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<1>
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.

<2>
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.

<3>
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.

<4>
Accession Number
2007545157
Title
Remote ischemic preconditioning effects on inflammatory markers and
myocardial protection in coronary artery bypass graft surgery.
Source
Perfusion (United Kingdom). 37(1) (pp 56-61), 2022. Date of Publication:
January 2022.
Author
Gorjipour F.; Saeedzadeh T.; Toloueitabar Y.; Kachoueian N.; Bahlouli
Ghashghaei S.; Mortazian M.; Dehghani Firoozabadi M.; Jadbabaie A.;
Tirgarfakheri K.; Motamednejad A.; Totonchi Z.
Institution
(Gorjipour, Kachoueian, Jadbabaie) Department of Cardiac Surgery, Imam
Hossein Educational Hospital, Shahid Beheshti University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Gorjipour) Iranian Scientific Society of Extracorporeal Technology,
Rajaie Cardiovascular Medical and Research Center, Iran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Saeedzadeh) Department of Biological Sciences, North Tehran Branch,
Islamic Azad University, Tehran, Iran, Islamic Republic of
(Toloueitabar, Bahlouli Ghashghaei, Tirgarfakheri, Motamednejad, Totonchi)
Rajaie Cardiovascular Medical and Research Center, Iran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Mortazian) AJA University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Dehghani Firoozabadi) Department of Anesthesiology, Tehran Heart Center,
Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
SAGE Publications Ltd
Abstract
Background: Induction of short episodes of ischemia to remote organs,
namely upper or lower limbs, literally known as remote ischemic
preconditioning (RIPC) has been suggested as a preconditioning approach to
ameliorate ischemia/reperfusion injury (IRI). RIPC has been demonstrated
to effectively protect various vital organs, including heart, against the
next ischemic events in preclinical studies. However, human studies are
required to approve its clinical applicability. Present study was
performed to evaluate the effect of RIPC on the myocardial protection and
inflammatory response markers in patients undergoing coronary artery
bypass graft surgery Methods: In this randomized clinical trial, 43
coronary artery bypass graft (CABG) patients from Imam Hossein educational
hospital were allocated in two groups, RIPC (21 patients) and control (22
patients). Serum level of interleukin (IL)-4, IL-8, and IL-10, interferon
(IFN)-gamma and Cardiac Troponin-I (cTnI) were measured in (1) after
induction of anesthesia (before incision of skin), (2) after separation
from CPB and (3) 24 hours after ICU arrival. <br/>Result(s): increase pack
cell transfusions were observed in control group in ICU. Serum level of
IL-10 at 24 hours after ICU admission was significantly higher in the RIPC
group. Significantly lower amounts of IL-8 at post-CPB time were observed
in the RIPC group in comparison with control. <br/>Conclusion(s): RIPC
regulates the circulatory inflammatory cytokines, IL-8 decrement and IL-10
elevation, which could be translated into protection against IRI. However,
further studies with larger sample sizes with careful consideration of
parameters such as use of propofol as an anesthetic in the patients should
be conducted to consolidate the findings from the current
study.<br/>Copyright &#xa9; The Author(s) 2020.

<5>
Accession Number
637197988
Title
Effect of Moderate Hypothermia vs Normothermia on 30-Day Mortality in
Patients with Cardiogenic Shock Receiving Venoarterial Extracorporeal
Membrane Oxygenation: A Randomized Clinical Trial.
Source
JAMA. 327(5) (pp 442-453), 2022. Date of Publication: 01 Feb 2022.
Author
Levy B.; Girerd N.; Amour J.; Besnier E.; Nesseler N.; Helms J.; Delmas
C.; Sonneville R.; Guidon C.; Rozec B.; David H.; Bougon D.; Chaouch O.;
Walid O.; Herve D.; Belin N.; Gaide-Chevronnay L.; Rossignol P.; Kimmoun
A.; Duarte K.; Slutsky A.S.; Brodie D.; Fellahi J.-L.; Ouattara A.; Combes
A.
Institution
(Levy, Kimmoun) Medecine Intensive et Reanimation, CHRU Nancy, Pole
Cardio-Medico-Chirurgical, Vandoeuvre-les-Nancy 54511, France
(Levy) INSERM U1116, Faculte de Medecine, Vandoeuvre-les-Nancy, France
(Levy) Universite de Lorraine, Nancy, France
(Girerd) Universite de Lorraine, INSERM, Centre d'Investigations Cliniques
Plurithematique, INSERM 1433, CHRU de Nancy, Institut Lorrain du Coeur et
des Vaisseaux, Nancy, France
(Girerd) INI-CRCT (Cardiovascular and Renal Clinical Trialists), F-CRIN
Network, Nancy, France
(Amour) Institut de Perfusion, De Reanimation et d'Anesthesie de Chirurgie
Cardiaque Paris Sud, Hopital Prive Jacques Cartier, Massy, France
(Besnier) Department of Anaesthesiology and Critical Care, Rouen
University Hospital, Rouen, France
(Besnier) Normandie University, UNIROUEN, INSERM U1096, EnVi, Rouen,
France
(Nesseler) Department of Anesthesia and Critical Care, Pontchaillou,
University Hospital of Rennes, Rennes, France
(Nesseler) University Rennes, CHU de Rennes, Inra, INSERM, Institut
NUMECAN, UMR_A 1341, UMR_S 1241, CIC 1414, Centre d'Investigation Clinique
de Rennes, Rennes, France
(Helms) Universite de Strasbourg, Faculte de Medecine, Hopitaux
Universitaires de Strasbourg, Service de Medecine Intensive-Reanimation,
Nouvel Hopital Civil, Strasbourg, France
(Delmas) Intensive Cardiac Care Unit, Rangueil University Hospital,
Toulouse, France
(Sonneville) AP-HP, Bichat Hospital, Medical and Infectious Diseases ICU,
Paris, France
(Guidon) Pole Anesthesie-Reanimation, Marseille, France
(Rozec) Service d'Anesthesie-Reanimation, Hopital GandR Laennec CHU de
Nantes, Nantes, France
(Rozec) L'Institut du Thorax INSERM, CNRS, CHU Nantes, UNIV Nantes,
Nantes, France
(David) Department of Anesthesiology and Critical Care Medicine, Arnaud de
Villeneuve Hospital, CHU Montpellier, Montpellier, France
(David) Montpellier University, INSERM, CNRS, PhyMedExp, Montpellier,
France
(Bougon, Rossignol) Service de Reanimation, Centre Hospitalier Annecy,
Genevois, France
(Chaouch) Hopital Europeen Georges Pompidou, AP-HP, Department of
Anesthesiology and Critical Care Medicine, Universite Paris Descartes,
Paris, France
(Walid) Service d'Anesthesie-Reanimation et Medecine Peri-Operatoire,
Nouvel Hopital Civil, Hopitaux Universitaires de Strasbourg, Strasbourg,
France
(Herve) Reanimation Medico-Chirurgicale Cardio-Thoracique, Vasculaire et
Respiratoire, CHU Amiens Picardie, Amiens, France
(Belin) Service de Reanimation Medicale, CHU Besancon, Besancon, France
(Gaide-Chevronnay) Unite de Reanimation Cardiovasculaire et Thoracique,
Pole Anesthesie Reanimation, CHU de Grenoble Alpes, Grenoble, France
(Duarte) Universite de Lorraine, Centre d'Investigations Cliniques
Plurithematique, INSERM 1433, CHRU de Nancy, Institut Lorrain du Coeur et
des Vaisseaux, Nancy, France
(Slutsky) Keenan Research Center, Li Ka Shing Knowledge Institute, St
Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
(Slutsky) Department of Medicine, Surgery, and Biomedical Engineering,
University of Toronto, Toronto, ON, Canada
(Brodie) Department of Medicine, College of Physicians and Surgeons,
Columbia University, The Center for Acute Respiratory Failure, New
York-Presbyterian Hospital, Columbia University, Medical Center, New York,
NY, United States
(Fellahi) Service d'Anesthesie-Reanimation, Hopital Louis Pradel, Hospices
Civils de Lyon, Lyon, France
(Fellahi) Laboratoire CarMeN, INSERM 1060, Universite Lyon 1 Claude
Bernard, Lyon, France
(Ouattara) CHU Bordeaux, Department of Anaesthesia and Critical Care,
Magellan Medico-Surgical Centre, Bordeaux, France
(Ouattara) University Bordeaux, INSERM, UMR 1034, Biology of
Cardiovascular Diseases, Pessac, France
(Combes) Sorbonne Universite, INSERM, UMRS_1166-ICAN, Institute of
Cardiometabolism and Nutrition, Paris, France
(Combes) Service de Medecine Intensive-Reanimation, Institut de
Cardiologie, APHP Sorbonne Universite, Hopital Pitie-Salpetriere, Paris,
France
Publisher
American Medical Association
Abstract
Importance: The optimal approach to the use of venoarterial extracorporeal
membrane oxygenation (ECMO) during cardiogenic shock is uncertain.
<br/>Objective(s): To determine whether early use of moderate hypothermia
(33-34 degreeC) compared with strict normothermia (36-37 degreeC) improves
mortality in patients with cardiogenic shock receiving venoarterial ECMO.
<br/>Design, Setting, and Participant(s): Randomized clinical trial of
patients (who were eligible if they had been endotracheally intubated and
were receiving venoarterial ECMO for cardiogenic shock for <6 hours)
conducted in the intensive care units at 20 French cardiac shock care
centers between October 2016 and July 2019. Of 786 eligible patients, 374
were randomized. Final follow-up occurred in November 2019.
<br/>Intervention(s): Early moderate hypothermia (33-34 degreeC; n = 168)
for 24 hours or strict normothermia (36-37 degreeC; n = 166). <br/>Main
Outcomes and Measures: The primary outcome was mortality at 30 days. There
were 31 secondary outcomes including mortality at days 7, 60, and 180; a
composite outcome of death, heart transplant, escalation to left
ventricular assist device implantation, or stroke at days 30, 60, and 180;
and days without requiring a ventilator or kidney replacement therapy at
days 30, 60, and 180. Adverse events included rates of severe bleeding,
sepsis, and number of units of packed red blood cells transfused during
venoarterial ECMO. <br/>Result(s): Among the 374 patients who were
randomized, 334 completed the trial (mean age, 58 [SD, 12] years; 24%
women) and were included in the primary analysis. At 30 days, 71 patients
(42%) in the moderate hypothermia group had died vs 84 patients (51%) in
the normothermia group (adjusted odds ratio, 0.71 [95% CI, 0.45 to 1.13],
P =.15; risk difference, -8.3% [95% CI, -16.3% to -0.3%]). For the
composite outcome of death, heart transplant, escalation to left
ventricular assist device implantation, or stroke at day 30, the adjusted
odds ratio was 0.61 (95% CI, 0.39 to 0.96; P =.03) for the moderate
hypothermia group compared with the normothermia group and the risk
difference was -11.5% (95% CI, -23.2% to 0.2%). Of the 31 secondary
outcomes, 30 were inconclusive. The incidence of moderate or severe
bleeding was 41% in the moderate hypothermia group vs 42% in the
normothermia group. The incidence of infections was 52% in both groups.
The incidence of bacteremia was 20% in the moderate hypothermia group vs
30% in the normothermia group. <br/>Conclusions and Relevance: In this
randomized clinical trial involving patients with refractory cardiogenic
shock treated with venoarterial ECMO, early application of moderate
hypothermia for 24 hours did not significantly increase survival compared
with normothermia. However, because the 95% CI was wide and included a
potentially important effect size, these findings should be considered
inconclusive. Trial Registration: ClinicalTrials.gov Identifier:
NCT02754193.<br/>Copyright &#xa9; 2022 American Medical Association. All
rights reserved.

<6>
Accession Number
2018876020
Title
Hospitalization Patterns and Impact of a Magnetically-Levitated Left
Ventricular Assist Device in the MOMENTUM 3 Trial.
Source
JACC: Heart Failure. 10(7) (pp 470-481), 2022. Date of Publication: July
2022.
Author
Vidula H.; Takeda K.; Estep J.D.; Silvestry S.C.; Milano C.; Cleveland
J.C.; Goldstein D.J.; Uriel N.; Kormos R.L.; Dirckx N.; Mehra M.R.
Institution
(Vidula) Division of Cardiology, University of Rochester School of
Medicine and Dentistry, Rochester, NY, United States
(Takeda) Division of Cardiac, Thoracic, and Vascular Surgery, Columbia
University College of Physicians and Surgeons and New York-Presbyterian
Hospital, New York, NY, United States
(Estep) Kaufman Center for Heart Failure and Recovery, The Cleveland
Clinic Foundation, Cleveland, OH, United States
(Silvestry) Thoracic Transplant, Thoracic, and Cardiovascular Surgery
Program, AdventHealth Transplant Institute, Orlando, FL, United States
(Milano) Division of Cardiothoracic Surgery, Duke University Medical
Center, Durham, NC, United States
(Cleveland) Division of Cardiothoracic Surgery, University of Colorado
School of Medicine, Aurora, CO, United States
(Goldstein) Department of Cardiothoracic Surgery, Montefiore Einstein
Center for Heart and Vascular Care, New York, NY, United States
(Uriel) Division of Cardiology, Columbia University College of Physicians
and Surgeons and New York-Presbyterian Hospital, New York, NY, United
States
(Kormos) Medical Affairs, Abbott, Austin, TX, United States
(Dirckx) Global Biometrics, Abbott, Plymouth, MN, United States
(Mehra) Center for Advanced Heart Disease, Brigham and Women's Hospital
Heart and Vascular Center and Harvard Medical School, Boston, MA, United
States
Publisher
Elsevier Inc.
Abstract
Background: In the MOMENTUM 3 (Multicenter Study of MagLev Technology in
Patients Undergoing Mechanical Circulatory Support Therapy with HeartMate
3) pivotal trial, the HeartMate 3 (HM3) fully magnetically levitated left
ventricular assist device (LVAD) demonstrated superiority over the
axial-flow HeartMate II (HMII) LVAD. The patterns and predictors of
hospitalizations with the HM3 LVAD have not been characterized.
<br/>Objective(s): This study sought to determine causes, predictors, and
impact of hospitalizations during LVAD support. <br/>Method(s): Patients
discharged after LVAD implantation were analyzed. In the pivotal trial,
485 recipients of HM3 were compared with 471 recipients of HMII. The
pivotal trial HM3 group was also compared to 949 recipients of HM3 in the
postapproval phase within the trial portfolio. Predictors of
cause-specific rehospitalization were analyzed. <br/>Result(s): The rates
of rehospitalization were lower with HM3 LVAD than with HMII LVAD in the
pivotal trial (225.7 vs 246.4 events per 100 patient-years; P < 0.05).
Overall, rehospitalization rates and duration were similar in the HM3
postapproval phase and pivotal trial but prolonged hospitalizations (>7
days) were less frequent (rate ratio: 0.90 [95% CI: 0.80-0.98]; P < 0.05).
In HM3 recipients, the most frequent causes of rehospitalization included
infection, heart failure (HF)-related events, and bleeding. First
rehospitalization caused by HF-related event versus other causes was
associated with reduced survival (HR: 2.2 [95% CI: 1.3-3.9]; P = 0.0014).
Male sex, non-White race, presence of cardiac resynchronization
therapy/implantable cardioverter-defibrillator, obesity, higher right
atrial pressure, smaller LV size, longer duration of index
hospitalization, and lower estimated glomerular filtration rate at index
discharge predicted HF hospitalizations. <br/>Conclusion(s): Contemporary
support with the HM3 fully magnetically levitated LVAD is associated with
a lower hospitalization burden than with prior pumps; however,
rehospitalizations for infection, HF, and bleeding remain important
challenges for progress in the patient journey. (MOMENTUM 3 IDE Clinical
Study, NCT02224755; MOMENTUM 3 Continued Access Protocol [MOMENTUM 3 CAP],
NCT02892955)<br/>Copyright &#xa9; 2022 The Authors

<7>
Accession Number
2017121926
Title
Pitfalls and Pearls of Imaging Non-traumatic Thoracic Aortic Disease.
Source
Seminars in Ultrasound, CT and MRI. 43(3) (pp 204-220), 2022. Date of
Publication: June 2022.
Author
Shmukler A.; Alis J.; Patel S.; Latson L.; Ko J.P.
Institution
(Shmukler, Ko) Department of Radiology, NYU Langone Health, New York, NY
(Alis) Department of Radiology, Jacobi Medical Center, Bronx, NY, United
States
(Patel) Department of Radiology, University of Michigan Health System, Ann
Arbor, MI, United States
(Latson) Department of Radiology, NewYork-Presbyterian / Weill Cornell
Medicine, New York, NY
Publisher
W.B. Saunders
Abstract
Imaging of the thoracic aorta is a common request in both the acute and
outpatient settings, playing a crucial role in diagnosis and treatment
planning of aortic disease. The findings of aortic pathology may be
obvious or occult on imaging. Recognizing subtle changes is essential and
may lead to early detection and prevention of serious morbidity and
mortality. Knowledge of the anatomy and understanding the pathophysiology
of aortic disease, as well as selecting the appropriate imaging modality
and protocol will enable prompt diagnosis and early intervention of aortic
pathology. Currently, computed tomography angiography and magnetic
resonance angiography of the aorta are the most commonly used imaging
modalities to evaluate the aorta. This review focuses on a spectrum of
aortic pathology manifestations on computed tomography and magnetic
resonance, including atherosclerosis and acute aortic syndromes,
highlighting diagnostic challenges and approaches to aid in image
interpretation.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<8>
Accession Number
2017103245
Title
Benefit of mechanical thrombectomy in acute ischemic stroke related to
calcified cerebral embolus.
Source
Journal of Neuroradiology. 49(4) (pp 317-323), 2022. Date of Publication:
June 2022.
Author
Grand T.; Dargazanli C.; Papagiannaki C.; Bruggeman A.; Maurer C.; Gascou
G.; Fauche C.; Bourcier R.; Tessier G.; Blanc R.; Machaa M.B.; Marnat G.;
Barreau X.; Ognard J.; Gentric J.-C.; Barbier C.; Gory B.; Rodriguez C.;
Boulouis G.; Eugene F.; Thouant P.; Ricolfi F.; Janot K.; Herbreteau D.;
Eker O.F.; Cappucci M.; Dobrocky T.; Mohlenbruch M.; Demerath T.;
Psychogios M.; Fischer S.; Cianfoni A.; Majoie C.; Emmer B.; Marquering
H.; Valter R.; Lenck S.; Premat K.; Cortese J.; Dormont D.; Sourour N.-A.;
Shotar E.; Samson Y.; Clarencon F.
Institution
(Grand, Lenck, Premat, Cortese, Dormont, Sourour, Shotar, Clarencon)
Department of Neuroradiology, Pitie-Salpetriere Hospital, Paris, France
(Dargazanli, Gascou) Department of Neuroradiology, Pitie-Salpetriere
Hospital, Paris, France
(Papagiannaki) Department of Neuroradiology, Pitie-Salpetriere Hospital,
Paris, France
(Bruggeman, Majoie, Emmer, Marquering) Department of Neuroradiology,
Pitie-Salpetriere Hospital, Paris, France
(Maurer) Department of Neuroradiology, Pitie-Salpetriere Hospital, Paris,
France
(Fauche) Department of Neuroradiology, Pitie-Salpetriere Hospital, Paris,
France
(Bourcier, Tessier) Department of Neuroradiology, Pitie-Salpetriere
Hospital, Paris, France
(Blanc, Machaa) Department of Neuroradiology, Pitie-Salpetriere Hospital,
Paris, France
(Marnat, Barreau) Department of Neuroradiology, Pitie-Salpetriere
Hospital, Paris, France
(Ognard, Gentric) Department of Neuroradiology, Pitie-Salpetriere
Hospital, Paris, France
(Barbier) Department of Neuroradiology, Pitie-Salpetriere Hospital, Paris,
France
(Gory) Department of Neuroradiology, Pitie-Salpetriere Hospital, Paris,
France
(Rodriguez, Boulouis) Department of Neuroradiology, Pitie-Salpetriere
Hospital, Paris, France
(Eugene) Department of Neuroradiology, Pitie-Salpetriere Hospital, Paris,
France
(Thouant, Ricolfi) Department of Neuroradiology, Pitie-Salpetriere
Hospital, Paris, France
(Janot, Herbreteau) Department of Neuroradiology, Pitie-Salpetriere
Hospital, Paris, France
(Eker, Cappucci) Department of Neuroradiology, Pitie-Salpetriere Hospital,
Paris, France
(Dobrocky) Department of Neuroradiology, Pitie-Salpetriere Hospital,
Paris, France
(Mohlenbruch) Department of Neuroradiology, Pitie-Salpetriere Hospital,
Paris, France
(Demerath) Department of Neuroradiology, Pitie-Salpetriere Hospital,
Paris, France
(Psychogios) Department of Neuroradiology, Pitie-Salpetriere Hospital,
Paris, France
(Fischer) Department of Neuroradiology, Pitie-Salpetriere Hospital, Paris,
France
(Cianfoni) Department of Neuroradiology, Pitie-Salpetriere Hospital,
Paris, France
(Valter) Department of Neuroradiology, Pitie-Salpetriere Hospital, Paris,
France
(Dormont, Clarencon) Department of Neuroradiology, Pitie-Salpetriere
Hospital, Paris, France
(Samson) Department of Neuroradiology, Pitie-Salpetriere Hospital, Paris,
France
(Clarencon) Department of Neuroradiology, Pitie-Salpetriere Hospital,
Paris, France
Publisher
Elsevier Masson s.r.l.
Abstract
Summary purpose: Mechanical thrombectomies (MT) in patients with large
vessel occlusion (LVO) related to calcified cerebral embolus (CCE) have
been reported, through small case series, being associated with low
reperfusion rate and worse outcome, compared to regular MT. The purpose of
the MASC (Mechanical Thrombectomy in Acute Ischemic Stroke Related to
Calcified Cerebral Embolus) study was to evaluate the incidence of CCEs
treated by MT and the effectiveness of MT in this indication.
<br/>Method(s): The MASC study is a retrospective multicentric (n = 37)
national study gathering the cases of adult patients who underwent MT for
acute ischemic stroke with LVO related to a CCE in France from January
2015 to November 2019. Reperfusion rate (mTICI >= 2B), complication rate
and 90-day mRS were systematically collected. We then conducted a
systematic review by searching for articles in PubMed, Cochrane Library,
Embase and Google Scholar from January 2015 to March 2020. A meta-analysis
was performed to estimate clinical outcome at 90 days, reperfusion rate
and complications. <br/>Result(s): We gathered data from 35 patients.
Reperfusion was obtained in 57% of the cases. Good clinical outcome was
observed in 28% of the patients. The meta-analysis retrieved 136 patients.
Reperfusion and good clinical outcome were obtained in 50% and 29% of the
cases, respectively. <br/>Conclusion(s): The MASC study found worse
angiographic and clinical outcomes compared to regular thrombectomies.
Individual patient-based meta-analysis including the MASC findings shows a
50% reperfusion rate and a 29% of good clinical outcome.<br/>Copyright
&#xa9; 2022 Elsevier Masson SAS

<9>
Accession Number
2016192733
Title
Meta-Analysis of One-Month Dual Antiplatelet Therapy Versus Standard Dual
Antiplatelet Therapy in Patients Undergoing Percutaneous Coronary
Intervention.
Source
American Journal of Cardiology. 166 (pp 138-140), 2022. Date of
Publication: 01 Mar 2022.
Author
Mohamed M.M.G.; Shaikh S.; Osman M.; Kheiri B.
Institution
(Mohamed, Shaikh) Internal Medicine Department, SSM Health St. Mary's
Hospital - St. Louis, St. Louis, Missouri, United States
(Osman, Kheiri) Knight Cardiovascular Institute, Oregon Health & Science
University, Portland, Oregon, United States
Publisher
Elsevier Inc.

<10>
Accession Number
639631394
Title
Protocol for a randomised controlled trial: reducing reintubation among
high-risk cardiac surgery patients with high-flow nasal cannula (I-CAN).
Source
BMJ open. 12(11) (pp e066007), 2022. Date of Publication: 25 Nov 2022.
Author
Freundlich R.E.; Wanderer J.P.; French B.; Moore R.P.; Hernandez A.; Shah
A.S.; Byrne D.W.; Pandharipande P.P.
Institution
(Freundlich, Wanderer, Hernandez, Pandharipande) Department of
Anesthesiology, Vanderbilt University Medical Center, Nashville, TN,
United States
(Freundlich) Department of Biomedical Informatics, Vanderbilt University
Medical Center, Nashville, TN, United States
(French, Moore, Byrne) Department of Biostatistics, Vanderbilt University
Medical Center, Nashville, TN, United States
(Shah) Department of Cardiac Surgery, Vanderbilt University Medical
Center, Nashville, TN, United States
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Heated, humidified, high-flow nasal cannula oxygen therapy
has been used as a therapy for hypoxic respiratory failure in numerous
clinical settings. To date, limited data exist to guide appropriate use
following cardiac surgery, particularly among patients at risk for
experiencing reintubation. We hypothesised that postextubation treatment
with high-flow nasal cannula would decrease the all-cause reintubation
rate within the 48 hours following initial extubation, compared with usual
care. METHODS AND ANALYSIS: Adult patients undergoing cardiac surgery
(open surgery on the heart or thoracic aorta) will be automatically
enrolled, randomised and allocated to one of two treatment arms in a
pragmatic randomised controlled trial at the time of initial extubation.
The two treatment arms are administration of heated, humidified, high-flow
nasal cannula oxygen postextubation and usual care (treatment at the
discretion of the treating provider). The primary outcome will be
all-cause reintubation within 48 hours of initial extubation. Secondary
outcomes include all-cause 30-day mortality, hospital length of stay,
intensive care unit length of stay and ventilator-free days. Interaction
analyses will be conducted to assess the differential impact of the
intervention within strata of predicted risk of reintubation, calculated
according to our previously published and validated prognostic model.
ETHICS AND DISSEMINATION: Vanderbilt University Medical Center IRB
approval, 15 March 2021 with waiver of written informed consent. Plan for
publication of study protocol prior to study completion, as well as
publication of results. TRIAL REGISTRATION NUMBER: clinicaltrials.gov,
NCT04782817 submitted 25 February 2021. DATE OF PROTOCOL: 29 August 2022.
Version 2.0.<br/>Copyright &#xa9; Author(s) (or their employer(s)) 2022.
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ.

<11>
Accession Number
639602148
Title
Does the division of the inferior pulmonary ligament in upper lobectomy
result in improved short-term clinical outcomes and long-term survival?.
Source
Interactive cardiovascular and thoracic surgery. 35(6) (no pagination),
2022. Date of Publication: 08 Nov 2022.
Author
Wang Y.-F.; Deng H.-Y.; Huang W.; Zhou Q.
Institution
(Wang, Deng, Huang, Zhou) Lung Cancer Center, West China Hospital, Sichuan
University, Chengdu, China
(Wang) West China School of Medicine, Sichuan University, Chengdu, China
Publisher
NLM (Medline)
Abstract
A best evidence topic in thoracic surgery was written according to a
structured protocol. The question addressed was 'Does the division of the
inferior pulmonary ligament (IPL) in upper lobectomy result in improved
short-term clinical outcomes and long-term survival?'. Altogether 43
papers were found using the reported search, of which 6 studies
represented the best evidence to answer the clinical question, including a
previous best evidence topic study, a meta-analysis and 4 retrospective
cohort studies. The author, journal, date and country of publication,
patient group studied, study type and relevant outcomes and results of
these papers are tabulated. Most of the enrolled studies reported that
there is no significant difference between the division groups and the
preservation groups in terms of drainage time, drainage volume,
postoperative dead space and complications. While 3 cohort studies
revealed unfavoured postoperative pulmonary function in the division
groups, including lung volume, forced vital capacity and forced expiratory
volume in 1s. The previous meta-analysis and a recent cohort study also
found that the division of IPL might lead to increased bronchus angle
change or torsion. Moreover, 2 cohort studies found that the division of
IPL could not improve the long-term survival of patients undergoing upper
lobectomy. Current evidence showed that dividing the IPL could not result
in clinical benefits but might lead to decreased pulmonary function
instead. Therefore, we recommended not dissecting the IPL routinely during
upper lobectomy.<br/>Copyright &#xa9; The Author(s) 2022. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<12>
Accession Number
639503041
Title
Evaluation of rhomboid intercostal and subserratus plane block under
direct vision for postoperative analgesia in thoracic surgeries: a
prospective, randomized controlled trial, thoracic non-oncologic.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 62(6) (no pagination),
2022. Date of Publication: 03 Nov 2022.
Author
West D.
Institution
(West) Department of Thoracic Surgery, University Hospitals Bristol and
Weston, Bristol BS2 8HW, United Kingdom
Publisher
NLM (Medline)

<13>
Accession Number
639232327
Title
Evaluation of rhomboid intercostal and subserratus plane block under
direct vision for postoperative analgesia in thoracic surgeries: a
prospective, randomized controlled trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 62(6) (no pagination),
2022. Date of Publication: 03 Nov 2022.
Author
Kozanhan B.; Semerkant T.; Esme H.; Canitez A.; Iyisoy M.S.
Institution
(Kozanhan) Department of Anesthesiology and Reanimation, University of
Health Sciences, Konya City Hospital, Konya, Turkey
(Semerkant, Esme) Department of Thorax Surgery, University of Health
Sciences, Konya City Hospital, Konya, Turkey
(Canitez) Department of Anesthesiology and Reanimation, Abdulkadir Yuksel
City Hospital, Gaziantep, Turkey
(Iyisoy) Department of Medical Education and Informatics, Necmettin
Erbakan University, Konya, Turkey
Publisher
NLM (Medline)
Abstract
OBJECTIVES: This study is designed to evaluate the efficacy of rhomboid
intercostal and subserratus plane (RISS) block under the surgeon's direct
vision for providing postoperative pain relief after thoracic surgeries.
<br/>METHOD(S): Forty patients who underwent thoracotomy were
prospectively recruited and randomly assigned to group R (intravenous
patient-controlled analgesia + continued RISS block; n=20) and group C
(intravenous patient-controlled analgesia; n=20). Numeric rating scale at
rest and cough, at post-anaesthetic care unit, 1, 2, 6, 9, 12, 24 and 48h,
was used as the primary outcome measure. Secondary outcome measures were
the amount of tramadol consumption, the number of patients required rescue
analgesia, the occurrence of postoperative adverse effects, pulmonary
functions and the overall satisfaction with pain management.
<br/>RESULT(S): Numeric rating scale scores both at rest and during
coughing were significantly lower in group R than in group C at all time
intervals (P<0.001 in each). Tramadol consumption at 24 and 48h was
significantly lower in the group R block than in group C (P<0.001 for
each). None of the patients in group R requires rescue analgesia. The
incidence of nausea and vomiting was similar among the groups. Compared
with group C, change in lung function from baseline levels was
significantly less in group R (P=0.047 and P=0.04 for FEV1 and FVC,
respectively). The satisfaction scores in group R were significantly
higher than that in group C (P<0.001). <br/>CONCLUSION(S): Continuous RISS
block improved postoperative outcomes of thoracic surgery in terms of
reduced postoperative pain scores, sparing opioid consumption, pulmonary
function and patient satisfaction.<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.

<14>
Accession Number
639016436
Title
Consequences of Preoperative Oral Carbohydrate Consumption in Septal
Deviation Patients Undergoing Endoscopic Septoplasty: A Retrospective
Cohort Study.
Source
Journal of perianesthesia nursing : official journal of the American
Society of PeriAnesthesia Nurses. 37(6) (pp 925-933), 2022. Date of
Publication: 01 Dec 2022.
Author
Zhu J.; Sun L.; Liu Y.-G.; Ding X.-J.; Deng J.-H.; Gong Y.-Q.; Xia Y.-W.;
Jin X.-Q.
Institution
(Zhu, Sun, Jin) Department of Nursing, Affiliated Kunshan Hospital of
Jiangsu University, Suzhou, Jiangsu, China
(Liu, Ding, Deng) Department of Otolaryngology, Affiliated Kunshan
Hospital of Jiangsu University, Suzhou, Jiangsu, China
(Gong) Information Department, Affiliated Kunshan Hospital of Jiangsu
University, Suzhou, Jiangsu, China
(Xia) Department of Nutriology, Affiliated Kunshan Hospital of Jiangsu
University, Suzhou, Jiangsu, China
Publisher
NLM (Medline)
Abstract
PURPOSE: Multiple reports have demonstrated the benefits of preoperative
oral carbohydrates (CHO) in patients receiving open abdominal, thoracic,
and orthopedic surgeries. However, thus far, no reports have investigated
the benefits of CHO in patients undergoing nasal endoscopic surgery. Our
goal was to evaluate the outcome of preoperative oral of administration of
CHO in septal deviation patients, undergoing endoscopic septoplasty, under
general anesthesia. DESIGN: A retrospective cohort study from a
prospectively collected database. <br/>METHOD(S): Consecutive 400 septal
deviation patients, undergoing endoscopic septoplasty, were randomly
assigned to receive CHO or plain water (80 CHO cohort vs. 320 control
cohort) before general anesthesia. The primary outcome was the risk of
acute postoperative hypertension (APH). The secondary outcomes included
length of hospital stay (LOS), hospitalization cost, sleep time the day
before surgery, fluid infusion volume on surgical day, as well the
incidence of postoperative nausea and vomiting (PONV) and aspiration.
FINDINGS: Patients in the CHO cohort experienced a lower risk of both
diastolic blood pressure (DBP)-based APH (OR, 0.49; 95% CI, 0.25 to 0.96;
P = 0.0375) and total APH (OR, 0.49; 95% CI, 0.26 to 0.92; P = 0.0258),
lower LOS, lower hospitalization cost, longer sleep time and less fluid
infusion volume after adjusting for gender, age, BMI, preoperative blood
pressure and pulse. Besides, data showed no significant differences in the
incidence of (P = 0.4173) and aspiration (P > 0.99). <br/>CONCLUSION(S):
Preoperative CHO administration can reduce APH risk in patients undergoing
endoscopic septoplasty under general anesthesia. Besides, preoperative CHO
administration can improve other clinical outcomes, such as, LOS,
hospitalization cost, sleep time, and fluid infusion volume. Moreover, CHO
safety was confirmed in our study. In the future, additional investigation
is necessary to confirm our results.<br/>Copyright &#xa9; 2022 American
Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights
reserved.

<15>
Accession Number
2021225450
Title
Osteopathic manipulative treatment in cardiac surgery patients: A
systematic review.
Source
International Journal of Osteopathic Medicine. 46 (pp 29-35), 2022. Date
of Publication: December 2022.
Author
Rorris F.-P.; Skouteli E.-A.T.; Papakonstantinou K.; Kokotsaki L.;
Skotiniotis E.; Kokotsakis J.
Institution
(Rorris, Skouteli, Papakonstantinou, Kokotsaki, Skotiniotis, Kokotsakis)
Department of Thoracic and Cardiovascular Surgery, Evangelismos General
Hospital, Athens, Greece
Publisher
Elsevier Ltd
Abstract
Objective: Osteopathic manipulative treatment (OMT) in surgical patients
aims at reducing postoperative pain and enhancing recovery. The effects of
OMT have not been extensively studied in cardiac surgery patients, mostly
owing to the fact that a limited number of osteopathic physicians are
trained in thoracic surgery. <br/>Method(s): A systematic review of the
literature was performed to identify all currently available data on
postoperative OMT in cardiac surgery patients. Case reports and case
series were excluded. Risk of bias of the eligible studies was assessed
individually using specific protocols. Among the outcomes of interest were
postoperative pain, hospital length of stay, changes in respiratory
capacity, and changes in cardiac index and mixed oxygen venous saturation
(SvO<inf>2</inf>) measurements. <br/>Result(s): We identified four
eligible studies which were included in the quantitative analysis of the
present review. There were three randomized controlled trials (RCTs) and
one non-randomized controlled cohort study which investigated on outcomes
of OMT in cardiac surgery patients. The most common cardiac operations
performed were coronary artery bypass grafting, valve procedures, combined
procedures, and aortic operations. Numerous OMT modalities were used on
postoperative patients. The OMT group of patients showed improvement in
pain management and respiratory capacity, and shorter hospital length of
stay. <br/>Conclusion(s): Osteopathic treatment might be helpful as an
adjunct to current medical therapies in mitigating postoperative pain and
improving the overall patient's functional status.<br/>Copyright &#xa9;
2022 Elsevier Ltd

<16>
Accession Number
2020312785
Title
Intravenous acetaminophen for postoperative pain control after open
abdominal and thoracic surgery in pediatric patients: a systematic review
and meta-analysis.
Source
Pediatric Surgery International. 39(1) (no pagination), 2023. Article
Number: 7. Date of Publication: December 2023.
Author
Archer V.; Cloutier Z.; Park L.; Briatico D.; Walton J.M.
Institution
(Archer, Cloutier, Park) Division of General Surgery, Department of
Surgery, McMaster University, Hamilton, ON, Canada
(Briatico, Walton) Division of Pediatric General Surgery, Department of
Surgery, McMaster University, Hamilton, ON, Canada
(Briatico, Walton) McMaster Pediatric Surgery Research Collaborative,
Hamilton, ON, Canada
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Pediatric opioid exposure increases short- and long-term adverse events
(AE). The addition of intravenous acetaminophen (IVA) to pediatric pain
regimes to may reduce opioids but is not well studied postoperatively. Our
objective was to quantify the impact of IVA on postoperative pain, opioid
use, and AEs in pediatric patients after major abdominal and thoracic
surgery. Medline, Embase, CINAHL, Web of Science, and Cochrane Library
were searched systematically for randomized controlled trials (RCTs)
comparing IVA to other modalities. Five RCTs enrolling 443 patients with
an average age of 2.12 years (+/- 2.81) were included. Trials comparing
IVA with opioids to opioids alone were meta-analyzed. Low to very
low-quality evidence demonstrated equivalent pain scores between the
groups (-0.23, 95% CI -0.88 to 0.40, p 0.47) and a reduction in opioid
consumption (-1.95 morphine equivalents/kg/48 h, 95% CI -3.95 to 0.05, p
0.06) and minor AEs (relative risk 0.39, 95% CI 0.11 to 1.43, p 0.15). We
conclude that the addition of IVA to opioid-based regimes in pediatric
patients may reduce opioid use and minor AEs without increasing
postoperative pain. Given the certainty of evidence, further research
featuring patient-important outcomes and prolonged follow-up is necessary
to confirm these findings.<br/>Copyright &#xa9; 2022, The Author(s), under
exclusive licence to Springer-Verlag GmbH Germany, part of Springer
Nature.

<17>
Accession Number
639649149
Title
Incentive spirometry is an effective strategy to improve the quality of
postoperative care in the patients undergoing pulmonary resection: A
systematic review and meta-analysis.
Source
Asian journal of surgery. (no pagination), 2022. Date of Publication: 24
Nov 2022.
Author
Chang P.-C.; Chen P.-H.; Chang T.-H.; Chen K.-H.; Jhou H.-J.; Chou S.-H.;
Chang T.-W.
Institution
(Chang) Division of Thoracic Surgery, Department of Surgery, Kaohsiung
Medical University Hospital/Kaohsiung Medical University, Kaohsiung City,
Taiwan; Weight Management Center, Kaohsiung Medical University
Hospital/Kaohsiung Medical University, Kaohsiung City, Taiwan; Ph. D.
Program in Biomedical Engineering, College of Medicine, Kaohsiung Medical
University, Kaohsiung City, Taiwan; Department of Sports Medicine, College
of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
(Chen) Department of Internal Medicine, Tri-Service General Hospital,
National Defense Medical Center, Taipei City, Taiwan (Republic of China)
(Chang) School of Medicine, China Medical University, Taichung City,
Taiwan (Republic of China)
(Chen) Department of Surgery, Kaohsiung Medical University
Hospital/Kaohsiung Medical University, Kaohsiung City, Taiwan (Republic of
China)
(Jhou) Department of Neurology, Changhua Christian Hospital, Changhua,
Taiwan (Republic of China)
(Chou) Division of Thoracic Surgery, Department of Surgery, Kaohsiung
Medical University Hospital/Kaohsiung Medical University, Kaohsiung City,
Taiwan; Department of Surgery, School of Medicine, College of Medicine,
Kaohsiung Medical University, Kaohsiung City, Taiwan
(Chang) Division of Thoracic Surgery, Department of Surgery, Kaohsiung
Medical University Hospital/Kaohsiung Medical University, Kaohsiung City,
Taiwan (Republic of China)
Publisher
NLM (Medline)
Abstract
Postoperative pulmonary complications (PPCs) most commonly occur after
thoracic surgery. Not only prolonged hospital stay and increased financial
expenses but also morbidity and even mortality may be troublesome for
those with PPCs. Herein, we aimed to conduct a comprehensive systematic
review and meta-analysis of available data to examine the effectiveness of
incentive spirometry (IS) to reduce PPCs and shorten hospital stay. This
systematic review and meta-analysis included 5 randomized controlled
trials (RCT) and 3 retrospective cohort study (10,322 patients in total)
in PubMed, Embase and Cochrane Library until September 31, 2021. We
assessed the clinical efficacy of IS using length of hospital stay, PPCs,
postoperative pneumonia, and postoperative atelectasis with meta-analysis,
meta-regression and trial sequential analysis (TSA). With this
meta-analysis, the length of hospital stay in patients undergoing IS was
significantly shorter (1.8 days) than that in patients not receiving IS
(MD = -1.80, 95% CI = -2.95 to -0.65). Patients undergoing IS also had
reduced risk of PPCs (32%) and postoperative pneumonia (17.9%) with
statistical significance than patients not undergoing IS (PPC: OR = 0.68,
95% CI = 0.51-0.90) (Pneumonia: OR = 0.821, 95% CI = 0.677-0.995).In
meta-regression, the benefits of undergoing IS in patients with
preoperative predicted FEV1 of <80% in a linear fashion with decreasing
PPCs. IS is an effective modality to improve the quality of postoperative
care for patients after pulmonary resection, compared with the control
group without using IS; and applying IS has favorable outcomes of shorter
length of hospital stay (1.8 days) and lower occurrence of PPCs (32% of
risk reduction), which are conclusive and robust based on our validation
via TSA. Moreover, the IS device is more beneficial for patients with
preoperative predicted FEV1 of <80% than that in others.<br/>Copyright
&#xa9; 2022 Asian Surgical Association and Taiwan Robotic Surgery
Association. Published by Elsevier B.V. All rights reserved.

<18>
Accession Number
639648817
Title
Continued non-vitamin K antagonist oral anticoagulants versus vitamin K
antagonists during transcatheter aortic valve implantation.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
(no pagination), 2022. Date of Publication: 28 Nov 2022.
Author
Mangner N.; Brinkert M.; Keller L.S.; Moriyama N.; Hagemeyer D.; Haussig
S.; Crusius L.; Kobza R.; Abdel-Wahab M.; Laine M.; Stortecky S.; Pilgrim
T.; Nietlispach F.; Ruschitzka F.; Thiele H.; Toggweiler S.; Linke A.
Institution
(Mangner, Haussig, Crusius, Linke) Department of Internal Medicine and
Cardiology, Heart Center Dresden, Technische Universitat Dresden, Dresden,
Germany
(Brinkert) Division of Cardiology, Medical University Department,
Kantonsspital Aarau, Aarau, Switzerland
(Keller) Quebec Heart and Lung Institute, Laval University, Quebec, QC,
Canada
(Moriyama, Laine) Division of Cardiology, Helsinki University Central
Hospital, Helsinki, Finland
(Moriyama) Division of Cardiology, Shonan Kamakura General Hospital,
Kamakura, Japan
(Hagemeyer, Stortecky, Pilgrim) Department of Cardiology, University
Hospital Bern, Bern, Switzerland
(Kobza, Toggweiler) Heart Center Lucerne, Luzerner Kantonsspital, Lucerne,
Switzerland
(Abdel-Wahab, Thiele) Department of Internal Medicine/Cardiology, Heart
Center Leipzig, University of Leipzig, Leipzig, Germany
(Nietlispach, Ruschitzka) Department of Cardiology, University Hospital
Zurich, Zurich, Switzerland
(Nietlispach) CardioVascular Center Zurich, Hirslanden Klinik im Park,
Zurich, Switzerland
Publisher
NLM (Medline)
Abstract
BACKGROUND: One-third of patients undergoing transcatheter aortic valve
implantation (TAVI) have an indication for long-term oral anticoagulation
(OAC). AIMS: We aimed to investigate whether continued non-vitamin K
antagonist oral anticoagulant (NOAC) therapy compared with continued
vitamin K antagonist (VKA) therapy during TAVI is equally safe and
effective. Methods: Consecutive patients on OAC with either NOAC or VKA
undergoing transfemoral TAVI at five European centres were enrolled. The
primary outcome measure was a composite of major/life-threatening
bleeding, stroke, and all-cause mortality at 30 days. <br/>RESULT(S): In
total, 584 patients underwent TAVI under continued OAC with 294 (50.3%)
patients receiving VKA and 290 (49.7%) patients receiving NOAC. At 30
days, the composite primary outcome had occurred in 51 (17.3%) versus 36
(12.4%) patients with continued VKA and with continued NOAC, respectively
(odds ratio [OR] 0.68, 95% confidence interval [CI]: 0.43-1.07; p=0.092).
Rates of major/life-threatening bleeding (OR 0.87, 95% CI: 0.52-1.47;
p=0.606) and stroke (OR 1.02, 95% CI: 0.29-3.59; p=0.974) were not
different between groups. In a multivariate Cox regression analysis,
continued NOAC, compared with continued VKA, was associated with a lower
risk for all-cause 1-year mortality (hazard ratio [HR] 0.61, 95% CI:
0.37-0.98; p=0.043). The analysis of the propensity score-matched cohort
revealed similar results. <br/>CONCLUSION(S): Continued NOAC compared with
continued VKA during TAVI led to comparable outcomes with regard to the
composite outcome measure indicating that continued OAC with both drugs is
feasible. These hypothesis-generating results need to be confirmed by a
dedicated randomised controlled trial.

<19>
Accession Number
2020280144
Title
The prognostic value of elevated neutrophil-lymphocyte ratio for cardiac
surgery-associated acute kidney injury: A systematic review and
meta-analysis.
Source
Acta Anaesthesiologica Scandinavica. (no pagination), 2022. Date of
Publication: 2022.
Author
Wheatley J.; Liu Z.; Loth J.; Plummer M.P.; Penny-Dimri J.C.; Segal R.;
Smith J.; Perry L.A.
Institution
(Wheatley) Department of Anaesthesia, Perioperative Medicine and Pain
Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
(Wheatley) Department of Intensive Care Medicine, Royal Melbourne
Hospital, Melbourne, VIC, Australia
(Liu, Loth, Segal, Perry) Department of Anaesthesia, Royal Melbourne
Hospital, Melbourne, VIC, Australia
(Liu, Plummer, Segal, Perry) Department of Critical Care, Melbourne
Medical School, Faculty of Medicine, Dentistry and Health Sciences,
University of Melbourne, Melbourne, VIC, Australia
(Plummer) Department of Intensive Care Medicine, Royal Adelaide Hospital,
Adelaide, SA, Australia
(Penny-Dimri, Smith) Department of Surgery (School of Clinical Sciences at
Monash Health), Monash University, Melbourne, VIC, Australia
(Penny-Dimri, Smith) Department of Cardiothoracic Surgery, Monash Health,
Melbourne, VIC, Australia
Publisher
John Wiley and Sons Inc
Abstract
Background: Patients undergoing cardiac surgery are at significant risk of
developing postoperative acute kidney injury (AKI). Neutrophil-lymphocyte
ratio (NLR) is a widely available inflammatory biomarker which may be of
prognostic value in this setting. <br/>Method(s): We conducted a
systematic review and meta-analysis of studies reporting associations
between perioperative NLR with postoperative AKI. We searched Medline,
Embase and the Cochrane Library, without language restriction, from
inception to May 2022 for relevant studies. We meta-analysed the reported
odds ratios (ORs) with 95% confidence intervals (CIs) for both elevated
preoperative and postoperative NLR with risk of postoperative AKI and need
for renal replacement therapy (RRT). We conducted a meta-regression to
explore inter-study statistical heterogeneity. <br/>Result(s): Twelve
studies involving 10,724 participants undergoing cardiac surgery were
included, with eight studies being deemed at high risk of bias using
PROBAST modelling. We found statistically significant associations between
elevated preoperative NLR and postoperative AKI (OR 1.45, 95% CI
1.18-1.77), as well as postoperative need for RRT (OR 2.37, 95% CI
1.50-3.72). Postoperative NLR measurements were not of prognostic
significance. <br/>Conclusion(s): Elevated preoperative NLR is a reliable
inflammatory biomarker for predicting AKI following cardiac
surgery.<br/>Copyright &#xa9; 2022 The Authors. Acta Anaesthesiologica
Scandinavica published by John Wiley & Sons Ltd on behalf of Acta
Anaesthesiologica Scandinavica Foundation.

<20>
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.

<21>
Accession Number
2017861547
Title
Dual left anterior descending artery: Case series based on novel
classification and its therapeutic implications.
Source
Indian Heart Journal. 74(3) (pp 218-228), 2022. Date of Publication: 01
May 2022.
Author
Jariwala P.; Jadhav K.
Institution
(Jariwala, Jadhav) Department of Cardiology, Yashoda Hospitals,
Somajiguda, Raj Bhavan Road, Hyderabad, Telangana 500082, India
Publisher
Elsevier B.V.
Abstract
Angiographically, a "dual LAD" is described as two distinct arteries
supplying the vascular territory of the LAD in parts, identified as the
short LAD/LAD<inf>1</inf> and the long LAD/LAD<inf>2</inf>. Using an
easy-to-understand three-step approach, Jariwala et al unveiled a novel
classification strategy for dual LAD systems in an attempt to decrease
ambiguity in diagnosis and management of the anomaly. As part of our
research, we looked at a wide range of published cases and case series in
the literature, and also those reported from our hospital. In our novel
classification system, we divide dual LADs into three main groups based on
their origin and vascular territory, each of which is further divided into
subgroups based on the course of LAD<inf>1</inf>/LAD<inf>2</inf> and the
variable feature that is a distinguishing attribute of the type of anomaly
to be specified. A review of 144 publications in the world literature
revealed 340 patients eligible for the study. The median age was 58.8
years (SD - 11.42; range - 29-89) with male predominance (3.3:1). Cases in
Group I comprised 60.6% of the total cases, followed by Group II (36.2%),
and Group III (3.2%). Subgroup I-A was the most common in terms of dual
LAD, followed by subgroup II-A. Acute coronary syndrome (45.5%) and
chronic coronary syndrome (55.8%) were the most common clinical
presentations in patients with significant coronary artery disease
(30.8%).<br/>Copyright &#xa9; 2022 Cardiological Society of India

<22>
Accession Number
2021245496
Title
The role of methylene blue in the management of vasoplegic syndrome: a
narrative review.
Source
Acta Anaesthesiologica Belgica. 73(2) (pp 91-102), 2022. Date of
Publication: June 2022.
Author
Cottyn J.; Roussel E.; Rex S.; Al Tmimi L.
Institution
(Cottyn, Rex, Al Tmimi) Department of Anaesthesiology, University
Hospitals Leuven, Herestraat 49, Leuven B-3000, Belgium
(Roussel) Department of Urology, University Hospitals Leuven, Herestraat
49, Leuven B-3000, Belgium
(Rex, Al Tmimi) Department of Cardiovascular Sciences, KU Leuven,
University of Leuven, Biomedical Sciences Group, Herestraat 49, Leuven
B-3000, Belgium
Publisher
BeSARPP
Abstract
Vasoplegic syndrome is an important clinical entity characterized by
profound arterial hypotension refractory to vasopressor therapy. The
underlying pathophysiology is characterized by a complex and
multifactorial dysregulation of both vasodilatory and vasoconstrictive
mechanisms. During the last decades, there is growing interest in using
methylene blue as an adjunct therapy to treat vasodilatory shock. The
present review evaluates the safety and efficacy of methylene blue in
cardiac and transplant surgery, severe sepsis and septic shock, severe
burn injury, paediatric intensive care, and intoxications. Although most
of the currently available evidence reports a benefit in haemodynamic
parameters and a decrease in vasopressor requirements following the
administration of methylene blue, study designs are heterogeneous, and the
overall level of evidence is low. Moreover, a clear and consistent benefit
in morbidity and mortality is lacking. Large prospective randomized
controlled trials are needed to evaluate the exact role and timing of
methylene blue in the treatment of vasopressor refractory
vasoplegia.<br/>Copyright &#xa9; 2022 Authors. All rights reserved.

<23>
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.

<24>
Accession Number
2021198874
Title
Peer-support interventions for women with cardiovascular disease: protocol
for synthesising the literature using an evidence map.
Source
BMJ Open. 12(10) (no pagination), 2022. Article Number: e067812. Date of
Publication: 05 Oct 2022.
Author
Parry M.; Visintini S.; Johnston A.; Colella T.J.F.; Kapur D.; Liblik K.;
Gomes Z.; Dancey S.; Liu S.; Goodenough C.; Hay J.L.; Noble M.; Adreak N.;
Robert H.; Tang N.; O'Hara A.; Wong A.; Mullen K.-A.
Institution
(Parry, Noble, O'Hara) Lawrence S. Bloomberg Faculty of Nursing,
University of Toronto, Toronto, ON, Canada
(Visintini) Berkman Library, University of Ottawa Heart Institute, Ottawa,
ON, Canada
(Visintini) Health Sciences Library, University of Ottawa, Ottawa, ON,
Canada
(Johnston) School of Epidemiology and Public Health, University of Ottawa,
Ottawa, ON, Canada
(Johnston) University of Ottawa Heart Institute, Ottawa, ON, Canada
(Colella) Toronto Rehabilitation Cardiovascular Prevention and
Rehabilitation Program, Kite - University Health Network, Toronto, ON,
Canada
(Colella) Lawrence S. Bloomberg Faculty of Nursing, The Rehabilitation
Sciences Institute, University of Toronto, Toronto, ON, Canada
(Kapur) Lawrence S. Bloomberg Faculty of Nursing (Research Assistant),
University of Toronto, Toronto, ON, Canada
(Liblik, Tang) School of Medicine, Faculty of Health Sciences, Queen's
University, Kingston, ON, Canada
(Gomes) Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
(Dancey) Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
(Liu) Section of Cardiology, Department of Internal Medicine, Rady Faculty
of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
(Goodenough, Robert) Canadian Women's Heart Health Alliance, University of
Ottawa Heart Institute, Ottawa, ON, Canada
(Hay) Faculty of Kinesiology and Recreation Management, University of
Manitoba, Winnipeg, MB, Canada
(Hay) Institute of Cardiovascular Sciences, St Boniface General Hospital
Albrechtsen Research Centre, Winnipeg, MB, Canada
(Noble) Indigenous Services Canada, Toronto, ON, Canada
(Adreak) Department of Surgery, The University of British Columbia,
Vancouver, BC, Canada
(Wong, Mullen) Canadian Women's Heart Health Centre, University of Ottawa
Heart Institute, Ottawa, ON, Canada
Publisher
BMJ Publishing Group
Abstract
Introduction The leading cause of death for women is cardiovascular
disease (CVD), including ischaemic heart disease, stroke and heart
failure. Previous literature suggests peer support interventions improve
self-reported recovery, hope and empowerment in other patient populations,
but the evidence for peer support interventions in women with CVD is
unknown. The aim of this study is to describe peer support interventions
for women with CVD using an evidence map. Specific objectives are to: (1)
provide an overview of peer support interventions used in women with
ischaemic heart disease, stroke and heart failure, (2) identify gaps in
primary studies where new or better studies are needed and (3) describe
knowledge gaps where complete systematic reviews are required. Methods and
analysis We are building on previous experience and expertise in knowledge
synthesis using methods described by the Evidence for Policy and Practice
Information (EPPI) and the Coordinating Centre at the Institute of
Education. Seven databases will be searched from inception: CINAHL,
Embase, MEDLINE, APA PsycINFO, the Cochrane Database of Systematic Reviews
and the Cochrane Central Register of Controlled Trials, and Scopus. We
will also conduct grey literature searches for registered clinical trials,
dissertations and theses, and conference abstracts. Inclusion and
exclusion criteria will be kept broad, and studies will be included if
they discuss a peer support intervention and include women, independent of
the research design. No date or language limits will be applied to the
searches. Qualitative findings will be summarised narratively, and
quantitative analyses will be performed using R. Ethics and dissemination
The University of Toronto's Research Ethics Board granted approval on 28
April 2022 (Protocol #42608). Bubble plots (ie, weighted scatter plots),
geographical heat/choropleth maps and infographics will be used to
illustrate peer support intervention elements by category of CVD.
Knowledge dissemination will include publication, presentation/public
forums and social media.<br/>Copyright &#xa9;

<25>
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

<26>
Accession Number
2021324792
Title
Effect of the Paravertebral Block on Chronic Postsurgical Pain After
Thoracic Surgery: A Systematic Review and Meta-Analysis of Randomized
Controlled Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2022.
Date of Publication: 2022.
Author
Na H.-S.; Koo C.-H.; Koo B.-W.; Ryu J.-H.; Jo H.; Shin H.-J.
Institution
(Na, Koo, Koo, Ryu, Jo, Shin) Department of Anesthesiology and Pain
Medicine, Seoul National University Bundang Hospital, Gyeonggi, Seongnam,
South Korea
(Na, Koo, Koo, Ryu, Shin) Department of Anesthesiology and Pain Medicine,
Seoul National University College of Medicine, Seoul, South Korea
Publisher
W.B. Saunders
Abstract
Objective: This study aimed to identify the benefits of thoracic
paravertebral block (PVB) by focusing on its role in reducing chronic
postsurgical pain (CPSP) after thoracic surgery. <br/>Design(s): A
systematic review and meta-analysis of randomized controlled trials
(RCTs). <br/>Setting(s): Electronic databases, including PubMed, EMBASE,
CENTRAL, Scopus, and Web of Science, were searched to identify studies.
<br/>Participant(s): Patients undergoing thoracic surgeries.
<br/>Intervention(s): Paravertebral block for postoperative analgesia.
Measurement and Main Results: A total of 1,028 adult patients from 10 RCTs
were included in the final analysis. The incidence of CPSP at 3 months
after surgery was not reduced in the PVB group compared with the no-block
(odds ratio [OR] 0.59, 95% CI 0.34-1.04; p = 0.07; I² = 6.96%)
and other-block (OR 1.39, 95% CI 0.30-6.42; p = 0.67; I² =
77.75%) groups. The PVB did not significantly reduce the incidence of CPSP
after 6 months from surgery when compared with no block (OR 0.44, 95% CI
0.08-2.53; p = 0.36; I² = 87.53%) and other blocks (OR 1.17,
95% CI 0.71-1.95; p = 0.93; I² = 45.75%). The PVB significantly
decreased postoperative pain at 24 and 48 hours at rest compared with the
no- block group. The pain score was higher in the PVB group than in the
other block groups 48 hours after surgery at rest. <br/>Conclusion(s):
Thoracic PVB does not prevent CPSP after thoracic surgery. Further large
RCTs are required to confirm and validate the authors'
results.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<27>
Accession Number
2020249129
Title
Higher blood pressure versus normotension targets to prevent acute kidney
injury: a systematic review and meta-regression of randomized controlled
trials.
Source
Critical Care. 26(1) (no pagination), 2022. Article Number: 364. Date of
Publication: December 2022.
Author
Tran P.N.T.; Kusirisin P.; Kaewdoungtien P.; Phannajit J.; Srisawat N.
Institution
(Tran, Kusirisin, Kaewdoungtien, Phannajit, Srisawat) Division of
Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn
University, Bangkok, Thailand
(Tran, Kusirisin, Kaewdoungtien, Srisawat) Excellence Center for Critical
Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
(Kusirisin, Kaewdoungtien, Srisawat) Center of Excellence in Critical Care
Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok,
Thailand
(Kusirisin) Division of Nephrology, Department of Internal Medicine,
Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
(Phannajit) Division of Clinical Epidemiology, Department of Medicine,
Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
(Kaewdoungtien) Division of Nephrology, Police General Hospital, Royal
Thai Police Headquarters, Bangkok, Thailand
(Srisawat) Academy of Science, Royal Society of Thailand, Bangkok,
Thailand
(Tran) Department of Internal Medicine, Faculty of Medicine, Can Tho
University of Medicine and Pharmacy, Cantho, Vietnam
Publisher
BioMed Central Ltd
Abstract
Background: Renal hypoperfusion is one of the most common causes of acute
kidney injury (AKI), especially in shock and perioperative patients. An
optimal blood pressure (BP) target to prevent AKI remains undetermined. We
conducted a systematic review and meta-analysis of available randomized
clinical trial (RCT) results to address this knowledge gap.
<br/>Method(s): From inception to May 13, 2022, we searched Ovid Medline,
EMBASE, Cochrane Library, SCOPUS, clinicaltrials.gov, and WHO ICTRP for
RCTs comparing higher BP target versus normotension in hemodynamically
unstable patients (shock, post-cardiac arrest, or surgery patients). The
outcomes of interest were post-intervention AKI rate and renal replacement
therapy (RRT) rate. Two investigators independently screened the citations
and reviewed the full texts for eligible studies according to a predefined
form. <br/>Result(s): Twelve trials were included, enrolling a total of
5759 participants, with shock, non-cardiac, and cardiac surgery patients
accounting for 3282 (57.0%), 1687 (29.3%) and 790 (13.7%) patients,
respectively. Compared to lower mean arterial blood pressure (MAP) targets
that served as normotension, targeting higher MAP had no significant
effect on AKI rates in shock (RR [95% CI] = 1.10 [0.93, 1.29]), in
cardiac-surgery (RR [95% CI] = 0.87 [0.73, 1.03]) and non-cardiac surgery
patients (RR [95% CI] = 1.25 [0.98, 1.60]) using random-effects
meta-analyses. In shock patients with premorbid hypertension, however,
targeting MAP above 70 mmHg resulted in significantly lower RRT risks, RR
[95%CI] = 1.20 [1.03, 1.41], p < 0.05. <br/>Conclusion(s): Targeting a
higher MAP in shock or perioperative patients may not be superior to
normotension, except in shock patients with premorbid hypertension.
Further studies are needed to assess the effects of a high MAP target to
preventing AKI in hypertensive patients across common settings of
hemodynamic instability. Trial registration This systematic review has
been registered on PROSPERO (CRD42021286203) on November 19, 2021, prior
to data extraction and analysis.<br/>Copyright &#xa9; 2022, The Author(s).

<28>
Accession Number
2020231670
Title
Special Care Patients and Caries Prevalence in Permanent Dentition: A
Systematic Review.
Source
International Journal of Environmental Research and Public Health. 19(22)
(no pagination), 2022. Article Number: 15194. Date of Publication:
November 2022.
Author
Pecci-Lloret M.R.; Pecci-Lloret M.P.; Rodriguez-Lozano F.J.
Institution
(Pecci-Lloret, Pecci-Lloret, Rodriguez-Lozano) Special Care in Dentistry
and Gerodontology Unit, Meseguer Hospital, Faculty of Medicine, University
of Murcia, Murcia 30100, Spain
Publisher
MDPI
Abstract
Due to the increase in the population with special needs and the
significant difficulty in their dental management, it is essential to
analyze the caries prevalence in this group of patients. The systematic
review was conducted following the PRISMA statement. A search was
performed on 9 May 2022 and updated on 5 June 2022, in three databases:
Pubmed, Scielo, and Cochrane library. Studies involving the analysis of
caries in permanent teeth in patients with special needs were included. A
total of 1277 studies were analyzed and 21 studies were selected. Quality
assessments were performed using an adapted version of the STROBE
guidelines. Among the analyzed groups (intellectual disabilities, human
immunodeficiency virus infection, schizophrenia, down syndrome, drug
addicts, adult heart transplant, kidney disease, diabetic, autism,
psychiatric patients, cerebral palsy, and hemophilia), the highest
prevalence of caries was observed in patients with intellectual
disability, without differences between genders. However, there is a need
for more studies with standardized methods for caries diagnosis to further
investigate the prevalence of caries in permanent teeth in patients with
special needs.<br/>Copyright &#xa9; 2022 by the authors.

<29>
Accession Number
2018020858
Title
Fractal dimension of the aortic annulus: a novel predictor of paravalvular
leak after transcatheter aortic valve implantation.
Source
International Journal of Cardiovascular Imaging. (no pagination), 2022.
Date of Publication: 2022.
Author
Stachel G.; Abdel-Wahab M.; de Waha-Thiele S.; Desch S.; Feistritzer
H.-J.; Kitamura M.; Farhan S.; Eitel I.; Kurz T.; Thiele H.
Institution
(Stachel, Abdel-Wahab, Desch, Feistritzer, Kitamura, Thiele) Department of
Internal Medicine/Cardiology and Leipzig Heart Institute, Heart Center
Leipzig at University of Leipzig, Leipzig, Germany
(de Waha-Thiele) Department of Cardiac Surgery, Heart Center Leipzig at
University of Leipzig, Strumpellstr. 39, Leipzig 04289, Germany
(Desch, Eitel, Kurz) University Clinic Schleswig-Holstein, University
Heart Center Luebeck, Lubeck, Germany
(Farhan) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Eitel) DZHK (German Centre for Cardiovascular Research), Partner Site
Hamburg/Luebeck/Kiel, Lubeck, Germany
Publisher
Springer Science and Business Media B.V.
Abstract
To evaluate the prognostic relevance of aortic annulus (AA) and left
ventricular outflow tract (LVOT) Fractal dimension (FD). FD is a
mathematical concept that describes geometric complexity of a structure
and has been shown to predict adverse outcomes in several contexts.
Computed tomography (CT) scans from the SOLVE-TAVI trial, which, in a 2 x
2 factorial design, randomized 447 patients to TAVI with the
balloon-expandable Edwards Sapien 3 or the self-expanding Medtronic Evolut
R, and conscious sedation or general anesthesia, were analyzed
semi-automatically with a custom-built software to determine border of AA
and LVOT. FD was measured by box counting using grid calibers between 0.8
and 6.75 mm and was compared between patients with none/trivial and
mild/moderate paravalvular regurgitation (PVR). Overall, 122 patients had
CT scans sufficient for semi-automatic PVR in 30-day echocardiography. PVR
was none in 65(53.3%) patients, trace in 9(7.4%), mild in 46(37.7%),
moderate in 2(1.6%) and severe in 0 patients. FD determined in diastolic
images was significantly higher in patients with mild/moderate PVR (1.0558
+/- 0.0289 vs. 1.0401 +/- 0.0284, p = 0.017). Annulus eccentricity was the
only conventional measure of AA and LVOT geometry significantly correlated
to FD (R = 0.337, p < 0.01). Area under the curve (AUC) of diastolic
annular FD for prediction of mild/moderate PVR in ROC analysis was 0.661
(0.542-0.779, p = 0.014). FD shows promise in prediction of PVR after
TAVI. Further evaluation using larger patient numbers and refined
algorithms to better understand its predictive performance is warranted.
Trial Registration:www.clinicaltrials.gov, identifier: NCT02737150, date
of registration: 13.04.2016.<br/>Copyright &#xa9; 2022, The Author(s).

<30>
Accession Number
639623000
Title
Investigating the Impact of Hyperoxia on Right Ventricular Function in
Anaesthetized CAD Patients.
Source
Swiss Medical Weekly. Conference: Swiss Anaesthesia 2022. Interlaken
Switzerland. 152(264) (pp 4S-5S), 2022. Date of Publication: November
2022.
Author
Rico B.; Kady F.; Jan-Oliver F.; Raouf M.; Gabor E.; Sandra T.; Balthasar
E.; Schoenhoff F.S.; Guensch D.P.
Institution
(Rico, Kady, Jan-Oliver, Gabor, Sandra, Balthasar, Guensch) Department of
Anaesthesiology and Pain Medicine, Bern University Hospital, University of
Bern, Switzerland
(Raouf) Department of Cardiology,Inselspital, Bern University Hospital,
University of Bern, Switzerland
(Schoenhoff) Department of Cardiovascular Surgery, Bern University
Hospital, University of Bern, Switzerland
Publisher
EMH Swiss Medical Publishers Ltd.
Abstract
Introduction: Patients with coronary artery disease (CAD) undergoing
general anaesthesia are at risk of perioperative complications. Hyperoxia
is a known coronary vasoconstrictor. However, it is also a pulmonary
vasodilator, reducing right ventricular afterload. Thus, there may be
competing effects of hyperoxia on right ventricular function. In this
study we investigated the effects of hyperoxia and normoxia on right
ventricular (RV) function assessed by 3D transesophageal echocardiography
(TEE) during general anaesthesia in CAD patients before elective coronary
artery bypass graft surgery. <br/>Method(s): In this randomized clinical
trial study participants (n = 106) were prospectively recruited using a
crossover design. In anaesthetized patients the fraction of inspired
oxygen (FiO<inf>2</inf>> was titrated to a normoxic state (FiO<inf>2</inf>
= 0.3) and a hyperoxic state (FiO<inf>2</inf> = 0.8). At both states TEE
images were acquired to assess RV ejection fraction (RVEF) and global
longitudinal free-wall strain (RVGLS). <br/>Result(s): There was no
difference between normoxia and hyperoxia in RVEF (46+/-6% vs. 45+/-8, p =
0.504) nor in RVGLS (-22.4+/-4.8 vs. -21.9+/-4.3, p = 0.352). However, RV
function improved and worsened in some patients. ROC analysis shows that
RVGLS at normoxia can better predict, which patients will worsen with
excess oxygen. With a cut-off of -20% for RVGLS (Sensitivity: 87%,
Specificity: 49%), it was demonstrated that hyperoxia was beneficial for
patients with a poor strain at normoxia (>-20%) but detrimental for those
with normal strain at normoxia (<-20%), while RVEF with a cut-off of 40%
(Sens: 88%, Spec: 33%) was unable to predict this response.
<br/>Conclusion(s): In CAD patients undergoing general anaesthesia,
hyperoxia has heterogenous effects on the RV and the potential detrimental
effects of hyperoxia were best predicted by RVGLS. Intraoperative strain
analysis might be a tool to target oxygen levels based on individual
needs.

<31>
Accession Number
639628617
Title
Association between remimazolam and postoperative delirium in older adults
undergoing elective cardiovascular surgery: a prospective cohort study.
Source
Intensive Care Medicine Experimental. Conference: European Society of
Intensive Care Medicine Annual Congress, ESICM 2022. Paris France.
10(Supplement 29) (no pagination), 2022. Date of Publication: 2022.
Author
Aoki Y.; Kato H.; Suzuki Y.; Kobayashi K.; Makino H.; Mimuro S.; Obata Y.;
Kurita T.; Doi M.; Nakajima Y.
Institution
(Aoki, Kato, Suzuki, Kobayashi, Mimuro, Obata, Kurita, Doi) Department of
Anesthesiology and Intensive Care Medicine, Hamamatsu University Hospital,
Hamamatsu, Japan
(Makino, Nakajima) Department of Anesthesiology and Intensive Care
Medicine, Hamamatsu University, School of Medicine, Hamamatsu, Japan
Publisher
Springer
Abstract
Introduction: Postoperative delirium is one of the most common
complications after cardiovascular surgery in older adults [1].
Benzodiazepines are a reported risk factor for delirium [2]; however,
there are no studies investigating remimazolam, a novel anaesthetic agent.
<br/>Objective(s): To investigate the effect of remimazolam on
postoperative delirium. <br/>Method(s): After the trial registry
(UMIN000041316), we included elective cardiovascular surgery patients aged
>= 65 years at Hamamatsu University Hospital between August 2020 and
February 2022. Patients who received general anaesthesia with remimazolam
were compared with those who received other anaesthetics (control group).
The primary outcome was delirium within 5 days after surgery. Secondary
outcomes were delirium during intensive care unit stay and
hospitalisation, total duration of delirium, subsyndromal delirium and
differences in the Mini-Mental State Examination (MMSE) scores from
preoperative to postoperative days 2 and 5. To adjust for differences in
the groups' baseline covariates, we used stabilised inverse probability
treatment weighting (IPTW) as the primary analysis and propensity score
matching as the sensitivity analysis. The following variables were used to
calculate the propensity score: age, sex, BMI category, ASA class,
comorbidities, preoperative oral medication, preoperative MMSE score,
living alone, type of surgery, cardiopulmonary bypass and scheduled
surgery time. All analyses were performed using Stata/ BE 17. Two-sided
p-values of < 0.05 were considered significant. <br/>Result(s): We
enrolled 200 patients; 78 in the remimazolam group and 122 in the control
group. After stabilised IPTW, both groups' baseline characteristics were
almost balanced. For primary outcome, 30.3% of the remimazolam group
patients and 26.6% of the control group patients developed delirium within
5 days (risk difference [RD], 3.8%; 95% confidence interval [CI], - 11.5%
to 19.1%; p = 0.63). The development of delirium in the ICU and during the
hospital stay (p = 0.59, p = 0.97, respectively), and the differences in
MMSE scores from the preoperative measurement to the measurements on
postoperative days 2 and 5 did not differ between the groups (p = 0.93, p
= 0.14, respectively). In addition, the total duration of delirium and the
rate of development of subsyndromal delirium did not differ significantly
between the groups (p = 0.57, p = 0.47, respectively). After one-to-one
propensity score matching, delirium developed within 5 days of surgery in
16/61 (26.2%) patients in the remimazolam group and 17/61 (27.9%) patients
in the control group, with no significant difference between the groups
(RD, - 1.6%; 95% CI, - 17.4 to 14.1; p = 0.84). For all other secondary
outcomes, sensitivity analysis showed similar results to those for the
primary analysis. <br/>Conclusion(s): Remimazolam was not significantly
associated with postoperative delirium compared with other anaesthetic
agents, suggesting that it may be a promising future sedative.

<32>
Accession Number
639628436
Title
Effectiveness of vibratory physiotherapeutic methods for respiratory
rehabilitation after cardiac surgery.
Source
Intensive Care Medicine Experimental. Conference: European Society of
Intensive Care Medicine Annual Congress, ESICM 2022. Paris France.
10(Supplement 29) (no pagination), 2022. Date of Publication: 2022.
Author
Ryabova D.; Alferova A.; Levitskaya M.; Eremenko A.
Institution
(Ryabova, Alferova, Levitskaya) Cardiac Intensive Care Unit, Petrovsky
National Research Center of Surgery, Moscow, Russian Federation
(Eremenko) Intensive Care Unit, Russian Research Center of Surgery,
Moscow, Russian Federation
Publisher
Springer
Abstract
Introduction: Postoperative respiratory complications in cardiac surgery
patients occur in 20-30% cases, and the most of them can be associated
with ineffective cough and bronchial mucus evacuation. One of the main
causes of its development is microatelectasis, which can cover a
significant part of the lung tissue as a result of impaired lung drainage
function and tracheobronchial patency. <br/>Objective(s): a comparative
assessment of the effectiveness of methods for stimulation the of mucus
passage in the early postoperative period of cardiac patients using
oscillatory PEP therapy, stimulation of cough with a mechanical
insufflator-aspirator, vibroacoustic lung massage, and the traditional
method of manual percussion of the chest. <br/>Method(s): 160 patients
were randomized in the study and divided into 4 groups, 40 in each.
Inclusion criteria: age over 18 years, spontaneous breathing after
tracheal extubation, the ability to maintain adequate gas exchange against
the background of oxygen inhalation, clear consciousness and productive
contact with the patient, adequate anesthesia (<= 2 points) according to a
10-point visual-analog pain scale. Exclusion criteria: the need for
re-intubation and mechanical ventilation, non-invasive mask ventilation,
acute cerebrovascular accident, shocks of various etiologies, ongoing
bleeding, extracorporeal detoxification methods, any neuromuscular
diseases, pneumothorax, hydro- or hemothorax. All procedures were
performed 10-12 h after tracheal extubation. The efficiency of mucus
discharge was assessed, gas exchange indices on room air breathing and
maximum inspiratory lung capacity (MILC) were measured. <br/>Result(s):
Before intervention ineffective bronchial mucus evacuating in the early
period after tracheal extubation was observed in 86.7% of the patients. A
single procedure of both PEP-therapy (group 1) and mechanical cough
stimulation (group 2) led to an improvement in sputum passage, as
evidenced by an increase in the number of patients with productive cough
by 4.25 times (p < 0.0009) and 5.3 times (p < 0.0007), respectively. In
patients of groups 1 and 2, an increase in MILC was observed (by 42.2% and
60.0%, respectively, p = 0.00000). In the control group 3, with manual
physiotherapy, the average increase in MILC was only 11.6%. Mechanical
respiratory therapy procedures led to a significant improvement in gas
exchange variables, as evidenced by an increase in SpO2 in groups 1 and 2
(P = 0.000009 and 0.000001, respectively) and a decrease in the proportion
of patients with impaired oxygenating lung function (SpO2 level below 92%)
by 11 and 12 times, respectively (P < 0.01). The arterial SaO2 in group 2
significantly increased after the procedure (P = 0.017), and PaCO2
decreased (P = 0.00048).The most significant effect in gas exchange
parameters were revealed after vibroacoustic lung massage. In group 3 the
number of patients with productive cough increased 12.3 times (p <
0.0001). There was an increase in SpO2 from 91 to 93% (p = 0.000000) and
MILC from 950 to 1150 ml (0.000000). Vibroacoustic lung massage was
accompanied by improvement of gas exchange indices, as evidenced by
statistically significant increase PaO2 and p/f index with simultaneous
decrease of PaCO2. <br/>Conclusion(s): Mechanical vibratory methods have
significant advantages over classical manual chest massage. Their positive
effect on mucus passage, ventilatory parameters and gas exchange was
noted. There were no complications associated with procedures. (Table
Presented).

<33>
Accession Number
639627933
Title
Cardiac Surgery Outcomes of COVID-19 Recovered Patients in a Cardiology
Referral Center in the Philippines: A Single Center Experience.
Source
Intensive Care Medicine Experimental. Conference: European Society of
Intensive Care Medicine Annual Congress, ESICM 2022. Paris France.
10(Supplement 29) (no pagination), 2022. Date of Publication: 2022.
Author
Lacanin M.R.A.; Patricio M.; Permejo C.C.
Institution
(Lacanin) Department of Ambulatory, Emergency and Critical Care,
Philippine Heart Center, Quezon City, Philippines
(Patricio, Permejo) Department of Ambulatory, Emergency and Critical Care,
Philippine Heart Center, East Avenue, Diliman, Quezon City, Metro Manila,
Philippines
Publisher
Springer
Abstract
Introduction: Current data suggest elevated mortality and poor surgical
outcomes in patients with peri-operative COVID-19 infection. Limited
studies have looked into the outcomes of cardiac surgery in patients who
have recovered. <br/>Objective(s): This study investigates the in-hospital
outcomes of adult patients who had COVID-19 prior to their cardiovascular
surgery at the primary cardiac referral center in the Philippines.
<br/>Method(s): This retrospective cohort study included 40 adult patients
with previous COVID-19 diagnosis who underwent cardiac surgery at our
institution from April 2020 to December 2021. Baseline characteristics,
pre-operative assessments, operative details and in-hospital outcomes were
collected through chart and electronic medical records review. Data were
compared to 50 propensity-matched randomly selected non- COVID-19 patients
who underwent cardiac surgery and generally identical post-operative
management during the same study period. <br/>Result(s): There were no
significant difference in most of the baseline characteristics between
groups except for the functional status (p-value 0.006), cardiopulmonary
bypass time (p-value 0.027) and vaccination status (p-value 0.006). The
mean age was 55 years, predominantly male; and hypertension is the most
common co-morbidity. The median Euroscore is 1.15% (IQR, 0.76-2.19).
Longer cardiopulmonary bypass times were observed in COVID-19 patients,
median 165 min (IQR, 137-228) vs 134 min (IQR, 118-193) for non-COVID
patients. COVID-19 recovered patients have a 10% in-hospital mortality
rate, mostly due to Hospital Acquired Pneumonia. In both groups, however,
there was no significant difference in their primary and secondary
post-surgical outcomes. <br/>Conclusion(s): This research is the first
study done locally that specifically addressed cardiovascular surgery
outcomes in COVID-19 recovered patients. The outcome of cardiac surgical
patients who had COVID-19 pre-operatively is comparable to their non-COVID
cohort.

<34>
Accession Number
639627644
Title
The impact of small volume resuscitation with hypertonic saline after
cardiac surgery on total body water distribution-Results of a post hoc
analysis of the HERACLES randomized controlled trial.
Source
Intensive Care Medicine Experimental. Conference: European Society of
Intensive Care Medicine Annual Congress, ESICM 2022. Paris France.
10(Supplement 29) (no pagination), 2022. Date of Publication: 2022.
Author
Waskowski J.; Mueller M.; Hess B.; Zuercher P.; Schefold J.C.;
Pfortmueller C.A.
Institution
(Waskowski, Hess, Zuercher) Departement of Intensive Care Medicine, Bern
University Hospital, University of Bern, Bern, Switzerland
(Mueller) Departement of Emergency Medicine, Bern University Hospital,
University of Bern, Bern, Switzerland
(Schefold, Pfortmueller) Department of Intensive Care Medicine, Bern
University Hospital, University of Bern, Bern, Switzerland
Publisher
Springer
Abstract
Introduction: Perioperative fluid overload contributes to mortality in
cardiac surgery (CS) [1, 2]. In the HERACLES trial, we evaluated whether
small volume resuscitation with a single bolus of 5 ml/kg of hypertonic
saline (7.3% NaCl) (HS) versus isotonic saline (0.9% NaCl) (control) over
60 min after cardiac surgery reduces cumulative perioperative fluid intake
[3]. We noted a decreased overall fluid balance and an increased urinary
output in the HS-group compared to controls. Controversly, some
investigations indicate increased fluid accumulation in patients receiving
large sodium loads through intravenous fluid administration [4, 5].
Currently, the impact of excess sodium loading on water and salt
distribution in critically ill patients is still unclear.
<br/>Objective(s): The primary objective was to assess the influence of HS
infusion on body water distribution measured by bioelectrical impedance
analysis (BIA) in patients after cardiac surgery. Secondary outcomes were
changes in urinary sodium, potassium and chloride excretion.
<br/>Method(s): Pre-defined post-hoc analysis of the HERACLES trial [3], a
single-center randomized controlled double blind clinical trial conducted
at Bern University Hospital, Bern Switzerland (NCT03280745). All patients
randomized were eligible for this analysis. Exclusion criteria: i)
patients without BIA on pre-operative day (d-1) and post-operative days 1
and 2, patients with general contraindications to BIA. BIA measurements
(BIACORPUS RX 4000, MEDI CAL HealthCare GmbH; Karlsruhe, Germany) were
performed at d-1 and post-operatively (d0), on the first post-operative
day (d1), 48-72 h after surgery (d3) and on post-operative day 6 (d6).
Urinary electrolytes (sodium, potassium, chloride) were measured at d-1,
d0, d3 and d6. <br/>Result(s): Out of 165 patients, 136 patients were
included (49 HSgroup, 87 controls). Patients received comparable median
total peri-operative fluid volumes (HS: 7,846 ml, interquartile range
[IQR] 5,831-9,095 ml vs. controls: 8,187 ml, IQR 6,063-9,791 ml; p = 0.2).
Median sodium load in the HS-group was 11.8 g, IQR 10.4-14.3 g (controls:
0.94 g, IQR 0-1.4 g; p < 0.001). The cumulative dose furosemide equivalent
patients received until d6 was higher in controls (200 mg, IQR 90-340 mg
vs HS: 130 mg, IQR 40-220 mg; p = 0.02). Peri-operative change in total
body water (TBW) did not differ between groups (HS: mean change 29%,
standard deviation [SD] 23% vs. control: mean change 27%, SD 19%; p =
0.47). We noted no peri-operative change in additional BIA parameters (all
p > 0.05). Higher TBW and intracellular water levels were noted in the HS
vs. control group over time (p = 0.01 and p = 0.006, adjusted for
cumulative dose furosemide equivalent). Urinary electrolyte excretion over
time were comparable between the HS and control groups (all p > 0.05).
<br/>Conclusion(s): A single HS bolus after cardiac surgery may induce
delayed but temporary water accumulation. This may suggest redistribution
of excess sodium into the extravascular space.

<35>
Accession Number
639627457
Title
Efficacy of programmed intermittent bolus infusion with serratus anterior
plane block catheter for analgesia in the intensive care unit after
minimally invasive cardiac surgery: a randomized, double-blind, controlled
trial.
Source
Intensive Care Medicine Experimental. Conference: European Society of
Intensive Care Medicine Annual Congress, ESICM 2022. Paris France.
10(Supplement 29) (no pagination), 2022. Date of Publication: 2022.
Author
Sato Y.; Kumagai M.; Kaiho Y.; Taguri M.; Sekine T.; Takei Y.; Sugino S.;
Inoue H.; Ito J.; Yamauchi M.
Institution
(Sato, Kumagai, Kaiho, Sekine, Takei, Sugino, Yamauchi) Department of
Anesthesiology and Perioperative Medicine, Tohoku University, Graduate
School of Medicine, Sendai, Japan
(Taguri) Department of Health Data Science, Tokyo Medical University,
Shinjuku City, Japan
(Inoue) Department of Anesthesiology, Southern Tohoku General Hospital,
Iwanuma, Japan
(Ito) Department of Anesthesiology, Sendai Kousei Hospital, Sendai, Japan
Publisher
Springer
Abstract
Introduction: Minimally invasive cardiac surgery (MICS) involves a small
lateral thoracotomy, which is expected to result in less complications and
faster recovery compared with median sternotomy. However, difficulties
with postoperative pain control after MICS can counteract this benefit,
and opioid-based analgesia can cause side effects such as respiratory
depression, nausea, and vomiting. Serratus anterior plane block (SAPB),
which requires high-volume infusion of local anesthetics into the optimal
compartment under the serratus muscle, allows effective analgesia after
thoracic surgery. Thus, programmed intermittent bolus infusion (PIBI) with
an SAPB catheter may improve postoperative pain management after MICS.
This study aimed to evaluate the effects of PIBI with an SAPB catheter for
postoperative fentanyl consumption following MICS. <br/>Method(s): This
study was a prospective, randomized, double-blind trial. Twenty patients,
aged 19-80 years, ECOG 0-II, and scheduled for elective MICS were randomly
allocated to 2 groups (SAPB or Control). Before the surgery, all patients
underwent SAPB followed by insertion of a catheter and received a bolus of
3 mg/kg 0.375% ropivacaine through the catheter. In the SAPB group,
participants received a bolus of 20 mL 0.25% ropivacaine every 6 h after
surgery, while a bolus of 20 mL saline was administered in the control
group. All participants received intravenous fentanyl via
patient-controlled analgesia. The primary outcome was the cumulative
fentanyl consumption up to postoperative day (POD) 5. The secondary
outcomes were: the Numerical Rating Scale (NRS) at rest and on movement at
the time of extubation and 1, 2, 6, 12, 24, 48, 72, and 96 h after
extubation; the length of intensive care unit and hospital stay;
evaluation of rehabilitation (grip strength, length around the thorax, and
upper limb range of motion at preoperative and postoperative days 1-5);
side effects (postoperative nausea and vomiting (PONV) and adverse events
due to ropivacaine); and time to the first postoperative fentanyl dose.
<br/>Result(s): Seventeen patients were left in the final analysis. The
cumulative fentanyl consumption at 5 days did not significantly differ
between the two groups (the SAPB group, median [interquartile range
(IQR)], 511.6 mug [457.3-752.9] versus the control group, 654.1 mug
[439.1-982.0]; P = 0.963). The incidence of PONV were significantly lower
in the SAPB group compared with the control group (11.1% versus 62.5%; P =
0.049). The median NRS score on movement during the study period was lower
in the SAPB group, but the result was not statistically significant (P =
0.057). <br/>Conclusion(s): Programmed intermittent bolus infusion with an
SAPB catheter did not reduce postoperative fentanyl consumption compared
with the control group after MICS. However, this method was associated
with a significantly lower incidence of PONV.

<36>
Accession Number
2021340106
Title
Cardiovascular Outcomes of Older versus Newer Generation Transcatheter
Aortic Valve Replacement Recipients: A Systematic Review & Meta-analysis.
Source
Current Problems in Cardiology. 48(2) (no pagination), 2023. Article
Number: 101467. Date of Publication: February 2023.
Author
Sattar Y.; Prakash P.; Almas T.; Mir T.; Titus A.; Ahmad S.; Khan M.S.;
Aggarwal A.; Ullah W.; Alhharbi A.; Kakouros N.; Alraies M.C.; Qureshi
W.T.
Institution
(Sattar, Alhharbi) Department of Cardiology, West Virginia University,
Morgantown, WV, United States
(Prakash, Mir) Department of Internal Medicine, Detroit Medical center,
Wayne State University, Detroit, MI, United States
(Almas) Royal College of Surgeons in Ireland, Dublin, Ireland
(Titus) Department of Internal Medicine, Saint Vincent Hospital,
Worcester, MA
(Ahmad) Department of Internal Medicine, Icahn School of Medicine at Mount
Sinai - Elmhurst Hospital, Queens, NY, United States
(Khan) Department of Internal Medicine, Mercy St Vincent Medical Centre,
Toledo Ohio
(Aggarwal) Department of Internal Medicine, Ascension providence Rochester
(Ullah) Department of Internal Medicine, Abington Jefferson Health,
Abington, PA
(Kakouros, Qureshi) Division of Cardiology, University of Massachusetts
School of Medicine, Worcester, MA
(Alraies) Department of Interventional Cardiology, Detroit Medical Center,
DMC Heart Hospital, Detroit, MI, United States
Publisher
Elsevier Inc.
Abstract
Newer generation transcatheter heart valves (THV) are presumed to yield
better clinical efficacy and postprocedural complication profile as
compared to transcatheter aortic valve replacement (TAVR) using older
generation THVs. The real impact of newer generation valves on TAVR
outcomes is not well known. Studies comparing older and newer generation
THVs were identified from online databases including PubMed, EMBASE,
Cochrane, and ClinicalTrials.gov from inception until August 2020. The
primary outcome of the study was to compare mortality. Secondary outcomes
included cerebrovascular events, myocardial infarction, major vascular
complications, major bleeding, acute kidney injury, paravalvular leak, and
post-procedural pacemaker implantation. Statistical analysis was performed
using the Mantel-Haenszel random effect model with an odds ratio (OR), 95%
confidence interval (CI), and p-value significance <=0.05. A total of 14
studies were included with a combined patient population of 5697 patients
(older generation n=1996; newer generation n=3701). Newer generation
valves showed statistically significant results favoring lower major
vascular complications (OR=2.05; 95% CI, 1.33-3.18; P = 0.00), major
bleeding (OR=1.99; 95% CI, 1.35-2.93; P = 0.00), acute kidney injury
(OR=1.71; 95% CI, 1.13-2.59; P = 0.01), paravalvular leak (OR=2.41; 95%
CI, 1.11-5.28; P = 0.03) and mortality (OR=1.50; 95% CI, 1.10-2.06; P =
0.01) as compared to older generation valves. Cerebrovascular events,
myocardial infarction, and pacemaker placement rates were found to be
similar between older and newer generation valves. TAVR outcomes using
newer generation valves are superior to those of older generation valves
in terms of major vascular complications, acute kidney injury,
paravalvular leak, and mortality.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<37>
Accession Number
2021329908
Title
Presentation cardiac troponin and early computed tomography coronary
angiography in patients with suspected acute coronary syndrome: a
pre-specified secondary analysis of the RAPID-CTCA trial.
Source
European Heart Journal: Acute Cardiovascular Care. 11(7) (pp 570-579),
2022. Date of Publication: 01 Jul 2022.
Author
Wang K.-L.; Roobottom C.; Smith J.E.; Goodacre S.; Oatey K.; O'Brien R.;
Storey R.F.; Curzen N.; Keating L.; Kardos A.; Felmeden D.; Thokala P.;
Mills N.L.; Newby D.E.; Gray A.J.
Institution
(Wang, Mills, Newby) Centre for Cardiovascular Science, University of
Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh
EH16 4SB, United Kingdom
(Wang) School of Medicine, National Yang Ming Chiao Tung University,
Taipei, Taiwan (Republic of China)
(Wang) General Clinical Research Center, Taipei Veterans General Hospital,
Taipei, Taiwan (Republic of China)
(Roobottom) Department of Radiology, University Hospitals Plymouth NHS
Trust, Plymouth, United Kingdom
(Smith) Emergency Department, University Hospitals Plymouth NHS Trust,
Plymouth, United Kingdom
(Goodacre, Thokala) School of Health and Related Research, University of
Sheffield, Sheffield, United Kingdom
(Oatey) Edinburgh Clinical Trials Unit, University of Edinburgh,
Edinburgh, United Kingdom
(O'Brien, Gray) Department of Emergency Medicine, Royal Infirmary of
Edinburgh, Edinburgh, United Kingdom
(Storey) Department of Infection, Immunity and Cardiovascular Disease,
University of Sheffield, Sheffield, United Kingdom
(Curzen) Faculty of Medicine, University of Southampton, Southampton,
United Kingdom
(Curzen) Department of Cardiology, University Hospital Southampton NHS
Foundation Trust, Southampton, United Kingdom
(Keating) Department of Emergency Medicine, Royal Berkshire NHS Foundation
Trust, Reading, United Kingdom
(Kardos) Translational Cardiovascular Research Group, Milton Keynes
University Hospital NHS Foundation Trust, Milton Keynes, United Kingdom
(Kardos) Faculty of Medicine and Health Science, University of Buckingham,
Buckingham, United Kingdom
(Felmeden) Department of Cardiology, Torbay and South Devon NHS Foundation
Trust, Torquay, United Kingdom
(Mills, Gray) Usher Institute, University of Edinburgh, Edinburgh, United
Kingdom
Publisher
Oxford University Press
Abstract
Aims: To evaluate the potential associations between presentation cardiac
troponin and the clinical impact of early computed tomography coronary
angiography (CTCA) in intermediate-risk patients with suspected acute
coronary syndrome. <br/>Methods and Results: In a large multicentre
randomized controlled trial of patients with intermediate-risk chest pain
due to suspected acute coronary syndrome, early CTCA had no effect on the
primary outcome - death or subsequent Type 1 or 4b myocardial infarction -
but reduced the rate of invasive coronary angiography. In this
pre-specified secondary analysis, cardiovascular testing and clinical
outcomes were compared between those with or without cardiac troponin
elevation at presentation. Of 1748 patients, 1004 (57%) had an elevated
cardiac troponin concentration and 744 (43%) had a normal concentration.
Patients with cardiac troponin elevation had a higher Global Registry of
Acute Coronary Events score (132 vs. 91; P < 0.001) and were more likely
to have obstructive coronary artery disease (59 vs. 33%; P < 0.001),
non-invasive (72 vs. 52%; P < 0.001) and invasive (72 vs. 38%; P < 0.001)
testing, coronary revascularization (47 vs. 15%; P < 0.001), and the
primary outcome (8 vs. 3%; P = 0.007) at 1 year. However, there was no
evidence that presentation cardiac troponin was associated with the
relative effects of early CTCA on rates of non-invasive (Pinteraction =
0.33) and invasive (Pinteraction = 0.99) testing, coronary
revascularization (Pinteraction = 0.57), or the primary outcome
(Pinteraction = 0.41). <br/>Conclusion(s): Presentation cardiac troponin
had no demonstrable associations between the effects of early CTCA on
reductions in non-invasive and invasive testing, or the lack of effect on
coronary revascularization or the primary outcome in intermediate-risk
patients with suspected acute coronary syndrome. <br/>Copyright &#xa9;
2022 The Author(s).

<38>
Accession Number
2021316217
Title
Letter on Incidence and prognosis of COVID-19 among heart transplant
recipients: a systematic review and meta-analysis.
Source
European Journal of Preventive Cardiology. 29(7) (pp E263), 2022. Date of
Publication: 01 May 2022.
Author
Shoar S.
Institution
(Shoar) Department of Clinical Research, ScientificCollaboration
Initiative, 7900 Cambridge Street, Houston, TX 77054, United States
Publisher
Oxford University Press

<39>
Accession Number
2014634466
Title
Aminophylline for prevention and/or treatment of post-dural puncture
headache: A systematic review and meta-analysis study protocol.
Source
Anesthesiology and Pain Medicine. 11(5) (no pagination), 2021. Article
Number: e119674. Date of Publication: 2021.
Author
Safarpour A.R.; Mehrabi M.; Tarkesh F.; Ashrafizadeh H.; Keshtkar A.;
Askari H.; Abazari D.; Amini A.; Barati-Boldaji R.
Institution
(Safarpour, Tarkesh, Askari, Barati-Boldaji) Gastroenterohepatology
Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,
Islamic Republic of
(Mehrabi) Department of E-Learning, Virtual School, Shiraz University of
Medical Sciences, Shiraz, Iran, Islamic Republic of
(Ashrafizadeh) Department of Nursing, School of Nursing and Midwifery,
Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran, Islamic
Republic of
(Keshtkar) Department of Health Sciences Education Development, School of
Public Health, Tehran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Abazari) Department of Cellular & Physiological Sciences & the Brain
Research Center, University of British Columbia, Vancouver, Canada
(Amini) Department of Anesthesiology, School of Medicine, Shiraz
University of Medical Sciences, Shiraz, Iran, Islamic Republic of
Publisher
Kowsar Medical Institute
Abstract
Objectives: Post-dural Puncture Headache (PDPH) is prevalent among
individuals undergoing lumbar punctures. The non-invasive effect of some
drugs, such as aminophylline on PDPH has been investigated in several
clinical studies. As there is no comprehensive systematic review and
meta-analysis about the preventive and therapeutic effects of
aminophylline on PDPH in the literature, the clinical effectiveness of
this drug on the prevention and/or treatment of PDPH will be assessed in
this study. <br/>Method(s): PubMed/MEDLINE, Embase, WoS (Clarivate
Analytics), the Cochrane Central Register of Controlled Trials (CENTRAL),
CINAHL Complete, Scopus, and Google Scholar as electronic databases will
be precisely searched for clinical studies that assessed the effect of
aminophylline on PDPH. Studies between 01-01-1980 and 30-06-2020 will be
evaluated in this study, and there will not be any language restrictions.
Contradictions between the reviewers within any phase of the study
(screening, selecting, quality assess-ment, and data extraction) will be
resolved by consensus; in case of unsolved disagreements, a third reviewer
will eventually decide. The combination method will be applied according
to the methodological resemblance in the selected articles using the
Random Effect Model or the Fixed Effect Model. Also, for the included
articles, forest plots will be drawn. For assessing statistical
heterogene-ity, the I² statistic and the Q-statistic test will
be applied. In addition, funnel plots will be used for assessing
non-significant study effects and potential reporting bias. Furthermore,
Egger's and Begg's tests will be done, and publication bias will be
indicated by significant findings (P < 0.05). <br/>Conclusion(s): It is
expected that the results of this study will be of benefit to researchers
and clinicians for managing PDPH, and will be reported in conferences and
publications.<br/>Copyright &#xa9; 2021, Author(s).

<40>
Accession Number
2018077041
Title
Meta-Analysis of Relation Between Left Ventricular Dysfunction and
Outcomes After Transcatheter Mitral Edge-to-Edge Repair.
Source
American Journal of Cardiology. 175 (pp 88-96), 2022. Date of Publication:
15 Jul 2022.
Author
Scotti A.; Massussi M.; Latib A.; Munafo A.; Colombo A.; Taramasso M.;
Margonato A.; Maisano F.; Godino C.
Institution
(Scotti, Latib) Montefiore-Einstein Center for Heart and Vascular Care,
Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY,
United States
(Massussi) Division of Cardiology, Spedali Civili University Hospital,
Brescia, Italy
(Munafo) Division of Cardiology, Istituto di Ricovero e Cura a Carattere
Scientifico (IRCCS) Policlinico San Matteo Foundation, Pavia, Italy
(Colombo) Humanitas Clinical and Research Center Istituto di Ricovero e
Cura a Carattere Scientifico (IRCCS) - Rozzano, Milan, Italy
(Taramasso) Division of Cardiothoracic Surgery, Arzt bei Herzzentrum
Hirslanden Zurich, Zurich, Switzerland
(Margonato, Godino) Division of Cardiology
(Maisano) Department of Cardiac Surgery, San Raffaele Scientific
Institute, Milan, Italy
Publisher
Elsevier Inc.
Abstract
Randomized controlled trials (RCTs) and observational studies provided
conflicting results regarding the role of left ventricular (LV) function
on outcomes after transcatheter edge-to-edge repair (TEER). The study
aimed to provide a comprehensive assessment of the interplay between
severe LV dysfunction and TEER outcomes. Multiple electronic databases,
including PubMed, EMBASE, Scopus, Web of Science, and CENTRAL, were
searched to identify studies on TEER for secondary mitral regurgitation
reporting outcomes stratified for LV ejection fraction <30% and >=30%. The
prespecified primary end points were the composite of all-cause death or
heart failure (HF) hospitalization and New York Heart Association (NYHA)
class III/IV. Odds ratios (ORs) and 95% confidence intervals (CIs) were
estimated by random-effects models. Multiple sensitivity analyses
accounting for baseline characteristics and study design were applied. A
total of 6 studies (1,957 patients) with 1 year or 2 years of follow-up
were available. Severe LV dysfunction was associated with an increased
risk of death or HF hospitalization (OR 1.71, 95% CI 1.14 to 2.57).
Conversely, comparable rates of NYHA class III/IV (OR 1.06, 95% CI 0.82 to
1.38) or secondary end points (reinterventions, recurrence of significant
secondary mitral regurgitation) were found regardless of the baseline LV
function. Subgroup meta-analysis found no difference in the composite
primary end point between patients with LV ejection fraction <30% and
>=30% enrolled in RCTs. In conclusion, TEER seems to be associated with
higher mortality or HF hospitalization rates in patients with severe LV
dysfunction. However, RCTs found no differences between groups. No impact
of LV function was found on the risk of NYHA class III/IV or other
clinical outcomes.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<41>
Accession Number
2021122850
Title
Bioresorbable vascular scaffolds versus conventional drug-eluting stents
across time: A meta-analysis of randomised controlled trials.
Source
Open Heart. 9(2) (no pagination), 2022. Article Number: 002107. Date of
Publication: 26 Oct 2022.
Author
Jackson-Smith E.; Zioupos S.; Banerjee P.
Institution
(Jackson-Smith, Zioupos, Banerjee) Warwick Medical School, University of
Warwick, Coventry, United Kingdom
(Banerjee) Centre for Sports, Exercise & Life Sciences (CSELS), Coventry
University, Faculty of Health and Life Sciences, Coventry, United Kingdom
(Banerjee) Department of Cardiology, University Hospitals Coventry and
Warwickshire, Coventry, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Background Bioresorbable vascular scaffolds (BVS) were designed to reduce
the rate of late adverse events observed in conventional drug-eluting
stents (DES) by dissolving once they have restored lasting patency.
Objectives Compare the safety and efficacy of BVS versus DES in patients
receiving percutaneous coronary intervention for coronary artery disease
across a complete range of randomised controlled trial (RCT) follow-up
intervals. Methods A systematic review and meta-analysis was performed
using Preferred Reporting Items for Systematic Reviews and Meta-Analyses
guidelines. MEDLINE, EMBASE and Web of Science were searched from
inception through 5 January 2022 for RCTs comparing the clinical outcomes
of BVS versus DES. The primary safety outcome was stent/scaffold
thrombosis (ST), and the primary efficacy outcome was target lesion
failure (TLF: composite of cardiac death, target vessel myocardial
infarction (TVMI) and ischaemia-driven target lesion revascularisation
(ID-TLR)). Secondary outcomes were patient-oriented composite endpoint
(combining all-death, all-MI and all-revascularisation), its individual
components and those of TLF. Studies were appraised using Cochrane's Risk
of Bias tool and meta-analysis was performed using RevMan V.5.4. Results
11 919 patients were randomised to receive either BVS (n=6438) or DES
(n=5481) across 17 trials (differing follow-up intervals from 3 months to
5 years). BVS demonstrated increased risk of ST across all timepoints
(peaking at 2 years with risk ratio (RR): 3.47; 95% CI 1.80 to 6.70;
p=0.0002). Similarly, they showed increased risk of TLF (peaking at 3
years, RR: 1.35; 95% CI 1.07 to 1.70; p=0.01) resulting from high rates of
TVMI and ID-TLR. Though improvements were observed after device
dissolution (5-year follow-up), these were non-significant. All other
outcomes were statistically equivalent. Applicability to all BVS is
limited by 91% of the BVS group receiving Abbott's Absorb. Conclusion This
meta-analysis demonstrates that current BVS are inferior to contemporary
DES throughout the first 5 years at minimum.<br/>Copyright &#xa9;

<42>
Accession Number
2020227844
Title
A comprehensive review of cerebral oximetry in cardiac surgery.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Moore C.C.; Yu S.; Aljure O.
Institution
(Moore, Aljure) Jackson Memorial Hospital/University of Miami Miller
School of Medicine, Miami, FL, United States
(Yu) Mayo Clinic, Phoenix, AZ, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Patients who undergo cardiac surgery are at increased risk of
stroke, postoperative cognitive decline, and delirium. These
neurocognitive complications have led to increased costs, intensive care
unit stays, morbidity, and mortality. As a result, there is a significant
push to mitigate any neurological complications in cardiac surgery
patients. Near-infrared spectroscopy to measure regional cerebral oxygen
saturations has gained consideration due to its noninvasive and
user-friendly nature. Cerebral oximetry desaturations during cardiac
surgery have been linked to an array of adverse clinical outcomes.
However, the most effective intraoperative interventions to protect this
vulnerable patient population have yet to be ascertained. Aim of Study: To
provide a comprehensive summary of the intraoperative management for
cerebral oximetry desaturations during cardiac surgery. The review
highlights clinical outcomes from cerebral oximetry use to quantify the
importance of identifying cerebral desaturations during cardiac surgery.
The review then interrogates possible interventions for cerebral oximetry
desaturations in an effort to determine which interventions are most
efficacious and to enlighten possible areas for further research.
<br/>Method(s): A narrative review of randomized controlled trials,
observational studies, and systematic reviews with metanalyses was
performed through August 2021. <br/>Result(s): There is significant
heterogeneity among patient populations for which cerebral oximetry
monitoring has been studied in cardiac surgery. Further, the definition of
a clinically significant cerebral desaturation and the assessment of
neurocognitive outcomes varied substantially across studies. As a result,
metanalysis is challenging and few conclusions can be drawn. Cerebral
oximetry use during cardiac surgery has not been associated with
improvements in neurocognitive outcomes, morbidity, or mortality to date.
The evidence to support a particular intervention for an acute
desaturation is equivocal. <br/>Conclusion(s): Future research is needed
to quantify a clinically significant cerebral desaturation and to
determine which interventions for an acute desaturation effectively
improve clinical outcomes.<br/>Copyright &#xa9; 2022 Wiley Periodicals
LLC.

<43>
Accession Number
2020227831
Title
Pre-emptive intraoperative administration of PCC4 in cardiac surgery
patients at high risk of bleeding: A pilot study.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Elder J.; McComb J.; Lirette S.; Herndon B.; Yancey G.; Mohammed A.;
Copeland H.
Institution
(Elder, McComb, Herndon, Yancey, Mohammed) Cardiothoracic and Transplant
Surgery, Lutheran Hospital of Indiana, Fort Wayne, IN, United States
(Lirette) Fulcrum, Jackson, MS, United States
(Copeland) Cardiothoracic Surgery, Heart Transplant and Mechanical
Circulatory Support, Lutheran Hospital - Fort Wayne Indiana, United States
(Copeland) Indiana University School of Medicine, Fort Wayne (IUSM-FW),
IN, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Four-factor prothrombin complex (PCC4), a concentrate of
factors II, VII, IX, and X and proteins C and S, has been used selectively
for reversal of oral anticoagulation before surgery. There is data to
support PCC4 as opposed to supplemental fresh frozen plasma (FFP) to
manage postoperative bleeding following cardiac surgery. The preemptive,
intraoperative use of PCC4 in cardiothoracic surgery has not been studied
though it may prevent postoperative bleeding, the need for blood
transfusion and the risk of transfusion-related acute lung injury, volume
overload, and right ventricular (RV) heart failure. The purpose of this
study is to evaluate the intraoperative administration of PCC4 to decrease
bleeding and lower the rate of blood transfusion. <br/>Method(s): A single
institution retrospective chart review was conducted from May 2020 to
November 2021 of patients who received PCC4 intraoperatively during
cardiothoracic surgery of high-risk variety. Patients were evaluated for
the type of surgery, demographics, baseline anticoagulation, PCC4 dose,
type and quantity of blood transfusion within 72 hours (h)
postoperatively, chest tube output, the incidence of RV failure,
hypersensitivity reactions, acute kidney injury (AKI), thrombosis, acute
lung injury, and mortality within 45 days of the operative dose of PCC4.
<br/>Result(s): Thirty-five patients received PCC4 at a mean dose of 2920
units (U). Sixty-five percent of cases were left ventricular assist
devices (LVADs) or heart transplants. The protocol is to use PCC4 30 units
(U)/kg immediately after the completion of protamine administration.
Inclusion criteria are cardiothoracic surgery with increased risk of
postoperative right heart failure commonly secondary to blood product
transfusion, or cardiothoracic surgery associated with increased risk of
bleeding, including heart transplant, LVAD implant, aortic dissection, and
redo sternotomy (e.g., coronary artery bypass). Total chest tube output
was recorded as a mean of 757 ml for 24 h after surgery (32 ml/h). Overall
median event rates of FFP and red blood cell (RBC) transfusions were 0
(interquartile range [IQR]: 0-3 U) and 4 (IQR: 2-5 U). Overall, 43% and
89% of cases received FFP and RBC, respectively. There was one occurrence
of RV failure, one occurrence of AKI requiring renal replacement therapy,
one occurrence of venoarterial extracorporeal membrane oxygenation, one
occurrence of venous thromboembolism related to a central venous access
line, and one death unrelated to surgery or PCC4 that was attributed to
advanced heart failure not amenable to advanced therapies.
<br/>Conclusion(s): Overall patients received a low rate of blood
transfusion, had minimal chest tube output, and there was a small
incidence of right heart failure. Patients did not have an increased risk
of adverse effects such as AKI or venous thromboembolism. A randomized
controlled clinical trial comparing the observed dose and timing of PCC4
versus routine postoperative bleeding management with blood product
transfusion is recommended.<br/>Copyright &#xa9; 2022 Wiley Periodicals
LLC.

<44>
Accession Number
2020227824
Title
Contemporary utilization of the axillary artery in cardiac surgery.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Rogers M.P.; DeSantis A.J.; Gemayel K.; Bommareddi S.R.; Caceres Polo M.;
Hooker R.L.
Institution
(Rogers, DeSantis, Gemayel, Bommareddi) Department of Surgery, University
of South Florida Morsani College of Medicine, Tampa, FL, United States
(Caceres Polo) Department of Cardiac Surgery, Christus Spohn Hospital,
Corpus Christi, TX, United States
(Hooker) Department of Surgery, Division of Cardiothoracic Surgery,
University of Arizona College of Medicine, Tucson, AZ, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction: The axillary artery is a reliable inflow vessel when
addressing pathology of the aortic root and aortic arch that may preclude
standard central cannulation strategies. This narrative review examines
the use of the axillary artery in cardiac surgery. Anatomy, indications
for use, cannulation strategies, and potential complications will be
discussed. <br/>Method(s): A comprehensive review of the current
literature was performed using PubMed, Cochrane Review, and authoritative
committee guidelines. A narrative review incorporating current available
evidence was undertaken. Comment: Use of the axillary artery in select
cardiac surgical cases is reliable, reproducible, and may be preferable in
certain cases involving ascending aortic pathology, reoperative surgery,
porcelain aorta, access for transcatheter valve therapies, and peripheral
mechanical circulatory support.<br/>Copyright &#xa9; 2022 Wiley
Periodicals LLC.

<45>
Accession Number
2020213763
Title
Postoperative delirium after transcatheter aortic valve replacement: An
updated systematic review and meta-analysis.
Source
Journal of the American Geriatrics Society. (no pagination), 2022. Date
of Publication: 2022.
Author
Ma X.; Chu H.; Han K.; Shao Q.; Yu Y.; Jia S.; Wang D.; Wang Z.; Zhou Y.
Institution
(Ma, Han, Shao, Yu, Jia, Wang, Zhou) Department of Cardiology, Beijing
Anzhen Hospital, Capital Medical University, Beijing, China
(Chu, Wang) Department of Anesthesia, Qingdao Women and Children's
Hospital, Qingdao University, Qingdao, China
Publisher
John Wiley and Sons Inc
Abstract
Aims: To perform an updated systematic review and meta-analysis of
postoperative delirium (POD) after transcatheter aortic valve replacement
(TAVR). <br/>Method(s): We conducted a systematic literature search of
PubMed, Embase, and Cochrane Library databases from the time of the first
human TAVR procedure in 2002 until December 24, 2021, which was
supplemented by manual searches of bibliographies. Data were collected on
incidence rates, risk factors, and/or associated mortality of POD after
TAVR. Pooled analyses were conducted using random effects models to yield
mean differences, odds ratios, hazard ratios, and risk ratios, with 95%
confidence intervals. <br/>Result(s): A total of 70 articles (69 studies)
comprising 413,389 patients were included. The study heterogeneity was
substantial. The pooled mean incidence of POD after TAVR in all included
studies was 9.8% (95% CI: 8.7%-11.0%), whereas that in studies using
validated tools to assess for delirium at least once a day for at least 2
consecutive days after TAVR was 20.7% (95% CI: 17.8%-23.7%). According to
the level of evidence and results of meta-analysis, independent
preoperative risk factors with a high level of evidence included increased
age, male sex, prior stroke or transient ischemic attack, atrial
fibrillation/flutter, weight loss, electrolyte abnormality, and impaired
Instrumental Activities of Daily Living; intraoperative risk factors
included non-transfemoral access and general anesthesia; and acute kidney
injury was a postoperative risk factor. POD after TAVR was associated with
significantly increased mortality (pooled unadjusted RR: 2.20, 95% CI:
1.79-2.71; pooled adjusted RR: 1.62, 95% CI: 1.25-2.10), particularly
long-term mortality (pooled unadjusted HR: 2.84, 95% CI: 1.91-4.23; pooled
adjusted HR: 1.88, 95% CI: 1.30-2.73). <br/>Conclusion(s): POD after TAVR
is common and is associated with an increased risk of mortality. Accurate
identification of risk factors for POD after TAVR and implementation of
preventive measures are critical to improve prognosis.<br/>Copyright
&#xa9; 2022 The American Geriatrics Society.

<46>
Accession Number
639601775
Title
Comparison of the effect of incentive spirometry and deep breathing
exercises on hemodynamic parameters of patients undergoing coronary artery
bypass graft surgery: A Clinical Trial.
Source
Journal of vascular nursing : official publication of the Society for
Peripheral Vascular Nursing. 40(3) (pp 134-139), 2022. Date of
Publication: 01 Sep 2022.
Author
Zerang F.; Amouzeshi A.; Barkhordari-Sharifabad M.
Institution
(Zerang) Medical Surgical Nursing, Razi Hospital, Birjand University of
Medical Sciences, Birjand, Iran, Islamic Republic of
(Amouzeshi) Department of Cardiovascular Surgery, Cardiovascular Diseases
Research Center, Birjand University of Medical Sciences, Birjand, Iran,
Islamic Republic of
(Barkhordari-Sharifabad) Department of Nursing, School of Medical
Sciences, Islamic Azad University, Shohadaye Gomnam Blvd., Yazd Branch,
Yazd, Iran, Islamic Republic of
Publisher
NLM (Medline)
Abstract
BACKGROUND AND OBJECTIVE: Hemodynamic changes are among the common
complications after coronary artery bypass graft (CABG) surgery. Incentive
spirometry (IS) and deep breathing exercises (DBEs) are widely used in
patients undergoing CABG surgery. The aim of the present study was to
compare the effect of IS and DBEs on hemodynamic and oxygenation
parameters of patients undergoing CABG surgery. <br/>METHOD(S): This is a
clinical trial that was performed on 40 patients with heart disease who
were candidates for coronary artery bypass graft surgery. Participants
were selected using convenience sampling and then randomly divided into
two groups. One day before surgery, one group was taught how to perform
DBE and the other group was taught how to use IS in practice. Hemodynamic
and oxygenation indices were measured and recorded before the
intervention, the first, second, and the third day after the intervention.
Data analysis was carried out using SPSS ver.16 and descriptive and
inferential statistical tests. <br/>RESULT(S): The mean systolic blood
pressure (SBP) and diastolic blood pressure (DBP) on the first day after
the intervention in patients undergoing the IS group was significantly
higher than the DBE group (p<0.05). On the third day after the
intervention, the mean arterial oxygen saturation (SaO2) in patients of
the IS group was significantly higher than the DBE group and the mean
respiratory rate (RR) in patients in the IS group was significantly lower
than the DBE group (p <0.05). However, there was no significant difference
between the two groups in terms of other indices (p> 0.05).
<br/>CONCLUSION(S): The results showed that IS has a greater effect on
hemodynamic and oxygenation indices of patients undergoing CABG compared
to DBE, so, it is recommended to use IS to improve hemodynamic and
oxygenation indices in these patients.<br/>Copyright &#xa9; 2022.
Published by Elsevier Inc.

<47>
Accession Number
2021310675
Title
Surgical and transcatheter aortic valve replacement for severe aortic
stenosis in low-risk elective patients: Analysis of the Aortic Valve
Replacement in Elective Patients From the Aortic Valve Multicenter
Registry.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2022.
Date of Publication: 2022.
Author
Kowalowka A.R.; Kowalewski M.; Wanha W.; Kolodziejczak M.; Mariani S.; Li
T.; Pasierski M.; Los A.; Stefaniak S.; Malinowski M.; Gocol R.; Hudziak
D.; Bachowski R.; Wojakowski W.; Jemielity M.; Rogowski J.; Lorusso R.;
Suwalski P.; Deja M.
Institution
(Kowalowka, Malinowski, Gocol, Hudziak, Bachowski, Deja) Department of
Cardiac Surgery, Upper-Silesian Heart Center, Katowice, Poland
(Kowalowka, Malinowski, Bachowski, Deja) Department of Cardiac Surgery,
Medical University of Silesia, Faculty of Medical Sciences, Katowice,
Poland
(Kowalewski, Pasierski, Suwalski) Department of Cardiac Surgery, Central
Clinical Hospital of the Ministry of Interior, Centre of Postgraduate
Medical Education, Warsaw, Poland
(Kowalewski, Mariani, Lorusso) Cardio-Thoracic Surgery Department, Heart
and Vascular Centre, Maastricht University Medical Centre, Maastricht,
Netherlands
(Kowalewski, Wanha, Kolodziejczak, Mariani, Li, Pasierski, Suwalski)
Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus
University, Innovative Medical Forum, Bydgoszcz, Poland
(Wanha, Wojakowski) Department of Cardiology and Structural Heart
Diseases, Medical University of Silesia, Katowice, Poland
(Kolodziejczak) Department of Anaesthesiology and Intensive Care,
Collegium Medicum Nicolaus Copernicus University, Antoni Jurasz University
Hospital No. 1, Bydgoszcz, Poland
(Li) Department of Cardiothoracic, Transplantation and Vascular Surgery,
Hannover Medical School, Hannover, Germany
(Los, Rogowski) Department of Cardiac and Vascular Surgery, Medical
University of Gdansk, Gdansk, Poland
(Stefaniak, Jemielity) Department of Cardiac Surgery and Transplantology,
Poznan University of Medical Sciences, Poznan, Poland
Publisher
Elsevier Inc.
Abstract
Objectives: Transcatheter aortic valve implantation (TAVI) remains the
preferred strategy for high-risk or elderly individuals with aortic valve
(AV) stenosis who are not considered to be optimal surgical candidates.
Recent evidence suggests that low-risk patients may benefit from TAVI as
well. The current study evaluates midterm survival in low-risk patients
undergoing elective surgical AV replacement (SAVR) versus TAVI.
<br/>Method(s): The Aortic Valve Replacement in Elective Patients From the
Aortic Valve Multicenter Registry (AVALON) compared isolated elective
transfemoral TAVI or SAVR with sternotomy or minimally invasive approach
in low-risk individuals performed between 2015 and 2019. Propensity score
matching was conducted to determine SAVR controls for TAVI group in a
1-to-3 ratio with 0.2 caliper. <br/>Result(s): A total of 2393 patients
undergoing elective surgery (1765 SAVR and 629 TAVI) with median European
System for Cardiac Operative Risk Evaluation II (EuroSCORE II) score 1.81
(interquartile range [IQR], 1.36 to 2.53]) were initially included. Median
follow-up was 2.72 years (IQR, 1.32-4.08; max 6.0). Propensity score
matching returned 329 TAVI cases and 593 SAVR controls. Thirty-day
mortality was 11 out of 329 (3.32%) in TAVI and 18 out of 593 (3.03%) in
SAVR (risk ratio, 1.10; 95% CI, 0.52-2.37; P = .801) groups, respectively.
At 2 years, survival curves began to diverge in favor of SAVR, which was
associated with 30% lower mortality (hazard ratio, 0.70; 95% CI,
0.496-0.997; P = .048). <br/>Conclusion(s): Our data did not demonstrate a
survival difference between TAVI and SAVR during the first 2 postprocedure
years. After that time, SAVR is associated with improved survival.
Extended observations from randomized trials in low-risk patients
undergoing elective surgery are warranted to confirm these findings and
draw definitive conclusions.<br/>Copyright &#xa9; 2022 The American
Association for Thoracic Surgery

<48>
Accession Number
637989949
Title
Sex differences in mortality after first time, isolated coronary artery
bypass graft surgery: a systematic review and meta-analysis of randomized
controlled trials.
Source
European journal of cardiovascular nursing. 21(8) (pp 759-771), 2022. Date
of Publication: 23 Nov 2022.
Author
Matthews S.; Buttery A.; O'Neil A.; Sanders J.; Marasco S.; Fredericks S.;
Martorella G.; Keenan N.; Ghanes A.; Wynne R.
Institution
(Matthews, Buttery) National Heart Foundation of Australia, Melbourne,
VIC, Australia
(Matthews, O'Neil) Melbourne School of Population & Global Health,
University of Melbourne, Parkville, VIC, Australia
(Matthews, Wynne) Royal Melbourne Hospital, Parkville, VIC, Australia
(O'Neil) Food and Mood Centre, School of Medicine, Barwon Health, Deakin
University, iMPACT (the Institute for Mental and Physical Health and
Clinical Translation), Geelong, VIC, Australia
(Sanders) Barts Health NHS Trust, St Bartholomew's Hospital, London,
United Kingdom
(Sanders) William Harvey Research Institute, Charterhouse Square Barts,
London, United Kingdom
(Sanders) London School of Medicine and Dentistry Queen Mary University of
London, London EC1 M 6BQ, United Kingdom
(Marasco) Department of Surgery, The Alfred Hospital, Melbourne, VIC,
Australia
(Marasco) Department of Surgery, Monash University, Melbourne, VIC,
Australia
(Fredericks) Daphne Cockwell School of Nursing, Ryerson University, 350
Victoria St, Toronto m5B 2K3, Canada
(Martorella) Tallahassee Memorial Healthcare Center for Research and
Evidence-Based Practice, Florida State University, FL 32304, 98 Varsity
Way, Tallahassee, United States
(Keenan) St James Hospital, Dublin, Ireland
(Ghanes) Barwon Health, Geelong, VIC, Australia
(Wynne) School of Nursing and Midwifery, Deakin University, Gheringhap
Street, Geelong, VIC 3220, Australia
Publisher
NLM (Medline)
Abstract
AIM: Reports of sex-specific differences in mortality after coronary
artery bypass graft surgery (CABGS) are contradictory. The review aim was
to determine whether CABGS is differentially efficacious than alternative
procedures by sex, on short- and longer-term mortality. METHODS AND
RESULTS: EMBASE, CINAHL, Medline, and the Cochrane Library were searched.
Inclusion criteria: English language, randomized controlled trials from
2010, comparing isolated CABGS to alternative revascularization. Analyses
were included Mantel-Haenszel fixed-effects modelling, risk of bias
(Cochrane RoB2), and quality assessment (CONSORT). PROSPERO Registration
ID: CRD42020181673. The search yielded 4459 citations, and full-text
review of 29 articles revealed nine studies for inclusion with variable
time to follow-up. Risk of mortality for women was similar in pooled
analyses [risk ratio (RR) 0.94, 95% confidence interval (CI) 0.84-1.05, P
= 0.26] but higher in sensitivity analyses excluding 'high risk' patients
(RR 1.22, 95% CI 1.01-1.48, P = 0.04). At 30 days and 10 years, in
contrast to men, women had an 18% (RR 0.82, 95% CI 0.66-1.02, P = 0.08)
and 19% (RR 0.81, 95% CI 0.69-0.95, P = 0.01) mortality risk reduction. At
1-2 years women had a 7% (RR 1.07, 95% CI 0.69-1.64, P = 0.77), and at 2-5
years a 25% increase in risk of mortality compared with men (RR 1.25, 95%
CI 1.03-1.53, P = 0.03). Women were increasingly under-represented over
time comprising 41% (30 days) to 16.7% (10 years) of the pooled
population. <br/>CONCLUSION(S): Meta-analysis revealed inconsistent
sex-specific differences in mortality after CABGS. Trials with
sex-specific stratification are required to ensure appropriate
sex-differentiated treatments for revascularization.<br/>Copyright &#xa9;
The Author(s) 2022. Published by Oxford University Press on behalf of
European Society of Cardiology. All rights reserved. For permissions,
please e-mail: journals.permissions@oup.com.

<49>
Accession Number
2021164716
Title
A Practical Approach to Left Main Coronary Artery Disease: JACC
State-of-the-Art Review.
Source
Journal of the American College of Cardiology. 80(22) (pp 2119-2134),
2022. Date of Publication: 29 Nov 2022.
Author
Davidson L.J.; Cleveland J.C.; Welt F.G.; Anwaruddin S.; Bonow R.O.;
Firstenberg M.S.; Gaudino M.F.; Gersh B.J.; Grubb K.J.; Kirtane A.J.;
Tamis-Holland J.E.; Truesdell A.G.; Windecker S.; Taha R.A.; Malaisrie
S.C.
Institution
(Davidson, Bonow, Taha, Malaisrie) Divisions of Cardiology and Cardiac
Surgery, Northwestern University, Chicago, IL, United States
(Cleveland) Department of Cardiothoracic Surgery, University of Colorado,
Aurora, CO, United States
(Welt) Department of Cardiovascular Medicine, University of Utah, Salt
Lake City, UT, United States
(Anwaruddin) Department of Cardiology & Interventional Cardiology, St.
Vincent Hospital, Worcester, MA, United States
(Firstenberg) Department of Cardiothoracic Surgery, St. Elizabeth Medical
Center, Appleton, WI, United States
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
(Gersh) Department of Cardiovascular Medicine, Mayo Clinic College of
Medicine and Science, Rochester, MN, United States
(Grubb) Department of Surgery, Division of Cardiothoracic Surgery, Emory
University, Atlanta, GA, United States
(Kirtane) Division of Cardiology and the Cardiovascular Research
Foundation, Columbia University Irving Medical Center/NewYork-Presbyterian
Hospital, New York, NY, United States
(Tamis-Holland) Department of Cardiology, Mount Sinai, New York, NY,
United States
(Truesdell) Department of Interventional Cardiology, Virginia Heart and
the Inova Heart and Vascular Institute, Falls Church, VA, United States
(Windecker) Department of Cardiology, Bern University Hospital,
Inselspital, Bern, Switzerland
Publisher
Elsevier Inc.
Abstract
The treatment of left main (LM) coronary artery disease (CAD) requires
complex decision-making. Recent clinical practice guidelines provide
clinicians with guidance; however, decisions regarding treatment for
individual patients can still be difficult. The American College of
Cardiology's Cardiac Surgery Team and Interventional Council joined
together to develop a practical approach to the treatment of LM CAD,
taking into account randomized clinical trial, meta-analyses, and clinical
practice guidelines. The various presentations of LM CAD based on anatomy
and physiology are presented. Recognizing the complexity of LM CAD, which
rarely presents isolated and is often in combination with multivessel
disease, a treatment algorithm with medical therapy alone or in
conjunction with percutaneous coronary intervention or coronary artery
bypass grafting is proposed. A heart team approach is recommended that
accounts for clinical, procedural, operator, and institutional factors,
and features shared decision-making that meets the needs and preferences
of each patient and their specific clinical situation.<br/>Copyright
&#xa9; 2022

<50>
Accession Number
639619235
Title
EARLY CAROTID STENT COMPLICATIONS AFTER SUCCESSFUL CAROTID ANGIOPLASTY AND
STENTING.
Source
International Journal of Stroke. Conference: 14th World Stroke Congress.
Singapore Singapore. 17(3 Supplement) (pp 186), 2022. Date of Publication:
October 2022.
Author
Chan Chung C.; Chia G.S.; Lim W.; Chang H.M.
Institution
(Chan Chung, Chang) NNI - SGH Campus, Neurology, Singapore, Singapore
(Chia, Lim) Singapore General Hospital, Radiology, Singapore, Singapore
Publisher
SAGE Publications Inc.
Abstract
Background and Aims: Carotid Artery Stenting (CAS) is nowadays an
established treatment option for carotid artery disease. There are many
known complications of CAS, including: intra-procedural (dissection), and
post-procedural (fluid collection, pseudoaneurysm, thrombosis,
thromboembolism, restenosis, stent deformation or fracture and
arteriovenous fistula). We aim to highlight the procedural complications
of incomplete stent apposition post-CAS. <br/>Method(s): We describe 3
cases of patients who underwent successful CAS but with early
complications. Two patients had stent malappositions and one patient had
stent shortening. We performed a non-systematic literature review to
identify the relevance of these stent complications in CAS patients.
<br/>Result(s): The majority of available studies on incomplete stent
apposition comes from coronary artery stenting studies. Laminar flow is
disrupted by malapposed stent struts, leading to areas of high shear rate.
This can increase the risk of stent thrombosis. <br/>Conclusion(s): There
are few descriptions of carotid artery stent malapposition. We hope to
highlight a less well-described complication. More studies are required to
determine the long-term outcomes of patients with incomplete stent
apposition.

<51>
Accession Number
2021315944
Title
The effects of Nurse Led Transitional Care Model on elderly patients
undergoing open heart surgery: a randomized controlled trial.
Source
European Journal of Cardiovascular Nursing. 21(1) (pp 46-55), 2022. Date
of Publication: 01 Jan 2022.
Author
Coskun S.; Duygulu S.
Institution
(Coskun) Nursing Department, Bolu Abant Izzet Baysal University, 14100 Go
Lkoy Campus, Bolu, Turkey
(Duygulu) Faculty of Nursing, Hacettepe University, S?hhiye, Ankara 06100
, Turkey
Publisher
Oxford University Press
Abstract
Aims Rate and number of successful cases in open heart surgery has been
increasing due to the advances in medical technology and surgery. To
improve patient convalescence results and reduce rate of post-discharge
readmission to hospital and unplanned post-discharge rehospitalization,
home-care and follow-up process of patients should be managed
successfully. To evaluate the effectiveness of Nurse Led Transitional Care
Model on the functional autonomy, quality of life, readmission, and
rehospitalization rates of elderly patients undergoing open heart surgery.
A randomized controlled trial was conducted from November 2017 to December
2018 and performed according to the CONSORT Guidelines. Methods and
results Sixty-six elderly patients were randomly allocated to the
intervention (n: 33) and control (n: 33) groups. Patients in intervention
group were given care based on the Transitional Care Model until the
post-discharge 9th week starting from date of hospitalization. Patients in
control group were given standard care services. Functional autonomy,
quality of life levels, and repeated admission/re-hospitalization rates to
the clinic were evaluated. The Functional Autonomy Measurement System and
SF-36 Quality of Life Scale scores of the intervention group were higher
than that of the control group at the 9th week (P < 0.05). In addition,
rate of readmission and rehospitalization during the follow-up period (6
months) of patients in the intervention group was found to be lower than
the patients in the control group (P< 0.05). Conclusion Care services
offered under the Transitional Care Model improved functional autonomy and
quality of life and decreased post-discharge hospital readmission and
rehospitalization rates of patients. Trial registration The study was
registered on ClinicalTrials.gov (ID: NCT04384289).<br/>Copyright &#xa9;
2022 SAGE Publications Inc.. All rights reserved.

<52>
[Use Link to view the full text]
Accession Number
2021323025
Title
Everolimus-Eluting Stents or Bypass Surgery for Multivessel Coronary
Artery Disease: Extended Follow-Up Outcomes of Multicenter Randomized
Controlled BEST Trial.
Source
Circulation. 146(21) (pp 1581-1590), 2022. Date of Publication: 22 Nov
2022.
Author
Ahn J.-M.; Kang D.-Y.; Yun S.-C.; Hur S.H.; Park H.-J.; Tresukosol D.;
Kang W.C.; Kwon H.M.; Rha S.-W.; Lim D.-S.; Jeong M.-H.; Lee B.-K.; Huang
H.; Lim Y.H.; Bae J.H.; Kim B.O.; Ong T.K.; Ahn S.G.; Chung C.-H.; Park
D.-W.; Park S.-J.
Institution
(Ahn, Kang, Yun, Chung, Park, Park) Heart Institute, Division of
Biostatistics, Center for Medical Research and Information, Asan Medical
Center, University of Ulsan College of Medicine, Seoul, South Korea
(Hur) Keimyung University Dongsan Medical Center, Daegu, South Korea
(Park) Catholic University of Korea, Seoul St. Mary's Hospital, South
Korea
(Tresukosol) Siriraj Hospital, Bangkok, Thailand
(Kang) Gachon University Gil Hospital, Incheon, South Korea
(Kwon) Gangnam Severance Hospital, Seoul, South Korea
(Rha, Lim) Korea University Guro Hospital, Seoul, South Korea
(Lim) Korea University Anam Hospital, Seoul, South Korea
(Jeong) Chonnam National University Hospital, Gwangju, South Korea
(Lee) Kangwon National University Hospital, Chuncheon, South Korea
(Huang) Sir Run Run Shaw Hospital, Zhejiang, Hangzhou, China
(Lim) Hanyang University Hospital, Seoul, South Korea
(Bae) Konyang University Hospital, Daejeon, South Korea
(Huang, Lim, Kim) Inje University Sanggye Paik Hospital, Seoul, South
Korea
(Ong) Sarawak General Hospital, Sarawak, Kuching, Malaysia
(Ahn) Yonsei University Wonju Severance Christian Hospital, Wonju, South
Korea
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Long-term comparative outcomes after percutaneous coronary
intervention (PCI) with everolimus-eluting stents and coronary artery
bypass grafting (CABG) are limited in patients with multivessel coronary
artery disease. <br/>METHOD(S): This prospective, multicenter, randomized
controlled trial was conducted in 27 international heart centers and was
designed to randomly assign 1776 patients with angiographic multivessel
coronary artery disease to receive PCI with everolimus-eluting stents or
CABG. After inclusion of 880 patients (438 in the PCI group and 442 in the
CABG group) between July 2008 and September 2013, the study was terminated
early because of slow enrollment. The primary end point was the composite
of death from any cause, myocardial infarction, or target vessel
revascularization. <br/>RESULT(S): During a median follow-up of 11.8 years
(interquartile range, 10.6-12.5 years; maximum, 13.7 years), the primary
end point occurred in 151 patients (34.5%) in the PCI group and 134
patients (30.3%) in the CABG group (hazard ratio [HR], 1.18 [95% CI,
0.88-1.56]; P=0.26). No significant differences were seen in the
occurrence of a safety composite of death, myocardial infarction, or
stroke between groups (28.8% and 27.1%; HR, 1.07 [95% CI, 0.75-1.53];
P=0.70), as well as the occurrence of death from any cause (20.5% and
19.9%; HR, 1.04 [95% CI, 0.65-1.67]; P=0.86). However, spontaneous
myocardial infarction (7.1% and 3.8%; HR, 1.86 [95% CI, 1.06-3.27];
P=0.031) and any repeat revascularization (22.6% and 12.7%; HR, 1.92 [95%
CI, 1.58-2.32]; P<0.001) were more frequent after PCI than after CABG.
<br/>CONCLUSION(S): In patients with multivessel coronary artery disease,
there were no significant differences between PCI and CABG in the
incidence of major adverse cardiac events, the safety composite end point,
and all-cause mortality during the extended follow-up. REGISTRATION: URL:
https://www.clinicaltrials.gov; Unique identifiers: NCT05125367 and
NCT00997828.<br/>Copyright &#xa9; 2022 American Heart Association, Inc.

<53>
Accession Number
2021316115
Title
Long-term prognostic value of late gadolinium enhancement and
periprocedural myocardial infarction after uncomplicated
revascularization: MASS-V follow-up.
Source
European Heart Journal Cardiovascular Imaging. 23(2) (pp 255-265), 2022.
Date of Publication: 01 Feb 2022.
Author
Linhares-Filho J.; Hueb W.; Lima E.; Rezende P.; Azevedo D.; Rochitte C.;
Nomura C.; Serrano-Junior C.; Ramires J.; Kalil-Filho R.
Institution
(Linhares-Filho, Hueb, Lima, Rezende, Azevedo, Rochitte, Nomura,
Serrano-Junior, Ramires, Kalil-Filho) Department of Clinical Cardiology,
Heart Institute (InCor) University of Sao Paulo, Av. Dr. Eneas de Carvalho
Aguiar 44, AB, Room 114, Cerqueira Cesar, Sao Paulo 05403-000, Brazil
Publisher
Oxford University Press
Abstract
Aims Cardiac biomarkers elevation is common after revascularization, even
in absence of periprocedural myocardial infarction (PMI) detection by
imaging methods. Thus, late gadolinium enhancement cardiac magnetic
resonance (LGE-CMR) may be useful on PMI diagnosis and prognosis. We
sought to evaluate long-term prognostic value of PMI and new LGE after
revascularization. Methods Two hundred and two patients with multivessel
coronary disease and preserved ventricular function who under- and results
went elective revascularization were included, of whom 136 (67.3%)
underwent coronary artery bypass grafting and 66 (32.7%) percutaneous
coronary intervention. The median follow-up was 5 years (4.8-5.8 years).
Cardiac biomarkers measurement and LGE-CMR were performed before and after
procedures. The Society for Cardiovascular Angiography and Interventions
definition was used to assess PMI. Primary endpoint was composed of death,
infarction, additional revascularization, or cardiac hospitalization.
Primary endpoint was observed in 29 (14.3%) patients, of whom 13 (14.9%)
had PMI and 16 (13.9%) did not (P = 0.93). Thirty-six (17.8%) patients had
new LGE. Twenty (12.0%) events occurred in patients without new LGE and 9
(25.2%) in patients with it (P = 0.045). LGE was also associated to
increased mortality, with 4 (2.4%) and 4 (11.1%) deaths in subjects
without and with it (P = 0.02). LGE was the only independent predictor of
primary endpoint and mortality (P = 0.03 and P = 0.02). Median LGE mass
was estimated at 4.6 g. Patients with new LGE had a greater biomarkers
release (median troponin: 8.9 ng/mL vs. 1.8 ng/mL and median creatine
kinase-MB: 38.0 ng/mL vs. 12.3 ng/mL; P < 0.001 in both comparisons).
Conclusions New LGE was shown to be better prognostic predictor than
biomarker-only PMI definition after uncomplicated revascularization.
Furthermore, new LGE was the only independent predictor of cardiovascular
events and mortality. Clinical trial
http://www.controlled-trials.com/ISRCTN09454308.
registration.<br/>Copyright &#xa9; The Author(s) 2020.

<54>
Accession Number
2021315945
Title
The effects of showering in 48-72 h after coronary artery bypass graft
surgery through median sternotomy on wound infection, pain, comfort, and
satisfaction: randomized controlled trial.
Source
European Journal of Cardiovascular Nursing. 21(1) (pp 56-66), 2022. Date
of Publication: 01 Jan 2022.
Author
Gok F.; Demir Korkmaz F.; Emrecan B.
Institution
(Gok) Department of Surgical Diseases Nursing, Faculty of Health Sciences,
Pamukkale University, Kinikli Yerleskesi, Denizli 20020, Turkey
(Demir Korkmaz) Department of Surgical Diseases Nursing, Faculty of
Nursing, Ege University, Izmir 35100, Turkey
(Emrecan) Department of Cardiac Surgery, Faculty of Medicine, Pamukkale
University, Denizli 20020, Turkey
Publisher
Oxford University Press
Abstract
Aims Time of showering after surgery is still a controversial issue for
surgical patients and health professionals. We evaluated the effects of
showering in 48-72 h after median sternotomy on sternal wound infections,
pain due to sternotomy, patient comfort, and satisfaction levels.Methods
and results The study was a randomized controlled clinical trial.
Fifty-one patients were randomly allocated (1:1) to the shower (n= 26) or
non-shower group (n= 25). The patients in the shower group (intervention
group) showered in the first 48-72 h after surgery and the patients in the
non-shower group (control group) were not allowed to shower until their
chest tube sutures were removed. They were instructed to shower on the
next day after removal of the chest tube sutures. The rate of sternal
wound infections was significantly lower in the shower group (n= 2, 7.7%)
than in the nonshower group patients (n= 8, 32.0%; P= 0.038). A logistic
regression analysis showed that early post-operative showering was
protective and significantly reduced the risk of sternal wound infections
independently of other variables [odds ratio (OR): 0.177; 95% confidence
interval (CI): 0.033-0.940; P= 0.042]. The pain severity score was
significantly lower in the shower group patients. Also, comfort and
satisfaction scores were significantly higher in this group (P< 0.05).
Conclusion Early showering after sternotomy was found to be protective
against sternal wound infections and had a positive effect on pain,
comfort, and satisfaction. Trial registration Clinical Trials.gov
registration number NCT04250961
(https://clinicaltrials.gov/ct2/show/NCT04250961).<br/>Copyright &#xa9;
2022 SAGE Publications Inc.. All rights reserved.

<55>
Accession Number
2021291418
Title
Vitamin C supplementation attenuates oxidative stress and improves
erythrocyte deformability in cardiac surgery with cardiopulmonary bypass.
Source
Chinese Journal of Physiology. 65(5) (pp 241-249), 2022. Date of
Publication: September 2022.
Author
Tai Y.-H.; Wu H.-L.; Chu Y.-H.; Huang C.-H.; Ho S.-T.; Lin T.-C.; Lu C.-C.
Institution
(Tai) Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical
University, New Taipei City, Taiwan (Republic of China)
(Tai) Department of Anesthesiology, School of Medicine, College of
Medicine, Taipei Medical University, Taipei, Taiwan (Republic of China)
(Wu, Chu, Lu) Department of Anesthesiology, Taipei Veterans General
Hospital, Taipei, Taiwan (Republic of China)
(Wu, Huang) School of Medicine, National Yang Ming Chiao Tung University,
Taipei, Taiwan (Republic of China)
(Chu, Lu) Graduate Institute of Life Sciences, National Defense Medical
Center, Taipei, Taiwan (Republic of China)
(Huang) Division of Cardiovascular Surgery, Department of Surgery, Taipei
Veterans General Hospital, Taipei, Taiwan (Republic of China)
(Ho, Lin) Department of Anesthesiology, Tri. Service General Hospital,
National Defense Medical Center, Taipei, Taiwan (Republic of China)
(Ho) Department of Anesthesiology, Kaohsiung Medical University Hospital,
Kaohsiung Medical University, Kaohsiung, Taiwan (Republic of China)
(Lu) Institute of Aerospace Medicine, National Defense Medical Center,
Taipei, Taiwan (Republic of China)
Publisher
Wolters Kluwer Medknow Publications
Abstract
Cardiopulmonary bypass (CPB) depletes endogenous Vitamin C and generates
oxidative stress in cardiac surgery. This study aimed to clarify whether
Vitamin C supplementation reduces oxidant production and improves
erythrocyte deformability in cardiac surgery with CPB. In a randomized and
controlled design, 30 eligible patients undergoing cardiac surgery with
hypothermic CPB were equally assigned to the Vitamin C group and control
group. Subjects of the Vitamin C group and control group received an
intravenous infusion of Vitamin C 20 mg.kg -1 and a placebo during
rewarming period of CPB, respectively. We measured the plasma level of
reactive oxygen species (ROS) and phosphorylation levels of non-muscle
myosin IIA (NMIIA) in erythrocyte membrane, as an index of erythrocyte
deformability, before and after CPB. Vitamin C supplementation attenuated
the surge in plasma ROS after CPB, mean 1.661 +/- standard deviation 0.801
folds in the Vitamin C group and 2.743 +/- 1.802 in the control group. The
tyrosine phosphorylation level of NMIIA after CPB was upregulated in the
Vitamin C group compared to the control group, 2.159 +/- 0.887 folds and
1.384 +/- 0.445 (P = 0.0237). In addition, the phosphorylation of
vasodilator-stimulated phosphoprotein (VASP) and focal adhesion kinase
(FAK) in erythrocytes was concurrently enhanced in the Vitamin C group
after CPB. The phosphorylation level of endothelial nitric oxide synthase
in erythrocytes was significantly increased in the Vitamin C group (1.734
+/- 0.371 folds) compared to control group (1.102 +/- 0.249; P = 0.0061).
Patients receiving Vitamin C had lower intraoperative blood loss and
higher systemic vascular resistance after CPB compared to controls.
Vitamin C supplementation attenuates oxidative stress and improves
erythrocyte deformability via VASP/FAK signaling pathway in erythrocytes
during CPB. <br/>Copyright &#xa9; 2022 Chinese Journal of Physiology.

<56>
[Use Link to view the full text]
Accession Number
2021323009
Title
Benefits of Icosapent Ethyl Across the Range of Kidney Function in
Patients With Established Cardiovascular Disease or Diabetes: REDUCE-IT
RENAL.
Source
Circulation. 144(22) (pp 1750-1759), 2021. Date of Publication: 30 Nov
2021.
Author
Majithia A.; Bhatt D.L.; Friedman A.N.; Miller M.; Steg G.; Brinton E.A.;
Jacobson T.A.; Ketchum S.B.; Juliano R.A.; Jiao L.; Doyle R.T.; Granowitz
C.; Budoff M.; Mason R.P.; Tardif J.-C.; Boden W.E.; Ballantyne C.M.
Institution
(Majithia) Division of Cardiovascular Medicine, Lahey Hospital and Medical
Center, Burlington, MA, United States
(Bhatt, Mason) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, Harvard Medical School, Boston, MA, United States
(Friedman) Department of Medicine, Indiana University School of Medicine,
Indianapolis, United States
(Miller) Department of Medicine, University of Maryland School of
Medicine, Baltimore, United States
(Steg) Universite de Paris, FACT (French Alliance for Cardiovascular
Trials), Assistance Publique-Hopitaux de Paris, Hopital Bichat, INSERM
Unite 1148, France
(Brinton) Utah Lipid Center, Salt Lake City, United States
(Jacobson) Office of Health Promotion and Disease Prevention, Department
of Medicine, Emory University School of Medicine, Atlanta, GA, United
States
(Ketchum, Juliano, Jiao, Doyle, Granowitz) Amarin Pharma, Inc.,
Bridgewater, NJ, United States
(Budoff) Division of Cardiology, Harbor UCLA Medical Center, Torrance, CA,
United States
(Tardif) Montreal Heart Institute, Universite de Montreal, Canada
(Boden) Division of Cardiovascular Medicine, Boston Medical Center, MA,
United States
(Ballantyne) Department of Medicine, Baylor College of Medicine, Center
for Cardiovascular Disease Prevention, Methodist DeBakey Heart and
Vascular Center, Houston, TX, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Chronic kidney disease is associated with adverse outcomes
among patients with established cardiovascular disease (CVD) or diabetes.
Commonly used medications to treat CVD are less effective among patients
with reduced kidney function. <br/>METHOD(S): REDUCE-IT (Reduction of
Cardiovascular Events with Icosapent Ethyl-Intervention Trial) was a
multicenter, double-blind, placebo-controlled trial that randomly assigned
statin-treated patients with elevated triglycerides (135-499 mg/dL) who
had CVD or diabetes and 1 additional risk factor to treatment with
icosapent ethyl (4 g daily) or placebo. Patients from REDUCE-IT were
categorized by prespecified estimated glomerular filtration rate (eGFR)
categories to analyze the effect of icosapent ethyl on the primary end
point (composite of cardiovascular death, nonfatal myocardial infarction,
nonfatal stroke, coronary revascularization, or unstable angina) and key
secondary end point (a composite of cardiovascular death, nonfatal
myocardial infarction, or nonfatal stroke). <br/>RESULT(S): Among the 8179
REDUCE-IT patients, median baseline eGFR was 75 mL.min^-1.1.73
m^-2 (range, 17-123 mL.min^-1.1.73 m^-2).
There were no meaningful changes in median eGFR for icosapent ethyl versus
placebo across study visits. Treatment with icosapent ethyl led to
consistent reduction in both the primary and key secondary composite end
points across baseline eGFR categories. Patients with eGFR <60
mL.min^-1.1.73 m^-2 treated with icosapent ethyl had
the largest absolute and similar relative risk reduction for the primary
composite end point (icosapent ethyl versus placebo, 21.8% versus 28.9%;
hazard ratio [HR], 0.71 [95% CI, 0.59-0.85]; P=0.0002) and key secondary
composite end point (16.8% versus 22.5%; HR 0.71 [95% CI, 0.57-0.88];
P=0.001). The numeric reduction in cardiovascular death was greatest in
the eGFR <60 mL.min^-1.1.73 m^-2 group (icosapent
ethyl: 7.6%; placebo: 10.6%; HR, 0.70 [95% CI, 0.51-0.95]; P=0.02).
Although patients with eGFR <60 mL.min^-1.1.73 m^-2
treated with icosapent ethyl had the highest numeric rates of atrial
fibrillation/ flutter (icosapent ethyl: 4.2%; placebo 3.0%; HR 1.42 [95%
CI, 0.86-2.32]; P=0.17) and serious bleeding (icosapent ethyl: 5.4%;
placebo 3.6%; HR, 1.40 [95% CI, 0.90-2.18]; P=0.13), HRs for atrial
fibrillation/flutter and serious bleeding were similar across eGFR
categories (P-interaction for atrial fibrillation/flutter=0.92;
P-interaction for serious bleeding=0.76). <br/>CONCLUSION(S): In
REDUCE-IT, icosapent ethyl reduced fatal and nonfatal ischemic events
across the broad range of baseline eGFR categories.<br/>Copyright &#xa9;
2021 The Authors.

<57>
Accession Number
2020215914
Title
Preoperative ultrasound-guided bilateral thoracic erector spinae plane
block within an enhanced recovery program is associated with decreased
intraoperative lactate levels in cardiac surgery.
Source
Perfusion (United Kingdom). (no pagination), 2022. Date of Publication:
2022.
Author
Demir A.Z.; Ozgok A.; Balci E.; Karaca O.G.; Simsek E.; Gunaydin S.
Institution
(Demir, Ozgok, Balci) Anesthesiology Department, The University of Health
Sciences, Ankara City Hospital, Ankara, Turkey
(Karaca, Simsek, Gunaydin) Cardiovascular Surgery Department, The
University of Health Sciences, Ankara City Hospital, Ankara, Turkey
Publisher
SAGE Publications Ltd
Abstract
Introduction: In the perioperative period, regional analgesia techniques
may play an increasingly important role in "Enhanced Recovery After
Surgery (ERAS)" programs, as they can facilitate recovery. We hypothesized
that Erector Spinae Plane (ESP) block could improve regional perfusion,
thereby limiting blood lactate increase. Therefore, we aimed to evaluate
the effect of ESP block on intraoperative blood lactate levels in patients
scheduled for elective on-pump cardiac surgery with ERAS protocol.
<br/>Method(s): A total of 68 adult patients scheduled for on-pump cardiac
surgery were included. All patients were randomized to the ESP group and
the non-ESP group. Blood lactate analyses were performed at intraoperative
five-time points. C-Reactive protein (CRP) values were also measured.
<br/>Result(s): Blood lactate values were significantly lower in the ESP
group than in the Non-ESP group, at the end of CPB [1.78 (1.23-2.78) mmol
L^-1 to 2.63 (1.70-3.12) mmol L^-1] and during the
sternal closure period [1.78 (1.27-2.42) mmol L^-1 to 2.40
(2.14-2.80) mmol L^-1] (p = 0.039, p = 0.009). In addition, CRP
values were significantly lower in the ESP group in the postoperative
period [0.048 (0.036-0.105) g L^-1 to 0.090 (0.049-0.154) g
L^-1] (p = 0.035). <br/>Conclusion(s): This study showed that
preoperative bilateral single-shot ESP block significantly reduces
intraoperative final blood lactate and postoperative CRP values. We
consider that these results are related to the attenuation of
intraoperative hypoperfusion and the alleviation of surgery-related
postoperative inflammation. ERAS programs aim to achieve the rapid
recovery of patients, a decrease in inflammation, and high-quality
analgesia with less opioid consumption. Therefore, our results also prove
that it is easier to reach the primary goals of ERAS programs with the
application of ESP block in cardiac surgery.<br/>Copyright &#xa9; The
Author(s) 2022.

<58>
Accession Number
639614963
Title
Racial Disparity Among Patients Undergoing Surgical Aortic Valve
Replacement and Transcatheter Aortic Valve Replacement in the United
States.
Source
Angiology. (pp 33197221137025), 2022. Date of Publication: 25 Nov 2022.
Author
Kulkarni A.; Arafat M.; Hou L.; Liang S.; Kassotis J.
Institution
(Kulkarni) 12287Rutgers Robert Wood Johnson Medical School, Piscataway,
NJ, United States
(Arafat, Hou, Liang) Department of Medicine, 12287Rutgers Robert Wood
Johnson Medical School, New Brunswick, NJ, USA
(Kassotis) Department of Cardiology, 12287Rutgers Robert Wood Johnson
Medical School, New Brunswick, NJ, USA
Publisher
NLM (Medline)
Abstract
Transcatheter aortic valve replacement (TAVR) has emerged as a minimally
invasive alternative to surgical aortic valve replacement (SAVR). However,
racial disparities in the utilization of TAVR persist. This meta-analysis
attempts to determine whether the prevalence of adverse outcomes
(procedure-related complications) represent barriers to the use of TAVR
among African Americans (AA). The TAVR cohort consisted of 89.6% Caucasian
(C) and 4.7% AA, while the SAVR cohort included 86.9% C and 6.4% AA. The
utilization rate (UR) of TAVR was 1.48 and .35 among C and AA,
respectively, while the UR of SAVR was 1.44 and .48 among C and AA,
respectively. Following TAVR, for AA the odds ratio (OR) was greater for
stroke (OR = 1.22, P = .02) and transient ischemic attack (TIA) (OR =
1.57, P < .001) and lower for undergoing the insertion of a permanent
pacemaker (OR = .81, P < .001). While there was a significant difference
between C and AA in TAVR and SAVR utilization, outcomes between groups
following TAVR are comparable; therefore, adverse outcomes do not appear
to be a barrier to the use of TAVR among eligible AA.

<59>
Accession Number
639610998
Title
Health-related quality of life impacts upon 5-year survival after coronary
artery bypass surgery.
Source
Journal of cardiac surgery. (no pagination), 2022. Date of Publication:
24 Nov 2022.
Author
Bishawi M.; Hattler B.; Almassi G.H.; Quin J.A.; Grover F.L.; Collins
J.F.; Ebrahimi R.; Wolbrom D.H.; Shroyer A.L.
Institution
(Bishawi) Department of Surgery, Duke University, Durham, NC, United
States
(Hattler) Rocky Mountain Regional Veterans Affairs Medical Center, Aurora,
CO, United States
(Hattler) Division of Cardiology, University of Colorado School of
Medicine, Aurora, CO, United States
(Almassi) Department of Surgery, Clement J. Zablocki Veterans Affairs (VA)
Medical Center, Milwaukee, WI, United States
(Almassi) Department of Surgery, Division of Cardiothoracic Surgery,
Medical College of Wisconsin, Milwaukee, WI, United States
(Quin) Department of Surgery, Division of Cardiac Surgery, VA Boston
Healthcare System, Boston, MA, United States
(Grover) Department of Surgery, Division of Cardiothoracic Surgery,
University of Colorado School of Medicine, Denver, CO, United States
(Collins) Cooperative Studies Program Coordinating Center, Veterans
Affairs Medical Center ,Perry Point, MD, United States
(Ebrahimi) Department of Cardiology, Veterans Affairs Greater Los Angeles
Healthcare System, Los Angeles, CA, United States
(Ebrahimi) Department of Medicine, University of California Los Angeles,
Los Angeles, CA, United States
(Wolbrom, Shroyer) Northport Veterans Affairs Medical Center, Research and
Development Office, Northport, NY, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Poor preoperative health-related quality of life (HRQoL) has
been associated with reduced short-term survival after coronary artery
bypass graft (CABG) surgery; however, its impact on long-term mortality is
unknown. This study's objective was to determine if baseline HRQoL status
predicts 5-year post-CABG mortality. <br/>METHOD(S): This prespecified,
randomized on/off bypass follow-up study (ROOBY-FS) subanalysis compared
baseline patient characteristics and HRQoL scores, obtained from the
Seattle Angina Questionnaire (SAQ) and Veterans RAND Short Form-36
(VR-36), between 5-year post-CABG survivors and nonsurvivors. Standardized
subscores were calculated for each questionnaire. Multivariable logistic
regression assessed whether HRQoL survey subcomponents independently
predicted 5-year mortality (p<=.05). <br/>RESULT(S): Of the 2203 ROOBY-FS
enrollees, 2104 (95.5%) completed baseline surveys. Significant
differences between 5-year post-CABG deaths (n=286) and survivors (n=1818)
included age, history of chronic obstructive pulmonary disease, stroke,
peripheral vascular disease, renal dysfunction, diabetes, lower left
ventricular ejection fraction, atrial fibrillation, depression, non-White
race/ethnicity, lower education status, and off-pump CABG. Adjusting for
these factors, baseline VR-36 physical component summary score (p=.01),
VR-36 mental component summary score (p<.001), and SAQ physical limitation
score (p=.003) were all associated with 5-year all-cause mortality.
<br/>CONCLUSION(S): Pre-CABG HRQoL scores may provide clinically relevant
prognostic information beyond traditional risk models and prove useful for
patient-provider shared decision-making and enhancing pre-CABG informed
consent.<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<60>
Accession Number
639609694
Title
Rationale and Design for the Myocardial Ischemia and Transfusion (MINT)
Randomized Clinical Trial.
Source
American heart journal. (no pagination), 2022. Date of Publication: 20
Nov 2022.
Author
Carson J.L.; Brooks M.M.; Chaitman B.R.; Alexander J.H.; Goodman S.G.;
Bertolet M.; Abbott J.D.; Cooper H.A.; Rao S.V.; Triulzi D.J.; Fergusson
D.A.; Kostis W.J.; Noveck H.; Simon T.; Steg P.G.; DeFilippis A.P.;
Goldsweig A.M.; Lopes R.D.; White H.; Alsweiler C.; Morton E.; Hebert
P.C.; On-Behalf-Of-The-Mint-Investigators
Institution
(Carson, Kostis, Noveck, On-Behalf-Of-The-Mint-Investigators) Rutgers
Robert Wood Johnson Medical School, New Brunswick, NJ
(Brooks, Triulzi) University of Pittsburgh School of Public Health,
Pittsburgh, PA, United States
(Chaitman) St Louis University School of Medicine, St Louis, MO, United
States
(Alexander) Duke Clinical Research Institute, Durham, NC, United States
(Goodman) St. Michael's Hospital, University of Toronto, Canadian VIGOUR
Centre, University of Alberta, Edmonton, AB, Canada
(Bertolet) University of Pittsburgh, Pittsburgh, PA, United States
(Abbott) Warren Alpert Medical School. Brown University, Providence, RI,
United States
(Cooper) Westchester Medical Center, Valhalla, NY, United States
(Rao) Durham VA Medical Center, Durham, NC and NYU Langone Health, New
York, NY
(Fergusson) Ottawa Hospital Research Institute Ottawa, ON, Canada
(Simon) Hopital Saint Antoine, Paris, France
(Steg) ParisFrance
(DeFilippis) Vanderbilt University, Nashville, TN, United States
(Goldsweig) University of Nebraska Medical Center, Omaha, NE, United
States
(Lopes) Brazilian Clinical Research Institute, Sao Paulo, Brazil and Duke
Clinical Research Institute, Durham, NC
(White, Alsweiler) Green Lane Clinical Coordinating Centre Ltd, Auckland,
New Zealand
(Morton) Finders University, Adelaide, Australia
(Hebert) Centre de Recherche du Centre Hosp. Universitaire de Montreal,
Montreal, Quebec, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: Accumulating evidence from clinical trials suggests that a
lower (restrictive) hemoglobin threshold (<8% g/dL) for red blood cell
(RBC) transfusion, compared with a higher (liberal) threshold (>=10 g/dL)
is safe. However, in anemic patients with acute myocardial infarction
(MI), maintaining a higher hemoglobin level may increase oxygen delivery
to vulnerable myocardium resulting in improved clinical outcomes.
Conversely, RBC transfusion may result in increased blood viscosity,
vascular inflammation, and reduction in available nitric oxide resulting
in worse clinical outcomes. We hypothesize that a liberal transfusion
strategy would improve clinical outcomes as compared to a more restrictive
strategy. <br/>METHOD(S): We will enroll 3500 patients with acute MI (type
1, 2, 4b or 4c) as defined by the Third Universal Definition of MI and a
hemoglobin <10 g/dL at 144 centers in the United States, Canada, France,
Brazil, New Zealand, and Australia. We randomly assign trial participants
to a liberal or restrictive transfusion strategy. Participants assigned to
the liberal strategy receive transfusion of RBCs sufficient to raise their
hemoglobin to at least 10 g/dL. Participants assigned to the restrictive
strategy are permitted to receive transfusion of RBCs if the hemoglobin
falls below 8 g/dL or for persistent angina despite medical therapy. We
will contact each participant at 30 days to assess clinical outcomes and
at 180 days to ascertain vital status. The primary endpoint is a composite
of all-cause death or recurrent MI through 30 days following
randomization. Secondary endpoints include all-cause mortality at 30 days,
recurrent adjudicated MI, and the composite outcome of all-cause
mortality, nonfatal recurrent MI, ischemia driven unscheduled coronary
revascularization (percutaneous coronary intervention or coronary artery
bypass grafting), or readmission to the hospital for ischemic cardiac
diagnosis within 30 days. The trial will assess multiple tertiary
endpoints. <br/>CONCLUSION(S): The MINT trial will inform RBC transfusion
practice in patients with acute MI.<br/>Copyright &#xa9; 2022 Elsevier
Ltd. All rights reserved.

<61>
Accession Number
2021198778
Title
Protocol for Guo's aortIc Arch recoNstrucTion: A prospective, multicentre
and single-arm study to evaluate the safety and efficacy of the
WeFlow-Arch modular inner branch stent-graft system for aortic arch
lesions (GIANT study).
Source
BMJ Open. 12(10) (no pagination), 2022. Article Number: e063245. Date of
Publication: 10 Oct 2022.
Author
Liu F.; Zhang H.; Rong D.; Ge Y.; Jia X.; Xiong J.; Ma X.; Wang L.; Fan
T.; Guo W.
Institution
(Liu, Zhang, Rong, Ge, Jia, Xiong, Ma, Wang, Guo) Department of Vascular
and Endovascular Surgery, Chinese PLA General Hospital, Beijing, China
(Fan) Department of Biomechanics and Rehabilitation Engineering, Capital
Medical University, Beijing, China
Publisher
BMJ Publishing Group
Abstract
Introduction Endovascular repair of the entire aortic arch provides
treatment opportunities for patients with aortic arch lesions who are
intolerant to open surgery. However, the complex anatomical configuration,
high-speed blood flow and long access from the femoral artery increase the
difficulty of endovascular aortic arch repair. On the basis of our earlier
studies, a new modular inner branch stent-graft system was developed
specifically for lesions located in the aortic arch and part of the
ascending aorta. This study aims to evaluate the safety and efficacy of
the novel modular branch stent-graft system in patients with aortic arch
lesions who are unsuitable for open aortic arch replacement. Methods and
analysis This prospective, multicentre, single-arm, clinical trial will
enrol 80 patients with aortic arch lesions requiring intervention, namely,
true aortic arch aneurysms, pseudo-aortic arch aneurysms and penetrating
ulcers involving the aortic arch. Clinical information and CT angiography
(CTA) images will be collected and analysed to investigate the safety and
efficacy of the novel modular branch stent-graft system. Patients will be
followed up for 5 years. The primary outcome will be all-cause mortality
and severe stroke within 12 months after the procedure. In addition, this
trial will evaluate mid-term to long-term clinical and imaging outcomes
through the annual clinical and CTA follow-up for 2-5 years
postoperatively. Ethics and dissemination We have registered the study on
a registry website (https://clinicaltrials.gov/ct2/home). The study
findings will be disseminated through peer-reviewed journals, physician
newsletters, conferences and the mass media. Trial registration number
NCT04765592.<br/>Copyright &#xa9; Author(s) (or their employer(s)) 2022.

<62>
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;

<63>
[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.

<64>
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;

<65>
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;

<66>
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.

<67>
Accession Number
2020156673
Title
Comparison of sitting and prone positions for real-time ultrasound-guided
thoracic epidural catheter placement: a randomized controlled trial.
Source
Regional Anesthesia and Pain Medicine. 47(12) (pp 738-743), 2022. Date of
Publication: 02 Sep 2022.
Author
Shin S.; Lee J.-H.; Kwon H.-J.; Lee I.; Kim D.; Cho H.; Kim D.-H.; Jeong
S.-M.
Institution
(Shin) Department of Anesthesiology and Pain Medicine, Uijeongbu Eulji
University Hospital, Uijeongbu, South Korea
(Lee, Kwon, Lee, Kim, Jeong) Department of Anesthesiology and Pain
Medicine, Asan Medical Center, Seoul, South Korea
(Kim, Cho) Department of Anesthesiology and Pain Medicine, Veterans Health
Service Medical Center, Seoul, South Korea
Publisher
BMJ Publishing Group
Abstract
Introduction Real-time ultrasound-guided thoracic epidural catheter
placement (US-TECP) has been recently introduced. Patient's position is
associated with the success of spine interventions; however, the effects
of position on the outcome of the procedure remain unknown. We aimed to
assess the clinical usefulness of patient positioning during real-time
US-TECP. Methods Patients were randomly assigned to the prone position
group (group P) and sitting position group (group S). The primary outcome
was needling time during the procedure. The secondary outcomes were time
to mark space, total number of needle passes, number of skin punctures,
first-pass success, final success, crossover success, and visibility of
ultrasound (US) views. Global Rating Scale (GRS) score, Patient Comfort
Scale score, procedural pain intensity, patient satisfaction, and
procedure-related complications were also determined. Results Sixty-four
patients were included in this study. The needling time was significantly
shorter in group P than in group S (36.5 (26.5-51.0) vs 59.5 (34.5-152.0)
s, p<0.01). The numbers of needle passes and skin punctures were
significantly lesser in group P than in group S. First-pass success was
higher in group P than in group S. Group P had higher GRS compared with
group S. The time to mark space, final success, US visibility score,
Patient Comfort Scale score, procedural pain intensity, and patient
satisfaction did not differ between the groups. One patient in group S
developed a vasovagal reaction. Discussion This study shows that prone
position may be preferred for real-time US-TECP, considering its better
clinical usefulness. Trial registration number KCT0005757.<br/>Copyright
&#xa9; 2022 BMJ Publishing Group. All rights reserved.

<68>
Accession Number
2018846427
Title
An unusual location of solitary fibrous tumor in heart-A case report and
review of literature.
Source
Cancer Reports. 5(11) (no pagination), 2022. Article Number: e1698. Date
of Publication: November 2022.
Author
Fain K.; Parmar K.; Sharma M.; Horn R.; Sethi P.
Institution
(Fain) School of Medicine, Texas Tech University Health Science Center,
Lubbock, TX, United States
(Parmar) Department of Internal Medicine, Texas Tech University Health
Science Center, Lubbock, TX, United States
(Sharma) Department of Pathology, Texas Tech University Health Science
Center, Lubbock, TX, United States
(Horn) Department of Hematology-Oncology, Texas Tech University Health
Science Center, Lubbock, TX, United States
(Sethi) Department of Cardiovascular Medicine, Texas Tech University
Health Science Center, Lubbock, TX, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Solitary fibrous tumor (SFT) are rare spindle cell tumors
originating from the mesenchymal cells mostly from the visceral pleura.
SFT was first described as a distinct entity in 1931 by Klemperer et al.
Until now, we have limited data regarding the manifestation and behavior
of extra pleural forms such as cardiac SFT. Here we present a case of SFT
involving the pericardium where the diagnosis was made by imaging followed
by biopsy findings. We also review the literature of SFT involving the
heart and the management approaches. Case Presentation: An 81-year-old
male presented with progressive dyspnea. Computed tomography (CT) of the
chest showed a 6.2 x 5.3 cm soft tissue mass in the anterior mediastinum.
Further imaging with CT angiogram showed a stalk-like connection to the
pericardium. A biopsy of the mass showed spindle cells positive for BCL-2,
CD34, and STAT 6, indicative of a solitary fibrous tumor. A surveillance
approach was adopted for the patient. <br/>Conclusion(s): Primary
pericardial tumors are exceedingly rare, with a prevalence rate of
0.001%-0.007%. Diagnosing a SFT requires a positive CD34 and BCL-2 marker.
The current recommendation is resection of localized disease which has
been documented to be curative in cases of benign disease however our
patient was put on surveillance.<br/>Copyright &#xa9; 2022 The Authors.
Cancer Reports published by Wiley Periodicals LLC.

<69>
Accession Number
2015544273
Title
Impact of diabetes on clinical outcomes after revascularization with the
dual therapy CD34 antibody-covered sirolimus-eluting Combo stent and the
sirolimus-eluting Orsiro stent.
Source
Catheterization and Cardiovascular Interventions. 99(7) (pp 1965-1975),
2022. Date of Publication: June 1, 2022.
Author
Jakobsen L.; Christiansen E.H.; Freeman P.; Kahlert J.; Veien K.; Maeng
M.; Raungaard B.; Ellert J.; Kristensen S.D.; Christensen M.K.; Terkelsen
C.J.; Thim T.; Eftekhari A.; Jensen R.V.; Stottrup N.B.; Junker A.; Hansen
H.S.; Jensen L.O.
Institution
(Jakobsen, Christiansen, Maeng, Kristensen, Terkelsen, Thim, Eftekhari,
Jensen, Stottrup) Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark
(Freeman, Raungaard, Christensen, Eftekhari) Department of Cardiology,
Aalborg University Hospital, Aalborg, Denmark
(Kahlert) Department of Clinical Epidemiology, Aarhus University Hospital,
Aarhus, Denmark
(Veien, Ellert, Junker, Hansen, Jensen) Department of Cardiology, Odense
University Hospital, Odense, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Objectives: To compare the efficacy and safety of the dual therapy CD34
antibody-covered sirolimus-eluting Combo stent (DTS) and the
sirolimus-eluting Orsiro stent (SES) in patients with and without diabetes
mellitus (DM) included in the Scandinavian Organization for Randomized
Trials with Clinical Outcome (SORT OUT) X study. <br/>Background(s): The
incidence of target lesion failure (TLF) after treatment with modern
drug-eluting stents has been reported to be significantly higher in
patients with DM when compared to patients without DM. Thus, whether the
results from the SORT OUT X study apply to patients with and without DM
remains unknown. <br/>Method(s): In total 3146 patients were randomized to
stent implantation with DTS (n = 1578; DM: n = 279) or SES (n = 1568; DM:
n = 271). The primary end point, TLF, was a composite of cardiac death,
target-lesion myocardial infarction (MI), or target lesion
revascularization (TLR) within 1 year. <br/>Result(s): At 1 year, the rate
of TLF was increased in the DTS group compared to the SES group, both
among patients with DM (9.3% vs. 4.8%; risk difference: 4.5%; incidence
rate ratio: 1.99, 95% confidence interval [CI]: 1.02-3.90) and without DM
(5.7% vs. 3.5%; incidence rate ratio: 1.67, 95% CI: 1.15-2.42). The
differences were mainly explained by higher rates of TLR.
<br/>Conclusion(s): Compared to the SES, the DTS was associated with an
increased risk of TLF at 12 months in patients with and without DM. The
differences were mainly explained by higher rates of TLR, whereas rates of
cardiac death and target lesion MI did not differ significantly between
the two stent groups in patients with or without DM.<br/>Copyright &#xa9;
2022 The Authors. Catheterization and Cardiovascular Interventions
published by Wiley Periodicals LLC.

<70>
Accession Number
2014694671
Title
Testosterone deficiency in male organ transplant recipients.
Source
International Journal of Impotence Research. 34(7) (pp 679-684), 2022.
Date of Publication: November 2022.
Author
Omil-Lima D.; Jesse E.; Gupta K.; Sellke N.; Muncey W.; Burrelli C.;
Ghayda R.A.; Loeb A.; Thirumavalavan N.
Institution
(Omil-Lima, Jesse, Gupta, Sellke, Muncey, Ghayda, Loeb, Thirumavalavan)
Urology Institute, University Hospitals Cleveland Medical Center. Case
Western Reserve University School of Medicine, Cleveland, OH, United
States
(Burrelli) University Hospitals Cleveland Medical Center, Cleveland, OH,
United States
Publisher
Springer Nature
Abstract
Testosterone deficiency is known to affect men with increasing incidence
throughout their lifespan. The clinical manifestations of testosterone
deficiency, in turn, negatively impact men's quality of life and
perception of overall health. The interaction of chronic systemic disease
and androgen deficiency represent an area for potential intervention.
Here, we explore the topic of testosterone deficiency amongst men with
end-stage organ failure requiring transplantation in order to elucidate
the underlying pathophysiology of androgen deficiency of chronic disease
and discuss whether intervention, including testosterone replacement and
organ transplantation, improve patients' outcomes and quality of
life.<br/>Copyright &#xa9; 2021, The Author(s), under exclusive licence to
Springer Nature Limited.

<71>
Accession Number
2019758502
Title
Intra-Arrest Therapeutic Hypothermia and Neurologic Outcome in Patients
Admitted after Out-of-Hospital Cardiac Arrest: A Post Hoc Analysis of the
Princess Trial.
Source
Brain Sciences. 12(10) (no pagination), 2022. Article Number: 1374. Date
of Publication: October 2022.
Author
MACCHINI E.; DILLENBECK E.; JONSSON M.; ANNONI F.; FORSBERG S.; HOLLENBERG
J.; TRUHLAR A.; SVENSSON L.; NORDBERG P.; TACCONE F.S.
Institution
(MACCHINI, ANNONI, TACCONE) Department of Intensive Care, Hopital
Universitaire de Bruxelles (HUB), Brussels 1070, Belgium
(DILLENBECK, JONSSON, FORSBERG, HOLLENBERG, NORDBERG) Department of
Clinical Science and Education, Sodersjukhuset, Centre for Resuscitation
Science, Karolinska Institutet, Stockholm 17177, Sweden
(TRUHLAR) Emergency Medical Services of the Hradec Kralove Region,
Department of Anaesthesiology and Intensive Care Medicine, Charles
University in Prague, University Hospital Hradec Kralove, Hradec Kralove
50022, Czechia
(SVENSSON) Department of Medicine, Karolinska Institute, Stockholm 17177,
Sweden
(NORDBERG) Function Perioperative Medicine and Intensive Care, Karolinska
University Hospital, Stockholm 17177, Sweden
Publisher
MDPI
Abstract
Background: Despite promising results, the role of intra-arrest
hypothermia in out-of-hospital cardiac arrest (OHCA) remains
controversial. The aim of this study was to assess the effects of
trans-nasal evaporative cooling (TNEC) during resuscitation on
neurological recovery in OHCA patients admitted alive to the hospital.
<br/>Method(s): A post hoc analysis of the PRINCESS trial, including only
patients admitted alive to the hospital, either assigned to TNEC or
standard of care during resuscitation. The primary endpoint was favorable
neurological outcome (FO) defined as a Cerebral Performance Category (CPC)
of 1-2 at 90 days. The secondary outcomes were overall survival at 90 days
and CPC 1 at 90 days. Subgroup analyses were performed according to the
initial cardiac rhythm. <br/>Result(s): A total of 149 patients in the
TNEC and 142 in the control group were included. The number of patients
with CPC 1-2 at 90 days was 56/149 (37.6%) in the intervention group and
45/142 (31.7%) in the control group (p = 0.29). Survival and CPC 1 at 90
days was observed in 60/149 patients (40.3%) vs. 52/142 (36.6%; p = 0.09)
and 50/149 (33.6%) vs. 35/142 (24.6%; p = 0.11) in the two groups. In the
subgroup of patients with an initial shockable rhythm, the number of
patients with CPC 1 at 90 days was 45/83 (54.2%) in the intervention group
and 27/78 (34.6%) in the control group (p = 0.01). <br/>Conclusion(s): In
this post hoc analysis of admitted OHCA patients, no statistically
significant benefits of TNEC on neurological outcome at 90 days was found.
In patients with initial shockable rhythm, TNEC was associated with
increased full neurological recovery.<br/>Copyright &#xa9; 2022 by the
authors.

<72>
Accession Number
2019658470
Title
Machine learning derived ECG risk score improves cardiovascular risk
assessment in conjunction with coronary artery calcium scoring.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 976769. Date of Publication: 05 Oct 2022.
Author
Siva Kumar S.; Al-Kindi S.; Tashtish N.; Rajagopalan V.; Fu P.;
Rajagopalan S.; Madabhushi A.
Institution
(Siva Kumar) Department of Biomedical Engineering, Case Western Reserve
University, Cleveland, OH, United States
(Al-Kindi, Tashtish, Rajagopalan, Rajagopalan) Harrington Heart and
Vascular Institute, University Hospitals, Cleveland, OH, United States
(Al-Kindi, Tashtish, Rajagopalan, Rajagopalan) School of Medicine, Case
Western Reserve University, Cleveland, OH, United States
(Fu) Department of Population and Quantitative Health Sciences, Case
Western Reserve University, Cleveland, OH, United States
(Madabhushi) Department of Biomedical Engineering, Radiology and Imaging
Sciences, Biomedical Informatics (BMI) and Pathology, Georgia Institute of
Technology and Emory University, Research Health Scientist, Atlanta
Veterans Administration Medical Center, Atlanta, GA, United States
Publisher
Frontiers Media S.A.
Abstract
Background: Precision estimation of cardiovascular risk remains the
cornerstone of atherosclerotic cardiovascular disease (ASCVD) prevention.
While coronary artery calcium (CAC) scoring is the best available
non-invasive quantitative modality to evaluate risk of ASCVD, it excludes
risk related to prior myocardial infarction, cardiomyopathy, and
arrhythmia which are implicated in ASCVD. The high-dimensional and
inter-correlated nature of ECG data makes it a good candidate for analysis
using machine learning techniques and may provide additional prognostic
information not captured by CAC. In this study, we aimed to develop a
quantitative ECG risk score (eRiS) to predict major adverse cardiovascular
events (MACE) alone, or when added to CAC. Further, we aimed to construct
and validate a novel nomogram incorporating ECG, CAC and clinical factors
for ASCVD. <br/>Method(s): We analyzed 5,864 patients with at least 1
cardiovascular risk factor who underwent CAC scoring and a standard ECG as
part of the CLARIFY study (ClinicalTrials.gov Identifier: NCT04075162).
Events were defined as myocardial infarction, coronary revascularization,
stroke or death. A total of 649 ECG features, consisting of measurements
such as amplitude and interval measurements from all deflections in the
ECG waveform (53 per lead and 13 overall) were automatically extracted
using a clinical software (GE MuseTM Cardiology Information System, GE
Healthcare). The data was split into 4 training (S<inf>tr</inf>) and
internal validation (S<inf>v</inf>) sets [S<inf>tr</inf> (1):
S<inf>v</inf> (1): 50:50; S<inf>tr</inf> (2): S<inf>v</inf> (2): 60:40;
S<inf>tr</inf> (3): S<inf>v</inf> (3): 70:30; S<inf>tr</inf> (4):
S<inf>v</inf> (4): 80:20], and the results were compared across all the
subsets. We used the ECG features derived from S<inf>tr</inf> to develop
eRiS. A least absolute shrinkage and selection operator-Cox (LASSO-Cox)
regularization model was used for data dimension reduction, feature
selection, and eRiS construction. A Cox-proportional hazards model was
used to assess the benefit of using an eRiS alone (M<inf>ecg</inf>), CAC
alone (M<inf>cac</inf>) and a combination of eRiS and CAC
(M<inf>ecg+cac</inf>) for MACE prediction. A nomogram (M<inf>nom</inf>)
was further constructed by integrating eRiS with CAC and demographics (age
and sex). The primary endpoint of the study was the assessment of the
performance of M<inf>ecg</inf>, M<inf>cac</inf>, M<inf>ecg+cac</inf> and
M<inf>nom</inf> in predicting CV disease-free survival in ASCVD.
<br/>Finding(s): Over a median follow-up of 14 months, 494 patients had
MACE. The feature selection strategy preserved only about 18% of the
features that were consistent across the various strata (S<inf>tr</inf>).
The M<inf>ecg</inf> model, comprising of eRiS alone was found to be
significantly associated with MACE and had good discrimination of MACE
(C-Index: 0.7, p = <2e-16). eRiS could predict time-to MACE (C-Index: 0.6,
p = <2e-16 across all S<inf>v</inf>). The M<inf>ecg+cac</inf> model was
associated with MACE (C-index: 0.71). Model comparison showed that
M<inf>ecg+cac</inf> was superior to M<inf>ecg</inf> (p = 1.8e-10) or
M<inf>cac</inf> (p < 2.2e-16) alone. The M<inf>nom</inf>, comprising of
eRiS, CAC, age and sex was associated with MACE (C-index 0.71). eRiS had
the most significant contribution, followed by CAC score and other
clinical variables. Further, M<inf>nom</inf> was able to identify unique
patient risk-groups based on eRiS, CAC and clinical variables.
<br/>Conclusion(s): The use of ECG features in conjunction with CAC may
allow for improved prognostication and identification of populations at
risk. Future directions will involve prospective validation of the risk
score and the nomogram across diverse populations with a heterogeneity of
treatment effects.<br/>Copyright &#xa9; 2022 Siva Kumar, Al-Kindi,
Tashtish, Rajagopalan, Fu, Rajagopalan and Madabhushi.

<73>
Accession Number
2019095688
Title
PRE-OPerative ECHOcardiograhy for prevention of cardiovascular events
after non-cardiac surgery in intermediate- and high-risk patients:
protocol for a low-interventional, mixed-cohort prospective study design
(PREOP-ECHO).
Source
Trials. 23(1) (no pagination), 2022. Article Number: 776. Date of
Publication: December 2022.
Author
Kim E.K.; Choi H.-M.; Choi E.-Y.; Lee H.S.; Park G.; Han D.W.; Lee S.-E.;
Park C.S.; Hwang J.-W.; Choi J.H.; Kim M.-N.; Kim H.-K.; Kim D.-H.; Shin
S.-H.; Sohn I.S.; Shin M.-S.; Na J.O.; Cho I.; Lee S.H.; Park Y.H.; Park
T.-H.; Kim K.H.; Cho G.-Y.; Jung H.O.; Park D.-G.; Hong J.Y.; Kang D.-H.
Institution
(Kim) Division of Cardiology, Department of Medicine, Cardiovascular
Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center,
Sungkyunkwan University School of Medicine, Seoul, South Korea
(Choi, Cho) Department of Cardiology, Cardiovascular Center, Seoul
National University Bundang Hospital, Seoul National University College of
Medicine, Gyeonggi-do, Seongnam, South Korea
(Choi) Division of Cardiology, Gangnam Severance Hospital, Yonsei
University College of Medicine, 211 Eonju-Ro, Gangnam-Gu, Seoul 06273,
South Korea
(Lee, Park) Biostatistics Collaboration Unit, Yonsei University College of
Medicine, Seoul, South Korea
(Han) Department of Anesthesiology and Pain Medicine, Yonsei University
College of Medicine, Seoul, South Korea
(Lee) Division of Cardiology, Department of Internal Medicine, Ewha Womans
University College of Medicine, Seoul, South Korea
(Park) Department of Cardiology, Bucheon St. Mary's Hospital, The Catholic
University College of Medicine, Bucheon, South Korea
(Hwang) Division of Cardiology, Department of Medicine, Ilsan Paik
Hospital, Inje University School of Medicine, Goyang, South Korea
(Choi) Division of Cardiology, Hallym University Dongtan Sacred Heart
Hospital, Hwaseong, South Korea
(Kim) Division of Cardiology, Korea University Anam Hospital, Seoul, South
Korea
(Kim) Division of Cardiology, Cardiovascular Center, Department of
Internal Medicine, Seoul National University College of Medicine, Seoul,
South Korea
(Kim, Kang) Department of Cardiology, Asan Medical Center, Ulsan
University College of Medicine, Seoul, South Korea
(Shin) Division of Cardiology, Inha University Medical Center, Incheon,
South Korea
(Sohn) Department of Cardiology, Cardiovascular Center, Kyung Hee
University Hospital at Gangdong, Seoul, South Korea
(Shin) Division of Cardiology, Department of Internal Medicine, Gil
Medical Center, Gachon University College of Medicine, Incheon, South
Korea
(Na) Cardiovascular Center, Korea University Guro Hospital, Seoul, South
Korea
(Cho) Division of Cardiology, Severance Cardiovascular Hospital, Yonsei
University College of Medicine, Seoul, South Korea
(Lee) Division of Cardiology, Department of Internal Medicine, Jeonbuk
National University Medical School, Jeonju, South Korea
(Park) Division of Cardiology, Department of Internal Medicine, Pusan
National University Yangsan Hospital, Yangsan, South Korea
(Park) Department of Cardiology, Dong-A University College of Medicine,
Busan, South Korea
(Kim) Department of Cardiovascular Medicine, Chonnam National University
Hospital, Gwangju, South Korea
(Jung) Division of Cardiology, Department of Internal Medicine, Seoul St.
Mary's Hospital, College of Medicine, The Catholic University of Korea,
Seoul, South Korea
(Park) Department of Internal Medicine, Kangdong Sacred Heart Hospital,
Hallym University, Seoul, South Korea
(Hong) Division of Cardiology, Hallym University Sacred Heart Hospital,
Hallym University College of Medicine, Anyang, South Korea
Publisher
BioMed Central Ltd
Abstract
Background: Cardiac evaluation using transthoracic echocardiography before
noncardiac surgery is common in real-world practice. However, evidence
supporting preoperative echocardiography is lacking. This study aims to
evaluate the additional benefit of preoperative echocardiography in
predicting postoperative cardiovascular events (CVE) in noncardiac
surgery. <br/>Method(s): This study is designed as a multicenter,
prospective study to assess the utility of preoperative echocardiography
in patients undergoing intermediate- or high-risk noncardiac surgery. This
trial comprises two studies: (1) a randomized controlled trial (RCT) for
patients undergoing intermediate-risk surgery with fewer than three
clinical risk factors from the revised cardiac risk index
(intermediate-risk group) and (2) a prospective cohort study for patients
undergoing intermediate-risk surgery with three or more clinical risk
factors, or who undergo high-risk surgery regardless of the number of
clinical risk factors (high-risk group). We hypothesize that the use of
preoperative echocardiography will reduce postoperative CVEs in patients
undergoing intermediate- to high-risk surgery through discovery of and
further intervention for unexpected cardiac abnormalities before elective
surgery. A total of 2330 and 2184 patients will be enrolled in the two
studies. The primary endpoint is a composite of all-cause death; aborted
sudden cardiac arrest; type I acute myocardial infarction; clinically
diagnosed unstable angina; stress-induced cardiomyopathy; lethal
arrhythmia, such as sustained ventricular tachycardia or ventricular
fibrillation; and/or newly diagnosed or acutely decompensated heart
failure within 30 days after surgery. <br/>Discussion(s): This study will
be the first large-scale prospective study examining the benefit of
preoperative echocardiography in predicting postoperative CVE. The
PREOP-ECHO trial will help doctors identify patients at risk of
postoperative CVE using echocardiography and thereby reduce postoperative
CVEs. Trial registration: The Clinical Research Information Service
KCT0006279 for RCT and KCT0006280 for prospective cohort study. Registered
on June 21, 2021.<br/>Copyright &#xa9; 2022, The Author(s).

<74>
Accession Number
2018873248
Title
Heart Rehabilitation for All (HeRTA): Protocol for a feasibility study and
pilot randomized trial.
Source
PLoS ONE. 17(6 June) (no pagination), 2022. Article Number: e0270159. Date
of Publication: June 2022.
Author
Birke H.; Foxvig I.; Burns K.; Toft U.; Hansen A.B.G.; Hauge P.I.; Foghmar
S.; Mindegaard R.B.; Jakobsen L.M.
Institution
(Birke, Foxvig, Burns, Toft, Hansen, Jakobsen) Center for Clinical
Research and Prevention, Frederiksberg Hospital, Frederiksberg, Denmark
(Toft) Section of Social Medicine, Department of Public Health, University
of Copenhagen, Copenhagen, Denmark
(Hauge) The Danish Heart Association, Copenhagen, Denmark
(Foghmar) Cardiology Department, University Hospital Hvidovre, Hvidovre,
Denmark
(Mindegaard) Rehabilitation Center, Albertslund Municipality, Albertslund,
Denmark
(Jakobsen) Capital Region, Hillerod, Denmark
Publisher
Public Library of Science
Abstract
Introduction Today, 50% of people with cardiac disease do not participate
in rehabilitation. The HeRTAstudy aims to develop and test a sustainable
rehabilitation model supporting vulnerable patients in participating in
rehabilitation and long-term physical activity. Methods A feasibility
study with a non-blinded pilot randomized trial was developed in
collaboration with partners and cardiac patients to test a multi-component
rehabilitation intervention across hospital, municipality, and civil
society. The study runs from January 2020 to December 2024. Eligibility
criteria for participants: a) diagnosed with either ischemic heart
disease, persistent atrial fibrillation, heart failure, or have had
cardiac valve surgery, b) residents in Hvidovre Hospitals uptake area, c)
cognitively functional, d) physically able to participate in
rehabilitation. Patient recruitment will be located at Hvidovre Hospital,
Capital Region of Denmark, data collection at Hvidovre Hospital,
Rehabilitation Center Albertslund, the Danish Heart Association, and in
two municipalities (Hvidovre and Brondby). Patients in the control group
have access to usual care at the hospital:
rehabilitation-needs-assessment, patient education, and physical training.
After or instead of hospital rehabilitation, the patient can be referred
to municipal rehabilitation with patient education, and a total of 12
weeks of physical training across sectors. Patients in the intervention
group will in addition to usual care, have access to an information book
about cardiac disease, patient supporters from the Danish Heart
Association, Information materials to inform employers about the
employees' rehabilitation participation, a rehabilitation goal setting
plan, a support cafe for relatives, and follow-up phone calls from
physiotherapists 1 and 3 months after rehabilitation to support physical
activities. Patients with vulnerabilities will additionally receive
patient education conducted in small groups, pro-active counselling by a
cardiac nurse, psychologist, or social worker, paid transportation to
rehabilitation, and paid membership in a sports association. Patients are
computer block-randomized so patients with vulnerability are distributed
evenly in the two study arms by stratifying on a) a cut-off score of >= 5
in the Tilburg Frailty Indicator questionnaire and/or b) need of language
translator support. A power calculation, based on an estimated 20%
difference in participation proportion between groups, 80% power, a type 1
error of 5% (two-tailed), results in 91 participants in each study arm.
The primary outcome: rehabilitation participation (attending >= two
activities: patient education, smoking cessation, dietary counseling, and
physical training) and reaching at least 50% attendance. <br/>Secondary
Outcomes: health-related quality of life, coping strategies, level of
physical activities, and sustainability regarding participation in active
communities after rehabilitation. The study is registered at
ClinicalTrials.gov (NCT05104658). Results Differences between changes in
outcomes between groups will be analyzed according to the
intention-to-treat principle. Sensitivity analysis and analysis of the
effect of the combined activities will be made. A process evaluation will
clarify the implementation of the model, the partnership, and patients'
experiences. Conclusion Cross-sectoral collaborations between hospitals,
municipalities, and organizations in civil society may lead to sustainable
and affordable long-term physical activities for persons with chronic
illness. The results can lead to improve cross-sectoral collaborations in
other locations and patient groups.<br/>Copyright &#xa9; 2022 Birke et al.
This is an open access article distributed under the terms of the Creative
Commons Attribution License, which permits unrestricted use, distribution,
and reproduction in any medium, provided the original author and source
are credited.

<75>
Accession Number
2021210434
Title
Transmission of Klebsiella pneumoniae carbapenemase (KPC)-producing
Klebsiella pneumoniae: the role of infection control.
Source
Journal of Antimicrobial Chemotherapy. 76(Supplement 1) (pp I4-I11), 2021.
Date of Publication: 01 Jan 2021.
Author
Tsioutis C.; Eichel V.M.; Mutters N.T.
Institution
(Tsioutis, Mutters) European Committee on Infection Control, Basel,
Switzerland
(Tsioutis) School of Medicine, European University Cyprus, Nicosia, Cyprus
(Eichel) Heidelberg University Hospital, Centre of Infectious Diseases,
Heidelberg, Germany
(Mutters) Bonn University Hospital, Institute for Hygiene and Public
Health, Venusberg-Campus 1, Bonn 53127, Germany
Publisher
Oxford University Press
Abstract
Background: The worldwide spread of carbapenemase-producing Gram-negative
bacteria (GNB) in healthcare settings is worrying. Of particular concern
is the occurrence of Klebsiella pneumoniae carbapenemase (KPC)-producing
Klebsiella pneumoniae (KP). In recent years, several guidelines and
recommendations have focused on the control of carbapenem-resistant GNB.
It remains, however, unknown to what extent individual infection control
measures are effective. Our aim was to critically review the recent
evidence regarding the effectiveness of measures to control KPC-KP spread
in healthcare settings. <br/>Method(s): Critical review of the literature
aiming to evaluate, in accordance with published recommendations, all
available studies reporting infection control (IC) measures to control
KPC-KP published in the past 5 years. <br/>Result(s): Among 11 included
studies, the majority consisted of outbreak reports, where application of
measures was reported in the absence of control groups. Variability was
observed related to the frequency of application of recommended measures
for control of KPC-KP. Additional measures were recorded, such as
environmental sampling and staff screening, whereas compliance with hand
hygiene was measured in relatively few studies. Finally, mortality in
patients harbouring KPC-KP was notable, reaching 42.9% of included
patients. <br/>Conclusion(s): Despite successful control of KPC-KP spread
during outbreaks, the impact of individual IC measures is difficult to
assess, as the quality of published evidence is low and controlled
intervention studies are lacking. The distribution of studies, the number
of reported cases and the high mortality rates, clearly show that KPC-KP
remains a major healthcare problem worldwide.<br/>Copyright &#xa9; The
Author(s) 2021.

<76>
Accession Number
2020319971
Title
Model for screening adult congenital heart disease surgery eligibility
with echocardiography parameters.
Source
Journal of Heart and Lung Transplantation. 41(12) (pp 1831-1838), 2022.
Date of Publication: December 2022.
Author
Zi-yang Y.; Hezhi L.; Nanshan X.; Yin Z.; Dongling L.; Hongwen F.; Caojin
Z.
Institution
(Zi-yang, Hezhi, Nanshan, Yin, Dongling, Hongwen, Caojin) Guangdong
Cardiovascular Institute, Guangdong Provincial People's Hospital,
Guangdong Academy of Medical Sciences, Guangdong, Guangzhou, China
(Zi-yang, Nanshan, Hongwen, Caojin) Southern Medical University, The
Second School of Clinical Medicine, Guangdong, Guangzhou, China
(Zi-yang, Nanshan, Yin, Caojin) Guangdong Provincial Key Laboratory of
South China Structural Heart Disease, Guangdong, Guangzhou, China
Publisher
Elsevier Inc.
Abstract
Objectives: This study aimed to screen for the eligibility of correction
in cases of adult congenital heart disease (CHD). Pulmonary to systemic
flow ratios (Qp/Qs) > 1.5 and pulmonary to systemic vascular resistance
ratios (Rp/Rs) < 1/3, acquired by right heart catheterization (RHC), are
two essential parameters. Nonetheless, performing RHC at every follow-up
is impractical and even harmful. Thus, it is important to establish a
model to predict Qp/Qs and Rp/Rs status before a RHC confirmation, using
echocardiography parameters. <br/>Method(s): A total of 1,785 patients
with adult CHD were enrolled and randomly assigned to the derivation or
validation groups. Echocardiogram parameters of the 974 patients in the
derivation group were considered candidate predictors for surgery
eligibility (Qp/Qs > 1.5 and Rp/Rs < 1/3). Binary logistic regression
analyses were performed to identify the independent predictors and
establish a scoring system. The scoring system was further examined in the
validation group using a receiver operating characteristic (ROC) analysis.
<br/>Result(s): Estimated pulmonary artery systolic pressure, velocity
through the pulmonary valve, and diameters of the left and right atria
were identified as independent predictors. The area under the ROC curve of
the predictive value in the validation group and its pre- and
post-tricuspid valve malformation subgroups were 0.87 (95% confidence
interval [CI]: 0.84-0.90, p < 0.01), 0.86 (95% CI: 0.82-0.91, p < 0.01),
and 0.85 (95% CI: 0.79-0.90, p < 0.01), respectively. <br/>Conclusion(s):
This scoring system could augment flexibility and convenience for
pre-screening CHD patients' eligibility for surgery, before
RHC.<br/>Copyright &#xa9; 2022 The Authors

<77>
Accession Number
639206678
Title
Outcomes of isolated tricuspid valve replacement: a systematic review and
meta-analysis of 5,316 patients from 35 studies.
Source
EuroIntervention : journal of EuroPCR in collaboration with the Working
Group on Interventional Cardiology of the European Society of Cardiology.
18(10) (pp 840-851), 2022. Date of Publication: 18 Nov 2022.
Author
Scotti A.; Sturla M.; Granada J.F.; Kodali S.K.; Coisne A.; Mangieri A.;
Godino C.; Ho E.; Goldberg Y.; Chau M.; Jorde U.P.; Garcia M.J.; Maisano
F.; Bapat V.N.; Ailawadi G.; Latib A.
Institution
(Scotti, Sturla, Granada, Coisne, Ho, Goldberg, Chau, Jorde, Garcia,
Latib) Montefiore-Einstein Center for Heart and Vascular Care, Montefiore
Medical Center, Albert Einstein College of Medicine, Bronx, NY, United
States
(Scotti, Granada, Coisne) Cardiovascular Research Foundation, New York,
NY, USA
(Kodali) Division of Cardiology, New York-Presbyterian Hospital/Columbia
University Irving Medical Center, New York, NY, USA
(Mangieri) Department of Biomedical Sciences, Humanitas University, Pieve
Emanuele, Italy and Cardio Center, Humanitas Research Hospital IRCCS,
Rozzano, Italy
(Godino, Maisano) Cardio-Thoracic-Vascular Department, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Bapat) Minneapolis Heart Institute, Abbott Northwestern Hospital,
Minneapolis, MN, United States
(Ailawadi) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, MI, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Transcatheter tricuspid valve replacement (TTVR) is rapidly
emerging as a therapeutic option amongst patients with secondary tricuspid
regurgitation. Historical data from surgical tricuspid valve replacement
(TVR) studies may serve as a benchmark for the development of TTVR trials.
AIMS: The aim of the study was to investigate the early and late outcomes
following isolated surgical TVR. <br/>METHOD(S): Multiple electronic
databases were searched to identify studies on isolated surgical TVR. The
prespecified primary endpoint was operative mortality; secondary endpoints
were early and late outcomes. Overall estimates of proportions and
incidence rates with 95% confidence intervals (CI) were calculated using
random-effects models. Multiple sensitivity analyses accounting for
baseline characteristics, country and the operative period were applied.
Results: A total of 35 studies (5,316 patients) were included in this
meta-analysis. The operative period ranged from 1974 to 2019. The overall
rate of operative mortality was 12% (95% CI: 9-15), with higher mortality
for patients who were operated on before 1995, who had prior cardiac
surgeries, or who had liver disease. The most frequent clinical events
were pacemaker implantation (10% [95% CI: 6-16]), bleeding (12% [95% CI:
8-17]), acute kidney injury (15% [95% CI: 9-24]) and respiratory
complications (15% [95% CI: 12-20]). At follow-up analysis of the
bioprosthetic TVR, there was an incidence rate per 100 person-years of 6
(95% CI: 2-13) for death and 8 (95% CI: 5-13) for recurrence of
significant tricuspid regurgitation. <br/>CONCLUSION(S): This
meta-analysis provides an overview of the historical clinical outcomes
following isolated surgical TVR. These findings can support the
development of future clinical trials in the tricuspid space by providing
thresholds for clinical outcomes.

<78>
Accession Number
2019950106
Title
Use of Cytokine Filters During Cardiopulmonary Bypass: Systematic Review
and Meta-Analysis.
Source
Heart Lung and Circulation. 31(11) (pp 1493-1503), 2022. Date of
Publication: November 2022.
Author
Naruka V.; Salmasi M.Y.; Arjomandi Rad A.; Marczin N.; Lazopoulos G.;
Moscarelli M.; Casula R.; Athanasiou T.
Institution
(Naruka, Salmasi, Arjomandi Rad, Marczin, Moscarelli, Athanasiou)
Department of Surgery and Cancer, Imperial College, London, United Kingdom
(Naruka, Casula, Athanasiou) Department of Cardiothoracic Surgery,
Hammersmith Hospital, London, United Kingdom
(Lazopoulos) Department of Cardiothoracic Surgery, University Hospital of
Heraklion, Crete, Greece
Publisher
Elsevier Ltd
Abstract
Introduction: Cardiac surgery involving cardiopulmonary bypass (CPB)
activates an inflammatory response releasing cytokines that are associated
with less favourable outcomes. This study aims to compare i) CPB during
cardiac surgery (control) versus ii) CPB with haemoadsorption therapy; and
assess the effect of adding this therapy in reducing the inflammatory
cytokines burden. <br/>Method(s): A systematic literature review with
meta-analysis was conducted regarding the main outcomes (operative
mortality, ventilation duration, intensive care unit [ICU] and hospital
stays) and day-1 inflammatory markers levels post-surgery. Fifteen (15)
studies were included for final analysis (eight randomised controlled
trials, seven observational studies) with no evidence of publication bias.
<br/>Result(s): Subgroup analysis of non-elective surgeries across
observational studies (emergency and infective endocarditis) significantly
favoured cytokine filters in terms of 30-day mortality (OR 0.40, 95% CI
0.20, 0.83; p=0.01) and shorter ICU stay (MD -42.36, 95% CI -68.07,
-16.65; p=0.001). At day-1 post-surgery, there was a significant
difference favouring the cytokine filter group in c-reactive protein (CRP)
(MD -0.71, 95% CI -0.84, -0.59; p<0.001) with no differences in white
blood count (WBC), procalcitonin (PCT), tumour necrosis factor-alpha
(TNF-alpha), IL-6, IL-8 and lactate. When comparing cytokine filters and
control across all studies there was no significant difference in
operative mortality, ventilation duration, hospital stay and ICU length of
stay. Also, there were no statistical differences in randomised controlled
trials (RCTs) using haemadsorption filters. <br/>Conclusion(s): A
significant reduction in 30-day mortality and ICU stay could be obtained
by using haemadsorption therapy during non-elective cardiac surgery,
especially emergency surgery and in patients with higher inflammatory
burden such as infective endocarditis.<br/>Copyright &#xa9; 2022

<79>
Accession Number
638711239
Title
The effect of tranexamic acid on myocardial injury in cardiac surgical
patients: a systematic review and meta-analysis.
Source
Blood coagulation & fibrinolysis : an international journal in haemostasis
and thrombosis. 33(8) (pp 429-437), 2022. Date of Publication: 01 Dec
2022.
Author
Wang X.; Li L.; He L.; Yao Y.
Institution
(Wang, Li) Department of Anesthesiology, Fuwai Yunnan Cardiovascular
Hospital, Yunnan Province, Kunming, China
(He, Yao) Department of Anesthesiology, Fuwai Hospital, National Center
for Cardiovascular Diseases, Peking Union Medical College and Chinese
Academy of Medical Sciences, Beijing, China
Publisher
NLM (Medline)
Abstract
Tranexamic acid (TXA) is one of the most commonly used antifibrinolytic
agents for surgical patients. However, the effect of TXA on myocardial
injury remains controversial. We systemically reviewed literature
regarding the effectiveness of TXA on myocardial injury in patients who
have undergone a cardiac surgery. We included all randomized controlled
trials (RCTs) comparing TXA and control (saline) in cardiac surgical
patients. Relevant studies were identified by a comprehensive electronic
literature search from database inception to 15 August 2021. A
standardized data extraction form was used to collect methodological and
outcome variables from each eligible study. We conducted a meta-analysis
to estimate the pooled effect size of TXA administration on myocardial
injury. In total, eight RCTs were identified, with 292 patients in the TXA
group, and 241 patients in saline or control group. The meta-analysis
demonstrated that patients in the TXA group had lower levels of CK-MB and
cTnI within 24 h postoperatively (CK-MB: P = 0.005; cTnI: P = 0.01),
compared with the saline group. No significant difference was found with
respect to AST level ( P = 0.71) between TXA and saline groups within 24
h postoperatively. TXA administration was found to be associated with less
myocardial injury among patients who have undergone cardiac surgery.
High-quality randomized controlled trials are warranted to further examine
the cardioprotective effects of TXA.<br/>Copyright &#xa9; 2022 Wolters
Kluwer Health, Inc. All rights reserved.

<80>
[Use Link to view the full text]
Accession Number
633230987
Title
Polygenic Contribution to Low-Density Lipoprotein Cholesterol Levels and
Cardiovascular Risk in Monogenic Familial Hypercholesterolemia.
Source
Circulation: Genomic and Precision Medicine. 13(5) (pp 515-523), 2020.
Date of Publication: 01 Oct 2020.
Author
Trinder M.; Paquette M.; Cermakova L.; Ban M.R.; Hegele R.A.; Baass A.;
Brunham L.R.
Institution
(Trinder, Brunham) Centre for Heart Lung Innovation, University of British
Columbia, Vancouver, Canada
(Trinder, Brunham) Experimental Medicine Program, University of British
Columbia, Vancouver, Canada
(Brunham) Departments of Medicine and Medical Genetics, University of
British Columbia, Vancouver, Canada
(Paquette, Baass) Nutrition, Metabolism and Atherosclerosis Clinic,
Institut de Recherches Cliniques de Montreal, QC, Canada
(Cermakova, Brunham) Healthy Heart Program Prevention Clinic, St Paul's
Hospital, Vancouver, BC, Canada
(Ban, Hegele) Departments of Medicine and Biochemistry, Schulich School of
Medicine and Dentistry and Robarts Research Institute, Western University,
London, ON, Canada
(Baass) Departments of Medicine, McGill University, Montreal, QC, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Familial hypercholesterolemia (FH) is a common autosomal
codominant genetic disorder, which causes elevated levels of low-density
lipoprotein cholesterol (LDL-C) and increased risk of premature
atherosclerotic cardiovascular disease (ASCVD). Even among individuals
with monogenic FH, there is substantial interindividual variability in
LDL-C levels and risk of ASCVD. We assessed the influence of an LDL-C
polygenic score on levels of LDL-C and risk of ASCVD for individuals with
monogenic FH. <br/>Method(s): We constructed a weighted LDL-C polygenic
score, composed of 28 single-nucleotide variants, for individuals with
monogenic FH from the British Columbia FH (n=262); Nutrition, Metabolism
and Atherosclerosis Clinic (n=552); and UK Biobank cohorts (n=306). We
assessed the association between LDL-C polygenic score with LDL-C levels
and ASCVD risk using linear regression and Cox-proportional hazard models,
respectively. ASCVD was defined as myocardial infarction, coronary or
carotid revascularization, transient ischemic attack, or stroke. The
results from individual cohorts were combined in fixed-effect
meta-analyses. <br/>Result(s): Levels of LDL-C were significantly
associated with LDL-C polygenic score in the Nutrition, Metabolism and
Atherosclerosis Clinic cohort, UK Biobank cohort, and in the meta-analysis
(beta [95% CI]=0.13 [0.072-0.19] per a 20% increase in LDL-C polygenic
score percentile, P<0.0001). Additionally, an elevated LDL-C polygenic
score (>=80th percentile) was associated with a trend towards increased
ASCVD risk in all 3 cohorts individually. This association was
statistically significant in the meta-analysis (hazard ratio [95% CI]=1.48
[1.02-2.14], P=0.04). <br/>Conclusion(s): Polygenic contributions to LDL-C
explain some of the heterogeneity in clinical presentation and ASCVD risk
for individuals with FH.<br/>Copyright &#xa9; 2020 American Heart
Association, Inc.

<81>
Accession Number
639585056
Title
The birth of an electronic chronic disease registry bank in Nigeria.
Source
International Journal of Epidemiology. Conference: IEA World Congress of
Epidemiology 2021. Virtual. 50(Supplement 1) (pp i147-i148), 2021. Date of
Publication: September 2021.
Author
Makinde O.; Mgbachi I.; Salau A.
Institution
(Makinde, Mgbachi, Salau) Viable Knowledge Masters, Gwarimpa, Nigeria
Publisher
Oxford University Press
Abstract
Background: Nigeria is rapidly undergoing epidemiological transition
resulting in a double burden of infectious and chronic diseases. Efforts
have been concentrated on addressing infectious diseases, neglecting
chronic diseases. However, the benefit of targeted chronic disease
investigation cannot be overemphasized. <br/>Method(s): We conducted a
literature search to identify ongoing chronic disease registry efforts in
Nigeria. We then contacted the researchers and obtained additional
information on the projects including information on the process for data
management and number of contributing institutions. <br/>Result(s): We
found several single institutional efforts but were able to identify five
efforts that were cross institutional and promising. These were the
Cancer, Paediatric Cardiology, Adult Cardiology, Nephrology and Cardiac
Surgery registries. Of the five, the cancer registry was well established
with an electronic system and several publications from this registry.
Next was the cardiac surgery registry with an online repository. Others
did not have proper electronic archives and were often made of single
institution efforts. <br/>Conclusion(s): To address the data management
need, we built a bank of chronic disease registries https://disreg.org/
and established partnerships with research teams. The bank is designed
with multiple levels of access control. Additional registries can be
plugged into the bank with ease. It provides a warehouse for chronic
disease researchers to archive their data in Nigeria and potentially
beyond. Key messages: The bank will enrich the data available for
investigating risk factors of chronic diseases pertinent in our
environment.

<82>
Accession Number
2021221506
Title
Bariatric surgery and cardiovascular disease: A systematic review and
meta-analysis.
Source
European Heart Journal. 43(20) (pp 1955-1969), 2022. Date of Publication:
21 May 2022.
Author
Van Veldhuisen S.L.; Gorter T.M.; Van Woerden G.; De Boer R.A.; Rienstra
M.; Hazebroek E.J.; Van Veldhuisen D.J.
Institution
(Van Veldhuisen, Hazebroek) Department of Surgery/Vitalys Clinic,
Rijnstate Hospital Arnhem, Arnhem, Netherlands
(Van Veldhuisen) Department of Surgery, Amsterdam UMC, University of
Amsterdam, Amsterdam, Netherlands
(Gorter, Van Woerden, De Boer, Rienstra, Van Veldhuisen) Department of
Cardiology, University of Groningen, University Medical Centre Groningen,
PO Box 30.001, Groningen 9700 RB, Netherlands
(Hazebroek) Division of Human Nutrition and Health, Wageningen University
& Research, Wageningen, Netherlands
Publisher
Oxford University Press
Abstract
Aims: Obesity is a global health problem, associated with significant
morbidity and mortality, often due to cardiovascular (CV) diseases. While
bariatric surgery is increasingly performed in patients with obesity and
reduces CV risk factors, its effect on CV disease is not established. We
conducted a systematic review and meta-analysis to evaluate the effect of
bariatric surgery on CV outcomes, in accordance with the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses guideline.
<br/>Methods and Results: PubMed and Embase were searched for literature
until August 2021 which compared bariatric surgery patients to
non-surgical controls. Outcomes of interest were all-cause and CV
mortality, atrial fibrillation (AF), heart failure (HF), myocardial
infarction, and stroke. We included 39 studies, all prospective or
retrospective cohort studies, but randomized outcome trials were not
available. Bariatric surgery was associated with a beneficial effect on
all-cause mortality [pooled hazard ratio (HR) of 0.55; 95% confidence
interval (CI) 0.49-0.62, P < 0.001 vs. controls], and CV mortality (HR
0.59, 95% CI 0.47-0.73, P < 0.001). In addition, bariatric surgery was
also associated with a reduced incidence of HF (HR 0.50, 95% CI 0.38-0.66,
P < 0.001), myocardial infarction (HR 0.58, 95% CI 0.43-0.76, P < 0.001),
and stroke (HR 0.64, 95% CI 0.53-0.77, P < 0.001), while its association
with AF was not statistically significant (HR 0.82, 95% CI 0.64-1.06, P =
0.12). <br/>Conclusion(s): The present systematic review and meta-analysis
suggests that bariatric surgery is associated with reduced all-cause and
CV mortality, and lowered incidence of several CV diseases in patients
with obesity. Bariatric surgery should therefore be considered in these
patients. <br/>Copyright &#xa9; The Author(s) 2022.

<83>
Accession Number
2021308281
Title
Curvularia alcornii Aortic Pseudoaneurysm Following Aortic Valve
Replacement: Case Report and Review of the Literature.
Source
Open Forum Infectious Diseases. 8(11) (no pagination), 2021. Article
Number: ofab536. Date of Publication: 01 Nov 2021.
Author
Narayanasamy S.; Williams A.R.; Schell W.A.; Moehring R.W.; Alexander
B.D.; Le T.; Bharadwaj R.A.; McGauvran M.; Schroder J.N.; Perfect J.R.
Institution
(Narayanasamy, Schell, Moehring, Alexander, Le, Perfect) Division of
Infectious Diseases, Department of Medicine, Duke University Hospital,
Durham, NC, United States
(Williams, Schroder) Division of Cardiovascular and Thoracic Surgery, Duke
University Hospital, Durham, NC, United States
(Bharadwaj) McLeod Health Infectious Diseases, McLeod Health, Florence,
SC, United States
(McGauvran) Division of Cardiothoracics, Department of Anesthesiology,
Duke University Hospital, Durham, NC, United States
Publisher
Oxford University Press
Abstract
We report the first case of Curvularia alcornii aortic pseudoaneurysm
following bioprosthetic aortic valve replacement in an immunocompetent
host. Infection was complicated by septic emboli to multiple organs.
Despite aggressive surgical intervention and antifungal therapy, infection
progressed. We review the literature on invasive Curvularia infection to
inform diagnosis and management.<br/>Copyright &#xa9; The Author(s) 2021.

<84>
Accession Number
2021071301
Title
Association of gestational diabetes mellitus with overall and type
specific cardiovascular and cerebrovascular diseases: systematic review
and meta-analysis.
Source
The BMJ. (no pagination), 2022. Article Number: e070244. Date of
Publication: 2022.
Author
Xie W.; Wang Y.; Xiao S.; Qiu L.; Yu Y.; Zhang Z.
Institution
(Xie, Zhang) Department of Rheumatology and Clinical Immunology, Peking
University First Hospital, Beijing 100034, China
(Wang, Yu) Department of Endocrinology, Peking University First Hospital,
Beijing, China
(Xiao) Department of Gastroenterology, University of Electronic Science
and Technology of China, Sichuan Provincial People's Hospital, Chengdu,
China
(Xiao) Department of Gastroenterology, Peking University Third Hospital,
Beijing, China
(Qiu) Department of Cardiology, Peking University First Hospital, Beijing,
China
Publisher
BMJ Publishing Group
Abstract
Objective: To quantify the risk of overall and type specific
cardiovascular and cerebrovascular diseases as well as venous
thromboembolism in women with a history of gestational diabetes mellitus.
<br/>Design(s): Systematic review and meta-analyses. Data sources: PubMed,
Embase, and the Cochrane Library from inception to 1 November 2021 and
updated on 26 May 2022. Review methods: Observational studies reporting
the association between gestational diabetes mellitus and incident
cardiovascular and cerebrovascular diseases were eligible. Data, pooled by
random effects models, are presented as risk ratios (95% confidence
intervals). Certainty of evidence was appraised by the Grading of
Recommendations, Assessment, Development, and Evaluations. <br/>Result(s):
15 studies rated as moderate or serious risk of bias were included. Of 513
324 women with gestational diabetes mellitus, 9507 had cardiovascular and
cerebrovascular disease. Of more than eight million control women without
gestational diabetes, 78 895 had cardiovascular and cerebrovascular
disease. Compared with women without gestational diabetes mellitus, women
with a history of gestational diabetes mellitus showed a 45% increased
risk of overall cardiovascular and cerebrovascular diseases (risk ratio
1.45, 95% confidence interval 1.36 to 1.53), 72% for cardiovascular
diseases (1.72, 1.40 to 2.11), and 40% for cerebrovascular diseases (1.40,
1.29 to 1.51). Women with gestational diabetes mellitus showed increased
risks of incident coronary artery diseases (1.40, 1.18 to 1.65),
myocardial infarction (1.74, 1.37 to 2.20), heart failure (1.62, 1.29 to
2.05), angina pectoris (2.27, 1.79 to 2.87), cardiovascular procedures
(1.87, 1.34 to 2.62), stroke (1.45, 1.29 to 1.63), and ischaemic stroke
(1.49, 1.29 to 1.71). The risk of venous thromboembolism was observed to
increase by 28% in women with previous gestational diabetes mellitus
(1.28, 1.13 to 1.46). Subgroup analyses of cardiovascular and
cerebrovascular disease outcomes stratified by study characteristics and
adjustments showed significant differences by region (P=0.078), study
design (P=0.02), source of data (P=0.005), and study quality (P=0.04),
adjustment for smoking (P=0.03), body mass index (P=0.01), and
socioeconomic status (P=0.006), and comorbidities (P=0.05). The risk of
cardiovascular and cerebrovascular diseases was, however, attenuated but
remained significant when restricted to women who did not develop
subsequent overt diabetes (all gestational diabetes mellitus: 1.45, 1.33
to 1.59, gestational diabetes mellitus without subsequent diabetes: 1.09,
1.06 to 1.13). Certainty of evidence was judged as low or very low
quality. <br/>Conclusion(s): Gestational diabetes mellitus is associated
with increased risks of overall and type specific cardiovascular and
cerebrovascular diseases that cannot be solely attributed to conventional
cardiovascular risk factors or subsequent diabetes. <br/>Copyright &#xa9;
Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ.

<85>
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

<86>
Accession Number
2017978118
Title
Negative interaction between nitrates and remote ischemic preconditioning
in patients undergoing cardiac surgery: the ERIC-GTN and ERICCA studies.
Source
Basic Research in Cardiology. 117(1) (no pagination), 2022. Article
Number: 31. Date of Publication: December 2022.
Author
Hamarneh A.; Ho A.F.W.; Bulluck H.; Sivaraman V.; Ricciardi F.; Nicholas
J.; Shanahan H.; Hardman E.A.; Wicks P.; Ramlall M.; Chung R.; McGowan J.;
Cordery R.; Lawrence D.; Clayton T.; Kyle B.; Xenou M.; Ariti C.; Yellon
D.M.; Hausenloy D.J.
Institution
(Hamarneh, Sivaraman, Ramlall, Chung, McGowan, Xenou, Yellon, Hausenloy)
Institute of Cardiovascular Sciences, The Hatter Cardiovascular Institute,
University College London, London WC1E 6HX, United Kingdom
(Ho) Department of Emergency Medicine, Singapore General Hospital,
Singapore, Singapore
(Ho) Pre-Hospital and Emergency Research Centre, Health Services and
Systems Research, Duke-NUS Medical School, Singapore, Singapore
(Bulluck) Leeds Institute of Cardiovascular and Metabolic Medicine,
University of Leeds, Leeds, United Kingdom
(Bulluck) Department of Cardiology, Leeds Teaching Hospitals NHS Trust,
Leeds, United Kingdom
(Ricciardi) Department of Statistical Science, University College London,
London, United Kingdom
(Nicholas, Clayton) Clinical Trials Unit and Department of Medical
Statistics, London School of Hygiene and Tropical Medicine, London, United
Kingdom
(Shanahan, Lawrence, Kyle) University College London Hospitals NHS
Foundation Trust, London, United Kingdom
(Hardman, Wicks) University Hospital Southampton NHS Foundation Trust,
London, United Kingdom
(Cordery) Barts Heart Centre, King's College London, London, United
Kingdom
(Ariti) University Hospital of Wales, Heath Park, Cardiff CF14 4YS, United
Kingdom
(Hausenloy) Cardiovascular and Metabolic Disorders Program, Duke-National
University of Singapore Medical School, Singapore, Singapore
(Hausenloy) National Heart Research Institute Singapore, National Heart
Centre Singapore, Singapore, Singapore
(Hausenloy) Yong Loo Lin School of Medicine, National University
Singapore, Singapore, Singapore
(Hausenloy) Cardiovascular Research Center, College of Medical and Health
Sciences, Asia University, Taichung City, Taiwan (Republic of China)
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Remote ischaemic preconditioning (RIPC) using transient limb ischaemia
failed to improve clinical outcomes following cardiac surgery and the
reasons for this remain unclear. In the ERIC-GTN study, we evaluated
whether concomitant nitrate therapy abrogated RIPC cardioprotection. We
also undertook a post-hoc analysis of the ERICCA study, to investigate a
potential negative interaction between RIPC and nitrates on clinical
outcomes following cardiac surgery. In ERIC-GTN, 185 patients undergoing
cardiac surgery were randomized to: (1) Control (no RIPC or nitrates); (2)
RIPC alone; (3); Nitrates alone; and (4) RIPC + Nitrates. An intravenous
infusion of nitrates (glyceryl trinitrate 1 mg/mL solution) was commenced
on arrival at the operating theatre at a rate of 2-5 mL/h to maintain a
mean arterial pressure between 60 and 70 mmHg and was stopped when the
patient was taken off cardiopulmonary bypass. The primary endpoint was
peri-operative myocardial injury (PMI) quantified by a 48-h
area-under-the-curve high-sensitivity Troponin-T (48 h-AUC-hs-cTnT). In
ERICCA, we analysed data for 1502 patients undergoing cardiac surgery to
investigate for a potential negative interaction between RIPC and nitrates
on clinical outcomes at 12-months. In ERIC-GTN, RIPC alone reduced 48
h-AUC-hs-cTnT by 37.1%, when compared to control (ratio of AUC 0.629 [95%
CI 0.413-0.957], p = 0.031), and this cardioprotective effect was
abrogated in the presence of nitrates. Treatment with nitrates alone did
not reduce 48 h-AUC-hs-cTnT, when compared to control. In ERICCA there was
a negative interaction between nitrate use and RIPC for all-cause and
cardiovascular mortality at 12-months, and for risk of peri-operative
myocardial infarction. RIPC alone reduced the risk of peri-operative
myocardial infarction, compared to control, but no significant effect of
RIPC was demonstrated for the other outcomes. When RIPC and nitrates were
used together they had an adverse impact in patients undergoing cardiac
surgery with the presence of nitrates abrogating RIPC-induced
cardioprotection and increasing the risk of mortality at 12-months
post-cardiac surgery in patients receiving RIPC.<br/>Copyright &#xa9;
2022, The Author(s).

<87>
[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.

<88>
[Use Link to view the full text]
Accession Number
2021157249
Title
Anaesthesia administered as S(+)-ketamine for cardiac intervention in
children with common congenital heart disease.
Source
Medicine (United States). 101(44) (pp E31624), 2022. Date of Publication:
04 Nov 2022.
Author
Liu W.; Xu F.; Guo L.; Li H.; Zhao L.; Ma J.
Institution
(Liu, Xu, Guo, Li, Zhao, Ma) Department of Anesthesiology, Beijing Anzhen
Hospital, Capital Medical University, Beijing 100029, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Safety and efficacy were assessed of different S(+)-ketamine
doses combined with propofol administered as anesthesia to common
pediatric congenital heart disease (CHD) patients undergoing cardiac
interventional surgery to provide reference data as guidance for use in
clinical settings. <br/>Method(s): Sixty CHD children admitted to Beijing
Anzhen Hospital, Capital Medical University from December 2020 to December
2021 who underwent elective cardiac intervention were assigned to 3 groups
(H, L, M, 20 patients/group) using a random number table-based method.
Patients received 1% propofol (2 mg/kg) and intravenous injections of
S(+)-ketamine (Group L, 0.4 mg/kg; Group M, 0.5 mg/kg; Group H, 0.6 mg/kg)
followed by intravenous pumping of 1% propofol (4-6 mg/kg/h). Heart rate
(HR), mean arterial pressure, and pulse oxygen saturation were recorded
preoperatively (T0), at the time of anesthesia maintenance (T1), at the
time of arteriovenous puncture (T2), and when they awakened (T3).
Additionally, propofol dose and incidence rates of intraoperative body
movement, postoperative agitation, and postoperative nausea/vomiting were
recorded. <br/>Result(s): For the 3 groups, Group H awakening time was
significantly longer than that of Group L (P = .039). Notably, intergroup
intraoperative propofol times differed significantly (P = .009).
Meanwhile, T0 to T3 intragroup HR values differences were significant (P =
.017; P = .001; P = .005, respectively). Group L HR was significantly
elevated at T2 relative to T0 (P = .003), Group M HR was significantly
elevated at T1 and T2 relative to T0 (P = .019; P = .003, respectively),
and Group H HR values were significantly elevated at T1 and T2 relative to
T0 (P = .012; P = .005, respectively). At all 4 time points no
statistically significant intergroup differences in mean arterial pressure
values were observed (P = .587). T1 to T3 pulse oxygen saturation values
for all 3 groups were significantly greater than corresponding T0 values.
Although intergroup intraoperative body movement incidence differed
significantly (P = .044), intergroup differences in awakening time
agitation and postoperative nausea/vomiting incidence rates were
insignificant (P = .732, P = .887, respectively). <br/>Conclusion(s): Use
of 0.6 mg/kg S(+)-ketamine with propofol was most effective as anesthesia
for common pediatric CHD patients undergoing cardiac interventional
surgery.<br/>Copyright &#xa9; 2022 the Author(s). Published by Wolters
Kluwer Health, Inc. This is an open access article distributed under the
Creative Commons Attribution License 4.0 (CCBY), which permits
unrestricted use, distribution, and reproduction in any medium, provided
the original work is properly cited.

<89>
Accession Number
2020982989
Title
Prediction of Survival After Implantation of a Fully Magnetically
Levitated Left Ventricular Assist Device.
Source
JACC: Heart Failure. 10(12) (pp 948-959), 2022. Date of Publication:
December 2022.
Author
Mehra M.R.; Nayak A.; Morris A.A.; Lanfear D.E.; Nemeh H.; Desai S.;
Bansal A.; Guerrero-Miranda C.; Hall S.; Cleveland J.C.; Goldstein D.J.;
Uriel N.; Chen L.; Bailey S.; Anyanwu A.; Heatley G.; Chuang J.; Estep
J.D.
Institution
(Mehra) Brigham and Women's Hospital, Boston, MA, United States
(Nayak, Morris) Emory University, Atlanta, GA, United States
(Lanfear, Nemeh) Henry Ford Hospital, Detroit, MI, United States
(Desai, Bansal) Ochsner Medical Center, New Orleans, LA, United States
(Guerrero-Miranda, Hall) Baylor University Medical Center, Dallas, TX,
United States
(Cleveland) University of Colorado School of Medicine, Aurora, CO, United
States
(Goldstein) Montefiore Einstein Center for Heart and Vascular Care, New
York, NY, United States
(Uriel) NewYork-Presbyterian Hospital, Columbia University College of
Physicians and Surgeons, New York, NY, United States
(Chen) University of Rochester Medical Center, Rochester, NY, United
States
(Bailey) Allegheny Health Network, Pittsburgh, PA, United States
(Anyanwu) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Heatley, Chuang) Abbott, Abbott Park, IL, United States
(Estep) Cleveland Clinic Florida, Weston, FL, United States
Publisher
Elsevier Inc.
Abstract
Background: Clinical trials inform on average efficacy, but individualized
risk assessments for outcome prediction are important in guiding treatment
implementation. <br/>Objective(s): The authors developed and validated a
patient-specific risk score to predict survival at 1 and 2 years after
HeartMate 3 (HM3) left ventricular assist device (LVAD) implantation.
<br/>Method(s): The MOMENTUM 3 (Multicenter Study of MagLev Technology in
Patients Undergoing Mechanical Circulatory Support Therapy with HeartMate
3) trial includes 2,200 HM3 LVAD patients in the pivotal trial and
Continued Access Protocol study (2014-2018). The authors randomly assigned
all patients to a derivation cohort (n = 1,540) or validation cohort (n =
660). Univariate mortality predictors were screened for potential model
inclusion, stepwise selection was used to build the multivariable Cox
proportional hazards regression model, and performance (discrimination and
calibration) was evaluated. <br/>Result(s): Age, prior cardiac surgery
(coronary artery bypass grafting [CABG] or valve procedure), lower serum
sodium, higher blood urea nitrogen (BUN), small left ventricular size, and
right atrial pressure-to-pulmonary capillary wedge pressure (RAP/PCWP)
ratio >0.6 were significant risk factors for mortality. Receiver-operating
characteristic (ROC) analysis in the validation cohort demonstrated an
area under the curve (AUC) of 0.76 (95% CI: 0.70-0.81) at 1 year and 0.71
(95% CI: 0.66-0.77) at 2 years. Calibration between predicted and observed
survival of the risk quintiles was high, with Pearson correlation
coefficients of 0.986 and 0.994 at 1 and 2 years, respectively. Patients
were successfully stratified into tertiles with higher-than-average,
average, and lower-than-average survival, and observed mortality risk
increased by 2-fold from one tertile to the next. <br/>Conclusion(s): A
practical, easy-to-use HM3 Survival Risk Score with 6 components was
developed to accurately predict 1- and 2-year survival after HM3 LVAD
implantation. The survival risk score can be used to provide individual
survival estimates to facilitate shared decision making when considering
HM3 LVAD therapy. (MOMENTUM 3 Trial Portfolio; NCT02224755,
NCT02892955)<br/>Copyright &#xa9; 2022 The Authors

<90>
Accession Number
639562239
Title
Prothrombin complex concentrate in cardiac surgery for the treatment of
coagulopathic bleeding.
Source
Cochrane Database of Systematic Reviews. 2022(11) (no pagination), 2022.
Article Number: CD013551. Date of Publication: 21 Nov 2022.
Author
Hayes K.; Fernando M.C.; Jordan V.
Institution
(Hayes, Fernando) Department of Cardiothoracic and ORL Anaesthesia,
Auckland City Hospital, Auckland, New Zealand
(Jordan) Department of Obstetrics and Gynaecology, Faculty of Medical and
Health Sciences, The University of Auckland, Auckland, New Zealand
Publisher
John Wiley and Sons Ltd
Abstract
Background: Coagulopathy following cardiac surgery is associated with
considerable blood product transfusion and high morbidity and mortality.
The treatment of coagulopathy following cardiac surgery is challenging,
with the replacement of clotting factors being based on transfusion of
fresh frozen plasma (FFP). Prothrombin complex concentrate (PCCs) is an
alternative method to replace clotting factors and warrants evaluation.
PCCs are also an alternative method to treat refractory ongoing bleeding
post-cardiac surgery compared to recombinant factor VIIa (rFVIIa) and also
warrants evaluation. <br/>Objective(s): Assess the benefits and harms of
PCCs in people undergoing cardiac surgery who have coagulopathic
non-surgical bleeding. <br/>Search Method(s): We searched the Cochrane
Central Register of Controlled Trials (CENTRAL) in the Cochrane Library,
MEDLINE, Embase and Conference Proceedings Citation Index-Science (CPCI-S)
on the Web of Science on 20 April 2021. We searched Clinicaltrials.gov
(www.clinicaltrials.gov), and the World Health Organisation (WHO)
International Clinical Trials Registry Platform (ICTRP;
apps.who.int/trialsearch/), for ongoing or unpublished trials. We checked
the reference lists for additional references. We did not limit the
searches by language or publication status. <br/>Selection Criteria: We
included randomised controlled trials (RCTs) and non-randomised trials
(NRSs). <br/>Data Collection and Analysis: We used standard methodological
procedures expected by Cochrane. <br/>Main Result(s): Eighteen studies
were included (4993 participants). Two were RCTs (151 participants) and 16
were NRSs. Both RCTs had low risk of bias (RoB) in almost all domains. Of
the 16 NRSs, 14 were retrospective cohort analyses with one prospective
study and one case report. The nine studies used in quantitative analysis
were judged to have critical RoB, three serious and three moderate. 1. PCC
versus standard treatment. Evidence from RCTs showed PCCs are likely to
reduce the number of units transfused compared to standard care (MD -0.89,
95% CI -1.78 to 0.00; participants = 151; studies = 2; moderate-quality
evidence). Evidence from NRSs agreed with this, showing that PCCs may
reduce the mean number of units transfused compared to standard care but
the evidence is uncertain (MD -1.87 units, 95% CI -2.53 to -1.20;
participants = 551; studies = 2; very low-quality evidence). There was no
evidence from RCTs showing a difference in the incidence of red blood cell
(RBC) transfusion compared to standard care (OR 0.53, 95% CI 0.20 to 1.40;
participants = 101; studies = 1; low-quality evidence). Evidence from NRSs
disagreed with this, showing that PCCs may reduce the mean number of units
transfused compared to standard care but the evidence is uncertain (OR
0.54, 95% CI 0.30 to 0.98; participants = 1046; studies = 4; low-quality
evidence). There was no evidence from RCTs showing a difference in the
number of thrombotic events with PCC compared to standard care (OR 0.68
95% CI 0.20 to 2.31; participants = 152; studies = 2; moderate-quality
evidence). This is supported by NRSs, showing that PCCs may have no effect
on the number of thrombotic events compared to standard care but the
evidence is very uncertain (OR 1.32, 95% CI 0.87 to 1.99; participants =
1359; studies = 7; very low-quality evidence). There was no evidence from
RCTs showing a difference in mortality with PCC compared to standard care
(OR 0.53, 95% CI 0.12 to 2.35; participants = 149; studies = 2;
moderate-quality evidence). This is supported by evidence from NRSs,
showing that PCCs may have little to no effect on mortality compared to
standard care but the evidence is very uncertain (OR 1.02, 95% CI 0.69 to
1.51; participants = 1334; studies = 6; very low-quality evidence).
Evidence from RCTs indicated that there was little to no difference in
postoperative bleeding (MD -107.05 mLs, 95% CI -278.92 to 64.83;
participants = 151, studies = 2; low-quality evidence). PCCs may have
little to no effect on intensive care length of stay (RCT evidence: MD
-0.35 hours, 95% CI -19.26 to 18.57; participants = 151; studies = 2;
moderate-quality evidence) (NRS evidence: MD -18.00, 95% CI -43.14 to
7.14; participants = 225; studies = 1; very low-quality evidence) or
incidence of renal replacement therapy (RCT evidence: OR 0.72, 95% CI 0.14
to 3.59; participants = 50; studies = 1; low-quality evidence) (NRS
evidence: OR 1.46, 95% CI 0.71 to 2.98; participants = 684; studies = 2;
very low-quality evidence). No studies reported on additional adverse
outcomes. 2. PCC versus rFVIIa. For this comparison, all evidence was
provided from NRSs. PCC likely results in a large reduction of RBCs
transfused intra-operatively in comparison to rFVIIa (MD-4.98 units, 95%
CI -6.37 to -3.59; participants = 256; studies = 2; moderate-quality
evidence). PCC may have little to no effect on the incidence of RBC units
transfused comparative to rFVIIa; evidence is very uncertain (OR 0.16, 95%
CI 0.02 to 1.56; participants = 150; studies = 1; very low-quality
evidence). PCC may have little to no effect on the number of thrombotic
events comparative to rFVIIa; evidence is very uncertain (OR 0.51, 95% CI
0.23 to 1.16; participants = 407; studies = 4; very low-quality evidence).
PCC may have little to no effect on the incidence of mortality (OR 1.07,
95% CI 0.38 to 3.03; participants = 278; studies = 3; very low-quality
evidence) or intensive care length of stay comparative to rFVIIa (MD -40
hours, 95% CI -110.41 to 30.41; participants = 106; studies = 1; very
low-quality evidence); evidence is very uncertain. PCC may reduce bleeding
(MD -674.34 mLs, 95% CI -906.04 to -442.64; participants = 150; studies =
1; very low-quality evidence) and incidence of renal replacement therapy
(OR 0.29, 95% CI 0.12 to 0.71; participants = 106; studies = 1; very
low-quality evidence) comparative to rFVIIa; evidence is very uncertain.
No studies reported on other adverse events. Authors' conclusions: PCCs
could potentially be used as an alternative to standard therapy for
coagulopathic bleeding post-cardiac surgery compared to FFP as shown by
moderate-quality evidence and it may be an alternative to rFVIIa in
refractory non-surgical bleeding but this is based on moderate to very low
quality of evidence.<br/>Copyright &#xa9; 2022 The Cochrane Collaboration.
Published by John Wiley & Sons, Ltd.

<91>
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.

<92>
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.

<93>
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.

<94>
Accession Number
2020217776
Title
The Efficacy and Safety of Direct Oral Anticoagulants versus Standard of
Care in Patients without an Indication of Anti-Coagulants after
Transcatheter Aortic Valve Replacement: A Meta-Analysis of Randomized
Controlled Trials.
Source
Journal of Clinical Medicine. 11(22) (no pagination), 2022. Article
Number: 6781. Date of Publication: November 2022.
Author
Abuelazm M.; Abdelazeem B.; Katamesh B.E.; Gamal M.; Simhachalam
Kutikuppala L.V.; Kheiri B.; Brasic J.R.; Paul T.K.
Institution
(Abuelazm, Katamesh, Gamal) Faculty of Medicine, Tanta University, Tanta
31527, Egypt
(Abdelazeem) Department of Internal Medicine, McLaren Health Care, Flint,
MI 48532, United States
(Abdelazeem) Department of Internal Medicine, Michigan State University,
East Lansing, MI 48823, United States
(Simhachalam Kutikuppala) Faculty of Modern Medicine, Dr. N.T.R.
University of Health Sciences, Andhra Pradesh, Vijayawada 520008, India
(Kheiri) Electrophysiology and Arrhythmias Service, Division of
Cardiology, Department of Medicine, University of California, San
Francisco, CA 94117, United States
(Brasic) Section of High-Resolution Brain Positron Emission Tomography
Imaging, Division of Nuclear Medicine and Molecular Imaging, The Russell
H. Morgan, Department of Radiology and Radiological Science, The Johns
Hopkins University School of Medicine, Baltimore, MD 21287, United States
(Paul) Department of Clinical Medical Education, The University of
Tennessee Health Sciences Center at Nashville, Nashville, TN 38163, United
States
Publisher
MDPI
Abstract
Transcatheter aortic valve replacement (TAVR) is now considered the
mainstay of aortic stenosis management; however, the optimal
antithrombotic therapy in patent without indications for an oral
anticoagulant (OAC) is yet to be identified. Therefore, we conducted a
systematic review and meta-analysis to evaluate the efficacy and safety of
direct oral anticoagulant (DOAC) treatment versus the standard of care in
patients without indications of OACs after TAVR. We synthesized randomized
controlled trials (RCTs) from Web of Science, SCOPUS, EMBASE, PubMed, and
Cochrane until 18 August 2022. We used the risk ratio (RR) for dichotomous
outcomes with the corresponding 95% confidence interval (CI). We
registered our protocol in PROSPERO with ID: CRD42022357027. Three RCTs
with 2922 patients were identified. DOACs were significantly associated
with higher incidence of all-cause mortality (RR: 1.68 with 95% CI [1.22,
2.30], p = 0.001), mortality due to non-cardiovascular causes (RR: 2.34
with 95% CI [1.36, 4.02], p = 0.002), and the composite outcome of death,
myocardial infarction, or stroke (RR: 1.41 with 95% CI [1.13, 1.76], p =
0.002). However, DOACs were associated with decreased incidence of reduced
leaflet motion (RLM) (RR: 0.19 with 95% CI [0.09, 0.41], p = 0.0001) and
hypoattenuated leaflet thickening (HALT) (RR: 0.50 with 95% CI [0.36,
0.70], p = 0.0001). DOACs were effective to reduce RLM and HALT; however,
the clinical effect of this is still controversial. DOACs were associated
with worse efficacy and safety outcomes, including all-cause mortality.
Further RCTs investigating the optimal antithrombotic regimen after
TAVR.<br/>Copyright &#xa9; 2022 by the authors.

<95>
Accession Number
639578950
Title
Percutaneous Coronary Intervention of Native Coronary Artery versus
Saphenous Vein Graft in Patients with Prior Coronary Artery Bypass Graft
Surgery: Rationale and Design of the Multicenter, Randomized PROCTOR
Trial.
Source
American heart journal. (no pagination), 2022. Date of Publication: 18
Nov 2022.
Author
de Winter R.W.; Walsh S.J.; Hanratty C.G.; Spratt J.C.; Sprengers R.W.;
Twisk J.W.; Vegting I.; Schumacher S.P.; Bom M.J.; Hoek R.; Verouden N.J.;
Delewi R.; Nap A.; Knaapen P.
Institution
(de Winter) Department of Cardiology, Heart Center Amsterdam, Amsterdam,
Netherlands
(Walsh) Department of Cardiology, Belfast Health and Social Care Trust,
Royal Victoria Hospital, Belfast, United Kingdom
(Hanratty) Heart &amp; Vascular Centre, Mater Private Day Hospital,
Dublin, Ireland
(Spratt) Department of Cardiology, St George's University Hospital NHS
Trust, London, United Kingdom
(Sprengers) Department of Radiology &amp; Nuclear Medicine, Amsterdam UMC,
Amsterdam, the Netherlands
(Twisk) Department of Epidemiology &amp; Data Science, Amsterdam UMC,
Amsterdam, the Netherlands
(Vegting, Schumacher, Bom, Hoek, Verouden, Delewi, Nap, Knaapen)
Department of Cardiology, Heart Center Amsterdam, Amsterdam, Netherlands
Publisher
NLM (Medline)
Abstract
BACKGROUND: Patients with prior coronary artery bypass grafting (CABG)
frequently require repeat percutaneous revascularization due to advanced
age, progressive coronary artery disease and bypass graft failure.
Percutaneous coronary intervention (PCI) of either the bypass graft or the
native coronary artery may be performed. Randomized trials comparing
native vessel PCI with bypass graft PCI are lacking and long-term outcomes
have not been reported. STUDY DESIGN: PROCTOR (NCT03805048) is a
prospective, multicenter, randomized controlled trial, that will include
584 patients presenting with saphenous vein graft (SVG) failure and a
clinical indication for revascularization, as determined by the local
Heart Team. The trial is designed to compare the clinical and angiographic
outcomes in patients randomly allocated in a 1:1 fashion to either a
strategy of native vessel PCI or SVG PCI. The primary study endpoint is a
3-year composite of major adverse cardiac events (MACE: all-cause
mortality, non-fatal target coronary territory myocardial infarction [MI],
or clinically driven target coronary territory revascularization). At
3-years, after evaluation of the primary endpoint, follow-up invasive
coronary angiography will be performed. Secondary endpoints comprise
individual components of MACE at 1, 3 and 5 years follow-up, PCI-related
MI, MI &gt;48 hours after index PCI, target vessel failure, target lesion
revascularization, renal failure requiring renal-replacement therapy,
angiographic outcomes at 3-years and quality of life (delta Seattle Angina
Questionnaire, Canadian Cardiovascular Society Grading Scale and Rose
Dyspnea Scale). <br/>CONCLUSION(S): PROCTOR is the first randomized trial
comparing an invasive strategy of native coronary artery PCI with SVG PCI
in post-CABG patients presenting with SVG failure.<br/>Copyright &#xa9;
2022. Published by Elsevier Inc.

<96>
Accession Number
639578869
Title
BA lloon Expandable vs. SElf Expanding Transcatheter VaLve for Degenerated
BioprosthesIs: Design and Rationale of the BASELINE Trial.
Source
American heart journal. (no pagination), 2022. Date of Publication: 18
Nov 2022.
Author
Nuis R.-J.; van Belle E.; Teles R.; Blackman D.; Veulemans V.; Santos
I.A.; Pilgrim T.; Tarantini G.; Saia F.; Iakovou I.; Mascherbauer J.;
Vincent F.; Geleijnse M.; Sathananthan J.; Wood D.; Makkar R.; Van Mieghem
N.M.
Institution
(Nuis, Geleijnse) Department of Cardiology, Erasmus University Medical
Center, Rotterdam, Netherlands
(van Belle, Vincent) Department of Cardiology, CHU Lille, Lille, France
(Teles) Hospital de Santa Cruz, CHLO; Nova Medical School, CEDOC, Lisbon,
Portugal
(Blackman) Department of Cardiology, Leeds Teaching Hospitals NHS Trust,
United Kindom, Leeds, United Kingdom
(Veulemans) Division of Cardiology, Heinrich Heine University Medical
Center Dusseldorf, Dusseldorf, Germany
(Santos) Departamento de Cardiologia, Hospital Clinico Universitario,
Valladolid, Spain
(Pilgrim) Department of Cardiology, Bern University Hospital, University
of Bern, Bern, Switzerland
(Tarantini) Department of Cardiac, Thoracic, Vascular Science and Public
Health, University of Padova, Padua, Italy
(Saia) U.O. Cardiologia, Dipartimento Cardio-Toraco-Vascolare, Azienda
Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi,
Bologna, Italy
(Iakovou) Department of Cardiology, Onassis Cardiac Surgery Center,
Athens, Greece
(Mascherbauer) Department of Cardiology, University Hospital St. Polten,
Austria
(Sathananthan, Wood) Centre for Cardiovascular and Heart Valve Innovation,
St. Paul's and Vancouver General Hospital, Vancouver, Canada
(Makkar) Department of Cardiology, Cedars-Sinai Medical Center, Los
Angeles, United States
(Van Mieghem) Department of Cardiology, Erasmus University Medical Center,
Rotterdam, Netherlands
Publisher
NLM (Medline)
Abstract
BACKGROUND: Surgical aortic valve bioprostheses may degenerate over time
and require redo intervention. Transcatheter aortic valve replacement
(TAVR) is a less invasive alternative to redo surgery. The BAlloon
Expandable vs. SElf Expanding Transcatheter VaLve for Degenerated
BioprosthesIs (BASELINE) trial was designed to compare the performance of
the balloon-expandable SAPIEN-3 Ultra and the self-expanding EVOLUT PRO+
valve systems in symptomatic patients with a failing surgical
bioprosthesis. <br/>METHOD(S): The BASELINE trial is an
investigator-initiated, non-funded, prospective, randomized, open-label,
superiority trial enrolling a total of 440 patients in up to 50 sites in
12 countries in Europe and North-America. The primary endpoint is device
success at 30-days defined by the Valve Academic Research Consortium-3
Criteria as the composite of technical success, freedom from mortality,
freedom for surgery or intervention related to the device or to a major
vascular or access-related or cardiac structural complication with an
intended performance of the valve (mean gradient <20 mmHg and less than
moderate aortic regurgitation). The co-primary endpoint at 1 year is
defined as the composite of all-cause death, disabling stroke,
rehospitalization for heart failure or valve related problems. Independent
Core Laboratories will conduct uniform analyses of echocardiography (pre-,
post-, 1-year post-procedure), multi-sliced computed tomography (pre-, and
if available post-procedure) and cine-fluoroscopy studies.
<br/>CONCLUSION(S): The BASELINE trial is a head-to-head comparative trial
investigating the two most used contemporary transcatheter heart valves
for the treatment of a failing surgical aortic bioprosthesis.
(ClinicalTrials.gov number NCT04843072).<br/>Copyright &#xa9; 2022.
Published by Elsevier Inc.

<97>
Accession Number
639576094
Title
The Effects of Mineralocorticoid Receptor Antagonists on Cardiovascular
Outcomes in Patients With End-Stage Renal Disease and Heart Failure.
Source
European journal of heart failure. (no pagination), 2022. Date of
Publication: 20 Nov 2022.
Author
Lin D.S.-H.; Lin F.-J.I.; Lin Y.-S.; Lee J.-K.; Lin Y.-H.
Institution
(Lin, Lee, Lin) Division of Cardiology, Department of Internal Medicine,
National Taiwan University Hospital, Taipei, Taiwan (Republic of China)
(Lin) Division of Cardiology, Department of Internal Medicine, National
Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan (Republic of
China)
(Lin) School of Pharmacy, College of Medicine, National Taiwan University,
Taipei, Taiwan (Republic of China)
(Lin) Department of Pharmacy, National Taiwan University Hospital, Taipei,
Taiwan (Republic of China)
(Lin) Graduate Institute of Clinical Pharmacy, College of Medicine,
National Taiwan University, Taipei, Taiwan (Republic of China)
(Lin) Division of Cardiology, Department of Internal Medicine, Chang Gung
Memorial Hospital, Chiayi, Taiwan (Republic of China)
(Lin) College of Medicine, Graduate Institute of Clinical Medical
Sciences, Chang Gung University, Taoyuan City, Taiwan (Republic of China)
(Lee) Department of Internal Medicine, National Taiwan University College
of Medicine, Taipei, Taiwan (Republic of China)
(Lee, Lin) Department of Laboratory Medicine, National Taiwan University
College of Medicine, Taipei, Taiwan (Republic of China)
(Lee, Lin) Cardiovascular Center, National Taiwan University Hospital,
Taipei, Taiwan (Republic of China)
(Lee) Telehealth Center, National Taiwan University Hospital, Taipei,
Taiwan (Republic of China)
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To evaluate the effects of mineralocorticoid receptor
antagonists (MRAs) on cardiovascular outcomes in patients with heart
failure under maintenance dialysis in a real-world setting. BACKGROUND:
MRAs have been shown to provide survival benefits in patients with heart
failure; however, MRA use in patients with chronic kidney disease has been
limited by safety concerns. The effects of MRAs on outcomes in patients
with end-stage renal disease (ESRD) and heart failure remain unknown.
<br/>METHOD(S): A retrospective cohort study was conducted by collecting
data from the Taiwan National Health Insurance Research Database (NHIRD).
Patients diagnosed with heart failure and ESRD and who started maintenance
dialysis between January 1, 2001, and December 31, 2013, were identified.
Patients were grouped according to MRA prescription. The outcomes of
interest included cardiovascular death (CV death), hospitalization for
heart failure (HHF), all-cause mortality, acute myocardial infarction
(AMI), ischemic stroke, any coronary revascularization procedures, and
new-onset hyperkalemia. Propensity score matching was performed at a 1:3
ratio between MRA users and non-users to minimize selection bias.
<br/>RESULT(S): A total of 50,872 patients who satisfied our inclusion and
exclusion criteria were identified. After 1:3 matching, 2,176 patients
were included in the MRA group, and 6,528 patients were included in the
non-MRA group. The risk of CV death was significantly lower among patients
who received MRAs than those who did not (hazard ratio [HR] 0.88, 95%
confidence interval [95% CI] 0.80-0.95), as was the risk of all-cause
mortality (HR 0.88, 95% CI 0.83-0.94). Reductions in the risks of CV death
and all-cause mortality were more prominent among patients undergoing
hemodialysis and those with coronary artery disease. <br/>CONCLUSION(S):
In patients undergoing regular dialysis who are diagnosed with heart
failure, the use of MRAs is associated with lower risks of all-cause
mortality and CV death. The benefits of MRA treatment in heart failure may
persist in patients with ESRD. Further investigations through randomized
controlled trials are needed to assess the efficacy and safety of MRAs in
this high-risk population. This article is protected by copyright. All
rights reserved.

<98>
Accession Number
639575603
Title
Fascia Iliaca Block Reduces Remifentanil Requirement in Conscious Sedation
for Transcatheter Aortic Valve Implantation- A Randomized Clinical Trial.
Source
Circulation journal : official journal of the Japanese Circulation
Society. (no pagination), 2022. Date of Publication: 18 Nov 2022.
Author
Kinoshita H.; Yamamoto M.; Adachi Y.; Yamaguchi R.; Takemura A.
Institution
(Kinoshita) Department of Dental Anesthesiology, Institute of Biomedical
Sciences, Tokushima University Graduate School
(Kinoshita) Department of Anesthesiology and Intensive Care, Hamamatsu
Medical University
(Kinoshita) Department of Anesthesiology, Toyohashi Heart Center
(Yamamoto, Adachi, Yamaguchi, Takemura) Department of Cardiology,
Toyohashi Heart Center
Publisher
NLM (Medline)
Abstract
BACKGROUND: Whether nerve block improves the quality of conscious sedation
(CS) in patients undergoing transcatheter aortic valve implantation (TAVI)
is unclear. This study investigated whether fascia iliaca block (FIB)
reduced the remifentanil requirement and relieved pain in CS for
TAVI.Methods and Results: This prospective study randomized 72 patients
scheduled for elective TAVI under CS into 2 groups, with (FIB) and without
(control) FIB (n=36 in each group). The sedation targeted a Bispectral
Index <90 with a Richmond Agitation-Sedation Scale of -2 to -1.
Dexmedetomidine (0.7 microg/kg, i.v.) combined with remifentanil (0.03
microg/kg/min, i.v.) and propofol (0.3 mg/kg/h, i.v.) was used to commence
sedation. FIB using 30 mL of 0.185% ropivacaine was implemented 2 min
before TAVI. Patient sedation was maintained with dexmedetomidine (0.4
microg/kg/h, i.v.) supplemented with remifentanil (0-0.02 microg/kg/min,
i.v.). Remifentanil (20 microg, i.v.) was used as a rescue dose for
intraprocedural pain. Compared with the control group, FIB reduced the
both the total (median [interquartile range] 83.0 [65.0-98.0] vs. 34.5
[26.0/45.8)] microg; P<0.001) and continuous (25.3 [20.9/31.5] vs. 9.5
[6.8/12.5] ng/kg/min; P<0.001) doses of remifentanil administered.
<br/>CONCLUSION(S): FIB reduced the remifentanil requirement and relieved
pain in patients undergoing TAVI with CS. Therefore, FIB improved the
quality of CS in TAVI.

<99>
Accession Number
2020155055
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:
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, Fondazione CNR-G. Monasterio, 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
John Wiley and Sons Inc
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.

<100>
Accession Number
2020154983
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:
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, ON,
Canada
(Zhang) Department of Biomedical and Molecular Sciences, Queen's
University, Kingston, ON, Canada
(Baranchuk) Department of Medicine, Division of Cardiology, Queen's
University, Kingston, ON, Canada
(Ross-White) Queen's University Library, Queen's University, Kingston, ON,
Canada
(Fernandez) Cardiac Surgery Department, University Hospital, Santiago de
Compostela, Spain
(El-Diasty) Cardiac Surgery Department, Queen's University, Kingston, ON,
Canada
Publisher
John Wiley and Sons Inc
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.

<101>
Accession Number
2020154981
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:
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
John Wiley and Sons Inc
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.

<102>
Accession Number
2020014242
Title
CytoSorb haemoadsorption for removal of apixaban-A proof-of-concept pilot
case for a randomized controlled trial.
Source
Journal of Clinical Pharmacy and Therapeutics. (no pagination), 2022.
Date of Publication: 2022.
Author
Buonocore M.; Rex S.; Degezelle K.; Meyns B.
Institution
(Buonocore, Degezelle, Meyns) Department of Cardiac Surgery, University
Hospitals Leuven, Leuven, Belgium
(Rex) Department of Anesthesiology, University Hospitals Leuven, Leuven,
Belgium
Publisher
John Wiley and Sons Inc
Abstract
What is known and objective: Emergent cardiac surgery in patients under
anticoagulant therapy is still a major point of concern. Recently approved
reversal agents are often not available or not suitable in the cardiac
surgery setting, and timely discontinuation of the drug is not always
feasible. CytoSorb haemoadsorption therapy has been approved in Europe for
intraoperative ticagrelor and rivaroxaban removal during cardiopulmonary
bypass (CPB), but thus far the efficacy of CytoSorb haemoadsorber on other
anticoagulants (apixaban, dabigatran, edoxaban) has only been tested in
vitro, and some signals of clinical benefits have reported in a few case
reports. Case summary: We describe a case of CPB implementation with
CytoSorb in a haemodynamic unstable patient with prosthetic aortic valve
endocarditis on apixaban therapy. What is new and conclusion: CytoSorb
proved to be effective for removal of apixaban in emergency surgery
setting by direct measurements of drug levels before and during CPB
circulation.<br/>Copyright &#xa9; 2022 John Wiley & Sons Ltd.