertain. No adverse effects were observed
with CPAP, and the results for adverse events in the best supportive care
group were not reported. Adaptive servo ventilation (ASV) versus CPAP in
CSA associated with chronic heart failure. The evidence is very uncertain
about the effect of ASV versus CPAP on quality of life evaluated in both
the short and medium term. Data on adverse events were not reported, and
it is not clear whether data were sought but not found. ASV versus bilevel
ventilation in CSA associated with chronic heart failure. In the short
term, ASV may result in little to no difference in central AHI. No adverse
events were detected with ASV, and the results for adverse events in the
bilevel ventilation group were not reported. ASV plus best supportive care
versus best supportive care in CSA associated with chronic heart failure.
In the medium term, ASV plus best supportive care may reduce AHI compared
to best supportive care alone (MD -20.30, 95% CI -28.75 to -11.85; 1
study; 30 participants). In the long term, ASV plus best supportive care
likely increases cardiovascular mortality compared to best supportive care
(risk ratio (RR) 1.25, 95% CI 1.04, 1.49; 1 study; 1325 participants). The
evidence suggests that ASV plus best supportive care may result in little
to no difference in quality of life in the short, medium, and long term,
and in all-cause mortality in the medium and long term. Data on adverse
events were evaluated but not reported. ASV plus best supportive care
versus best supportive care in CSA with acute heart failure with preserved
ejection fraction. Only adverse events were reported for this comparison,
and no adverse events were recorded in either group. ASV versus CPAP
maintenance in CPAP-induced CSA. In the short term, ASV may slightly
reduce central AHI (MD -4.10, 95% CI -6.67 to -1.53; 1 study; 60
participants), but may result in little to no difference in quality of
life. Data on adverse events were not reported, and it is not clear
whether data were sought but not found. ASV versus bilevel ventilation in
CPAP-induced CSA. In the short term, ASV may slightly reduce central AHI
(MD -8.70, 95% CI -11.42 to -5.98; 1 study; 30 participants) compared to
bilevel ventilation. Data on adverse events were not reported, and it is
not clear whether data were sought but not found. Authors' conclusions:
CPAP plus best supportive care may reduce central AHI in people with CSA
associated with chronic heart failure compared to best supportive care
alone. Although ASV plus best supportive care may reduce AHI in people
with CSA associated with chronic heart failure, it likely increases
cardiovascular mortality in these individuals. In people with CPAP-induced
CSA, ASV may slightly reduce central AHI compared to bilevel ventilation
and to CPAP. In the absence of data showing a favourable impact on
meaningful patient-centred outcomes and defining clinically important
differences in outcomes in CSA patients, these findings need to be
interpreted with caution. Considering the level of certainty of the
available evidence and the heterogeneity of participants with CSA, we
could draw no definitive conclusions, and further high-quality trials
focusing on patient-centred outcomes, such as quality of life, quality of
sleep, and longer-term survival, are needed to determine whether one mode
of NIPV is better than another or than best supportive care for any
particular CSA patient group.<br/>Copyright &#xa9; 2022 The Cochrane
Collaboration. Published by John Wiley & Sons, Ltd.

<76>
Accession Number
2019956538
Title
Evaluation of a Wearable in-Ear Sensor for Temperature and Heart Rate
Monitoring: A Pilot Study.
Source
Journal of Medical Systems. 46(12) (no pagination), 2022. Article Number:
91. Date of Publication: December 2022.
Author
Ellebrecht D.B.; Gola D.; Kaschwich M.
Institution
(Ellebrecht, Kaschwich) Department of Surgery, University Medical Center
Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, Luebeck 23538,
Germany
(Gola) Institute of Medical Biometry and Statistics, University of Lubeck,
Ratzeburger Allee 160, Luebeck 23562, Germany
(Ellebrecht) Department of Thoracic Surgery, LungenClinic Groshansdorf,
Woehrendamm 80, Grosshansdorf 22927, Germany
(Kaschwich) Department of Vascular Medicine, University Heart & Vascular
Centre Hamburg, Martinistrase 52, Hamburg 20246, Germany
Publisher
Springer
Abstract
In the context of the COVID-19 pandemic, wearable sensors are important
for early detection of critical illness especially in COVID-19
outpatients. We sought to determine in this pilot study whether a wearable
in-ear sensor for continuous body temperature and heart rate monitoring
(Cosinuss company, Munich) is sufficiently accurate for body temperature
and heart rate monitoring. Comparing with several anesthesiologic standard
of care monitoring devices (urinary bladder and zero-heat flux thermometer
and ECG), we evaluated the in-ear sensor during non-cardiac surgery
(German Clinical Trials Register Reg.-No: DRKS00012848). Limits of
Agreement (LoA) based on Bland-Altman analysis were used to study the
agreement between the in-ear sensor and the reference methods. The
estimated LoA of the Cosinuss One and bladder temperature monitoring were
[-0.79, 0.49] degreeC (95% confidence intervals [-1.03, -0.65] (lower LoA)
and [0.35, 0.73] (upper LoA)), and [-0.78, 0.34] degreeC (95% confidence
intervals [-1.18, -0.59] (lower LoA) and [0.16, 0.74] (upper LoA)) of the
Cosinuss One and zero-heat flux temperature monitoring. 89% and 79% of
Cosinuss One temperature monitoring were within +/- 0.5 degreeC limit of
bladder and zero-heat flux monitoring, respectively. The estimated LoA of
Cosinuss One and ECG heart rate monitoring were [-4.81, 4.27] BPM (95%
confidence intervals [-5.09, -4.56] (lower LoA) and [4.01, 4.54] (upper
LoA)). The proportion of detection differences within +/- 2BPM was 84%.
Body temperature and heart rate were reliably measured by the wearable
in-ear sensor.<br/>Copyright &#xa9; 2022, The Author(s).

<77>
Accession Number
2019862341
Title
Comparison of the effect of double-lumen endotracheal tubes and bronchial
blockers on lung collapse in video-assisted thoracoscopic surgery: a
systematic review and meta-analysis.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 330. Date
of Publication: December 2022.
Author
Xiang Y.-Y.; Chen Q.; Tang X.-X.; Cao L.
Institution
(Xiang, Chen, Tang) Department of Anesthesiology, Chongqing Cancer
Institute, Chongqing University Cancer Hospital, Chongqing Cancer
Hospital, 181# Hanyu Road, Shapingba District, Chongqing 400030, China
(Cao) Department of Anesthesiology, Xinqiao Hospital of Army Military
Medical University, 83# Xinqiao Zhengjie, Shapingba District, Chongqing
400037, China
Publisher
BioMed Central Ltd
Abstract
Objective: This meta-analysis compared the quality of lung collapse and
the resultant adverse reactions between the use of double-lumen
endotracheal tubes (DLT) and bronchial blockers (BB) in minimally invasive
thoracic surgery. <br/>Method(s): A search was performed in five
bibliographic databases, namely PubMed, Springer, Medline, EMBASE, and
Cochrane Library ignoring the original language, which identified five
randomized controlled trials (RCTs) published on or before December 31,
2021. These studies were subsequently analyzed. All included studies
compared the efficacy and safety of DLT and BB as a lung isolation
technique in surgery. The methodological quality of each study was
assessed by the Cochrane Collaboration's risk of bias tool. The quality of
lung collapse and the malposition rate were adopted as the main outcome
indicators. Alternatively, the intubation time and the incidence of
postoperative sore throat were adopted as secondary indicators.
<br/>Result(s): When either DLT or BB were utilized in minimally invasive
thoracic surgery, no differences were observed in the quality of lung
collapse (odds ratio [OR], 1.00; 95% confidence interval [CI], 0.63 to
1.58), the intubation time (mean difference [MD], 0.06; 95% CI, -1.02 to
1.14), or the malposition rate (OR, 0.88; 95% CI, 0.37 to 2.06). However,
the incidence of postoperative sore throat among patients treated with BB
was significantly lower than that among patients treated with DLT (OR,
5.25; 95% CI, 2.55 to 10.75). <br/>Conclusion(s): When utilized in
minimally invasive thoracic surgery, the quality of lung collapse with DLT
was identical to that with BB. However, patients treated with the latter
demonstrated a significantly lower incidence of postoperative sore
throat.<br/>Copyright &#xa9; 2022, The Author(s).

<78>
[Use Link to view the full text]
Accession Number
2020913332
Title
Efficacy and safety of dual antiplatelet therapy after percutaneous
coronary drug-eluting stenting: A network meta-analysis.
Source
Medicine (United States). 101(42) (pp E31158), 2022. Date of Publication:
21 Oct 2022.
Author
Luo L.; Wang S.; Tang K.; Yang X.; Wu J.; Wang D.; Xu L.; Feng T.; Ran J.;
Li D.; Zhang L.; Zhao D.
Institution
(Luo, Tang, Wu, Wang, Xu, Feng, Li, Ran, Zhang, Zhao) Department of
Cardiovascular, The First People's Hospital of Shuangliu District,
Chengdu, China
(Wang) Department of Neurology, The First Hospital of Chongqing Medical
University, Chongqing, China
(Yang) Department of Ophthalmolgy, Sichuan Academy of Medical Sciences,
Sichuan Provincial People's Hospital, Chengdu, China
(Li) Department of Neurology, The First People's Hospital of Shuangliu
District, Chengdu, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: To evaluate the efficacy and safety of dual antiplatelet
regimens after coronary drug-eluting stenting by network meta-analysis
(NMA). <br/>Method(s): PubMed, The Cochrane Library, Embase, and Web of
Science databases were electronically searched to collect randomized
controlled trials (RCTs) of the comparison of different dual antiplatelet
regimens after coronary drug-eluting stenting from inception to September
1st, 2021. Two reviewers independently screened literature, extracted
data, and assessed the risk bias of included studies. Stata 16.0 software
was used for NMA. <br/>Result(s): A total of 27 RCTs involving 79,880
patients were included. The results of NMA: in terms of myocardial
infarction (MI), other 3 interventions were higher than the long-term dual
antiplatelet therapy (L-DAPT) (the standard dual antiplatelet therapy
[Std-DAPT] [odds ratio [OR]=1.82, 95%confidence interval [CI]: 1.49-2.21),
the aspirin monotherapy after short-term dual antiplatelet therapy (S-DAPT
+ As) (OR=2.06, 95%CI: 1.57-2.70), the P2Y12 inhibitor monotherapy after
short-term dual antiplatelet therapy (S-DAPT + P2Y12) (OR=1.71, 95%CI:
1.29-2.28)]. In terms of stent thrombosis, other 3 interventions were
higher than L-DAPT [Std-DAPT (OR=2.18, 95%CI: 1.45-3.28), S-DAPT + As
(OR=2.32, 95%CI: 1.52-3.54), S-DAPT + P2Y12 (OR=2.31, 95%CI: 1.22-4.36)].
There was no statistically significant difference among the 4
interventions in prevention of stroke and all-cause mortality (P > .05).
In terms of cardiovascular and cerebrovascular adverse events, other 3
interventions were higher than L-DAPT (Std-DAPT [OR=1.28, 95%CI:
1.12-1.45], S-DAPT + As [OR=1.27, 95%CI: 1.09-1.48], S-DAPT + P2Y12
[OR=1.24, 95%CI: 1.01-1.52]). In terms of safety, bleeding rate of other 3
interventions were lower than L-DAPT (Std-DAPT [OR=0.67, 95%CI:
0.52-0.85], S-DAPT + As [OR=0.51, 95%CI: 0.39-0.66], S-DAPT + P2Y12
[OR=0.36, 95%CI: 0.26-0.49]). Two interventions were lower than L-DAPT
(S-DAPT + As [OR=0.77, 95%CI: 0.65-0.90], S-DAPT + P2Y12 [OR=0.54, 95%CI:
0.44-0.66]). S-DAPT + As was higher than L-DAPT (OR=1.42, 95%CI:
1.10-1.83). <br/>Conclusion(s): S-DAPT + P2Y12 has the lowest bleeding
risk, while L-DAPT has the highest bleeding risk. In the outcome of MI,
stent thrombosis, and cardiovascular and cerebrovascular adverse events,
L-DAPT has the best efficacy. In the outcome of stroke and all-cause
mortality, the 4 interventions were equally effective.<br/>Copyright
&#xa9; 2022 Lippincott Williams and Wilkins. All rights reserved.

<79>
Accession Number
2020828809
Title
Polypill Strategy in Secondary Cardiovascular Prevention.
Source
New England Journal of Medicine. 387(11) (pp 967-977), 2022. Date of
Publication: 15 Sep 2022.
Author
Castellano J.M.; Pocock S.J.; Bhatt D.L.; Quesada A.J.; Owen R.;
Fernandez-Ortiz A.; Sanchez P.L.; Ortuno F.M.; Vazquez Rodriguez J.M.;
Domingo-Fernandez A.; Lozano I.; Roncaglioni M.C.; Baviera M.; Foresta A.;
Ojeda-Fernandez L.; Colivicchi F.; Di Fusco S.A.; Doehner W.; Meyer A.;
Schiele F.; Ecarnot F.; Linhart A.; Lubanda J.-C.; Barczi G.; Merkely B.;
Ponikowski P.; Kasprzak M.; Fernandez Alvira J.M.; Andres V.; Bueno H.;
Collier T.; Van de Werf F.; Perel P.; Rodriguez-Manero M.; Garcia A.A.;
Proietti M.; Schoos M.M.; Simon T.; Ferro J.F.; Lopez N.; Beghi E.; Bejot
Y.; Vivas D.; Cordero A.; Ibanez B.; Fuster V.
Institution
(Castellano, Pocock, Quesada, Fernandez-Ortiz, Fernandez Alvira, Andres,
Bueno, Ferro, Ibanez, Fuster) Centro Nacional de Investigaciones
Cardiovasculares, Madrid, Spain
(Castellano) Centro Integral de Enfermedades Cardiovasculares, Hospital
Universitario Monteprincipe, Grupo HM Hospitales, Madrid, Spain
(Fernandez-Ortiz, Vivas) Hospital Clinico San Carlos, Universidad
Complutense, Madrid, Spain
(Fernandez-Ortiz, Sanchez, Ortuno, Vazquez Rodriguez, Andres, Bueno,
Cordero, Ibanez) Centro de Investigacion Biomedica en Red de Enfermedades
Cardiovasculares, Madrid, Spain
(Domingo-Fernandez) Unidad de Investigacion Clinica y Ensayos Clinicos,
Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos,
Madrid, Spain
(Bueno) Health Research Institute, October 12 Hospital, Madrid, Spain
(Ferro, Ibanez) Fundacion Jimenez Diaz University Hospital, Madrid, Spain
(Ferro) Universidad Autonoma de Madrid, Madrid, Spain
(Sanchez) Department of Cardiology, Hospital Universitario Salamanca,
Salamanca, Spain
(Ortuno) Servicio de Cardiologia, Hospital Clinico Universitario Virgen de
la Arrixaca, Murcia, Spain
(Vazquez Rodriguez) Servicio de Cardiologia, Hospital Universitario A
Coruna, Instituto de Investigacion Biomedica A Coruna, La Coruna, Spain
(Lozano) Servicio de Cardiologia, Hospital Universitario de Cabuenes,
Gijon, Spain
(Rodriguez-Manero) The Cardiovascular Area and Coronary Unit, University
Clinical Hospital of Santiago de Compostela, Santiago, Spain
(Ferro) The Department of Neurology, Hospital Universitario Rey Juan
Carlos, Getafe, Spain
(Lopez) Servicio de Neurologia, Hospital General Universitario de
Alicante, Alicante, Spain
(Cordero) Department of Cardiology, Hospital Universitario de San Juan,
Alicante, Spain
(Pocock, Owen, Collier) Department of Medical Statistics, Imperial College
NHS Trust, London, United Kingdom
(Perel) Centre for Global Chronic Conditions, Imperial College NHS Trust,
London, United Kingdom
(Garcia) London School of Hygiene and Tropical Medicine, Imperial College
NHS Trust, London, United Kingdom
(Proietti) Liverpool Centre for Cardiovascular Science, University of
Liverpool, Liverpool Heart, Chest Hospital, Liverpool, United Kingdom
(Bhatt) Brigham and Women's Hospital Heart, Vascular Center, Harvard
Medical School, Boston, United States
(Roncaglioni, Baviera, Foresta, Ojeda-Fernandez) Laboratory of
Cardiovascular Prevention, IRCCS Istituti Clinici Scientifici Maugeri,
Italy
(Beghi) Laboratorio di Malattie Neurologiche, Dipartimento di
Neuroscienze, IRCCS Istituti Clinici Scientifici Maugeri, Italy
(Proietti) Istituto di Ricerche Farmacologiche Mario Negri, IRCCS, The
Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Italy
(Proietti) Department of Clinical Sciences and Community Health,
University of Milan, Milan, Italy
(Colivicchi, Di Fusco) Clinical and Rehabilitation Cardiology Unit,
Emergency Department, San Filippo Neri Hospital, Rome, Italy
(Doehner, Meyer) Berlin Institute of Health, Center for Regenerative
Therapies, The Department of Internal Medicine and Cardiology (Virchow
Klinikum), German Center for Cardiovascular Research, The Center for
Stroke Research Berlin, Charite Universitatsmedizin, Berlin, Germany
(Schiele, Ecarnot) Department of Cardiology, University Hospital Besancon,
Besancon, France
(Schiele, Ecarnot) University of Burgundy Franche-Comte, Besancon, France
(Simon) Department of Clinical Pharmacology, Clinical Research Platform,
Assistance Publique-Hopitaux de Paris, Hopital Saint Antoine, French
Alliance for Cardiovascular Trials, FranceSorbonne Universite, Paris,
France
(Bejot) Department of Neurology, University Hospital of Dijon Burgundy,
Dijon, France
(Bejot) The Medical School of Dijon, University of Burgundy, Dijon, France
(Bejot) Hopital Francois Mitterrand, Dijon, France
(Linhart, Lubanda) 2nd Department of Medicine, Department of
Cardiovascular Medicine of the 1st Faculty of Medicine, Charles
University, General University Hospital, Prague, Czechia
(Barczi, Merkely) Semmelweis Egyetem Varosmajori Sziv Es Ergyogyaszati
Klinika, Budapest, Hungary
(Ponikowski, Kasprzak) Department of Heart Disease, Medical University,
Wroclaw, Poland
(Van de Werf) Department of Cardiovascular Sciences, University of Leuven,
Leuven, Belgium
(Schoos) Department of Cardiology, Zealand University Hospital, Roskilde,
Denmark
(Fuster) Cardiovascular Institute, Icahn School of Medicine at Mount
Sinai, New York, United States
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND A polypill that includes key medications associated with
improved outcomes (aspirin, angiotensin-converting-enzyme [ACE] inhibitor,
and statin) has been proposed as a simple approach to the secondary
prevention of cardiovascular death and complications after myocardial
infarction. METHODS In this phase 3, randomized, controlled clinical
trial, we assigned patients with myocardial infarction within the previous
6 months to a polypill-based strategy or usual care. The polypill
treatment consisted of aspirin (100 mg), ramipril (2.5, 5, or 10 mg), and
atorvastatin (20 or 40 mg). The primary composite outcome was
cardiovascular death, nonfatal type 1 myocardial infarction, nonfatal
ischemic stroke, or urgent revascularization. The key secondary end point
was a composite of cardiovascular death, nonfatal type 1 myocardial
infarction, or nonfatal ischemic stroke. RESULTS A total of 2499 patients
underwent randomization and were followed for a median of 36 months. A
primary-outcome event occurred in 118 of 1237 patients (9.5%) in the
polypill group and in 156 of 1229 (12.7%) in the usual-care group (hazard
ratio, 0.76; 95% confidence interval [CI], 0.60 to 0.96; P=0.02). A key
secondary-outcome event occurred in 101 patients (8.2%) in the polypill
group and in 144 (11.7%) in the usual-care group (hazard ratio, 0.70; 95%
CI, 0.54 to 0.90; P=0.005). The results were consistent across
prespecified subgroups. Medication adherence as reported by the patients
was higher in the polypill group than in the usual-care group. Adverse
events were similar between groups. CONCLUSIONS Treatment with a polypill
containing aspirin, ramipril, and atorvastatin within 6 months after
myocardial infarction resulted in a significantly lower risk of major
adverse cardiovascular events than usual care.<br/>Copyright &#xa9; 2022
Massachusetts Medical Society.

<80>
Accession Number
2014888696
Title
Hemopericardium in the Setting of Direct Oral Anticoagulant Use: An
Updated Systematic Review.
Source
Cardiovascular Revascularization Medicine. 39 (pp 73-83), 2022. Date of
Publication: June 2022.
Author
Sheikh A.B.; Shah I.; Sagheer S.; Javed N.; Minhas A.M.K.; Lopez E.D.;
Parikh C.; Shekhar R.
Institution
(Sheikh, Shah, Lopez) University of New Mexico Health Sciences Center,
Department of Internal Medicine, Albuquerque, NM, United States
(Sagheer) Division of Cardiology, University of New Mexico Health Sciences
Center, Albuquerque, NM, United States
(Javed) Shifa College of Medicine, Shifa Tameer-e-Millat University,
Islamabad, Pakistan
(Minhas) Forrest General Hospital, Department of Internal Medicine,
Hattiesburg, United States
(Parikh) Pramukh Swami Medical College, Department of Internal Medicine,
Gujarat, Karamsad, India
(Shekhar) Division of Hospital Medicine, University of New Mexico School
of Medicine, Department of Internal Medicine, Albuquerque, NM, United
States
Publisher
Elsevier Inc.
Abstract
Background: Spontaneous hemopericardium, associated with direct oral
anticoagulant (DOAC) use, is one of the uncommon complications with high
morbidity that has not been extensively studied We aimed to determine
demographic characteristics, clinical features, lab evaluation,
management, and outcomes of the studies focusing on hemopericardium as a
DOAC use. <br/>Method(s): PubMed, Web of Science, Google Scholar, and
CINAHL databases were searched for relevant articles using MeSH key-words
and imported into referencing/review software. The data regarding
demographics, clinical characteristics, cardiac investigations, and
management were analyzed in IBM Statistics SPSS 21. t-Test and Chi-square
test were used. A P score of <0.05 was considered statistically
significant. <br/>Result(s): After literature search, a total of 41
articles were selected for analysis. The mean age of the patients was
70.09 +/- 11.06 years (p < 0.05); the majority of them were males (58.5%).
Most of the patients presented with shortness of breath (75.2%) and had
more than 3 co-morbid conditions (43.9%). The most frequently used
anticoagulant was rivaroxaban (15/41; 36.6%); the common indication being
arrhythmia (78.0%). CYP4503A4/P-Gp inhibitors (22.2%) were commonly used
by the patients. Majority of the cases had a favorable outcome (95.1%).
Pericardial tamponade was noted in 31/41 cases. Pericardiocentesis was
performed in 37/41 cases. <br/>Conclusion(s): Hemopericardium from DOAC
use has a favorable outcome but requires urgent pericardiocentesis.
However, long term mortality, monitoring of DOAC activity, and drug-drug
interactions have not been widely studied.<br/>Copyright &#xa9; 2021
Elsevier Inc.

<81>
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. 36(12) (pp 4483-4495),
2022. Date of Publication: December 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
(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
(Economy) Division of Maternal-Fetal Medicine, Brigham, and Women's
Hospital, Harvard Medical School, Boston, MA
(Valente) Department of Cardiology, Boston Children's Hospital, Harvard
Medical School, Boston, MA
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.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<82>
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. 26(4) (pp 260-265),
2022. Date of Publication: December 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.<br/>Copyright &#xa9; The Author(s) 2022.

<83>
Accession Number
2019168364
Title
Factor eight inhibiting bypass activity for refractory bleeding in acute
type A aortic dissection repair: A propensity-matched analysis.
Source
Transfusion. 62(11) (pp 2235-2244), 2022. Date of Publication: November
2022.
Author
Pupovac S.S.; Levine R.; Giammarino A.T.; Scheinerman S.J.; Hartman A.R.;
Brinster D.R.; Hemli J.M.
Institution
(Pupovac, Hartman) Department of Cardiovascular and Thoracic Surgery,
North Shore University Hospital/Northwell Health, Manhasset, NY, United
States
(Levine) Department of Hematology and Oncology, Lenox Hill
Hospital/Northwell Health, New York, NY, United States
(Giammarino, Scheinerman, Brinster, Hemli) Department of Cardiovascular
and Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, NY,
United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Perioperative bleeding and transfusion have been associated
with adverse outcomes after cardiac surgery. The use of factor eight
inhibiting bypass activity (FEIBA) in managing bleeding after repair of
acute Stanford type A aortic dissection (ATAAD) has not previously been
evaluated. We report our experience in utilizing FEIBA in ATAAD repair.
Study Design and Methods: A retrospective review was undertaken of all
consecutive patients who underwent repair of ATAAD between July 2014 and
December 2019. Patients were divided into two groups, dependent upon
whether or not they received FEIBA intraoperatively: "FEIBA" (n = 112)
versus "no FEIBA" (n = 119). From this, 53 propensity-matched pairs of
patients were analyzed with respect to transfusion requirements and
short-term clinical outcomes. <br/>Result(s): Thirty-day mortality for the
entire cohort was 11.7% (27 deaths), not significantly different between
patient groups. Those patients who received FEIBA demonstrated reduced
transfusion requirements for all types of blood products in the first 48 h
after surgery as compared with the "no FEIBA" cases, including red blood
cells, platelets, plasma, and cryoprecipitate (p <.0001). There was no
significant difference in major postoperative morbidity between the two
groups. The FEIBA cohort did not demonstrate an increased incidence of
thrombotic complications (stroke, deep venous thrombosis, pulmonary
thromboembolism). <br/>Discussion(s): When used as rescue therapy for
refractory bleeding following repair of ATAAD, FEIBA appears to be
effective in decreasing postoperative transfusion requirements whilst not
negatively impacting clinical outcomes. These findings should prompt
further investigation and validation via larger, multi-center, randomized
trials.<br/>Copyright &#xa9; 2022 AABB.

<84>
Accession Number
2013245614
Title
Impact of preoperative glycometabolic status on outcomes in cardiac
surgery: Systematic review and meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 164(6) (pp 1950-1960.e10),
2022. Date of Publication: December 2022.
Author
Corazzari C.; Matteucci M.; Kolodziejczak M.; Kowalewski M.; Formenti
A.M.; Giustina A.; Beghi C.; Barili F.; Lorusso R.
Institution
(Corazzari, Matteucci, Kowalewski, Lorusso) Department of Cardiothoracic
Surgery, Heart and Vascular Centre, Maastricht University Medical Centre,
Maastricht, Netherlands
(Corazzari, Matteucci, Beghi) Department of Surgical and Morphological
Sciences, Circolo Hospital, University of Insubria, Varese, Italy
(Kolodziejczak) Department of Anaesthesiology and Intensive Care,
Collegium Medicum Nicolaus Copernicus University, Antoni Jurasz University
Hospital No. 1, Bydgoszcz, Poland
(Kolodziejczak) Yale Cardiovascular Research Group, Yale School of
Medicine, New Haven, Conn
(Kowalewski) Department of Cardiac Surgery, Central Clinical Hospital of
the Ministry of Interior, Centre of Postgraduate Medical Education,
Warsaw, Poland
(Kowalewski) Thoracic Research Centre, Collegium Medicum Nicolaus
Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
(Formenti, Giustina) Institute of Endocrine and Metabolic Sciences, San
Raffaele Vita-Salute University, IRCCS San Raffaele Hospital, Milan, Italy
(Barili) Cardiac Surgery Unit, S. Croce Hospital, Cuneo, Italy
(Lorusso) Cardiovascular Research Institute Maastricht (CARIM), Maastricht
University, Maastricht, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Historically, impaired glucose metabolism has been associated
with early and late complicated clinical outcomes after cardiac surgery;
however, such a condition is not specific to subjects with diabetes
mellitus and involves a larger patient population. <br/>Method(s):
Databases were screened (January 2000 to December 2020) to identify
eligible articles; studies that evaluated the association between
preoperative metabolic status, as assessed by glycosylated hemoglobin
levels and clinical outcomes, were considered. The studies were stratified
in thresholds by baseline glycosylated hemoglobin level (lower vs higher).
<br/>Result(s): Thirty studies, involving 34,650 patients, were included
in the review. In a meta-analysis stratified by glycosylated hemoglobin
levels, early mortality was numerically reduced in each threshold
comparison and yielded the highest reductions when less than 5.5% versus
greater than 5.5% glycosylated hemoglobin levels were compared (risk
ratio, 0.39; 95% confidence interval, 0.18-0.84; P =. 02). Comparing
higher glycosylated hemoglobin threshold values yielded comparable
results. Late mortality was reduced with lower levels of glycosylated
hemoglobin. Low preoperative glycosylated hemoglobin was associated with
the lowest risk of sternal wound infections (risk ratio, 0.50; 95%
confidence interval, 0.32-0.80; P =. 003 and risk ratio, 0.53; 95%
confidence interval, 0.39-0.70; P <. 0001) for comparisons of less than
7.5% versus greater than 7.5% and less than 7.0% versus greater than 7.0%
glycosylated hemoglobin thresholds, respectively. Additionally, levels of
glycosylated hemoglobin lower than 7% were associated with reduced
hospital stay, lower risk of stroke/transient ischemic attack (risk ratio
0.53; 95% confidence interval, 0.39-0.70; P <. 0001), and acute kidney
injury (risk ratio, 0.65; 95% confidence interval, 0.54-0.79; P <. 0001).
<br/>Conclusion(s): Lower levels of glycosylated hemoglobin in patients
undergoing cardiac surgery are associated with a lower risk of early and
late mortality, as well as in the incidence of postoperative acute kidney
injury, neurologic complications, and wound infection, compared with
higher levels.<br/>Copyright &#xa9; 2021 The Authors

<85>
Accession Number
2011073139
Title
Optimal medical therapy with or without surgical revascularization and
long-term outcomes in ischemic cardiomyopathy.
Source
Journal of Thoracic and Cardiovascular Surgery. 164(6) (pp 1890-1899.e4),
2022. Date of Publication: December 2022.
Author
Farsky P.S.; White J.; Al-Khalidi H.R.; Sueta C.A.; Rouleau J.L.; Panza
J.A.; Velazquez E.J.; O'Connor C.M.; Dabrowski R.; Djokovic L.; Drazner
M.; Haddad H.; Ali I.S.; Keltai M.; Naik A.; Sopko G.; Golba K.; Andersson
B.; Carson P.; Kukulski T.
Institution
(Farsky) Instituto Dante Pazzanese de Cardiologia and Hospital Israelita
Albert Einstein, Sao Paulo, Brazil
(White, Al-Khalidi) Duke Clinical Research Institute and Department of
Biostatics and Bioinformatics, Duke University School of Medicine, Durham,
NC
(Sueta) Division of Cardiology, University of North Carolina, Chapel Hill,
NC, United States
(Rouleau) Department of Medicine, Montreal Heart Institute, Universite de
Montreal, Montreal, QC, Canada
(Panza) Westchester Medical Center and New York Medical College, Valhalla,
NY, United States
(Velazquez) Department of Medicine, Yale University, New Haven, Conn
(O'Connor) Inova Heart and Vascular Institute, Fairfax, Va
(Dabrowski) National Institute of Cardiology, Warsaw, Poland
(Djokovic) Dedinje Cardiovascular Institute, University of Belgrade School
of Medicine, Belgrade, Serbia
(Drazner) Department of Internal Medicine, University of Texas
Southwestern Medical Center, Dallas, Tex
(Haddad) Department of Medicine, University of Saskatchewan, Saskatoon,
SK, Canada
(Ali) Section of Cardiac Surgery, Department of Cardiac Sciences, Libin CV
Institute, University of Calgary, Calgary, AB, Canada
(Keltai) George Gottsegen National Institute of Cardiology, Budapest,
Hungary
(Naik) CIMS Hospital, Ahmedabad, India
(Sopko) Division of Cardiovascular Sciences, National Heart, Lung, and
Blood Institute, National Institutes of Health, Bethesda, Md
(Golba) Medical University of Silesia, Katowice, Poland
(Andersson) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Carson) Washington VA Medical Center, Washington, DC
(Kukulski) Silesian Center for Heart Diseases, Silesian Medical
University, Zabrze, Poland
Publisher
Elsevier Inc.
Abstract
Objectives: Optimal medical therapy in patients with heart failure and
coronary artery disease is associated with improved outcomes. However,
whether this association is influenced by the performance of coronary
artery bypass grafting is less well established. Thus, the aim of this
study was to determine the possible relationship between coronary artery
bypass grafting and optimal medical therapy and its effect on the outcomes
of patients with ischemic cardiomyopathy. <br/>Method(s): The Surgical
Treatment for Ischemic Heart Failure trial randomized 1212 patients with
coronary artery disease and left ventricular ejection fraction 35% or less
to coronary artery bypass grafting with medical therapy or medical therapy
alone with a median follow-up over 9.8 years. For the purpose of this
study, optimal medical therapy was collected at baseline and 4 months, and
defined as the combination of 4 drugs: angiotensin-converting enzyme
inhibitor or angiotensin receptor blocker, beta-blocker, statin, and 1
antiplatelet drug. <br/>Result(s): At baseline and 4 months, 58.7% and
73.3% of patients were receiving optimal medical therapy, respectively.
These patients had no differences in important parameters such as left
ventricular ejection fraction and left ventricular volumes. In a
multivariable Cox model, optimal medical therapy at baseline was
associated with a lower all-cause mortality (hazard ratio, 0.78; 95%
confidence interval, 0.66-0.91; P =. 001). When landmarked at 4 months,
optimal medical therapy was also associated with a lower all-cause
mortality (hazard ratio, 0.82; 95% confidence interval, 0.62-0.99; P =.
04). There was no interaction between the benefit of optimal medical
therapy and treatment allocation. <br/>Conclusion(s): Optimal medical
therapy was associated with improved long-term survival and lower
cardiovascular mortality in patients with ischemic cardiomyopathy and
should be strongly recommended.<br/>Copyright &#xa9; 2021 The American
Association for Thoracic Surgery

<86>
Accession Number
2010760375
Title
A scoping review to identify competencies for transcatheter cardiovascular
procedures.
Source
Journal of Thoracic and Cardiovascular Surgery. 164(6) (pp e457-e469),
2022. Date of Publication: December 2022.
Author
Muller Moran H.R.; Maurice-Ventouris M.; Alharbi M.; Harley J.M.;
Lachapelle K.J.
Institution
(Muller Moran) Department of Surgery, University of Manitoba, Winnipeg,
MB, Canada
(Muller Moran, Maurice-Ventouris, Alharbi, Harley, Lachapelle) Department
of Surgery, McGill University, Montreal, QC, Canada
Publisher
Elsevier Inc.
Abstract
Objectives: Transcatheter procedures are increasingly being recognized as
a priority for cardiac surgeons and cardiac surgery trainees. The optimal
method of teaching these procedures during residency training has not been
established. We used an evidence-based approach to systematically review
the literature and identify competencies to inform future paradigms of
transcatheter training in cardiac surgery. <br/>Method(s): A scoping
review was conducted to retrieve relevant literature on the performance of
transcatheter cardiovascular procedures, identify competencies required by
surgical residents learning to perform these procedures, and develop a
preliminary list of competencies for consideration during transcatheter
training. MEDLINE, Scopus, and ERIC were queried until April 1, 2020,
using a systematic search strategy. No limitations were placed on
publication date or type. <br/>Result(s): A total of 1456 sources of
evidence were retrieved. After deduplication and screening, there remained
33 that were included in the scoping review, published between 2006 and
2020. The distribution of publication types included 10 comparative
studies (30.3% of total), 8 societal statements (24.2% of total), 5
surveys and 5 opinion articles (each 15.2% of total), 2 editorials and 2
descriptions of a simulator (each 6.1% of total), and 1 narrative review
(3.0% of total). From these, a total of 400 items were identified and
organized into 97 competencies. <br/>Conclusion(s): Evidence on the
competencies required to perform transcatheter cardiovascular procedures
is available from a variety of sources. The identified competencies may be
a useful resource for developing curricula and teaching transcatheter
procedures to cardiac surgery residents.<br/>Copyright &#xa9; 2020

<87>
Accession Number
2021029565
Title
Combined retropleural thoracotomy and posterior spinal approach for
thoracic dumbbell Schwannoma: Case series and review of the literature.
Source
Journal of Clinical Neuroscience. 106 (pp 173-179), 2022. Date of
Publication: December 2022.
Author
Kurland D.B.; Lau D.; Dalle Ore C.L.; Haddad A.; Deviren V.; Ames C.P.
Institution
(Kurland, Lau) Department of Neurological Surgery, New York University,
New York, NY, United States
(Lau, Dalle Ore, Haddad, Ames) Department of Neurological Surgery,
University of California, San Francisco, San Francisco, CA, United States
(Deviren) Department of Orthopedic Surgery, University of California, San
Francisco, San Francisco, CA, United States
Publisher
Churchill Livingstone
Abstract
Background: Dumbbell schwannomas of the thoracic spine are challenging to
cure surgically. Surgeons are familiar with posterolateral approaches to
the spine, however, these may provide inadequate exposure for large tumors
extending to ventral extraspinal compartments. Ventrolateral transpleural
approaches offer direct access to the ventral thoracic spine and
intrathoracic cavity, though are associated with increased morbidity and
pulmonary complications, and may necessitate a staged procedure in order
to address concomitant dorsal pathology. Herein we describe our experience
with single-stage, posterior approach to dumbbell schwannomas with large
ventral extraspinal components, and review the literature regarding
surgical approaches for these tumors. <br/>Method(s): Retrospective review
of patients who underwent a single-stage, posterior spinal surgery for
thoracic dumbbell schwannomas from 2008 to 2018. Inclusion criteria were
age > 18 years and ventral thoracic tumor component. <br/>Result(s): Three
patients underwent a simultaneous retropleural thoracotomy and posterior
spinal approach, through a single incision, for the resection of dumbbell
(intradural and extradural) schwannomas. Mean age was 49.7 years and 2
patients were female. All patients were neurologically intact at baseline.
Lesions were 4-8.2 cm in the largest dimension (mean 6.1 cm). GTR was
achieved in all patients. One pleural rent occurred intraoperatively;
there were no other intraoperative or perioperative complications. At a
mean follow-up of 14.1 months all patients remained motor and sensory
intact and there was no evidence of recurrence. <br/>Conclusion(s): The
combined retropleural thoracotomy-posterior spinal approach provides safe
and sufficient access for resection of large dumbbell schwannomas of the
thoracic spine.<br/>Copyright &#xa9; 2022

<88>
Accession Number
631653403
Title
REDUCE-IT USA: Results From the 3146 Patients Randomized in the United
States.
Source
Circulation. 141(5) (pp 367-375), 2020. Date of Publication: 04 Feb 2020.
Author
Bhatt D.L.; Miller M.; Brinton E.A.; Jacobson T.A.; Steg P.G.; Ketchum
S.B.; Doyle R.T.; Juliano R.A.; Jiao L.; Granowitz C.; Tardif J.-C.;
Olshansky B.; Chung M.K.; Gibson C.M.; Giugliano R.P.; Budoff M.J.;
Ballantyne C.M.
Institution
(Bhatt) Brigham and Women's Hospital Heart, Vascular Center and Harvard
Medical School, Boston, MA, United States
(Miller) Department of Medicine, University of Maryland School of
Medicine, Baltimore, United States
(Brinton) Utah Lipid Center, Salt Lake City, United States
(Jacobson) Lipid Clinic and Cardiovascular Risk Reduction Program,
Department of Medicine, Emory University School of Medicine, Atlanta, GA,
United States
(Steg) French Alliance for Cardiovascular Trials, Hopital Bichat, Paris,
France
(Steg) Assistance Publique-Hopitaux de Paris, Universite de Paris, INSERM
Unite 1148, Paris, France
(Ketchum, Doyle, Juliano, Jiao, Granowitz) Amarin Pharma, Inc.,
Bridgewater, NJ, United States
(Tardif) Montreal Heart Institute, Universite de Montreal, QC, Canada
(Olshansky) University of Iowa, Iowa City, United States
(Chung) Cleveland Clinic, OH, United States
(Gibson) Beth Israel Deaconess Hospital, Boston, MA, United States
(Gibson) Baim Clinical Research Institute, Boston, MA, United States
(Giugliano) Cardiovascular Division, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Budoff) Los Angeles Biomedical Research Institute, Harbor UCLA Medical
Center, Torrance, CA, United States
(Ballantyne) Department of Medicine, Baylor College of Medicine, Houston,
TX, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Some trials have found that patients from the United States
derive less benefit than patients enrolled outside the United States. This
prespecified REDUCE-IT (Reduction of Cardiovascular Events with Icosapent
Ethyl - Intervention Trial) subgroup analysis was conducted to determine
the degree of benefit of icosapent ethyl in the United States.
<br/>Method(s): REDUCE-IT randomized 8179 statin-treated patients with
qualifying triglycerides >=135 and <500 mg/dL and low-density lipoprotein
cholesterol >40 and <=100 mg/dL and a history of atherosclerosis or
diabetes mellitus to icosapent ethyl 4 g/d or placebo. The primary
composite end point was cardiovascular death, nonfatal myocardial
infarction, nonfatal stroke, coronary revascularization, or
hospitalization for unstable angina. The key secondary composite end point
was cardiovascular death, nonfatal myocardial infarction, or nonfatal
stroke. A hierarchy was prespecified for examination of individual and
composite end points. <br/>Result(s): A total of 3146 US patients (38.5%
of the trial) were randomized and followed for a median of 4.9 years;
32.3% were women and 9.7% were Hispanic. The primary composite end point
occurred in 24.7% of placebo-treated patients versus 18.2% of icosapent
ethyl-treated patients (hazard ratio [HR], 0.69 [95% CI, 0.59-0.80];
P=0.000001); the key secondary composite end point occurred in 16.6%
versus 12.1% (HR, 0.69 [95% CI, 0.57-0.83]; P=0.00008). All prespecified
hierarchical end points were meaningfully and significantly reduced,
including cardiovascular death (6.7% to 4.7%; HR, 0.66 [95% CI,
0.49-0.90]; P=0.007), myocardial infarction (8.8% to 6.7%; HR, 0.72 [95%
CI, 0.56-0.93]; P=0.01), stroke (4.1% to 2.6%; HR, 0.63 [95% CI,
0.43-0.93]; P=0.02), and all-cause mortality (9.8% to 7.2%; HR, 0.70 [95%
CI, 0.55-0.90]; P=0.004); for all-cause mortality in the US versus non-US
patients, P<inf>interaction</inf>=0.02. Safety and tolerability findings
were consistent with the full study cohort. <br/>Conclusion(s): Whereas
the non-US subgroup showed significant reductions in the primary and key
secondary end points, the US subgroup demonstrated particularly robust
risk reductions across a variety of individual and composite end points,
including all-cause mortality.<br/>Copyright &#xa9; 2020 Lippincott
Williams and Wilkins. All rights reserved.

<89>
Accession Number
639462538
Title
CAN POOR ORAL HYGIENE BE RESPONSIBLE FOR MESH INFECTION FOLLOWING HERNIA
REPAIR? A SYSTEMATIC REVIEW AND SUGGESTION FOR NEW PRACTICE.
Source
British Journal of Surgery. Conference: 44th Annual International Congress
of the European Hernia Society. Manchester United Kingdom. 109(Supplement
7) (pp vii53), 2022. Date of Publication: October 2022.
Author
East B.; Podda M.; Beznoskova-Seydlova M.; De Beaux A.C.
Institution
(East) 3rd Department of Surgery, Charles University, Motol University
Hospital, Prague, Czechia
(Podda) Department of Surgical Science, University of Cagliari, Cagliari,
Italy
(Beznoskova-Seydlova) Private Dentist, Prague, Czechia
(De Beaux) University of Edinburgh, Spire Murrayfield Hospital, Edinburgh,
United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Background: There is a reasonable evidence around oral/dental health and
implant infection in orthopaedic and cardiovascular surgery. Mesh hernia
repair is another area of surgical practice associated with a permanent
implant. The aim of this SR was to review the evidence around oral/dental
health and mesh infection. Mehods: The study was registered at Prospero. A
systematic review of the literature was undertaken according to the
PRISMA2020 statement. The initial search identified 520 publications.
After a review by title and abstract, 40 papers were read in full text. A
further 4 papers were identified from references and searching.15
publications were included in the final review. <br/>Result(s): There is
no published evidence investigating the state of oral hygiene/health and
the risk of mesh infection. Improvement in oral hygiene/health can reduce
surgical site infection and implant infection in colorectal, gastric,
liver, orthopaedic and cardiovascular surgery. Poor oral hygiene/health is
associated with a large increase in oral bacteria and bacteraemia on
everyday activities such as when chewing or brushing teeth. Antibiotic
prophylaxis does not appear to be necessary before invasive dental care in
patients with an implant. <br/>Conclusion(s): Good oral hygiene and oral
health is a strong public health message. The effect of poor oral hygiene
on mesh infection and other complications of mesh hernia repair is
unknown. While research is clearly needed in this area, extrapolating from
evidence in other areas of surgery where implants are used, good oral
hygiene/health should be encouraged amongst hernia patients both prior and
after their surgery.

<90>
[Use Link to view the full text]
Accession Number
639459740
Title
Evaluating the Safety and Efficacy of a Novel Polysaccharide Hemostatic
System for Multidisciplinary Application: A Multicenter Prospective
Randomized Controlled Trial.
Source
Journal of the American College of Surgeons. Conference: 2022 Owen H
Wangensteen Scientific Forum of the American College of Surgeons. San
Diego, CA United States. 235(5 Supplement 2) (pp S25), 2022. Date of
Publication: November 2022.
Author
House M.G.; Kim R.D.; Tseng E.E.; Kaufman R.P.; Moon M.R.; Yopp A.C.;
Master V.
Institution
(House, Kim, Tseng, Kaufman, Moon, Yopp, Master) Indiana University,
Indianapolis, IN, University of Utah, Salt Lake City, UT, San Francisco
Veteran Affairs, San Francisco, CA, Albany Medical College, Slingerlands,
NY, Washington University, St. Louis, MO, University of Texas
Southwestern, Dallas, TX, Emory University, Atlanta, GA
Publisher
Elsevier Inc.
Abstract
Introduction: Operative blood loss is associated with postoperative
morbidity and mortality. Hemostatic agents are used as adjunctive methods
for hemostasis during surgery and to prevent postoperative bleeding. We
evaluated safety and efficacy of an investigational polysaccharide
hemostatic (PH) device, compared with an FDA-approved control in clinical
use comprising microporous polysaccharide hemospheres (MPH), to achieve
hemostasis of bleeding surfaces during surgery. <br/>Method(s): This
prospective multicenter trial enrolled patients undergoing open elective
cardiac, general, or urological operation. Patients were stratified by
bleeding severity and therapeutic area, then randomized 1:1 to receive PH
or MPH. Bleeding assessments occurred intraoperatively using a novel
bleeding assessment methodology. Primary endpoint was non-inferiority as
compared with control via effective hemostasis at 7 minutes. Patients were
followed postoperatively, discharge, and 6-weeks. Survival was assessed in
oncology patients at 24-months. Safety of PH vs MPH was determined by
comparing relative incidence of adverse events. <br/>Result(s): Across 19
centers, 324 (161 PH, 163 MPH) patients were randomized; approximately
half underwent general surgery, while 25% each underwent cardiac and
urologic surgery. PH met the primary endpoint of hemostatic success at
7-minutes demonstrating efficacy of PH was non-inferior to MPH. No
significant differences were found in adverse event rates or supplementary
safety measures. Six deaths were reported through 6-week follow-up. There
was no difference in survival at 2 years (76% (PH) vs 74% (MPH), p = 0.66)
for patients undergoing cancer operation. <br/>Conclusion(s): Across 3
therapeutic areas, PH was noninferior to MPH at all hemostasis assessment
time points. No safety concerns were identified.

<91>
Accession Number
2021075201
Title
Effect of Continuous Positive Airway Pressure in Phase-I Cardiac
Rehabilitation after CABG.
Source
Pakistan Journal of Medical and Health Sciences. 16(9) (pp 501-503), 2022.
Date of Publication: September 2022.
Author
Salal M.; Ubaid S.; Batool A.; Razzaq M.; Rana M.; Suleman H.; Anwer N.;
Niazi A.K.; Muneeb M.
Institution
(Salal, Rana) Peshawar Institute of Cardiology, Peshawar, Pakistan
(Ubaid, Razzaq) Riphah International University, Islamabad, Pakistan
(Batool) Imran Idrees Institute of Rehabilitation Sciences, Pakistan
(Suleman) Bolan University of Medical and Health Sciences, Quetta,
Pakistan
(Anwer, Niazi, Muneeb) Shalamar Institute of Health Sciences, Pakistan
Publisher
Lahore Medical And Dental College
Abstract
Background: Coronary artery bypass surgery is associated with sever
alteration of Lung parameters after 1st post-operative day. The purpose of
this study to determine The effect of CPAP on, arterial blood gasses,
walking time and long term effect on Ejection fraction and quality of
life. <br/>Objective(s): To determine the effect of continues positive
airway pressure on arterial blood gases, walking time, long term effect on
ejection fraction and quality of life in post coronary artery bypass
grafting patients. <br/>Method(s): Randomized control study was conducted
in North West General Hospital Peshawar, from July 2019 to December 2019.
Patients underwent coronary artery bypass grafting were included in
cardiac rehabilitation. 60 patients were randomly divided into two groups
with equal half's. Experimental group received exercises with continues
positive airway pressure (CPAP) and control group received only exercise.
PAP was applied 20 minutes prior to exercise and ABG's test and Vitals
were recorded after 5minutes of exercise. Walking time was observed by
6MWT on last day of hospital discharge. Ejection fraction was observed by
Echo and quality of life by SF12 questionnaire after four weeks.
<br/>Result(s): mean age in control group was (55.27+/-8.80) and in
experimental group was (4.70+/-1.535). Mean and standard deviation of post
Echo in experimental group was 48.30+/-1.493 and control group was
46.17+/-1.191. Both groups showed significant difference P value less than
0.05 in arterial blood gases PH, HCO3, and PCO2. PO2 showed significant
difference only in experimental group. Both groups showed statistically
significant difference for 6 MWT. Mean of quality of life in experimental
group was 37.4+/-5.062 and in control was 36.54+/-4.46.
<br/>Conclusion(s): it is concluded that the use of CPAP in post CABG
patients have effective outcome in arterial blood gases, walking time,
ejection fraction and in quality of life.<br/>Copyright &#xa9; 2022 Lahore
Medical And Dental College. All rights reserved.

<92>
Accession Number
2021131813
Title
Meta-Analysis on the Clinical Outcomes of Transcatheter Aortic Valve
Implantation in Low-Surgical Risk Patients With Bicuspid Aortic Valves.
Source
American Journal of Cardiology. 187 (pp 26-29), 2023. Date of Publication:
15 Jan 2023.
Author
Mahmoudi E.; Gupta R.; Behnoush A.H.; Vyas A.V.; Patel N.C.
Institution
(Mahmoudi) Universal Scientific Education and Research Network and
Non-communicable Diseases Research Center, Endocrinology and Metabolism
Population Sciences Institute, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Gupta, Vyas, Patel) Lehigh Valley Heart Institute, Lehigh Valley Health
Network, AllentownPennsylvania
(Behnoush) Non-communicable Diseases Research Center, Endocrinology and
Metabolism Population Sciences Institute, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
Publisher
Elsevier Inc.

<93>
Accession Number
2021126744
Title
Causes and Determinants of Heart Failure Readmissions Post Transcutaneous
Aortic Valve Replacement: A Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 48(1) (no pagination), 2023. Article
Number: 101428. Date of Publication: January 2023.
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) Department of Medicine, Dow Medical College,
Dow University of Health Sciences, Karachi, Pakistan
(Aamir) Division of Cardiology, Lehigh Valley Heart and Vascular
Institute, Allentown, PA, United States
(Asghar) Division of Nephrology and Hypertension, Mayo Clinic, Rochester,
MN
(Ullah, Rajapreyar, Brailovsky) Division of Cardiology, Thomas Jefferson
University Hospitals, Philadelphia, PA
(Brailovsky) Department of Advanced Heart Failure, Mechanical Circulatory
Support, Heart Transplant, Jefferson Heart Institute, Sidney Kimmel School
of Medicine at Thomas Jefferson University, 833 Chestnut Street, Suite
640, Philadelphia, PA
Publisher
Elsevier Inc.
Abstract
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. 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. 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. 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.<br/>Copyright &#xa9; 2022

<94>
Accession Number
2021116418
Title
Shannon entropy as a reliable score to diagnose human fibroelastic
degenerative mitral chords: A micro-ct ex-vivo study.
Source
Medical Engineering and Physics. 110 (no pagination), 2022. Article
Number: 103919. Date of Publication: December 2022.
Author
Ferreno D.; Revuelta J.M.; Sainz-Aja J.A.; Wert-Carvajal C.; Casado J.A.;
Diego S.; Carrascal I.A.; Silva J.; Gutierrez-Solana F.
Institution
(Ferreno, Revuelta, Sainz-Aja, Casado, Diego, Carrascal, Gutierrez-Solana)
LADICIM (Laboratory of Materials Science and Engineering), University of
Cantabria. E.T.S. de Ingenieros de Caminos, Canales y Puertos, Av/Los
Castros 44, Santander 39005, Spain
(Revuelta) Cardiovascular Surgery, Hospital Universitario Marques de
Valdecilla, Av/Valdecilla, s/n, Santander 39008, Spain
(Wert-Carvajal) Universidad Carlos III de Madrid, Avda. de la Universidad,
30, Madrid 28911, Spain
(Wert-Carvajal) University of California, San Diego, 9500 Gilman Drive,
MC, La Jolla, California 0412
(Silva) Hospital Universitario Central de Asturias, Av. Roma, s/n,
Asturias, Oviedo 33011, Spain
Publisher
Elsevier Ltd
Abstract
This paper is aimed at identifying by means of micro-CT the
microstructural differences between normal and degenerative mitral
marginal chordae tendineae. The control group is composed of 21 normal
chords excised from 14 normal mitral valves from heart transplant
recipients. The experimental group comprises 22 degenerative fibroelastic
chords obtained at surgery from 11 pathological valves after mitral repair
or replacement. In the control group the superficial endothelial cells and
spongiosa layer remained intact, covering the wavy core collagen. In
contrast, in the experimental group the collagen fibers were arranged as
straightened thick bundles in a parallel configuration. 100 cross-sections
were examined by micro-CT from each chord. Each image was randomized
through the K-means machine learning algorithm and then, the global and
local Shannon entropies were obtained. The optimum number of clusters, K,
was estimated to maximize the differences between normal and degenerative
chords in global and local Shannon entropy; the p-value after a nested
ANOVA test was chosen as the parameter to be minimized. Optimum results
were obtained with global Shannon entropy and 2<=K<=7, providing p < 0.01;
for K=3, p = 2.86.10^-3. These findings open the door to novel
perioperative diagnostic methods in order to avoid or reduce postoperative
mitral valve regurgitation recurrences.<br/>Copyright &#xa9; 2022 The
Author(s)

<95>
Accession Number
639359604
Title
Long-term Outcomes of Transcatheter Aortic Valve Replacement With the
Lotus Valve vs CoreValve/EvolutR: A Secondary Analysis of the REPRISE III
Randomized Clinical Trial.
Source
JAMA Network Open. 5(10) (pp E2238792), 2022. Article Number: e2238792.
Date of Publication: 27 Oct 2022.
Author
Rizik D.G.; Rajagopal V.; Makkar R.R.; Bajwa T.; Kleiman N.S.; Linke A.;
Kereiakes D.J.; Waksman R.; Thourani V.H.; Stoler R.C.; Mishkel G.J.; Iyer
V.S.; Buchbinder M.; Gotberg M.; Bjursten H.; Allocco D.J.; Reardon M.J.
Institution
(Rizik) Department of Cardiology, HonorHealth and the Scottsdale-Lincoln
Health Network, Scottsdale, AZ, United States
(Rajagopal) Cardiology Department, Piedmont Hospital, Atlanta, GA, United
States
(Makkar) Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles,
CA, United States
(Bajwa) Department of Medicine, Aurora St Luke's Medical Center,
Milwaukee, WI, United States
(Kleiman) Department of Cardiology, Houston Methodist DeBakey Heart and
Vascular Center, Houston, TX, United States
(Linke) Department of Internal Medicine and Cardiology, Technische
Universitat Dresden, Dresden, Germany
(Kereiakes) The Christ Hospital Heart and Vascular Center, The Lindner
Research Center Cincinnati, Cincinnati, OH, United States
(Waksman) Section of Interventional Cardiology, MedStar Washington
Hospital Center, Washington, DC, United States
(Thourani) Department of Cardiovascular Surgery, Marcus Valve Center,
Piedmont Heart Institute, Atlanta, GA, United States
(Stoler) Baylor Heart & Vascular Hospital, Dallas, TX, United States
(Mishkel) Division of Cardiology, NorthShore University HealthSystem,
University of Chicago Pritzker School of Medicine, Chicago, IL, United
States
(Iyer) Gates Vascular Institute, Interventional Cardiology, University at
Buffalo, School of Medicine and Biomedical Sciences, Buffalo, NY, United
States
(Buchbinder) Department of Cardiology, Foundation for Cardiovascular
Medicine, Stanford University, Stanford, CA, United States
(Gotberg) Department of Cardiology, Clinical Sciences, Lund University,
Skane University Hospital, Lund, Sweden
(Bjursten) Department of Cardiothoracic Surgery, Skane University
Hospital, Lund, Sweden
(Allocco) Boston Scientific Corp, Marlborough, MA, United States
(Reardon) Department of Cardiovascular Surgery, Houston Methodist DeBakey
Heart and Vascular Center, Houston, TX, United States
Publisher
American Medical Association
Abstract
Importance: Long-term follow-up after transcatheter aortic valve
replacement (TAVR) is of interest given that longitudinal data on
mortality and durability of transcatheter heart valves are limited. The
REPRISE III (Repositionable Percutaneous Replacement of Stenotic Aortic
Valve Through Implantation of Lotus Valve System - Randomized Clinical
Evaluation) randomized clinical trial compared the mechanically expanded
Lotus valve with the self-expanding CoreValve/EvolutR TAVR platforms.
<br/>Objective(s): To describe the final 5-year outcomes of the REPRISE
III trial. <br/>Design, Setting, and Participant(s): This prespecified
secondary analysis assessed the final 5-year clinical, functional, and
echocardiographic outcomes of 912 patients from the REPRISE III trial,
which was conducted at 55 centers in North America, Europe, and Australia
between September 22, 2014, and December 24, 2015. Patients had high risk
for aortic stenosis or severe or symptomatic aortic stenosis. Data were
analyzed from September 22, 2014, to May 21, 2021. <br/>Intervention(s):
Lotus valve or CoreValve/EvolutR TAVR platforms. <br/>Main Outcomes and
Measures: Valve Academic Research Consortium-2 end points, hemodynamic
measures, functional status, and health status were examined through the
5-year follow-up. <br/>Result(s): A total of 912 patients (mean [SD] age,
82.8 [7.3] years; 463 women [50.8%]) were randomized to either the Lotus
valve group (n = 607) or CoreValve/EvolutR group (n = 305), with a
baseline Society of Thoracic Surgeons risk score of 6.8%. Clinical
follow-up data from the REPRISE III trial were available for 581 patients
(95.7%) in the Lotus valve group and 285 patients (93.4%) in the
CoreValve/EvolutR group. At 5 years, the cumulative event rate for
all-cause mortality was 50.9% in the Lotus valve group vs 52.8% in the
CoreValve/EvolutR group (P =.59). Disabling stroke was less frequent with
the Lotus valve vs CoreValve/EvolutR (cumulative event rates, 8.3% vs
12.2%; P =.04), whereas the cumulative event rates for overall stroke were
similar in both groups (14.1% vs 15.3%; P =.38). Insertion of a new
permanent pacemaker (38.9% vs 27.3%; P <.001) and detection of prosthetic
aortic valve thrombosis (5.8% vs 1.8%; P =.007) were more common in the
Lotus valve group than in the CoreValve/EvolutR group. A smaller
proportion of patients who received the Lotus valve experienced valve
malpositioning (0% vs 2.6%; P <.001) and required the use of a second
valve (1.0% vs 3.8%; P <.001) during the procedure compared with those who
received the CoreValve/EvolutR. Compared with the Lotus valve group, the
CoreValve/EvolutR group had a significantly lower mean (SD) aortic
gradient (7.8 [4.2] mm Hg vs 12.6 [6.7] mm Hg; P <.001) and larger valve
areas (1.57 [0.56] cm²vs 1.42 [0.42] cm²; P =.10).
After 5 years, the proportion of patients with moderate or greater
paravalvular leak was not significantly higher with the CoreValve/EvolutR
than with the Lotus valve (1.9% vs 0%; P =.31); however, the proportion of
patients with mild paravalvular leak was higher in the CoreValve/EvolutR
group compared with the Lotus valve group (23.1% vs 7.8%; P =.006).
Long-term, similar improvements in New York Heart Association class and
Kansas City Cardiomyopathy Questionnaire score were observed in both
groups. <br/>Conclusions and Relevance: The REPRISE III trial found that,
at 5 years, the clinical outcomes of the Lotus valve were comparable to
those of the CoreValve/EvolutR and that the Lotus valve was safe and
effective.<br/>Copyright &#xa9; 2022 American Society of Civil Engineers
(ASCE). All rights reserved.

<96>
Accession Number
2021083018
Title
Impact of moderate or severe left ventricular outflow tract calcification
on clinical outcomes of patients with severe aortic stenosis undergoing
transcatheter aortic valve implantation with self- and balloon-expandable
valves: a post hoc analysis from the SOLVE-TAVI trial.
Source
EuroIntervention. 18(9) (pp 759-768), 2022. Date of Publication: October
2022.
Author
Farhan S.; Stachel G.; Desch S.; Kurz T.; Feistritzer H.-J.; Hartung P.;
Eitel I.; Nef H.; Doerr O.; Lauten A.; Landmesser U.; Sandri M.; Holzhey
D.; Borger M.; Ince H.; Oner A.; Meyer-Saraei R.; Wienbergen H.; Fach A.;
Frey N.; de Waha-Thiele S.; Thiele H.
Institution
(Farhan) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
(Stachel, Desch, Feistritzer, Hartung, Sandri, Thiele) Department of
Internal Medicine and Cardiology, Heart Center Leipzig, University of
Leipzig, Leipzig, Germany
(Stachel, Desch, Feistritzer, Hartung, Sandri, Holzhey, Borger, de
Waha-Thiele, Thiele) Department of Cardiology, Heart Center Leipzig at
University of Leipzig, Leipzig, Germany
(Stachel, Desch, Feistritzer, Hartung, Sandri, Holzhey, Borger, de
Waha-Thiele, Thiele) Leipzig Heart Institute, Leipzig, Germany
(Desch, Kurz, Eitel, Meyer-Saraei) University Clinic Schleswig-Holstein,
Kiel, Germany
(Desch, Kurz, Eitel, Meyer-Saraei) University Heart Center Lubeck, Lubeck,
Germany
(Desch, Kurz, Eitel, Landmesser, Meyer-Saraei, Frey) German Center for
Cardiovascular Research (DZHK), Campus Lubeck, Lubeck, Germany
(Nef, Doerr) Medizinische Klinik I, Abteilung fur Kardiologie,
Universitatsklinikum Marburg/Giesen, Giesen, Germany
(Lauten) Department of Cardiology and Intensive Care Medicine, Helios
Klinikum Erfurt, Erfurt, Germany
(Landmesser) Universitatsklinikum Charite, Campus Benjamin Franklin,
Berlin, Germany
(Holzhey, Borger, de Waha-Thiele) Department of Cardiac Surgery, Heart
Center Leipzig, University of Leipzig, Leipzig, Germany
(Ince, Oner) Medizinische Klinik I im Zentrum fuer Innere Medizin (ZIM),
Universitaetsklinikum Rostock, Rostock, Germany
(Wienbergen, Fach) Klinikum Links der Weser, Herzzentrum Bremen, Bremen,
Germany
(Frey) Department of Cardiology, Angiology and Pneumology, University
Hospital Heidelberg, Heidelberg, Germany
Publisher
Europa Group
Abstract
Background: Left ventricular outflow tract (LVOT) calcification has been
associated with worse outcomes in patients undergoing transcatheter aortic
valve implantation (TAVI) and may influence the selection of prosthetic
valve type. <br/>Aim(s): We aimed to evaluate the impact of LVOT
calcification on outcomes after TAVI with a self-expanding valve (SEV)
versus a balloon-expandable valve (BEV). <br/>Method(s): Patients of the
SOLVE-TAVI trial, randomised to Edwards SAPIEN 3 or Medtronic Evolut R,
were divided according to LVOT calcification into no/mild (<=1 calcium
nodule extending <5 mm and covering <10% of the LVOT perimeter) and
moderate/severe LVOT calcification groups. The primary endpoint was a
composite of death, stroke, moderate/severe paravalvular regurgitation,
permanent pacemaker implantation and annulus rupture at 30 days.
Additional endpoints included all-cause and cardiovascular mortality at 1
year. <br/>Result(s): Out of 416 eligible patients, moderate/severe LVOT
calcification was present in 143 (34.4%). Moderate/severe LVOT
calcification was associated with significantly longer fluoroscopy time
and higher rates of pre- and post-dilation. Regardless of the LVOT
calcification group, there was no significant difference in the primary
endpoint associated with the valve type (no/mild LVOT calcification group:
SEV 25.0% vs BEV 27.0%; hazard ratio [HR] 1.10, 95% confidence interval
[95% CI]: 0.68-1.73; p=0.73 and moderate/severe LVOT calcification group:
SEV 25.0% vs BEV 19.4%; HR 0.76, 95% CI: 0.38-1.61; p=0.49), no
significant interaction between LVOT calcification and valve type
(p<inf>int</inf>=0.29) and no differences between SEV vs BEV within LVOT
calcification groups regarding 1-year all-cause and cardiovascular
mortality. <br/>Conclusion(s): Moderate/severe LVOT calcification was
associated with longer fluoroscopy time and an increased need for pre- and
post-dilation, but not with a higher incidence of early and mid-term
adverse clinical outcomes, regardless of valve type.<br/>Copyright &#xa9;
Europa Digital & Publishing 2022. All rights reserved.

<97>
Accession Number
2021075184
Title
1% Versus 2% Lignocaine for Airway Anaesthesia in Flexible Bronchoscopy.
Source
Pakistan Journal of Medical and Health Sciences. 16(9) (pp 448-450), 2022.
Date of Publication: September 2022.
Author
Imran M.M.; Gul N.; Ahmad U.; Usman U.; Hussain H.A.
Institution
(Imran) Pulmonology, Services Hospital, Lahore, Pakistan
(Gul) DHQ Hospital, Faisalabad, Pakistan
(Ahmad) Medicine, Allied Hospital, Faisalabad, Pakistan
(Usman) Pulmonology, DHQ Hospital, Faisalabad, Pakistan
(Hussain) Medicine, DHQ Hospital, Faisalabad, Pakistan
Publisher
Lahore Medical And Dental College
Abstract
Introduction: Flexible bronchoscopy is one of the most widely performed
procedures for diagnosis of various bronchopulmonary diseases. Most
patients tolerate the procedure well although cough is often reported as a
distressing symptom. <br/>Objective(s): The main objective of the study is
to find the comparison of 1% versus 2% lignocaine for airway anaesthesia
in flexible bronchoscopy. <br/>Material(s) and Method(s): This randomized
control trial was conducted in pulmonology department of DHQ Hospital
Faisalabad and the duration of this study was from July 2018 to December
2018. The data was collected with the permission of ethical committee of
hospital. Data was collected with the permission of ethical committee of
hospital. The data was collected through random sampling technique.
Demographic and baseline values of all the selected patients were
collected. Before the start of the bronchoscopy procedure, blood pressure,
heart rate, respiratory rate, and pulse oximetric saturation were recorded
and monitoring continued during the procedure. <br/>Result(s): The data
was collected from 100 patients with mean age 44.56+/-2.45 years in group
I and 46.78+/-2.34 years in group II. The demographic and baseline values
were similar in both groups. Table 01 explains all the basic parameters of
both groups. Fifty subjects each were randomized to 1% and 2% groups, and
all randomized subjects completed the study protocol. The cumulative dose
of lignocaine administered in 2% lignocaine group was significantly
greater than in 1%. The doses of midazolam in 1% and 2% lignocaine groups
administered were similar Practical implications: After this trial we may
apply this procedure for airway anaesthesia in flexible bronchoscopy
<br/>Conclusion(s): It is concluded that there was no significant
difference in operator-rated overall procedure satisfaction or cough in
between the two groups.<br/>Copyright &#xa9; 2022 Lahore Medical And
Dental College. All rights reserved.

<98>
Accession Number
2020023992
Title
A Meta-Analysis on the Impact of High BMI in Patients Undergoing
Transcatheter Aortic Valve Replacement.
Source
Journal of Cardiovascular Development and Disease. 9(11) (no pagination),
2022. Article Number: 386. Date of Publication: November 2022.
Author
Seo J.; Li W.; Safiriyu I.; Kharawala A.; Nagraj S.; Tahir A.;
Doundoulakis I.; Koliastasis L.; Rios S.; Palaiodimos L.; Kokkinidis D.G.
Institution
(Seo, Safiriyu, Kharawala, Nagraj, Tahir, Palaiodimos) Department of
Internal Medicine, Jacobi Medical Center/Albert Einstein College of
Medicine, The Bronx, NY 10461, United States
(Doundoulakis, Koliastasis) Department of Cardiology, Hippokration
Hospital, National and Kapodistrian University of Athens, Athens 10679,
Greece
(Rios) Montefiore Einstein Center for Heart & Vascular Care, Albert
Einstein College of Medicine, Montefiore Medical Center, The Bronx, NY
10467, United States
(Kokkinidis) Section of Cardiovascular Medicine, Yale New Haven Hospital,
Yale University School of Medicine, New Haven, CT 06510, United States
Publisher
MDPI
Abstract
Background: A paradoxical association of obesity with lower risk of
transcatheter aortic valve replacement (TAVR) outcomes has been reported.
We aimed to systematically review the literature and compare TAVR-related
morbidity and mortality among individuals with overweight or obesity and
their peers with normal body mass index (BMI). <br/>Method(s): PubMed and
Embase databases were systematically searched for studies reporting TAVR
outcomes in different BMI groups. Separate meta-analyses were conducted
for studies reporting hazard ratios (HR) and odds ratios/relative risks.
Short- and mid-/long-term outcomes were examined. <br/>Result(s): 26
studies with a total of 74,163 patients were included in our study.
Overweight was associated with lower risk of short-term mortality (HR:
0.77; 95% CI: 0.60-0.98) and mid-/long-term mortality (HR: 0.79; 95% CI:
0.70-0.89). Obesity was associated with lower risk for mid-/long-term
mortality (HR: 0.79; 95% CI: 0.73-0.86), but no difference was observed in
short-term mortality, although a trend was noted (HR: 0.87l 95% CI:
0.74-1.01). Individuals with obesity demonstrated an association with
higher odds of major vascular complications (OR: 1.33; 95% CI: 1.05-1.68).
Both overweight (OR: 1.16; 95% CI: 1.03-1.30) and obesity (OR: 1.26; 95%
CI: 1.06-1.50) were associated with higher likelihood for receiving
permanent pacemakers after TAVR. <br/>Conclusion(s): Individuals with
overweight and obesity were associated with lower mortality risk compared
to those with normal BMI but with higher likelihood of major vascular
complications and permanent pacemaker implantation after
TAVR.<br/>Copyright &#xa9; 2022 by the authors.

<99>
Accession Number
2021070893
Title
Early surgical intervention versus conservative management of asymptomatic
severe aortic stenosis: a systematic review and meta-analysis.
Source
Heart. (no pagination), 2022. Article Number: 321411. Date of
Publication: 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
BMJ Publishing Group
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. <br/>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. <br/>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%). <br/>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.<br/>Copyright &#xa9; 2022
Author(s) (or their employer(s)).

<100>
Accession Number
2019975078
Title
Hybrid coronary revascularization (HCR) versus coronary artery bypass
grafting (CABG) in multivessel coronary artery disease (MVCAD): A
meta-analysis of 14 studies comprising 4226 patients.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2022.
Date of Publication: 2022.
Author
Nagraj S.; Tzoumas A.; Kakargias F.; Giannopoulos S.; Ntoumaziou A.;
Kokkinidis D.G.; Alvarez Villela M.; Latib A.
Institution
(Nagraj) Jacobi Medical Center/Albert Einstein College of Medicine, The
Bronx, NY, United States
(Tzoumas) University of Cincinnati Medical Center, Cincinnati, OH, United
States
(Kakargias) Department of Medicine, Aristotle University of Thessaloniki,
Thessaloniki, Greece
(Giannopoulos) Division of Cardiology, Rocky Mountain Regional VA Medical
Center, Aurora, CO, United States
(Ntoumaziou) General Hospital of Filiates, Filiates, Greece
(Kokkinidis) Section of Cardiovascular Medicine, Yale University School of
Medicine, Yale New Haven Hospital, New Haven, CT, United States
(Alvarez Villela) Division of Cardiology, Jacobi Medical Center/Albert
Einstein College of Medicine, The Bronx, NY, United States
(Latib) Department of Cardiology, Montefiore Medical Center/Albert
Einstein College of Medicine, New York City, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Objectives: To compare the outcomes of hybrid coronary revascularization
(HCR) with traditional coronary artery bypass grafting (CABG) in
multivessel coronary artery disease (MVCAD). <br/>Background(s): HCR has
emerged as an alternative to CABG in patients with MVCAD. Through
minimally invasive surgical techniques, HCR carries the potential for
faster recovery postoperatively, fewer complications, and lower
utilization of resources. <br/>Method(s): Systematic search of electronic
databases was conducted up to December 2021 and studies comparing HCR with
CABG in the treatment of MVCAD were included in this meta-analysis.
Primary outcomes of interest were incidence of 5-year mortality and major
adverse cardiac and cerebral event (MACCE). <br/>Result(s): Fourteen
studies (12 observational studies and 2 randomized controlled trials)
comprising 4226 patients were included. The rates of 5-year mortality
(odds ratios [OR]: 1.55; 95% confidence interval [CI]: 0.92-2.62;
I² = 83.0%) and long-term MACCE (OR: 0.97; 95% CI: 0.47-2.01;
I² = 74.7%) were comparable between HCR and CABG groups. HCR
was associated with a significantly lower likelihood of perioperative
blood transfusion (OR: 0.36; 95% CI: 0.25-0.51; I² = 55.9%),
shorter mean hospital stay (weighted mean difference: -2.04; 95% CI: -2.60
to -1.47; I² = 54%), and risk of postoperative acute kidney
injury (OR: 0.45; 95% CI: 0.23-0.88; p = 0.02). CABG demonstrated a lower
likelihood of requiring long-term repeat revascularization (OR: 1.51; 95%
CI: 1.03-2.20; I² = 18%) over a follow-up duration of 29.14 +/-
21.75 months. <br/>Conclusion(s): This meta-analysis suggests that HCR is
feasible and safe for the treatment of MVCAD. However, benefits of HCR
should be carefully weighed against the increased long-term risk of
repeat-revascularization when selecting patients, and further studies
evaluating differences in long-term mortality between HCR and CABG are
required.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<101>
Accession Number
2019974965
Title
Early surgery or conservative management for asymptomatic severe aortic
stenosis: Meta-analysis of RECOVERY and AVATAR.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Changal K.; Devarasetty P.P.; Royfman R.; Veria S.; Yassen M.; Vyas R.;
Gossl M.
Institution
(Changal, Devarasetty, Royfman, Veria, Yassen, Vyas) Cardiovascular
Medicine, University of Toledo College of Medicine and Life Sciences,
Ohio, United States
(Gossl) Valve Science Center, Minneapolis Heart Institute, Abbott
Northwestern Hospital, part of Allina Health, Minneapolis, United States
Publisher
John Wiley and Sons Inc
Abstract
The standard practice for management for asymptomatic severe aortic
stenosis with a normal left ventricular systolic function is conservative
management with a few exceptions. This practice is challenged by two
recent randomized controlled trials (RCT). All the prior data is
observational. We performed a meta-analysis of these 2 RCTs to determine
if early surgical aortic valve replacement in this patient population is
beneficial compared with the standard conservative therapy.<br/>Copyright
&#xa9; 2022 Wiley Periodicals LLC.

<102>
Accession Number
2019974950
Title
Mitral valve surgery via repeat median sternotomy versus right
mini-thoracotomy: A systematic review and meta-analysis of clinical
outcomes.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Shirke M.M.; Ravikumar N.; Shawn T.J.X.; Mutsonziwa N.; Soh V.; Harky A.
Institution
(Shirke, Ravikumar, Shawn, Mutsonziwa, Soh) Department of Medicine,
Queen's University Belfast, School of Medicine, Belfast, United Kingdom
(Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest,
Liverpool, United Kingdom
(Harky) Department of Integrative Biology, Faculty of Life Science,
University of Liverpool, Liverpool, United Kingdom
(Harky) Liverpool Centre for Cardiovascular Science, University of
Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United
Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Redo mitral valve surgeries have high mortality and morbidity
and can be physically demanding for patients. Median sternotomy remains
the gold standard for most cardiac surgeries. To tackle certain risks with
a re-sternotomy, alternative procedures such as the right anterolateral
minithoracotomy have been explored. This review aims to compare the
clinical outcomes of re-sternotomy (MS) versus right mini thoracotomy (MT)
in mitral valve surgery. <br/>Method(s): A systematic, electronic search
was performed according to Preferred Reporting items for Systematic
Reviews and Meta-analysis guidelines to identify relevant articles that
compared outcomes of the MS versus MT procedures in patients who have had
cardiac surgery via a MS approach. <br/>Result(s): Twelve studies were
identified, enrolling 4514 patients. Length of hospital stay(MD = -3.71,
95% confidence interval [CI] [-4.92, -2.49]), 30-day mortality(odds ratio
[OR] = 0.59, 95% CI [0.39, 0.90]), and new-onset renal failure(OR = 0.38,
95% CI [0.22, 0.65]) were statistically significant in favor of the MT
approach. Infection rates(OR = 0.56, 95% CI[0.25, 1.21]) and length of
intensive care unit (ICU) stay (MD = -0.55, 95% CI[-1.16, 0.06]) was lower
in the MT group; however, the difference was not significant. No
significant differences were observed in the CPB time(MD = -2.33, 95% CI
[-8.15, 3.50]), aortic cross-clamp time MD = -1.67, 95% CI[-17.07,
13.76]), and rates of stroke(OR = 1.03, 95% CI[0.55, 1.92]).
<br/>Conclusion(s): Right MT is a safe alternative to the traditional
re-sternotomy for patients who have had previous cardiac surgery. The
approach offers a reduced length of hospital stay, ICU stay, and a lower
risk of new-onset renal failure requiring dialysis. This review calls for
robust trials in the field to further strengthen the
evidence.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<103>
Accession Number
2019974948
Title
Efficacy of chest X-rays after drain removal in adult and pediatric
patients undergoing cardiac and thoracic surgery: A systematic review.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Thet M.S.; Han K.P.P.; Hlwar K.E.; Thet K.S.; Oo A.Y.
Institution
(Thet) Department of Surgery & Cancer, Faculty of Medicine, Imperial
College London, London, United Kingdom
(Han, Hlwar, Thet) Mandalay General Hospital, University of Medicine,
Mandalay, Myanmar
(Oo) Department of Cardiothoracic Surgery, St Bartholomew's Hospital,
London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Chest X-rays are routinely obtained after the removal of chest
drains in patients undergoing cardiac and thoracic surgical procedures.
However, a lack of guidelines and evidence could question the practice.
Routine chest X-rays increase exposure to ionizing radiation, increase
health-care costs, and lead to overutilisation of available resources.
This review aims to explore the evidence in the literature regarding the
routine use of chest X-rays following the removal of chest drains.
<br/>Material(s) and Method(s): A systematic literature search was
conducted in PubMed, Medline via Ovid, Cochrane central register of
control trials (CENTRAL), and ClinicalTrials. gov without any limit on the
publication year. The references of the included studies are manually
screened to identify potentially eligible studies. <br/>Result(s): A total
of 375 studies were retrieved through the search and 18 studies were
included in the review. Incidence of pneumothorax remains less than 10%
across adult cardiac, and pediatric cardiac and thoracic surgical
populations. The incidence may be as high as 50% in adult thoracic
surgical patients. However, the reintervention rate remains less than 2%
across the populations. Development of respiratory and cardiovascular
symptoms can adequately guide for a chest X-ray following the drain
removal. As an alternative, bedside ultrasound can be used to detect
pneumothorax in the thorax after the removal of a chest drain without the
need for ionizing radiation. <br/>Conclusion(s): A routine chest X-ray
following chest drain removal in adult and pediatric patients undergoing
cardiac and thoracic surgery is not necessary. It can be omitted without
compromising patient safety. Obtaining a chest X-ray should be clinically
guided. Alternatively, bedside ultrasound can be used for the same purpose
without the need for radiation exposure.<br/>Copyright &#xa9; 2022 The
Authors. Journal of Cardiac Surgery published by Wiley Periodicals LLC.

<104>
Accession Number
2010596137
Title
Valve-in-Valve Transcatheter Aortic Valve Replacement Versus Redo Surgical
Aortic Valve Replacement: An Updated Meta-Analysis.
Source
JACC: Cardiovascular Interventions. 14(2) (pp 211-220), 2021. Date of
Publication: 25 Jan 2021.
Author
Sa M.P.B.O.; Van den Eynde J.; Simonato M.; Cavalcanti L.R.P.; Doulamis
I.P.; Weixler V.; Kampaktsis P.N.; Gallo M.; Laforgia P.L.; Zhigalov K.;
Ruhparwar A.; Weymann A.; Pibarot P.; Clavel M.-A.
Institution
(Sa, Cavalcanti) Division of Cardiovascular Surgery of Pronto Socorro
Cardiologico de Pernambuco-PROCAPE, University of Pernambuco-UPE, Recife,
Brazil
(Van den Eynde) Department of Cardiovascular Diseases, Research Unit of
Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium
(Van den Eynde) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Simonato) Division of Cardiac Surgery, Escola Paulista de
Medicina-UNIFESP, Sao Paulo, Brazil
(Doulamis) Department of Cardiac Surgery, Boston Children's Hospital,
Harvard Medical School, Boston, MA, United States
(Weixler) German Heart Center, Berlin, Germany
(Kampaktsis) NYU Langone Medical Center, New York, NY, United States
(Gallo) Department of Cardiac Surgery, Cardiocentro Ticino, Lugano,
Switzerland
(Laforgia) I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Milan,
Italy
(Zhigalov, Ruhparwar, Weymann) Department of Thoracic and Cardiovascular
Surgery, West German Heart and Vascular Center Essen, University Hospital
of Essen, University Duisburg-Essen, Essen, Germany
(Pibarot, Clavel) Centre de Recherche de l'Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Quebec City, Quebec, Canada
(Pibarot, Clavel) Department of Medicine, Faculty of Medicine, Universite
Laval, Quebec City, Quebec, Canada
Publisher
Elsevier Inc.
Abstract
Objectives: The aim of this study was to evaluate early results of
valve-in-valve (ViV) transcatheter aortic valve replacement (TAVR) versus
redo surgical aortic valve replacement (SAVR) for structural valve
degeneration (SVD). <br/>Background(s): ViV TAVR has been increasingly
used for SVD, but it remains unknown whether it produces better or at
least comparable results as redo SAVR. <br/>Method(s): Observational
studies comparing ViV TAVR and redo SAVR were identified in a systematic
search of published research. Random-effects meta-analysis was performed,
comparing clinical outcomes between the 2 groups. <br/>Result(s): Twelve
publications including a total of 16,207 patients (ViV TAVR, n = 8,048;
redo SAVR, n = 8,159) were included from studies published from 2015 to
2020. In the pooled analysis, ViV TAVR was associated with lower rates of
30-day mortality overall (odds ratio [OR]: 0.53; 95% confidence interval
[CI]: 0.32 to 0.87; p = 0.017) and for matched populations (OR: 0.419; 95%
CI: 0.278 to 0.632; p = 0.003), stroke (OR: 0.65; 95% CI: 0.55 to 0.76; p
< 0.001), permanent pacemaker implantation (OR: 0.73; 95% CI: 0.22 to
2.43; p = 0.536), and major bleeding (OR: 0.49; 95% CI: 0.26 to 0.93; p =
0.034), as well as with shorter hospital stay (OR: -3.30; 95% CI: -4.52 to
-2.08; p < 0.001). In contrast, ViV TAVR was associated with higher rates
of myocardial infarction (OR: 1.50; 95% CI: 1.01 to 2.23; p = 0.045) and
severe patient-prosthesis mismatch (OR: 4.63; 95% CI: 3.05 to 7.03; p <
0.001). The search revealed an important lack of comparative studies with
long-term results. <br/>Conclusion(s): ViV TAVR is a valuable option in
the treatment of patients with SVD because of its lower incidence of
post-operative complications and better early survival compared with redo
SAVR. However, ViV TAVR is associated with higher rates of myocardial
infarction and severe patient-prosthesis mismatch.<br/>Copyright &#xa9;
2021 American College of Cardiology Foundation

<105>
Accession Number
2016521072
Title
The Outcome of Post-cardiotomy Extracorporeal Membrane Oxygenation in
Neonates and Pediatric Patients: A Systematic Review and Meta-Analysis.
Source
Frontiers in Pediatrics. 10 (no pagination), 2022. Article Number: 869283.
Date of Publication: 25 Apr 2022.
Author
Cho H.J.; Choi I.; Kwak Y.; Kim D.W.; Habimana R.; Jeong I.-S.
Institution
(Cho, Choi) Division of Pediatric Cardiology and Cardiac Critical Care,
Department of Pediatrics, Chonnam National University Children's Hospital
and Medical School, Gwangju, South Korea
(Cho, Kim, Habimana, Jeong) Cardiovascular and Respiratory Research Team,
Chonnam National University Hospital, Gwangju, South Korea
(Kwak, Kim, Jeong) Department of Thoracic and Cardiovascular Surgery,
Chonnam National University Hospital and Medical School, Gwangju, South
Korea
(Habimana) Department of Biomedical Sciences, College of Medicine, Chonnam
National University Graduate School, Gwangju, South Korea
Publisher
Frontiers Media S.A.
Abstract
Objective: Post-cardiotomy extracorporeal membrane oxygenation (PC-ECMO)
is a known rescue therapy for neonates and pediatric patients who failed
to wean from cardiopulmonary bypass (CPB) or who deteriorate in intensive
care unit (ICU) due to various reasons such as low cardiac output syndrome
(LCOS), cardiac arrest and respiratory failure. We conducted a systematic
review and meta-analysis to assess the survival in neonates and pediatric
patients who require PC-ECMO and sought the difference in survivals by
each indication for PC-ECMO. <br/>Design(s): Systematic review and
meta-analysis. <br/>Setting(s): Multi-institutional analysis.
<br/>Participant(s): Neonates and pediatric patients who requires PC-
ECMO. <br/>Intervention(s): ECMO after open-heart surgery. <br/>Result(s):
Twenty-six studies were included in the analysis with a total of 186,648
patients and the proportion of the population who underwent PC-ECMO was
2.5% (2,683 patients). The overall pooled proportion of survival in this
population was 43.3% [95% Confidence interval (CI): 41.3-45.3%;
I²: 1%]. The survival by indications of PC-ECMO were 44.6% (95%
CI: 42.6-46.6; I²: 0%) for CPB weaning failure, 47.3% (95% CI:
39.9-54.7%; I²: 5%) for LCOS, 37.6% (95% CI: 31.0-44.3%;
I²: 32%) for cardiac arrest and 47.7% (95% CI: 32.5-63.1%;
I²: 0%) for respiratory failure. Survival from PC-ECMO for
single ventricle or biventricular physiology, was reported by 12 studies.
The risk ratio (RR) was 0.74 for survival in patients with single
ventricle physiology (95% CI: 0.63-0.86; I²: 40%, P < 0.001).
Eight studies reported on the survival after PC-ECMO for genetic
conditions. The RR was 0.93 for survival in patients with genetic
condition (95% CI: 0.52-1.65; I²: 65%, P = 0.812).
<br/>Conclusion(s): PC-ECMO is an effective modality to support neonates
and pediatric patients in case of failed CPB weaning and deterioration in
ICU. Even though ECMO seems to improve survival, mortality and morbidity
remain high, especially in neonates and pediatric patients with single
ventricle physiology. Most genetic conditions alone should not be
considered a contraindication to ECMO support, further studies are needed
to determine which genetic abnormalities are associated with favorable
outcome.<br/>Copyright &#xa9; 2022 Cho, Choi, Kwak, Kim, Habimana and
Jeong.

<106>
Accession Number
2015636212
Title
Ready to deploy prophylactics?.
Source
Journal of Cardiovascular Electrophysiology. 33(6) (pp 1197-1198), 2022.
Date of Publication: June 2022.
Author
Aktas M.K.; Steinberg J.S.
Institution
(Aktas, Steinberg) Department of Medicine, Clinical Cardiovascular
Research Center, University of Rochester School of Medicine & Dentistry,
Rochester, NY, United States
Publisher
John Wiley and Sons Inc

<107>
Accession Number
2018303374
Title
Influenza Myopericarditis and Pericarditis: A Literature Review.
Source
Journal of Clinical Medicine. 11(14) (no pagination), 2022. Article
Number: 4123. Date of Publication: July 2022.
Author
Radovanovic M.; Petrovic M.; Barsoum M.K.; Nordstrom C.W.; Calvin A.D.;
Dumic I.; Jevtic D.; Hanna R.D.
Institution
(Radovanovic, Barsoum, Nordstrom, Calvin, Dumic, Hanna) Mayo Clinic Alix
School of Medicine, Rochester, MN 55905, United States
(Radovanovic, Nordstrom, Dumic) Department of Hospital Medicine, Mayo
Clinic Health System, Eau Claire, WI 54703, United States
(Petrovic, Jevtic) Icahn School of Medicine at Mount Sinai, New York City,
NY 10029, United States
(Barsoum, Calvin, Hanna) Department of Cardiology, Mayo Clinic Health
System, Eau Claire, WI 54703, United States
(Jevtic) Department of Internal Medicine, Elmhurst Hospital Center,
Elmhurst, NY 11373, United States
Publisher
MDPI
Abstract
Myopericarditis is a rare complication of influenza infection. The
presentation may range from mild and frequently unrecognized, to fulminant
and potentially complicated by cardiogenic and/or obstructive shock
(tamponade), which is associated with high mortality. We performed a
review of literature on all influenza pericarditis and myopericarditis
cases according to PRISMA guidelines using the PubMed search engine of the
Medline database. Seventy-five cases of influenza myopericarditis and
isolated pericarditis were identified from 1951 to 2021. Influenza A was
reported twice as often as influenza B; however, influenza type did not
correlate with outcome. Men and elderly patients were more likely to have
isolated pericarditis, while women and younger patients were more likely
to have myopericarditis. All included patients had pericardial effusion,
while 36% had tamponade. Tamponade was more common in those with isolated
pericarditis (41.2%) than myopericarditis (13.8%). Cardiogenic shock was
more common in patients with myopericarditis (64%), with an overall
mortality rate of 14.7%. Nearly 88% of the recovered patients remained
without long-term complications reported. <br/>Conclusion(s): Influenza A
appears a more common cause of pericarditis and myopericarditis. Isolated
pericarditis was more commonly associated with tamponade but without
reported deaths, whereas myopericarditis was more commonly associated with
cardiogenic shock and death (19%).<br/>Copyright &#xa9; 2022 by the
authors.

<108>
Accession Number
2018043142
Title
2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure.
Source
Journal of Cardiac Failure. 28(5) (pp e1-e167), 2022. Date of Publication:
May 2022.
Author
Heidenreich P.A.; Bozkurt B.; Aguilar D.; Allen L.A.; Byun J.J.; Colvin
M.M.; Deswal A.; Drazner M.H.; Dunlay S.M.; Evers L.R.; Fang J.C.; Fedson
S.E.; Fonarow G.C.; Hayek S.S.; Hernandez A.F.; Khazanie P.; Kittleson
M.M.; Lee C.S.; Link M.S.; Milano C.A.; Nnacheta L.C.; Sandhu A.T.;
Stevenson L.W.; Vardeny O.; Vest A.R.; Yancy C.W.; Beckman J.A.; O'Gara
P.T.; Al-Khatib S.M.; Armbruster A.L.; Birtcher K.K.; Cigarroa J.E.; de
las Fuentes L.; Dixon D.L.; Fleisher L.A.; Gentile F.; Goldberger Z.D.;
Gorenek B.; Haynes N.; Hlatky M.A.; Joglar J.A.; Jones W.S.; Marine J.E.;
Mark D.B.; Mukherjee D.; Palaniappan L.P.; Piano M.R.; Rab T.; Spatz E.S.;
Tamis-Holland J.E.; Wijeysundera D.N.; Woo Y.J.
Publisher
Elsevier B.V.
Abstract
Aim: The "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure"
replaces the "2013 ACCF/AHA Guideline for the Management of Heart Failure"
and the "2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline
for the Management of Heart Failure." The 2022 guideline is intended to
provide patient-centric recommendations for clinicians to prevent,
diagnose, and manage patients with heart failure. <br/>Method(s): A
comprehensive literature search was conducted from May 2020 to December
2020, encompassing studies, reviews, and other evidence conducted on human
subjects that were published in English from MEDLINE (PubMed), EMBASE, the
Cochrane Collaboration, the Agency for Healthcare Research and Quality,
and other relevant databases. Additional relevant clinical trials and
research studies, published through September 2021, were also considered.
This guideline was harmonized with other American Heart
Association/American College of Cardiology guidelines published through
December 2021. Structure: Heart failure remains a leading cause of
morbidity and mortality globally. The 2022 heart failure guideline
provides recommendations based on contemporary evidence for the treatment
of these patients. The recommendations present an evidence-based approach
to managing patients with heart failure, with the intent to improve
quality of care and align with patients' interests. Many recommendations
from the earlier heart failure guidelines have been updated with new
evidence, and new recommendations have been created when supported by
published data. Value statements are provided for certain treatments with
high-quality published economic analyses.<br/>Copyright &#xa9; 2021
Elsevier Inc.

<109>
Accession Number
2018442957
Title
Cost-effectiveness of Community-Based Depression Interventions for Rural
and Urban Adults With Type 2 Diabetes: Projections From Program ACTIVE
(Adults Coming Together to Increase Vital Exercise) II.
Source
Diabetes Care. 44(4) (pp 874-882), 2021. Date of Publication: April 2021.
Author
Kuo S.; Ye W.; de Groot M.; Saha C.; Shubrook J.H.; Hornsby W.G.; Pillay
Y.; Mather K.J.; Herman W.H.
Institution
(Kuo, Ye, Herman) University of Michigan, Ann Arbor, MI, United States
(de Groot, Saha, Mather) Indiana University, School of Medicine,
Indianapolis, IN, United States
(Shubrook) Touro University College of Osteopathic Medicine in California,
Vallejo, CA, United States
(Shubrook) Heritage College of Osteopathic Medicine, Ohio University,
Athens, OH, United States
(Hornsby) West Virginia University, School of Medicine, Morgantown, WV,
United States
(Pillay) Ohio University, Athens, OH, United States
Publisher
American Diabetes Association Inc.
Abstract
OBJECTIVE We estimated the cost-effectiveness of the Program ACTIVE
(Adults Coming Together to Increase Vital Exercise) II community-based
exercise (EXER), cognitive behavioral therapy (CBT), and EXER1CBT
interventions in adults with type 2 diabetes and depression relative to
usual care (UC) and each other. RESEARCH DESIGN AND METHODS Data were
integrated into the Michigan Model for Diabetes to estimate cost and
health outcomes over a 10-year simulation time horizon from the health
care sector and societal perspectives, discounting costs and benefits at
3% annually. Primary outcome was cost per quality-adjusted life-year
(QALY) gained. RESULTS From the health care sector perspective, the EXER
intervention strategy saved $313 (USD) per patient and produced 0.38 more
QALY (cost saving), the CBT intervention strategy cost $596 more and
gained 0.29 more QALY ($2,058/QALY), and the EXER1CBT intervention
strategy cost $403 more and gained 0.69 more QALY ($585/ QALY) compared
with UC. Both EXER and EXER1CBT interventions dominated the CBT
intervention. Compared with EXER, the EXER1CBT intervention strategy cost
$716 more and gained 0.31 more QALY ($2,323/QALY). From the societal
per-spective, compared with UC, the EXER intervention strategy saved $126
(cost saving), the CBT intervention strategy cost $2,838/QALY, and the
EXER1CBT intervention strategy cost $1,167/QALY. Both EXER and EXER1CBT
interventions still dominated the CBT intervention. In comparison with
EXER, the EXER1CBT intervention strategy cost $3,021/QALY. Results were
robust in sensitivity analyses. CONCLUSIONS All three Program ACTIVE II
interventions represented a good value for money compared with UC. The
EXER1CBT intervention was highly cost-effective or cost saving compared
with the CBT or EXER interventions.<br/>Copyright &#xa9; 2021 by the
American Diabetes Association.

<110>
Accession Number
2020648013
Title
The Impact of Cognitive Impairment on Clinical Outcomes After
Transcatheter Aortic Valve Implantation (from a Systematic Review and
Meta-Analysis).
Source
American Journal of Cardiology. 185 (pp 63-70), 2022. Date of Publication:
15 Dec 2022.
Author
Sim J.J.L.; Ling R.R.; Neo V.S.Q.; Tan F.L.; Djohan A.H.; Yeo L.L.L.; Chan
K.A.; Lim Y.; Tan B.Y.Q.; Yeo T.-C.; Chan M.Y.; Poh K.-K.; Kong W.K.F.;
Yip J.W.L.; Chong Y.F.; Sharma V.K.; Kuntjoro I.; Sia C.-H.
Institution
(Sim, Ling, Neo, Tan, Yeo, Tan, Yeo, Chan, Poh, Kong, Yip, Chong, Sharma,
Sia) Yong Loo Lin School of Medicine, National University of Singapore,
Singapore
(Djohan, Lim, Yeo, Chan, Poh, Kong, Yip, Kuntjoro, Sia) Department of
Cardiology, National University Heart Centre, Singapore
(Yeo, Tan, Chong, Sharma) Division of Neurology, Department of Medicine,
National University Hospital, Singapore
(Chan) Section of Adult Cardiology, Chong Hua Heart Institute, Chong Hua
Hospital, Cebu, Philippines
Publisher
Elsevier Inc.
Abstract
This study sought to investigate the impact of pre-existing cognitive
impairment on outcomes after transcatheter aortic valve implantation
(TAVI). TAVI has been increasingly used in seniors, and evidence suggests
better outcomes than surgical aortic valve replacement. Although frailty
has been shown to be associated with poorer outcomes after TAVI, the
effect of pre-existing cognitive impairment on patient outcomes after TAVI
remains unclear. We searched the Medline, Embase, Scopus and Cochrane
databases until May 14, 2022. The risk of bias was assessed using the
Newcastle-Ottawa scale. The primary outcome was short-term (6 months to 1
year) mortality, and secondary outcomes included long-term (1 year to 3
years) mortality, in-hospital mortality, and postoperative delirium. A
total of 14 studies with 32,746 patients (5,098 patients with cognitive
impairment at baseline, 27,648 without) were included in our
meta-analysis. Among studies that reported the raw proportion of patients
with mortality of postoperative delirium, cognitive impairment
significantly increased mortality (risk ratio 2.10, 95% confidence
intervals [CIs] 1.43 to 3.08, p = 0.0002) and postoperative delirium (risk
ratio 2.27, 95% CI 1.76 to 2.93, p <0.0001). Studies which reported the
hazards for mortality (pooled hazards ratio 1.97, 95% CI 1.50 to 2.60, p
<0.0001) and odds of postoperative delirium (pooled odds ratio 2.40, 95%
CI: 1.51 to 3.80, p = 0.0002) yielded results consistent with the primary
meta-analysis. In conclusion, pre-existing cognitive impairment is a
significant risk factor for poorer outcomes after TAVI and should be
carefully considered in this group of patients. Guidelines and future
studies should take cognitive impairment into consideration for
preoperative risk stratification.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<111>
Accession Number
639451706
Title
AORTIC VALVE REPLACEMENT EFFECTIVELY REDUCES VON WILLEBRAND DISEASE AND
GASTROINTESTINAL BLEEDING IN PATIENTS WITH HEYDE SYNDROME.
Source
United European Gastroenterology Journal. Conference: 30th United European
Gastroenterology Week, UEG Week 2022. Virtual. 10(Supplement 8) (pp 315),
2022. Date of Publication: October 2022.
Author
Goltstein L.; Rooijakkers M.; Hoeks M.; Li W.; Van Wely M.; Van Royen N.;
Drenth J.P.H.; Van Geenen E.J.M.
Institution
(Goltstein, Drenth, Van Geenen) Radboud University Medical Center,
Gastroenterology and Hepatology, Nijmegen, Netherlands
(Rooijakkers, Van Wely, Van Royen) Radboud University Medical Center,
Cardiology, Nijmegen, Netherlands
(Hoeks) Radboud University Medical Center, Hematology, Nijmegen,
Netherlands
(Li) Radboud University Medical Center, Cardiothoracic Surgery, Nijmegen,
Netherlands
Publisher
SAGE Publications Ltd
Abstract
Introduction: Heyde syndrome is the co-occurrence of aortic stenosis and
gastrointestinal bleeding (GIB) due to angiodysplasias. Acquired von
Willebrand syndrome (AVWS) connects both disorders. Stenotic aortic valves
induce significant shear stress on the von Willebrand protein, leading to
proteolysis. We investigated the efficacy of aortic valve replacement
(AVR) on AVWS recovery and GIB cessation. Aims & Methods: We performed a
systematic review and meta-analysis according to the PRISMA-IPD guidelines
using Medline, Embase, and the Cochrane Library to identify articles on
Heyde syndrome and AVR. Primary outcomes were the proportion of patients
with AVWS recovery within 24 hours (T1), 24 to 72 hours (T2), 3 to 21 days
(T3), and 4 weeks to 2 years (T4) after AVR and the proportion of patients
with complete GIB cessation after AVR. AVR can be performed surgically
(SAVR) or via transcatheter implantation (TAVI). Secondary outcomes
included periprocedural bleeding and stroke. Pooled proportions and risk
ratios (RR) were calculated using randomeffects models. <br/>Result(s): We
identified 35 studies on Heyde patients with AVWS, nine on Heyde patients
with GIB, and one reported on both associated disorders. AVWS recovery was
analysed in 925 patients and GIB cessation in 228 patients. The pooled
proportion of Heyde patients with AVWS recovery after AVR was 82% (95% CI,
76-86%) at T1, 91% (95% CI, 77-97%) at T2, 92% (95% CI, 84-96%) at T3, and
87% (95% CI, 67-96%) at T4. There was complete GIB cessation after AVR in
72% (95% CI, 60-82%) of Heyde patients. AVWS recovery was more prevalent
after SAVR than after TAVI at T2 (95% vs 75%; p=0.013) and resulted in
more GIB cessation (82% vs 56%; p<0.001). Patient prosthesis mismatch and
paravalvular leakage yielded less AVWS recovery, especially at T1 (RR,
0.16; 0.09-0.31; p<0.001) and T4 (RR, 0.20; 0.05-0.72; p=0.014), as well
as GIB cessation (RR, 0.57; 0.40-0.81; p=0.002). Periprocedural bleeding
was more prevalent in those with sustained AVWS (RR, 1.80; 1.40-2.30;
p<0.001) and those with GIB (RR, 1.81; 1.28-2.55; p=0.001). Sustained AVWS
was also associated with higher stroke rates (RR, 2.56; 1.02-6.44;
p=0.046). <br/>Conclusion(s): AVR is associated with a rapid recovery of
the bleeding diathesis in Heyde syndrome, which results in complete
cessation of GIB. Sustained AVWS, mostly related to patient prosthesis
mismatch and paravalvular leakage, compromises clinical benefits and is
associated with higher periprocedural bleeding and stroke rates.

<112>
Accession Number
2019935605
Title
Review of bioprosthetic structural valve deterioration: Patient or valve?.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Tnay T.D.; Shell D.; Lui A.
Institution
(Tnay, Shell, Lui) Department of Cardiothoracic Surgery, St Vincent's
Hospital - Melbourne St Vincent's Health Australia, Melbourne, Australia
Publisher
John Wiley and Sons Inc
Abstract
Background: With guidelines progressively recommending bioprosthetic
aortic valves in younger patients, a greater emphasis is placed on
structural valve deterioration (SVD) as an important clinical endpoint for
both transcatheter and surgically implanted valves. However, SVD of
bioprosthetic valves is a complex entity with varying definitions in the
literature and a multifaceted pathogenesis. <br/>Aim(s): This review first
aims to establish the most updated definitions of SVD as per the
literature. We then explore the patient- and valve-related factors that
play the greatest roles in facilitating early SVD. <br/>Method(s): A
PubMed literature review was conducted to identify the relevant research
in this field within the past two decades. <br/>Conclusion(s): Increasing
rates of obesity and metabolic syndrome pose a significant risk to the
longevity of bioprosthetic valves. Additionally, externally mounted valves
have proven to sacrifice durability for superior haemodynamics.
Bioprosthetic SVD continues to be a multifactorial issue that will require
various patient- and valve-related factors to be addressed.<br/>Copyright
&#xa9; 2022 Wiley Periodicals LLC.

<113>
Accession Number
2019925621
Title
Coronary angiography of the ex-situ beating donor heart in a portable
organ care system.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2022.
Date of Publication: 2022.
Author
Meredith T.; Scheuer S.; Hoffman M.; Joshi Y.; Kathir K.; Gunalingam B.;
Roy D.; Wilson S.; Jansz P.; Macdonald P.; Muller D.
Institution
(Meredith, Hoffman, Kathir, Gunalingam, Roy, Wilson, Muller) Department of
Interventional Cardiology, St Vincent's Hospital, Sydney, NSW, Australia
(Meredith, Scheuer, Joshi, Jansz, Macdonald) Victor Chang Cardiac Research
Institute, Darlinghurst, NSW, Australia
(Meredith, Scheuer, Joshi, Jansz, Macdonald, Muller) Faculty of Medicine
and Health, University of New South Wales, Sydney, NSW, Australia
(Scheuer, Joshi, Jansz, Macdonald) Department of Heart and Lung
Transplantation, St Vincent's Hospital, Sydney, NSW, Australia
Publisher
John Wiley and Sons Inc
Abstract
Objectives: To determine safety and feasibility of ex-situ coronary
angiography. <br/>Background(s): To cater for the perpetually growing
demand for heart donors, interest in donation following circulatory death
(DCD) has been rekindled. Further pursuit of donor pool expansion has led
to eligibility extension to "marginal" donors who are at higher risk of
coronary artery disease (CAD). Excluding CAD in potentially eligible DCD
donors, for whom ante-mortem angiography is commonly not permitted, is
therefore challenging. Ex-situ coronary angiography serves as an ethical
and feasible diagnostic tool to assess for preclusive CAD. <br/>Method(s):
We undertook a systematic review of the published literature and
institutional retrospective review of case experience with ex-situ
coronary angiography of donor hearts, supported by a portable organ care
system. <br/>Result(s): Combined literature and institutional case review
yielded nine total cases of ex-situ coronary angiography of donor human
hearts plus one experimental porcine model. Of the eight cases of ex-situ
coronary angiography performed at our institute, all were conducted
without complication or injury to the allograft. Two thirds of reported
human cases have proceeded to successful transplantation.
<br/>Conclusion(s): Diagnostic coronary angiography of the ex-situ beating
donor heart is safe, feasible, and demonstrates novel clinical utility in
mitigating subsequent transplantation of unsuitable allografts. In the
setting of suspected coronary atherosclerosis of the donor heart, which
may preclude favorable transplantation outcomes, ex-situ coronary
angiography should be considered at eligible transplant
centers.<br/>Copyright &#xa9; 2022 The Authors. Catheterization and
Cardiovascular Interventions published by Wiley Periodicals LLC.

<114>
Accession Number
639457190
Title
Cardiac surgery, ICU sedation, and delirium: is dexmedetomidine the silver
bullet.
Source
Current opinion in anaesthesiology. (no pagination), 2022. Date of
Publication: 08 Nov 2022.
Author
Smith W.; Whitlock E.L.
Institution
(Smith) Department of Anesthesia & Perioperative Care, University of
California, San Francisco, CA, United States
Publisher
NLM (Medline)
Abstract
PURPOSE OF REVIEW: Delirium is a marker of acute brain insufficiency and a
harbinger of poor outcomes and increased healthcare costs. Despite success
preventing delirium by nonpharmacologic measures, the incidence in the
postcardiac surgical ICU population remains high. Dexmedetomidine, a
selective alpha-2 agonist, is a plausible preventive agent with sedative,
anxiolytic, analgesic, sympatholytic and anti-inflammatory properties, and
is the subject of very active study in cardiac surgery populations. RECENT
FINDINGS: Recent trials, including DEXACET (2019), DECADE (2020),
LOWDEXDEL (2021), and DIRECT (2022) individually, failed to show a benefit
for dexmedetomidine and highlighted associated risks. Meta-analyses have
offered conflicting results, highlighting the complexity of delirium, and
likely interaction of multiple etiological pathways; those that concluded
benefit often were driven by trials at high risk of bias. Meta-analyses
excluding biased trials currently suggest no benefit for dexmedetomidine
over control in unselected cardiac surgical populations. SUMMARY: Although
using dexmedetomidine to prevent delirium in unselected cardiac surgical
patients is not supported by current evidence, there remains hope that it
may offer benefits in highly selected populations, and further trials are
ongoing.<br/>Copyright &#xa9; 2022 Wolters Kluwer Health, Inc. All rights
reserved.