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<1>
Accession Number
2016795362
Title
Autonomic Neuromodulation for Atrial Fibrillation Following Cardiac
Surgery: JACC Review Topic of the Week.
Source
Journal of the American College of Cardiology. 79(7) (pp 682-694), 2022.
Date of Publication: 22 Feb 2022.
Author
Zafeiropoulos S.; Doundoulakis I.; Farmakis I.T.; Miyara S.; Giannis D.;
Giannakoulas G.; Tsiachris D.; Mitra R.; Skipitaris N.T.; Mountantonakis
S.E.; Stavrakis S.; Zanos S.
Institution
(Zafeiropoulos, Miyara) Elmezzi Graduate School of Molecular Medicine,
Northwell Health, Manhasset, NY, United States
(Zafeiropoulos, Miyara, Giannis, Zanos) Feinstein Institutes for Medical
Research at Northwell Health, Manhasset, NY, United States
(Doundoulakis) Department of Cardiology, 424 General Military Training
Hospital, Thessaloniki, Greece
(Doundoulakis, Tsiachris) Athens Heart Center, Athens Medical Center,
Athens, Greece
(Farmakis, Giannakoulas) Department of Cardiology, AHEPA University
Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
(Mitra) Division of Electrophysiology, Department of Cardiology, North
Shore University Hospital, Northwell Health, Manhasset, NY, United States
(Skipitaris, Mountantonakis) Department of Cardiology, Lenox Hill
Hospital, Northwell Health, New York City, New York, United States
(Stavrakis) Heart Rhythm Institute, University of Oklahoma Health Sciences
Center, Oklahoma City, OK, United States
Publisher
Elsevier Inc.
Abstract
Autonomic neuromodulation therapies (ANMTs) (ie, ganglionated plexus
ablation, epicardial injections for temporary neurotoxicity, low-level
vagus nerve stimulation [LL-VNS], stellate ganglion block, baroreceptor
stimulation, spinal cord stimulation, and renal nerve denervation)
constitute an emerging therapeutic approach for arrhythmias. Very little
is known about ANMTs' preventive potential for postoperative atrial
fibrillation (POAF) after cardiac surgery. The purpose of this review is
to summarize and critically appraise the currently available evidence.
Herein, the authors conducted a systematic review of 922 articles that
yielded 7 randomized controlled trials. In the meta-analysis, ANMTs
reduced POAF incidence (OR: 0.37; 95% CI: 0.25 to 0.55) and burden (mean
difference [MD]: -3.51 hours; 95% CI: -6.64 to -0.38 hours), length of
stay (MD: -0.82 days; 95% CI: -1.59 to -0.04 days), and interleukin-6 (MD:
-79.92 pg/mL; 95% CI: -151.12 to -8.33 pg/mL), mainly attributed to LL-VNS
and epicardial injections. Moving forward, these findings establish a base
for future larger and comparative trials with ANMTs, to optimize and
expand their use.<br/>Copyright &#xa9; 2022 American College of Cardiology
Foundation

<2>
Accession Number
2015593501
Title
Non-Vitamin K Antagonists Versus Warfarin in Patients with Atrial
Fibrillation and Bioprosthetic Valves: A Systematic Review and
Meta-Analysis.
Source
American Journal of Medicine. 135(2) (pp 228-234.e1), 2022. Date of
Publication: February 2022.
Author
Cardoso R.; Ternes C.M.P.; Justino G.B.; Fernandes A.; Rocha A.V.; Knijnik
L.; d'Avila A.; Lopes R.D.
Institution
(Cardoso) Heart and Vascular Center, Brigham and Women's Hospital, Harvard
Medical School, Mass, Boston
(Ternes, Justino) Department of Medicine, Federal University of Santa
Catarina, Florianopolis, Brazil
(Ternes, d'Avila) Cardiac Arrhythmia Service, Hospital SOS Cardio,
Florianopolis, Brazil
(Fernandes, Knijnik) Division of Medicine, University of Miami, Fla, Miami
(Rocha) Division of Medicine, Federal University of Goias, Brazil
(d'Avila) Harvard-Thorndike Electrophysiology Institute, Beth Israel
Deaconess Medical Center, Harvard Medical School, Mass, Boston
(Lopes) Duke Clinical Research Institute, Duke University School of
Medicine, NC, Durham
Publisher
Elsevier Inc.
Abstract
Background: Patients with atrial fibrillation and bioprosthetic valves are
at high risk for thromboembolic events. The pooled efficacy and safety of
non-vitamin K oral anticoagulants (NOACs), as a class, relative to
warfarin in this population is not well-known. We aimed to compare the
efficacy and safety of NOACs relative to warfarin in patients with
bioprosthetic valves or valve repair. <br/>Method(s): We systematically
searched EMBASE, PubMed, and Cochrane databases for randomized controlled
trials comparing NOACs to warfarin in patients with atrial fibrillation
and bioprosthetic valves or valve repair. We pooled outcomes for stroke or
systemic embolism, ischemic stroke, hemorrhagic stroke, and major
bleeding. <br/>Result(s): We included 4 trials with 1379 patients, of whom
723 (52.4%) received a NOAC. Mean follow-up ranged from 90 days to 2.8
years. In the pooled analysis, stroke or systemic embolism was
significantly lower in patients treated with NOACs (1.9%) compared with
warfarin (3.7%) (odds ratio [OR] 0.43; 95% confidence interval [CI]
0.22-0.85; P =.02). Ischemic stroke (OR 0.72; 95% CI 0.18-2.93),
hemorrhagic stroke (OR 0.18; 95% CI 0.03-1.05), cardiovascular death (OR
0.78; 95% CI 0.38-1.62), and all-cause mortality (OR 0.94; 95% CI
0.55-1.62) were not significantly different among groups. Major bleeding
was significantly lower in patients treated with NOAC (2.8%) compared with
warfarin (4.7%) (OR 0.49; 95% CI 0.28-0.88; P =.02). <br/>Conclusion(s):
In patients with atrial fibrillation and bioprosthetic valves or valve
repair, NOACs are associated with a reduced incidence of thromboembolic
events and major bleeding as compared with warfarin. Thus, NOACs may be
considered a preferred option for this patient population.<br/>Copyright
&#xa9; 2021

<3>
Accession Number
2020896615
Title
Manifestation and management of intravenous leiomyomatosis: A systematic
review of the literature.
Source
Surgical Oncology. 45 (no pagination), 2022. Article Number: 101879. Date
of Publication: December 2022.
Author
Lim W.H.; Lamaro V.P.; Sivagnanam V.
Institution
(Lim, Lamaro, Sivagnanam) Department of Gynaecology, St Vincent's Hospital
Sydney, 390 Victoria Street, Darlinghurst, NSW 2010, Australia
(Lim) Graduate School of Medicine, The University of Wollongong,
Wollongong, NSW 2500, Australia
Publisher
Elsevier Ltd
Abstract
Intravenous leiomyomatosis (IVL) is characterized by the presence of
vascular extension and invasion of benign smooth muscle lesions in a
worm-like manner from uterine fibroids into the systemic vasculature
system. Surgery with complete tumour resection remains the main treatment
approach, however both treated and untreated of this disease is associated
with high morbidity and mortality. The aim of this systematic review is to
highlight the systemic manifestations and surgical management of
IVL.<br/>Copyright &#xa9; 2022 Elsevier Ltd

<4>
Accession Number
2020693684
Title
Concomitant tricuspid annuloplasty in patients with mild to moderate
tricuspid valve regurgitation undergoing mitral valve surgery:
meta-analysis.
Source
Journal of Cardiovascular Surgery. 63(5) (pp 624-631), 2022. Date of
Publication: October 2022.
Author
Yokoyama Y.; Tsukagoshi J.; Takagi H.; Takayama H.; Kuno T.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Bethlehem, PA, United States
(Tsukagoshi) Department of Surgery, University of Texas Medical Branch,
Galveston, TX, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Takayama) Department of Surgery, Columbia University Medical Center, New
york, Ny, United States
(Kuno) Department of Cardiology, Montefiore Medical Center, Albert
Einstein College of Medicine, New york, Ny, United States
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: Clinical effects of concomitant tricuspid annuloplasty (TA)
in patients with mild to moderate tricuspid regurgitation at the time of
mitral valve surgery (MVS) remains indefinite. We aimed to perform a
meta-analysis to determine the long-term clinical and echocardiographic
effects of concomitant TA in patients undergoing MVS. EVIDENCE
ACQUISITION: MEDLINE and EMBASE were searched through January 2022 to
identify randomized controlled trials (RCT) and observational studies with
adjusted outcomes that investigated outcomes of concomitant TA versus
conservative management for mild to moderate tricuspid regurgitation in
patients undergoing MVS. EVIDENCE SYNTHESIS: Two RCT and 11 observational
studies included in the meta-analysis with a total of 3,953 patients
underwent MVS with (N.=1837) or without (N.=2166) concomitant TA. Mean
follow-up period ranged from 24 to 115.5 months. MVS with concomitant TA
was associated with all-cause mortality (hazard ratio [HR] 1.15; 95%
confidence interval [CI]: 0.81-1.55; P=0.34, I²=0%) compared
with MVS alone. Similarly, heart failure events (HR 0.74; 95% CI:
0.46-1.20; P=0.22, I²=0%) as well as rates of tricuspid
reoperation (HR 0.55; 95% CI: 0.27-1.10; P=0.09, I²=1%) were
comparable between the groups. However, MVS with concomitant TA was
associated with a significant reduction in TR progression (HR 0.30; 95%
CI: 0.17-0.53; P<0.00001, I²=11%). <br/>CONCLUSION(S):
Concomitant TA for patients undergoing MVS was associated with similar
long-term clinical outcomes compared to MVS alone. However, concomitant TA
was associated with a significant reduction in TR progression. Longer
follow-up is necessary to assess the effect on further clinical
outcomes.<br/>Copyright &#xa9; 2022 Edizioni Minerva Medica. All rights
reserved.

<5>
Accession Number
2021176488
Title
Influenza vaccine to reduce adverse vascular events in patients with heart
failure: a multinational randomised, double-blind, placebo-controlled
trial.
Source
The Lancet Global Health. 10(12) (pp e1835-e1844), 2022. Date of
Publication: December 2022.
Author
Loeb M.; Roy A.; Dokainish H.; Dans A.; Palileo-Villanueva L.M.; Karaye
K.; Zhu J.; Liang Y.; Goma F.; Damasceno A.; Alhabib K.F.; Yonga G.; Mondo
C.; Almahameed W.; Al Mulla A.; Thanabalan V.; Rao-Melacini P.; Grinvalds
A.; McCready T.; Bangdiwala S.I.; Yusuf S.
Institution
(Loeb, Thanabalan) Department of Pathology and Molecular Medicine,
McMaster University, Hamilton, ON, Canada
(Loeb, Bangdiwala) Department of Health Research Methods, Evidence, and
Impact, McMaster University, Hamilton, ON, Canada
(Yusuf) Department of Medicine, McMaster University, Hamilton, ON, Canada
(Roy) All India Institute of Medical Sciences, Delhi, India
(Dokainish, Rao-Melacini, Grinvalds, McCready, Bangdiwala, Yusuf)
Population Health Research Institute, Hamilton, ON, Canada
(Dans, Palileo-Villanueva) Department of Medicine, College of Medicine,
University of the Philippines Manila, Manila, Philippines
(Karaye) Department of Medicine, Bayero University and Aminu Kano Teaching
Hospital, Kano, Nigeria
(Zhu, Liang) Department of Cardiovascular Medicine, Cardiovascular
Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and
Peking Union Medical College, Beijing, China
(Goma) Department of Physiological Sciences, School of Medicine,
University of Zambia, Lusaka, Zambia
(Damasceno) Department of Medicine, Faculty of Medicine, Eduardo Mondlane
University, Maputo, Mozambique
(Alhabib) Department of Cardiac Sciences, King Fahad Cardiac Center,
College of Medicine, King Saud University, Riyadh, Saudi Arabia
(Yonga) Department of Clinical Medicine and Therapeutics, University of
Nairobi, Nairobi, Kenya
(Mondo) Kirudda Hospital, Kampala, Uganda
(Almahameed) Department of Cardiovascular Medicine, Heart and Vascular
Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
(Al Mulla) Division of Cardiology, Cardiac Sciences Institute, Sheikh
Khalifa Medical City, Abu Dhabi, United Arab Emirates
Publisher
Elsevier Ltd
Abstract
Background: Influenza increases the risk of cardiovascular events and
deaths. We aimed to see whether influenza vaccination reduces death and
vascular events in patients with heart failure. <br/>Method(s): We did a
pragmatic, randomised, double-blind, placebo-controlled trial in 30
centres (mostly hospitals affliated with universities or a research
institute) in ten countries in Asia, the Middle East, and Africa (7 in
India, 4 in Philippines, 4 in Nigeria, 6 in China, 1 in Zambia, 2 in
Mozambique, 3 in Saudi Arabia, 1 in Kenya, 1 in Uganda, and 1 in Zambia).
Participants (aged >=18 years; 52.1% female; not disaggregated by race or
ethnicity) with heart failure (New York Heart Association class II, III,
or IV) were randomly assigned (1:1) by a centralised web-based system with
block randomisation stratified by site, to receive 0.5 ml intramuscularly
once a year for up to 3 years of either inactivated standard dose
influenza vaccine or placebo (saline). We excluded people who had received
influenza vaccine in 2 of the previous 3 years, and those likely to
require valve repair or replacement. Those who administered assigned
treatments were not masked and had no further role in the study.
Investigators, study coordinators, outcome adjudicators, and participants
were masked to group assignment. The first of two co-primary outcomes was
a first-event composite for cardiovascular death, non-fatal myocardial
infarction, and non-fatal stroke, and the second was a recurrent-events
composite for cardiovascular death, non-fatal myocardial infarction,
non-fatal stroke, and hospitalisation for heart failure. Outcomes were
assessed every 6 months in the intention-to-treat population. Secondary
outcomes were all-cause death, cardiovascular death, non-fatal myocardial
infarction, non-fatal stroke, all-cause hospitalisation, hospitalisation
for heart failure, and pneumonia, both overall and during periods of peak
influenza exposure. This study is registered with ClinicalTrials.gov,
NCT02762851. <br/>Finding(s): Between June 2, 2015, and Nov 21, 2021, we
enrolled 5129 participants and randomly assigned (1:1) 2560 (50.0%) to
influenza vaccine and 2569 (50.0%) to placebo. The first co-primary
outcome occurred in 380 (14.8%) of 2560 participants in the vaccine group
and 410 (16.0%) of 2569 participants in the placebo group (hazard ratio
[HR] 0.93 [95% CI 0.81-1.07]; p=0.30). The second co-primary outcome
occurred in 754 (29.5%) of 2560 participants in the vaccine group and 819
(31.9%) of 2569 participants in the placebo group; HR 0.92 [95% CI
0.84-1.02]; p=0.12). The secondary outcomes of all-cause hospitalisations
(HR 0.84 [95% CI 0.74-0.97]; p=0.013) and pneumonia (HR 0.58 [0.42-0.80];
p=0.0006) were significantly reduced in the vaccine group compared with in
the placebo group but there was no significant difference between groups
for all-cause death, cardiovascular death, non-fatal myocardial
infarction, non-fatal stroke, and hospitalisation for heart failure. In a
prespecified analysis, in which events were limited to periods of peak
influenza circulation, the first co-primary outcome, and the secondary
outcomes of all-cause death, cardiovasular death, and pneumonia were
significantly lower in the vaccinated group than in the placebo group,
whereas the second co-primary outcome and the secondary outcomes of
non-fatal myocardial infarction, non-fatal stroke, all-cause
hospitalisation, and hospitalisation for heart failure were not
significantly lower. <br/>Interpretation(s): Although the prespecified
co-primary outcomes during the entire period of observation were not
statistically significant, the reduction during the peak influenza
circulating period suggests that there is likely to be a clinical benefit
of giving influenza vaccine, given the clear reduction in pneumonia, a
moderate reduction in hospitalisations, and a reduction in cardiovascular
events and deaths during periods of peak circulation of influenza. Taken
in conjunction with previous trials and the observational studies, the
collective data suggest benefit. <br/>Funding(s): UK Joint Global Health
Trials Scheme and Canadian Institutes for Health Research
Foundation.<br/>Copyright &#xa9; 2022 The Author(s). Published by Elsevier
Ltd. This is an Open Access article under the CC BY 4.0 license

<6>
Accession Number
639572179
Title
LMWH safety and efficacy in pregnancy with rheumatic heart disease
patients with heart valves replacement.
Source
Research and Practice in Thrombosis and Haemostasis. Conference: 2022
Congress of the International Society of Thrombosis and Haemostasis, ISTH
2022. London United Kingdom. 6(Supplement 1) (no pagination), 2022. Date
of Publication: October 2022.
Author
Alqahtani F.; Alghamdi N.; Allehyani L.; Alosaimi H.; Almutairi W.
Institution
(Alqahtani) King Saud Univesrity, Dammam-Alkhobar,Ar Riyad, Saudi Arabia
(Alghamdi, Allehyani, Alosaimi, Almutairi) King Saud Univesrty, Ryidh,Ar
Riyad, Saudi Arabia
Publisher
Wiley-Blackwell Publishing Ltd
Abstract
Background: The risk of thromboembolic complications is higher in
pregnancy than at other times especially in Rheumatic heart disease
patients who underwent heart valve replacement. Thus, maintenance of
therapeutic anticoagulation during pregnancy is needed to diminish the
chance of thromboembolic complications. <br/>Aim(s): Investigated the
efficacy and safety of LMWH in the management of RHD-related valvular
disease management in pregnant women. <br/>Method(s): A retrospective
study was conducted at King Saud Medical City between January
2011-February 2020. All pregnant women with rheumatic heart disease and
who had heart valve replacements were reviewed in this study. The reviewed
patients were on one of the following regimens: LMWH, LMWH plus warfarin,
or Unfarctinated heparin plus warfarin. Primary endpoints were
thromboembolism, hemorrhagic complications, and fetal outcomes.
<br/>Result(s): A total of 744 pregnancies in 149 women were identified.
The mean age +/- SD of the women was 43.8 +/- 12 years. Eighty-six women
(58%) were on LMWH regimen, thirty-five women (23%) were on LMWH and
warfarin regimen, and twenty-eight women (19%) were Unfarctinated heparin
and warfarin regimen. Overall, thromboembolic compilations developed in
five (0.7 %) pregnancies of these, two were in the LMWH group, two were in
the LMWH and warfarin group, and one in the heparin and warfarin group. In
addition, significant hemorrhage occurred in five pregnancies. Of these,
two occurred in the LMWH group, two in the LMWH and warfarin group, and
one in the heparin and warfarin group. Conclusion(s): This study presents
the largest retrospective study of LMWH use in pregnant women with RHD and
had a valve replacement. This study has assured that LMWH is safe and
effective in preventing thrombosis in pregnancy. Further studies including
randomized controlled trials investigating the use of LMWH for these
indications are encouraged.

<7>
Accession Number
639571167
Title
LEX-211 (FARES-II): A phase 3, prospective, active-control randomised
study of four-factor prothrombin complex concentrate versus frozen plasma
in bleeding adult cardiac surgery patients.
Source
Research and Practice in Thrombosis and Haemostasis. Conference: 2022
Congress of the International Society of Thrombosis and Haemostasis, ISTH
2022. London United Kingdom. 6(Supplement 1) (no pagination), 2022. Date
of Publication: October 2022.
Author
Karkouti K.; Callum J.; Solomon C.; Knaub S.
Institution
(Karkouti) University of Toronto, Toronto, ON, Canada
(Callum) Queen's University, Kingston, ON, Canada
(Solomon) Octapharma AG, Lachen, Zurich, Switzerland
(Knaub) Octapharma AG, Lachen, Schwyz, Lachen, Switzerland
Publisher
Wiley-Blackwell Publishing Ltd
Abstract
Background: Cardiac surgery is often complicated by coagulopathic
bleeding, leading to transfusion and poor outcomes. Prothrombin complex
concentrate (PCC) and frozen plasma (FP) are used for coagulation factor
replacement during surgery. <br/>Aim(s): To demonstrate that four-factor
PCC (4F-PCC, Octaplex, Octapharma) is clinically non-inferior to FP in
terms of haemostatic effectiveness, as measured by the need for
post-therapy haemostatic interventions. <br/>Method(s): LEX-211 (sponsor:
Octapharma) will include patients (>=18 years) undergoing cardiac surgery
with cardiopulmonary bypass (CPB) who require coagulation factor
replacement due to post-CPB bleeding and known/suspected coagulation
factor deficiency. Exclusion criteria include heart transplant,
insertion/removal of ventricular assist devices, high probability of death
within 24 h, severe right heart failure, heparin contraindications,
thromboembolic event (TEE) within 3 months and IgA deficiency.
Approximately 500 patients will be randomised to PCC (20-25 IU/kg) or FP
(10-15 ml/ kg) (Figure 1). The primary endpoint is haemostatic response to
PCC vs. FP, rated 'effective' if no further haemostatic intervention
(systemic haemostatic agents, including second dose of study drug, or
surgical re-opening for bleeding) is required 60 min-24 h after initiation
of first dose. Secondary endpoints include global haemostatic response (60
min-24 h), bleeding (24 h), blood product/coagulation factor usage (24 h,
7 d), surgical re-exploration (24 h) and coagulation parameters (~1 h
post-treatment). Safety endpoints include serious treatment-emergent
adverse events (e.g., TEE, major adverse cardiac events), mechanical
ventilation, ICU stay, hospitalisation and mortality (30 d).
<br/>Result(s): LEX-211 is planned to start in Q2 2022. An unblinded
interim analysis (100 evaluable patients/group) will test sample size
assumptions and re-estimate if necessary. Completion is expected Q1 2024.
Conclusion(s): The results of this study will inform clinical practice for
bleeding cardiac surgery patients requiring coagulation factor
replacement, potentially reducing blood product usage, and improving
outcomes. (Figure Presented).

<8>
Accession Number
639570921
Title
Platelet function testing and timing of bypass surgery -A platelet
function sub-study from the RAPID CABG randomized trial.
Source
Research and Practice in Thrombosis and Haemostasis. Conference: 2022
Congress of the International Society of Thrombosis and Haemostasis, ISTH
2022. London United Kingdom. 6(Supplement 1) (no pagination), 2022. Date
of Publication: October 2022.
Author
Lordkipanidze M.; Wells G.; Le May M.; Rubens F.; Chen L.; Ruel M.; Chong
A.; Welman M.; Perrault L.; Chan V.; Tanguay J.; So D.
Institution
(Lordkipanidze, Welman) Montreal Heart Institute, Montreal, QC, Canada
(Wells, Le May, Rubens, Chen, Ruel, Chong, Chan, So) University of Ottawa
Heart Institute, Ottawa, ON, Canada
(Perrault, Tanguay) Montreal Heart Institute, Montreal, QC, Canada
Publisher
Wiley-Blackwell Publishing Ltd
Abstract
Background: The RAPID CABG (NCT02668562) randomized trial demonstrated
early coronary artery bypass surgery (CABG), 2-3 days after ticagrelor
cessation, was non-inferior in incurring perioperative bleeding compared
to waiting 5-7 days. Platelet function testing has been proposed as a tool
to guide timing to surgery. In this pre-specified platelet function
sub-study, we evaluate perioperative platelet function as a determinant of
bleeding. <br/>Aim(s): To assess whether pharmacodyamic measurement of
platelet function following ticagrelor cessation is a predictor of
bleeding and ischemic outcomes. <br/>Method(s): Patients with acute
coronary syndromes and requiring CABG were randomly assigned to early
surgery, 2-3 days after ticagrelor cessation, vs standard delay of 5-7
days. Platelet function was measured using the VerifyNow P2Y12 assay
before, immediately after and at 24, 48 and 72 hours post-CABG. The
primary outcome was bleeding, defined as class 3 or 4 (severe and massive)
universal definition of peri-operative bleeding (UDPB). Secondary outcomes
included: Other bleeding outcomes (BARC type 4, TIMI CABG-related
bleeding, cardiac tamponade) and ischemic outcomes (CV death, stroke,
myocardial infarction, refractory ischemia, urgent unplanned
revascularization). <br/>Result(s): In the per-protocol population,
platelet function measures were available in 60/65 patients in the early
group and 54/58 in the delayed group. At all perioperative time points,
the delayed group had significantly higher platelet reactivity (Figure A).
Proportion of patients with low platelet reactivity (LPR -defined by PRU <
85, a correlate to increased bleeding risk), was similar in the early (5%)
vs. delayed (1.9%) groups (p = 0.62). A higher proportion had high
platelet reactivity (HPR, defined as PRU > 208) in the delayed (89%) vs.
the early (45%) group at time of surgery (p < 0.001). Preoperative
platelet reactivity was not associated with blood loss (Figure B).
Correlation to other bleeding and ischemic outcomes will be presented.
Conclusion(s): Platelet function recovery after ticagrelor cessation
followed expected pharmacokinetics, but did not predict perioperative
bleeding. (Figure Presented).

<9>
Accession Number
2021067132
Title
Effect of a patient education video and prehabilitation on the quality of
preoperative person-centred coordinated care experience: protocol for a
randomised controlled trial.
Source
BMJ Open. 12(9) (no pagination), 2022. Article Number: e063583. Date of
Publication: 29 Sep 2022.
Author
Wong S.S.Y.; Cheung H.H.T.; Ng F.F.; Yau D.K.W.; Wong M.K.H.; Lau V.N.M.;
Leung W.W.; Mak T.W.C.; Lee A.
Institution
(Wong) Faculty of Medicine, The Chinese University of Hong Kong, Hong
Kong, Hong Kong
(Cheung, Ng, Yau, Lee) Anaesthesia and Intensive Care, The Chinese
University of Hong Kong, Hong Kong, Hong Kong
(Wong, Lau) Anaesthesia and Intensive Care, Prince of Wales Hospital, Hong
Kong, Hong Kong
(Leung, Mak) Division of Colorectal Surgery, Department of Surgery, The
Chinese University of Hong Kong, Hong Kong, Hong Kong
Publisher
BMJ Publishing Group
Abstract
Introduction Multimodal prehabilitation, an emerging field within the
Perioperative Medicine specialty, requires close multidisciplinary team
coordination. The goal is to optimise the patient's health status in the
4-8 weeks before elective surgery to withstand surgical stress. Most
patients are unfamiliar with the concept of prehabilitation but are
interested in participating in such a programme after explanation. The
objective of this randomised controlled trial is to evaluate the effect of
prehabilitation (patient education video and multimodal prehabilitation)
on the preoperative patient-centred coordinated care experience. Method
and analysis One hundred patients undergoing major elective surgery
(cardiac, colorectal, hepatobiliary-pancreatic and urology) will be
recruited into a two-group, parallel, superiority, single-blinded
randomised controlled trial. Patients will be randomised to receive either
preoperative patient education comprising of a video and prehabilitation
programme with standard care (intervention) or standard care (control).
The primary outcome measure will be the quality of preoperative patient
care experience using the 11-item Chinese version of the Person-Centred
Coordinated Care Experience Questionnaire (P3CEQ) before surgery.
Secondary outcomes will include the change in Hospital Anxiety and
Depression Scale (HADS) score from trial enrolment to before surgery,
Quality of Recovery Score (QoR-15) on third day after surgery and Days
Alive and At Home within 30 days after surgery (DAH 30).
Intention-to-treat and per-protocol analyses will be performed. Ethics and
dissemination The Joint CUHK-NTEC Clinical Research Ethics Committee
approved the study protocol (CREC Ref. No. 2021.518-T). The findings will
be presented at scientific meetings, in peer-reviewed journals and to
study participants. Trial registration number
ChiCTR2100053637.<br/>Copyright &#xa9; 2022 BMJ Publishing Group. All
rights reserved.

<10>
Accession Number
2021286060
Title
Use of sodium-glucose co-transporter 2 inhibitors in solid organ
transplant recipients with pre-existing type 2 or post-transplantation
diabetes mellitus: A systematic review.
Source
Transplantation Reviews. 37(1) (no pagination), 2023. Article Number:
100729. Date of Publication: January 2023.
Author
Lin Y.; Mok M.; Harrison J.; Battistella M.; Farrell A.; Leung M.; Cheung
C.
Institution
(Lin) Vancouver General Hospital, Vancouver, BC, Canada
(Mok) Richmond Health Services, Richmond, BC, Canada
(Harrison, Battistella) Leslie Dan Faculty of Pharmacy, University of
Toronto, Toronto, ON, Canada
(Harrison) Ajmera Transplant Centre, Toronto General Hospital, University
Health Network, Toronto, ON, Canada
(Battistella) Nephrology, University Health Network, Toronto, ON, Canada
(Farrell) Library and Information Services, University Health Network,
Toronto, ON, Canada
(Leung) Faculty of Pharmaceutical Sciences, University of British
Columbia, Vancouver, BC, Canada
(Leung) St. Paul's Hospital, Providence Healthcare, Vancouver, BC V6Z 1Y6,
Canada
(Cheung) Fraser Health Post Transplant Clinic, Surrey, BC, Canada
Publisher
Elsevier Inc.
Abstract
Introduction: Sodium-Glucose Co-Transporter 2 (SGLT2) inhibitors have
demonstrated kidney, cardiovascular and mortality benefits in the general
population; however, the evidence is limited in solid organ transplant
recipients. The aim of this systematic review was to evaluate the current
efficacy and safety data of SGLT2 inhibitors in adult kidney, heart, lung,
and liver transplant recipients with pre-existing type 2 or
post-transplantation diabetes mellitus. <br/>Method(s): We searched
MEDLINE, MEDLINE Epub, CENTRAL, CDSR, EMBASE, CINAHL, and sources of
unpublished literature. All primary interventional and observational
studies on SGLT2 inhibitors in transplant recipients were included.
Clinical outcomes included mortality, cardiovascular and kidney events,
and adverse events such as graft rejection. Surrogate markers including
hemoglobin A1c (HbA1c) and weight reduction were also evaluated.
<br/>Result(s): Of the 17 studies that were included in this systematic
review, there were 15 studies on kidney transplant recipients (n = 2417
patients) and two studies on heart transplant recipients (n = 122
patients). There was only one randomized controlled trial which evaluated
49 kidney transplant patients over 24 weeks. Overall, studies were
heterogeneous in study design, sample size, duration of diabetes, time to
SGLT2 inhibitor initiation post-transplantation (ranging from 0.88 to 11
years post kidney transplant; five to 5.7 years post heart transplant) and
follow-up (ranging from 0.4 to 5.25 years in kidney transplant patients;
0.75 to one year in heart transplant patients). Only one retrospective
study evaluated mortality as a part of a composite outcome in kidney
transplant patients; however, study limitations restrict generalizability
of results. Overall, studies could not confirm clinical cardiovascular and
kidney benefits in the transplant population. Findings suggested that
SGLT2 inhibitors may improve glycemic control; however, they are
associated with urinary tract infection. Diabetic ketoacidosis and acute
kidney injury also occurred in these studies, with precipitating factors
such as infection and acute heart failure exacerbation.
<br/>Conclusion(s): While SGLT2 inhibitors are promising agents with
expanding indications in the non-transplant population, these agents may
not be suitable for all solid organ transplant recipients, and close
monitoring (e.g. for urinary tract infections) and patient education (e.g.
sick day management) are essential if these agents are initiated. Evidence
is based on short-term findings and suggests an association with
hemoglobin A1c reduction and increased adverse events. Further long-term
randomized controlled trials are needed to evaluate the effect of SGLT2
inhibitors on clinically important outcomes, including mortality
reduction, in solid organ transplant recipients.<br/>Copyright &#xa9; 2022

<11>
Accession Number
2020195552
Title
Effect of different ventilation strategies during cardiopulmonary bypass
on cardiac de-airing in congenital cardiac surgery: A trans-esophageal
echocardiography comparative study.
Source
Egyptian Journal of Anaesthesia. 38(1) (pp 694-700), 2022. Date of
Publication: 2022.
Author
Hayes S.M.S.; Magdy M.; El Rahamawy G.A.; Elgamal M.A.; Elnegeery N.A.
Institution
(Hayes, Magdy, El Rahamawy, Elnegeery) Department of Anesthesia and
Surgical Intensive Care, Faculty of Medicine, Mansoura University,
Mansoura, Egypt
(Elgamal) Department of Cardiothoracic Surgery, Faculty of Medicine,
Mansoura University, Mansoura, Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Objectives: This study was conducted to evaluate the efficacy of using
either low tidal ventilation or continuous positive pressure ventilation
on the quality of de-airing procedure during cardiopulmonary bypass (CPB)
surgery for correction of congenital heart diseases. <br/>Patients and
Methods: This study was conducted on 48 children under the age of 6 years
scheduled for elective correction of congenital heart diseases. Patients
were randomly allocated into three groups. In the low tidal volume (LTV)
group, ventilator was set to a respiratory rate of 5 breaths per minute
with tidal volume of 2-3 ml/kg of ideal body weight and a positive
end-expiratory pressure of 3-5 cmH<inf>2</inf>O. In continuous positive
airway pressure (CPAP) group, oxygen flow was maintained at 0.5 L/min
during CPB, ventilator was shut off and the adjustable pressure-limiting
valve (APL) was set at a pressure of 10 cmH<inf>2</inf>O. In the no
ventilation (NV) group, ventilator was shut off, fresh flow air was
completely stopped and APL was adjusted on spontaneous position. The
primary outcome was the total de-airing time using transesophageal
echocardiography. <br/>Result(s): The total de-airing time was
significantly decreased in CPAP group, with the shortest duration of
246.88 +/- 5.40 sec in comparison to both LTV group with 284.25 +/- 6.52
sec and NV group with 452.12 +/- 26.6 sec with p-value 0.001.
<br/>Conclusion(s): Use of CPAP 10 cmH<inf>2</inf>O ventilation during CPB
surgery for correction of congenital heart diseases could improve the
process of de-airing by decreasing the total time needed to de-air heart
chambers.<br/>Copyright &#xa9; 2022 The Author(s). Published by Informa UK
Limited, trading as Taylor & Francis Group.

<12>
Accession Number
2018675594
Title
The Effect of Pre-emptive Oral Melatonin versus Placebo on Post-operative
Analgesia in Infants after Thoracotomy for Closed Cardiac Surgeries: A
Randomized Controlled Study.
Source
Open Access Macedonian Journal of Medical Sciences. Part B. 10 (pp
2195-2201), 2022. Date of Publication: 01 Jan 2022.
Author
Saleh A.; Hassan P.
Institution
(Saleh, Hassan) Department of Anesthesia, Surgical Intensive Care and Pain
Management, Cairo University, Cairo, Egypt
Publisher
Scientific Foundation SPIROSKI
Abstract
BACKGROUND: Thoracotomy pain is one of the severest types of pain that
should be managed properly, especially in children. Opioids are the most
widely prescribed analgesics for post-operative pain, but they can have a
number of undesirable side effects. Melatonin could be employed as an
adjuvant analgesic therapy during procedural discomfort as it had no known
major side effects. STUDY DESIGN: This was a double-blinded, controlled
randomized study. <br/>METHOD(S): Fifty patients divided randomly into two
equal groups. One hour before surgery, children in M group (n = 25) were
given 0.5 mg/kg orally of melatonin 3 mg tablets) and patients in Group P
(n = 25) received a placebo (5 ml of water by syringe 5 ml) orally.
Post-operative pethidine consumption over the 1^st 24 h (mg) was
recorded, the intraoperative fentanyl consumption (HR and ABP) at
baseline, 1 min after induction, at skin incision, and every 30 min till
the end of the surgery were recorded. Neonatal Infant Pain Score (NIPS) at
4 h, 6 h, 8 h, 12 h, 18 h, and 24 h postoperatively was recorded. Other
reported data include demographic data, extubation time, days of ICU stay,
and complications. <br/>RESULT(S): Total post-operative pethidine
consumption (mg) over 24 h was significantly lower in M group than P group
(3.48 +/- 2.23 vs. 7.68 +/- 4.52 p = 0.01). Intraoperative fentanyl
consumption (ug) was significantly lower in M group than P group (10.28
+/- 4.98 vs. 17.08 +/- 7.39 p < 0.001). As regards NIPS, it was
statistically lower in M group than P group in all times except at 8 h and
24 h with significant difference. <br/>CONCLUSION(S): Oral melatonin is an
effective and safe pre-emptive drug as it reduces the total post-operative
pethidine consumption over the first 24 h and decreased post-operative
pain scores without any unpleasant effects in pediatrics undergoing closed
heart surgery.<br/>Copyright &#xa9; 2022 Amany Saleh, Passaint Hassan.

<13>
Accession Number
2018662707
Title
Paravalvular Leak: A Systemic Review.
Source
Current Cardiology Reviews. 18(6) (pp 54-59), 2022. Article Number:
e110522204571. Date of Publication: November 2022.
Author
Randall M.; Betageri O.; Hanayneh S.; Anderson R.D.
Institution
(Randall, Anderson) Division of Cardiovascular Medicine, Department of
Medicine, University of Florida, Gainesville, FL 32611, United States
(Betageri, Hanayneh) Department of Medicine, University of Florida,
Gainesville, FL 32611, United States
Publisher
Bentham Science Publishers
Abstract
Background: Paravalvular Leak (PVL) refers to the retrograde flow of blood
in the space between an implanted cardiac valve and native tissue. These
are unfortunately but luckily relatively uncommon complications of
prosthetic valve replacement that, especially when moder-ate or severe,
have important clinical consequences. <br/>Objective(s): Addressing PVL
requires a multidisciplinary team to properly diagnose this process and
choose the corrective option most likely to result in success.
<br/>Method(s): A comprehensive literature search was undertaken to
formulate this narrative review. <br/>Result(s): This review highlights
the complex nature of PVL and the promising contemporary treat-ments
available. <br/>Conclusion(s): Clinicians should be adept at recognizing
PVL and characterizing it using multimo-dality imaging. Using the many
available tools and a multidisciplinary approach should lead to favorable
outcomes in patients with PVL.<br/>Copyright &#xa9; 2022 Bentham Science
Publishers.

<14>
Accession Number
2021245492
Title
Hyperalgesia and fentanyl dosing in on-pump coronary artery bypass
grafting: a prospective, randomised, double-blinded clinical trial.
Source
Acta Anaesthesiologica Belgica. 73(2) (pp 53-61), 2022. Date of
Publication: June 2022.
Author
Slagmulder S.; Mauermann E.; Vandenheuvel M.
Institution
(Slagmulder, Vandenheuvel) Department of Anesthesiology, University
Hospital Ghent, Corneel Heymanslaan 11, Gent 9000, Belgium
(Mauermann) Department of Anesthesiology, University Hospital Basel,
Basel, Switzerland
Publisher
BeSARPP
Abstract
Background: Chronic post-sternotomy pain after coronary artery bypass
grafting (CABG) is an underestimated complication. Pain has a major impact
on quality of life. Increasingly, low-dose or even opioid-free anesthesia
has been shown to be feasible and in some cases beneficial. Different
intraoperative analgesic treatment strategies may significantly impact
occurrence of hyperalgesia and subsequent pain in cardiac surgery.
<br/>Objective(s): To investigate whether different intraoperative dosing
regimens of fentanyl during CABG influence the area of hyperalgesia 24 and
48 hours postoperatively. As secondary endpoints, we investigated whether
acute postoperative pain measured by the numerical rating scale (NRS)
scores at 24 and 48 hours and the occurrence of chronic pain after 3, 6
and 12 months were influen ced by perioperative fentanyl dosing.
<br/>Design(s): Prospective, randomized double-blind clinical trial.
<br/>Setting(s): A preliminary analysis of a randomized multicenter study
(University Hospital of Ghent and the University Hospital of Basel),
including patients undergoing elective on-pump CABG in University Hospital
of Ghent. <br/>Method(s): We screened 80 patients, of whom 66 were
included and randomized into three groups: a high fentanyl regimen (20
mug.kg-1 IBW (Ideal Body Weight)), a low dosing regimen (3 mug.kg-1 IBW),
or a Shibutani continuous dosing regimen. When extubated and responsive,
protocolized pin-pricking was performed at 24 and 48h to evaluate the
surface area of hyperalgesia. Additionally, patients are asked to report
the Numeric Rating Scale (NRS) at 24h, 48h, as well as the occurrence of
persistent pain at 3, 6, and 12 months. Additional preoperative rescue
fentanyl dosing and postoperative remifentanil dosing were taken into
account as possible confounders. <br/>Result(s): Primary endpoint: the
difference in the measured area of hyperalgesia between the randomization
groups was not significantly different. At 24h a mean area of 88 cm2, 90
cm2 and 96 cm2 was found in the low, high and Shibutani groups,
respectively. At 48h areas of 91 cm2, 96 cm2 and 103 cm2 were measured in
the respective groups. Secondary endpoints: significantly higher NRS
scores were recorded at 24 hours in the lowdose group. A higher NRS score
was found at 6 months in the Shibutani group compared to the other groups
in the longer term. Postoperative administration of remifentanil is was
not found to be a confounding cause of hyperalgesia. <br/>Conclusion(s):
More short-term pain was reported in patients administered lower doses of
fentanyl intraoperatively. Other clinically relevant differences in
outcomes were not found. Our findings suggest that the benefits of opioid
low anesthesia may not be as relevant to cardiac surgery with median
sternotomy. The total postoperative opioid dosing (including remifentanil)
could be a possible cause of hyperalgesia.<br/>Copyright &#xa9; 2022
Authors. All rights reserved.

<15>
Accession Number
2021067074
Title
Prevention of vasoplegia with CytoSorb in heart failure patients
undergoing cardiac surgery (CytoSorb-HF trial): protocol for a randomised
controlled trial.
Source
BMJ Open. 12(9) (no pagination), 2022. Article Number: e061337. Date of
Publication: 19 Sep 2022.
Author
Papazisi O.; Bruggemans E.F.; Berendsen R.R.; Hugo J.D.V.; Lindeman
J.H.N.; Beeres S.L.M.A.; Arbous M.S.; Van Den Hout W.B.; Mertens B.J.A.;
Ince C.; Klautz R.J.M.; Palmen M.
Institution
(Papazisi, Bruggemans, Hugo, Klautz, Palmen) Department of Cardiothoracic
Surgery, Leiden University Medical Center, Leiden, Netherlands
(Berendsen) Department of Anaesthesiology, Leiden University Medical
Center, Leiden, Netherlands
(Lindeman) Department of Vascular Surgery, Leiden University Medical
Center, Leiden, Netherlands
(Beeres) Department of Cardiology, Leiden University Medical Center,
Leiden, Netherlands
(Arbous) Department of Intensive Care, Leiden University Medical Center,
Leiden, Netherlands
(Van Den Hout, Mertens) Department of Biomedical Data Sciences, Leiden
University Medical Center, Leiden, Netherlands
(Ince) Department of Intensive Care, Laboratory of Translational Intensive
Care, Erasmus University Rotterdam, Rotterdam, Netherlands
Publisher
BMJ Publishing Group
Abstract
Introduction Vasoplegia is a common complication after cardiac surgery and
is associated with poor prognosis. It is characterised by refractory
hypotension despite normal or even increased cardiac output. The
pathophysiology is complex and includes the systemic inflammatory response
caused by cardiopulmonary bypass (CPB) and surgical trauma. Patients with
end-stage heart failure (HF) are at increased risk for developing
vasoplegia. The CytoSorb adsorber is a relatively new haemoadsorption
device which can remove circulating inflammatory mediators in a
concentration based manner. The CytoSorb-HF trial aims to evaluate the
efficacy of CytoSorb haemoadsorption in limiting the systemic inflammatory
response and preventing postoperative vasoplegia in HF patients undergoing
cardiac surgery with CPB. Methods and analysis This is an
investigator-initiated, single-centre, randomised, controlled clinical
trial. In total 36 HF patients undergoing elective cardiac surgery with an
expected CPB duration of more than 120 min will be randomised to receive
CytoSorb haemoadsorption along with standard surgical treatment or
standard surgical treatment alone. The primary endpoint is the change in
systemic vascular resistance index with phenylephrine challenge after CPB.
Secondary endpoints include inflammatory markers, sublingual
microcirculation parameters and 30-day clinical indices. In addition, we
will assess the cost-effectiveness of using the CytoSorb adsorber.
Vascular reactivity in response to phenylephrine challenge will be
assessed after induction, after CPB and on postoperative day 1. At the
same time points, and before induction and on postoperative day 4 (5 time
points in total), blood samples will be collected and the sublingual
microcirculation will be recorded. Study participants will be followed up
until day 30. Ethics and dissemination The trial protocol was approved by
the Medical Ethical Committee of Leiden The Hague Delft (METC LDD,
registration number P20.039). The results of the trial will be published
in peer-reviewed medical journals and through scientific conferences.
Trial registration number NCT04812717. <br/>Copyright &#xa9;

<16>
Accession Number
2020195479
Title
Systematic review of academic robotic surgery curricula.
Source
Journal of Robotic Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Khan M.T.A.; Patnaik R.; Lee C.S.; Willson C.M.; Demario V.K.; Krell R.W.;
Laverty R.B.
Institution
(Khan, Patnaik) Department of Surgery, UT Health San Antonio, University
of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX
78229-3900, United States
(Lee, Krell, Laverty) Department of Surgery, Brooke Army Medical Center,
San Antonio, TX, United States
(Willson) School of Osteopathic Medicine, Des Moines University, Des
Moines, IA, United States
(Demario) School of Osteopathic Medicine, University of the Incarnate
Word, San Antonio, TX, United States
Publisher
Springer Nature
Abstract
The use of robotic surgery has increased exponentially in the United
States. Despite this uptick in popularity, no standardized training
pathway exists for surgical residents or practicing surgeons trying to
cross-train onto the platform. We set out to perform a systematic review
of existing literature to better describe and analyze existing robotic
surgical training curricula amongst academic surgery programs. A
systematic electronic search of the PubMed, Cochrane, and EBSCO databases
was performed for articles describing simulation in robotic surgery from
January 2010 to May 2022. Medical Subject Heading (MeSH) terms and
keywords used to conduct this search were "Robotic," "Surgery," "Robotic
Surgery," "Training," "Curriculum," "Education," and "Residency Program."
A total of 110 articles were identified for the systematic review. After
screening the titles and abstracts, a total of 36 full-text original
articles were included in this systematic review. Of these, 24 involved
robotic surgery curricula designed to teach general robotic skills,
whereas the remaining 12 were for teaching procedure specific skills. Of
the 24 studies involving general robotic skills, 13 included didactics as
a part of the curriculum, 23 utilized virtual reality trainers, 3 used
inanimate tissue, and 1 used live animal models. Of the 12 papers reviewed
regarding procedure specific curricula, seven involved urologic procedures
(radical prostatectomy and nephrectomy), two involved general surgical
procedures (colectomy and Roux-en-Y gastric bypass surgery), two involved
obstetrics and gynecology procedures (hysterectomy with myomectomy and
sacrocolpopexy, hysterectomy with pelvic lymphadenectomy) and one involved
a cardiothoracic surgery procedure (robotic internal thoracic artery
harvest). With the rapid implementation of robotic surgery, training
programs have been tasked with the responsibility of ensuring their
trainees are adequately proficient in the platform prior to graduation.
However, due to the lack of uniformity between surgical training programs,
when it comes to robotic surgical experience, a strong need persists for a
standardized national robotics training curriculum.<br/>Copyright &#xa9;
2022, The Author(s), under exclusive licence to Springer-Verlag London
Ltd., part of Springer Nature.

<17>
Accession Number
2020155279
Title
Risk Factors for Tube Feeding at Discharge in Infants Undergoing Neonatal
Surgery for Congenital Heart Disease: A Systematic Review.
Source
Pediatric Cardiology. (no pagination), 2022. Date of Publication: 2022.
Author
Elgersma K.M.; Trebilcock A.L.; Whipple M.O.; Tanner L.R.; Pilditch S.J.;
Shah K.M.; McKechnie A.C.
Institution
(Elgersma, Trebilcock, Whipple, Tanner, Pilditch, McKechnie) University of
Minnesota School of Nursing, Minneapolis, MN, United States
(Tanner) Children's Minnesota, Minneapolis, MN, United States
(Shah) Department of Pediatrics, M Health Fairview University of Minnesota
Masonic Children's Hospital, Minneapolis, MN, United States
Publisher
Springer
Abstract
Approximately 30-50% of infants undergoing neonatal surgery for congenital
heart disease (CHD) cannot meet oral feeding goals by discharge and
require feeding tube support at home. Feeding tubes are associated with
increased readmission rates and consequent hospital, payer, and family
costs, and are a burden for family caregivers. Identification of
modifiable risk factors for oral feeding problems could support targeted
care for at-risk infants. Therefore, the aim of this systematic review is
to determine risk factors for tube feeding at discharge in infants
undergoing neonatal surgery for CHD. Following Preferred Reporting Items
for Systematic Reviews and Meta-analyses (PRISMA) guidelines, a search was
conducted using MEDLINE, CINAHL, and Cochrane Database of Systematic
Reviews. Studies published before 2010 were excluded. The search resulted
in 607 records, of which 18 were included. Studies were primarily
retrospective cohort designs and results were often inconsistent. Study
quality was assessed using the Joanna Briggs Critical Appraisal Tools. As
a group, the studies exhibited substantial risk for bias. Based on the
findings, infants who struggle with feeding preoperatively, experience
increased nil per os duration and/or low oral feeding volume
postoperatively, experience increased duration of mechanical ventilation,
or have vocal cord dysfunction may be at risk for tube feeding at hospital
discharge. Factors warranting further examination include cardiac
physiology (e.g., aortic arch obstruction) and the relationship between
neurodevelopment and oral feeding. Clinicians should use caution in
assuming risk for an individual and prioritize early implementation of
interventions that facilitate oral feeding development.<br/>Copyright
&#xa9; 2022, The Author(s), under exclusive licence to Springer
Science+Business Media, LLC, part of Springer Nature.

<18>
Accession Number
639570328
Title
Pearls, pitfalls, and surgical indications of the Intuity TM heart valve:
A rapid deployment bioprosthesis. A systematic review of the literature.
Source
Journal of cardiac surgery. (no pagination), 2022. Date of Publication:
20 Nov 2022.
Author
Dokollari A.; Torregrossa G.; Sicouri S.; Veshti A.; Margaryan R.; Cameli
M.; Mandoli G.E.; Maccherini M.; Montesi G.; Cabrucci F.; Coku L.; Arora
R.; Li Q.R.; Bonacchi M.; Gelsomino S.
Institution
(Dokollari, Torregrossa, Sicouri) Department of Cardiothoracic Surgery
Research, Lankenau Institute for Medical Research, Wynnewood, PA, United
States
(Dokollari, Torregrossa) Department of Cardiothoracic Surgery, Lankenau
Medical Center, Lankenau Heart Institute, Main Line Health, Wynnewood, PA,
United States
(Veshti) Department of Cardiac Surgery, Mother Teresa Hospital, University
of Tirana, Tirana, Albania
(Margaryan) Department of Adult Cardiac Surgery, G. Pasquinucci Heart
Hospital, Massa, Italy
(Cameli, Mandoli, Maccherini, Montesi) Department of Experimental and
Clinical Medicine, Cardiac Surgery Unit, University of Florence, Firenze,
Italy
(Cabrucci, Bonacchi) Department of Cardiac Surgery/Cardiology, University
of Siena, Siena, Italy
(Coku) Department of Cardiac Surgery, Appalachian Regional Health,
University of Kentucky, Hazard, KY, United States
(Arora) Department of Surgery, Section of Cardiac Surgery, Max Rady
College of Medicine, University of Manitoba, Winnipeg, MB, Canada
(Li) 2010 Vision Associates, Toronto, ON, Canada
(Gelsomino) Department of Cardiac Surgery, CARIM Maastricht Medical
University, Maastricht, Netherlands
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To highlight short- and long-term clinical outcomes of the
Intuity TM rapid deployment prosthesis for surgical aortic valve
replacement. <br/>METHOD(S): We reviewed on PubMed/MEDLINE, Embase,
SciELO, LILACS, CCTR/CENTRAL, and Google Scholar for clinical trials,
retrospective clinical studies, meta-analysis, and gray literature.
<br/>RESULT(S): Fourty-five clinical studies with 12.714 patients were
included in the analysis. Thirty-day mortality ranged from 3.8% for
Intuity and 3.9% for transcatheter aortic valve replacement (TAVR). The
incidence of paravalvular leak (PVL) (Intuity 0% and TAVR 2.17%),
permanent pacemaker implantation (Intuity 11.11% and TAVR 12.5%), stroke
(Intuity 2.2% and TAVR 2.6%), myocardial infarction (MI) (Intuity 0% and
TAVR 1%), were all higher in the TAVR group. Compared to other sutured
bioprosthesis (SB), mortality ranged from 0% to 3.9% for Intuity and
0%-6.9% for SB. Long-term cardiac mortality ranged from 0.9% to 1.55% for
Intuity and 1.4%-3.3% for the Perceval valve. The incidence of PVL
(Intuity 0.24%-0.7% and Perceval 0%-1%), endocarditis (Intuity 0.2%-0.7%
and Perceval 1.6%-6.6%), stroke (Intuity 0.36%-1.4% and Perceval 0%-0.8%),
MI (Intuity 0.07%-0.26%), and SVD (Intuity 0.12%-0.7% and Perceval 0%)
were comparable. Compared to standard full sternotomy (SFS), minimally
invasive surgery (MINV) mortality ranged from 0% to 4.3% for MINV and
0%-2.1% for SFS. Hospital costs outcomes ranged from $37,187-$44,368 for
the Intuity, $69,389 for TAVR, and $13,543 for SB. Intuity short-term
mortality ranged between 0.9% and 12.4% while long-term mortality ranged
between 2.6% and 20%. <br/>CONCLUSION(S): This manuscript provides a
360degree overview of the current rapid deployments, sutureless, and TAVR
prosthesis.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<19>
Accession Number
639570163
Title
Postoperative cardiac troponin I as an indicator of surgical outcomes: A
systematic review.
Source
Journal of cardiac surgery. (no pagination), 2022. Date of Publication:
20 Nov 2022.
Author
Ahmed S.H.; Pervez N.; Rehan S.T.; Shaikh T.G.; Waseem S.
Institution
(Ahmed, Pervez, Rehan, Shaikh, Waseem) Dow University of Health Sciences,
Karachi, Pakistan
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Cardiac surgeries are generally associated with high
morbidity and mortality. To prevent any adverse outcomes, it is crucial to
identify patients at risk of developing postoperative complications and
initiate relevant therapeutic interventions. Several biomarkers are used
to determine postoperative myocardial injury but they either lack
sensitivity and specificity or are elevated for a short time. In this
systematic review, we evaluate postoperative troponin I as a predictor of
postoperative myocardial infarction, mortality, and hospital and Intensive
Care Unit stay. <br/>METHOD(S): This systematic review was conducted in
accordance with the Preferred Reporting Items for Systematic Review and
Meta-Analysis guidelines. A thorough literature search was conducted over
PubMed, clinicaltrials. gov, and the Cochrane library from inception till
May 24, 2022 using relevant keywords, and only articles that met the
pre-defined criteria were recruited. <br/>RESULT(S): Following a
comprehensive literature search, a total of 359 articles were obtained.
Following a rigid screening and full-length review, only 13 studies met
our inclusion criteria and were included. The recruited studies evaluated
data from a total of 12,483 individuals and assessed troponin I as a
predictor of at least one outcome. <br/>CONCLUSION(S): Troponin I has the
potential to be used as a stand-alone predictor of surgical outcomes
following coronary artery bypass grafting and valvular surgeries. However,
supplementing it with other markers and scores offers the best chance at
timely diagnosing any complications.<br/>Copyright &#xa9; 2022 Wiley
Periodicals LLC.

<20>
Accession Number
639569526
Title
Effectiveness of intra-operative topical amiodarone for prevention of
postcardiac surgery new-onset atrial fibrillation: A review of current
evidence.
Source
Journal of cardiac surgery. (no pagination), 2022. Date of Publication:
20 Nov 2022.
Author
Chen X.; Sartor C.; Zhang S.; Baranchuk A.; Ross-White A.; Fernandez A.L.;
El-Diasty M.
Institution
(Chen, Sartor) School of Medicine, Queen's University, Kingston, Ontario,
Canada
(Zhang) Department of Biomedical and Molecular Sciences, Queen's
University, Kingston, Ontario, Canada
(Baranchuk) Department of Medicine, Division of Cardiology, Queen's
University, Kingston, Ontario, Canada
(Ross-White) Queen's University Library, Queen's University, Kingston,
Ontario, Canada
(Fernandez) Cardiac Surgery Department, University Hospital, Santiago de
Compostela, Spain
(El-Diasty) Cardiac Surgery Department, Queen's University, Kingston,
Ontario, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: Postoperative atrial fibrillation (POAF) is one of the most
common complications following cardiac surgery and is associated with
increased morbidity. Intraoperative topical amiodarone application on
epicardial tissue has been shown to reduce systemic concentrations while
maintaining therapeutic myocardial concentrations, thereby, lowering the
risk of extracardiac adverse effects associated with oral and intravenous
amiodarone therapy. However, the efficacy and safety of topical amiodarone
in preventing POAF is unclear. <br/>OBJECTIVE(S): This study summarizes
the clinical studies to-date that have investigated the efficacy and
safety of topical amiodarone administration in preventing POAF following
cardiac surgery. <br/>METHOD(S): A database search was conducted using
Medline, Embase, and Cochrane Library to identify relevant studies.
Abstracts were screened and data were extracted from relevant full-text
articles that met the inclusion and exclusion criteria. <br/>RESULT(S):
The search returned four studies with variable findings on the effect of
topical amiodarone therapy on the incidence of POAF, cardiac effects,
extracardiac effects, and hospital length of stay. <br/>CONCLUSION(S):
Prophylactic topical application of amiodarone may be effective and safe
for preventing post-operative new-onset atrial fibrillation. Further
investigation is required to evaluate the efficacy and safety of topical
amiodadrone therapy before it can be widely integrated into current
practice.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<21>
[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.

<22>
Accession Number
2016834672
Title
Five-Year Outcomes of Concomitant Maze Procedure Using Nitrous Oxide vs
Argon-Based Cryoablation.
Source
Annals of Thoracic Surgery. 114(6) (pp 2244-2252), 2022. Date of
Publication: December 2022.
Author
Park I.; Jeong D.S.; Ahn J.H.; Park P.W.
Institution
(Park) Department of Thoracic and Cardiovascular Surgery, Samsung Medical
Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
(Jeong, Ahn) Biostatistics and Clinical Epidemiology Center, Samsung
Medical Center, Sungkyunkwan University School of Medicine, Seoul, South
Korea
(Park) Department of Thoracic and Cardiovascular Surgery, Incheon Sejong
Hospital, Incheon, South Korea
Publisher
Elsevier Inc.
Abstract
Background: Cryoablation is effective for not only ablating the
myocardium, but also maintaining the structure of the ablated tissue.
However, data comparing nitrous oxide (N<inf>2</inf>O)-based and argon
gas-based cryoprobes are limited. <br/>Method(s): This study was a
follow-up study of a single-center, prospective, randomized controlled
trial in which 60 patients were randomly allocated to either the
N<inf>2</inf>O group or the argon group. The primary endpoint of this
study was sinus rhythm maintenance, and the key secondary endpoint was a
composite of major adverse cardiovascular and cerebrovascular events
(MACCEs) (ie, cardiac death, stroke, major bleeding, and readmission for
heart failure). <br/>Result(s): The baseline and operative characteristics
of the patients in the N<inf>2</inf>O and argon groups were comparable. At
the 5-year follow-up, the rate of sinus rhythm maintenance was 81.8% in
the N<inf>2</inf>O group, whereas it was 78.5% in the argon group (P >
.999). No significant differences in the rate of freedom from MACCEs
(80.6% in the N<inf>2</inf>O group vs 81.9% in the argon group; P = .978)
were observed at the 5-year follow-up. The left atrial volume index
decreased over time from 114.65 mL/m² to 65.74 mL/m²
(P < .0001) and reached similar values in the 2 groups (P = .279) at the
5-year follow-up. <br/>Conclusion(s): Both N<inf>2</inf>O- and argon
gas-based cryoprobes showed similar rates of sinus rhythm maintenance and
freedom from MACCEs at the 5-year follow-up. Both cryoprobes might have
similar efficacy and safety in the arrested heart in the long
term.<br/>Copyright &#xa9; 2022 The Society of Thoracic Surgeons

<23>
Accession Number
2011532678
Title
Ultrasound guidance for internal jugular vein cannulation in neonates:
Modified dynamic needle tip positioning short-axis out-of-plane technique
versus long-axis in-plane technique, a randomized controlled trial.
Source
Journal of Vascular Access. 23(6) (pp 922-929), 2022. Date of Publication:
November 2022.
Author
Tan Y.; Tu Z.; Ye P.; Xu Y.; Ye M.; Bai L.; Liu L.
Institution
(Tan, Tu, Ye, Xu, Ye, Bai, Liu) Department of Anesthesiology, Children's
Hospital of Chongqing Medical University, Chongqing, China
(Tan, Liu) National Clinical Research Center for Child Health and
Disorders, Chongqing, China
(Tu) Ministry of Education Key Laboratory of Child Development and
Disorders, Chongqing, China
(Ye) China International Science and Technology Cooperation Base of Child
Development and Critical Disorders, China
(Bai) Chongqing Key Laboratory of Pediatrics, Chongqing, China
Publisher
SAGE Publications Ltd
Abstract
Background: Ultrasound-guided central venous catheter placement has
significantly improved the success rate of punctures and reduced the risk
of complications. However, catheterizing the internal jugular vein under
ultrasound guidance in neonates remains challenging. <br/>Method(s):
Ninety-six patients were screened for eligibility in this randomized
controlled trial between November 2018 and October 2019. After meeting the
inclusion criteria, 90 term neonates undergoing cardiothoracic, general,
or neurosurgery procedures were randomly assigned to the modified dynamic
needle tip positioning short-axis (n = 45) or long-axis groups (n = 45)
using a computer-generated random numbers table. The primary outcome was
the first-attempt success rate. The secondary outcomes included the total
success rate, cannulation time, and incidence of cannulation-related
complications, including hematoma, accidental arterial puncture, or
pneumothorax. Data were compared between the two groups. <br/>Result(s):
The success rate for the first attempt was higher (88.9% vs 64.4%; p =
0.001; relative risk, 1.4; 95% confidence interval, 1.1-1.8), while the
cannulation time was shorter (171.0 +/- 47.8 s vs 304.4 +/- 113.5 s; p =
0.001; estimated difference, -133.4; 95% confidence interval, -170.1 to
-96.7), in the modified dynamic needle tip positioning short-axis group
compared with the long-axis group. Six hematomas and two common carotid
artery punctures were identified in the long-axis group, while none were
identified in the modified dynamic needle tip positioning short-axis
group. <br/>Conclusion(s): The modified dynamic needle tip positioning
short-axis out-of-plane technique enhanced the procedural efficacy and
safety of internal jugular vein catheterization in neonates.<br/>Copyright
&#xa9; The Author(s) 2021.

<24>
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

<25>
Accession Number
2019702988
Title
The effect of topical airway anesthesia on hemodynamic profiles during the
induction period in patients undergoing cardiac surgery: Study protocol
for a randomized controlled trial.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 992534. Date of Publication: 10 Oct 2022.
Author
Du W.; Lv M.; Chen T.; Sun X.; Wang J.; Zhang H.; Wei C.; Liu Y.; Qiao C.;
Wang Y.
Institution
(Du, Chen, Sun) Shandong First Medical University, Taian, China
(Lv, Wang, Zhang, Wei, Liu, Qiao, Wang) Department of Anesthesiology and
Perioperative Medicine, The First Affiliated Hospital of Shandong First
Medical University, Jinan, China
Publisher
Frontiers Media S.A.
Abstract
Background: Patients scheduled for cardiac surgery are often accompanied
by cardiac dysfunction and hemodynamic instability. However, the
conventional induction strategy for anesthesia using high-dose intravenous
anesthetics is often associated with persistent and recurrent hypotension
after tracheal intubation. The purpose of this study is to investigate the
effects of topical airway anesthesia on the hemodynamic profile of
patients undergoing cardiac surgery during the induction period.
<br/>Method(s): This is a superiority, single-blind, randomized controlled
study with two parallel groups. Participants scheduled to undergo elective
cardiac surgery will be allocated into two blocks according to the New
York Heart Association (NYHA) classification and then randomly assigned to
the following two groups at a 1:1 ratio: the conventional induction group
and the combined topical airway anesthesia induction group. The combined
topical airway anesthesia induction strategy includes aerosol inhalation
airway anesthesia, subglottic airway anesthesia, and general anesthesia
induction using low-dose intravenous anesthetics. The primary outcome is
the area under the curve (AUC) of blood pressure below baseline mean
arterial pressure (MAP) from 3 to 15 min after endotracheal intubation.
Secondary outcomes include the AUC above baseline MAP and below baseline
MAP at other time points, the highest and lowest arterial blood pressure
values during the induction period, type and dose of vasoactive drugs,
incidence of arrhythmias, cardiac function, and the incidence of
postoperative hoarseness and sore throat. <br/>Discussion(s): The study
will explore whether aerosol inhalation airway anesthesia and subglottic
airway anesthesia could reduce the incidence and duration of hypotension
during the induction period in patients undergoing cardiac surgery.
Clinical Trial Registration: This trial was registered on
www.ClinicalTrials.gov (NCT05323786).<br/>Copyright &#xa9; 2022 Du, Lv,
Chen, Sun, Wang, Zhang, Wei, Liu, Qiao and Wang.

<26>
Accession Number
2015979833
Title
Clinical and Cardiovascular Characteristics of Patients Suffering
ST-Segment Elevation Myocardial Infarction After Covid-19: A Systematic
Review and Meta-Analysis.
Source
Current Problems in Cardiology. 48(1) (no pagination), 2023. Article
Number: 101045. Date of Publication: January 2023.
Author
Gharibzadeh A.; Shahsanaei F.; Rahimi Petrudi N.
Institution
(Gharibzadeh) Assistant Professor of Cardiology, Cardiovascular Research
Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran,
Islamic Republic of
(Shahsanaei) Interventional Cardiologist, Hypertension Research center,
Cardiovascular Research Institute, Isfahan University Of Medical Sciences,
Isfahan, Iran, Islamic Republic of
(Rahimi Petrudi) Resident Of Cardiology, Cardiovascular Research Center,
Hormozgan University of Medical Sciences, Bandar Abbas, Iran, Islamic
Republic of
Publisher
Elsevier Inc.
Abstract
ST-segment elevation myocardial infarction (STEMI) is one of the fatal
complications following Covid-19. We aimed to systematically assess the
clinical sequels as well as cardiovascular findings in patients suffering
STEMI following Covid-19.The manuscripts databases including PubMed, Web
of knowledge (ISI), SCOPUS, Embase, and Google Scholar were deeply
searched by the two reviewers using the relevant keywords related to the
issue considered in the current review. Of 88 studies initially reviewed,
9 articles were included in final assessment. Nine articles including 447
patients with Covid-19 were included in the study. In terms of
electrocardiographic findings, anterior lead involvement was reported in
12% - 61.6% of cases, inferior lead in 28.2% - 75% and lateral involvement
in 7.7% - 100% of cases. The prevalence of LBBB was in the range of 10.7%
- 61.6% of cases. In terms of echocardiographic findings, a decrease in
left ventricular ejection fraction was reported in 60% - 88% of patients.
Wall motion abnormality was also observed in 60% - 82.1% of patients. In
terms of angiographic findings, the multi-vessel disease was reported in
17.9% - 69% of cases. Also, 24% - 83% of cases needed to revascularization
procedures. Cardiac arrest was also reported in 3.1% - 28.2% of cases.
Based on the meta-analysis performed on the mortality of patients with
STEMI in the field of Covid-19, the pooled prevalence of mortality was
estimated at 25.2% (95%CI:17.5%-34.8%). Mortality and adverse consequences
of STEMI in patients with Covid-19 are far higher than in the general
population. Therefore, in-hospital cardiovascular tracking and monitoring
of Covid-19 patients with potential cardiovascular disorders is necessary
to achieve a more favorable outcome.<br/>Copyright &#xa9; 2021 Elsevier
Inc.

<27>
Accession Number
2014436138
Title
Non-Governmental Organizations Delivering Global Cardiac Surgical Care: A
Quantitative Impact Assessment.
Source
Seminars in Thoracic and Cardiovascular Surgery. 34(4) (pp 1160-1165),
2022. Date of Publication: Winter 2022.
Author
Vervoort D.; Guetter C.R.; Munyaneza F.; Trager L.E.; Argaw S.T.; Abraham
P.J.; Dayan V.
Institution
(Vervoort, Guetter) Department of Health Policy and Management, Johns
Hopkins Bloomberg School of Public Health, Baltimore, Maryland
(Munyaneza) College of Medicine and Health Sciences, University of Rwanda,
Kigali, Rwanda
(Trager) School of Medicine, University of Minnesota, Minneapolis, MN,
United States
(Argaw) Feinberg School of Medicine, Northwestern University, Chicago,
Illinois, United States
(Abraham) Department of Surgery, University of Alabama at Birmingham,
Birmingham, Alabama
(Dayan) Centro Cardiovascular Universitario, Hospital de Clinicas,
Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay
Publisher
W.B. Saunders
Abstract
In low- and middle-income countries (LMICs), 93% of the population lacks
safe, timely, and affordable access to cardiac surgical care when needed.
As countries slowly build or expand local, independent cardiac centers,
non-governmental organizations (NGOs) partially bridge the gap in cardiac
surgical care delivery in LMICs. However, little is known about the
current scope of cardiac NGOs. Here, we perform an analysis of active NGOs
involved with the delivery of cardiac surgical services in LMICs or for
patients from LMICs. Cardiac surgery NGOs were identified from medical
literature, established NGO databases, and Google Scholar searches. The
search was performed between December 2019 and May 2020. NGOs whose
websites were not updated or described missions or projects taking place
no later than 2015 were considered inactive. Eighty-six NGOs are actively
providing cardiac surgery services in LMICs or treating patients from
LMICs. Five NGOs performed adult cardiac surgery only, 56 performed
pediatric cardiac surgery only, and 25 performed both adult and pediatric
cardiac surgery. NGOs originated from 23 different countries and were
operational in a total of 111 countries, 96 of them being LMICs.
Fifty-three NGOs reported data on annual surgical volume, of which half
performed less than 50 operations per year. NGOs effectively address the
burden of cardiac surgical disease in LMICs and contribute to local
capacity-building. Increased, more detailed, and standardized reporting of
the impact and outcomes of NGOs is necessary to better understand annual
cardiac surgical volume and to support local centers working towards
independent services.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<28>
Accession Number
2020135218
Title
Effect of personalized perioperative blood pressure management on
postoperative complications and mortality in high-risk patients having
major abdominal surgery: protocol for a multicenter randomized trial
(IMPROVE-multi).
Source
Trials. 23(1) (no pagination), 2022. Article Number: 946. Date of
Publication: December 2022.
Author
Bergholz A.; Meidert A.S.; Flick M.; Krause L.; Vettorazzi E.; Zapf A.;
Brunkhorst F.M.; Meybohm P.; Zacharowski K.; Zarbock A.; Sessler D.I.;
Kouz K.; Saugel B.
Institution
(Bergholz, Flick, Kouz, Saugel) Department of Anesthesiology, Center of
Anesthesiology and Intensive Care Medicine, University Medical Center
Hamburg-Eppendorf, Martinistrasse 52, Hamburg 20246, Germany
(Meidert) Department of Anaesthesiology, University Hospital LMU Munich,
Munich, Germany
(Krause, Vettorazzi, Zapf) Institute of Medical Biometry and Epidemiology,
University Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Brunkhorst) Center for Clinical Studies, Jena University Hospital, Jena,
Germany
(Brunkhorst) Center for Sepsis Control and Care, Jena University Hospital,
Jena, Germany
(Meybohm) Department of Anesthesiology, Intensive Care, Emergency and Pain
Medicine, University Hospital Wurzburg, Wurzburg, Germany
(Zacharowski) Department of Anaesthesiology, Intensive Care Medicine and
Pain Therapy, University Hospital Frankfurt, Goethe University, Frankfurt,
Germany
(Zarbock) Department of Anesthesiology, Intensive Care, and Pain Medicine,
University Hospital Munster, Munster, Germany
(Sessler) Department of Outcomes Research, Anesthesiology Institute,
Cleveland Clinic, Cleveland, OH, United States
(Sessler, Saugel) Outcomes Research Consortium, Cleveland, OH, United
States
Publisher
BioMed Central Ltd
Abstract
Background: Intraoperative hypotension is common in patients having
non-cardiac surgery and is associated with serious complications and
death. However, optimal intraoperative blood pressures for individual
patients remain unknown. We therefore aim to test the hypothesis that
personalized perioperative blood pressure management-based on preoperative
automated blood pressure monitoring-reduces the incidence of a composite
outcome of acute kidney injury, acute myocardial injury, non-fatal cardiac
arrest, and death within 7 days after surgery compared to routine blood
pressure management in high-risk patients having major abdominal surgery.
<br/>Method(s): IMPROVE-multi is a multicenter randomized trial in 1272
high-risk patients having elective major abdominal surgery that we plan to
conduct at 16 German university medical centers. Preoperative automated
blood pressure monitoring using upper arm cuff oscillometry will be
performed in all patients for one night to obtain the mean of the
nighttime mean arterial pressures. Patients will then be randomized either
to personalized blood pressure management or to routine blood pressure
management. In patients assigned to personalized management,
intraoperative mean arterial pressure will be maintained at least at the
mean of the nighttime mean arterial pressures. In patients assigned to
routine management, intraoperative blood pressure will be managed per
routine. The primary outcome will be a composite of acute kidney injury,
acute myocardial injury, non-fatal cardiac arrest, and death within 7 days
after surgery. <br/>Discussion(s): Our trial will determine whether
personalized perioperative blood pressure management reduces the incidence
of major postoperative complications and death within 7 days after surgery
compared to routine blood pressure management in high-risk patients having
major abdominal surgery. Trial registration: ClinicalTrials.gov
NCT05416944. Registered on June 14, 2022.<br/>Copyright &#xa9; 2022, The
Author(s).

<29>
Accession Number
2020132798
Title
Differences in long-term survival outcomes after coronary artery bypass
grafting using single vs multiple arterial grafts: a meta-analysis with
reconstructed time-to-event data and subgroup analyses.
Source
General Thoracic and Cardiovascular Surgery. (no pagination), 2022. Date
of Publication: 2022.
Author
Magouliotis D.E.; Fergadi M.P.; Zotos P.-A.; Rad A.A.; Xanthopoulos A.;
Bareka M.; Spiliopoulos K.; Athanasiou T.
Institution
(Magouliotis, Zotos, Spiliopoulos) Department of Cardiothoracic Surgery,
University of Thessaly, Biopolis, Larissa 41110, Greece
(Fergadi) Department of Radiology, University of Thessaly, Larissa, Greece
(Rad, Athanasiou) Department of Surgery and Cancer, Imperial College
London, London, United Kingdom
(Xanthopoulos) Department of Cardiology, University of Thessaly, Larissa,
Greece
(Bareka) Department of Anesthesiology, University of Thessaly, Larissa,
Greece
Publisher
Springer
Abstract
Objective: We reviewed the available literature on patients with coronary
artery disease undergoing isolated coronary artery bypass grafting (CABG)
with either single (SAG) or multiple arterial grafting (MAG).
<br/>Method(s): Original research studies that evaluated the long-term
survival of MAG versus SAG were identified, from 1995 to 2022. The median
overall survival (OS) and event-free OS were the primary endpoints.
Comparison of median OS between the right internal mammary artery (RIMA)
and radial artery (RA) as a second arterial conduit was the secondary
endpoint. Subgroup analyses were performed regarding patients older than
70 years, with diabetes mellitus, and females. A sensitivity analysis was
performed with the leave-one-out method. <br/>Result(s): Forty-four
studies were included in the qualitative and thirty-nine in the
quantitative synthesis. After pooling data from 180 to 459 patients, the
MAG group demonstrated a higher OS (HR, 0.589; 95% CI, 0.58-0.60; p <
0.0001) and event-free OS compared with the SAG group (HR, 0.828; 95% CI,
0.80-0.86; p < 0.0001). In addition, RITA was associated with superior OS
compared with RA as a second arterial conduit (HR, 0.936; 95% CI,
0.89-0.98; p = 0.009). MAG was also superior to SAG in patients over 70
years, females, and patients with diabetes mellitus. Sensitivity analysis
demonstrated a small-size study effect on the female subgroup analysis.
<br/>Conclusion(s): The present meta-analysis indicates that MAG is
associated with enhanced survival outcomes compared to SAG for patients
undergoing isolated CABG.<br/>Copyright &#xa9; 2022, The Author(s).

<30>
Accession Number
636952740
Title
Bilateral internal thoracic artery coronary grafting: risks and benefits
in elderly patients.
Source
European heart journal. Quality of care & clinical outcomes. 8(8) (pp
861-870), 2022. Date of Publication: 17 Nov 2022.
Author
Zhou Z.; Fu G.; Huang S.; Chen S.; Liang M.; Wu Z.
Institution
(Zhou, Fu, Huang, Chen, Liang, Wu) Department of Cardiac Surgery, First
Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan II Road,
Guangzhou 510080, China
(Zhou, Fu, Huang, Chen, Liang, Wu) NHC Key Laboratory of Assisted
Circulation, Sun Yat-sen University, Guangzhou 510080, China
Publisher
NLM (Medline)
Abstract
AIMS: Whether bilateral internal thoracic artery (BITA) grafting benefits
elderly patients in coronary artery bypass grafting (CABG) remains unclear
since they tend to have a limited life expectancy and severe
comorbidities. We aim to evaluate the outcomes of BITA vs. single internal
thoracic artery (SITA) grafting in elderly patients. METHODS AND RESULTS:
A meta-analysis was performed by database searching until May 2021.
Studies comparing BITA and SITA grafting among elderly patients were
included. One randomized controlled trial, nine propensity score matching,
and six unmatched studies were identified, with a total of 18 146 patients
(7422 received BITA grafting and 10 724 received SITA grafting). Compared
with SITA grafting, BITA grafting had a higher risk of deep sternal wound
infection (DSWI) [odds ratio: 1.67; 95% confidence interval (CI):
1.22-2.28], and this risk could not be significantly reduced by the
skeletonization technique. Meanwhile, BITA grafting was associated with a
higher long-term survival [hazard ratio: 0.83; 95% CI: 0.77-0.90], except
for the octogenarian subgroup. Reconstructed Kaplan-Meier survival curves
revealed 4-year, 8-year, and 12-year overall survival rates of 85.5%,
66.7%, and 45.3%, respectively, in the BITA group and 79.3%, 58.6%, and
34.9%, respectively, in the SITA group. No significant difference was
observed in early mortality, perioperative myocardial infarction,
perioperative cerebral vascular accidents, or re-exploration for bleeding.
<br/>CONCLUSION(S): Compared with SITA grafting, BITA grafting could
provide a long-term survival benefit for elderly patients, although this
benefit remained uncertain in octogenarians. Meanwhile, elderly patients
who received BITA were associated with a higher risk of DSWI and such a
risk could not be eliminated by the skeletonization
technique.<br/>Copyright &#xa9; The Author(s) 2021. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<31>
Accession Number
636857252
Title
Multicentric randomized evaluation of a tricuspid valve percutaneous
repair system (clip for the tricuspid valve) in the treatment of severe
secondary tricuspid regurgitation Tri.Fr Design paper.
Source
European heart journal. Cardiovascular Imaging. 23(12) (pp 1617-1627),
2022. Date of Publication: 17 Nov 2022.
Author
Donal E.; Leurent G.; Ganivet A.; Lurz P.; Coisne A.; De Groote P.;
Lafitte S.; Leroux L.; Karam N.; Biere L.; Rouleau F.; Sportouch C.;
Dreyfus J.; Nejjari M.; Josselin J.-M.; Anselmi A.; Galli E.; Bajeux E.;
Guerin P.; Obadia J.-F.; Trochu J.-N.; Oger E.
Institution
(Donal, Leurent, Anselmi, Galli) Univ Rennes, CHU Rennes, Inserm, Rennes
1099, France
(Ganivet) Direction for Research and Innovation, CHU Rennes, Rennes,
France
(Lurz) Heart Center at University of Leipzig, Leipzig, Germany
(Coisne, De Groote) Department of Clinical Physiology and
Echocardiography, Univ Lille, CHU Lille, France
(Lafitte, Leroux) CHU Bordeaux, University of Bordeaux, Bordeaux, France
(Karam) University of Paris, Medico-Surgical Heart Valve Unit, European
Hospital Georges-Pompidou, INSERM, Paris U970, France
(Biere, Rouleau) Angers University, CHU Angers, CNRS UMR6015, INSERM U,
Angers 1083, France
(Sportouch) Clinique du Millenaire, Montpellier, France
(Dreyfus, Nejjari) Centre Cardiologique du Nord, Saint Denis, France
(Josselin, Bajeux) IRSET, University Rennes, CHU Rennes, Rennes, France
(Guerin, Trochu) Institut du Thorax, CHU Nantes, University Nantes,
Nantes, France
(Obadia) Department of Cardiac Surgery, Cardiologic CHU Lyon, University
Lyon, Lyon, France
(Oger) CHU Rennes, University Rennes, Rennes, France
Publisher
NLM (Medline)
Abstract
AIMS: Tricuspid regurgitation (TR) is associated with significant
morbidity and mortality. Its independent prognostic role has been
repeatedly demonstrated. However, this valvular heart condition is largely
undertreated because of the increased risk of surgical repair. Recently,
transcatheter techniques for the treatment of TR have emerged, but their
implications for the clinical endpoints are still unknown. METHODS AND
RESULTS: The Tri.fr trial will be a multicentre, controlled, randomized
(1:1 ratio), superior, open-label, and parallel-group study conducted in
300 patients with severe secondary TR that is considered non-surgical by
heart teams. Inclusion will be possible only after core laboratory review
of transthoracic and transoesophageal echocardiography and after
validation by the clinical eligibility committee. A description of the
mechanisms of the TR will be conducted by the core laboratory. Atrial or
ventricular impacts on the severity of the secondary TR will be taken into
account for the randomization. The patients will be followed for 12-month,
and the primary outcome will be the Packer composite clinical endpoint
[combining New York Heart Association class, patient global assessment
(PGA), and major cardiovascular events]. It will test the hypothesis that
a tricuspid valve percutaneous repair strategy using a clip dedicated to
the tricuspid valve is superior to best guideline-directed medical therapy
in symptomatic patients with severe secondary TR. <br/>CONCLUSION(S):
Tri.fr will be the first randomized, academic, multicentre study testing
the value of percutaneous correction in patients with severe secondary
TR.<br/>Copyright Published on behalf of the European Society of
Cardiology. All rights reserved. &#xa9; The Author(s) 2021. For
permissions, please email: journals.permissions@oup.com.

<32>
Accession Number
2015913481
Title
Comparison of Preoperative Surgical Risk Estimated by Thoracic Surgeons vs
a Standardized Surgical Risk Prediction Tool.
Source
Seminars in Thoracic and Cardiovascular Surgery. 34(4) (pp 1378-1385),
2022. Date of Publication: Winter 2022.
Author
Dyas A.R.; Colborn K.L.; Bronsert M.R.; Henderson W.G.; Mason N.J.;
Rozeboom P.D.; Pradhan N.; Lambert-Kerzner A.; Meguid R.A.
Institution
(Dyas, Colborn, Bronsert, Henderson, Mason, Rozeboom, Pradhan,
Lambert-Kerzner, Meguid) Surgical Outcomes and Applied Research Program,
Department of Surgery, University of Colorado School of Medicine, Aurora,
Colorado
(Bronsert, Henderson, Lambert-Kerzner, Meguid) Adult and Child Center for
Health Outcomes Research and Delivery Science, University of Colorado
School of Medicine, Aurora, Colorado
(Colborn, Henderson) Department of Biostatistics and Informatics, Colorado
School of Public Health, Aurora, Colorado
Publisher
W.B. Saunders
Abstract
Considerable variability exists between surgeons' assessments of a
patient's individual preoperative surgical risk. Surgical risk calculators
are not routinely used despite their validation. We sought to compare
thoracic surgeons' prediction of patients' risk of postoperative adverse
outcomes vs a surgical risk calculator, the Surgical Risk Preoperative
Assessment System (SURPAS). We developed vignettes from 30 randomly
selected patients who underwent thoracic surgery in the American College
of Surgeons' National Surgical Quality Improvement Program database.
Twelve thoracic surgeons estimated patients' preoperative risks of
postoperative morbidity and mortality. These were compared to SURPAS
estimates of the same vignettes. C-indices and Brier scores were
calculated for the surgeons' and SURPAS estimates. Agreement between
surgeon estimates was examined using intraclass correlation coefficients
(ICCs). Surgeons estimated higher morbidity risk compared to SURPAS for
low-risk patients (ASA classes 1-2, 11.5% vs 5.1%, P <= 0.001) and lower
morbidity risk compared to SURPAS for high-risk patients (ASA class 5,
37.6% vs 69.8%, P < 0.001). This trend also occurred in high-risk patients
for mortality (ASA 5, 11.1% vs 44.3%, P < 0.001). C-indices for SURPAS vs
surgeons were 0.84 vs 0.76 (P = 0.3) for morbidity and 0.98 vs 0.85 (P =
0.001) for mortality. Brier scores for SURPAS vs surgeons were 0.1579 vs
0.1986 for morbidity (P = 0.03) and 0.0409 vs 0.0543 for mortality (P =
0.006). ICCs showed that surgeons had moderate risk agreement for
morbidity (ICC = 0.654) and mortality (ICC = 0.507). Thoracic surgeons and
patients could benefit from using a surgical risk calculator to better
estimate patients' surgical risks during the informed consent
process.<br/>Copyright &#xa9; 2021 Elsevier Inc.

<33>
Accession Number
2015371040
Title
Surgeon Strength: Ergonomics and Strength Training in Cardiothoracic
Surgery.
Source
Seminars in Thoracic and Cardiovascular Surgery. 34(4) (pp 1220-1229),
2022. Date of Publication: Winter 2022.
Author
Dairywala M.I.; Gupta S.; Salna M.; Nguyen T.C.
Institution
(Dairywala) Department of Cardiothoracic and Vascular Surgery, University
of Texas Health Science Center Houston, McGovern Medical School, Houston,
Texas, United States
(Gupta) Division of Cardiac Surgery, Department of Surgery, McMaster
University, Hamilton, ON, Canada
(Salna) Division of Cardiac, Thoracic, and Vascular Surgery, Department of
Surgery, Columbia University Irving Medical Center, New York, New York,
United States
(Nguyen) Division of Adult Cardiothoracic Surgery, Department of Surgery,
UCSF Health, San Francisco, California
Publisher
W.B. Saunders
Abstract
With the high prevalence of musculoskeletal pain in surgeons and
interventionalists, it is critical to analyze the impact of ergonomics on
cardiothoracic surgeon health. Here, we review the existing literature and
propose recommendations to improve physical preparedness for surgery both
in and outside the operating room. For decades, cardiothoracic surgeons
have suffered from musculoskeletal pain, most commonly in the neck, and
back due to a lack of proper ergonomics during surgery. A lack of
dedicated ergonomics curriculum during training may leave surgeons at a
high predisposition for work-related musculoskeletal disorders. We
searched PubMed, Google Scholar, and other sources for studies relevant to
surgical ergonomics and prevalence of musculoskeletal disease among
surgeons and interventionalists. Whenever possible, data from quantitative
studies, and meta-analyses are presented. We also contacted experts and
propose an exercise routine to improve physical preparedness for demands
of surgery. To date, many studies have reported astonishingly high rates
of work-related pain in surgeons with rates as high as 87% in
minimally-invasive surgeons. Several optimizations regarding correct table
height, monitor positioning, and loupe angles have been discussed. Lastly,
implementation of ergonomics training at some programs have been effective
at reducing the rates of musculoskeletal pain among surgeons. Surgical
work-related stress injuries are more common than we think. Many factors
including smaller incisions and technological advancements have led to
this plight. Ultimately, work-related injuries are underreported and
understudied and the field of surgical ergonomics remains open for
investigative study.<br/>Copyright &#xa9; 2021

<34>
Accession Number
2021198798
Title
Stroke prevention of thoracoscopic left atrial appendage clipping in
patients with non-valvular atrial fibrillation at high risk of stroke and
bleeding: Study protocol for a non-randomised controlled clinical trial.
Source
BMJ Open. 12(10) (no pagination), 2022. Article Number: e063931. Date of
Publication: 28 Oct 2022.
Author
Ye C.; Han X.; Chen Y.; Liu F.; Ma H.; Yang Y.; Liu Y.; Hu Q.; Yao Q.; Xie
W.; Xu D.
Institution
(Ye) Department of Cardiac Surgery, Capital Medical University, Beijing,
China
(Ye, Han, Chen, Liu, Ma, Yang, Liu, Hu, Yao, Xie, Xu) Department of
Cardiac Surgery, Beijing Tiantan Hospital, Beijing, China
Publisher
BMJ Publishing Group
Abstract
Introduction Non-valvular atrial fibrillation (NVAF) is a high-risk factor
for ischaemic stroke. The 2016 European Society of Cardiology Atrial
Fibrillation Management guidelines recommend oral anticoagulants (OACs) to
prevent stroke in men with CHA 2 DS 2 -VASc scores >=2 and women >=3.
However, in patients with a high risk of stroke and a high risk of
bleeding (HAS-BLED (Hypertension, Abnormal renal/liver function, Stroke,
Bleeding history or predisposition, Labile international normalized ratio,
Elderly (> 65 years), Drugs/alcohol concomitantly) score>=3), OAC had a
higher risk of bleeding. Left atrial appendage closure (LAAC) is
non-inferior to OAC as a means of preventing stroke in several studies. As
a minimally invasive intervention to prevent stroke, transthoracic LAAC
(TS-LAAC) has a high successful closure rate, but there is a lack of
literature reports directly comparing it with OAC. Our research compares
TS-LAAC with novel oral anticoagulants (NOACs) and provides an appropriate
programme for stroke prevention in a specific population. Methods and
analysis This is a non-randomised controlled trial study protocol, and we
will conduct this study from April 2022 to April 2025. The study included
186 patients with confirmed NVAF, 93 of whom completed thoracoscopic LAAC,
and the control group treated with NOACs. The primary outcome was the
incidence of stroke and systemic embolism, as well as the composite
endpoint events (stroke, systemic embolism, myocardial infarction,
bleeding, cardiovascular death, etc). Secondary outcomes were ischaemic
stroke, haemorrhagic stroke, any bleeding events, death from
cardiovascular causes, death from all causes, residual root rate in the
surgery group, device-related thrombosis in the surgery group, changes in
blood pressure, cardiac chamber size changes, etc. Each subject completed
at least 1 year of follow-up. Ethics and dissemination The study has been
approved by the Medical Ethics Committee of Beijing Tiantan Hospital,
Capital Medical University, China (approval number: KY2022-013-02). The
results from this study will be disseminated through manuscript
publications and national/international conferences. Trial registration
number ChiCTR2200058109.<br/>Copyright &#xa9; Author(s) (or their
employer(s)) 2022.

<35>
Accession Number
2021157354
Title
Low Anti-Factor Xa Level Predicts 90-Day Symptomatic Venous
Thromboembolism in Surgical Patients Receiving Enoxaparin Prophylaxis: A
Pooled Analysis of Eight Clinical Trials.
Source
Annals of Surgery. 276(6) (pp E682-E690), 2022. Date of Publication: 01
Dec 2022.
Author
Pannucci C.J.; Fleming K.I.; Varghese T.K.; Stringham J.; Huang L.C.;
Pickron T.B.; Prazak A.M.; Bertolaccini C.; Momeni A.
Institution
(Pannucci) Plastic Surgery Northwest, Spokane, WA, United States
(Fleming) Division of Plastic Surgery, University of Utah, Salt Lake City,
UT, United States
(Varghese, Stringham) Division of Cardiothoracic Surgery, University of
Utah, Salt Lake City, UT, United States
(Huang, Pickron) Division of General Surgery, University of Utah, Salt
Lake City, UT, United States
(Prazak, Bertolaccini) Department of Pharmacy, University of Utah, Salt
Lake City, UT, United States
(Momeni) Division of Plastic Surgery, Stanford University, Palo Alto, CA,
United States
Publisher
Wolters Kluwer Health
Abstract
Objective: To examine the relationship between enoxaparin dose adequacy,
quantified with anti-Factor Xa (aFXa) levels, and 90-day symptomatic
venous thromboembolism (VTE) and postoperative bleeding. Summary
Background Data: Surgical patients often develop "breakthrough" VTE
eventsathose which occur despite receiving chemical anticoagulation. We
hypothesize that surgical patients with low aFXa levels will be more
likely to develop 90-day VTE, and those with high aFXa will be more likely
to bleed. <br/>Method(s): Pooled analysis of eight clinical trials (N =
985) from a single institution over a 4 year period. Patients had peak
steady state aFXa levels in response to a known initial enoxaparin dose,
and were followed for 90 days. Survival analysis log-rank test examined
associations between aFXa level category and 90-day symptomatic VTE and
bleeding. <br/>Result(s): Among 985 patients, 2.3% (n = 23) had
symptomatic 90-day VTE, 4.2% (n = 41) had 90-day clinically relevant
bleeding, and 2.1% (n = 21) had major bleeding. Patients with initial low
aFXa were significantly more likely to have 90-day VTE than patients with
adequate or high aFXa (4.2% vs 1.3%, P = 0.007). In a stratified analysis,
this relationship was significant for patients who received twice daily
(6.2% vs 1.5%, P = 0.003), but not once daily (3.0% vs 0.7%, P = 0.10)
enoxaparin. No association was seen between high aFXa and 90-day
clinically relevant bleeding (4.8% vs 2.9%, P = 0.34) or major bleeding
(3.6% vs 1.6%, P = 0.18). <br/>Conclusion(s): This manuscript establishes
inadequate enoxaparin dosing as a plausible mechanism for breakthrough VTE
in surgical patients, and identifies anticoagulant dose adequacy as a
novel target for process improvement measures.<br/>Copyright &#xa9; 2022
Lippincott Williams and Wilkins. All rights reserved.

<36>
Accession Number
2021269763
Title
Development and internal validation of a prediction model for acute kidney
injury following cardiac valve replacement surgery.
Source
International Journal of Cardiology. (no pagination), 2022. Date of
Publication: 2022.
Author
Pan L.; Deng Y.; Dai S.; Feng X.; Feng L.; Yang Z.; Liao Y.; Zheng B.
Institution
(Pan, Deng, Dai, Feng, Yang, Liao) Department of Nephrology, The First
Affiliated Hospital of Guangxi Medical University, China
(Feng, Zheng) Department of Cardiac surgery, The First Affiliated Hospital
of Guangxi Medical University, China
Publisher
Elsevier Ireland Ltd
Abstract
Background: Acute kidney injury (AKI) is a common complication after
cardiac surgery. This study aims to develop and validate a risk model for
predicting AKI after cardiac valve replacement surgery. <br/>Method(s):
Data from patients undergoing surgical valve replacement between January
2015 and December 2018 in our hospital were retrospectively analyzed. The
subjects were randomly divided into a derivation cohort and a validation
cohort at a ratio of 7:3. The primary outcome was defined as AKI within 7
days after surgery. Logistic regression analysis was conducted to select
risk predictors for developing the prediction model. Receiver operator
characteristic curve (ROC), calibration plot and clinical decision curve
analysis (DCA) will be used to evaluate the discrimination, precision and
clinical benefit of the prediction model. <br/>Result(s): A total of 1159
patients were involved in this study. The prevalence of AKI following
surgery was 37.0% (429/1159). Logistic regression analysis showed that
age, hemoglobin, fibrinogen, serum uric acid, cystatin C, bicarbonate, and
cardiopulmonary bypass time were independent risk factors associated with
AKI after surgical valve replacement (all P < 0.05). The areas under the
ROC curves (AUCs) in the derivation cohort and the validation cohort were
0.777 (95% CI 0.744-0.810) and 0.760 (95% CI 0.706-0.813), respectively.
The calibration plots indicated excellent consistency between the
prediction probability and actual probability. DCA demonstrated great
clinical benefit of the prediction model. <br/>Conclusion(s): We developed
a prediction model for predicting AKI after cardiac valve replacement
surgery that was internally validated to have good discrimination,
calibration, and clinical practicability.<br/>Copyright &#xa9; 2022
Elsevier B.V.

<37>
Accession Number
2021213240
Title
Authorship Trends and Disparities in Cardiothoracic Surgery.
Source
Annals of Thoracic Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Papageorge M.V.; Luc J.G.Y.; Olive J.K.; Antonoff M.B.
Institution
(Papageorge) Department of Surgery, Yale University School of Medicine,
New Haven, CT, United States
(Luc) Division of Cardiovascular Surgery, University of British Columbia,
Vancouver, BC, Canada
(Olive) Division of Cardiothoracic Surgery, Department of Surgery, Duke
University School of Medicine, Durham, NC, United States
(Antonoff) Division of Surgery, Department of Thoracic and Cardiovascular
Surgery, University of Texas MD Anderson Cancer Center, Houston, TX,
United States
Publisher
Elsevier Inc.
Abstract
Background: Previous investigations have revealed significant gender
disparities in the academic arenas of cardiothoracic surgery. However, the
status of gender representation in cardiothoracic publications has not
been well described. This study aimed to evaluate authorship trends by
gender in two high-impact cardiothoracic surgical journals.
<br/>Method(s): In this bibliometric analysis, PubMed was searched for
articles published in The Annals of Thoracic Surgery and the Journal of
Thoracic and Cardiovascular Surgery from 2010 to 2021. The web-based
application Genderize.io was used to classify names of first and last
authors as men vs women. The Cochran-Armitage trend test and multivariable
logistic regression were used to evaluate authorship per year and the
association of first and last author gender, respectively. <br/>Result(s):
Among 14,443 articles, 16.7% had women first authors and 8.1% had women
last authors. The proportion of articles written by women authors
increased, rising from 12.6% to 21.1% (P <.0001) for first and 5.4% to
11.5% (P <.0001) for last authors. Papers written with women as first
author were associated with 2.0 higher odds of having a woman as last
author (95% CI, 1.7-2.3; P <.0001). The mean number of last author
publications was higher for men than for women (2.4 vs 1.7, P <.0001).
<br/>Conclusion(s): Over the past decade, despite a welcomed increase in
women authorship in high-impact journals in cardiothoracic surgery, women
represent a small proportion of published authors. Women first authors are
more likely to publish with women last authors, demonstrating the impact
of same-gender collaborations while emphasizing a need for cross-gender
mentorship.<br/>Copyright &#xa9; 2022 The Society of Thoracic Surgeons

<38>
Accession Number
2021196083
Title
Impact of Paravalvular Leak on Outcomes After Transcatheter Aortic Valve
Implantation: Meta-Analysis of Kaplan-Meier-derived Individual Patient
Data.
Source
Structural Heart. (no pagination), 2022. Article Number: 100118. Date of
Publication: 2022.
Author
Sa M.P.; Jacquemyn X.; Van den Eynde J.; Tasoudis P.; Erten O.; Sicouri
S.; Macedo F.Y.; Pasala T.; Kaple R.; Weymann A.; Ruhparwar A.; 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, Tasoudis, Erten, Sicouri, Ramlawi) Department of Cardiothoracic
Surgery Research, Lankenau Institute for Medical Research, Wynnewood, PA,
United States
(Jacquemyn, Van den Eynde) Department of Cardiovascular Sciences, KU
Leuven, Leuven, Belgium
(Macedo, Pasala, Kaple) Division of Structural Heart Disease, Department
of Medicine, Hackensack University Medical Center, Hackensack, NJ, 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
(Clavel, Pibarot) Quebec Heart & Lung Institute, Universite Laval, Quebec
City, Quebec, Canada
(Clavel, Pibarot) Department of Medicine, Faculty of Medicine, Universite
Laval, Quebec City, Quebec, Canada
Publisher
Cardiovascular Research Foundation
Abstract
Background: Paravalvular leak (PVL) after transcatheter aortic valve
implantation (TAVI) is frequent and the impact of mild PVL on outcomes
remains uncertain. Our study aimed to evaluate the impact of PVL on TAVI
outcomes. <br/>Method(s): To analyze late outcomes of patients after TAVI
according to the presence and severity of PVL, PubMed/MEDLINE, EMBASE and
Google Scholar were searched for studies that reported rates of all-cause
mortality/survival and/or rehospitalization and/or cardiovascular
mortality accompanied by at least one Kaplan-Meier curve for any of these
outcomes. We adopted a 2-stage approach to reconstruct individual patient
data based on the published Kaplan-Meier graphs. <br/>Result(s):
Thirty-eight studies with Kaplan-Meier curves met our eligibility criteria
including over 25,000 patients. Patients with any degree of PVL after TAVI
had a significantly higher risk of overall mortality (hazard ratio (HR),
1.52; 95% confidence interval (CI), 1.43-1.61; p < 0.001),
rehospitalization (HR, 1.81; 95% CI, 1.54-2.12; p < 0.001), and
cardiovascular mortality (HR, 1.52; 95% CI, 1.33-1.75; p < 0.001) over
time. These findings remained consistent when we stratified the results
for the methods of assessment of PVL (i.e., echocardiography vs.
angiography) and PVL severity. Both moderate/severe PVL and mild PVL were
associated with increased risk of overall mortality (p < 0.001),
rehospitalization (p < 0.001), and cardiovascular mortality (p < 0.001)
during follow-up. <br/>Conclusion(s): Patients with PVL, even if mild,
experience higher risk of all-cause mortality, rehospitalization, and
cardiovascular mortality following TAVI. These findings provide support to
the implementation of procedural strategies to prevent any degree of PVL
at the time of TAVI.<br/>Copyright &#xa9; 2022 The Author(s)

<39>
Accession Number
2020127723
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. (no pagination), 2022. Date of Publication: 2022.
Author
Kuchay M.S.; Mathew A.; Mishra M.; Surendran P.; Kaur P.; Wasir J.S.; Gill
H.K.; Jain R.; Gagneja S.; Kohli C.; Kumari P.; Singh M.K.; Mishra S.K.
Institution
(Kuchay, Mathew, Mishra, Kaur, Wasir, Gill, Jain, Gagneja, Kohli, Kumari,
Mishra) Division of Endocrinology and Diabetes, Medanta-The Medicity
Hospital, Gurugram, India
(Surendran, Singh) Department of Clinical Research and Studies,
Medanta-The Medicity Hospital, Gurugram, India
Publisher
John Wiley and Sons Inc
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. <br/>Method(s): 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. 9
days), 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 &#xa9; 2022 Diabetes UK.

<40>
Accession Number
2020121924
Title
Risk factors for venous thromboembolism following surgical treatment of
fractures: A systematic review and meta-analysis.
Source
International Wound Journal. (no pagination), 2022. Date of Publication:
2022.
Author
Xia Z.-H.; Chen W.-H.; Wang Q.
Institution
(Xia, Chen, Wang) Department of Surgery, Shanghai Shidong Hospital,
Shanghai, China
Publisher
John Wiley and Sons Inc
Abstract
This study aimed to determine the risk factors for postoperative venous
thromboembolism (VTE) in patients treated surgically for fractures using a
meta-analytic approach. Electronic searches were performed in PubMed,
Embase, and the Cochrane library from inception until February 2022. The
odds ratio (OR) and 95% confidence interval (CI) were applied to calculate
the pooled effect estimate using the random-effects model. Sensitivity,
subgroup, and publication bias tests were also performed. Forty-four
studies involving 3 239 291 patients and reporting 11 768 VTE cases were
selected for the meta-analysis. We found that elderly (OR: 1.72; 95% CI:
1.38-2.15; P <.001), American Society of Anesthesiologists (ASA) >= 3 (OR:
1.82; 95% CI: 1.46-2.29; P <.001), blood transfusion (OR: 1.82; 95% CI:
1.14-2.92; P =.013), cardiovascular disease (CVD) (OR: 1.40; 95% CI:
1.22-1.61; P <.001), elevated D-dimer (OR: 4.55; 95% CI: 2.08-9.98; P
<.001), diabetes mellitus (DM) (OR: 1.36; 95% CI: 1.19-1.54; P <.001),
hypertension (OR: 1.31; 95% CI: 1.09-1.56; P =.003), immobility (OR: 3.45;
95% CI: 2.23-5.32; P <.001), lung disease (LD) (OR: 2.40; 95% CI:
1.29-4.47; P =.006), obesity (OR: 1.52; 95% CI: 1.27-1.82; P <.001),
peripheral artery disease (PAD) (OR: 2.13; 95% CI: 1.21-3.73; P =.008),
prior thromboembolic event (PTE) (OR: 5.17; 95% CI: 3.14-8.50; P <.001),
and steroid use (OR: 2.37; 95% CI: 1.73-3.24; P <.001) were associated
with an increased risk of VTE. Additionally, regional anaesthesia (OR:
0.66; 95% CI: 0.45-0.96; P =.029) was associated with a reduced risk of
VTE following surgical treatment of fractures. However, alcohol intake,
cancer, current smoking, deep surgical site infection, fusion surgery,
heart failure, hypercholesterolemia, liver and kidney disease, sex, open
fracture, operative time, preoperative anticoagulant use, rheumatoid
arthritis, and stroke were not associated with the risk of VTE.
Post-surgical risk factors for VTE include elderly, ASA >= 3, blood
transfusion, CVD, elevated D-dimer, DM, hypertension, immobility, LD,
obesity, PAD, PTE, and steroid use.<br/>Copyright &#xa9; 2022 The Authors.
International Wound Journal published by Medicalhelplines.com Inc (3M) and
John Wiley & Sons Ltd.

<41>
Accession Number
639561505
Title
Justification Of Empiric Methodology to Determine Dexmedetomidine Dose for
the TREX Study.
Source
Paediatric anaesthesia. (no pagination), 2022. Date of Publication: 17
Nov 2022.
Author
Disma N.; Goffredo B.M.; Cairoli S.; Cirillo G.; Morse J.D.; Anderson B.J.
Institution
(Disma, Cirillo) Unit for Research and Innovation, Department of
Anaesthesia, IRCCS Istituto Giannina Gaslini, Genova, Italy
(Goffredo, Cairoli) Division of Metabolic Disease and Drug Biology, IRCCS
Ospedale Bambino Gesu, Rome, Italy
(Morse, Anderson) Department Anesthesiology, Faculty Medicine and Health
Science, University of Auckland, New Zealand
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Dexmedetomidine is the sedative agent administered in
combination with remifentanil and low dose of sevoflurane in the
interventional arm of the ongoing TREX trial (Trial Remifentanil
DExmedetomidine). The TREX pilot study (published in Paediatr Anaesth
2019;29:59-67) established infusion rates higher than those initially
proposed. This could be attributed to an inappropriate target
concentration for sedation or incorrect initial pharmacokinetic parameter
estimates. <br/>METHOD(S): The TREX study is a Phase III, randomized,
active controlled, parallel group, blinded evaluator, multicentre,
superiority trial comparing neurological outcome after standard
sevoflurane anaesthesia with dexmedetomidine/remifentanil and low dose
sevoflurane anaesthesia in children aged less than 2years undergoing
anaesthesia of 2 hours or longer. In this report, dexmedetomidine
pharmacokinetics were analysed in the interventional arm of the Italian
population. <br/>RESULT(S): There were 162 blood samples from 32 infants
(22 male and 10 female). The median (IQR) age was 12 (5.2-15.5) months,
weight 9.9 (7.3-10.8) kg. Duration of anaesthesia ranged from 2-6 hours.
None of the children were born premature (median postnatal age 39weeks,
IQR 38-40weeks). A 3-compartment PK model that incorporated allometric
scaling and a maturation function demonstrated plasma concentration
observations from the current Italian arm of the TREX study were
consistent with those predicted by a "universal" model using pooled data
obtained from neonates to adults. <br/>CONCLUSION(S): This current PK
analysis from the Italian arm of the TREX study confirms that plasma
concentration of dexmedetomidine is predictable using known covariates
such as age and size. The initial target concentration (0.6 mug.L-1 ) used
to sedate children cared for in the intensive care after cardiac surgery
was inadequate for infants in the current TREX study. A target
concentration 1 mcg.L-1 , corresponding to a loading dose of 1 mcg.kg-1
followed by an infusion of 1 mcg.kg-1 .hour-1 , provided adequate
sedation.<br/>Copyright This article is protected by copyright. All rights
reserved.

<42>
Accession Number
639559420
Title
Cerebral Embolic Protection in Transcatheter Aortic Valve Replacement: A
Meta-Analysis of Randomized Clinical Trials.
Source
The American journal of cardiology. (no pagination), 2022. Date of
Publication: 14 Nov 2022.
Author
Al-Abcha A.; Saleh Y.; Abbasi M.; El-Am E.; Alkhouli M.
Institution
(Al-Abcha, Abbasi, El-Am, Alkhouli) Department of Cardiovascular Medicine,
Mayo Clinic, Rochester, MN, United States
(Saleh) Department of Cardiovascular Medicine, Houston Methodist DeBakey
Heart and Vascular Center, Houston, TX, United States
Publisher
NLM (Medline)

<43>
Accession Number
639558576
Title
A randomized trial of clopidogrel versus ticagrelor after off-pump
coronary bypass.
Source
The Annals of thoracic surgery. (no pagination), 2022. Date of
Publication: 14 Nov 2022.
Author
Kim H.-H.; Yoo K.-J.; Youn Y.-N.
Institution
(Kim, Yoo, Youn) Division of Cardiovascular Surgery, Severance
Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei
University Health System, Seoul, South Korea
Publisher
NLM (Medline)
Abstract
BACKGROUND: This study aimed to compare the outcomes of aspirin plus
either ticagrelor or clopidogrel after off-pump coronary artery bypass
grafting (OPCAB) in patients with clopidogrel resistance. <br/>METHOD(S):
Between November 2014 and November 2020, 1,739 patients underwent OPCAB.
Aspirin and clopidogrel treatment was initiated the day after surgery. On
postoperative days 7-9, clopidogrel resistance was evaluated using a
point-of-care assay. A total of 278 (18.9%) patients had clopidogrel
resistance (PRU>208) and were enrolled. We excluded patients with
co-resistant to aspirin (n=74) and divided the remaining patients (mean
age 67.4+/-8.5 years) into two groups (aspirin plus ticagrelor, AT group
[n=102]; aspirin plus clopidogrel, AC group [n=102]), randomly assigned
using a 1:1 ratio block table. Primary endpoint was the graft patency and
major adverse cardiovascular events (MACEs; defined as the composite of
cardiovascular mortality, MI, and repeat revascularization at 1 years
after OPCAB), and co-primary endpoint was the graft patency rate. The data
was analyzed using the intension-to-treat method. <br/>RESULT(S): The
graft occlusion rates in the AT and AC groups were 3.9% and 5.9%,
respectively (p=0.52). Neither death from cardiovascular causes (1.0% vs.
2.9%; p=0.32) nor myocardial infarction showed significant differences
(1.0% vs. 3.9%; p=0.18). No significant difference in the rates of major
bleeding were found between the two groups (p=0.75). However, the AT group
was associated with a lower rate of MACEs after OPCAB (hazard ratio, 0.77;
95% confidence interval, 0.684-0.891, p=0.01). <br/>CONCLUSION(S): These
results suggest that ticagrelor may be associated with reducing MACEs in
patients with clopidogrel resistance after OPCAB.<br/>Copyright &#xa9;
2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All
rights reserved.

<44>
Accession Number
639556922
Title
Long-term outcomes of mini-sternotomy versus conventional sternotomy for
aortic valve replacement: a randomised controlled trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2022.
Date of Publication: 17 Nov 2022.
Author
Telyuk P.; Hancock H.; Maier R.; Batty J.A.; Goodwin A.; Owens W.A.;
Ogundimu E.; Akowuah E.
Institution
(Telyuk, Batty) Department of Cardiology, James Cook University Hospital,
Middlesbrough, United Kingdom
(Hancock, Maier) Newcastle Clinical Trials Unit, Newcastle upon Tyne,
United Kingdom
(Goodwin, Owens, Akowuah) Department of Cardiovascular Surgery, James Cook
University Hospital, Middlesbrough, United Kingdom
(Ogundimu) Department of Mathematical Sciences, Durham University, Durham,
United Kingdom
Publisher
NLM (Medline)
Abstract
OBJECTIVES: Aortic valve replacement (AVR) for severe symptomatic aortic
stenosis is one of the most common cardiac surgical procedures with
excellent long-term outcomes. Multiple previous studies have compared
short-term outcomes of AVR with mini-sternotomy versus AVR with
conventional sternotomy. We have previously reported the results of the
randomized MAVRIC trial, which aimed to evaluate early post-operative
morbidity among patients undergoing mini-sternotomy and conventional
sternotomy AVR. We now report the long-term all-cause mortality,
reoperation, MACE outcomes and echocardiographic data from this trial.
<br/>METHOD(S): The prospective, randomized, single-centre, single-blind
MAVRIC trial compared manubrium limited mini-sternotomy and conventional
median sternotomy for treatment of patients with severe aortic stenosis.
The previously reported primary outcome was the proportion of patients
receiving red cell transfusion postoperatively and within 7days of the
index procedure. Currently reported exploratory analyses of a combined
long-term all-cause mortality and reoperation were compared between groups
via the log-rank test. Sensitivity analyses reviewed individual components
of the combined end-point. The primary analysis and long-term exploratory
analyses were based on an intention-to-treat principle. <br/>RESULT(S):
Between March 2014 and June 2016, 270 patients were enrolled and
randomized in a 1:1 fashion to undergo mini-sternotomy AVR (n=135) or
conventional median sternotomy AVR (n=135). At the median follow-up of
6.1years, the composite outcome of all-cause mortality and reoperation
occurred in 18.5% (25/135) of patients in conventional sternotomy group
and in 17% (23/135) of patients in mini-sternotomy group. The incidence of
chronic kidney disease, CVA, myocardial infarction was not significantly
different between two groups. Follow up echocardiographic data suggested
no difference in peak and mean gradients or incidence of aortic
regurgitation between two approaches. <br/>CONCLUSION(S): This exploratory
long-term analysis demonstrated that in patients with severe aortic
stenosis undergoing isolated AVR, there was no significant difference
between manubrium limited mini-sternotomy and conventional sternotomy with
respect to all-cause mortality, rate of reoperation, MACE events and
echocardiographic data at the median of 6.1years follow-up.<br/>Copyright
&#xa9; The Author(s) 2022. Published by Oxford University Press on behalf
of the European Association for Cardio-Thoracic Surgery. All rights
reserved.

<45>
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

<46>
Accession Number
2020693687
Title
Sex differences in acute type A aortic dissection: a systematic review and
meta-analysis.
Source
Journal of Cardiovascular Surgery. 63(5) (pp 632-644), 2022. Date of
Publication: October 2022.
Author
Fialka N.M.; Bozso S.J.; El-Andari R.; Kang J.J.; O'Connell A.; Moon M.C.;
Macarthur R.; Nagendran J.
Institution
(Fialka, El-Andari) Faculty of Medicine and Dentistry, University of
Alberta, Edmonton, AB, Canada
(Bozso, Kang, O'Connell, Moon, Macarthur, Nagendran) Division of Cardiac
Surgery, Department of Surgery, University of Alberta, Edmonton, AB,
Canada
Publisher
Edizioni Minerva Medica
Abstract
INTRODUCTION: The objective of this study is to provide a comprehensive
comparison of outcomes following acute type A aortic dissection (ATAAD)
repair in males and females. EVIDENCE ACQUISITION: PubMed, Medline, and
Web of Science were systematically searched by two authors for studies
published from January 1^st, 2000, to May 10^th, 2021.
Overall, 2405 articles were screened, and 16 were included in this review.
Meta-analysis of the compiled data was performed. EVIDENCE SYNTHESIS:
Pooled estimates indicated no difference in operative (odds ratio (OR)
1.00, 95% confidence interval (CI) 0.59-1.67, P=0.99, I²=52%),
in-hospital (OR 0.78, 95% CI 0.56-1.08; P=0.13, I²=57%), and
30-day mortality (OR 1.09, 95% CI 0.83-1.43, P=0.52, I²=45%)
between the sexes. However, males had significantly reduced 5-year
mortality rates (OR 0.71, 95% CI 0.51-1.00, P=0.05, I²=45%).
There was no difference between sexes in rates of postoperative stroke (OR
1.07, 95% CI 0.86-1.33, P=0.54, I²=0%), atrial fibrillation (OR
0.99, 95% CI 0.82-1.19, P=0.92, I²=0%), as well as mesenteric
or limb ischemia (OR 0.73, 95% CI 0.22-2.43, P=0.61, I²=77%; OR
0.83, 95% CI 0.30-2.30, P=0.72, I²=76%, respectively). Males
did experience significantly increased rates of acute renal failure and
reoperation (OR 1.35, 95% CI 1.16-1.56, P=0.0001, I²=29%; OR
1.40, 95% CI 1.09-1.81, P=0.010, I²=42%). <br/>CONCLUSION(S):
Composite analysis indicates that early mortality does not differ between
the sexes; however, late outcomes favor males. Differences in preoperative
presentation and subsequent procedure selection between the sexes likely
contribute to the disparity in late outcomes. Decision-making for surgical
treatment of ATAAD should account for sex-specific risk
factors.<br/>Copyright &#xa9; 2022 EDIZIONI MINERVA MEDICA.

<47>
Accession Number
2020140721
Title
Immediate versus staged complete myocardial revascularization in patients
with ST-segment elevation myocardial infarction and multivessel disease: A
post hoc analysis of the randomized FLOWER-MI trial.
Source
Archives of Cardiovascular Diseases. 115(10) (pp 496-504), 2022. Date of
Publication: October 2022.
Author
Tea V.; Morelle J.-F.; Gallet R.; Cayla G.; Lemesle G.; Lhermusier T.;
Dillinger J.-G.; Ducrocq G.; Angouvant D.; Cottin Y.; Chamandi C.; le Bras
A.; Steg P.G.; Montalescot G.; Nelson A.C.; Simon T.; Chatellier G.;
Danchin N.; Puymirat E.
Institution
(Tea, Chamandi, Danchin, Puymirat) Department of Cardiology, Hopital
Europeen Georges Pompidou, AP-HP, Paris 75015, France
(Morelle) Clinique St. Martin, Caen 14000, France
(Gallet) Service de cardiologie, Hopitaux Universitaires Henri Mondor,
AP-HP, Creteil 94000, France
(Cayla) Centre Hospitalier Universitaire de Nimes, Nimes 30900, France
(Cayla, Lemesle, Dillinger, Ducrocq, Angouvant, Steg, Simon, Danchin,
Puymirat) French Alliance for Cardiovascular Trials (FACT), Paris 75018,
France
(Lemesle) Cardiac Intensive Care Unit, CHU de Lille, Lille 59000, France
(Lhermusier) Department of Cardiology, Intensive Cardiac Care Unit,
Rangueil University Hospital, Toulouse 31059, France
(Dillinger) Department of Cardiology, Hopital Lariboisiere, AP-HP, Inserm
U-942, Universite de Paris, Paris 75010, France
(Ducrocq, Steg) Department of Cardiology, Hopital Bichat, AP-HP, Paris
75018, France
(Angouvant) Cardiology Department, University Hospital of Tours, Tours
37000, France
(Cottin) PEC2, EA 7460, University of Bourgogne Franche-Comte, Dijon
21000, France
(le Bras) Clinical Research Unit Eco Ile de France, Hopital Hotel Dieu,
AP-HP, Paris 75004, France
(Montalescot) Sorbonne Universite, ACTION Study Group, Institut de
Cardiologie (AP-HP), Inserm UMRS 1166, Hopital Pitie-Salpetriere, Paris
75013, France
(Nelson, Chatellier) Clinical Research Unit and CIC 1418 Inserm, Hopital
Europeen Georges Pompidou, AP-HP, Paris 75015, France
(Simon) Department of Clinical Pharmacology and Unite de Recherche
Clinique (URCEST), Hopital Saint Antoine, AP-HP, Paris 75012, France
(Tea, Chamandi, Danchin, Puymirat) Universite de Paris, Paris 75006,
France
(Gallet) U955-IMRB, Equipe 03, Inserm, Universite Paris Est Creteil
(UPEC), Ecole Nationale Veterinaire D'Alfort (EnVA), Maisons-Alfort 94700,
France
(Lemesle) Heart and Lung Institute, CHU de Lille, Institut Pasteur of
Lille, Inserm U1011, Lille 59000, France
(Lhermusier) Medical School, Toulouse III Paul Sabatier University,
Toulouse 31059, France
(Ducrocq, Steg) Inserm U1148, Laboratory for Vascular Translational
Science, Paris 75018, France
(Ducrocq, Steg) Universite de Paris, Paris 75005, France
(Cottin) Cardiology Department, University Hospital Centre of Dijon
Bourgogne, Dijon 21000, France
(Simon) Universite Pierre et Marie Curie (UPMC-Paris 06), Paris 75005,
France
(Simon) Inserm U-698, Paris 75012, France
Publisher
Elsevier Masson s.r.l.
Abstract
Background: In patients with ST-segment elevation myocardial infarction
and multivessel disease, percutaneous coronary intervention for
non-culprit lesions is superior to treatment of the culprit lesion alone.
The optimal timing for non-infarct-related artery revascularization -
immediate versus staged - has not been investigated adequately.
<br/>Aim(s): We aimed to assess clinical outcomes at 1 year in patients
with ST-segment elevation myocardial infarction with multivessel disease
using immediate versus staged non-infarct-related artery
revascularization. <br/>Method(s): Outcomes were analysed in patients from
the randomized FLOWER-MI trial, in whom, after successful primary
percutaneous coronary intervention, non-culprit lesions were assessed
using fractional flow reserve or angiography during the index procedure or
during a staged procedure during the initial hospital stay, <= 5 days
after the index procedure. The primary outcome was a composite of
all-cause death, non-fatal myocardial infarction and unplanned
hospitalization with urgent revascularization at 1 year. <br/>Result(s):
Among 1171 patients enrolled in this study, 1119 (96.2%) had complete
revascularization performed during a staged procedure, and 44 (3.8%) at
the time of primary percutaneous coronary intervention. During follow-up,
a primary outcome event occurred in one of the patients (2.3%) with an
immediate strategy and in 55 patients (4.9%) with a staged strategy
(adjusted hazard ratio 1.44, 95% confidence interval 0.39-12.69; P =
0.64). <br/>Conclusion(s): Staged non-infarct-related artery complete
revascularization was the strategy preferred by investigators in practice
in patients with ST-segment elevation myocardial infarction with
multivessel disease. This strategy was not superior to immediate
revascularization, which, in the context of this trial, was used in a
small proportion of patients. Further randomized studies are needed to
confirm these observational findings.<br/>Copyright &#xa9; 2022 Elsevier
Masson SAS

<48>
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.

<49>
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.

<50>
Accession Number
2018329260
Title
High Residual Gradient Following a Self-Expandable Transcatheter Aortic
Valve-in-Valve Implantation - Risk Factor Analysis, Outcomes, and
Survival.
Source
Brazilian Journal of Cardiovascular Surgery. 37(5) (pp 710-720), 2022.
Date of Publication: 2022.
Author
Stankowski T.; Aboul-Hassan S.S.; Stepinski P.; Gasior T.; Salem M.;
Erkenov T.; Herwig V.; Harnath A.; Muehle A.; Sa M.P.B.O.; Fritzsche D.;
Perek B.
Institution
(Stankowski, Erkenov, Herwig, Harnath, Muehle, Fritzsche) Department of
Cardiac Surgery, Sana Heart Center Cottbus, Cottbus, Germany
(Aboul-Hassan) Department of Cardiac Surgery, Medinet Heart Center Ltd,
Nowa Sol, Poland
(Stepinski) Department of Cardiac Surgery, Lodz Medical University, Lodz,
Poland
(Gasior) Division of Cardiology and Structural Heart Diseases, Medical
University of Silesia, Katowice, Poland
(Salem) Department of Cardiology, Carl-Thiem-Klinikum, Cottbus, Germany
(Sa) Division of Cardiovascular Surgery, Pronto-Socorro Cardiologico de
Pernambuco (PROCAPE), Universidade de Pernambuco, Pernambuco, Recife,
Brazil
(Perek) Department of Cardiac Surgery and Transplantology, Poznan
University of Medical Sciences, Poznan, Poland
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Transcatheter aortic valve-in-valve implantation (TAVI-ViV)
can be associated with unfavorable hemodynamic outcomes. This study aimed
to estimate the prevalence, identify the risk factors, and evaluate the
outcomes and survival of patients with high residual gradients after
TAVI-ViV. <br/>Method(s): A total of 85 patients were included in the
study. The cohort was divided into group A, with postprocedural mean
pressure gradient (PG) >= 20 mmHg, and group B, with mean PG < 20 mmHg.
<br/>Result(s): Postprocedural PG >= 20 mmHg was observed in 24.7% of the
patients. In a univariate analysis, preoperative gradient, preexisting
patient-prosthesis mismatch (PPM), deep valve implantation, small
degenerated valves, and an older generation of transcatheter aortic valves
were found to be risk factors for high residual gradient. Multivariate
analysis showed that preexisting maxPG > 60 mmHg, implantation level of 4
mm below neo-annulus, and degenerated valve size <= 23 mm were independent
predictors of high residual gradient. There were no differences in early
morbidity (myocardial infarction, pacemaker implantation, stroke, acute
renal insufficiency) between groups. Kaplan-Meier estimated that the
survival rate was comparable at one and five years regardless of
postoperative gradient. Survivors with high residual mean gradient were
significantly affected by a high New York Heart Association (NYHA) class.
<br/>Conclusion(s): High residual transvalvular gradient after TAVI-ViV is
not rare, but it does not significantly affect mortality. High residual
mean gradient has a negative impact on NYHA functional class improvement
after the procedure. High preoperative gradient, implantation level, and
small failed bioprosthesis may predispose to increased residual
gradient.<br/>Copyright &#xa9; 2022, Sociedade Brasileira de Cirurgia
Cardiovascular. All rights reserved.

<51>
Accession Number
639545978
Title
Native BK Polyomavirus Nephropathy in an Orthotopic Heart Transplant
Recipient.
Source
Journal of the American Society of Nephrology. Conference: Kidney Week
2022. Orlando, FL United States. 33 (pp 614), 2022. Date of Publication:
2022.
Author
Thompson Z.M.; Ajene G.O.; Kandary M.; Kulkarni P.A.; Aggarwal N.; Fedson
S.; Shah M.
Institution
(Thompson, Ajene, Kandary, Kulkarni, Aggarwal, Fedson, Shah) Baylor
College of Medicine, Houston, TX, United States
(Kulkarni, Aggarwal, Fedson, Shah) Michael E DeBakey VA Medical Center,
Houston, TX, United States
Publisher
American Society of Nephrology
Abstract
Introduction: BK polyomavirus nephropathy (BKVN) is a common cause of
kidney allograft dysfunction. It typically occurs within the first year
post-transplantation. BKVN in native kidneys after extra-renal solid-organ
transplantation (SOT) is unusual. Here, we report a case of native BKVN
occurring 13 years after orthotopic heart transplant (OHT). Case
Description: A 75-year-old man with Grade 3b chronic kidney disease
presented with acute kidney injury. He had undergone OHT 13 years prior
with stable allograft function and no recent episodes of rejection. His
immunosuppressive regimen consisted of tacrolimus, sirolimus, and
mycophenolate mofetil (MMF). Three months prior to presentation, he had
developed obstructive ureterolithiasis requiring ureteral stenting.
Imaging at the time of his current presentation showed resolution of prior
ureteral obstruction. Serum levels of immunosuppressive agents were within
therapeutic range. The serum BK viral load was 362,000 copies/ml. Kidney
biopsy revealed acute tubular injury with focal viral cytopathic changes
and SV40 staining within tubular epithelium, consistent with BKVN.
Immunosuppression was reduced by stopping sirolimus and exchanging MMF for
leflunomide with subsequent improvement in kidney function.
<br/>Discussion(s): While BK virus seropositivity is common worldwide,
BKVN is almost exclusively seen in kidney transplant patients.
Native-kidney BKVN after extrarenal SOT is uncommon. Intensity of
immunosuppression is a well-known risk factor for viral replication;
ureteral stenting has also been associated with BKVN. However, since
clinical manifestations of BKV infection often include genitourinary (GU)
tract pathology, ureteral strictures may be either a symptom or risk
factor of infection. Although rare, it is important for clinicians
consider BKVN even in patients with non-renal SOT, especially in the
clinical context of known GU disease. Treatment of native BKVN is based on
experience from treatment of BKVN in kidney transplant patients. While
there are no randomized controlled trials, the current mainstay of
treatment is reduction of immunosuppression, backed by meta-analyses and
observational studies. Additional possible therapies without strong
evidence include intravenous immunoglobulin, leflunomide, cidofovir,
brincidofovir, and fluoroquinolones.

<52>
Accession Number
639543573
Title
Effect of Cytokine Adsorption on Mortality: A Meta-Analysis.
Source
Journal of the American Society of Nephrology. Conference: Kidney Week
2022. Orlando, FL United States. 33 (pp 729), 2022. Date of Publication:
2022.
Author
Schmidt B.M.; Lang H.; Barbosa C.V.; Tian Z.; Melk A.
Institution
(Schmidt, Lang, Barbosa, Tian) Department of Nephrology and Hypertension,
Hannover Medical School, Hannover, Germany
(Melk) Department of Pediatric Kidney,Liver and Metabolic Diseases,
Hannover Medical School, Hannover, Germany
Publisher
American Society of Nephrology
Abstract
Background: Cytokine adsorption using the CytoSorb device had been
proposed to be beneficial in various clinical settings including sepsis,
ARDS, hyperinflammatory syndromes, cardiac surgery or recovery after
cardiac arrest. The aim of this analysis was to provide evidence for the
efficacy of the CytoSorb device with regard to mortality in these
settings. <br/>Method(s): We searched Medline, Cochrane Library database
and used the database provided by CytosorbentsTM. Central Register of
Controlled Trials and clinicaltrials. gov for randomized, controlled
studies (01.1.2010-28.2.22). We considered randomized controlled trials
and observational studies with a control group. The longest reported
mortality (30 days-, hospital- or ICU-mortality) was defined as primary
endpoint. For analyzing the data we computed risk ratios and
95%-confidence intervals and used DerSimonian and Lairds random effects
model (R 4.1). We analysed all studies together and separated in the
subgroups sepsis, cardiac surgery, SARS-CoV-2 infection, recovery from
cardiac arrest, other severe illness. The meta-analysis was registered in
advance (PROSPERO: CRD42022290334). <br/>Result(s): Of initial 1249
publications, 37 trials were found eligible, in total including 1256
patients treated with CytoSorb and 1230 controls. Concerning the primary
endpoint mortality Cytosorb did not show a positive effect in all studies
together 1.10 [0.92; 1.33] RR [95%-CI], in sepsis 1.03 [0.81; 1.31], CPB
surgery 0.85 [0.51; 1.44], severe illness 1.05 [0.79; 1.39], SARS-CoV-2
1.58 [0.50; 4.94], and recovery from cardiac arrest 1.22 [1.02; 1.46]
(figure). Likewise we did not find significant difference in ICU length of
stay, lactate levels, or norepinephrine after treatment.
<br/>Conclusion(s): To date there is no evidence for a positive effect of
the CytoSorb adsorber on mortality across a bunch of indications that
justifies its widespread use in intensive care medicine. (Table
Presented).

<53>
Accession Number
2020119699
Title
A case report and review of literature: Tuberculous pericarditis with
pericardial effusion as the only clinical manifestation.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 1020672. Date of Publication: 02 Nov 2022.
Author
Wang S.; Wang J.; Liu J.; Zhang Z.; He J.; Wang Y.
Institution
(Wang, Wang, Liu, Zhang, He, Wang) Department of Cardiology, The First
Hospital of Jilin University, Changchun, China
Publisher
Frontiers Media S.A.
Abstract
Tuberculosis is a main cause of pericardial disease in developing
countries. However, in patients with atypical clinical presentation, it
can lead to misdiagnosis, missed diagnosis, and delayed treatment. In this
study, we report a case of a 61-year-old woman admitted to the cardiac
intensive care unit with "weakness and loss of appetite" and a large
pericardial effusion shown by echocardiography. After hospitalization, a
pericardiocentesis was performed, and the pericardial fluid was
hemorrhagic. However, the Xpert MTB/RIF and T-SPOT tests were negative,
and repeated phlegm antacid smears and culture of pericardial fluid did
not reveal antacid bacilli. The patient eventually underwent thoracoscopic
pericardial biopsy, which revealed extensive inflammatory cells and
significant granulomas. Combined with the fact that the patient's
pericardial effusion was exudate, the patient was considered to be
suspected of tuberculous pericarditis (TBP) and given empirical
anti-tuberculosis treatment the patient's symptoms improved and the final
diagnosis was TBP. In this case report, it is further shown that a
negative laboratory test cannot exclude tuberculosis infection. In
recurrent unexplained pericardial effusions, the pericardial biopsy is
feasible. In countries with a high burden of tuberculosis, empirical
antituberculosis therapy may be used to treat the pericardial effusion
that excludes other possible factors.<br/>Copyright &#xa9; 2022 Wang,
Wang, Liu, Zhang, He and Wang.

<54>
Accession Number
2021198653
Title
Recruitment manoeuvre s during mechanical ventilation with sequential
high-flow nasal oxygen after extubation to prevent postoperative pulmonary
complications in patients undergone thoracic surgery: a protocol,
prospective randomised controlled trial.
Source
BMJ Open. 12(10) (no pagination), 2022. Article Number: e056438. Date of
Publication: 28 Oct 2022.
Author
Wang Z.; Wang B.; Xia W.; Wang P.; Liang G.; Mei J.D.; Zhang Y.-G.; Yan K.
Institution
(Wang, Xia) Department of Respiratory Care, Sichuan University West China
Hospital, Sichuan, Chengdu, China
(Wang, Liang) Department of Critical Care Medicine, Sichuan University
West China Hospital, Sichuan, Chengdu, China
(Wang) Department of Respiratory Care, Sichuan University, Sichuan,
Chengdu, China
(Liang) Sichuan Provincial Clinical Research Center for Emergency and
Critical Care Medicine, Sichuan University West China Hospital, Sichuan,
Chengdu, China
(Mei) Department of Thoracic Surgery, Sichuan University, Sichuan,
Chengdu, China
(Zhang) Department of Periodical Press and National Clinical Research
Center for Geriatrics, West China Hospital, Sichuan, Chengdu, China
(Yan) Department of Critical Care Medicine, Sichuan University West China
Medical Center, Sichuan, Chengdu, China
Publisher
BMJ Publishing Group
Abstract
Introduction The incidence of postoperative pulmonary complications (PPCs)
following thoracic surgery is high, which increases the mortality rate,
prolongs the length of hospital stay and increases medical costs. Some
studies have confirmed that preoperative risk assessment, intraoperative
anaesthesia methods and intraoperative mechanical ventilation strategies,
including recruitment manoeuvres (RMs), can reduce the incidence of PPCs.
Despite these improved strategies, the incidence of PPCs remains high.
However, mechanical ventilation strategies have not been studied in the
postoperative period. Methods and analysis We assume that RM during
mechanical ventilation with sequential high-flow nasal oxygen therapy
(HFNO) after extubation can maintain the opening of the postoperative
alveoli and ultimately reduce the incidence of PPCs after thoracic
surgery. We will include thoracic surgery patients and divide them into
the RM with sequential HFNO group and the control group. They will be
given RMs and sequential HFNO or be given conventional treatment. The
sample size is 654 adult patients (327 per group) undergone thoracic
surgery and presenting to the intensive care unit. Ethics and
dissemination This study was approved by the Biomedical Research Ethics
Committee of West China Hospital of Sichuan University (REC2019-730). It
is expected that this study will lead to a randomised controlled trial. We
assume that the findings will provide more evidence about PPCs and improve
the management of patients undergone thoracic surgery. Trial registration
number ChiCTR2100046356. <br/>Copyright &#xa9;

<55>
Accession Number
2021122846
Title
Coronary perforation incidence, outcomes and temporal trends (COPIT): A
systematic review and meta-analysis.
Source
Open Heart. 9(2) (no pagination), 2022. Article Number: 002076. Date of
Publication: 21 Oct 2022.
Author
Mikhail P.; Howden N.; Monjur M.; Jeyaprakash P.; Said C.; Bland A.;
Collison D.; McCartney P.; Adamson C.; Morrow A.; Carrick D.; McEntegart
M.; Ford T.J.
Institution
(Mikhail, Howden, Said, Bland, Ford) Department of Cardiology, Central
Coast Local Health District, Gosford, NSW, Australia
(Mikhail, Howden, Bland, Ford) Faculty of Medicine, The University of
Newcastle, Newcastle, NSW, Australia
(Monjur) Department of Cardiology, South Eastern Sydney Local Health
District, Kogarah, NSW, Australia
(Jeyaprakash) Department of Cardiology, Nepean Hospital, Penrith, NSW,
Australia
(Collison, McCartney) Department of Cardiology, Golden Jubilee Hospital,
Clydebank, United Kingdom
(Collison, McCartney, Adamson, Morrow, Carrick, Ford) Institute of
Cardiovascular and Medical Sciences, University of Glasgow, Glasgow,
United Kingdom
(Carrick) Department of Cardiology, University Hospital Hairmyres, East
Kilbride, United Kingdom
(McEntegart) Department of Cardiology, Columbia University, New York, NY,
United States
Publisher
BMJ Publishing Group
Abstract
Coronary perforation is a potentially life-threatening complication of
percutaneous coronary intervention (PCI). We studied incidence, outcomes
and temporal trends following PCI-related coronary artery perforation
(CAP). Methods Prospective systematic review and meta-analysis including
meta-regression using MEDLINE and EMBASE to November 2020. We included
'all-comer' PCI cohorts including large PCI registries and randomised
controlled trials and excluding registries or trials limited to PCI in
high-risk populations such as chronic total occlusion PCI or cohorts
treated only with atheroablative devices. Regression analysis and
corresponding correlation coefficients were performed comparing
perforation incidence, mortality rate, tamponade rate and the rate of
Ellis III perforations against the midpoint (year) of data collection to
determine if a significant temporal relationship was present. Results 3997
studies were screened for inclusion. 67 studies met eligibility criteria
with a total of 5 568 191 PCIs included over a 38-year period (1982-2020).
The overall pooled incidence of perforation was 0.39% (95% CI 0.34% to
0.45%) and remained similar throughout the study period. Around 1 in 5
coronary perforations led to tamponade (21.1%). Ellis III perforations are
increasing in frequency and account for 43% of all perforations.
Perforation mortality has trended lower over the years (7.5%; 95% CI 6.7%
to 8.4%). Perforation risk factors derived using meta-regression were
female sex, hypertension, chronic kidney disease and previous coronary
bypass grafting. Coronary perforation was most frequently caused by distal
wire exit (37%) followed by balloon dilation catheters (28%). Covered
stents were used to treat 25% of perforations, with emergency cardiac
surgery needed in 17%. Conclusion Coronary perforation complicates
approximately 1 in 250 PCIs. Ellis III perforations are increasing in
incidence although it is unclear whether this is due to reporting bias.
Despite this, the overall perforation mortality rate (7.5%) has trended
lower in recent years. Limitations of our findings include bias that may
be introduced through analysis of multidesign studies and registries
without pre-specified standardised perforation reporting CMore research
into coronary perforation management including the optimal use of covered
stents seems warranted. PROSPERO registration number CRD42020207881.
<br/>Copyright &#xa9;

<56>
Accession Number
2021241978
Title
Transcatheter Mitral Valve Repair for Failed Surgical Mitral Valve Repair:
A Systematic Review and Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 23(10) (no pagination), 2022. Article
Number: 332. Date of Publication: October 2022.
Author
Xu H.; Song W.; Liu S.; Zhong Z.
Institution
(Xu, Song, Liu, Zhong) Department of Cardiovascular Surgery, Fuwai
Hospital, National Clinical Research Center for Cardiovascular Diseases,
National Center for Cardiovascular Diseases, Chinese Academy of Medical
Sciences, Peking Union Medical College Chinese Academy of Medical Science,
Beijing 100037, China
Publisher
IMR Press Limited
Abstract
Objectives: To assess the outcomes of transcatheter mitral valve repair
(TMVr) for failed previous surgical mitral valve repair (MVr).
<br/>Method(s): We searched Pubmed, Embase, and Cochrane Library databases
for studies that reported the outcomes of TMVr for failed initial surgical
MVr. Data were extracted by 2 independent investigators and subjected to
meta-analysis. The 95% confidence interval (CI) was calculated for
preoperative demographics, peri-operative outcomes, and follow-up outcomes
using binary and continuous data from single-arm studies. <br/>Result(s):
Eight single-arm studies were included, with a total of 212 patients, and
mean follow-up ranged from 1.0 to 15.9 months. The pooled rate of residual
procedural mitral regurgitation <=mild was 76% (95% CI: 67%~84%;
I² = 0%; 7 studies, 199 patients). During follow-up, mitral
regurgitation <=mild was found in 68% of patients (95% CI: 52%~82%;
I² = 57%; 6 studies, 147 patients). Follow-up survival was 94%
(95% CI: 88%~98%; I² = 0%; 7 studies, 196 patients). 83%
patients (95% CI: 75%~89%; I² = 47%; 6 studies, 148 patients)
were in NYHA class I or II. <br/>Conclusion(s): TMVr for failed surgical
MVr was safe and effective, which should be recommended in selected
patients if technically feasible.<br/>Copyright &#xa9; 2022 The Author(s).
Published by IMR Press.

<57>
Accession Number
2021241966
Title
Unsolved Questions in the Revascularization of Older Myocardial Infarction
Patients with Multivessel Disease.
Source
Reviews in Cardiovascular Medicine. 23(10) (no pagination), 2022. Article
Number: 344. Date of Publication: October 2022.
Author
Pavasini R.; Sanguettoli F.; Zanarelli L.; Deserio M.A.; Bianchi N.;
Fabbri G.; Tebaldi M.; Biscaglia S.; Campo G.
Institution
(Pavasini, Sanguettoli, Zanarelli, Deserio, Bianchi, Fabbri, Tebaldi,
Biscaglia, Campo) UO Cardiologia, Azienda Ospedaliero Universitaria di
Ferrara, Ferrara 44124, Italy
Publisher
IMR Press Limited
Abstract
Background: In cardiology, the global phenomenon of population ageing
poses new major challenges, ranging from more comorbid and frail patients
to the presence of complex, calcified and multiple coronary lesions.
Considering that elderly patients are under-represented in randomized
clinical trials (RCT), the aim of this systematic review is to summarize
the current knowledge on the revascularization of the elderly patient with
myocardial infarction and multivessel coronary artery disease.
<br/>Method(s): A systematic review following PRISMA guidelines has been
performed. The search was conducted on Pubmed (Medline), Cochrane library,
Google Scholar and Biomed Central databases between January and February
2022. We selected the articles focusing on patients hospitalized for
myocardial infarction (MI) with multivessel disease and aged 75 years or
older. A total of 36 studies have been included. <br/>Result(s):
Multivessel coronary artery disease is present in around 50-60% of older
patients with MI. The in-hospital mortality rate of patients older than 75
years is double compared to their younger counterpart, and the most
prevalent complications after revascularization are bleeding and renal
failure. In the treatment of patients with ST elevation MI (STEMI),
primary percutaneous coronary intervention should be the first choice over
fibrinolysis. However, it is not clear whether this population would
benefit from complete revascularization or not. In patients with non-ST
elevation MI (NSTEMI), an invasive approach with either percutaneous
coronary intervention or coronary artery bypass graft may be chosen, but a
conservative strategy is also accepted. There are no data from large
trials about the comparison of possible revascularization strategies in
NSTEMI patients. <br/>Conclusion(s): This systematic review shows that
this field of research lacks randomized clinical trials to guide
revascularization strategy in older STEMI or NSTEMI patients with MI. New
results are expected from ongoing trials.<br/>Copyright &#xa9; 2022 The
Author(s). Published by IMR Press.

<58>
Accession Number
2021241964
Title
Direct Oral Anticoagulants (DOACs) are Non-Inferior to Vitamin K
Antagonists for Patients Undergoing Transcatheter Aortic Valve Replacement
with Indications of Anticoagulation.
Source
Reviews in Cardiovascular Medicine. 23(10) (no pagination), 2022. Article
Number: 346. Date of Publication: October 2022.
Author
Wang J.; Zhang F.-Y.; Liu L.; Pan M.-M.; Zhang C.; Chen J.; Bian Y.; Lin
H.-W.; Gu Z.-C.
Institution
(Wang, Liu, Pan, Zhang, Lin, Gu) Department of Pharmacy, Ren Ji Hospital,
Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
(Zhang, Chen) Department of Evidence-Based Medicine and Clinical
Epidemiology, West China Hospital, Sichuan University, Sichuan, Chengdu
610041, China
(Bian) Personalized Drug Therapy Key Laboratory of Sichuan Province,
Department of Pharmacy, Sichuan Provincial People's Hospital, School of
Medicine, University of Electronic Science and Technology of China,
Sichuan, Chengdu 610072, China
(Gu) Drug Clinical Comprehensive Evaluation Group, Shanghai Pharmaceutical
Association, Shanghai 200040, China
Publisher
IMR Press Limited
Abstract
Background: The best anticoagulation choice for patients undergoing
transcatheter aortic valve replacement (TAVR) with indications of oral
anticoagulation (OAC) remains uncertain. We carried out a comprehensive
analysis adopting updated evidence that investigated the efficacy and
safety of direct oral anticoagulants (DOACs) versus vitamin K antagonists
(VKAs) in this population. <br/>Method(s): A systematic search has been
conducted through PubMed, Embase, and Cochrane Library to collect
randomized controlled trials (RCTs) and real-world studies comparing the
therapy outcomes of DOACs with VKAs in patients undergoing TAVR with
indications of OAC up to Dec 2021. Included studies reported all-cause
mortality, bleeding, stroke, or composite endpoint. A random-effects model
was used and followed a sensitivity analysis based on the heterogeneity.
In addition, five scenario analyses were performed to robust our findings.
<br/>Result(s): Our analysis included 11 articles enrolling a total of
8934 patients undergone TAVR with indications of OAC (DOACs group = 3890,
VKAs group = 5044). Pooled analysis revealed no significant different risk
of all-cause mortality (aHR: 0.95, 95% CI: 0.65-1.39, I²:
90.6%), stroke (aHR: 0.86, 95% CI: 0.55-1.35, I²: 44.3%),
bleeding (aHR: 0.83, 95% CI: 0.61-1.13, I²: 76.3%), and
composite endpoint (aHR: 1.05, 95% CI: 0.88-1.24, I²: 11.7%) in
the DOACs and VKAs groups. Various forms of death, stroke and bleeding,
including cardiovascular death (aHR: 0.92, 95% CI: 0.64-1.33,
I²: 34.1%), hemorrhagic stroke (aHR: 0.63, 95% CI: 0.23-1.75,
I²: 22.7%), ischemic stroke (aHR: 0.79, 95% CI: 0.56-1.15,
I²: 0.0%), transient ischemic attack (aHR: 0.75, 95% CI:
0.40-1.41, I²: 0.0%), major or life-threatening bleeding (aHR:
0.96, 95% CI: 0.74-1.24, I²: 27.9%), and minor bleeding (aHR:
0.90, 95% CI: 0.52-1.57, I²: 54.3%), also showed similar rates
among DOACs and VKAs groups. The results based on five scenarios confirmed
the said findings. <br/>Conclusion(s): Compared with VKAs, the efficacy
and safety of DOACs were comparable for treating TAVR patients combined
with anticoagulation indications. Further large-scale RCTs investigating
more detailed scenarios are still needed to confirm the optimal
anticoagulation strategy.<br/>Copyright &#xa9; 2022 The Author(s).
Published by IMR Press.

<59>
Accession Number
2020121913
Title
Infection following CF-LVAD exchange for non-infectious indications: A
systematic review and meta-analysis.
Source
International Journal of Artificial Organs. (no pagination), 2022. Date
of Publication: 2022.
Author
Sukhavasi A.; Blazoski C.M.; Maynes E.J.; Wood C.T.; Weber M.P.; O'Malley
T.J.; Rajapreeyal I.; Massey H.T.; Tchantchaleishvili V.
Institution
(Sukhavasi, Blazoski, Wood, Weber) Sidney Kimmel Medical College, Thomas
Jefferson University, Philadelphia, PA, United States
(Maynes, O'Malley, Massey, Tchantchaleishvili) Division of Cardiac
Surgery, Department of Surgery, Thomas Jefferson University, Philadelphia,
PA, United States
(Rajapreeyal) Department of Cardiology, Thomas Jefferson University,
Philadelphia, PA, United States
Publisher
SAGE Publications Ltd
Abstract
Introduction: Patients on continuous flow left ventricular assist devices
(CF-LVADs) often require CF-LVAD exchange. The purpose of this study was
to investigate the incidence of infection following CF-LVAD exchange
performed for non-infectious indications. <br/>Method(s): An electronic
literature search was performed to identify all studies of patients
undergoing CF-LVAD exchange for pump thrombosis or device malfunction. Of
2,698 articles identified, 6 studies with 81 total patients met the
inclusion criteria. Cohort-level data were pooled for meta-analysis.
<br/>Result(s): Mean patient age was 60 years (95% CI: 41-78), and 74%
were male (95% CI: 61-84). Pump thrombosis was the most common indication
for exchange in 70% of patients (95% CI: 47-86). Other indications were
driveline fracture and electrical malfunction in 21% (95% CI: 5-56) and
12% (95% CI: 4-33) of patients, respectively. Prior to exchange, 95% of
patients were on HeartMate II (HM2) LVADs (95% CI: 86-98) and average
duration of support for these patients was 27.1 months (95% CI: 9.3-44.8).
The majority were placed on a HM2 following exchange (88% (95% CI: 45-98))
versus HM3 (12% (95% CI: 2-55)). Follow-up was an average of 16.4 months
(95% CI: 6.8-26.0). Following exchange, 16 of 81 patients developed
infection, with pooled mean incidence of 24% (95% CI: 14-38). 30-day
mortality was 14% (95% CI: 7-26). Survival at follow-up was 65% (95% CI:
52-76). <br/>Conclusion(s): Infection following CF-LVAD exchange can occur
at rates higher than those observed with primary implantation; therefore,
effective strategies need to implemented early and consistently to help
lower infections rates and help improve outcomes following
exchange.<br/>Copyright &#xa9; The Author(s) 2022.

<60>
Accession Number
2020121884
Title
Prophylactic Left Atrial Appendage Exclusion in Cardiac Surgery Patients
With Elevated CHA<inf>2</inf>DS<inf>2</inf>-VASc Score: Results of the
Randomized ATLAS Trial.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. (no pagination), 2022. Date of Publication: 2022.
Author
Gerdisch M.W.; Garrett H.E.; Mumtaz M.A.; Grehan J.F.; Castillo-Sang M.;
Miller J.S.; Zorn G.L.; Gall S.A.; Johnkoski J.A.; Ramlawi B.
Institution
(Gerdisch) Franciscan Health, Indianapolis, IN, United States
(Garrett) Cardiovascular Surgery Clinic, Memphis, TN, United States
(Mumtaz) University of Pittsburgh Medical Center Central PA, Harrisburg,
PA, United States
(Grehan) Allina Health System, St. Paul, MN, United States
(Castillo-Sang) The Christ Hospital, Cincinnati, OH, United States
(Miller) Emory University Hospital, Atlanta, GA, United States
(Zorn) University of Kansas, Medical Center, Kansas City, KS, United
States
(Gall) CVA Heart Institute, Kingsport, TN, United States
(Johnkoski) Aspirus Wausau Hospital, WI, United States
(Ramlawi) Lankenau Heart Institute, Philadelphia, PA, United States
Publisher
SAGE Publications Ltd
Abstract
Objective: Patients with elevated CHA<inf>2</inf>DS<inf>2</inf>-VASc
scores are at high risk for atrial fibrillation (AF) and thromboembolic
events (TE) after cardiac surgery. Left atrial appendage exclusion (LAAE)
is a permanent, continuous approach to stroke prevention in AF, overcoming
limitations of oral anticoagulation (OAC). We report ATLAS trial results
focused on LAAE technical success and perioperative safety and TE rates
with and without LAAE in cardiac surgery patients who developed
postoperative AF (POAF). <br/>Method(s): ATLAS (NCT02701062) was a
prospective, multicenter, feasibility trial. Patients age >=18 years,
undergoing structural heart procedure, with no preoperative AF,
CHA<inf>2</inf>DS<inf>2</inf>-VASc >=2, and HAS-BLED >=2 were randomized
2:1 to LAAE or no LAAE. Patients who developed POAF and/or received LAAE
were followed for 1 year. LAAE was evaluated with intraoperative
transesophageal echocardiography. <br/>Result(s): A total of 562 patients
were randomized to LAAE (n = 376) or no LAAE (n = 186). Mean
CHA<inf>2</inf>DS<inf>2</inf>-VASc (3.4 vs 3.4) and HAS-BLED (2.8 vs 2.9)
scores were similar for LAAE and no LAAE groups. LAAE success (no flow nor
residual stump >10 mm) was 99%. One LAAE-related serious adverse event
(0.27%) occurred and was resolved without sequelae. There were 44.3% of
patients who developed POAF. Through 1 year, 3.4% of LAAE patients and
5.6% of no LAAE patients had TE. OAC was used by 32.5% of POAF patients.
Bleeding was higher with OAC than without (16.1% vs 5.4%, P = 0.008).
<br/>Conclusion(s): ATLAS demonstrated a high rate of successful LAAE with
low LAAE-related serious adverse events in cardiac surgery patients. Study
results should be considered in future trial design to further evaluate
prophylactic LAAE for stroke prevention in cardiac surgery patients with
elevated stroke risk.<br/>Copyright &#xa9; The Author(s) 2022.

<61>
Accession Number
2020108152
Title
Surgical versus transcatheter aortic valve replacement: Impact of
patient-prosthesis mismatch on outcomes.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Alnajar A.; Hamad N.; Azhar M.Z.; Mousa Y.; Arora Y.; Lamelas J.
Institution
(Alnajar, Hamad, Arora, Lamelas) Department of Surgery, Division of
Cardiothoracic Surgery, University of Miami Miller School of Medicine,
Miami, FL, United States
(Azhar) University of Kansas School of Medicine, Wichita, KS, United
States
(Mousa) Florida Atlantic University, Boca Raton, FL, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The hemodynamics of most prosthetic valves are often inferior
to that of the normal native valve, and a significant proportion of
patients undergoing surgical (SAVR) or transcatheter aortic valve
replacement (TAVR) have high residual transaortic pressure gradients due
to prosthesis-patient mismatch (PPM). As the experience with TAVR has
increased and long-term outcomes are reported, a close look at the PPM
literature is required in light of new evidence. <br/>Method(s): For this
review, we searched the Embase, Medline, and Cochrane databases from 2000
to 2022. Articles reporting PPM as an outcome following aortic valve
replacements were identified and reviewed. <br/>Result(s): The impact of
PPM on clinical outcomes in aortic valve replacement has not been clear as
multiple studies failed to report PPM incidence. However, the PPM outcomes
after SAVR vary more widely than after TAVR, ranging from 8% to 80% in
SAVR and from 24% to 35% in TAVR. Incidence of severe PPM following redo
SAVR ranges from 2% to 9% and following valve-in-valve TAVR is from 14% to
33%, however, while PPM is higher in valve-in-valve TAVR, patients had
better survival rates. <br/>Conclusion(s): The gap between valve
performance and clinical outcomes in SAVR and TAVR could be reduced by
carefully selecting patients for either treatment option. Understanding
predictors of PPM can add to the safety, effectiveness, and increased
survival benefit of both SAVR and TAVR.<br/>Copyright &#xa9; 2022 Wiley
Periodicals LLC.

<62>
Accession Number
2020108086
Title
Sex differences in saphenous vein graft patency: A systematic review and
meta-analysis.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Lehtinen M.L.; Harik L.; Soletti G.; Rahouma M.; Dimagli A.;
Perezgrovas-Olaria R.; Audisio K.; Demetres M.; Gaudino M.
Institution
(Lehtinen) Department of Cardiac Surgery, Heart and Lung Center, Helsinki
University Hospital and University of Helsinki, Helsinki, Finland
(Harik, Soletti, Rahouma, Dimagli, Perezgrovas-Olaria, Audisio, Gaudino)
Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York,
NY, United States
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Centre, Weill Cornell, Medicine, New York, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Saphenous vein grafts (SVG) are the most commonly used
conduits in coronary artery bypass grafting (CABG). Graft failure is
observed in up to 50% of SVG at 10 years after surgery. Whether a
difference in SVG patency rates exists between men and women remains
unclear. <br/>Method(s): We performed a study-level meta-analysis to
evaluate sex-related differences in follow-up patency rates of SVG after
CABG. A systematic literature search was conducted to identify studies on
CABG that reported follow-up SVG patency rates in men and women. The
primary outcome was SVG patency rates by sex at follow-up. <br/>Result(s):
Seventeen studies totaling 8235 patients and 14,781 SVG grafts were
included. There was no significant difference in follow-up SVG patency
rates between men and women (incidence rate ratio 0.96, 95% confidence
interval 0.90-1.03, p =.24), with mean angiographic follow-up of 33.5
months (standard deviation 29.2). Leave-one-out and cumulative analysis
were consistent with the main analysis. We concluded that follow-up SVG
patency rate is similar between men and women undergoing
CABG.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<63>
Accession Number
2020107998
Title
Minimally invasive versus conventional aortic valve replacement: The
network meta-analysis.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Ogami T.; Yokoyama Y.; Takagi H.; Serna-Gallegos D.; Ferdinand F.D.;
Sultan I.; Kuno T.
Institution
(Ogami, Serna-Gallegos, Ferdinand, Sultan) Department of Cardiothoracic
Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Fountain Hill, PA, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Serna-Gallegos, Ferdinand, Sultan) Department of Cardiothroacic Surgery,
Heart and Vascular Institute, University of Pittsburgh Medical Center,
Pittsburgh, PA, United States
(Kuno) Division of Cardiology, Montefiore Medical Center, Albert Einstein
College of Medicine, New York City, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Outcome comparisons after surgical aortic valve replacement
(SAVR) with minimally invasive approaches including mini-sternotomy (MS)
and right mini-thoracotomy (RMT) and full sternotomy (FS) have been
conflicting. Furthermore, the synthesis of mid-term mortality has not been
performed. <br/>Method(s): MEDLINE and EMBASE were searched through April
2022 to identify propensity score matched (PSM) studies or randomized
controlled trial (RCT) which compared outcomes following SAVR among three
incisional approaches: FS, MS, or RMT. The network analysis was performed
to compare these approaches with random effects model. Mid-term mortality
was defined as 1-year mortality. <br/>Result(s): A total of 42 studies met
the inclusion criteria enrolling 14,925 patients. RCT and PSM were
performed in 13 and 29 studies, respectively. The operative mortality was
significantly lower with MS compared to FS (risk ratio [RR]: 0.60, 95%
confidence interval [CI]: 0.41-0.90, p =.01, I² = 25.8%) or RMT
(RR: 0.51, 95% CI: 0.27-0.97, p =.03, I² = 25.8%). RMT had
significantly higher risk of reoperation for bleeding compared to MS (RR:
1.65, 95% CI: 1.18-2.30, p =.003, I² = 0%). Hospital length of
stay was significantly shorter with MS compared to FS (mean difference:
-0.89 days, 95% CI: -1.58 to -0.2, p =.01, I² = 95.5%) while it
was equivocal between FS and RMT. The mid-term mortality was similar among
the three approaches. <br/>Conclusion(s): While mid-term mortality was
comparable among approaches, MS may be a safe and potentially more
effective approach than FS and RMT for SAVR in the short
term.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<64>
Accession Number
2020107997
Title
Pulmonary hypertension associated with cardiopulmonary bypass and cardiac
surgery.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Fayad F.H.; Sellke F.W.; Feng J.
Institution
(Fayad, Sellke, Feng) The Warren Alpert Medical School of Brown
University, Providence, RI, United States
(Fayad) Program in Liberal Medical Education, Brown University,
Providence, RI, United States
(Sellke, Feng) Division of Cardiothoracic Surgery, Rhode Island Hospital,
Alpert Medical School of Brown University, Providence, RI, United States
Publisher
John Wiley and Sons Inc
Abstract
Background and Aim: Pulmonary hypertension (PH) is frequently associated
with cardiovascular surgery and is a common complication that has been
observed after surgery utilizing cardiopulmonary bypass (CPB). The purpose
of this review is to explain the characteristics of PH, the mechanisms of
PH induced by cardiac surgery and CPB, treatments for postoperative PH,
and future directions in treating PH induced by cardiac surgery and CPB
using up-to-date findings. <br/>Method(s): The PubMed database was
utilized to find published articles. <br/>Result(s): There are many
mechanisms that contribute to PH after cardiac surgery and CPB which
involve pulmonary vasomotor dysfunction, cyclooxygenase, the thromboxane
A2 and prostacyclin pathway, the nitric oxide pathway, inflammation, and
oxidative stress. Furthermore, there are several effective treatments for
postoperative PH within different types of cardiac surgery.
<br/>Conclusion(s): By possessing a deep understanding of the mechanisms
that contribute to PH after cardiac surgery and CPB, researchers can
develop treatments for clinicians to use which target the mechanisms of PH
and ultimately reduce and/or eliminate postoperative PH. Additionally,
learning about the most up-to-date studies regarding treatments can allow
clinicians to choose the best treatments for patients who are undergoing
cardiac surgery and CPB.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<65>
Accession Number
639549411
Title
Device-Based Approaches Targeting Cardioprotection in Myocardial
Infarction: The Expanding Armamentarium of Innovative Strategies.
Source
Journal of the American Heart Association. (pp e7728), 2022. Date of
Publication: 16 Nov 2022.
Author
Romeo F.J.; Mazurek R.; Sakata T.; Mavropoulos S.A.; Ishikawa K.
Institution
(Romeo, Mazurek, Sakata, Mavropoulos, Ishikawa) Cardiovascular Research
Institute Icahn School of Medicine at Mount Sinai New York NY
Publisher
NLM (Medline)
Abstract
Coronary reperfusion therapy has played a pivotal role for reducing
mortality and heart failure after acute myocardial infarction. Although
several adjunctive approaches have been studied for reducing infarct size
further, both ischemia-reperfusion injury and microvascular obstruction
are still major contributors to both early and late clinical events after
acute myocardial infarction. The progress in the field of cardioprotection
has found several promising proof-of-concept preclinical studies. However,
translation from bench to bedside has not been very successful. This
comprehensive review discusses the importance of infarct size as a driver
of clinical outcomes post-acute myocardial infarction and summarizes
recent novel device-based approaches for infarct size reduction.
Device-based interventions including mechanical cardiac unloading,
myocardial cooling, coronary sinus interventions, supersaturated oxygen
therapy, and vagal stimulation are discussed. Many of these approaches can
modify ischemic myocardial biology before reperfusion and offer unique
opportunities to target ischemia-reperfusion injury.

<66>
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

<67>
Accession Number
2018329267
Title
Custodiol versus Blood Cardioplegia: Comparison of Myocardial
Immunohistochemical Analysis and Clinical Outcomes.
Source
Brazilian Journal of Cardiovascular Surgery. 37(5) (pp 680-687), 2022.
Date of Publication: 2022.
Author
Sen O.; Aydin U.; Kadirogullari E.; Guler S.; Gonca S.; Solakoglu S.;
Karacalilar M.; Timur B.; Onan B.
Institution
(Sen, Aydin, Kadirogullari, Karacalilar, Timur, Onan) Department of
Cardiovascular Surgery, Istanbul Mehmet Akif Ersoy Thoracic and
Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
(Guler) Department of Cardiovascular Surgery, GATA, Ankara, Turkey
(Gonca) Department of Histology and Embryology, Kocaeli University School
of Medicine, Kocaeli, Turkey
(Solakoglu) Department of Histology and Embryology, Istanbul University
School of Medicine, Istanbul, Turkey
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Custodiol (histidine-tryptophan-ketoglutarate) and
repetitive blood cardioplegia are the solutions for myocardial protection
and cardiac arrest. In this study, we aimed to compare immunohistochemical
analysis, clinical outcomes, and cardiac enzyme values of Custodiol and
blood cardioplegia groups. <br/>Method(s): This was a randomized
prospective study consisting of 2 groups and 20 patients, 10 patients for
each group, who underwent mitral and mitral/tricuspid valve surgery. Group
1 was formed for Custodiol cardioplegia and group 2 for blood
cardioplegia. Perioperative and postoperative cardiac events were
recorded, cardiac enzymes were analyzed with intervals, and myocardial
samples were taken for immunohistochemical analysis. Recorded data were
statistically evaluated. <br/>Result(s): There was no significant
difference for the Custodiol and blood cardioplegia groups in
perioperative and postoperative cardiac performance and adverse events.
Cardiac enzyme analysis showed no significant difference between groups.
However, two parameters (eNOS, Bcl-2) were in favor of the Custodiol group
in immunohistochemical studies. Custodiol performed better in cellular
oxidative stress resistance and cellular viability. <br/>Conclusion(s):
Clinical outcomes and cardiac enzyme analysis results were similar
regarding myocardial protection. However, Custodiol performed better in
the immunohistochemical analysis.<br/>Copyright &#xa9; 2022, Sociedade
Brasileira de Cirurgia Cardiovascular. All rights reserved.

<68>
Accession Number
2018329249
Title
Mechanical Circulatory Assist Devices: Which Is the Best Device as Bridge
to Heart Transplantation?.
Source
Brazilian Journal of Cardiovascular Surgery. 37(5) (pp 737-743), 2022.
Date of Publication: 2022.
Author
Hette A.N.; Sobral M.L.P.
Institution
(Hette, Sobral) Faculdade de Medicina, Centro Universitario Faculdade das
Americas, Sao Paulo, Sao Paulo, Brazil
(Sobral) Hospital Beneficencia Portuguesa de Sao Paulo, Sao Paulo, Sao
Paulo, Brazil
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Heart transplantation is the recommended treatment method
for patients with advanced heart failure that is refractory to clinical
treatment. Due to the progressive severity of these patients and the
impossibility of performing the transplant in a short term, there are
mechanical circulatory assist devices that can offer necessary hemodynamic
support and clinical stability in the period preceding the heart
transplant surgery. The present study aims to address and describe the
main devices used as bridges for heart transplantation, as well as to
analyze their advantages and disadvantages. <br/>Method(s): This work is a
literature review, developed with scientific production in the period from
2010 to 2020, that focus on circulatory assist devices as a bridge for
heart transplantation. <br/>Result(s): These devices are characterized as
a bridge for transplantation. Short-term or temporary devices are those
used for hemodynamic support to stabilize the individual clinically in the
presence of refractory cardiogenic shock. And long-term devices are
indicated for stable patients with long-term strategic planning.
<br/>Conclusion(s): According to the present study, it is possible to
observe that there is a wide variety of devices available on the market,
enabling the most appropriate choice according to the patient's
need.<br/>Copyright &#xa9; 2022, Sociedade Brasileira de Cirurgia
Cardiovascular. All rights reserved.

<69>
Accession Number
2020046370
Title
Statin use and the risk of CVD events, stroke, and all-cause mortality in
patients with diabetes: A systematic review and meta-analysis.
Source
Nutrition, Metabolism and Cardiovascular Diseases. 32(11) (pp 2470-2482),
2022. Date of Publication: November 2022.
Author
Yang X.H.; Zhang B.L.; Cheng Y.; Fu S.K.; Jin H.M.
Institution
(Yang, Cheng, Fu, Jin) Division of Nephrology, Shanghai Pudong Hospital,
Fudan University, Pudong Medical Center, 2800 Gong Wei Road, Shanghai,
China
(Zhang) The Institutes of Biomedical Sciences (IBS), Fudan University, 130
Dongan Road, Shanghai, China
Publisher
Elsevier B.V.
Abstract
Aims: Considering the lack of evidence on statin use and the risk of
cardiovascular disease (CVD) in patients with diabetes in primary and
secondary prevention, this study aimed to evaluate the effect of statin
use in individuals with diabetes for primary and secondary prevention.
Data synthesis: The MEDLINE, Web of Science, Embase, ClinicalTrials.gov,
and Cochrane Central Register for Controlled Trials databases were
searched. We included studies that assessed the effect of statin use in
individuals with diabetes for at least 1 year. The outcomes included CVD,
all-cause mortality, and stroke. A total of 24 studies including 2,152,137
patients with diabetes were included in the meta-analysis. Compared with
statin non-users, patients who received statins showed a lower risk of CVD
events (primary prevention: risk ratio [RR] = 0.80, 95% confidence
interval [CI] 0.69-0.94, P = 0.006; secondary prevention: RR = 0.75, 95%
CI 0.65-0.87, P < 0.0001). No association was observed between statin and
non-statin users and the risk of all-cause mortality. The pooled results
also revealed that statin use reduced the risk of ischemic stroke in
patients with diabetes (primary prevention: RR = 0.83, 95% CI 0.70-0.97, P
= 0.020; secondary prevention: RR = 0.74, 95% CI 0.63-0.85, P < 0.0001).
<br/>Conclusion(s): Statin use significantly reduced the risk of CVD
events and stroke, but not all-cause mortality, in individuals with
diabetes undergoing both primary and secondary prevention. More data are
required to verify the effects of statins in patients with diabetes.
Systematic review registration: PROSPERO CRD42021281132.<br/>Copyright
&#xa9; 2022 The Author(s)

<70>
Accession Number
2019518409
Title
Strategies for post-cardiac surgery acute kidney injury prevention: A
network meta-analysis of randomized controlled trials.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 960581. Date of Publication: 27 Sep 2022.
Author
Chen J.-J.; Lee T.H.; Kuo G.; Huang Y.-T.; Chen P.-R.; Chen S.-W.; Yang
H.-Y.; Hsu H.-H.; Hsiao C.-C.; Yang C.-H.; Lee C.-C.; Chen Y.-C.; Chang
C.-H.
Institution
(Chen, Kuo, Yang, Hsu, Lee, Chen, Chang) Department of Nephrology, Chang
Gung Memorial Hospital, Taoyuan, Taiwan (Republic of China)
(Lee) Chansn Hospital, Taoyuan, Taiwan (Republic of China)
(Kuo, Yang, Hsu, Lee, Chen, Chang) Department of Nephrology, Kidney
Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
(Republic of China)
(Huang) Department of Surgery, National Cheng Kung University Hospital,
College of Medicine, National Cheng Kung University, Tainan, Taiwan
(Republic of China)
(Chen) Department of Anesthesiology, Mackay Memorial Hospital, Taipei,
Taiwan (Republic of China)
(Chen) Department of Cardiothoracic and Vascular Surgery, Chang Gung
Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan (Republic of
China)
(Hsiao) Department of Nephrology, New Taipei Municipal TuCheng Hospital,
New Taipei City, Taiwan (Republic of China)
(Yang) Department of Cardiology, Chang Gung Memorial Hospital, Taoyuan,
Taiwan (Republic of China)
Publisher
Frontiers Media S.A.
Abstract
Objects: Cardiac surgery is associated with acute kidney injury (AKI).
However, the effects of various pharmacological and non-pharmacological
strategies for AKI prevention have not been thoroughly investigated, and
their effectiveness in preventing AKI-related adverse outcomes has not
been systematically evaluated. <br/>Method(s): Studies from PubMed,
Embase, and Medline and registered trials from published through December
2021 that evaluated strategies for preventing post-cardiac surgery AKI
were identified. The effectiveness of these strategies was assessed
through a network meta-analysis (NMA). The secondary outcomes were
prevention of dialysis-requiring AKI, mortality, intensive care unit (ICU)
length of stay (LOS), and hospital LOS. The interventions were ranked
using the P-score method. Confidence in the results of the NMA was
assessed using the Confidence in NMA (CINeMA) framework. <br/>Result(s): A
total of 161 trials (involving 46,619 participants) and 53 strategies were
identified. Eight pharmacological strategies {natriuretic peptides [odds
ratio (OR): 0.30, 95% confidence interval (CI): 0.19-0.47], nitroprusside
[OR: 0.29, 95% CI: 0.12-0.68], fenoldopam [OR: 0.36, 95% CI: 0.17-0.76],
tolvaptan [OR: 0.35, 95% CI: 0.14-0.90], N-acetyl cysteine with carvedilol
[OR: 0.37, 95% CI: 0.16-0.85], dexmedetomidine [OR: 0.49, 95% CI:
0.32-0.76;], levosimendan [OR: 0.56, 95% CI: 0.37-0.84], and
erythropoietin [OR: 0.62, 95% CI: 0.41-0.94]} and one non-pharmacological
intervention (remote ischemic preconditioning, OR: 0.76, 95% CI:
0.63-0.92) were associated with a lower incidence of post-cardiac surgery
AKI with moderate to low confidence. Among these nine strategies, five
(fenoldopam, erythropoietin, natriuretic peptides, levosimendan, and
remote ischemic preconditioning) were associated with a shorter ICU LOS,
and two (natriuretic peptides [OR: 0.30, 95% CI: 0.15-0.60] and
levosimendan [OR: 0.68, 95% CI: 0.49-0.95]) were associated with a lower
incidence of dialysis-requiring AKI. Natriuretic peptides were also
associated with a lower risk of mortality (OR: 0.50, 95% CI: 0.29-0.86).
The results of a sensitivity analysis support the robustness and
effectiveness of natriuretic peptides and dexmedetomidine.
<br/>Conclusion(s): Nine potentially effective strategies were identified.
Natriuretic peptide therapy was the most effective pharmacological
strategy, and remote ischemic preconditioning was the only effective
non-pharmacological strategy. Preventive strategies might also help
prevent AKI-related adverse outcomes. Additional studies are required to
explore the optimal dosages and protocols for potentially effective AKI
prevention strategies.<br/>Copyright &#xa9; 2022 Chen, Lee, Kuo, Huang,
Chen, Chen, Yang, Hsu, Hsiao, Yang, Lee, Chen and Chang.

<71>
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.

<72>
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.

<73>
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.

<74>
Accession Number
2021123313
Title
Utility of high-frequency B-mode and contrast-enhanced ultrasound for the
differential diagnosis of benign and malignant pleural diseases: a
prospective study.
Source
Journal of Thoracic Disease. 14(10) (pp 3695-3705), 2022. Date of
Publication: October 2022.
Author
Yang H.; Zhang Y.; Wei D.; Chen W.; Zhang S.; He L.; Liao H.; Tang Q.; Liu
J.
Institution
(Yang) Department of Ultrasound, First Affiliated Hospital of Jinan
University, Guangzhou, China
(Yang, Zhang, Wei, Chen, Zhang, He, Liao, Tang) Department of Ultrasound,
First Affiliated Hospital of Guangzhou Medical University, Guangzhou,
China
(Liu) Department of Medical Ultrasound, Guangzhou First People's Hospital,
School of Medicine, South China University of Technology, Guangzhou, China
Publisher
AME Publishing Company
Abstract
Background: Pleural disease is a prevalent condition. As precision therapy
advances, noninvasive imaging modalities play even more important roles in
the evaluation of pleural diseases. This study investigated the diagnostic
capabilities of high-frequency B-mode ultrasound (US) and
contrast-enhanced US (CEUS) in terms of differentiating between benign and
malignant pleural diseases. <br/>Method(s): Patients with unexplained
thickened pleurae were prospectively analyzed via transthoracic US.
High-frequency B-mode US was used to derive the pleural thickness,
morphology, and echogenicity. We analyzed the high-frequency CEUS data
including the enhancement mode and time intensity curve (TIC). The cause
of pleural thickening was confirmed by pleural biopsy and follow-up after
the biopsy. We analyzed the differences in various ultrasonic features
between the malignant and benign groups. Moreover, we plotted receiver
operator curves (ROCs) and obtained the area under the curves,
sensitivities, and specificities of all significant continuous variables.
Multivariate logistic regression was used to assess the combined
usefulness of multiple US indicators in terms of predicting malignant
pleurae. <br/>Result(s): Thirty malignant and twenty benign thickened
pleurae were finally diagnosed via pleural biopsy and at least six months
of follow-up. The pleural morphology and enhancement modes significantly
differed between the two groups (all P<0.05). The thickness derived from
B-mode US and CEUS were significantly thicker in the malignant group (both
P<0.05). Arrival time (AT) and the time to peak (TTP) of TIC were
significantly shorter in the malignant group, whereas peak intensity and
the area under the TIC were significantly higher in the malignant group
(all P<0.05). The area under the ROC for pleural thickness derived from
B-mode US was 0.819; pleural thickness derived from CEUS was 0.848; AT was
0.804; TTP was 0.750; peak intensity was 0.745; the area under the TIC was
0.743; and the combined various B-mode and CEUS parameter was 0.975.
<br/>Conclusion(s): Pleural thickness, morphology, enhancement mode, and
the TIC of high-frequency US aided the differentiation of benign from
malignant pleural diseases. Combined analysis of US indicators further
improved the diagnostic capability.<br/>Copyright &#xa9; 2022 AME
Publishing Company. All rights reserved.

<75>
[Use Link to view the full text]
Accession Number
2021104107
Title
Efficacy and safety of ciprofol for general anaesthesia induction in
elderly patients undergoing major noncardiac surgery: A randomised
controlled pilot trial.
Source
European Journal of Anaesthesiology. 39(12) (pp 960-963), 2022. Date of
Publication: 01 Dec 2022.
Author
Ding Y.-Y.; Long Y.-Q.; Yang H.-T.; Zhuang K.; Ji F.-H.; Peng K.
Institution
(Ding, Long, Yang, Zhuang, Ji, Peng) Department of Anesthesiology, First
Affiliated Hospital of Soochow University, China
(Ding, Long, Yang, Zhuang, Ji, Peng) Institute of Anesthesiology, Soochow
University, Jiangsu, Suzhou, China
Publisher
Lippincott Williams and Wilkins

<76>
[Use Link to view the full text]
Accession Number
2020686530
Title
Transcatheter Aortic Valve Replacement for Severe Symptomatic Aortic
Stenosis in Rheumatic Heart Disease: A Systematic Review.
Source
Cardiology in Review. 30(6) (pp 318-323), 2022. Date of Publication: 01
Nov 2022.
Author
Fernandes A.D.F.; Fernandes G.C.; Grant J.; Knijnik L.; Cardoso R.; Cohen
M.G.; Ferreira A.C.; Alfonso C.E.
Institution
(Fernandes, Grant, Knijnik) Department of Internal Medicine, University of
Miami, Jackson Memorial Hospital, Miami, FL, United States
(Fernandes) Division of Cardiology, University of Miami, Jackson Memorial
Hospital, Miami, FL, United States
(Cardoso) Division of Cardiology, Brigham and Women's Hospital, Boston,
MA, United States
(Cohen, Alfonso) Division of Cardiology, University of Miami, Miami, FL,
United States
(Ferreira) Division of Cardiology, Jackson Memorial Hospital, Miami, FL,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
Transcatheter aortic valve replacement (TAVR) is well-established for
severe symptomatic aortic stenosis (AS), but its use in rheumatic heart
disease (RHD) has been limited. We systematically review the use of TAVR
for severe symptomatic AS in RHD. Pubmed, Embase, and Scopus were searched
for TAVR for symptomatic severe AS and proven or suspected RHD. Procedure
characteristics, efficacy, and safety endpoints were collected and all
definitions were based on the Valve Academic Research Consortium-2
(VARC-2) criteria. We included 3 case series and 12 case reports, with a
total of 43 patients. Mean age was 76 years, 75% were female, and 85% had
NYHA class III-IV symptoms. Follow up ranged from 1 to 29 months. Patients
were moderate to high risk, with Society of Thoracic Surgery score ranging
from 6.1% to 17.6%. The approach was transfemoral in 30 (83%) cases.
Procedural success occurred in 37 (86%) patients. Of the 7 patients with
periprocedural complications, 4 had valve dislodgement, 1 deployment
failure, 1 unplanned cardiopulmonary bypass, and 1 moderate aortic
regurgitation. Paravalvular leak was reported in 5 (11.6%) patients. Only
1 patient had heart block requiring pacemaker. Among 13 studies (23
patients), 30-day mortality was 0%. One case series with 19 patients had a
30-day, 1-year, 2-year, and 5-year mortality of 5%, 11%, 31%, and 48%,
respectively. TAVR appears feasible for selected patients with rheumatic
severe AS, albeit our results indicate a 14% incidence of device failure.
Future randomized clinical trials may clarify the role of TAVR in this
group.<br/>Copyright &#xa9; 2022 Lippincott Williams and Wilkins. All
rights reserved.

<77>
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.

<78>
Accession Number
2020666927
Title
Efficacy of ultrasound-guided single-injection erector spinae plane block
for thoracoscopic wedge resection: a prospective randomized control trial.
Source
Regional Anesthesia and Pain Medicine. 47(12) (pp 749-754), 2022. Date of
Publication: 23 Sep 2022.
Author
Klaibert B.; Lohser J.; Tang R.; Jew M.; McGuire A.; Wilson J.
Institution
(Klaibert, Lohser, Tang, Jew, Wilson) Department of Anesthesiology and
Perioperative Care, Vancouver General Hospital, Vancouver, BC, Canada
(McGuire) Department of Surgery, Division of Thoracic Surgery, Vancouver
General Hospital, Vancouver, BC, Canada
Publisher
BMJ Publishing Group
Abstract
Background Despite advances in minimally invasive thoracic surgery,
patients remain at risk of adverse pulmonary events with suboptimal
postoperative analgesia. Novel methods of regional analgesia are
warranted. Our objective was to prospectively evaluate the impact of
ultrasound-guided single-injection erector spinae plane (ESP) block with
ropivacaine compared with placebo control on standard of care
postoperative recovery in subjects undergoing video-assisted thoracoscopic
surgery (VATS) wedge resection. Methods This prospective, randomized,
placebo-controlled, double-blinded study was conducted at a tertiary
thoracic surgical center. Consecutive subjects undergoing VATS wedge
resection were randomized to receive a single-injection ESP block with
0.5% ropivacaine or 0.9% saline placebo, in addition to the current
standard of care of multimodal analgesia including patient-controlled
analgesia and surgical local anesthetic wound infiltration. The primary
outcome was difference in 40-point Quality of Recovery (QoR-40) on day 1
postoperatively. The secondary outcomes included opioid consumption,
Visual Analog Pain Scale (VAS) score, time spent in the postanesthesia
care unit (PACU), and block-related and postoperative complications.
Results Eighty subjects were enrolled, 40 in each group, with 76
completing follow-up (38 subjects in each group). There was no difference
in the median QoR-40 score between groups, 169.5 for the ropivacaine group
and 172.5 for the control group (difference 3, p=0.843). No significant
differences existed between groups in all secondary outcomes, with the
exception of the ropivacaine group having lower VAS pain scores measured
at 1 hour postoperatively and a shorter duration of stay in the PACU of
117 min. Conclusions Following VATS wedge resection, the addition of an
ESP block with ropivacaine to standard multimodal analgesia is unlikely to
add meaningful clinical value. Trial registration number
NCT03419117.<br/>Copyright &#xa9; 2022 BMJ Publishing Group. All rights
reserved.

<79>
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.

<80>
Accession Number
2021157409
Title
Sex Representation among Principal Investigators in Cardiac Surgery
Clinical Trials in the United States: The Glass Ceiling and Room for
Improvement.
Source
Annals of Surgery. 276(6) (pp E1101-E1106), 2022. Date of Publication: 01
Dec 2022.
Author
Nguyen Q.; Luc J.G.Y.; Lawton J.S.; Chikwe J.; Cornwell L.D.; Simpson K.;
Estrera A.L.; Moon M.R.; Preventza O.
Institution
(Nguyen) Faculty of Medicine and Dentistry, University of Alberta,
Edmonton, AB, Canada
(Luc) Division of Cardiovascular Surgery, Department of Surgery,
University of British Columbia, Vancouver, BC, Canada
(Lawton) Division of Cardiac Surgery, Department of Surgery, John Hopkins
University, Baltimore, MD, United States
(Chikwe) Department of Cardiac Surgery, Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Cornwell) Division of Cardiothoracic Surgery, Michael E. DeBakey
Department of Surgery, Baylor College of Medicine, Houston, TX, United
States
(Cornwell, Simpson) Division of Cardiothoracic Surgery, Michael E. DeBakey
VA Medical Center, Houston, TX, United States
(Estrera) Department of Cardiothoracic and Vascular Surgery,
Cardiothoracic Surgery Section, University of Texas Health Science Center
Houston, McGovern Medical School, Houston, TX, United States
(Moon) Division of Cardiothoracic Surgery, Department of Surgery,
Washington University School of Medicine at Barnes-Jewish Hospital, St.
Louis, MO, United States
(Preventza) Department of Cardiovascular Surgery, Texas Heart Institute,
Houston, TX, United States
Publisher
Wolters Kluwer Health
Abstract
Objective: The aim of this study was to determine the sex representation
among principal investigators (PIs) in US cardiac surgery clinical trials.
Summary Background Data: Being a principal investigator in a US clinical
trial confers national recognition among peers. Sex representation among
principal investigators (PIs) in US cardiac surgery clinical trials has
not been evaluated. <br/>Method(s): We evaluated 124 US cardiac surgery
trials registered on Clin-icalTrials.gov from 2014 to 2019. Sixty trials
included PIs (n = 266) from 128 institutions that had a combined total of
1040 adult cardiac surgeons. We examined sex representation among
junior-level (instructor or assistant professor) and senior-level
(associate, full, or Emeritus professor) PIs by calculating the
participation-to-prevalence ratio (PPR), whereby a PPR range of 0.8 to 1.2
reflects equitable representation. <br/>Result(s): The pool representation
percentage was 6.1% (63/1040) for women and 93.9% (977/1040) for men. A
total of 266 PI positions were assigned to adult cardiac surgeons: 6
(9.5%; PPR = 0.37) from the female pool and 260 (26.6%; PPR = 1.04) from
the male pool (P = 0.004). The percentage of PIs with studies funded by
industry was 9.5% ofthe female pool (PPR = 0.39) and 25.0% of the male
pool (PPR = 1.04) (P = 0.009). No National Institutes of Health-funded or
other funded trials had female PIs. An overall trend was observed toward
disproportionally more men than women among PIs, especially at the senior
level (P = 0.027). <br/>Conclusion(s): Equitable opportunities for PI
positions are available for junior-level but not senior-level
cardiothoracic surgeons. These results suggest a need for active
engagement and promotion of equal opportunities in cardiac
surgery.<br/>Copyright &#xa9; 2022 Lippincott Williams and Wilkins. All
rights reserved.

<81>
Accession Number
2021209314
Title
Days at home after transcatheter or surgical aortic valve replacement in
high-risk patients.
Source
American Heart Journal. 255 (pp 125-136), 2023. Date of Publication:
January 2023.
Author
Chung M.; Butala N.M.; Faridi K.F.; Almarzooq Z.I.; Liu D.; Xu J.; Song
Y.; Baron S.J.; Shen C.; Kazi D.S.; Yeh R.W.
Institution
(Chung) Department of Anesthesia, Critical Care and Pain Medicine,
Massachusetts General Hospital, Boston, MA, United States
(Chung, Almarzooq, Xu, Song, Baron, Shen, Kazi, Yeh) Smith Center for
Outcomes Research in Cardiology, Division of Cardiovascular Medicine,
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
(Butala) Department of Medicine, University of Colorado School of
Medicine, Aurora, CO
(Faridi) Section of Cardiovascular Medicine, Department of Medicine, Yale
School of Medicine, New Haven, CT
(Almarzooq) Division of Cardiovascular Medicine, Department of Medicine,
Brigham and Women's Hospital, Boston, MA
(Liu) Baim Institute for Clinical Research, Boston, MA
(Xu, Song, Kazi, Yeh) Division of Cardiovascular Medicine, Department of
Medicine, Beth Israel Deaconess Medical Center, Boston, MA
(Baron) Department of Cardiology, Lahey Hospital & Medical Center,
Burlington, MA
(Shen) Biogen, Cambridge, MA
Publisher
Elsevier Inc.
Abstract
Background: Days at home (DAH) quantifies time spent at home after a
medical event but has not been fully evaluated for TAVR. We sought to
compare 1- and 5-year DAH (DAH<inf>365</inf>, DAH<inf>1825</inf>) among
high-risk patients participating in a randomized trial of transcatheter
aortic valve replacement (TAVR) with a self-expanding bioprosthesis versus
surgical aortic valve replacement (SAVR). <br/>Method(s): We linked data
from the U.S. CoreValve High Risk Trial to Medicare Fee-for-Service claims
in 456 patients with 450 (234 TAVR/216 SAVR) and 427 (222 TAVR/205 SAVR)
analyzed at 1 and 5 years. DAH was calculated as the number of days alive
and spent outside of a hospital, skilled nursing facility, rehabilitation,
long-term acute care hospital, emergency department, or observation stay.
<br/>Result(s): Mean DAH<inf>365</inf> was higher in patients who
underwent TAVR compared with SAVR (295.1 +/- 106.9 vs 267.8 +/- 122.3,
difference in days 27.2 [95% CI 6.0, 48.5], P = .01). Compared with SAVR,
TAVR patients had a shorter index length of stay (LOS) (7.4 +/- 4.5 vs
12.5 +/- 9.0, difference in days -5.1 [-6.5, -3.8], P < .001). The largest
contributions to decreased DAH<inf>365</inf> were mortality days and total
facility days after discharge from the index hospitalization (mortality
days-TAVR: 34.7 +/- 93.1 vs SAVR: 48.0 +/- 108.8, difference in days -13.3
[95% CI -32.1, 5.5], P = .17; total facility days-TAVR: 27.9 +/- 47.4 vs
SAVR: 36.7 +/- 48.9, difference in days -8.8 [95% CI -17.8, 0.1], P =
.05). Mean DAH<inf>1825</inf> was numerically but not statistically
significantly higher in TAVR (TAVR: 1154.2 +/- 659.0 vs SAVR: 1067.6 +/-
697.3, difference in days 86.6 [95% CI -42.3, 215.6], P = .19). Landmark
analysis showed no difference in DAH from years 1 to 5 (TAVR: 1040.4 +/-
477.5 vs SAVR: 1022.9 +/- 489.3, P = .74). <br/>Conclusion(s): In the U.S.
CoreValve High Risk Trial linked to Medicare, high-risk patients
undergoing TAVR spend an average of 27 additional DAH compared with SAVR
in the first year after the procedure due to a shorter index LOS and the
additive effect of fewer but nonsignificantly different mortality and
total facility days after discharge from the index hospitalization
compared with SAVR. After the first year, both groups spend a similar
number of DAH. These results describe the postprocedural course of
high-risk patients from a patient-centered perspective, which may guide
expectations regarding longitudinal health care needs and inform shared
decision-making.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<82>
Accession Number
2021208226
Title
Association between cuffed tracheal tube use and reduced
ventilator-associated pneumonia and conditions after elective cardiac
surgery in infants and young children.
Source
Minerva Anestesiologica. 88(11) (pp 890-900), 2022. Date of Publication:
November 2022.
Author
Nacoti M.; Carobbio A.; Finazzi S.; Pellicioli I.; Consonni F.; Ferrari
F.; Favarato M.; Fazzi F.; Bonanomi E.
Institution
(Nacoti, Pellicioli, Consonni, Ferrari, Favarato, Fazzi, Bonanomi)
Pediatric Intensive Care Unit, Department of Anesthesia and Critical Care,
Papa Giovanni XXIII Hospital, Bergamo, Italy
(Carobbio) FROM Research Foundation, ASST Papa Giovanni XXIII, Bergamo,
Italy
(Finazzi) Department of Clinical Epidemiology, Mario Negri IRCCS
Pharmacological Research Institute, Ranica, Bergamo, Italy
Publisher
Edizioni Minerva Medica
Abstract
BACKGROUND: Ventilator-associated pneumonia (VAP) is a serious
complication in children after cardiac surgery that may result from
micro-aspiration. However, the current recommendation to use cuffed
tracheal tubes (TTs) versus uncuffed TTs in children is still uncertain.
Our main aim was to evaluate the incidence of VAP, ventilator-associated
tracheobronchitis (VAT) and ventilator-associated conditions (VAC) in
children up to five years old who underwent elective cardiac surgery.
<br/>METHOD(S): Single-center, prospective before-and-after study at a
tertiary pediatric intensive care unit (PICU) in Italy. 242 patients (121
in each group) through the following periods: phase I (from Jan 2017 to
20^th Feb 2018), during which children were intubated with
uncuffed TTs; phase II (from 21^th Feb 2018 to Feb 2019), during
which children were intubated with cuffed TTs. <br/>RESULT(S): Data were
collected using an electronic dedicated database. Median age was five
months. The use of cuffed tubes reduced the risk of VAC and VAP
respectively 15.8 times (95% CI 3.4-73.1, P=0.0008) and 14.8 times (95% CI
3.1-71.5, P=0.002). No major related airway complications were observed in
the cuffed TTs group. Average treatment effect, calculated after
propensity score matching, confirmed the significant effect of cuffed TTs
on VAC and VAP. <br/>CONCLUSION(S): Our study suggests a marked reduction
of VAP and VAC associated with use of a cuffed versus uncuffed TT in
infants and children <=5 years of age after elective cardiac surgery. A
randomized clinical trial is needed to confirm these results and define
the impact of use of a cuffed versus uncuffed TT across other relevant ICU
outcomes and non-cardiac PICU patients.<br/>Copyright &#xa9; 2022 EDIZIONI
MINERVA MEDICA.

<83>
Accession Number
2021198506
Title
Fractional flow reserve versus angiography alone in guiding myocardial
revascularisation: a systematic review and meta-analysis of randomised
trials.
Source
Heart. 108(21) (pp 1699-1706), 2022. Date of Publication: 13 May 2022.
Author
Elbadawi A.; Sedhom R.; Dang A.T.; Gad M.M.; Rahman F.; Brilakis E.S.;
Elgendy I.Y.; Jneid H.
Institution
(Elbadawi, Rahman, Jneid) Cardiology, Baylor College of Medicine, Houston,
TX, United States
(Sedhom) Internal Medicine, Albert Einstein Medical Center, Philadelphia,
PA, United States
(Dang) Internal Medicine, The University of Texas Medical Branch at
Galveston, Galveston, TX, United States
(Gad) Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH,
United States
(Brilakis) Cardiology, Minneapolis Heart Institute and Minneapolis Heart
Institute Foundation, Minneapolis, MN, United States
(Elgendy) Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
Publisher
BMJ Publishing Group
Abstract
Background Randomised trials evaluating the efficacy and safety of
fractional flow reserve (FFR)-guided versus angiography-guided
revascularisation among patients with obstructive coronary artery disease
(CAD) have yielded mixed results. Aims To examine the comparative efficacy
and safety of FFR-guided versus angiography-guided revascularisation among
patients with obstructive CAD. Methods An electronic search of MEDLINE,
SCOPUS and Cochrane databases without language restrictions was performed
through November 2021 for randomised controlled trials that evaluated the
outcomes of FFR-guided versus angiography-guided revascularisation. The
primary outcome was major adverse cardiac events (MACE). Data were pooled
using a random-effects model. Results The final analysis included seven
trials with 5094 patients. The weighted mean follow-up duration was 38
months. Compared with angiography guidance, FFR guidance was associated
with fewer number of stents during revascularisation (standardised mean
difference=-0.80; 95% CI -1.33 to -0.27), but no difference in total
hospital cost. There was no difference between FFR-guided and
angiography-guided revascularisation in long-term MACE (13.6% vs 13.9%;
risk ratio (RR) 0.97, 95% CI 0.85 to 1.11). Meta-regression analyses did
not reveal any evidence of effect modification for MACE with acute
coronary syndrome (p=0.36), proportion of three-vessel disease (p=0.88) or
left main disease (p=0.50). There were no differences between FFR-guided
and angiography-guided revascularisation in the outcomes all-cause
mortality (RR 1.16, 95% CI 0.80 to 1.68), cardiovascular mortality (RR
1.27, 95% CI 0.50 to 3.26), repeat revascularisation (RR 0.99, 95% CI 0.81
to 1.21), recurrent myocardial infarction (RR 0.92, 95% CI 0.74 to 1.14)
or stent thrombosis (RR 0.61, 95% CI 0.31 to 1.21). Conclusion Among
patients with obstructive CAD, FFR-guided revascularisation did not reduce
the risk of long-term adverse cardiac events or the individual outcomes.
However, FFR-guided revascularisation was associated with fewer number of
stents. PROSPERO registration number CRD42021291596. <br/>Copyright &#xa9;

<84>
[Use Link to view the full text]
Accession Number
2021157491
Title
Evaluating the Utility of Colchicine in Acute Coronary Syndrome: A
Systematic Review and Meta-Analysis.
Source
Journal of Cardiovascular Pharmacology. 80(5) (pp 639-647), 2022. Date of
Publication: 03 Nov 2022.
Author
Bao Y.-L.; Gu L.-F.; Du C.; Wang Y.-X.; Wang L.-S.
Institution
(Bao, Gu, Du, Wang, Wang) The Department of Cardiology, The First Hospital
of Nanjing Medical University, Nanjing, China
Publisher
Lippincott Williams and Wilkins
Abstract
Abstract:Colchicine has demonstrated promising effects in inhibiting local
and systemic inflammation during acute coronary syndrome (ACS). However,
the efficacy of colchicine in ACS is controversial. We performed a
meta-analysis to assess the utility of colchicine in ACS by systematically
searching randomized controlled trials. Recurrent myocardial infarction,
coronary revascularization, and stroke were included as efficacy endpoint
parameters whereas safety endpoints chosen were all-cause mortality,
cardiovascular mortality, infectious events, and gastrointestinal (GI)
adverse events. Nine identified studies were included (n = 7207
participants). Colchicine may reduce the risk of coronary
revascularization by 54% [relative risk (RR) 0.46, 95% confidence interval
(CI) 0.29-0.73; P < 0.01] and stroke by 61% (RR 0.39, 95%CI 0.18-0.81; P =
0.01). We observed no significant difference in all-cause mortality (RR
1.25, 95%CI 0.70-2.24; P = 0.46), cardiovascular mortality (RR 0.99, 95%CI
0.58-1.69; P = 0.98), recurrent myocardial infarction (RR 0.75, 95%CI
0.49-1.14; P = 0.18), and infectious events (RR 0.67, 95%CI 0.08-5.52; P =
0.71). Colchicine increased the risk of GI adverse reactions (RR 1.89,
95%CI 1.25-2.84; P < 0.01). Subgroup analysis of loading doses did not
reveal significant differences in all endpoints (all P > 0.05), whereas
subgroup analysis of follow-up periods showed a lower risk of GI adverse
reactions with longer follow-up (P < 0.01), which may be related to
establishing tolerability. Trial sequential analysis suggested that
further data are needed before definitive conclusions can be drawn.
Colchicine may decrease the occurrence of stroke and revascularization in
ACS, whereas slightly increasing the risk of GI reactions. The loading
doses probably did not significantly improve the prognosis of
patients.<br/>Copyright &#xa9; 2022 Lippincott Williams and Wilkins. All
rights reserved.

<85>
[Use Link to view the full text]
Accession Number
2021157436
Title
Management of Infective Endocarditis in People Who Inject Drugs: A
Scientific Statement from the American Heart Association.
Source
Circulation. 146(14) (pp E187-E201), 2022. Date of Publication: 04 Oct
2022.
Author
Baddour L.M.; Weimer M.B.; Wurcel A.G.; McElhinney D.B.; Marks L.R.;
Fanucchi L.C.; Esquer Garrigos Z.; Pettersson G.B.; Desimone D.C.
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The American Heart Association has sponsored both guidelines
and scientific statements that address the diagnosis, management, and
prevention of infective endocarditis. As a result of the unprecedented and
increasing incidence of infective endocarditis cases among people who
inject drugs, the American Heart Association sponsored this original
scientific statement. It provides a more in-depth focus on the management
of infective endocarditis among this unique population than what has been
provided in prior American Heart Association infective
endocarditis-related documents. <br/>Method(s): A writing group was named
and consisted of recognized experts in the fields of infectious diseases,
cardiology, addiction medicine, and cardiovascular surgery in October
2021. A literature search was conducted in Embase on November 19, 2021,
and multiple terms were used, with 1345 English-language articles
identified after removal of duplicates. <br/>Conclusion(s): Management of
infective endocarditis in people who inject drugs is complex and requires
a unique approach in all aspects of care. Clinicians must appreciate that
it requires involvement of a variety of specialists and that consultation
by addiction-trained clinicians is as important as that of more
traditional members of the endocarditis team to improve infective
endocarditis outcomes. Preventive measures are critical in people who
inject drugs and are cured of an initial bout of infective endocarditis
because they remain at extremely high risk for subsequent bouts of
infective endocarditis, regardless of whether injection drug use is
continued.<br/>Copyright &#xa9; 2022 Lippincott Williams and Wilkins. All
rights reserved.

<86>
[Use Link to view the full text]
Accession Number
2021157279
Title
Prognostic Value of Measuring Fractional Flow Reserve after Percutaneous
Coronary Intervention in Patients with Complex Coronary Artery Disease:
Insights from the FAME 3 Trial.
Source
Circulation: Cardiovascular Interventions. 15(11) (pp 884-891), 2022. Date
of Publication: 01 Nov 2022.
Author
Piroth Z.; Otsuki H.; Zimmermann F.M.; Ferenci T.; Keulards D.C.J.; Yeung
A.C.; Pijls N.H.J.; De Bruyne B.; Fearon W.F.
Institution
(Piroth) Gottsegen National Cardiovascular Center, Budapest, Hungary
(Otsuki, Yeung, Fearon) Division of Cardiovascular Medicine and Stanford
Cardiovascular Institute, Stanford University, CA, United States
(Zimmermann, Keulards) Catharina Hospital, Eindhoven, Netherlands
(Ferenci, Pijls) Physiological Controls Research Center, Obuda University
and Department of Statistics, Corvinus University of Budapest, Hungary
(De Bruyne) Cardiovascular Center Aalst, Belgium
(De Bruyne) Lausanne University Centre Hospital, Switzerland
(De Bruyne) Stanford University School of Medicine, Stanford
Cardiovascular Institute, VA Palo Alto Health Care System, CA, United
States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: We evaluate the prognostic value of measuring fractional flow
reserve (FFR) after percutaneous coronary intervention (post-PCI FFR) and
intravascular imaging in patients undergoing PCI for 3-vessel coronary
artery disease in the FAME 3 trial (Fractional Flow Reserve versus
Angiography for Multivessel Evaluation). <br/>Method(s): The FAME 3 trial
is a multicenter, international, randomized study comparing FFR-guided PCI
with coronary artery bypass grafting in patients with multivessel coronary
artery disease. PCI was not noninferior with respect to the primary end
point of death, myocardial infarction, stroke, or repeat revascularization
at 1 year. Post-PCI FFR data were acquired on a patient and vessel-related
basis. Intravascular imaging guidance was tracked. The primary end point
is a comparison of target vessel failure (TVF) defined as a composite of
cardiac death, target vessel myocardial infarction, and target vessel
revascularization at 1 year based on post-PCI FFR values. Cox regression
with robust SEs was used for analysis. <br/>Result(s): Of the 757 patients
randomized to PCI, 461 (61%) had post-PCI FFR measurement and 11.1% had
intravascular imaging performed. The median post-PCI FFR was 0.89 [IQR
0.85-0.94]. On a vessel-level, post-PCI FFR was found to be a significant
predictor of TVF univariately (hazard ratio=0.67 [95% CI 0.48-0.93] for
0.1 unit increase, P=0.0165). On a patient-level, the single lowest
post-PCI FFR value was also found to be a significant predictor of TVF
univariately (hazard ratio=0.65 [95% CI 0.48-0.89] for 0.1 unit increase,
P=0.0074). Post-PCI FFR was an independent predictor of TVF in
multivariable analysis adjusted for key clinical parameters. Outcomes were
similar between patients who had intravascular imaging guidance and those
who did not. <br/>Conclusion(s): Post-PCI FFR measurement was a
significant predictor of TVF on a vessel and patient level and an
independent predictor of outcomes in a population with complex 3-vessel
coronary artery disease eligible for coronary artery bypass grafting. The
limited use of intravascular imaging did not affect outcomes.
Registration: URL: https://www.clinicaltrials.gov; Unique identifier:
NCT02100722.<br/>Copyright &#xa9; 2022 Lippincott Williams and Wilkins.
All rights reserved.

<87>
[Use Link to view the full text]
Accession Number
2021157273
Title
Instantaneous Wave-Free Ratio for the Assessment of Intermediate Left Main
Coronary Artery Stenosis: Correlations with Fractional Flow
Reserve/Intravascular Ultrasound and Prognostic Implications: The
iLITRO-EPIC07 Study.
Source
Circulation: Cardiovascular Interventions. 15(11) (pp 861-871), 2022. Date
of Publication: 01 Nov 2022.
Author
Rodriguez-Leor O.; De La Torre Hernandez J.M.; Garcia-Camarero T.; Garcia
Del Blanco B.; Lopez-Palop R.; Fernandez-Nofrerias E.; Cuellas Ramon C.;
Jimenez-Kockar M.; Jimenez-Mazuecos J.; Fernandez Salinas F.; Gomez-Lara
J.; Brugaletta S.; Alfonso F.; Palma R.; Gomez-Menchero A.E.; Millan R.;
Tejada Ponce D.; Linares Vicente J.A.; Ojeda S.; Pinar E.;
Fernandez-Pelegrina E.; Morales-Ponce F.J.; Cid-Alvarez A.B.; Rama-Merchan
J.C.; Molina Navarro E.; Escaned J.; Perez De Prado A.
Institution
(Rodriguez-Leor, Fernandez-Nofrerias) Institut Del Cor, Hospital
Universitari Germans Trias i Pujol, Badalona, Spain
(Rodriguez-Leor, Cid-Alvarez) Centro de Investigacion Biomedica en Red de
Enfermedades Cardiovasculares (CIBERCV), Spain
(Rodriguez-Leor) Institut de Recerca en Ciencies de la Salut Germans Trias
i Pujol, Badalona, Spain
(De La Torre Hernandez, Garcia-Camarero) Cardiology Department, Hospital
Universitario Marques de Valdecilla, Santander, Spain
(Garcia-Camarero) Instituto de Investigacion Marques de Valdecilla
(IDIVAL), Santander, Spain
(Garcia Del Blanco, Palma) Cardiology Department, Hospital Universitari
Vall d'Hebron, Barcelona, Spain
(Lopez-Palop, Pinar) Cardiology Department, Hospital Virgen de la
Arrixaca, Murcia, Spain
(Cuellas Ramon, Perez De Prado) Servicio de Cardiologia, Hospital
Universitario de Leon, Spain
(Jimenez-Kockar, Fernandez-Pelegrina) Cardiology Department, Hospital de
la Santa Creu i Sant Pau, Barcelona, Spain
(Jimenez-Mazuecos) Servicio de Cardiologia, Complejo Hospitalario
Universitario de Albacete, Spain
(Fernandez Salinas) Cardiology Department, Hospital Universitari Joan
XXIII, Tarragona, Spain
(Gomez-Lara) Cardiology Department, Hospital Universitari de Bellvitge,
l'Hospital de Llobregat, Spain (J.G.-L.)., Spain
(Brugaletta) Cardiology Department, Hospital Clinic, Barcelona, Spain
(Brugaletta) Institut d'Investigacions Biomediques August Pi i Sunyer
(IDIBAPS), Barcelona, Spain
(Brugaletta) University of Barcelona, Spain
(Alfonso) Cardiology Department, Hospital de la Princesa, Madrid, Spain
(Gomez-Menchero) Cardiology Department, Hospital Universitario Juan Ramon
Jimenez, Huelva, Spain
(Millan) Cardiology Department, Hospital Del Mar, Barcelona, Spain
(Tejada Ponce) Cardiology Department, Hospital General Universitario de
Castellon, Castellon de la Plana, Spain
(Linares Vicente) Cardiology Department, Hospital Clinico Universitario
Lozano Blesa, Zaragoza, Spain
(Ojeda) Division of Interventional Cardiology, Hospital Universitario
Reina Sofia, Cordoba, Spain
(Morales-Ponce) University of Cordoba, Cordoba Maimonides Institute for
Research in Biomedicine of Cordoba (IMIBIC), Spain (S.O.) Cardiology
Department, Hospital Universitario de Puerto Real, Spain
(Morales-Ponce) Servicio de Cardiologia, Hospital Clinico Universitario de
Santiago, Santiago de Compostela, Spain
(Rama-Merchan) Cardiology Department, Hospital Universitario Virgen de Las
Nieves, Granada, Spain
(Molina Navarro) Cardiology Department, Hospital de Merida, Extremadura,
Spain
(Escaned) Cardiology Department, Hospital Clinico San Carlos, Madrid,
Spain
(Escaned) Instituto de Investigacion Sanitaria Hospital Clinico San Carlos
(IdSSC), Madrid, Spain
(Escaned) Universidad Complutense de Madrid, Spain
Publisher
Lippincott Williams and Wilkins
Abstract
Background: There is little information available on agreement between
fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) in
left main coronary artery (LMCA) intermediate stenosis. Besides, several
meta-Analyses support the use of FFR to guide LMCA revascularization, but
limited information is available on iFR in this setting. Our aims were to
establish the concordance between FFR and iFR in intermediate LMCA
lesions, to evaluate with intravascular ultrasound (IVUS) in cases of
FFR/iFR discordance, and to prospectively validate the safety of deferring
revascularization based on a hybrid decision-making strategy combining iFR
and IVUS. <br/>Method(s): Prospective, observational, multicenter registry
with 300 consecutive patients with intermediate LMCA stenosis who
underwent FFR and iFR and, in case of discordance, IVUS and minimal lumen
area measurements. Primary clinical end point was a composite of
cardiovascular death, LMCA lesion-related nonfatal myocardial infarction,
or unplanned LMCA revascularization. <br/>Result(s): FFR and iFR had an
agreement of 80% (both positive in 67 and both negative in 167 patients);
in case of disagreement (31 FFR+/iFR-and 29 FFR-/iFR+) minimal lumen area
was >=6 mm²in 8.7% of patients with FFR+ and 14.6% with iFR+.
Among the 300 patients, 105 (35%) underwent revascularization and 181
(60%) were deferred according to iFR and IVUS. At a median follow-up of 20
months, major adverse cardiac events incidence was 8.3% in the defer group
and 13.3% in the revascularization group (hazard ratio, 0.71 [95% CI
0.30-1.72]; P=0.45). <br/>Conclusion(s): In patients with intermediate
LMCA stenosis, a physiology-guided treatment decision is feasible either
with FFR or iFR with moderate concordance between both indices. In case of
disagreement, the use of IVUS may be useful to indicate revascularization.
Deferral of revascularization based on iFR appears to be safe in terms of
major adverse cardiac events. Registration: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT03767621.<br/>Copyright &#xa9; 2022 Lippincott Williams and Wilkins.
All rights reserved.

<88>
Accession Number
2020127676
Title
Revisiting prediction of collapse in hip osteonecrosis with artificial
intelligence and machine learning: a new approach for quantifying and
ranking the contribution and association of factors for collapse.
Source
International Orthopaedics. (no pagination), 2022. Date of Publication:
2022.
Author
Hernigou P.
Institution
(Hernigou) University Paris East, Creteil, France
Publisher
Institute for Ionics
Abstract
Purpose: This study proposes machine learning to analyze the risk factors
of the collapse in patients with non-traumatic hip osteonecrosis of the
femoral head. <br/>Method(s): We collected data of 900 consecutive
patients (634 males) with bilateral (428) or unilateral non-traumatic
osteonecrosis diagnosed before collapse (at stage I or stage II). The
follow-up was average five years (3 to 8 years). A total of 50 variables
related to the osteonecrosis were included in the study. The osteonecroses
were randomly divided into a training set (80%) and a validation set (20%)
with a similar percentage of hips with collapse in the two groups. Machine
learning (ML) algorithms were trained with the selected variables.
Performance was evaluated and the different factors (variables) for
collapse were ranked with Shapley values. The primary outcome was
prediction of occurrence of collapse from automated inventory systems.
<br/>Result(s): In this series of patients, the accuracy with machine
learning for predicting collapse within three years follow-up was 81.2%.
Accuracies for predicting collapse within six to 12-24 months were 54.2%,
67.3%, and 71.2%, respectively, demonstrating that the accuracy is lower
for a prevision in the short term than for the mid-term. Despite none of
the risk-factors alone achieving statistical significance for prediction,
the system allowed ranking the different variables for risk of collapse.
The highest risk factors for collapse were sickle cell disease, liver, and
cardiac transplantation treated with corticosteroids, osteonecrosis volume
> 50% of the femoral head. Cancer (such as leukemia), alcohol abuse, lupus
erythematosus, Crohn's disease, pemphigus vulgaris treated with
corticosteroids, and osteonecrosis volume between 40 and 50% were medium
risk factors for collapse. Familial cluster of collapse, HIV infection,
chronic renal failure, nephrotic syndrome, and renal transplantation, when
treated with corticosteroids, stage II, osteonecrosis volume between 30
and 40%, chemotherapy, hip pain with VAS > 6, and collapse progression on
the contralateral side, were also significant but lowest risk factors. A
heat map is proposed to illustrate the ranking of the combinations of the
different variables. The highest risk of collapse is obtained with
association of various risks factors. <br/>Conclusion(s): This study, for
the first time, demonstrated prediction of collapse and ranking of factors
for collapse with a machine learning system. This study also shows that
collapse is due to a multifactorial risk factors.<br/>Copyright &#xa9;
2022, The Author(s) under exclusive licence to SICOT aisbl.

<89>
Accession Number
2020056639
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. (no pagination), 2022. Date of Publication: 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, National University of Singapore, Singapore
(Chan, Tay, Lim, Yip, Chew, Kuntjoro) Department of Cardiology, National
University Health System, National University Heart Centre, Singapore
Publisher
SAGE Publications Inc.
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.<br/>Copyright &#xa9; The
Author(s) 2022.

<90>
Accession Number
639539495
Title
Inspiratory muscle training improves cardiopulmonary function in patients
after transcatheter aortic valve replacement: a randomized clinical trial.
Source
European journal of preventive cardiology. (no pagination), 2022. Date of
Publication: 15 Nov 2022.
Author
Xu L.; Wei J.; Liu J.; Feng Y.; Wang L.; Wang S.; Li Q.; He S.; Chen Y.;
Peng Y.; Bao Y.; Yang X.; He C.; Chen M.; Wei Q.
Institution
(Xu, Liu, Wang, Wang, He, Wei) Rehabilitation Medicine Center and
Institute of Rehabilitation Medicine, West China Hospital, Sichuan
University, PR China, Chengdu, Sichuan, China
(Xu, Liu, Wang, Wang, He, Wei) Key Laboratory of Rehabilitation Medicine
in Sichuan Province, PR China, Chengdu, Sichuan, China
(Wei, Feng, Li, He, Chen, Peng, Bao, Yang, Chen) Department of Cardiology,
West China Hospital, Sichuan University, P.R. China, Chengdu, China
Publisher
NLM (Medline)
Abstract
AIMS: Inspiratory muscle training (IMT) can increase the strength or
endurance of the diaphragm and accessory muscles of inspiration, yet there
is no evidence that endorses the role of IMT in patients of transcatheter
aortic valve replacement (TAVR). This study tested for the first time the
effects of IMT plus usual cardiac rehabilitation (CR) on function in
patients after TAVR. <br/>METHOD(S): A double-blinded, randomized
controlled, single-center clinical trial was undertaken. Participants who
had a confirmed diagnosis of valve heart disease and were clinically
stable after TAVR were recruited and received a CR program during the
hospital stay. <br/>RESULT(S): A total of 96 patients were recruited and
randomly assigned to the IMT+CR group (n=48) or the CR group (n=48) in a
1:1 ratio. The group difference in the primary outcome, the six-minute
walk distance at the discharge of hospital, significantly favored the
IMT+CR group (Mean difference -33.52, 95%CI -64.42 to -2.62, p=0.034). The
significant difference was maintained at the 1-month and 3-month
follow-ups (Mean difference 41.51, 95%CI 1.82 to 81.21, p=0.041). In
addition, the mean hospital stays of subjects in the IMT+CR group was 11
days, which was significantly shorter than the 12.5 days in the CR group
(p=0.016). Sensitivity analysis using per-protocol analysis supported
these findings. No adverse treatment-related events were reported.
<br/>CONCLUSION(S): Compared with usual CR, IMT plus CR can effectively
improve exercise endurance, pulmonary ventilation function and inspiratory
muscle strength in patients after TAVR and shorten the length of hospital
stay.<br/>Copyright &#xa9; The Author(s) 2022. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<91>
Accession Number
639537184
Title
Effects of ferric carboxymaltose on hemoglobin level after cardiac
surgery: A randomized controlled trial.
Source
Anaesthesia, critical care & pain medicine. (pp 101171), 2022. Date of
Publication: 11 Nov 2022.
Author
Houry M.; Tohme J.; Sleilaty G.; Jabbour K.; Bou Gebrael W.; Jebara V.;
Madi-Jebara S.
Institution
(Houry, Tohme, Jabbour, Bou Gebrael, Madi-Jebara) Department of Anesthesia
and Critical Care, Hotel-Dieu de France hospital, Universite Saint-Joseph,
Beirut, Lebanon
(Sleilaty) Department of Cardiovascular and Thoracic Surgery, Hotel-Dieu
de France hospital, Universite Saint-Joseph, Beirut, Lebanon; Clinical
Research Center, Faculty of Medicine, Universite Saint-Joseph, Beirut,
Lebanon
(Jebara) Department of Cardiovascular and Thoracic Surgery, Hotel-Dieu de
France hospital, Universite Saint-Joseph, Beirut, Lebanon
Publisher
NLM (Medline)
Abstract
BACKGROUND: Perioperative anemia is common in cardiac surgery. Few studies
investigated the effect of postoperative intravenous (IV) iron
supplementation and were mostly inconclusive. <br/>METHOD(S): Design: A
randomized single-center, double-blind, placebo-controlled, parallel-group
trial. PARTICIPANTS: 195 non-anemic patients were recruited from December
2018 until December 2020: 97 patients received 1g of ferric carboxymaltose
(FCM) and 98 patients received 100mL of physiological serum on
postoperative day 1. MEASUREMENTS: hemoglobin levels, reticulocyte count,
serum iron, serum ferritin, and transferrin saturation were measured at
induction of anesthesia, postoperative days 1, 5, and 30. Transfusion
rate, duration of mechanical ventilation, critical care unit length of
stay, and side effects associated with IV iron administration were
measured. The primary outcome was hemoglobin level on day 30. Secondary
outcomes included iron balance, transfused red cell packs, and critical
care unit length of stay. <br/>RESULT(S): At day 30, the hemoglobine level
was higher in the FCM group than in the placebo group (mean 12.9+/-1.2 vs.
12.1+/-1.3g/dL, 95%CI 0.41-1.23, p-value <0.001). Patients in the FCM
group received fewer blood units (median 1[0-2] unit vs. 2 [0-3] units,
p-value=0.037) and had significant improvement in iron balance compared to
the control group. No side effects associated with FCM administration were
reported. <br/>CONCLUSION(S): In this randomized controlled trial,
administration of FCM on postoperative day 1 in non-anemic patients
undergoing cardiac surgery increased hemoglobin levels by 0.8g/dL on
postoperative day 30, leading to reduced transfusion rate, and improved
iron levels on postoperative day 5 and 30 (NCT03759964). CLINICAL TRIAL
REGISTRY NUMBER: NCT03759964.<br/>Copyright &#xa9; 2022. Published by
Elsevier Masson SAS.

<92>
Accession Number
2021083200
Title
Virulent endocarditis due to Haemophilus parainfluenzae: A systematic
review of the literature.
Source
World Journal of Cardiology. 14(10) (pp 546-556), 2022. Date of
Publication: 26 Oct 2022.
Author
Olagunju A.; Kenny D.; Martinez J.; Gideon P.; Mookadam F.; Unzek S.
Institution
(Olagunju, Kenny) Department of Internal Medicine, Creighton University,
School of Medicine, Phoenix, AZ 85013, United States
(Martinez, Gideon, Mookadam, Unzek) Department of Cardiology, Heart
Center, University of Arizona, College of Medicine-Phoenix, Banner
University Medical Center, Phoenix, AZ 85006, United States
(Mookadam) Department of Cardio-oncology, Banner MD Anderson Cancer
Center, Phoenix, AZ 85006, United States
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND Haemophilus parainfluenzae (HPI) belongs to the HACEK
(Haemophilus spp., Aggregatibacter spp., Cardiobacterium spp., Eikenella
spp., and Kingella spp.) group of organisms. The HACEK group of organisms
are a part of the oropharyngeal flora and can cause invasive opportunistic
infection such infective endocarditis (IE) in hosts with compromised
immunological barriers. AIM To perform a 20-year systematic review of the
literature characterizing the clinical presentation, epidemiology and
prognosis of HPI IE. METHODS We performed a systematic review of Medline,
Pubmed, Scopus and Embase from 2000 to 2022 to identify all cases of HPI
IE. RESULTS Thirty-nine adult cases were identified. HPI IE was found to
affect males slightly more than females and is common in patients with
predisposing risk factors such as underlying valvular abnormalities. It
mostly affected the mitral valve and had an indolent course; significantly
sized vegetations (> 1 cm) developed in most cases. Central nervous system
septic embolization was common. It had a favorable prognosis compared to
staphylococcal and streptococcal IE. CONCLUSION Clinicians should be
attentive to the indolent course of HPI IE and the presence of
predisposing risk factors in order to allow for timely
management.<br/>Copyright &#xa9; The Author(s) 2022.

<93>
Accession Number
2016795383
Title
Temporary Spinal Cord Stimulation to Prevent Postcardiac Surgery Atrial
Fibrillation: 30-Day Safety and Efficacy Outcomes.
Source
Journal of the American College of Cardiology. 79(7) (pp 754-756), 2022.
Date of Publication: 22 Feb 2022.
Author
Romanov A.; Lomivorotov V.; Chernyavskiy A.; Murtazin V.; Kliver E.;
Ponomarev D.; Mikheenko I.; Yakovlev A.; Yakovleva M.; Steinberg J.S.
Publisher
Elsevier Inc.

<94>
Accession Number
2014419930
Title
Effect of physical manipulation pulmonary rehabilitation on lung cancer
patients after thoracoscopic lobectomy.
Source
Thoracic Cancer. 13(3) (pp 308-315), 2022. Date of Publication: February
2022.
Author
Zhou T.; Sun C.
Institution
(Zhou) Thoracic surgery Department, Beijing Hospital, National Center of
Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical
Sciences, Beijing, China
(Sun) Nursing Department, Beijing Hospital, National Center of
Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical
Sciences, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
Background: To introduce a new postoperative pulmonary rehabilitation
program named physical manipulation pulmonary rehabilitation (PMPR) and to
explore the effect of perioperative management, including PMPR, on
patients with non-small cell lung cancer (NSCLC) after thoracoscopic
lobectomy. <br/>Method(s): A randomized controlled trial was conducted
between April and June 2021 at the Department of Thoracic Surgery, Beijing
Hospital. Adult patients with NSCLC who had undergone thoracoscopic
lobectomy were allocated to the treatment and control groups using a
random number table. The treatment group received both conventional
pulmonary rehabilitation (CVPR) and 14 days of PMPR after surgery; the
control group patients received CVPR only. PMPR included relaxing and
exercising the intercostal muscles, thoracic costal joint and abdominal
breathing muscles. Pulmonary function tests and the 6-min walk test were
conducted preoperatively and 7, 14, 21 and 28 days postoperatively. The
postoperative length of hospital stay, chest tube retention time and
postoperative pulmonary complications were recorded. The baseline data,
pulmonary function parameters and prognosis were compared with t- and
chi-square tests between the two groups. <br/>Result(s): A total of 86
patients were enrolled, and 44 patients were allocated to the treatment
group. There were no significant differences in the baseline data for age,
sex, body mass index, basic disease, surgical plan or preoperative
pulmonary function between the two groups (all p > 0.05). The peak
expiratory flow of patients in the treatment group was higher than that of
those in the control group 21 days after surgery (316 +/- 95 vs. 272 +/-
103 l/min, respectively, p = 0.043), and forced expiratory volume in the
first second on day 28 after surgery was greater than that in the control
group (2.1 +/- 0.2 vs. 1.9 +/- 0.3 L, respectively, p < 0.001). There were
no significant differences in forced vital capacity or 6-min walk test
scores (both p > 0.05). There were no significant differences in the
incidences of pneumonia and atelectasis between the two groups (both p >
0.05). The postoperative length of hospital stay (3.3 +/- 1.3 vs. 3.9 +/-
1.5 days, p = 0.043) and chest tube retention time (66 +/- 30 vs. 81 +/-
35 h, p = 0.036) in the treatment group were shorter than those in the
control group. <br/>Conclusion(s): We determined that PMPR could improve
early lung function in patients with NSCLC after thoracoscopic lobectomy,
and that chest tube retention time and length of hospital stay were
shortened.<br/>Copyright &#xa9; 2021 The Authors. Thoracic Cancer
published by China Lung Oncology Group and John Wiley & Sons Australia,
Ltd.

<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
636989232
Title
Fractional flow reserve-guided PCI as compared with coronary bypass
surgery.
Source
New England Journal of Medicine. 386(2) (pp 128-137), 2022. Date of
Publication: 13 Jan 2022.
Author
Fearon W.F.; Zimmermann F.M.; de Bruyne B.; Piroth Z.; van Straten A.H.M.;
Szekely L.; Davidavicius G.; Kalinauskas G.; Mansour S.; Kharbanda R.;
Ostlund-Papadogeorgos N.; Aminian A.; Oldroyd K.G.; Al-Attar N.; Jagic N.;
Jan-Henk E.D.; Kala P.; Angeras O.; MacCarthy P.; Wendler O.; Casselman
F.; Witt N.; Mavromatis K.; Miner S.E.S.; Sarma J.; Engstrom T.;
Christiansen E.H.; Tonino P.A.L.; Reardon M.J.; Lu D.; Ding V.Y.;
Kobayashi Y.; Hlatky M.A.; Mahaffey K.W.; Desai M.; Woo Y.J.; Yeung A.C.;
Pijls N.H.J.
Institution
(Fearon) Stanford University School of Medicine, 300 Pas- teur Dr., H2103,
Stanford, CA 94305, United States
(Fearon, Hlatky, Yeung) Division of Cardiovascular Medicine, Stanford
Cardiovascular Institute, United States
(Lu, Ding, Desai) The Quantitative Sciences Unit
(Hlatky) Departments of Health Policy
(Woo) Cardiotho- racic Surgery
(Mahaffey) Stanford University, Stanford Center for Clinical Research,
Department of Medicine, Stanford University School of Medicine, United
States
(Fearon) VA Palo Alto Health Care System, Palo Alto, CA, United States
(Zimmermann, van Straten, Tonino) Catharina Hospital, Eindhoven,
Netherlands
(Jan-Henk, Pijls) Isala Hospital, Zwolle, Netherlands
(de Bruyne, Casselman) Cardio- vascular Center Aalst, Aalst, Belgium
(Aminian) Centre Hospitalier Universitaire de Charleroi, Charleroi,
Belgium
(de Bruyne) Lausanne University Center Hospital, Lausanne, Switzerland
(Piroth, Szekely) Gottsegen National Cardiovascular Center, Budapest,
Hungary
(Davidavicius, Kalinauskas) Clinic of Cardiac and Vascular Diseases,
Institute of Clinical Medicine, Vilnius University, Vilnius University
Hospi- tal Santaros Klinikos, Vilnius, Lithuania
(Mansour) Centre Hospitalier de l'Universite de Montreal, Montreal, Canada
(Davidavicius, Kalinauskas) Southlake Regional Health Centre, Newmarket,
ON, Canada
(Mansour) Oxford University Hospitals NHS Foundation Trust, Oxford, United
Kingdom
(Miner) Golden Jubilee National Hospital, Glasgow, United Kingdom
(Kharbanda) Wythenshawe Hospital, Manchester, United Kingdom
(Oldroyd, Al-Attar) Danderyd University Hospital, Sweden
(Sarma) Karolinska Institutet, Solna, Sweden
(Ostlund-Papadogeorgos) Sahlgrenska University Hospital, Gothenburg,
Sweden
(Ostlund-Papadogeorgos, Witt) Clinical Hospital Centre Zemun, University
of Belgrade, Belgrade, Serbia
(Angeras) Medical Faculty of Masaryk University and University Hospital
Brno, Brno, Czechia
(Jagic) Kings College Hospital, London, United Kingdom
(Kala) The Atlanta VA Healthcare System, Decatur, United States
(MacCarthy, Wendler) Rigshospitalet, Copenhagen, Denmark
(Mavromatis) Aarhus University Hospital, Aarhus, Denmark
(Engstrom) Houston Methodist Hospital, Houston, United States
(Christiansen) Montefiore Medical Center, New York, United States
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND Patients with three-vessel coronary artery disease have been
found to have better outcomes with coronary-artery bypass grafting (CABG)
than with percutaneous coronary intervention (PCI), but studies in which
PCI is guided by measurement of fractional flow reserve (FFR) have been
lacking. METHODS In this multicenter, international, noninferiority trial,
patients with three-vessel coronary artery disease were randomly assigned
to undergo CABG or FFR-guided PCI with current-generation
zotarolimus-eluting stents. The primary end point was the occurrence
within 1 year of a major adverse cardiac or cerebrovascular event, defined
as death from any cause, myocardial infarction, stroke, or repeat
revascularization. Noninferiority of FFR-guided PCI to CABG was
prespecified as an upper boundary of less than 1.65 for the 95% confidence
interval of the hazard ratio. Secondary end points included a composite of
death, myocardial infarction, or stroke; safety was also assessed. RESULTS
A total of 1500 patients underwent randomization at 48 centers. Patients
assigned to undergo PCI received a mean (+/-SD) of 3.7+/-1.9 stents, and
those assigned to undergo CABG received 3.4+/-1.0 distal anastomoses. The
1-year incidence of the composite primary end point was 10.6% among
patients randomly assigned to undergo FFR-guided PCI and 6.9% among those
assigned to undergo CABG (hazard ratio, 1.5; 95% confidence interval [CI],
1.1 to 2.2), findings that were not consistent with noninferiority of
FFR-guided PCI (P=0.35 for noninferiority). The incidence of death,
myocardial infarction, or stroke was 7.3% in the FFR-guided PCI group and
5.2% in the CABG group (hazard ratio, 1.4; 95% CI, 0.9 to 2.1). The
incidences of major bleeding, arrhythmia, and acute kidney injury were
higher in the CABG group than in the FFR-guided PCI group. CONCLUSIONS In
patients with three-vessel coronary artery disease, FFR-guided PCI was not
found to be noninferior to CABG with respect to the incidence of a
composite of death, myocardial infarction, stroke, or repeat
revascularization at 1 year. (Funded
byMedtronicandAbbottVascular;FAME3ClinicalTrials.govnumber,NCT02100722.)<b
r/>Copyright &#xa9; 2022 BMJ Publishing Group. All rights reserved.

<97>
Accession Number
637126971
Title
Evaluation of Rhomboid Intercostal Block in Video-Assisted Thoracic
Surgery: Comparing Three Concentrations of Ropivacaine.
Source
Frontiers in Pharmacology. 12 (no pagination), 2021. Article Number:
774859. Date of Publication: 17 Jan 2022.
Author
Deng W.; Jiang C.-W.; Qian K.-J.; Liu F.
Institution
(Deng, Qian, Liu) Department of Critical Medicine, The First Affiliated
Hospital of Nanchang University, Nanchang, China
(Deng, Qian, Liu) Medical Innovation Center, First Affiliated Hospital of
Nanchang University, Nanchang, China
(Jiang) Department of Anesthesiology and Pain Medicine, The Affiliated
Hospital of Jiaxing University, Jiaxing, China
Publisher
Frontiers Media S.A.
Abstract
Background: Ultrasound-guided rhombic intercostal block (RIB) is a novel
regional block that provides analgesia for patients who have received
video-assisted thoracoscopic surgery (VATS). The anesthetic
characteristics of ultrasound-guided RIB with different concentrations of
ropivacaine are not known. This research primarily hypothesizes that
ultrasound-guided RIB, given in combination with the same volume of
different concentrations of ropivacaine, would improve the whole quality
of recovery-40 (QoR-40) among patients with VATS. Approaches: This
double-blinded, single-center, prospective, and controlled trial
randomized 100 patients undergoing VATS to receive RIB. One hundred
patients who have received elective VATS and satisfied inclusion standards
were fallen into four groups randomly: control group with no RIB and
R<inf>0.2%</inf>, R<inf>0.3%</inf>, and R<inf>0.4%</inf>; they underwent
common anesthesia plus the RIB with ropivacaine at 0.2%, 0.3%, and 0.4% in
a volume of 30 ml. <br/>Outcome(s): Groups R<inf>0.2%</inf>,
R<inf>0.3%</inf>, and R<inf>0.4%</inf> displayed great diversities in the
overall QoR-40 scores and QoR-40 dimensions (in addition to psychological
support) by comparing with the control group (Group C) (p < 0.001 for all
contrasts). Groups R<inf>0.3%</inf> and R<inf>0.4%</inf> displayed great
diversities in the overall QoR-40 scores and QoR-40 dimensions (in
addition to psychological support) by comparing with the R<inf>0.2%</inf>
group (p < 0.001 for all contrasts). The overall QoR-40 scores and QoR-40
dimensions [physical comfort (p = 0.585)] did not vary greatly between
Groups R<inf>0.3%</inf> and R<inf>0.4%</inf> (p > 0.05 for all contrasts).
Groups R<inf>0.2%</inf>, R<inf>0.3%</inf>, and R<inf>0.4%</inf> showed
significant differences in numerical rating scales (NRS) score region
under the curve (AUC) at rest and on movement in 48 h when compared with
the Group C (p < 0.001 for all contrasts). Groups R<inf>0.3%</inf> and
R<inf>0.4%</inf> displayed great diversities in NRS score AUC at rest and
on movement in 48 h when compared with the R<inf>0.2%</inf> group (p <
0.001 for all contrasts). The NRS mark AUC at rest and, on movement in 48
h, did not vary greatly between the Group R<inf>0.3%</inf> and
R<inf>0.4%</inf> (p > 0.05 for all contrasts). <br/>Conclusion(s): In this
study it was found that a dose of 0.3% ropivacaine is the best
concentration for RIB for patients undergoing VATS. Through growing
ropivacaine concentration, the analgesia of the RIB was not improved
greatly. Clinicaltrials.gov Registration: https://clinicaltrials.gov/,
identifier ChiCTR2100046254.<br/>Copyright &#xa9; 2022 Deng, Jiang, Qian
and Liu.

<98>
[Use Link to view the full text]
Accession Number
634780675
Title
A Comparison of the Required Bronchial Cuff Volume Obtained by 2 Cuff
Inflation Methods, Capnogram Waveform-Guided Versus Pressure-Guided: A
Prospective Randomized Controlled Study.
Source
Anesthesia and Analgesia. 132(3) (pp 827-835), 2021. Date of Publication:
01 Mar 2021.
Author
Yamada Y.; Tanabe K.; Nagase K.; Ishihara T.; Iida H.
Institution
(Yamada, Tanabe, Nagase, Iida) Department of Anesthesiology and Pain
Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu
501-1194, Japan
(Ishihara) Gifu University Hospital Innovative and Clinical Research
Promotion Center, Gifu University, Gifu, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Double-lumen endobronchial tubes (DLTs) are used for one-lung
ventilation (OLV) during thoracic surgery. Overinflation into the
bronchial cuff causes damage to the tracheobronchial mucosa, whereas
underinflation leads to an incomplete collapse of the nonventilated lung
or incomplete ventilation of the ventilated lung. However, how to
determine the appropriate bronchial cuff volume and pressure during OLV is
unclear. The objective of this study is to compare the required bronchial
cuff volume for lung separation obtained by 2 different cuff inflation
methods under closed- and open-chest conditions. <br/>METHOD(S): A total
of 64 patients scheduled to undergo elective thoracic surgery requiring
OLV were recruited. Left DLTs were used for both right- and left-sided
surgery. The patients were randomly assigned to 1 of 2 inflation-type
groups to estimate the bronchial cuff volume. In the capnogram
waveform-guided bronchial cuff inflation group (capno group, n = 27), the
bronchial cuff was inflated until a capnometer sampling gas containing
CO²from the nonventilated lung displayed a flat line. The
corresponding bronchial cuff volume and pressure were then recorded. In
the pressure-guided bronchial cuff inflation group (pressure group, n =
29), the bronchial cuff was inflated by a cuff inflator to a pressure of
20 cm H²O. Lung separation was confirmed when a flat line of a
capnometer was observed after gas sampling from the nonventilated lung.
<br/>RESULT(S): Under closed-chest conditions, the bronchial cuff sealing
volume for the capno group was significantly lower than that for the
pressure group (mean [standard deviation {SD}], 1.00 [0.65] mL vs 1.44
[0.59] mL, mean difference, -0.44; 97.5% confidence interval [CI], -0.78
to -0.11; P =.010). Under open-chest conditions, the bronchial cuff
sealing volume for the capno group was also significantly lower than that
for the pressure group (mean [SD], 0.65 [0.66] mL vs 1.22 [0.45] mL, mean
difference, -0.58; 97.5% CI, -0.88 to -0.27; P <.001). <br/>CONCLUSION(S):
The lowest cuff volume providing an air-tight bronchial seal was obtained
by the capnogram waveform-guided bronchial cuff inflation method. Since
the cuff volume required to achieve an air-tight seal decreases after
opening the chest, readjustment of the bronchial cuff volume to prevent
bronchial cuff damage to the tracheobronchial mucosa after opening the
chest may be advisable.<br/>Copyright &#xa9; 2021 Lippincott Williams and
Wilkins. All rights reserved.

<99>
Accession Number
2020808315
Title
Cardiac Autonomic Neuropathy in Type 1 and 2 Diabetes: Epidemiology,
Pathophysiology, and Management.
Source
Clinical Therapeutics. 44(10) (pp 1394-1416), 2022. Date of Publication:
October 2022.
Author
Williams S.; Raheim S.A.; Khan M.I.; Rubab U.; Kanagala P.; Zhao S.S.;
Marshall A.; Brown E.; Alam U.
Institution
(Williams, Raheim, Khan, Rubab, Kanagala, Brown, Alam) Department of
Medicine, Aintree University Hospital, Liverpool University Hospitals NHS
Foundation Trust, Liverpool, United Kingdom
(Kanagala, Zhao, Marshall, Brown, Alam) Department of Eye & Vision
Sciences, Institute of Life Course and Medical Sciences, University of
Liverpool, Liverpool, United Kingdom
(Zhao) Centre for Epidemiology Versus Arthritis, Division of
Musculoskeletal and Dermatological Sciences, School of Biological
Sciences, Faculty of Biology Medicine and Health, Manchester Academic
Health Science Centre, University of Manchester, Manchester, United
Kingdom
Publisher
Elsevier Inc.
Abstract
Purpose: Cardiac autonomic neuropathy (CAN) is a serious complication of
type 1 and type 2 diabetes and is independently associated with major
cardiovascular events, morbidity, and mortality. This narrative review
examines the epidemiology, pathophysiology, and management and identifies
areas of future research to address the challenge posed by CAN.
<br/>Method(s): We conducted a comprehensive literature search using a
range of sources, including the electronic databases PubMed Central,
Google Scholar, OVID, and Open Athens, to search for studies on CAN,
diabetes mellitus, lifestyle intervention, and cardiovascular risk. We set
inclusion criteria to consider review articles or original research
published in peer-reviewed journals that examined CAN in diabetes.
<br/>Finding(s): Epidemiologic data indicate a varied prevalence of CAN in
type 1 and 2 diabetes, with prevalences of 17% to 73%) depending on
clinical and demographic factors. Indeed, duration of diabetes and
hyperglycemia are the strongest risk factors for CAN development in type 1
diabetes. However, in type 2 diabetes, multifactorial risk factors,
including obesity, hypertension, and hyperlipidemia, are associated with
the development of CAN. Insulin resistance, which underpins type 2
diabetes and metabolic syndrome, has a direct role in the pathogenesis of
CAN. Lifestyle interventions, including dietary measures and tailored
exercise programs, have been beneficial in improving cardiac autonomic
function primarily measured through heart rate variability. In addition,
weight loss through bariatric surgery also improves heart rate variability
and may prevent or reduce CAN progression in people living with obesity
and concomitant type 2 diabetes. For optimization in type 2 diabetes, both
lifestyle and targeted pharmacologic interventions are required to achieve
glycemic/metabolic targets, and weight loss is required to prevent or
reverse early CAN or prevent the progression to definite and severe CAN.
Implications: The focused use of diagnostic testing for CAN, including
cardiac autonomic reflex testing in those at high risk of CAN, will enable
earlier diagnosis. This testing will allow timely interventions at a
reversible stage. Future research should examine targeted early diagnostic
testing with subsequent intervention with a combination of lifestyle
measures and newer pharmacotherapeutics (eg, sodium-glucose cotransporter
2 inhibitors and glucagon-like peptide 1 receptor agonists), which have
produced significant cardiovascular benefit in diabetes.<br/>Copyright
&#xa9; 2022

<100>
Accession Number
2019804897
Title
Patent foramen ovale and perioperative stroke in noncardiac surgery: a
systematic review and meta-analysis.
Source
British Journal of Anaesthesia. 129(6) (pp 898-908), 2022. Date of
Publication: December 2022.
Author
Rais G.; Vassallo P.; Schorer R.; Bollen Pinto B.; Putzu A.
Institution
(Rais, Schorer, Bollen Pinto, Putzu) Department of Acute Medicine,
Division of Anaesthesiology, Geneva University Hospitals, Geneva,
Switzerland
(Vassallo) Department of Clinical Neuroscience, Lausanne University
Hospital, Lausanne, Switzerland
Publisher
Elsevier Ltd
Abstract
Background: Patent foramen ovale (PFO) is associated with perioperative
stroke in noncardiac surgery. The magnitude of this association was
assessed in a systematic review and meta-analysis. <br/>Method(s):
Electronic databases were searched up to June 2022 for studies assessing
the association between patent foramen ovale and perioperative stroke in
adult patients undergoing noncardiac surgery. The primary analysis was
limited to studies reporting effect estimates adjusted for significant
clinical confounders. We calculated the adjusted odds ratio (aOR) and 95%
confidence interval (CI). <br/>Result(s): We included nine retrospective
and two prospective observational studies, including 21 257 082 patients.
The presence of a patent foramen ovale was independently associated with
stroke at 30 days after surgery (aOR=6.68 [95% CI: 3.51-12.73]; P<0.001)
and at longest follow-up available (aOR=7.36 [95% CI: 3.56-15.21];
P<0.001). The odds of stroke at 30 days varied according to surgical
specialty: neurosurgery (aOR=4.52 [95% CI: 3.17-6.43]), vascular surgery
(aOR=7.15 [95% CI: 2.52-20.22]), thoracic surgery (aOR=10.64 [95% CI:
5.97-18.98]), orthopaedic surgery (aOR=11.85 [95% CI: 5.38-26.08]),
general surgery (aOR=14.40 [95% CI: 10.88-19.06]), and genitourinary
surgery (aOR=17.28 [95% CI: 10.36-28.84]). <br/>Conclusion(s): The
presence of a patent foramen ovale is associated with a large and
consistent increase in odds of stroke across all explored surgical
settings. Prospective trials should further explore this association by
systematically assessing patent foramen ovale and stroke prevalence and
identifying a specific population at risk. This is crucial for the
elaboration of prevention plans and may improve perioperative
outcomes.<br/>Copyright &#xa9; 2022 British Journal of Anaesthesia

<101>
Accession Number
639513261
Title
CardioAlex 2022.
Source
European Heart Journal, Supplement. Conference: CardioAlex 2022.
Alexandria Egypt. 24(Supplement G) (no pagination), 2022. Date of
Publication: September 2022.
Author
Anonymous
Publisher
Oxford University Press
Abstract
The proceedings contain 12 papers. The topics discussed include:
accelerated streptokinase infusion regimen versus standard infusion
regimen in STEMI patients. A randomized clinical trial to compare clinical
and angiographic outcomes; impact of the type of annuloplasty prosthesis
on hemodynamic status after mitral valve repair in Egyptian patients;
assessment of left and right ventricular functions in overweight and obese
females by different echo-doppler modalities; coronary calcification in
asymptomatic metabolic syndrome; impact of cardiac resynchronization
therapy (CRT) on the severity of mitral regurgitation in dilated
cardiomyopathy patients; long term results of LAD reconstruction with LIMA
patch in patients with multiple significant lad disease; management of
ST-segment elevation myocardial infarction in comparison to European
society of cardiology guidelines in Alexandria university hospitals; and
the prognostic value of duke treadmill score in prediction of MPI result.

<102>
Accession Number
2018633901
Title
Effect of short-term magnesium supplementation on anxiety, depression and
sleep quality in patients after open-heart surgery.
Source
Magnesium Research. 35(2) (pp 62-70), 2022. Date of Publication:
April-May-June 2022.
Author
Saba S.; Faizi F.; Sepandi M.; Nehrir B.
Institution
(Saba) Critical Care Nursing, Baqiyatallah University of Medical Sciences,
Student's Research Committee, Tehran, Iran, Islamic Republic of
(Faizi) Atherosclerosis Research Center, Nursing Faculty, Baqiyatallah
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Sepandi) Health Management Research Center, Life Style Institute,
Baqiyatallah University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Nehrir) Health Management Research Center, Nursing Faculty, Baqiyatallah
University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
John Libbey
Abstract
Objective: This study aimed to evaluate the effect of magnesium
supplementation on anxiety, depression and sleep quality of patients after
openheart surgery. <br/>Material(s) and Method(s): Based on a clinical
trial, 60 candidates for open-heart surgery were separated into control
and intervention groups. In the intervention group, 500 mg of magnesium
was administered daily in the form of two 250-mg magnesium oxide tablets
for five days, and routine care was performed in the control group.
Patients' demographic information and assessment based on the Hospital
Anxiety and Depression Scale (HADS) and Petersburg Sleep Quality Inventory
(PSQI) were documented at the beginning of the study, after surgery and
endotracheal intubation, and at the end of the study. Data were
statistically analysed using Stata software version 13. <br/>Result(s):
After the intervention, the mean level of magnesium in the intervention
group was significantly higher (p=0.001). At the end of the study, the
mean level of anxiety and depression was significantly lower in the
intervention group than the control group (p=0.007), moreover, mean sleep
quality improved in the intervention group (8.3+2.1) compared to the
control group (10.3+2.0) (p=0.001). <br/>Conclusion(s): Due to the effects
of magnesium supplementation in patients after heart surgery, it is
recommended that this supplement be included in the treatment plan in
order to prevent anxiety and depression in these patients after surgery
and improve their quality of sleep.<br/>Copyright &#xa9; 2022, John
Libbey. All rights reserved.

<103>
Accession Number
2018633896
Title
Comparison of effectiveness and safety of epsilon-aminocaproic acid and
tranexamic acid in adult patients undergoing cardiac surgery.
Source
JMS - Journal of Medical Society. 36(2) (pp 52-59), 2022. Date of
Publication: May-August 2022.
Author
Singh L.C.; Singh S.; Okyere I.; Annamalai A.; Singh A.
Institution
(Singh) Department of Anaesthesia, RIMS, Manipur, Imphal, India
(Singh) Departments of Anaesthesiology and Intensive Care Kwame Nkrumah
University of Science and Technology, Ghana
(Okyere) Departments of Surgery, Kwame Nkrumah University of Science and
Technology, Kumasi, Ghana
(Singh) Department of Community Health, School of Public Health, Kwame
Nkrumah University of Science and Technology, Kumasi, Ghana
(Singh, Annamalai) Department of Cardiac Anaesthesia, SAMSRI, Uttar
Pradesh, Lucknow, India
Publisher
Regional Institute of Medical Sciences
Abstract
Objective: The objective of the study is to evaluate the effectiveness and
safety of epsilon-aminocaproic acid (EACA) and tranexamic acid (TXA) in
reducing bleeding, re-exploration, and blood transfusion in patients who
underwent a cardiac surgical procedure for mitral valve replacement on
cardiopulmonary bypass. <br/>Method(s): A single-center, prospective,
randomized, and double-blind clinical comparison study was conducted after
obtaining institutional ethical approval; sixty patients of either gender
between 18 and 60 years of age were randomly divided into two batches:
EACA batch (n = 30) given 100 mg/kg EACA as a bolus during induction of
anesthesia and then infused at 20 mg/kg/h during surgery and 6 h after
surgery and TXA batch (n = 30) given TXA 20 mg/kg/h as a bolus during
induction of anesthesia and then infused at 2 mg/kg/h during surgery and 6
h after surgery. The patient parameters, blood loss, transfusion
requirements in the first 24 h, and other complications were recorded.
<br/>Result(s): Blood loss per hour through the chest tube drain was
significantly lower for the first 6 postoperative hours in the TXA than in
the EACA (P < 0.05). The total postoperative blood loss was 416 +/- 47.74
ml and 489 +/- 42.12 ml in 24 h (P = 0.0001), and the blood transfusion
requirement was 0.45 +/- 0.62 units and 0.86 +/- 0.87 units (P = 0.0481)
in the TXA and EACA, respectively. The re-exploration rate was 3.34% and
13.34% in TXA and EACA (P = 0.0629). Five percent of the patients reported
seizures in the study (P > 0.05). The findings of this study suggested
that prophylactic therapy with EACA or TXA was effective and safer in
reducing perioperative blood loss in cardiac surgical procedures with
mitral valve replacement. Furthermore, TXA was significantly more
effective than EACA.<br/>Copyright &#xa9; 2022 Journal of Medical Society
<br/> Published by Wolters Kluwer-Medknow.

<104>
Accession Number
2021164643
Title
Transcatheter Edge-to-Edge Mitral Valve Repair in Patients With Severe
Mitral Regurgitation and Cardiogenic Shock.
Source
Journal of the American College of Cardiology. 80(22) (pp 2072-2084),
2022. Date of Publication: 29 Nov 2022.
Author
Simard T.; Vemulapalli S.; Jung R.G.; Vekstein A.; Stebbins A.; Holmes
D.R.; Czarnecki A.; Hibbert B.; Alkhouli M.
Institution
(Simard, Holmes, Alkhouli) Department of Cardiovascular Medicine, Mayo
Clinic, Rochester, MN, United States
(Vemulapalli, Vekstein, Stebbins) Division of Cardiology, Department of
Medicine, Duke University School of Medicine, Durham, NC, United States
(Vemulapalli, Vekstein, Stebbins) Duke Clinical Research Institute,
Durham, NC, United States
(Jung, Hibbert) University of Ottawa Heart Institute, Ottawa, ON, Canada
(Czarnecki) Sunnybrook Health Sciences Centre, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Data on the efficacy of transcatheter edge-to-edge repair
(TEER) in patients with cardiogenic shock (CS) are limited.
<br/>Objective(s): This study investigated the characteristics and
outcomes of consecutive patients with significant mitral regurgitation
(MR) and CS who underwent TEER. <br/>Method(s): The Society of Thoracic
Surgeons/American College of Cardiology Transcatheter Valve Therapy
Registry was assessed from November 22, 2013, to December 31, 2021. CS was
defined as the coding of: 1) CS; 2) inotrope use; or 3) mechanical
circulatory support before TEER. Device success was defined as MR
reduction of >=1 grade and a final MR grade <=2+. The primary outcome was
the impact of device success on 1-year mortality or heart failure (HF)
readmissions. Cox proportional hazards models were used to report the
risk-adjusted association between device success and 1-year outcomes.
<br/>Result(s): A total of 3,797 patients met the inclusion criteria. Mean
age was 73.0 +/- 11.9 years, and 59.5% were male. Mean Society of Thoracic
Surgery score (MV repair) was 14.9% +/- 15.3%. MR etiology was
degenerative (53.4%) and functional (27.5%). Device success was achieved
in 3,249 (85.6%) patients given successful achievement of final MR grade
<=2+ (88.2%) and MR reduction >=1 absolute grade (91.4%). At 1 year after
TEER, device success was associated with significantly lower all-cause
mortality (34.6% vs 55.5%; adjusted HR: 0.49; 95% CI: 0.41-0.59; P <
0.001) and a composite of mortality or HF admissions (29.6% vs 45.2%;
adjusted HR: 0.51; 95% CI: 0.42-0.62; P < 0.001). <br/>Conclusion(s):
Successful MR reduction is achievable in most patients with CS and is
associated with significantly lower mortality and HF hospitalization at 1
year. Randomized trials assessing TEER in CS are needed to establish this
potential therapeutic approach.<br/>Copyright &#xa9; 2022 American College
of Cardiology Foundation

<105>
Accession Number
2021107092
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 (no pagination), 2022. Article
Number: 3380605. 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, United States
(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, Nablus,
Palestine
(Yagmour) Al Quds University School of Medicine, Hebron, Palestine
(Kashani) Division of Nephrology and Hypertension, Mayo Clinic, Rochester,
MN, United States
Publisher
Hindawi Limited
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. Objective. We aim to
compare the risk of developing AKI after transfemoral (TF), transapical
(TA), and transaortic (TAo) approaches following TAVR. Methods. 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. Results. 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). Conclusion. 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.

<106>
Accession Number
2021177317
Title
Design and Rationale of Routine UltrasouNd GuIdance for Vascular AccEss
foR Cardiac Procedures: A Randomized TriaL (UNIVERSAL).
Source
CJC Open. (no pagination), 2022. Date of Publication: 2022.
Author
Alrashidi S.; d'Entremont M.-A.; Alansari O.; Winter J.; Brochu B.; Heenan
L.; Skuriat E.; Tyrwhitt J.; Raco M.; Tsang M.B.; Valettas N.; Velianou
J.; Sheth T.; Sibbald M.; Mehta S.R.; Pinilla-Echeverri N.; Schwalm J.D.;
Natarajan M.K.; Kelly A.; Akl E.; Tawadros S.; Camargo M.; Faidi W.; Dutra
G.; Jolly S.S.
Institution
(Alrashidi, Alansari, Raco, Tsang, Valettas, Velianou, Sheth, Sibbald,
Mehta, Pinilla-Echeverri, Schwalm, Natarajan, Kelly, Dutra, Jolly)
McMaster University, Hamilton, ON, Canada
(Alrashidi, Alansari, Raco, Tsang, Valettas, Velianou, Sheth, Sibbald,
Mehta, Pinilla-Echeverri, Schwalm, Natarajan, Kelly, Tawadros, Camargo,
Faidi, Dutra, Jolly) Hamilton Health Sciences, Hamilton, ON, Canada
(Alrashidi, Alansari, Raco, Tsang, Valettas, Velianou, Sheth, Sibbald,
Mehta, Pinilla-Echeverri, Schwalm, Natarajan, Kelly, Jolly) Niagara
Health, St. Catharines, ON, Canada
(d'Entremont, Heenan, Skuriat, Tyrwhitt, Sheth, Mehta, Pinilla-Echeverri,
Schwalm, Natarajan, Jolly) Population Health Research Institute, Hamilton,
ON, Canada
(d'Entremont) Centre Hospitalier Universitaire de Sherbrooke (CHUS),
Sherbrooke, QC, Canada
(Winter) Clinica Alemana de Santiago, Santiago, Chile
(Brochu) CK Hui Heart Centre, Royal Alexandra Hospital, Edmonton, AB,
Canada
(Akl) McGill University Health Centre, Montreal, QC, Canada
Publisher
Elsevier Inc.
Abstract
Background: A significant limitation of femoral artery access for cardiac
interventions is the increased risk of vascular complications and bleeding
compared to radial access. Ultrasound (US)-guided femoral access may
reduce major vascular complications and bleeding. We aim to determine
whether routinely using US guidance for femoral arterial access for
coronary angiography or intervention will reduce Bleeding Academic
Research Consortium (BARC) 2, 3, or 5 bleeding or major vascular
complications. <br/>Method(s): The Ultrasound Guidance for Vascular Access
for Cardiac Procedures: A Randomized Trial (UNIVERSAL) is a multicentre,
prospective, open-label, randomized trial with blinded outcomes
assessment. Patients undergoing coronary angiography with or without
intervention via a femoral approach with fluoroscopic guidance will be
randomized 1:1 to US-guided femoral access, compared to no US. The primary
outcome is the composite of major bleeding based on the BARC 2, 3, or 5
criteria or major vascular complications within 30 days. The trial is
designed to have 80% power and a 2-sided alpha level of 5% to detect a 50%
relative risk reduction for the primary outcome based on a control event
rate of 14%. <br/>Result(s): We completed enrollment on April 29, 2022,
with 621 randomized patients. The patients had a mean age of 71 years
(25.4% female), with a high rate of comorbidities, as follows: 45% had a
prior percutaneous coronary intervention; 57% had previous coronary artery
bypass surgery; and 18% had peripheral vascular disease.
<br/>Conclusion(s): The UNIVERSAL trial will be one of the largest
randomized trials of US-guided femoral access and has the potential to
change guidelines and increase US uptake for coronary procedures
worldwide.<br/>Copyright &#xa9; 2022 The Authors

<107>
Accession Number
2021160038
Title
A systematic review and meta-analysis of general versus regional
anesthesia for lower extremity amputation.
Source
Journal of Vascular Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Mufarrih S.H.; Qureshi N.Q.; Yunus R.A.; Katsiampoura A.; Quraishi I.;
Sharkey A.; Mahmood F.; Matyal R.
Institution
(Mufarrih, Qureshi, Yunus, Katsiampoura, Quraishi, Sharkey, Mahmood,
Matyal) Department of Anesthesia, Critical Care and Pain Medicine, Beth
Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
Publisher
Elsevier Inc.
Abstract
Objective: Postoperative morbidity in patients undergoing lower extremity
amputation (LEA) has remained high. Studies investigating the influence of
the anesthetic modality on the postoperative outcomes have yielded
conflicting results. The aim of our study was to assess the effects of
regional anesthesia vs general anesthesia on postoperative complications
for patients undergoing LEA. <br/>Method(s): We systematically searched
PubMed, Embase, MEDLINE, Web of Science, and Google Scholar from 1990 to
2022 for studies investigating the effect of the anesthetic modality on
the postoperative outcomes after LEA. Regional anesthesia (RA) included
neuraxial anesthesia and peripheral nerve blocks. The outcomes included
30-day mortality, respiratory failure (unplanned postoperative intubation,
failure to wean, mechanical ventilation >24 hours), surgical site
infection, cardiac complications, urinary tract infection, renal failure,
sepsis, venous thrombosis, pneumonia, and myocardial infarction.
<br/>Result(s): Of the 25 studies identified, we included 10 retrospective
observational studies with 81,736 patients, of whom 69,754 (85.3%) had
received general anesthesia (GA) and 11,980 (14.7%) had received RA. In
the GA group, 50,468 patients were men (63.8%), and in the RA group, 7813
patients were men (62.3%). The results of the meta-analyses revealed that
GA was associated with a higher rate of respiratory failure (odds ratio,
1.38; 95% confidence interval, 1.06-1.80; P = .02) and sepsis (odds ratio,
1.21; 95% confidence interval, 1.11-1.33; P < .0001) compared with RA. No
differences were found in postoperative 30-day mortality, surgical site
infection, cardiac complications, urinary tract infection, renal failure,
venous thrombosis, pneumonia, and myocardial infarction between the GA and
RA groups. <br/>Conclusion(s): The results of our meta-analysis have shown
that GA could be associated with a higher rate of respiratory failure and
sepsis compared with RA for LEA.<br/>Copyright &#xa9; 2022

<108>
Accession Number
2020023270
Title
Cognitive function and delirium following sevoflurane or propofol
anesthesia for valve replacement surgery: A multicenter randomized
controlled trial.
Source
Kaohsiung Journal of Medical Sciences. (no pagination), 2022. Date of
Publication: 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, The First Affiliated Hospital of Army
Medical University, Chongqing, China
(Zuo) Department of Anesthesiology, University of Virginia,
Charlottesville, VA, United States
Publisher
John Wiley and Sons Inc
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 7-14 days
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.

<109>
Accession Number
639517680
Title
Spinal drain for aortic aneurysm repairs: tool or toy?.
Source
Current opinion in anaesthesiology. (no pagination), 2022. Date of
Publication: 15 Nov 2022.
Author
Bastug N.; Worrall E.; Webb L.; Larson R.
Institution
(Bastug, Worrall, Webb) Department of Anesthesiology
(Larson) Department of Vascular Surgery, Virginia Commonwealth University
Health System, Richmond, VA, United States
Publisher
NLM (Medline)
Abstract
PURPOSE OF REVIEW: Spinal cord injury (SCI) is one of the biggest
complications in open and endovascular aortic repairs. Historically,
cerebrospinal fluid drains (CSFD) have been one of the most effective
modalities in reducing SCI and one of the most studied. CSFD placement
also carries its' own set of procedural risks. This editorial intends to
evaluate recent literature to determine whether CSFDs remain a valuable
tool in aortic repair. RECENT FINDINGS: As the surgical management of
thoracic aortic aneurysms has evolved, there has been an increasing number
of endovascular repairs. Current recommendations emphasize prophylactic
CSFD placement in endovascular repair cases deemed 'high risk.' However,
several meta-analyses differ on whether prophylactic CSFD placement
reduced the risk of SCI. The incidence of SCI decreased between 2014 and
2018, despite a similar rate of prophylactic CSFD placement suggesting
other techniques are being performed and may be effective in spinal cord
protection as well. SUMMARY: There has been conflicting data on whether
CSFDs have a role in reducing the risk of SCI in endovascular aortic
repair. Some studies suggest that there is no benefit to placement while
others suggest that routine prophylactic drains should be placed for all
endovascular cases. Despite this, efforts have been made to selectively
place CSFDs in those patients deemed at 'high risk' for SCI. CSFDs also
remain a part of rescue treatment for postoperative SCI. This suggests
that CSFDs continue to be a valuable tool that we need to better
comprehend. Future research is necessary to better understand how patient
risk factors can be balanced with perioperative management to help
identify patients who may benefit from CSFD placement.<br/>Copyright
&#xa9; 2022 Wolters Kluwer Health, Inc. All rights reserved.

<110>
Accession Number
639516502
Title
Study Protocol and Baseline Characteristics of Randomized Trial for
Evaluating Secondary Prevention Efficacy of Combination Therapy-Statin and
Eicosapentaenoic Acid: RESPECT-EPA, The Combination of a Randomized
Control Trial and an Observational Biomarker Study.
Source
American heart journal. (no pagination), 2022. Date of Publication: 10
Nov 2022.
Author
Nishizaki Y.; Miyauchi K.; Iwata H.; Inoue T.; Hirayama A.; Kimura K.;
Ozaki Y.; Murohara T.; Ueshima K.; Kuwabara Y.; Tanaka-Mizuno S.;
Yanagisawa N.; Sato T.; Daida H.
Institution
(Nishizaki, Miyauchi, Iwata) Department of Cardiovascular Biology and
Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
(Inoue) Japan Red Cross Sciety, Nasu Red Cross Hospital, Otawara, Tochigi,
Japan; Dokkyo Medical University, Mibu, Tochigi, Japan
(Hirayama) Department of Cardiology, Osaka Police Hospital, Osaka, Japan
(Kimura) Department of Cardiology, Yokohama City University Medical
Center, Yokohama, Japan
(Ozaki) Department of Cardiology, Fujita Health University, Toyoake,
Aichi, Japan
(Murohara) Department of Cardiology, Nagoya University Graduate School of
Medicine, Nagoya, Aichi, Japan
(Ueshima) Medical Examination Center, Uji-Takeda Hospital, Kyoto, Japan
(Kuwabara) Cancer Control Center, Osaka, Japan
(Tanaka-Mizuno) Department of Digital Health and Epidemiology, Graduate
School of Medicine, Kyoto University, Kyoto, Japan
(Yanagisawa) Medical Technology Innovation Center, Juntendo University,
Tokyo, Japan
(Sato) Department of Biostatistics, Kyoto University School of Public
Health, Kyoto, Japan
(Daida) Department of Cardiovascular Biology and Medicine, Juntendo
University Graduate School of Medicine, Tokyo, Japan; Faculty of Health
Science, Juntendo University, Tokyo, Japan
Publisher
NLM (Medline)
Abstract
BACKGROUND: Omega-3 polyunsaturated fatty acids (PUFAs) have been a hot
topic since the Japan EPA Lipid Intervention Study (JELIS), the first
landmark study using a highly purified eicosapentaenoic acid (EPA),
indicated that EPA could decrease the incidence of cardiovascular events.
Over 20 years have passed since the JELIS was conducted, and the standard
treatment for dyslipidemia has altered significantly since then. The JELIS
subjects did not undertake the current risk management especially current
standard statins and did not exclusively target secondary prevention
patients. In addition, the subjects included are relatively high EPA
population. Furthermore, the clinical implication of the plasma
EPA/arachidonic acid (AA) ratio as a biomarker has not yet been validated.
Therefore, the Randomized Trial for Evaluating the Secondary Prevention
Efficacy of Combination Therapy - statin and EPA (RESPECT-EPA) was planned
and is currently underway in Japan. <br/>METHOD(S): The RESPECT-EPA
comprises two parts: the open-label randomized controlled trial (RCT) and
biomarker study (prospective cohort study design). The RCT included
patients with a low EPA/AA ratio. These patients were then randomized to
highly purified EPA (1800 mg/day) or control groups. The primary endpoint
was cardiovascular death, non-fatal myocardial infarction, non-fatal
ischemic stroke, unstable angina pectoris, and clinically indicated
coronary revascularization. The biomarker study assesses the EPA/AA
ratio's usefulness as a biomarker for cardiovascular events prediction.
<br/>RESULT(S): In the RCT, a total of 2460 patients were enrolled in 95
sites in Japan. Patients' baseline characteristics were similar between
intervention and control groups in the RCT. The baseline median EPA/AA
ratio was 0.243 and 0.235, respectively. A total of 1314 patients were
participated in the observational part, and the baseline median EPA/AA
ratio was 0.577. <br/>CONCLUSION(S): After this study is completed, we
will have further evidence on whether a highly purified EPA is effective
in reducing cardiovascular events for secondary prevention or not, as well
as whether if EPA/AA ratio is a predictor for future cardiovascular
events.<br/>Copyright &#xa9; 2022. Published by Elsevier Inc.