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<1>
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.
 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). 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. Copyright © The Author(s) 2022.

<2>
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Accession Number
2021157494
Title
Safety, Tolerability, and Effects of a Single Subcutaneous Administration
of SP16 - A SERPIN-like, Small Peptide Agonist of the Low-Density
Lipoprotein-like Receptor 1- on the Acute Inflammatory Response in
Patients with ST-Segment Elevation Myocardial Infarction.
Source
Journal of Cardiovascular Pharmacology. 80(5) (pp 672-678), 2022. Date of
Publication: 03 Nov 2022.
Author
Van Tassell B.W.; Wohlford G.F.; Del Buono M.G.; Damonte J.I.; Markley R.;
Turlington J.; Kadariya D.; Talasaz A.; Ho J.; Marawan A.; Thomas G.K.;
Austin D.; Gineste C.; Gelber C.; Abbate A.
Institution
(Van Tassell, Wohlford, Talasaz, Ho) Department of Pharmacotherapy and
Outcomes Sciences, Virginia Commonwealth University, Richmond, VA, United
States
(Del Buono, Damonte, Markley, Turlington, Kadariya, Marawan, Thomas,
Abbate) VCU Pauley Heart Center, Virginia Commonwealth University,
Richmond, VA, United States
(Del Buono) Department of Cardiovascular and Pulmonary Sciences, Catholic
University of the Sacred Heart, Rome, Italy
(Damonte) Interventional Cardiology Department, Hospital Italiano de
Buenos Aires, Buenos Aires, Argentina
(Austin, Gineste, Gelber) SERPIN Pharma, Manassas, VA, United States
(Abbate) Berne Cardiovascular Research Center, University of Virginia,
Charlottesville, VA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background:Modulation of the inflammatory response is a promising
therapeutic strategy in acute myocardial infarction. The novel approach is
based on the anti-inflammatory and cytoprotective properties mediated by
the engagement of the low-density lipoproteinrelated protein 1 (LRP1)
receptor. SERPIN peptide 16 (SP16) is a synthetic, selective LRP1 agonist.
We herein present the results of a study with a single subcutaneous
administration of SP16 in 10 patients with STEMI, to appraise its safety
and tolerability and explore the effects on the acute inflammatory
response, infarct size, and cardiac function. Method(s):Ten patients
with ST-segment elevation myocardial infarction (STEMI) were enrolled
within 12 hours of symptoms onset and 6 hours of percutaneous coronary
intervention in a single-center, single-arm, open-label study of a single
subcutaneous administration of SP16 (0.2 mg/kg). Serial clinical
biomarkers and echocardiography data were collected up to 12 months. The
data are presented separately for the treatment group and compared with
historical controls from a placebo-treated arm in a recently completed
clinical trial (N = 28) with similar enrollment criteria.
 Result(s):All ten patients with STEMI received subcutaneous
administration of SP16, 381 [272-478] minutes after percutaneous coronary
intervention, without any treatment-related adverse events. The area under
the curve for C-reactive protein was 133 [46-528] mg.d/L in the
SP16-treated group versus 286 [141-581] mg.d/L in the historical
placebo-treated group (P = 0.161). The area under the curve for creatine
kinase-myocardial band was 1432 [675-3089] ng.d/mL in the SP16-treated
group versus 2367 [830-4750] ng.d/mL in the historical placebo-treated
patients (P = 0.428). Left ventricular ejection fraction was 46% [39-54]
at baseline and 51% [46-58] at 1 year follow-up in SP16-treated patients
(interval change 5% [-0.3% to +9%] P = 0.05) and 44% [38%-56%] at baseline
and 53% [43%-59%] at 1 year follow-up in historical placebo-treated
patients (interval change 3% [-5% to 10%], P = 0.305).
 Conclusion(s):A single subcutaneous administration of SP16, a
synthetic targeted LRP1 agonist, was safe and well-tolerated in patients
with STEMI. A trend toward reduction in the inflammatory response and
infarct size with SP16 was noted; however, the sample size for this study
was not based on formal statistical criteria. More extensive studies are
planned to determine the clinical efficacy of SP16 in STEMI.NCT:
NCT04225533. Copyright © 2022 Lippincott Williams and Wilkins.
All rights reserved.

<3>
Accession Number
2020958715
Title
Edoxaban vs. Vitamin K Antagonist for Atrial Fibrillation After
Transcatheter Aortic Valve Replacement in Japanese Patients - A
Subanalysis of the ENVISAGE-TAVI AF Trial -.
Source
Circulation Journal. 86(11) (pp 1756-1763), 2022. Date of Publication:
2022.
Author
Watanabe Y.; Hayashida K.; Yamamoto M.; Yamanaka F.; Yamasaki K.; Naganuma
T.; Ohno Y.; Yamawaki M.; Morioka N.; Mizutani K.; Tada N.; Ueno H.;
Nishina H.; Izumo M.; Nakajima Y.; Ando K.; Takagi K.; Kimura T.; Sugio
K.; Dangas G.; Van Mieghem N.M.; Hengstenberg C.; Chen C.; Jin J.;
Unverdorben M.; Saito S.
Institution
(Watanabe) Division of Cardiology, Teikyo University Hospital, Tokyo,
Japan
(Hayashida) Department of Cardiology, Keio University School of Medicine,
Tokyo, Japan
(Yamamoto) Department of Cardiology, Toyohashi Heart Center, Aichi, Japan
(Yamanaka) Shonan Kamakura General Hospital, Kamakura, Japan
(Yamasaki) Sapporo Higashi Tokushukai Hospital, Hokkaido, Japan
(Naganuma) New Tokyo Hospital, Chiba, Japan
(Ohno) Tokai University Hospital, Isehara, Japan
(Yamawaki) Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
(Morioka) Department of Cardiology, Kishiwada Tokushukai Hospital, Osaka,
Japan
(Mizutani) Department of Cardiovascular Medicine, Osaka City University
Hospital, Osaka, Japan
(Tada) Department of Cardiology, Sendai Kousei Hospital, Miyagi, Japan
(Ueno) Department of Cardiology, Toyama University Hospital, Toyama, Japan
(Nishina) Department of Cardiology, Tsukuba Medical Center Hospital,
Tsukuba, Japan
(Izumo) Division of Cardiology, St. Marianna University, School of
Medicine Hospital, Kawasaki, Japan
(Nakajima) Division of Cardiology, Iwate Medical University, Iwate, Japan
(Ando) Department of Cardiology, Kokura Memorial Hospital, Kitakyusyu,
Japan
(Takagi) Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan
(Kimura, Sugio) Daiichi Sankyo Co., Ltd., Tokyo, Japan
(Dangas) Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai
Hospital, New York, NY, United States
(Van Mieghem) Department of Cardiology, Erasmus University Medical Center,
Thoraxcenter, Rotterdam, Netherlands
(Hengstenberg) Division of Cardiology, Vienna General Hospital, Medical
University, Vienna, Austria
(Chen, Jin, Unverdorben) Daiichi Sankyo, Inc., Basking Ridge, NJ, United
States
(Saito) Division of Cardiology & Catheterization Laboratories, Shonan
Kamakura General Hospital, Kamakura, Japan
Publisher
Japanese Circulation Society
Abstract
Background: Japanese patients undergoing transcatheter aortic valve
replacement (TAVR) are often female and have a small body size,
potentially impacting bleeding risk with antithrombotic therapy. Outcomes
of direct oral anticoagulant use in these patients with atrial
fibrillation (AF) need to be clarified. Methods and Results: This
prespecified analysis included Japanese patients from ENVISAGE-TAVI AF, a
prospective, randomized, open-label, adjudicator-masked trial that
compared treatment with edoxaban and vitamin K antagonists (VKAs) in
patients with AF after TAVR. The primary efficacy and safety outcomes were
net adverse clinical events (NACE; composite of all-cause death,
myocardial infarction, ischemic stroke, systemic embolic event, valve
thrombosis, and International Society on Thrombosis and Haemostasis
[ISTH]-defined major bleeding) and ISTH-defined major bleeding,
respectively. Intention-to-treat (ITT) and on-treatment analyses were
performed. Overall, 159 Japanese patients were enrolled (edoxaban group:
82, VKA group: 77) and followed for on average 483 days. Mean patient age
was 83.8 years; 52.2% were female. In the ITT analysis, NACE rates were
10.9%/year with edoxaban and 12.5%/year with VKA (hazard ratio [HR], 0.85;
95% confidence interval [CI], 0.38-1.90); major bleeding occurred in
8.9%/year and 7.3%/year, respectively (HR, 1.17; 95% CI, 0.45-3.05). In
edoxaban- and VKA-treated patients, rates of ischemic stroke were
1.8%/year and 1.0%/year, respectively; fatal bleeding rates were 0.9%/year
and 2.0 %/year. On-treatment results were similar to ITT.
 Conclusion(s): In Japanese patients with AF after successful TAVR,
edoxaban and VKA treatment have similar safety and efficacy
profiles. Copyright © 2022 Japanese Circulation Society. All
rights reserved.

<4>
Accession Number
2018352191
Title
Effect of feeding with standard or higher-density formulas on
anthropometric measures in children with congenital heart defects after
corrective surgery: a randomized clinical trial.
Source
European Journal of Clinical Nutrition. 76(12) (pp 1713-1718), 2022. Date
of Publication: December 2022.
Author
Aryafar M.; Mahdavi M.; Shahzadi H.; Nasrollahzadeh J.
Institution
(Aryafar, Nasrollahzadeh) Department of Clinical Nutrition and Dietetics,
Faculty of Nutrition Sciences and Food Technology, National Nutrition and
Food Technology, Research Institute, Shahid Beheshti University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Mahdavi, Shahzadi) Rajaei Cardiovascular Medical and Research Center,
Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Springer Nature
Abstract
Objectives: The aim of the present study was to assess the efficacy of
feeding a higher-density formula (HDF) in infant with congenital heart
disease (CHD). Method(s): In a parallel randomized trial, infants (6
to 12 months) who underwent CHD corrective surgery received either a
standard-density formula (SDF, 67 kcal /100 ml) or an HDF (90 kcal/100 ml)
after discharge from the intensive care unit for 8 weeks. In addition to
the formula, infants could receive breast milk or complementary food.
Anthropometry, biochemistry, and formula intake were collected.
 Result(s): Sixty-four infants completed the study (n = 32 in each
group). All infants gained weight. The mean +/- standard deviation (SD) of
weight z score at baseline and week-8 were -2.38 +/- 10.04 to -1.38 + 0.97
in the SDF group and -2.69 +/- 1.19 to -0.89 +/- 0.90 in the HDF group
(between-group p = 0.0001). Both groups gained length, but showed a
decline in length z-score which was significant in the SDF group but not
significant in the HDF group. Mid-upper arm circumference and its z score
improved in both groups, with more improvement in the HDF group. Serum
albumin level was higher in the HDF than the SDF group at week-8, but no
significant between-group differences were observed in hemoglobin, serum
ferritin, or iron. Symptoms of gastrointestinal intolerance were not
reported, but parents of 4 infants in the HDF group complained of their
infants' constipation. Conclusion(s): Feeding infants using a
concentrated formula could increase infants' weight gain and growth, and
improve the nutritional status after CHD surgery. Copyright ©
2022, The Author(s), under exclusive licence to Springer Nature Limited.

<5>
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Accession Number
634795228
Title
Restrictive Transfusion Strategy after Cardiac Surgery: Role of Central
Venous Oxygen Saturation Trigger: A Randomized Controlled Trial.
Source
Anesthesiology. 134(3) (pp 370-380), 2021. Date of Publication: 01 Mar
2021.
Author
Zeroual N.; Blin C.; Saour M.; David H.; Aouinti S.; Picot M.-C.; Colson
P.H.; Gaudard P.
Institution
(Zeroual, Blin, Saour, David, Colson, Gaudard) Department of
Anesthesiology and Critical Care Medicine, Arnaud de Villeneuve Hospital,
Montpellier, France
(Aouinti, Picot) Clinical Research and Epidemiology Unit, University
Hospital of Montpellier, Montpellier, France
(Colson) Institute of Functional Genomics, Montpellier, France
(Gaudard) PhyMedExp, Montpellier University, National Institute of Health
and Medical Research, National Center for Scientific Research,
Montpellier, France
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Recent guidelines on transfusion in cardiac surgery suggest
that hemoglobin might not be the only criterion to trigger transfusion.
Central venous oxygen saturation (Svo<inf>2</inf>), which is related to
the balance between tissue oxygen delivery and consumption, may help the
decision process of transfusion. We designed a randomized study to test
whether central Svo<inf>2</inf>-guided transfusion could reduce
transfusion incidence after cardiac surgery. Method(s): This single
center, single-blinded, randomized controlled trial was conducted on adult
patients after cardiac surgery in the intensive care unit (ICU) of a
tertiary university hospital. Patients were screened preoperatively and
were assigned randomly to two study groups (control or Svo<inf>2</inf>) if
they developed anemia (hemoglobin less than 9 g/dl), without active
bleeding, during their ICU stay. Patients were transfused at each anemia
episode during their ICU stay except the Svo<inf>2</inf>patients who were
transfused only if the pretransfusion central Svo<inf>2</inf>was less than
or equal to 65%. The primary outcome was the proportion of patients
transfused in the ICU. The main secondary endpoints were (1) number of
erythrocyte units transfused in the ICU and at study discharge, and (2)
the proportion of patients transfused at study discharge. Result(s):
Among 484 screened patients, 100 were randomized, with 50 in each group.
All control patients were transfused in the ICU with a total of 94
transfused erythrocyte units. In the Svo<inf>2</inf>group, 34 (68%)
patients were transfused (odds ratio, 0.031 [95% CI, 0 to 0.153]; P <
0.001 vs. controls), with a total of 65 erythrocyte units. At study
discharge, eight patients of the Svo<inf>2</inf>group remained
nontransfused and the cumulative count of erythrocyte units was 96 in the
Svo<inf>2</inf>group and 126 in the control group. Conclusion(s): A
restrictive transfusion strategy adjusted with central Svo<inf>2</inf>may
allow a significant reduction in the incidence of
transfusion. Copyright © 2021 Lippincott Williams and Wilkins.
All rights reserved.

<6>
Accession Number
2021131813
Title
Meta-Analysis on the Clinical Outcomes of Transcatheter Aortic Valve
Implantation in Low-Surgical Risk Patients With Bicuspid Aortic Valves.
Source
American Journal of Cardiology. 187 (pp 26-29), 2023. Date of Publication:
15 Jan 2023.
Author
Mahmoudi E.; Gupta R.; Behnoush A.H.; Vyas A.V.; Patel N.C.
Institution
(Mahmoudi) Universal Scientific Education and Research Network and
Non-communicable Diseases Research Center, Endocrinology and Metabolism
Population Sciences Institute, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Gupta, Vyas, Patel) Lehigh Valley Heart Institute, Lehigh Valley Health
Network, AllentownPennsylvania
(Behnoush) Non-communicable Diseases Research Center, Endocrinology and
Metabolism Population Sciences Institute, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
Publisher
Elsevier Inc.

<7>
Accession Number
2021597928
Title
Comparison Between Sedative And Analgesic Effects Of Dexmedetomidine
Versus Fentanyl For Pediatric Patients Following Cardiac Surgery In
Intensive Care Unit.
Source
Journal of Pharmaceutical Negative Results. 13 (pp 1058-1064), 2022. Date
of Publication: 2022.
Author
Attia W.A.; Aziz O.M.A.; Reheem A.M.A.; Sayed O.M.E.-E.; Mahmoud M.M.
Institution
(Attia, Aziz, Mahmoud) Pediatric Cardiology Department, Faculty of
Medicine, Cairo University, Egypt
(Reheem) Anesthesia Department, Faculty of Medicine, Cairo University,
Egypt
(Attia, Aziz, Sayed) Pediatric Cardiology Department, Al-NAS Hospital,
Egypt
Publisher
ResearchTrentz Academy Publishing Education Services
Abstract
The ICU staff should make careful pharmacological choices for sedation
following cardiac surgery. The purpose of this research was to assess the
effectiveness and safety of dexmedetomidine versus fentanyl for
postoperative sedation, hemodynamic and ventilatory parameters in
pediatric patients admitted to the ICU following cardiovascular surgery. A
total of 60 pediatric patients admitted to the ICU following heart
surgery, ranging in age from one day to fifteen years, and requiring
mechanical ventilation upon admission, were included in the prospective
and comparative research. They were randomly assigned to one of two
groups: Group D (n = 30) received dexmedetomidine, whereas Group F (n =
30) received fentanyl. In terms of age, weight, height, gender, and type
of surgery, there was no statistically significant difference between the
two groups. There were no significant variations in ventilatory measures
such as respiratory rate, oxygen saturation, or arterial blood gases in
either group when compared to baseline or to each other. There were no
significant variations in sedation (COMFORT-B) or pain (FLACC) scores
between the two groups. There was no statistically significant difference
in the use of rescue sedatives between the two groups. There was a
statistically significant difference in intubation length between the two
groups. In comparison to fentanyl, dexmedetomidine is a safe and similarly
effective medication for the sedation of mechanically ventilated pediatric
patients admitted to the ICU following cardiac surgery, with good
hemodynamic stability and earlier extubation. Copyright © 2022
Wolters Kluwer Medknow Publications. All rights reserved.

<8>
Accession Number
2021623615
Title
SODIUM BICARBONATE INFUSION: TO PREVENT CARDIAC SURGERY-ASSOCIATED ACUTE
KIDNEY INJURY.
Source
International Journal of Academic Medicine and Pharmacy. 4(5) (pp 27-30),
2022. Date of Publication: 2022.
Author
Namdev H.
Institution
(Namdev) Department of Cardiothoracic and Vascular Surgery,
Superspeciality Hospital, MGMMC, Madhya Pradesh, Indore, India
Publisher
Necati Ozpinar
Abstract
Background: Acute kidney injury (AKI) is a frequent and severe
postoperative complication in patients undergoing cardiac surgery with an
incidence varying from 36.3 to 52.0%. With increasing interest, this topic
has been specifically referred to as cardiac surgery-associated acute
kidney injury (CSA-AKI). CSA-AKI could contribute to increased in-hospital
mortality, 5-year mortality, 30-day readmission, requirement for renal
replacement therapy (RRT), ICU length of stay, and total postoperative
cost. Material(s) and Method(s): Study was done in the period of
February 2019 to February 2020 at Super speciality hospital GMC Nagpur.
This study was a double-blind, randomized controlled trial designed to
assess if the administration of sodium bicarbonate as a continuous
infusion commenced prior to cardiopulmonary bypass would result in less
postoperative acute renal dysfunction in patients undergoing cardiac
surgery. This prospective study enrolled 70 consecutive patients who
underwent on pump cardiac surgery. A Microsoft Excel-based (Microsoft
Corp., Redmond, WA) random-number generator was used to create the
randomization list. Allocation concealment to patients, anesthesiologists,
cardiac surgeons, intensive care specialists, bedside nurses, and
investigators was ensured. Treatment allocation was only revealed after
the study had been completed, the database locked, and statistical
analysis completed. Result(s): No statistical difference between the
groups was detected in terms of age (41.84 +/- 13.762 vs 46.77 +/- 13.249)
days, P=0.331; age range, 16 year -80 years), weight (49.17 +/- 10.413vs
56.17 +/- 17.666 kg, P =0.183, and duration of CPB (93.2857 +/- 33.79913
vs 105.8429 +/- 41.68955 minutes, P=0.270) and in cross clamp time
(67.1143 +/- 27.20110 vs 75.9143 +/- 37.93539 minutes, P=0.079) which is
shown in Table.1, 3. Conclusion(s): Perioperative alkalization of
blood and urine using an infusion of sodium bicarbonate did not result in
a decrease in the incidence of acute kidney injury in patients undergoing
cardiac surgery. Copyright © 2022 University of Agriculture. All
rights reserved.

<9>
Accession Number
2021623614
Title
HYPOMAGNESAEMIA AND ROLE OF MAGNESIUM SUPPLEMENTATION DURING
CARDIOPULMONARY BYPASS IN PEDIATRICS CARDIAC SURGERY.
Source
International Journal of Academic Medicine and Pharmacy. 4(5) (pp 23-26),
2022. Date of Publication: 2022.
Author
Namdev H.; Goel A.; Piyushgupta
Institution
(Namdev, Goel, Piyushgupta) Department of Cardiothoracic and Vascular
Surgery, Superspeciality Hospital, MGMMC, Madhya Pradesh, Indore, India
Publisher
Necati Ozpinar
Abstract
Background: A significant source of morbidity and mortality following
cardiac surgery for congenital heart disease is postoperative arrhythmias.
Patients with congenital cardiac disease are particularly susceptible to
rhythm abnormalities in the early postoperative period. Little is known
about the prevalence, danger signs, treatment, and prevention of early
postoperative arrhythmias in juvenile cardiac surgery. An incidence of
between 15% and 17.7% was observed in a recent report by Roos-Hesselink
and Karamermer. Material(s) and Method(s): This prospective study was
conducted at Super speciality hospital GMC Nagpur, All patients with
tetralogy of Fallot undergoing intra-cardiac repair in the Department of
Cardiothoracic and Vascular Surgery between February 2019 to February 2020
were enrolled in this study. A total of 90 patients were included in this
study.The patients receiving any antiarrhythmic medication either prior to
surgery or intraoperative were excluded from the study.The patients were
randomly assigned to one of the following groups: Group 1 (Mg0), receiving
normal saline (placebo), group 2 (Mg25), receiving 25mg/kg of MgSO4, and
group 3 (Mg50), and receiving 50mg/kg of MgSO4. Maximum total dose of
MgSO4 did not exceed 2g. All subjects received a single bolus of either
placebo or drug into the CPB circuit at the initiation of the rewarming
period. MgSO4 (500mg/mL; 4mEq/mL). The composition of the bypass circuit
and perfusion protocols were according to established institutional
practices. Patients receiving antiarrhythmics preoperatively or
intraoperatively were excluded from the study. Result(s):
Hypomagnesaemia was present in 28% of patients. None of the patients who
were administered magnesium developed hypomagnesaemia. The incidence of
JET was found to be increased (53.3%) in the placebo group as compared to
13.3% and 6.7% in the groups receiving 25 and 50mg/kg of magnesium
(p<.001). 22 patients having JET 14 (64%) had hypomagnesaemia and rest of
the 8(36%) occurred in patients with normal magnesium levels (p<.001). The
mean mechanical ventilation time and the mean length of ICU stay were both
prolonged those with hypomagnesaemia. The mean mechanical ventilation time
and length of ICU stay were both prolonged in the patients with JET.
 Conclusion(s): Hypomagnesemia is one of the factors responsible for
JET and in turn with prolonged ICU stay and prolonged mechanical
ventilation time. Our study suggests that supplementation of MgSO4 during
CPB reduces the incidence of hypomagnesaemia and reduces the overall
incidence of JET. Copyright © 2022 University of Agriculture. All
rights reserved.

<10>
Accession Number
639692037
Title
Outcomes of cardiac arrest with valve surgery among infective endocarditis
patients: A United States National cohort study.
Source
Cardiovascular revascularization medicine : including molecular
interventions. (no pagination), 2022. Date of Publication: 11 Nov 2022.
Author
Mir T.; Uddin M.M.; Shanah L.; Hussain T.; Parajuli T.; Shafi O.; Ullah
W.; Rab T.; Sheikh M.; Eltahawy E.
Institution
(Mir) Internal Medicine, Wayne State University. Detroit, MI, USA;
Internal Medicine, Baptist Health System. Montgomery, AL, USA. Electronic
address: gr6723@wayne.edu
(Uddin, Shanah) Internal Medicine, Wayne State University. Detroit, MI,
United States
(Hussain) Internal Medicine, Wayne State University. Detroit, MI, USA;
Critical Care Medicine, Summa Health System, Akron, OH, USA
(Parajuli) Internal Medicine, Baptist Health System. Montgomery, AL,
United States
(Shafi) Clinical Informatics, University of Arkansas for Medical Sciences,
Little Rock, AR, United States
(Ullah) Division of Cardiology, Thomas Jefferson Hospital, PA, United
States
(Rab) Division of Cardiology, Emory University, Atlanta, GA, United States
(Sheikh) Division of Cardiology, Promedica Toledo Hospital, OH, United
States
(Eltahawy) Division of Cardiology, University of Toledo College of
Medicine, Life Sciences, OH, United States
Publisher
NLM (Medline)
Abstract
OBJECTIVE: Cardiac arrest can complicate infective endocarditis (IE) and
is associated with significant in-hospital complications and mortality
rates. We report the characteristics, outcomes, and readmission rates for
IE patients with cardiac arrest in the United States. METHOD(S): We
surveyed the Nationwide Readmission Database (NRD), a database designed to
support national level readmission analyses, for patients admitted with IE
and who had cardiac arrest during index admission between 2016 and 2019.
Baseline demographics, comorbidities, surgical procedures, and outcomes
were identified using their respective International Classification of
Diseases (ICD) codes. RESULT(S): There were 663 index admissions
(mean age 55.87 +/- 17.21 years;34.2 % females) for IE with cardiac arrest
in the study period, with an overall mortality rate of 55.3 %. Of these,
270 (40.7 %) had surgical procedures performed during the hospitalization
encounter. In patients who had a surgical procedure, 72 (26.8 %) patients
had in-hospital mortality while 293 (74.9 %) patients without surgical
procedures had in-hospital mortality (p < 0.001). After coarsened matching
for baseline characteristics, surgical valve procedures were less likely
to be associated with mortality (OR = 0.09, 95%CI 0.04-0.24; p < 0.001).
Among the 295 alive discharges associated with cardiac arrest, 76 (38.57
%) were readmitted within 30-days, with a mortality rate of 22 % noted for
readmissions. CONCLUSION(S): Among IE patients who had cardiac
arrest, surgical procedures subgroup had low mortality despite having
higher complication rates. However, due to chances of bias more randomized
trials are needed evaluate the hypothesis. Copyright © 2022
Elsevier Inc. All rights reserved.

<11>
Accession Number
2020421673
Title
Outcomes of catheter ablation of atrial tachyarrhythmia guided exclusively
by activation mapping.
Source
Journal of Interventional Cardiac Electrophysiology. (no pagination),
2022. Date of Publication: 2022.
Author
Zhang X.; Li W.; Lin A.; Zou F.; Marazzato J.; Varrias D.; Nagraj S.; Wang
Y.-C.; Seo J.; Della Rocca D.G.; Levine E.; Santangeli P.; Lakkireddy D.;
Natale A.; Di Biase L.
Institution
(Zhang, Lin, Zou, Marazzato, Levine, Di Biase) Montefiore Medical Center,
Albert Einstein College of Medicine, Bronx, NY, United States
(Li, Varrias, Nagraj, Wang, Seo) New York City Health + Hospitals/Jacobi
Medical Center, Albert Einstein College of Medicine, Bronx, NY, United
States
(Marazzato) Department of Medicine and Surgery, University of Insubria,
Varese, Italy
(Della Rocca, Natale, Di Biase) Texas Cardiac Arrhythmia Institute, St.
David's Medical Center, Austin, TX, United States
(Santangeli) Hospital of the University of Pennsylvania, Philadelphia, PA,
United States
(Lakkireddy) Kansas City Heart Rhythm Institute, HCA Midwest Health,
Kansas City, MO, United States
Publisher
Springer
Abstract
Introduction: Complex atrial tachyarrhythmias (CATs) are commonly observed
in patients with prior catheter ablation or cardiac surgery. These
arrhythmias are challenging to map and ablate. Historically, entrainment
mapping was utilized to characterize CAT. With the advent of
high-definition mapping (HDM), full visualization of the CAT circuit is
possible which may obviate the need for entrainment mapping.
 Method(s): We sought to investigate the outcomes of catheter ablation
of CAT guided only by HDM. Consecutive patients who underwent CAT ablation
from 2017 to 2021 were included in our study (excluding right atrial
tachyarrhythmias). Patients were sorted by the type of mapping performed.
Group I consisted of patients where HDM alone was utilized with no attempt
of entrainment. Group II consisted of patients where both entrainment and
HDM were utilized. Result(s): A total of 67 patients were included in
our study, with 40 patients in HDM group (I) and 27 patients in
entrainment group (II). No statistically significant difference regarding
1-year freedom from atrial arrhythmias was found between the two groups
(80% vs 77.8%, p = 0.819). Four CATs were terminated by entrainment during
procedure versus none in the HDM-only group (p = 0.011).
 Conclusion(s): CAT ablation with HDM alone yielded similar 1-year
freedom from atrial arrhythmias compared to ablation with HDM and
entrainment. Entrainment combined with HDM was associated with higher
undesired CAT interruption rate. Further validation is needed with
randomized control trials. Copyright © 2022, The Author(s), under
exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature.

<12>
Accession Number
639695192
Title
Perioperative Management of Vitamin K Antagonists and Direct Oral
Anticoagulants: a Systematic Review and Meta-analysis.
Source
Chest. (no pagination), 2022. Date of Publication: 30 Nov 2022.
Author
Shah S.; Nayfeh T.; Hasan B.; Urtecho M.; Firwana M.; Saadi S.; Abd-Rabu
R.; Nanaa A.; Flynn D.N.; Rajjoub N.S.; Hazem W.; Seisa M.O.; Hassett
L.C.; Spyropoulos A.C.; Douketis J.D.; Murad M.H.
Institution
(Shah, Nayfeh, Hasan, Urtecho, Firwana, Saadi, Abd-Rabu, Nanaa, Rajjoub,
Hazem, Seisa, Murad) Evidence-Based Practice Center, Mayo Clinic,
Rochester, Minnesota; Robert D. and Patricia E. Kern Center for the
Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota
(Flynn) University of North Carolina at Chapel Hill School of Medicine,
Chapel Hill, NC, United States
(Hassett) Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, United States
(Spyropoulos) Institute of Health Systems Science - Feinstein Institutes
for Medical Research and The Donald and Barbara Zucker School of Medicine
at Hofstra/Northwell, Department of Medicine, Anticoagulation and Clinical
Thrombosis Services, Northwell Health at Lenox Hill Hospital, NY, United
States
(Douketis) Department of Medicine, McMaster University, Hamilton, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: The management of patients who are receiving chronic oral
anticoagulation therapy and require an elective surgery or invasive
procedure is a common clinical scenario. RESAERCH QUESTION: What is the
best available evidence to support the development of American College of
Chest Physicians (ACCP) guideline on the perioperative management of
patients who are receiving long-term vitamin K agonist (VKA) or direct
oral anticoagulant (DOAC) and require elective surgery/procedures? STUDY
DESIGH AND METHODS: Literature search including multiple databases from
database inception to July 16, 2020, was performed. Meta-analyses were
conducted when appropriate. RESULT(S): In patients receiving VKA
(warfarin) undergoing elective non-cardiac surgery, shorter (<5 days) VKA
interruption is associated with an increased risk of major bleeding. In
patients who required VKA interruption, heparin bridging [mostly with low
molecular weight heparin (LMWH)] was associated with a statistically
significant increased risk of major bleed (RR: 9.1 [95% CI, 1.62-51.3]);
very low certainty of evidence (COE). Compared with DOACs interruption 1-4
days before surgery, continuing DOACs was not associated with a
statistically significant difference in the risk of bleeding; very low
COE. Continuing dabigatran was associated with a statistically significant
increased risk of thromboembolism (RR: 2.2 [95% CI, 1.3-3.8]); low COE. In
patients who needed DOACs interruption, bridging with LMWH was associated
a with statistically significant increased risk of minor bleeding compared
to no bridging (RR: 1.7 [95% CI, 1.13-2.7]); low COE. INTERPRETATION: The
certainty in the evidence supporting the perioperative management of
anticoagulants remains limited. No high quality evidence exists to support
the practice of heparin bridging during the interruption of VKA or DOAC
therapy for an elective surgery/procedure, or the practice of interrupting
VKA therapy for minor procedures, including cardiac device implantation,
or continuation of a DOAC vs. short-term interruption of a DOAC (1-4 days)
perioperatively. Copyright © 2022. Published by Elsevier Inc.

<13>
Accession Number
2015005119
Title
Effects of 12-Week Supervised Early Resistance Training (SEcReT) Versus
Aerobic-Based Rehabilitation on Cognitive Recovery Following Cardiac
Surgery via Median Sternotomy: A Pilot Randomised Controlled Trial.
Source
Heart Lung and Circulation. 31(3) (pp 395-406), 2022. Date of Publication:
March 2022.
Author
Pengelly J.; Royse C.; Williams G.; Bryant A.; Clarke-Errey S.; Royse A.;
El-Ansary D.
Institution
(Pengelly, Royse, Royse, El-Ansary) Department of Nursing and Allied
Health, Swinburne University of Technology, Melbourne, Vic, Australia
(Pengelly) School of Science, Psychology and Sport, Federation University
Australia, Ballarat, Vic, Australia
(Royse, Royse, El-Ansary) Department of Surgery, University of Melbourne,
Melbourne, Vic, Australia
(Royse) Department of Anaesthesia and Pain Management, Royal Melbourne
Hospital, Melbourne, Vic, Australia
(Royse) Outcomes Research Consortium Cleveland Clinic, Cleveland, OH,
United States
(Williams, Bryant) Department of Physiotherapy, University of Melbourne,
Melbourne, Vic, Australia
(Clarke-Errey) Statistical Consulting Centre, University of Melbourne,
Melbourne, Vic, Australia
(Royse) Department of Cardiothoracic Surgery, Royal Melbourne Hospital,
Melbourne, Vic, Australia
(El-Ansary) Clinical Research Institute, Westmead Private Hospital,
Sydney, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Aims: To investigate the effects of a 12-week early moderate-intensity
resistance training program compared to aerobic-based rehabilitation on
postoperative cognitive recovery following cardiac surgery via median
sternotomy. Method(s): This was a multicentre, prospective,
pragmatic, non-blinded, pilot randomised controlled trial (1:1
randomisation) of two parallel groups that compared a 12-week early
moderate-intensity resistance training group to a control group, receiving
aerobic-based rehabilitation. English-speaking adults (>=18 years)
undergoing elective cardiac surgery via median sternotomy were randomised
using sealed envelopes, with allocation revealed before surgery. The
primary outcome was cognitive function, assessed using the Alzheimer's
Disease Assessment Scale-cognitive subscale (ADAS-cog), at baseline, 14
weeks and 6 months postoperatively. Result(s): The ADAS-cog score at
14 weeks was significantly better for the resistance training group (n=14,
7.2+/-1.4; 95% CI 4.3, 10.2, vs n=17, 9.2+/-1.3; 95% CI 6.6, 11.9,
p=0.010). At 14 weeks postoperatively, 53% of the aerobic-based
rehabilitation group (n=9/17) experienced cognitive decline by two points
or more from baseline ADAS-cog score, compared to 0% of the resistance
training group (n=0/14; p=0.001). Conclusion(s): Early resistance
training appears to be safe and may improve cognitive recovery compared to
standard, aerobic-based rehabilitation following cardiac surgery via
median sternotomy, however as this was a pilot study, the sample size was
small and further research is needed to determine a causal
relationship. Copyright © 2021 Australian and New Zealand Society
of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of
Australia and New Zealand (CSANZ)

<14>
Accession Number
2018122595
Title
Assessment of myocardial salvage in patients with STEMI undergoing
thrombolysis: ticagrelor versus clopidogrel.
Source
BMC Cardiovascular Disorders. 22(1) (no pagination), 2022. Article Number:
301. Date of Publication: December 2022.
Author
Petousis S.; Hamilos M.; Pagonidis K.; Vardas P.; Lazopoulos G.;
Anastasiou I.; Zacharis E.; Kochiadakis G.; Skalidis E.
Institution
(Petousis, Hamilos, Pagonidis, Anastasiou, Zacharis, Kochiadakis,
Skalidis) Cardiology Department, University Hospital of Heraklion, Voutes
and Stavrakia, Crete, Heraklion 71110, Greece
(Petousis, Vardas, Lazopoulos, Kochiadakis, Skalidis) School of Medicine,
University of Crete, Heraklion, Greece
(Vardas) Hellenic Cardiovascular Research Society, Athens, Greece
(Lazopoulos) Division of Cardiac Surgery, University Hospital of
Heraklion, Heraklion, Greece
Publisher
BioMed Central Ltd
Abstract
Background: In the setting of ST-segment elevation myocardial infarction
(STEMI), the faster and stronger antiplatelet action of ticagrelor
compared to clopidogrel, as well as its pleiotropic effects, could result
in a greater degree of cardioprotection and final infarct size (FIS)
limitation. The aim of our study was to comparatively evaluate the effect
of ticagrelor and clopidogrel on myocardial salvage index (MSI) in STEMI
patients undergoing thrombolysis. Method(s): Forty-two STEMI patients
treated with thrombolysis were randomized to receive clopidogrel (n = 21)
or ticagrelor (n = 21), along with aspirin. Myocardial area at risk (AAR)
was calculated according to the BARI and the APPROACH jeopardy scores. FIS
was quantified by cardiac magnetic resonance imaging (CMR) performed 5-6
months post-randomization. MSI was calculated as (AAR-FIS)/AAR x 100%.
Primary endpoint of our study was MSI. Secondary endpoints were FIS and
CMR-derived left ventricular ejection fraction (LVEF) at 5 -6 months
post-randomization. Result(s): By using the BARI score for AAR
calculation, mean MSI was 52.25 +/- 30.5 for the clopidogrel group and
54.29 +/- 31.08 for the ticagrelor group (p = 0.83), while mean MSI using
the APPROACH score was calculated at 51.94 +/- 30 and 53.09 +/- 32.39 (p =
0.9), respectively. Median CMR-derived FIS-as a percentage of LV-was 10.7%
+/- 8.25 in the clopidogrel group and 12.09% +/- 8.72 in the ticagrelor
group (p = 0.6). Mean LVEF at 5-6 months post-randomization did not differ
significantly between randomization groups. Conclusion(s): Our
results suggest that the administration of ticagrelor in STEMI patients
undergoing thrombolysis offer a similar degree of myocardial salvage,
compared to clopidogrel. Copyright © 2022, The Author(s).

<15>
Accession Number
2019919646
Title
Benefits and risks of antihypertensive medication in adults with different
systolic blood pressure: A meta-analysis from the perspective of the
number needed to treat.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 986502. Date of Publication: 19 Oct 2022.
Author
Mao Y.; Ge S.; Qi S.; Tian Q.-B.
Institution
(Mao, Ge, Qi, Tian) Hebei Key Laboratory of Environment and Human Health,
Department of Epidemiology and Statistics, School of Public Health, Hebei
Medical University, Shijiazhuang, China
Publisher
Frontiers Media S.A.
Abstract
Background: The blood pressure (BP) threshold for initial pharmacological
treatment remains controversial. The number needed to treat (NNT) is a
significant indicator. This study aimed to explore the benefits and risks
of antihypertensive medications in participants with different systolic
BPs (SBPs), and cardiovascular disease status from the perspective of the
NNT. Method(s): We conducted a meta-analysis of 52 randomized
placebo-controlled trials. The data were extracted from published articles
and pooled to calculate NNTs. The participants were divided into five
groups, based on the mean SBP at entry (120-129.9, 130-139.9, 140-159.9,
160-179.9, and >=180 mmHg). Furthermore, we stratified patients into those
with and without cardiovascular disease. The primary outcomes were the
major adverse cardiovascular events (MACEs), and adverse events (AEs)
leading to discontinuation. Result(s): Antihypertensive medications
were not associated with MACEs, however, it increased AEs, when the SBP
was <140 mmHg. For participants with cardiovascular disease or at a high
risk of heart failure and stroke, antihypertensive treatment reduced MACEs
when SBP was >=130 mmHg. Despite this, only 2-4 subjects had reduced MACEs
per 100 patients receiving antihypertensive medications for 3.50 years.
The number of individuals who needed to treat to avoid MACEs declined with
an increased cardiovascular risk. Conclusion(s): Pharmacological
treatment could be activated when SBP reaches 140 mmHg. For people with
cardiovascular disease or at a higher risk of stroke and heart failure,
130 mmHg may be a better therapeutic threshold. It could be more
cost-effective to prioritize antihypertensive medications for people with
a high risk of developing cardiovascular disease. Copyright ©
2022 Mao, Ge, Qi and Tian.

<16>
[Use Link to view the full text]
Accession Number
2018427504
Title
Treatment Failures of Direct Oral Anticoagulants.
Source
American Journal of Therapeutics. 28(1) (pp E87-E95), 2021. Date of
Publication: 01 Jan 2021.
Author
Kajy M.; Mathew A.; Ramappa P.
Institution
(Kajy) Department of Internal Medicine, Detroit Medical Center, Wayne
State University School of Medicine, Detroit, MI, United States
(Mathew) Department of Cardiology, University of Toledo Medical Center,
Toledo, OH, United States
(Ramappa) Department of Cardiology, Detroit Medical Center, John D.
Dingell Va Medical Center, Wayne State University School of Medicine,
Detroit, MI, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background:Use of direct oral anticoagulants (DOACs) has increased over
the years, because they have become a safe and effective alternative to
the Vitamin-K antagonists in various clinical scenarios. With their
increased use, reports have emerged describing their failure.Study
Question:What are the patient characteristics and clinical settings in
which DOAC treatment failure manifests?Data Sources:We searched published
reports in Google Scholar, PubMed, MEDLINE, and Embase from the
introduction of DOACs in any therapy until March 2019. Study
Design:Information on patient characteristics, comorbidities, primary
anticoagulation indications, pharmacologic treatment, and outcomes were
collected. Primary endpoints were new thrombus formation, failure of
resolution of an existing thrombus, or discovery of subtherapeutic drug
level. Other endpoints were time to treatment failure, manifestations of
treatment failure, and new treatment after DOAC failure.
 Result(s):Our search yielded 51 manuscripts, describing 79 patients
who exhibited DOAC failure. The most common treatment failures were in
patients with antiphospholipid syndrome (44.3%), atrial fibrillation
(30.4%), and deep venous thrombosis (6.3%). There was a trend toward
higher failure rate for rivaroxaban (65.8%) followed by dabigatran
(27.8%), apixaban (7.6%), and then edoxaban (1.3%). Each agent had
different median failure times. Most common manifestations of treatment
failure were stroke/transient ischemic attack (20.3%), pulmonary embolism
(19.0%), and deep venous thrombosis (19.0%). More than half of patients
were transitioned to a Vitamin-K antagonist after DOAC failure (55.7%).
 Conclusion(s):Our analysis illustrates that DOACs may fail in the
setting of Food and Drug Administration and non-Food and Drug
Administration- approved indications. In clinical practice, it may be best
to choose between available anticoagulant drugs on a case-by-case
basis. Copyright © 2021 Lippincott Williams and Wilkins. All
rights reserved.

<17>
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. 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.
 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. 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. 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) Copyright © 2022 The Authors

<18>
Accession Number
639675631
Title
The incidence and mortality rate of catheter-related neonatal pericardial
effusion: A meta-analysis.
Source
Medicine. 101(47) (pp e32050), 2022. Date of Publication: 25 Nov 2022.
Author
Wang J.; Wang Q.; Liu Y.; Lin Z.; Janjua M.U.; Peng J.; Du J.
Institution
(Wang) First Clinical Medical Institute, Hainan Medical University,
Hainan, China
(Wang, Liu, Lin, Du) Department of Neonatology, Hainan Modern Women and
Children's Hospital, Haikou, Hainan, China
(Janjua) International Education Institute, Changsha Medical University,
Changsha, Hunan, China
(Peng) Medical Administration Department, Hainan Modern Women and
Children's Hospital, Haikou, Hainan, China
Publisher
NLM (Medline)
Abstract
BACKGROUD: Neonatal pericardial effusion (PCE) is one of the most severe
complications of central catheters in neonates with its rapid progression
and high mortality. We aim to estimate the overall incidence and mortality
of catheter-related neonatal PCE, more importantly, to identify possible
predictors for clinical reference. METHOD(S): We searched MEDLINE,
Embase, Cochrane Library, Web of Science, china national knowledge
infrastructure, Wanfang Data, and Sinomed databases for subject words
"central catheter," "neonate," "pericardial effusion" and their random
words till June 8, 2020. This meta-analysis is based on the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Possible predictors of occurrences and deaths were extracted and assessed
cooperatively. The pooled incidence rate of catheter-related neonatal PCE
was calculated using a random effects model. RESULT(S): Twenty-one
cohort studies and 99 cases were eligible. Pooled incidence is 3.8[2.2,
6.7]. Polyurethane catheters generate significantly more neonatal PCE than
silicone counterparts (P < .01). 27% of the patients die. The mortality of
patients with bradycardia is higher than others (P < .05). Catheters with
a guidewire result in more deaths than umbilical venous catheter (UVC) and
peripherally inserted central catheters (PICC) (P < .05). Without
pericardiocentesis, mortality increases (P < .01). The difference of
deaths between reposition and removing the catheter is insignificant (P >
.05). CONCLUSION(S): Central catheters in Seldinger Technique (with a
guidewire) put neonates at greater risk of PCE and consequent death.
Silicone catheters excel at avoiding deadly catheter-related PCE, which
could be a better choice in neonatal intensive care units (NICU). When
catheter-related PCE occurs, timely diagnosis and pericardiocentesis save
lives. Copyright © 2022 the Author(s). Published by Wolters
Kluwer Health, Inc.

<19>
Accession Number
639238907
Title
Routine Ultrasonography Guidance for Femoral Vascular Access for Cardiac
Procedures: The UNIVERSAL Randomized Clinical Trial.
Source
JAMA Cardiology. 7(11) (pp 1110-1118), 2022. Date of Publication: 09 Nov
2022.
Author
Jolly S.S.; Alrashidi S.; D'Entremont M.-A.; Alansari O.; Brochu B.;
Heenan L.; Skuriat E.; Tyrwhitt J.; Raco M.; Tsang M.; Valettas N.;
Velianou J.L.; Sheth T.; Sibbald M.; Mehta S.R.; Pinilla-Echeverri N.;
Schwalm J.D.; Natarajan M.K.; Kelly A.; Akl E.; Tawadros S.; Camargo M.;
Faidi W.; Bauer J.; Moxham R.; Nkurunziza J.; Dutra G.; Winter J.
Institution
(Jolly, D'Entremont, Heenan, Skuriat, Tyrwhitt, Sheth, Mehta,
Pinilla-Echeverri, Schwalm, Natarajan) Population Health Research
Institute, Hamilton, ON, Canada
(Jolly, Alrashidi, Alansari, Raco, Tsang, Valettas, Velianou, Sheth,
Sibbald, Mehta, Pinilla-Echeverri, Schwalm, Natarajan, Kelly, Nkurunziza,
Dutra) McMaster University, Hamilton, ON, Canada
(Jolly, Alrashidi, Alansari, Raco, Tsang, Valettas, Velianou, Sheth,
Sibbald, Mehta, Pinilla-Echeverri, Schwalm, Natarajan, Kelly, Tawadros,
Camargo, Faidi, Bauer, Moxham, Nkurunziza, Dutra) Hamilton Health
Sciences, Hamilton, ON, Canada
(Jolly, Alrashidi, Alansari, Raco, Tsang, Valettas, Velianou, Sheth,
Sibbald, Mehta, Pinilla-Echeverri, Schwalm, Natarajan, Kelly, Nkurunziza)
Niagara Health, ON, Canada
(D'Entremont) Centre Hospitalier Universitaire de Sherbrooke (CHUS),
Sherbrooke, QC, Canada
(Brochu) CK Hui Heart Centre, Royal Alexandra Hospital Edmonton, Edmonton,
AB, Canada
(Akl) McGill University Faculty of Medicine and Health Sciences, Montreal,
QC, Canada
(Winter) Departamento de Enfermedades Cardiovasculares, Clinica Alemana de
Santiago, Universidad Del Desarrollo, Chile
Publisher
American Medical Association
Abstract
Importance: A significant limitation of femoral artery access for cardiac
interventions is the increased risk of vascular complications and bleeding
compared with radial access. Strategies to make femoral access safer are
needed. Objective(s): To determine whether routinely using
ultrasonography guidance for femoral arterial access for coronary
angiography/intervention reduces bleeding or vascular complications.
 Design, Setting, and Participant(s): The Routine Ultrasound Guidance
for Vascular Access for Cardiac Procedures (UNIVERSAL) randomized clinical
trial is a multicenter, prospective, open-label trial of
ultrasonography-guided femoral access vs no ultrasonography for coronary
angiography or intervention with planned femoral access. Patients were
randomized from June 26, 2018, to April 26, 2022. Patients with
ST-elevation myocardial infarction were not eligible.
 Intervention(s): Ultrasonography guidance vs no ultrasonography
guidance for femoral arterial access on a background of fluoroscopic
landmarking. Main Outcomes and Measures: The primary composite
outcome is the composite of major bleeding based on the Bleeding Academic
Research Consortium 2, 3, or 5 criteria or major vascular complications
within 30 days. Result(s): A total of 621 patients were randomized at
2 centers in Canada (mean [SD] age, 71 [10.24] years; 158 [25.4%] female).
The primary outcome occurred in 40 of 311 patients (12.9%) in the
ultrasonography group vs 50 of 310 patients (16.1%) without
ultrasonography (odds ratio, 0.77 [95% CI, 0.49-1.20]; P =.25). The rates
of Bleeding Academic Research Consortium 2, 3, or 5 bleeding were 10.0%
(31 of 311) vs 10.7% (33 of 310) (odds ratio, 0.93 [95% CI, 0.55-1.56]; P
=.78). The rates of major vascular complications were 6.4% (20 of 311) vs
9.4% (29 of 310) (odds ratio, 0.67 [95% CI, 0.37-1.20]; P =.18).
Ultrasonography improved first-pass success (277 of 311 [86.6%] vs 222 of
310 [70.0%]; odds ratio, 2.76 [95% CI, 1.85-4.12]; P <.001) and reduced
the number of arterial puncture attempts (mean [SD], 1.2 [0.5] vs 1.4
[0.8]; mean difference, -0.26 [95% CI, -0.37 to -0.16]; P <.001) and
venipuncture (10 of 311 [3.1%] vs 37 of 310 [11.7%]; odds ratio, 0.24 [95%
CI, 0.12-0.50]; P <.001) with similar times to access (mean [SD], 114
[185] vs 129 [206] seconds; mean difference, -15.1 [95% CI, -45.9 to
15.8]; P =.34). All prerandomization prespecified subgroups were
consistent with the overall finding. Conclusions and Relevance: In
this randomized clinical trial, use of ultrasonography for femoral access
did not reduce bleeding or vascular complications. However,
ultrasonography did reduce the risk of venipuncture and number of
attempts. Larger trials may be required to demonstrate additional
potential benefits of ultrasonography-guided access. Trial Registration:
ClinicalTrials.gov Identifier: NCT03537118. Copyright © 2022
American Medical Association. All rights reserved.

<20>
Accession Number
2018075780
Title
Transcatheter aortic valve replacement in aortic stenosis and cardiac
amyloidosis: a systematic review and meta-analysis.
Source
ESC Heart Failure. 9(5) (pp 3188-3197), 2022. Date of Publication: October
2022.
Author
Cannata F.; Chiarito M.; Pinto G.; Villaschi A.; Sanz-Sanchez J.; Fazzari
F.; Regazzoli D.; Mangieri A.; Bragato R.M.; Colombo A.; Reimers B.;
Condorelli G.; Stefanini G.G.
Institution
(Cannata, Chiarito, Pinto, Villaschi, Condorelli, Stefanini) Department of
Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4,
Pieve Emanuele-Milan, Italy
(Cannata, Chiarito, Pinto, Villaschi, Fazzari, Regazzoli, Mangieri,
Bragato, Colombo, Reimers, Condorelli, Stefanini) IRCCS Humanitas Research
Hospital, Rozzano-Milan, Italy
(Sanz-Sanchez) Hospital Universitario y Politecnico La Fe, Valencia, Spain
(Sanz-Sanchez) Centro de Investigacion Biomedica en Red (CIBERCV), Madrid,
Spain
Publisher
John Wiley and Sons Inc
Abstract
Aims: Aortic stenosis (AS) and cardiac amyloidosis (CA) are typical
diseases of the elderly. Up to 16% of older adults with severe AS referred
to transcatheter aortic valve replacement (TAVR) have a concomitant
diagnosis of CA. CA-AS population suffers from reduced functional capacity
and worse prognosis than AS patients. As the prognostic impact of TAVR in
patients with CA-AS has been historically questioned and in light of
recently published evidence, we aim to provide a comprehensive synthesis
of the efficacy and safety of TAVR in CA-AS patients. Methods and
Results: We performed a systematic review and meta-analysis of studies:
(i) evaluating mortality with TAVR as compared with medical therapy in
CA-AS patients and (ii) reporting complications and clinical outcomes of
TAVR in CA-AS patients as compared with patients with AS alone. A total of
seven observational studies were identified: four reported mortality with
TAVR, and four reported complications and clinical outcomes after TAVR of
patients with CA-AS compared with AS alone patients. In patients with
CA-AS, the risk of mortality was lower with TAVR (n = 44) as compared with
medical therapy (n = 36) [odds ratio (OR) 0.23, 95% confidence interval
(CI) 0.07-0.73, I2 = 0%, P = 0.001, number needed to treat =
3]. The safety profile of TAVR seems to be similar in patients with CA-AS
(n = 75) as compared with those with AS alone (n = 536), with comparable
risks of stroke, vascular complications, life-threatening bleeding, acute
kidney injury, and 30 day mortality, although CA-AS was associated with a
trend towards an increased risk of permanent pacemaker implantation (OR
1.76, 95% CI 0.91-4.09, I2 = 0%, P = 0.085). CA is associated
with a numerically higher rate of long-term mortality and
rehospitalizations following TAVR in patients with CA-AS as compared with
those with AS alone. Conclusion(s): TAVR is an effective and safe
procedure in CA-AS patients, with a substantial survival benefit as
compared with medical therapy, and a safety profile comparable with
patients with AS alone except for a trend towards higher risk of permanent
pacemaker implantation. Copyright © 2022 The Authors. ESC Heart
Failure published by John Wiley & Sons Ltd on behalf of European Society
of Cardiology.

<21>
Accession Number
639684331
Title
The Influence of Surgical Mask on Heart Rate, Muscle Saturation of Oxygen,
and Hemoglobin during Whole-Body Vibration Exercise.
Source
BioMed research international. 2022 (pp 3958554), 2022. Date of
Publication: 2022.
Author
Apolo-Arenas M.D.; Tomas-Carus P.; Galan-Lopez P.; Escribano J.N.;
Carvalho B.; Cana-Pino A.; Parraca J.A.
Institution
(Apolo-Arenas, Escribano, Cana-Pino) Departamento Terapeutica Medico
Quirurgica, Facultad de Medicina, Universidad de Extremadura, Badajoz
06006, Spain
(Tomas-Carus, Carvalho, Parraca) Departamento de Desporto e Saude, Escola
de Saude e Desenvolvimento Humano, Universidade de Evora, 7004-516 Evora,
Portugal
(Tomas-Carus, Parraca) Comprehensive Health Research Centre (CHRC),
Universidade de Evora, 7004-516 Evora, Portugal
(Galan-Lopez) Department of Communication and Education, Universidad
Loyola Andalucia, 41704 Dos Hermanas (Sevilla), Spain
Publisher
NLM (Medline)
Abstract
Background: Whole-body vibration (WBV) is a safe and effective exercise
system that affects muscle oxygen through several physiological processes,
although its effects on different protocols are still unclear.
Unfortunately, the COVID-19 pandemic has generated various health problems
and controversy or confusion on its possible adverse consequences and
impact on performance when wearing a mask during the practice of physical
exercise. Aim(s): To analyze the acute effects of WBV exercise in
muscle oxygen variables during different intervention phases with or
without a surgical mask and compare protocols that differ in the order of
vibration frequencies. Method(s): Forty-seven healthy students
participated in WBV training. They were randomly assigned to use or not
use a mask between the three intervention groups: group A (8, 12.6, and
20Hz), group B (12.6, 20, and 8Hz), and group C (20, 8, and 12.6Hz).
Besides the 3 WBV moments, the intervention had a baseline moment, two
rest time and a recovery moment. During the whole intervention, the heart
rate (HR), muscle oxygen saturation (SatO2), oxyhemoglobin (O2Hb), and
deoxyhemoglobin (HHb) were registered. Result(s): There were no
significant differences between the mask use and not use groups.
Significant differences were found between the variables during the seven
intervention moments and between intervention groups (A, B, or C).
 Conclusion(s): HR, SatO2, and Hb were not influenced by the use of a
surgical mask, but they reacted differently through the different moments
and were sensitive to vibration frequencies and respective
order. Copyright © 2022 M. Dolores Apolo-Arenas et al.

<22>
Accession Number
2021287907
Title
Cerebral Embolic Protection during Transcatheter Aortic-Valve Replacement.
Source
New England Journal of Medicine. 387(14) (pp 1253-1263), 2022. Date of
Publication: 06 Oct 2022.
Author
Kapadia S.R.; Makkar R.; Leon M.; Abdel-Wahab M.; Waggoner T.; Massberg
S.; Rottbauer W.; Horr S.; Sondergaard L.; Karha J.; Gooley R.; Satler L.;
Stoler R.C.; Messe S.R.; Baron S.J.; Seeger J.; Kodali S.; Krishnaswamy
A.; Thourani V.H.; Harrington K.; Pocock S.; Modolo R.; Allocco D.J.;
Meredith I.T.; Linke A.
Institution
(Kapadia) The Department of Cardiovascular Medicine, Cleveland, United
States
(Krishnaswamy) Cleveland Clinic Foundation, Cleveland, United States
(Makkar) Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles,
United States
(Leon) Columbia Interventional Cardiovascular Care, New York, United
States
(Kodali) Columbia University Medical Center, New York, United States
(Abdel-Wahab) Leipzig Heart Center, University of Leipzig, Leipzig,
Germany
(Massberg) Medizinische Klinik und Poliklinik I, Klinikum der Universitat
Munchen, German Center for Cardiovascular Research (DZHK), Munich Heart
Alliance, Munich, Germany
(Rottbauer) Universitaetsklinikum Ulm, Ulm, Germany
(Seeger) Medical Campus Lake Constance, Friedrichshafen, Germany
(Linke) The Clinic for Internal Medicine and Cardiology, Technische
Universitat Dresden, Herzzentrum, Dresden, Germany
(Waggoner) Pima Heart and Vascular, Tucson Medical Center Healthcare,
Tucson, AZ, United States
(Horr) Centennial Medical Center, Nashville, United States
(Sondergaard) Rigshospitalet, Copenhagen University Hospital, Copenhagen,
Denmark
(Karha) Heart Hospital of Austin, Austin, TX, United States
(Stoler) Baylor Heart and Vascular Hospital, Dallas, TX, United States
(Harrington) Baylor Scott and White the Heart Hospital-Plano, Plano, TX,
United States
(Gooley) Monash Medical Centre, Clayton, VIC, Australia
(Satler) Washington Hospital Center, Washington, DC, United States
(Messe) The Department of Neurology, University of Pennsylvania,
Philadelphia, United States
(Baron) Lahey Hospital and Medical Center, Burlington, MA, United States
(Modolo, Allocco, Meredith) Boston Scientific, Marlborough, MA, United
States
(Thourani) Piedmont Heart Institute, Atlanta, United States
(Pocock) The London School of Hygiene and Tropical Medicine, London,
United Kingdom
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND Transcatheter aortic-valve replacement (TAVR) for the treatment
of aortic stenosis can lead to embolization of debris. Capture of debris
by devices that provide cerebral embolic protection (CEP) may reduce the
risk of stroke. METHODS We randomly assigned patients with aortic stenosis
in a 1:1 ratio to undergo transfemoral TAVR with CEP (CEP group) or
without CEP (control group). The primary end point was stroke within 72
hours after TAVR or before discharge (whichever came first) in the
intention-to-treat population. Disabling stroke, death, transient ischemic
attack, delirium, major or minor vascular complications at the CEP access
site, and acute kidney injury were also assessed. A neurology professional
examined all the patients at baseline and after TAVR. RESULTS A total of
3000 patients across North America, Europe, and Australia underwent
randomization; 1501 were assigned to the CEP group and 1499 to the control
group. A CEP device was successfully deployed in 1406 of the 1489 patients
(94.4%) in whom an attempt was made. The incidence of stroke within 72
hours after TAVR or before discharge did not differ significantly between
the CEP group and the control group (2.3% vs. 2.9%; difference, -0.6
percentage points; 95% confidence interval, -1.7 to 0.5; P = 0.30).
Disabling stroke occurred in 0.5% of the patients in the CEP group and in
1.3% of those in the control group. There were no substantial differences
between the CEP group and the control group in the percentage of patients
who died (0.5% vs. 0.3%); had a stroke, a transient ischemic attack, or
delirium (3.1% vs. 3.7%); or had acute kidney injury (0.5% vs. 0.5%). One
patient (0.1%) had a vascular complication at the CEP access site.
CONCLUSIONS Among patients with aortic stenosis undergoing transfemoral
TAVR, the use of CEP did not have a significant effect on the incidence of
periprocedural stroke, but on the basis of the 95% confidence interval
around this outcome, the results may not rule out a benefit of CEP during
TAVR. Copyright © 2022 Massachusetts Medical Society.

<23>
Accession Number
2021409763
Title
Effect of nurse-initiated forced-air warming blanket on the reduction of
hypothermia complications following coronary artery bypass grafting: a
randomized clinical trial.
Source
European Journal of Cardiovascular Nursing. 20(5) (pp 445-453), 2021. Date
of Publication: 01 Jun 2021.
Author
Bezerra A.S.D.M.; Santos V.B.; Lopes C.T.; De Barros A.L.B.L.
Institution
(Bezerra, Santos, Lopes, De Barros) Escola Paulista de Enfermagem,
Universidade Federal de Sao Paulo (EPE-UNIFESP), Departamento de
Enfermagem Clinica e Cirurgica and Programa de Pos Graduacao em
Enfermagem, 754 Napoleao de Barros St, Vila Clementino, Sao Paulo-SP
04024-002, Brazil
(Bezerra) Instituto Dante Pazzanese de Cardiologia (IDPC), Divisao de
Enfermagem, 500 Dr Dante Pazzanese Av, Ibirapuera, Sao Paulo-SP 04012-909,
Brazil
Publisher
Oxford University Press
Abstract
Aims: To evaluate the effect of postoperative forced-air warming (FAW) on
the incidence of excessive bleeding (ExB), arrhythmia, acute myocardial
infarction (AMI), and blood product transfusion in hypothermic patients
following on-pump CABG and compare temperatures associated with the use of
FAW and warming with a sheet and wool blanket. Methods and Results: A
randomized clinical trial conducted with 200 patients undergoing isolated
on-pump CABG from January to November 2018. Patients were randomly
assigned into an Intervention Group (IG, FAW, n = 100) and Control Group
(CG, sheet and blanket, n = 100). The tympanic temperature of all patients
was measured over a 24-h period. ExB was the primary outcome, while
arrhythmia, AMI, and blood product transfusion were secondary outcomes.
The effect of the interventions on the outcomes was investigated through
using bivariate logistic regression, with a level of significance of 5%.
The IG was 79% less likely to experience bleeding than the CG [odds ratio
(OR) = 0.21, confidence interval (CI) 95% 0.12-0.39, P < 0.001]; the
occurrence of AMI in the IG was 94% lower than that experienced by the CG
(OR = 0.06, CI 95% 0.01-0.48, P < 0.001); and the IG was also 77% less
likely to experience arrhythmia than the CG (OR = 0.23, CI 95% 0.12-0.47,
P < 0.001); no difference was found between groups in terms of blood
product transfusion (P < 0.279). Conclusion(s): These findings show
that FAW can be used following CABG until patients reach normothermia to
avoid undesirable clinical outcomes. Trial registration: REBeC RBR-5t582g.
 Copyright © 2020 Published on behalf of the European Society of
Cardiology. All rights reserved.

<24>
Accession Number
2020375153
Title
Impact of rapid rehabilitation surgery on perioperative nursing in
patients undergoing cardiac surgery: A meta-analysis.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Feng W.; Zhou J.; Lei Y.; Chen W.; Miao Y.; Fu X.; Pi J.; Zhang M.; Na Z.;
Lou W.
Institution
(Feng, Lei, Chen, Miao, Fu, Pi, Zhang, Na) Cardiac Surgery Department,
Yan'an Hospital, Kunming, China
(Zhou) Department of Stomatology, Kunming Yanan Hospital, Kunming, China
(Zhou) Key Laboratory of Tumor Immunological Prevention and Treatment of
Yunnan Province, Yan'an Hospital, Yunnan, Kunming, China
(Lou) E.N.T. Department, Yan'an Hospital, Yunnan, Kunming, China
Publisher
John Wiley and Sons Inc
Abstract
Objective: To systematically evaluate the effect of enhanced recovery
after surgery (ERAS) on perioperative nursing of patients undergoing
cardiac surgery. Method(s): A systematic literature search was
performed in PubMed, Embase, Web of science, Cochrane, CNKI, Wanfang, and
VIP using predefined search strings from inception of database to May
2021. Randomized control trials (RCTs) with sample size >40 on cardiac
surgery with either ERAS nursing or routine nursing reporting extubation
(trachea) time, length of stay, out of bed activity time, and nursing
satisfaction were included in the analysis. Stata SE 12.0 software was
used for statistical analysis. Result(s): A total of 27 RCTs were
included. All the included studies were Chinese due to lack of studies in
English. The results of meta-analysis showed that the extubation time
standardized mean difference ([SMD] = -3.11; 95% confidence interval [CI]:
-3.77, -2.45; p <.001), out of bed activity time (SMD = -2.89; 95% CI:
-3.34, -2.44; p <.001), and hospitalization time (SMD = -2.08; 95% CI:
-2.37, -1.79; p <.001) of cardiac surgery patients with ERAS nursing was
significantly shorter than those with routine nursing. The patient's
satisfaction after surgery with ERAS was higher than that of routine
nursing relative risk ([RR] = 1.24; 95% CI: 1.18, 1.30; p <.001).
 Conclusion(s): ERAS nursing can accelerate perioperative
rehabilitation of patients undergoing cardiac surgery and highly accepted
by patients. Copyright © 2022 The Authors. Journal of Cardiac
Surgery published by Wiley Periodicals LLC.

<25>
Accession Number
639685202
Title
DEX, Delirium and Dilemma.
Source
Brazilian journal of cardiovascular surgery. (no pagination), 2022. Date
of Publication: 01 Dec 2022.
Author
Magoon R.; Mahajan S.; Jose J.
Institution
(Magoon) Department of Cardiac Anaesthesia, Atal Bihari Vajpayee Institute
of Medical Sciences (ABVIMS) and Dr. Ram Manohar Lohia Hospital, New
Delhi, India
(Mahajan) Department of Anaesthesia and Intensive Care, Post Graduate
Institute of Medical Education & Research (PGIMER), Chandigarh, India
(Jose) Department of Cardiac Anesthesiology, Sri Jayadeva Institute of
Cardiovascular Sciences and Research, Jayanagar, Bengaluru, Karnataka,
India
Publisher
NLM (Medline)
Abstract
Dexmedetomidine has been subjected to an extensive evaluation for its'
role in the prevention of postoperative delirium following cardiac
surgery. In striking contrast to the preexisting meta-analysis supporting
postoperative delirium-reduction with dexmedetomidine, few recently
concluded multicentric large scale randomized controlled trials suggest
otherwise. This article aims to present a nuanced perspective of the
evolving controversy by attempting to decode the apparent incongruences in
the literature accumulating off-late, which is particularly pertinent
amidst an ever-escalating heterogeneity in the current research ecosystem.

<26>
Accession Number
2020930980
Title
Transcatheter Mitral Valve Repair in Patients With Atrial Functional
Mitral Regurgitation.
Source
JACC: Cardiovascular Imaging. 15(11) (pp 1843-1851), 2022. Date of
Publication: November 2022.
Author
Doldi P.; Stolz L.; Orban M.; Karam N.; Praz F.; Kalbacher D.; Lubos E.;
Braun D.; Adamo M.; Giannini C.; Melica B.; Nabauer M.; Higuchi S.; Wild
M.; Neuss M.; Butter C.; Kassar M.; Petrescu A.; Pfister R.; Iliadis C.;
Unterhuber M.; Thiele H.; Baldus S.; von Bardeleben R.S.; Schofer N.; Hagl
C.; Petronio A.S.; Massberg S.; Windecker S.; Lurz P.; Metra M.;
Hausleiter J.
Institution
(Doldi, Stolz, Orban, Braun, Nabauer, Higuchi, Wild, Massberg, Hausleiter)
Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen,
Munich, Germany
(Doldi, Orban, Braun, Massberg, Hausleiter) Munich Heart Alliance, Partner
Site German Center for Cardiovascular Disease (DZHK), Munich, Germany
(Karam) Paris University, PARCC, INSERM, F-75015, European Hospital
Georges Pompidou, Paris, France
(Praz, Kassar, Windecker) Universitatsklinik fur Kardiologie, Bern
University Hospital, Inselspital Bern, Switzerland
(Kalbacher, Lubos, Schofer) Universitares Herz- und Gefaszentrum Hamburg,
Klinik fur Kardiologie, Germany
(Kalbacher, Lubos) German Center for Cardiovascular Research (DZHK),
Partner Site Hamburg/Lubeck/Kiel, Germany
(Adamo, Neuss, Metra) Cardiac Catheterization Laboratory and Cardiology,
ASST Spedali Civili and Department of Medical and Surgical Specialties,
Radiological Sciences and Public Health, University of Brescia, Brescia,
Italy
(Giannini, Petronio) Cardiac Catheterization Laboratory, Cardiothoracic
and Vascular Department, University of Pisa, Pisa, Italy
(Melica) Cardiology Department, Centro Hospitalar Vila Nova de Gaia e
Espinho, Portugal
(Butter) Herzzentrum Brandenburg, Medizinische Hochschule Brandenburg
Theodor Fontane, Bernau, Germany
(Petrescu, von Bardeleben) Zentrum fur Kardiologie, Johannes
Gutenberg-Universitat, Mainz, Germany
(Pfister, Iliadis, Baldus) Department III of Internal Medicine, Heart
Center, University of Cologne, Cologne, Germany
(Unterhuber, Thiele, Lurz) Department of Cardiology, Heart Center Leipzig
at University of Leipzig, Leipzig, Germany
(Hagl) Herzchirurgische Klinik und Poliklinik, Klinikum der Universitat
Munchen, Munich, Germany
Publisher
Elsevier Inc.
Abstract
Background: Among patients with severe functional mitral regurgitation
(FMR), atrial functional mitral regurgitation (aFMR) represents an
underrecognized entity. Data regarding outcomes after mitral valve
transcatheter edge-to-edge repair (M-TEER) in aFMR remain scarce.
 Objective(s): The objective of this study was to analyze the outcome
of aFMR patients undergoing M-TEER. Method(s): Using patients from
the international EuroSMR (European Registry of Transcatheter Repair for
Secondary Mitral Regurgitation) registry undergoing M-TEER for FMR, the
authors analyzed baseline characteristics and 2-year outcomes in aFMR in
comparison to non-aFMR and ventricular FMR. Additionally, the impact of
right ventricular dysfunction (RVD) (defined as right ventricular to
pulmonary artery uncoupling) on outcome after M-TEER was assessed.
 Result(s): Among 1,608 FMR patients treated by M-TEER, 126 (7.8%)
were categorized as aFMR. All 126 aFMR patients had preserved left
ventricular function without regional wall motion abnormalities, left
arterial dilatation and Carpentier leaflet motion type I. Procedural
success (defined as mitral regurgitation <=2+ at discharge) was 87.2% (P <
0.001) and New York Heart Association (NYHA) functional class
significantly improved during follow-up (NYHA functional class III/IV:
86.5% at baseline to 36.6% at follow-up; P < 0.001). The estimated 2-year
survival rate in aFMR patients was 70.4%. Two-year survival did not differ
significantly between aFMR, non-aFMR, and ventricular FMR. Besides NYHA
functional class IV, RVD was identified as a strong independent predictor
for 2-year survival (HR: 2.82 [95% CI: 1.24-6.45]; P = 0.014).
 Conclusion(s): aFMR is a frequent cause of FMR and can be effectively
treated with M-TEER to improve symptoms at follow-up. Advanced heart
failure symptoms and RVD were identified as important risk factors for
survival in aFMR patients. Copyright © 2022 American College of
Cardiology Foundation

<27>
Accession Number
2015645347
Title
A Prospective Randomized Controlled Research to Assess the Outcome of
Oxiport Laryngoscope Blade Versus Miller Laryngoscope Blade for Intubation
in Neonates and Infants During General Anesthesia.
Source
International Journal of Pharmaceutical and Clinical Research. 14(1) (pp
254-260), 2022. Date of Publication: 2022.
Author
Kumar S.; Kumar J.; Kumar R.R.; Kashyap B.K.
Institution
(Kumar, Kumar, Kumar, Kashyap) Department of Anesthesiology & Critical
Care, Patna Medical College & Hospital, Bihar, Patna, India
Publisher
Dr Yashwant Research Labs Pvt Ltd
Abstract
Aim: Comparative study of oxiport laryngoscope blade versus miller
laryngoscope blade for intubation in neonates and infants during general
anesthesia. Method(s): This prospective, randomised, controlled
interventional single-blind study conducted in the Department of
Anesthesiology & Critical Care Patna Medical College & Hospital, Patna,
Bihar, India for 1 year. 80 neonates/infants in groups of 40 each posted
for surgery in paediatric operation theatre (OT) over a period of 6 months
were included in the study. Full-term neonates and infants up to 6 months
of age of either sex requiring general anaesthesia with endotracheal
intubation for elective as well as emergency surgery were included in the
study. Result(s): Out of the 80 patients 40 patients in Miller group
and 40 patients in Oxiport group were included. Both groups were
comparable with respect to age, sex, weight, mean time to intubation (P =
0.57) and anaesthesiologist performing the laryngoscopy (P = 0.72). Mean
lowest SpO2 recorded was 96.1% +/- 4.75% in Miller group and 98.15% +/-
2.83% in Oxiport group. This difference was statistically significant (P =
0.041). The incidence of mild desaturation (SpO2 up to 90%) was 87.5% in
Miller group and 95% in Oxiport group. The incidence of moderate
desaturation (SpO2 between 85% and 92.5%) was 2.5% in Miller group and 5%
in Oxiport group. Incidence of severe desaturation (SpO2 <85%) was 15% in
Miller group and 0 in Oxiport group (Chi-square test P = 0.04).
Correlation between time to intubation and SpO2 in Miller group (Pearson's
R2 = -0.12) was statistically not significant at P = 0.41. Correlation
between time to intubation and SpO2 in Oxiport group (Pearson's R2 =
-0.42) was statistically significant at P = 0.001. Both groups were
comparable with respect to the type of surgery (abdominal, thoracic,
miscellaneous) (P = 0.71). Abdominal surgeries were associated with a
higher number of severe desaturations (70%) compared to thoracic (15%) and
miscellaneous (15%) surgeries. Conclusion(s): In this study, apnoeic
laryngeal oxygen insufflation with Oxiport laryngoscope blade decreased
the incidence of severe desaturation while intubating neonates and
infants. This was easily done as it was non-cumbersome and did not
increase the overall cost of anaesthesia. Copyright © 2022, Dr
Yashwant Research Labs Pvt Ltd. All rights reserved.

<28>
Accession Number
2014944429
Title
A randomized controlled clinical trial of prolonged balloon inflation
during stent deployment strategy in primary percutaneous coronary
intervention for ST-segment elevation myocardial infarction: a pilot
study.
Source
BMC Cardiovascular Disorders. 22(1) (no pagination), 2022. Article Number:
30. Date of Publication: December 2022.
Author
Ma M.; Wang L.; Diao K.-Y.; Liang S.-C.; Zhu Y.; Wang H.; Wang M.; Zhang
L.; Yang Z.-G.; He Y.
Institution
(Ma, Liang, Zhu, Wang, Wang, Zhang, He) Department of Cardiology, West
China Hospital, Sichuan University, No. 37 GuoXueXiang, Chengdu 610041,
China
(Ma) Department of Cardiology, The Sixth People's Hospital of Chengdu,
Chengdu, China
(Wang) Department of Cardiology, Mian Yang People's Hospital, Chengdu,
China
(Diao, Yang) Department of Radiology, State Key Laboratory of Biotherapy,
West China Hospital, Sichuan University, No. 37 Guoxue Street, Chengdu
610041, China
Publisher
BioMed Central Ltd
Abstract
Background: Primary percutaneous coronary intervention (PPCI) is the
standard procedure for reperfusion for ST-segment elevation myocardial
infarction (STEMI), but the occurrence of the no-reflow phenomenon remains
common and is associated with adverse outcomes. Aim(s): This study
aimed to evaluate whether prolonged balloon inflation in stent deployment
would lessen the occurrence of the no-reflow phenomenon in PPCI compared
with conventional rapid inflation/deflation strategy. Method(s):
Patients were randomly assigned to either the prolonged balloon inflation
in stent deployment group (PBSG) or conventional deployment strategy group
(CDSG) in a 1:1 ratio. A subset of patients was included in the cardiac
magnetic resonance (CMR) assessment. Result(s): Thrombolysis in MI
(TIMI) flow grade 3 was found in 96.7% and 63.3% of the patients of the
PBSG and CDSG, respectively (P = 0.005). The results of the PBSG and CDSG
are respectively shown as follows: 0% versus 30% no-reflow or slow flow (P
= 0.002); 90% versus 66.7% ST-segment resolution >= 50% (P = 0.028); 35.6
+/- 14.5 frames versus 49.18 +/- 25.2 frames on corrected TIMI frame count
(P = 0.014); and 60% versus 20% myocardial blush grade 3 (P = 0.001). At 1
month, the major cardiovascular adverse event (cardiovascular mortality)
rate was 3.3% in both groups; at 1 year, the rate was 3.3% and 6.7% for
the PBSG and CDSG, respectively (P = 1.00). In the CMR subset of cases,
the presence of microvascular obstruction (MVO) was detected in 6.7% and
50% of the patients in the PBSG and CDSG, respectively (P = 0.023).
 Conclusion(s): In our pilot trial, prolonged balloon inflation during
stent deployment strategy in PPCI reduces the occurrence of the no-reflow
phenomenon in patients with STEMI and improved the myocardial
microcirculation perfusion (ClinicalTrials.gov number: NCT03199014;
registered: 26/June/2017). Copyright © 2022, The Author(s).

<29>
Accession Number
2014427612
Title
Cost-effectiveness of noninvasive telemedical interventional management in
patients with heart failure: health economic analysis of the TIM-HF2
trial.
Source
Clinical Research in Cardiology. 111(11) (pp 1231-1244), 2022. Date of
Publication: November 2022.
Author
Sydow H.; Prescher S.; Koehler F.; Koehler K.; Dorenkamp M.; Spethmann S.;
Westerhoff B.; Wagner C.J.; Liersch S.; Rebscher H.; Wobbe-Ribinski S.;
Rindfleisch H.; Muller-Riemenschneider F.; Willich S.N.; Reinhold T.
Institution
(Sydow, Muller-Riemenschneider, Willich, Reinhold) Division of Health
Economics and Health Services Research, Institute of Social Medicine,
Epidemiology and Health Economics, Charite-Universitatsmedizin Berlin,
Luisenstr. 57, Berlin 10117, Germany
(Prescher, Koehler, Koehler) Centre for Cardiovascular Telemedicine,
Medical Department, Division of Cardiology and Angiology,
Charite-Universitatsmedizin Berlin, Berlin, Germany
(Dorenkamp) Department of Cardiology, Charite-Universitatsmedizin Berlin,
Campus Virchow-Klinikum, Berlin, Germany
(Spethmann) Department of Cardiology and Angiology ,
Charite-Universitatsmedizin Berlin, Campus Charite Mitte, Berlin, Germany
(Westerhoff) BARMER, Wuppertal, Germany
(Wagner, Liersch) AOK Nordost-Die Gesundheitskasse, Health Services
Management, Berlin, Germany
(Rebscher) IGVresearch-Institut fur Gesundheitsokonomie und
Versorgungsforschung, Hamburg, Germany
(Rebscher) Faculty of Law, Business and Economics, University of Bayreuth,
Bayreuth, Germany
(Wobbe-Ribinski) DAK Gesundheit, Health Services Research and Innovation,
Hamburg, Germany
(Rindfleisch) Internal Medicine with Gastroenterology and Nephrology (CC
13), Charite-Universitatsmedizin Berlin, Berlin, Germany
(Muller-Riemenschneider) Saw Swee Hock School of Public Health, National
University of Singapore, Singapore, Singapore
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Noninvasive remote patient management (RPM) in patients with
heart failure (HF) has been shown to reduce the days lost due to unplanned
cardiovascular hospital admissions and all-cause mortality in the
Telemedical Interventional Management in Heart Failure II trial (TIM-HF2).
The health economic implications of these findings are the focus of the
present analyses from the payer perspective. Methods and Results: A
total of 1538 participants of the TIM-HF2 randomized controlled trial were
assigned to the RPM and Usual Care group. Health claims data were
available for 1450 patients (n = 715 RPM group, n = 735 Usual Care group),
which represents 94.3% of the original TIM-HF2 patient population, were
linked to primary data from the study documentation and evaluated in terms
of the health care cost, total cost (accounting for intervention costs),
costs per day alive and out of hospital (DAOH), and cost per
quality-adjusted life year (QALY). The average health care costs per
patient year amounted to 14,412 (95% CI 13,284-15,539) in the RPM group
and 17,537 (95% CI 16,179-18,894) in the UC group. RPM led to cost
savings of 3125 per patient year (p = 0.001). After including the
intervention costs, a cost saving of 1758 per patient year remained (p =
0.048). Conclusion(s): The additional noninvasive telemedical
interventional management in patients with HF was cost-effective compared
to standard care alone, since such intervention was associated with
overall cost savings and superior clinical effectiveness. Graphical
abstract: [Figure not available: see fulltext.] Copyright © 2021,
The Author(s).

<30>
Accession Number
2014327849
Title
Magnetic Resonance Imaging for Cerebral Micro-embolizations During
Minimally Invasive Mitral Valve Surgery.
Source
Journal of Cardiovascular Translational Research. 15(4) (pp 828-833),
2022. Date of Publication: August 2022.
Author
Barbero C.; Rinaldi M.; Marchetto G.; Valentini M.C.; Cura Stura E.; Bosco
G.; Pocar M.; Filippini C.; Boffini M.; Ricci D.
Institution
(Barbero, Rinaldi, Marchetto, Cura Stura, Pocar, Boffini) Department of
Cardiovascular and Thoracic Surgery, Citta della Salute e della Scienza,
University of Turin, Turin, Italy
(Valentini) Department of Neuroradiology, Citta della Salute e della
Scienza, University of Turin, Turin, Italy
(Bosco) Department of Neurology, Citta Della Salute E Della Scienza,
University of Turin, Turin, Italy
(Filippini) Department of Anesthesia and Critical Care, Citta della Salute
e della Scienza, University of Turin, Turin, Italy
(Ricci) Cardiac Surgery Unit, IRCCS Policlinic Hospital San Martino,
Genova, Italy
(Ricci) Department of Integrated Surgical and Diagnostic Sciences,
University of Genova, Genova, Italy
Publisher
Springer
Abstract
Abstract: The role of aortic clamping techniques on the occurrence of
neurological complications after right mini-thoracotomy mitral valve
surgery is still debated. Brain injuries can occur also as silent cerebral
micro-embolizations (SCM), which have been linked to significant deficits
in physical and cognitive functions. Aims of this study are to evaluate
the overall rate of SCM and to compare endoaortic clamp (EAC) with
trans-thoracic clamp (TTC). Patients enrolled underwent a pre-operative, a
post-operative, and a follow-up MRI. Forty-three patients were enrolled;
EAC was adopted in 21 patients, TTC in 22 patients. Post-operative SCM
were reported in 12 cases (27.9%). No differences between the 2 groups
were highlighted (23.8% SCM in the EAC group versus 31.8% in the TTC). MRI
analysis showed post-operative SCM in nearly 30% of selected patients
after right mini-thoracotomy mitral valve surgery. Subgroup analysis on
different types of aortic clamping showed comparable results. Clinical
Relevance: The rate of SCM reported in the present study on patients
undergoing minimally invasive MVS and RAP is consistent with data in the
literature on patients undergoing cardiac surgery through median
sternotomy and antegrade arterial perfusion. Moreover, no differences were
reported between EAC and TTC: both the aortic clamping techniques are
safe, and the choice of the surgical setting to adopt can be really done
according to the patient's characteristics. Copyright © 2021, The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature.

<31>
Accession Number
2019862125
Title
One-year outcomes of polymer-free amphilimus-eluting stents versus durable
polymer zotarolimus-eluting stents in patients with diabetes mellitus: a
meta-analysis.
Source
Cardiovascular Diabetology. 21(1) (no pagination), 2022. Article Number:
220. Date of Publication: December 2022.
Author
Wang H.; Xie X.; Zu Q.; Lu M.; Chen R.; Yang Z.; Gao Y.
Institution
(Wang, Gao) Department of Cardiology, The People's Hospital of Guangxi
Zhuang Autonomous Region, Guangxi, Nanning 530021, China
(Xie) Macau University of Science and Technology, Macao
(Zu, Lu) College of Management and Economics, Tianjin University, Tianjin
300072, China
(Chen, Yang) The State Key Laboratory Management and Control for Complex
Systems, Institute of Automation, Chinese Academy of Sciences, Beijing
100190, China
Publisher
BioMed Central Ltd
Abstract
Background: Diabetes mellitus (DM) and cardiovascular diseases often
co-exist. Today, percutaneous coronary intervention (PCI) is the preferred
revascularization procedure for majority of patients with coronary artery
disease. Polymer-free amphilimus-eluting stents (AES) represent a novel
elution technology in the current era of drug-eluting stents. In this
analysis, we aimed to systematically compare the cardiovascular outcomes
which are associated with polymer-free amphilimus-eluting stents (AES)
versus the durable polymer zotarolimus-eluting stents (ZES) for the
treatment of patients with DM. Method(s):
Http://www.ClinicalTrials.gov, EMBASE, Web of Science, MEDLINE, Cochrane
database and Google Scholar were searched for publications comparing
polymer-free AES versus durable polymer ZES in patients with DM. Selective
cardiovascular outcomes were assessed. Statistical analysis was carried
out by the latest version of the RevMan software. Risk ratio (RR) with 95%
confidence interval (CI) was used to represent the data analysis.
 Result(s): Four studies with a total number of 1795 participants with
DM whereby 912 patients were assigned to be revascularized by the
polymer-free AES and 883 patients were assigned to be revascularized by
the durable polymer ZES were included in this analysis. In patients with
DM, at one year, polymer-free AES were associated with significantly lower
risk of major adverse cardiac events (MACEs) (RR: 0.69, 95% CI: 0.54-0.88;
P = 0.002) and target lesion failure (TLF) (RR: 0.66, 95% CI: 0.48-0.91; P
= 0.01) compared to durable polymer ZES. However, there was no significant
change in all-cause mortality (RR: 0.79, 95% CI: 0.51-1.22; P = 0.28),
cardiac death and the other cardiovascular outcomes. Similar risk of total
stent thrombosis (RR: 1.13, 95% CI: 0.60-2.13; P = 0.70), including
definite stent thrombosis (RR: 1.12, 95% CI: 0.38-3.31; P = 0.84),
probable stent thrombosis (RR: 0.87, 95% CI: 0.37-2.09; P = 0.76),
possible stent thrombosis (RR: 1.19, 95% CI: 0.50-2.87; P = 0.69) and late
stent thrombosis (RR: 1.00, 95% CI: 0.17-5.72; P = 1.00) as between
polymer-free AES and durable polymer ZES in patients with DM.
 Conclusion(s): At 1 year follow-up, polymer-free AES were associated
with significantly lower MACEs and TLF compared to durable polymer ZES in
these patients with DM, without any increase in mortality, stent
thrombosis and other cardiovascular outcomes. However, this analysis is
only based on a follow-up time period of one year, therefore, future
research should focus on the long term follow-up time
period. Copyright © 2022, The Author(s).

<32>
Accession Number
2018122430
Title
A spray-as-you-go airway topical anesthesia attenuates cardiovascular
responses for double-lumen tube tracheal intubation.
Source
BMC Anesthesiology. 22(1) (no pagination), 2022. Article Number: 203. Date
of Publication: December 2022.
Author
Chen C.; Wen D.; Wang Y.; Li H.; Yu Q.; Li M.
Institution
(Chen, Wen, Wang, Li, Yu, Li) Department of Anesthesiology, Affiliated
Hospital of North Sichuan Medical College, Nanchong 637000, China
Publisher
BioMed Central Ltd
Abstract
Background: Spray-as-you-go (SAYGo) airway topical anesthesia and nerve
block are common techniques used during awake tracheal intubation.
However, their effects have not been described during double-lumen tube
intubation. We report on a prospective randomized study that aimed to
compare the intubation effects of SAYGo and nerve block patients
undergoing thoracic surgery. Method(s): Sixty-six American Society of
Anesthesiologists (ASA) physical status I and II patients were scheduled
to undergo double-lumen tube (DLT) tracheal intubation for thoracic
surgery. The patients were randomly assigned into control (Group C),
ultrasound (Group U), and flexible intubation scope (Group F) groups with
22 cases in each group. Patients in Group C were induced with a standard
anesthetic regimen. Patients in Groups U and F were treated with superior
laryngeal nerve (SLN) block combined with transtracheal injection (TTI)
and given a SAYGo airway topical anesthesia before intubation. Hemodynamic
variables during intubation process were recorded as the primary outcome.
Additional patient data were recorded including the occurrence of adverse
events, the level of hoarseness, the occurrence of sore throats, memory
function and the level of patient satisfaction with anesthesia.
 Result(s): The blood pressure (BP) and heart rate (HR) of patients in
group C was significantly increased 1 min after tracheal intubation (P <
0.05) compared to before anesthesia. The BP and HR of patients in Groups U
and F remained stable. 10 cases of hypertension were observed in Group C,
6 cases in Group U and 1 case in Group F. In Group C, tachycardia was
observed in 9 patients along with 9 cases in Group U and 4 cases in Group
F. In Group U, 4 patients experienced puncture and bleeding were and 8
patients had a poor memory of TTI. No significant differences were found
in the incidence of hoarseness, sore throats, and satisfaction with
anesthesia in postoperative follow-up. Conclusion(s): SAYGo airway
topical anesthesia and SLN block combined with the TTI technique can
inhibit the cardiovascular response during DLT tracheal intubation. The
SAYGo technique has fewer complications and more advantages compared to
other approaches. Copyright © 2022, The Author(s).

<33>
Accession Number
2017975821
Title
Superficial Femoral Artery Access for Infrainguinal Antegrade Endovascular
Interventions in the Hostile Groin: A Prospective Randomized Study.
Source
Annals of Vascular Surgery. 86 (pp 127-134), 2022. Date of Publication:
October 2022.
Author
Zenunaj G.; Traina L.; Acciarri P.; Mucignat M.; Scian S.; Alesiani F.;
Serra R.; Gasbarro V.
Institution
(Zenunaj, Traina, Acciarri) Vascular Surgeon, Unit of Vascular and
Endovascular Surgery, University Hospital of Ferrara, Ferrara, Italy
(Mucignat, Scian, Alesiani) Vascular Surgery, School of Vascular Surgery,
Department of Translational Medicine for Romagna, University of Ferrara,
University Hospital of Ferrara, Ferrara, Italy
(Serra) Vascular Surgeon, Universita Magna Graecia di Catanzaro,
Catanzaro, Italy
(Gasbarro) Vascular Surgery, Unit of Vascular and Endovascular Surgery,
University Hospital of Ferrara, Ferrara, Italy
Publisher
Elsevier Inc.
Abstract
Background: In a hostile groin, it may be difficult to perform antegrade
endovascular procedures at the lower extremities using the ipsilateral
common femoral artery as vascular access; therefore, the use of the
ipsilateral superficial femoral artery (SFA) could be a useful
alternative. In this study, we evaluated the feasibility and safety of
ultrasound-guided SFA puncture versus traditional SFA cutdown to achieve
arterial access. Method(s): This prospective observational randomized
study examined patients with symptomatic peripheral arterial disease who
required endovascular interventions at the lower extremities. A hostile
groin was defined as a high femoral bifurcation, obesity, and surgical
scarring due to previous surgical interventions. A 6-Fr sheath (12 cm
long; ULTIMUM EV INTRODUCER; Abbott, Plymouth, MN, USA) was used in all
procedures. In the percutaneous group, the puncture was performed under
ultrasound guidance and hemostasis was performed using a percutaneous
closure device (PCD) (ANGIO-SEAL VIP 6-Fr; Terumo Medical Corporation,
Somerset, NJ, USA). The primary end points were technical success and
perioperative complications. The secondary end points were the time
required for the management of vascular access and the type of anesthesia
administered. Result(s): Between 2020 and 2021, 107 patients who
underwent antegrade revascularization were enrolled. SFA was achieved in
50 cases by the femoral cutdown technique (c-group) and in 57 cases by
percutaneous ultrasound-guided puncture (p-group). In the c-group, the
time from incision to sheath introduction and the time of suturing the
artery and wound closure was 35 +/- 8 min. In the p-group, the time from
skin puncture and sheath placement plus that from the sheath removal and
hole closure with the PCD was 6 +/- 3 min. For the c-group versus p-group,
the following variables were as follows: high bifurcation, 10 vs. 6 cases
(P = 0.2); severe obesity, 33 vs. 40 cases (P = 0.46); and previous
surgical groin interventions, 7 vs. 9 cases (P = 0.53), respectively. The
technical success rates were 100% vs. 96.49% for the c-group versus
p-group, respectively (P = 0.63). Two percutaneous puncture failures were
managed using the cutdown technique. In the p-group, 2 postprocedural
hematomas were recorded, with only one requiring surgical treatment and 2
with SFA occlusion to intravascular cap hemostatic dislocation, which were
subjected to surgical revision. A total of 3 percutaneous procedures in
the p-group required surgical revision versus none in the c-group (P =
0.1). Within 3 months, complications consisted of 6 cases of surgical
wound complications in the c-group versus none in the p-group (P = 0.009).
All procedures in the p-group versus 72% of patients in the c-group were
managed with local anesthesia (P < 0.0001). Conclusion(s): The
femoral cutdown technique seems to be a safe and successful approach for
achieving vascular access in cases of hostile groin. Ultrasound-guided
puncture and PCD make SFA puncture a successful and safe alternative with
an acceptable complications rate. Moreover, it reduces the time required
to manage vascular access and can be performed mainly under local
anesthesia. Copyright © 2022 Elsevier Inc.

<34>
Accession Number
2020371176
Title
The role of stress echocardiography in transcatheter aortic valve
implantation and transcatheter edge-to-edge repair era: A systematic
review.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 964669. Date of Publication: 16 Nov 2022.
Author
Pavasini R.; Fabbri G.; Bianchi N.; Deserio M.A.; Sanguettoli F.;
Zanarelli L.; Tonet E.; Passarini G.; Serenelli M.; Campo G.
Institution
(Pavasini, Fabbri, Bianchi, Deserio, Sanguettoli, Zanarelli, Tonet,
Passarini, Serenelli, Campo) Cardiology Unit, Azienda
Ospedaliero-Universitaria di Ferrara, Ferrara, Italy
Publisher
Frontiers Media S.A.
Abstract
Objectives: In the last decade, percutaneous treatment of valve disease
has changed the approach toward the treatment of aortic stenosis (AS) and
mitral regurgitation (MR). The clinical usefulness of stress
echocardiography (SE) in the candidates for transcatheter aortic valve
implantation (TAVI) and transcatheter edge-to-edge repair (TEER) of MR
remains to be established. Therefore, the key aim of this review is to
assess the main applications of SE in patients undergoing TAVI or TEER.
 Method(s): We searched for relevant studies to be included in the
systematic review on PubMed (Medline), Cochrane library, Google Scholar,
and Biomed Central databases. The literature search was conducted in
February 2022. The inclusion criteria of the studies were: observational
and clinical trials or meta-analysis involving patients with AS or MR
evaluated with SE (excluding those in which SE was used only for screening
of pseudo-severe stenosis) and treated with percutaneous procedures.
 Result(s): Thirteen studies published between 2013 and 2021 were
included in the review: five regarding candidates for TEER and eight for
TAVI. In TEER candidates, seeing an increase in MR grade, and stroke
volume of >40% during SE performed before treatment was, respectively,
related to clinical benefits (p = 0.008) and an increased quality of life.
Moreover, overall, 25% of patients with moderate secondary MR at rest
before TEER had the worsening of MR during SE. At the same time, in SE
performed after TEER, an increase in mean transvalvular diastolic gradient
and in systolic pulmonary pressure is expected, but without sign and
symptoms of heart failure. Regarding TAVI, several studies showed that
contractile reserve (CR) is not predictive of post-TAVI ejection fraction
recovery and mortality in low-flow low-gradient AS either at 30 days or at
long-term. Conclusion(s): This systematic review shows in TEER
candidates, SE has proved useful in the optimization of patient selection
and treatment response, while its role in TAVI candidates is less defined.
Therefore, larger trials are needed to test and confirm the utility of SE
in candidates for percutaneous procedures of valve diseases. Copyright
© 2022 Pavasini, Fabbri, Bianchi, Deserio, Sanguettoli, Zanarelli,
Tonet, Passarini, Serenelli and Campo.

<35>
Accession Number
2020363365
Title
Prevalence and factors associated with pressure injury in patients
undergoing open heart surgery: A systematic review and meta-analysis.
Source
International Wound Journal. (no pagination), 2022. Date of Publication:
2022.
Author
Taghiloo H.; Ebadi A.; Saeid Y.; Jalali Farahni A.; Davoudian A.
Institution
(Taghiloo) Department of Operating Room and Anesthesiology, School of
Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan,
Iran, Islamic Republic of
(Ebadi) Behavioral Sciences Research Centre, Life Style Institute, School
of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Saeid) Trauma Research Center and Faculty of Nursing, Baqiyatallah
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Jalali Farahni) Atherosclerosis Research Center, Baqiyatallah University
of Medical Sciences, Tehran, Iran, Islamic Republic of
(Davoudian) Deputy of Research and Technology, Zanjan University of
Medical Sciences, Zanjan, Iran, Islamic Republic of
Publisher
John Wiley and Sons Inc
Abstract
Pressure injuries (PIs) are one of the major and costliest medical
problems with severe implications for patients. Cardiovascular surgery
patients are at the higher risk of developing surgery-related PIs. So this
study was conducted with the aim of investigating the prevalence and
factors associated with PIs in patients undergoing open heart surgery. We
identified articles through electronic databases such as Web of Science,
Scopus, PubMed, ProQuest; and Persian Databases: SID, Magiran and Irandoc
without restriction on language or publication period (from inception
through June 2022). Finally, 17 studies that fulfilled eligibility
criteria were included in final systematic review and meta-analysis. Data
analyses were conducted using STATA version 14. The pooled prevalence of
PI in patients undergoing open heart surgery was 24.06% (95% CI:
17.85-30.27). High heterogeneity was observed across the included studies
(I2 = 96.0, P < 0.000). The prevalence by gender was reported
as 25.19% (95% CI: 13.45-36.93) in men and 33.36% (95 CI%: 19.99-46.74) in
women. The result showed there was statistically significant association
between PI and Female sex (Pooled Est: 1.551, 95% CI: 1.199-2.006, z =
3.345, P = 0.001), diabetes (Pooled Est: 1.985, 95% CI: 1.383-2.849, z =
3.719, P = 0.000), advanced age (SMD: 0.33 years; 95% CI: 0.09-0.57),
Duration of surgery (SMD: 0.47; 95% CI: 0.19-0.75) and preoperative serum
albumin level (SMD: 0.56; 95% CI: 0.14-0.98). The relatively high PIs
incidence among patients undergoing open heart surgery suggests that
typical PI prevention methods are insufficient for this population.
Targeted prevention measures must be developed and
implemented. Copyright © 2022 The Authors. International Wound
Journal published by Medicalhelplines.com Inc (3M) and John Wiley & Sons
Ltd.

<36>
Accession Number
639675339
Title
Association between Serum Oxysterols and Coronary Plaque Regression during
Lipid-Lowering Therapy with Statin and Ezetimibe: Insights from the CuVIC
Trial.
Source
Journal of atherosclerosis and thrombosis. (no pagination), 2022. Date of
Publication: 01 Dec 2022.
Author
Nakano Y.; Yamamoto M.; Matoba T.; Katsuki S.; Nakashiro S.; Takase S.;
Akiyama Y.; Nagata T.; Mukai Y.; Inoue S.; Oi K.; Higo T.; Takemoto M.;
Suematsu N.; Eshima K.; Miyata K.; Usui M.; Sadamatsu K.; Kadokami T.;
Hironaga K.; Ichi I.; Todaka K.; Kishimoto J.; Tsutsui H.
Institution
(Nakano, Matoba, Katsuki, Takase, Akiyama, Nagata, Tsutsui) Department of
Cardiovascular Medicine, Kyushu University Hospital
(Yamamoto) Department of Cardiovascular Medicine, Harasanshin Hospital
(Nakashiro) Department of Cardiovascular Medicine, Matsuyama Red Cross
Hospital
(Mukai) Department of Cardiovascular Medicine, Japanese Red Cross Fukuoka
Hospital
(Inoue) Department of Cardiovascular Medicine, Aso Iizuka Hospital
(Oi, Suematsu) Department of Cardiovascular Medicine, Saiseikai Fukuoka
General Hospital
(Higo) Department of Cardiovascular Medicine, National Hospital
Organization Kyushu Medical Centre
(Takemoto) Cardiovascular Center, Steel Memorial Yawata Hospital
(Eshima) Department of Cardiovascular Medicine, Saga-ken Medical Centre
Koseikan
(Miyata) Department of Cardiovascular Medicine, Japan Community Health
Care Organization, Kyushu Hospital
(Usui) Department of Cardiovascular Medicine, Hamanomachi Hospital
(Sadamatsu) Department of Cardiovascular Medicine, Omuta City Hospital
(Kadokami) Department of Cardiovascular Medicine, Saiseikai Futsukaichi
Hospital
(Hironaga) Department of Cardiovascular Medicine, Fukuoka City Hospital
(Ichi) Graduate School of Humanities and Science, Ochanomizu University
(Todaka, Kishimoto) Center for Clinical and Translational Research of
Kyushu University Hospital
(Tsutsui) Department of Cardiovascular Medicine, Kyushu University
Graduate School of Medical Sciences
Publisher
NLM (Medline)
Abstract
AIM: Several clinical trials using intravascular ultrasound (IVUS)
evaluation have demonstrated that intensive lipid-lowering therapy by
statin or a combination therapy with statin and ezetimibe results in
significant regression of coronary plaque volume. However, it remains
unclear whether adding ezetimibe to statin therapy affects coronary plaque
composition and the molecular mechanisms of plaque regression. We
conducted this prospective IVUS analysis in a subgroup from the CuVIC
trial. METHOD(S): The CuVIC trial was a prospective randomized, open,
blinded-endpoint trial conducted among 11 cardiovascular centers, where
260 patients with coronary artery disease who received coronary stenting
were randomly allocated into either the statin group (S) or the combined
statin and ezetimibe group (S+E). We enrolled 79 patients (S group, 39
patients; S+E group, 40 patients) in this substudy, for whom serial IVUS
images of nonculprit lesion were available at both baseline and after 6-8
months of follow-up. RESULT(S): After the treatment period, the S+E
group had significantly lower level of low-density lipoprotein cholesterol
(LDL-C; 80.9+/-3.7 vs. 67.7+/-3.8 mg/dL, p=0.0143). Campesterol, a marker
of cholesterol absorption, and oxysterols (beta-epoxycholesterol,
4beta-hydroxycholesterol, and 27-hydroxycholesterol) were also lower in
the S +E group. IVUS analyses revealed greater plaque regression in the
S+E group than in the S group (-6.14% vs. -1.18% for each group, p=0.042).
It was noteworthy that the lowering of campesterol and
27-hydroxycholesterol, but not LDL-C, had a significant positive
correlation with plaque regression. CONCLUSION(S): Compared with
statin monotherapy, ezetimibe in combination with statin achieved
significantly lower LDL-C, campesterol, and 27-hydroxycholesterol, which
resulted in greater coronary plaque regression.

<37>
Accession Number
638581346
Title
Effect of High-vs Low-Dose Tranexamic Acid Infusion on Need for Red Blood
Cell Transfusion and Adverse Events in Patients Undergoing Cardiac
Surgery: The OPTIMAL Randomized Clinical Trial.
Source
JAMA. 328(4) (pp 336-347), 2022. Date of Publication: 26 Jul 2022.
Author
Shi J.; Zhou C.; Pan W.; Sun H.; Liu S.; Feng W.; Wang W.; Cheng Z.; Wang
Y.; Zheng Z.
Institution
(Shi, Zhou, Sun, Liu, Feng, Wang, Zheng) Department of Cardiovascular
Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital,
National Center for Cardiovascular Diseases, Chinese Academy of Medical
Sciences, Peking Union Medical College, No. 167 Beilishi Rd, Xicheng
District, Beijing 100037, China
(Pan) Department of Anesthesiology, Baylor College of Medicine, Texas
Heart Institute, Houston, United States
(Wang) Department of Anesthesiology, First Affiliated Hospital of Wenzhou
Medical University, Wenzhou, China
(Cheng) Department of Cardiovascular Surgery, Henan Province People's
Hospital, Fuwai Central China Cardiovascular Hospital, Henan
Cardiovascular Hospital, Zhengzhou University, Zhengzhou, China
(Zheng) National Health Commission Key Laboratory of Cardiovascular
Regenerative Medicine, Fuwai Central China Hospital, Central China Branch
of National Center for Cardiovascular Diseases, No. 1 Fuwai Ave, Zhengdong
New District, Zhengzhou 451464, China
Publisher
American Medical Association
Abstract
Importance: Tranexamic acid is recommended for reducing blood loss and
transfusion in cardiac surgery. However, it remains unknown whether a high
dose of tranexamic acid provides better blood-sparing effect than a low
dose without increasing the risk of thrombotic complications or seizures
in cardiac surgery. Objective(s): To compare the efficacy and adverse
events of high-dose vs low-dose tranexamic acid in patients undergoing
cardiac surgery with cardiopulmonary bypass. Design, Setting, and
Participant(s): Multicenter, double-blind, randomized clinical trial among
adult patients undergoing cardiac surgery with cardiopulmonary bypass. The
study enrolled 3079 patients at 4 hospitals in China from December 26,
2018, to April 21, 2021; final follow-up was on May 21, 2021.
 Intervention(s): Participants received either a high-dose tranexamic
acid regimen comprising a 30-mg/kg bolus, a 16-mg/kg/h maintenance dose,
and a 2-mg/kg prime (n = 1525) or a low-dose regimen comprising a 10-mg/kg
bolus, a 2-mg/kg/h maintenance dose, and a 1-mg/kg prime (n = 1506).
 Main Outcomes and Measures: The primary efficacy end point was the
rate of allogeneic red blood cell transfusion after start of operation
(superiority hypothesis), and the primary safety end point was a composite
of the 30-day postoperative rate of mortality, seizure, kidney dysfunction
(stage 2 or 3 Kidney Disease: Improving Global Outcomes [KDIGO] criteria),
and thrombotic events (myocardial infarction, ischemic stroke, deep vein
thrombosis, and pulmonary embolism) (noninferiority hypothesis with a
margin of 5%). There were 15 secondary end points, including the
individual components of the primary safety end point. Result(s):
Among 3079 patients who were randomized to treatment groups (mean age,
52.8 years; 38.1% women), 3031 (98.4%) completed the trial. Allogeneic red
blood cell transfusion occurred in 333 of 1525 patients (21.8%) in the
high-dose group and 391 of 1506 patients (26.0%) in the low-dose group
(risk difference [RD],-4.1% [1-sided 97.55% CI,- to-1.1%]; relative risk,
0.84 [1-sided 97.55% CI,- to 0.96; P =.004]). The composite of
postoperative seizure, thrombotic events, kidney dysfunction, and death
occurred in 265 patients in the high-dose group (17.6%) and 249 patients
in the low-dose group (16.8%) (RD, 0.8%; 1-sided 97.55% CI,- to 3.9%; P
=.003 for noninferiority). Fourteen of the 15 prespecified secondary end
points were not significantly different between groups, including seizure,
which occurred in 15 patients (1.0%) in the high-dose group and 6 patients
(0.4%) in the low-dose group (RD, 0.6%; 95% CI,-0.0% to 1.2%; P =.05).
 Conclusions and Relevance: Among patients who underwent cardiac
surgery with cardiopulmonary bypass, high-dose compared with low-dose
tranexamic acid infusion resulted in a modest statistically significant
reduction in the proportion of patients who received allogeneic red blood
cell transfusion and met criteria for noninferiority with respect to a
composite primary safety end point consisting of 30-day mortality,
seizure, kidney dysfunction, and thrombotic events. Trial Registration:
ClinicalTrials.gov Identifier: NCT03782350. Copyright © 2022
American Medical Association. All rights reserved.

<38>
[Use Link to view the full text]
Accession Number
630982106
Title
Society of Cardiovascular Anesthesiologists Clinical Practice Improvement
Advisory for Management of Perioperative Bleeding and Hemostasis in
Cardiac Surgery Patients.
Source
Anesthesia and Analgesia. 129(5) (pp 1209-1221), 2019. Date of
Publication: 01 Nov 2019.
Author
Raphael J.; Mazer C.D.; Subramani S.; Schroeder A.; Abdalla M.; Ferreira
R.; Roman P.E.; Patel N.; Welsby I.; Greilich P.E.; Harvey R.; Ranucci M.;
Heller L.B.; Boer C.; Wilkey A.; Hill S.E.; Nuttall G.A.; Palvadi R.R.;
Patel P.A.; Wilkey B.; Gaitan B.; Hill S.S.; Kwak J.; Klick J.; Bollen
B.A.; Shore-Lesserson L.; Abernathy J.; Schwann N.; Lau W.T.
Institution
(Raphael) University of Virginia Health System, Charlottesville, VA 22908,
United States
(Mazer) St Michael's Hospital, University of Toronto, Toronto, ON, Canada
(Subramani) University of Iowa, Iowa City, IA, United States
(Schroeder) University of Wisconsin Medical Center, Madison, WI, United
States
(Abdalla) Cleveland Clinic, Cleveland, OH, United States
(Ferreira) University of Washington Medical Center, Seattle, WA, United
States
(Roman) Centura St Anthony Hospital, Lakewood, CO, United States
(Patel) University of California San Francisco, San Francisco, CA, United
States
(Welsby) Duke University Hospital, Durham, NC, United States
(Greilich) UT Southwestern Medical Center, Dallas, TX, United States
(Harvey) UCLA Medical Center, Los Angeles, CA, United States
(Ranucci) IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
(Heller) Swedish Medical Center, Seattle, WA, United States
(Boer) VU University Medical Center, Amsterdam, Netherlands
(Wilkey) Abbott Northwestern Hospital, Minneapolis, MN, United States
(Hill) Mayo Clinic, Rochester, MN, United States
(Nuttall) Baylor College of Medicine, Houston, TX, United States
(Palvadi) University of Pennsylvania Medical Center, Philadelphia, PA,
United States
(Patel) University of Colorado, Denver, CO, United States
(Wilkey) Mayo Clinic, Phoenix, AZ, United States
(Gaitan) Weill Cornell Medical Center, New York, NY, United States
(Hill) Loyola University Medical Center, Maywood, IL, United States
(Kwak) Case Western University Medical Center, Cleveland, OH, United
States
(Klick) Missoula Anesthesiology, Missoula, MT, United States
(Bollen) Zucker School of Medicine at Hofstra/Northwell, Northshore
University Hospital, Manhasset, NY, United States
(Shore-Lesserson) Johns Hopkins Medical Center, Baltimore, MD, United
States
(Abernathy) Lehigh Valley Health Network, University of South Florida
Morsani College of Medicine, Tampa, FL, United States
(Schwann) AAA Anesthesia Associates, PhyMed Healthcare Group, Allentown,
PA, United States
(Lau) Pacific Anesthesia, Honolulu, HI, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Bleeding after cardiac surgery is a common and serious complication
leading to transfusion of multiple blood products and resulting in
increased morbidity and mortality. Despite the publication of numerous
guidelines and consensus statements for patient blood management in
cardiac surgery, research has revealed that adherence to these guidelines
is poor, and as a result, a significant variability in patient transfusion
practices among practitioners still remains. In addition, although
utilization of point-of-care (POC) coagulation monitors and the use of
novel therapeutic strategies for perioperative hemostasis, such as the use
of coagulation factor concentrates, have increased significantly over the
last decade, they are still not widely available in every institution.
Therefore, despite continuous efforts, blood transfusion in cardiac
surgery has only modestly declined over the last decade, remaining at
>=50% in high-risk patients. Given these limitations, and in response to
new regulatory and legislature requirements, the Society of Cardiovascular
Anesthesiologists (SCA) has formed the Blood Conservation in Cardiac
Surgery Working Group to organize, summarize, and disseminate the
available best-practice knowledge in patient blood management in cardiac
surgery. The current publication includes the summary statements and
algorithms designed by the working group, after collection and review of
the existing guidelines, consensus statements, and recommendations for
patient blood management practices in cardiac surgery patients. The
overall goal is creating a dynamic resource of easily accessible
educational material that will help to increase and improve compliance
with the existing evidence-based best practices of patient blood
management by cardiac surgery care teams. Copyright © 2019
International Anesthesia Research Society.

<39>
Accession Number
2021325648
Title
Coordinating Cardiology clinics randomized trial of interventions to
improve outcomes (COORDINATE) - Diabetes: rationale and design.
Source
American Heart Journal. 256 (pp 2-12), 2023. Date of Publication: February
2023.
Author
Nelson A.J.; Pagidipati N.J.; Kelsey M.D.; Ardissino M.; Aroda V.R.;
Cavender M.A.; Lopes R.D.; Al-Khalidi H.R.; Braceras R.; Gaynor T.;
Kaltenbach L.A.; Kirk J.K.; Lingvay I.; Magwire M.L.; O'Brien E.C.; Pak
J.; Pop-Busui R.; Richardson C.R.; Levya M.; Senyucel C.; Webb L.; McGuire
D.K.; Green J.B.; Granger C.B.
Institution
(Nelson, Pagidipati, Kelsey, Ardissino, Lopes, Al-Khalidi, Kaltenbach,
O'Brien, Levya, Webb, Green, Granger) Duke Clinical Research Institute,
Durham, NC
(Aroda) Brigham and Women's Hospital, Boston, MA
(Cavender) University of North Carolina, Chapel Hill, NC, United States
(Braceras, Gaynor, Pak) Boehringer Ingelheim Pharmaceuticals, Inc.,
Ridgefield, CT, United States
(Kirk) Wake Forest University School of Medicine, Winston Salem, NC
(Lingvay, McGuire) University of Texas Southwestern Medical Center,
Dallas, TX, United States
(Magwire) St Luke's Health System, Kansas, MO, United States
(Pop-Busui, Richardson) University of Michigan Medical School, Ann Arbor,
MI, United States
(Senyucel) Eli Lilly and Company, Indiannapolis, IN
(McGuire) Parkland Health and Hospital System, Dallas, TX, United States
Publisher
Elsevier Inc.
Abstract
Several medications that are proven to reduce cardiovascular events exist
for individuals with type 2 diabetes mellitus (T2DM) and atherosclerotic
cardiovascular disease, however they are substantially underused in
clinical practice. Clinician, patient, and system-level barriers all
contribute to these gaps in care; yet, there is a paucity of high quality,
rigorous studies evaluating the role of interventions to increase
utilization. The COORDINATE-Diabetes trial randomized 42 cardiology
clinics across the United States to either a multifaceted, site-specific
intervention focused on evidence-based care for patients with T2DM or
standard of care. The multifaceted intervention comprised the development
of an interdisciplinary care pathway for each clinic, audit-and-feedback
tools and educational outreach, in addition to patient-facing tools. The
primary outcome is the proportion of individuals with T2DM prescribed
three key classes of evidence-based medications (high-intensity statin,
angiotensin converting enzyme inhibitor or angiotensin receptor blocker,
and either a sodium/glucose cotransporter-2 inhibitor (SGLT-2i) inhibitor
or glucagon-like peptide 1 receptor agonist (GLP-1RA) and will be assessed
at least 6 months after participant enrollment. COORDINATE-Diabetes aims
to identify strategies that improve the implementation and adoption of
evidence-based therapies. Copyright © 2022 Elsevier Inc.

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

<41>
Accession Number
2019857886
Title
Oral anticoagulants: a systematic overview of reviews on efficacy and
safety, genotyping, self-monitoring, and stakeholder experiences.
Source
Systematic Reviews. 11(1) (no pagination), 2022. Article Number: 232. Date
of Publication: December 2022.
Author
Khouja C.; Brunton G.; Richardson M.; Stokes G.; Blanchard L.; Burchett
H.; Khatwa M.; Walker R.; Wright K.; Sowden A.; Thomas J.
Institution
(Khouja, Walker, Wright, Sowden) Centre for Reviews and Dissemination,
University of York, York, United Kingdom
(Brunton, Richardson, Stokes, Khatwa, Thomas) EPPI-Centre, UCL Institute
of Education, London, United Kingdom
(Blanchard, Burchett) London School of Hygiene and Tropical Medicine,
London, United Kingdom
Publisher
BioMed Central Ltd
Abstract
Background: This systematic overview was commissioned by England's
Department of Health and Social Care (DHSC) to assess the evidence on
direct (previously 'novel') oral anticoagulants (OACs), compared with
usual care, in adults, to prevent stroke related to atrial fibrillation
(AF), and to prevent and treat venous thromboembolism (VTE). Specifically,
to assess efficacy and safety, genotyping, self-monitoring, and patient
and clinician experiences of OACs. Method(s): We searched MEDLINE,
Embase, ASSIA, and CINAHL, in October, 2017, updated in November 2021. We
included systematic reviews, published from 2014, in English, assessing
OACs, in adults. We rated review quality using AMSTAR2 or the JBI
checklist. Two reviewers extracted and synthesised the main findings from
the included reviews. Result(s): We included 49 systematic reviews;
one evaluated efficacy, safety, and cost-effectiveness, 17 assessed
genotyping, 23 self-monitoring or adherence, and 15 experiences (seven
assessed two topics). Generally, the direct OACs, particularly apixaban (5
mg twice daily), were more effective and safer than warfarin in preventing
AF-related stroke. For VTE, there was little evidence of differences in
efficacy between direct OACs and low-molecular-weight heparin
(prevention), warfarin (treatment), and warfarin or aspirin (secondary
prevention). The evidence suggested that some direct OACs may reduce the
risk of bleeding, compared with warfarin. One review of genotype-guided
warfarin dosing assessed AF patients; no significant differences in stroke
prevention were reported. Education about OACs, in patients with AF, could
improve adherence. Pharmacist management of coagulation may be better than
primary care management. Patients were more adherent to direct OACs than
warfarin. Drug efficacy was highly valued by patients and most clinicians,
followed by safety. No other factors consistently affected patients'
choice of anticoagulant and adherence to treatment. Patients were more
satisfied with direct OACs than warfarin. Conclusion(s): For stroke
prevention in AF, direct OACs seem to be more effective and safer than
usual care, and apixaban (5 mg twice daily) had the best profile. For VTE,
there was no strong evidence that direct OACs were better than usual care.
Education and pharmacist management could improve coagulation control.
Both clinicians and patients rated efficacy and safety as the most
important factors in managing AF and VTE. Systematic review registration:
PROSPERO CRD42017084263-one deviation; efficacy and safety were from one
review. Copyright © 2022, The Author(s).

<42>
Accession Number
2021241964
Title
Direct Oral Anticoagulants (DOACs) are Non-Inferior to Vitamin K
Antagonists for Patients Undergoing Transcatheter Aortic Valve Replacement
with Indications of Anticoagulation.
Source
Reviews in Cardiovascular Medicine. 23(10) (no pagination), 2022. Article
Number: 346. Date of Publication: October 2022.
Author
Wang J.; Zhang F.-Y.; Liu L.; Pan M.-M.; Zhang C.; Chen J.; Bian Y.; Lin
H.-W.; Gu Z.-C.
Institution
(Wang, Liu, Pan, Zhang, Lin, Gu) Department of Pharmacy, Ren Ji Hospital,
Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
(Zhang, Chen) Department of Evidence-Based Medicine and Clinical
Epidemiology, West China Hospital, Sichuan University, Sichuan, Chengdu
610041, China
(Bian) Personalized Drug Therapy Key Laboratory of Sichuan Province,
Department of Pharmacy, Sichuan Provincial People's Hospital, School of
Medicine, University of Electronic Science and Technology of China,
Sichuan, Chengdu 610072, China
(Gu) Drug Clinical Comprehensive Evaluation Group, Shanghai Pharmaceutical
Association, Shanghai 200040, China
Publisher
IMR Press Limited
Abstract
Background: The best anticoagulation choice for patients undergoing
transcatheter aortic valve replacement (TAVR) with indications of oral
anticoagulation (OAC) remains uncertain. We carried out a comprehensive
analysis adopting updated evidence that investigated the efficacy and
safety of direct oral anticoagulants (DOACs) versus vitamin K antagonists
(VKAs) in this population. Method(s): A systematic search has been
conducted through PubMed, Embase, and Cochrane Library to collect
randomized controlled trials (RCTs) and real-world studies comparing the
therapy outcomes of DOACs with VKAs in patients undergoing TAVR with
indications of OAC up to Dec 2021. Included studies reported all-cause
mortality, bleeding, stroke, or composite endpoint. A random-effects model
was used and followed a sensitivity analysis based on the heterogeneity.
In addition, five scenario analyses were performed to robust our findings.
 Result(s): Our analysis included 11 articles enrolling a total of
8934 patients undergone TAVR with indications of OAC (DOACs group = 3890,
VKAs group = 5044). Pooled analysis revealed no significant different risk
of all-cause mortality (aHR: 0.95, 95% CI: 0.65-1.39, I2:
90.6%), stroke (aHR: 0.86, 95% CI: 0.55-1.35, I2: 44.3%),
bleeding (aHR: 0.83, 95% CI: 0.61-1.13, I2: 76.3%), and
composite endpoint (aHR: 1.05, 95% CI: 0.88-1.24, I2: 11.7%) in
the DOACs and VKAs groups. Various forms of death, stroke and bleeding,
including cardiovascular death (aHR: 0.92, 95% CI: 0.64-1.33,
I2: 34.1%), hemorrhagic stroke (aHR: 0.63, 95% CI: 0.23-1.75,
I2: 22.7%), ischemic stroke (aHR: 0.79, 95% CI: 0.56-1.15,
I2: 0.0%), transient ischemic attack (aHR: 0.75, 95% CI:
0.40-1.41, I2: 0.0%), major or life-threatening bleeding (aHR:
0.96, 95% CI: 0.74-1.24, I2: 27.9%), and minor bleeding (aHR:
0.90, 95% CI: 0.52-1.57, I2: 54.3%), also showed similar rates
among DOACs and VKAs groups. The results based on five scenarios confirmed
the said findings. Conclusion(s): Compared with VKAs, the efficacy
and safety of DOACs were comparable for treating TAVR patients combined
with anticoagulation indications. Further large-scale RCTs investigating
more detailed scenarios are still needed to confirm the optimal
anticoagulation strategy. Copyright © 2022 The Author(s).
Published by IMR Press.

<43>
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. 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. 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. 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. Copyright ©
2022 Elsevier Ltd

<44>
Accession Number
2021291580
Title
Prediction of endotracheal tube size in the pediatric age group by
ultrasound: A systematic review and meta-analysis.
Source
Journal of Anaesthesiology Clinical Pharmacology. 38(3) (pp 371-383),
2022. Date of Publication: July 2022.
Author
Gupta B.; Ahluwalia P.
Institution
(Gupta) AIIMS, Uttrakhand, Rishikesh, India
(Ahluwalia) Department of Anaesthesia, Teerthanker Mahaveer Medical
College, Uttar Pradesh, Moradabad, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Anatomical differences in the airway in pediatric patients, compared to
adults pose many challenges during endotracheal intubation, such as
selecting the proper sized endotracheal tube (ETT) during intubation. Our
primary objective was to assess how accurate is ultrasound (US)
co-relation in comparison to standard age-based formulas in pediatric
patients. Meta-analysis was registered in PROSPERO 2020, CRD42020220041.
Online literature available in PubMed, Cochrane, and Embase, Goggle
scholar was searched from year 2000 till November 30, 2020, using relevant
Mesh terms, ('airway US' OR (('airway'/exp OR airway) AND ('US'/exp OR
US))) AND ('endotracheal intubation'/exp OR 'endotracheal intubation') AND
('pediatric'/exp OR pediatric)' to Predict endotracheal tube
size/placement in pediatric age (neonate till 18 years) by the US.
Bibliographic cross-references of selected publications were further
manually screened. The full texts of each article were studied, once the
abstract was found appropriate independently by two reviewers. A total of
48 papers published between 2010 and 2020 were identified as relevant and
read in detail. Average numbers of patients were 86 and total numbers of
patients were 1978. Most of the studies included pediatric patients posted
for elective surgeries under general anesthesia and excluded emergency
procedures, known laryngeal or tracheal pathology, high-risk patients,
recent upper respiratory tract infections or allergy to ultrasound gel. A
total of 18 independent correlations were analyzed. Final combined r value
calculated from all the included articles was 0.824 (95% CI 0.677, 0.908)
with a P < 0.00001 {strong co-relation (r > 0.80)}. Q statistic of
756.484, and I 2 statistics of 97.53% showed a large degree of
heterogeneity in the effect size across the studies. Use of US for upper
airway in pediatric patients is an effective modality and can effectively
predict endotracheal tube size estimations in comparison to standard
age-based or height-based formulae in the pediatric age group. US is a
non-invasive, cost-effective, portable, and reproducible technique as
compared to CT and MRI. It also takes less time with increasing expertise
and experience. Copyright © 2022 Wolters Kluwer Medknow
Publications. All rights reserved.

<45>
Accession Number
2013498473
Title
Outcomes of conduction system pacing compared to right ventricular pacing
as a primary strategy for treating bradyarrhythmia: systematic review and
meta-analysis.
Source
Clinical Research in Cardiology. 111(11) (pp 1198-1209), 2022. Date of
Publication: November 2022.
Author
Abdin A.; Aktaa S.; Vukadinovic D.; Arbelo E.; Burri H.; Glikson M.; Meyer
C.; Munyombwe T.; Nielsen J.C.; Ukena C.; Vernooy K.; Gale C.P.
Institution
(Abdin, Vukadinovic, Ukena) Cardiology, Angiology and Intensive Care
Medicine, Internal Medicine Clinic III, Saarland University Hospital,
Kirrberger Street 100, Saarland, Homburg 66421, Germany
(Aktaa, Munyombwe, Gale) Leeds Institute of Cardiovascular and Metabolic
Medicine, Faculty of Medicine and Health, University of Leeds, Leeds LS2
9JT, United Kingdom
(Aktaa, Gale) Department of Cardiology, Leeds Teaching Hospitals NHS
Trust, Leeds LS1 3EX, United Kingdom
(Arbelo) Cardiology Department, Arrhythmia Section, Hospital Clinic,
Universitat de Barcelona, C. Villarroel 170, Esc 3, Planta 6, Barcelona
08036, Spain
(Arbelo) IDIBAPS, Institut D'Investigacio August Pi I Sunyer (IDIBAPS),
Barcelona, Spain
(Arbelo) Centro de Investigacion Biomedica en Red de Enfermedades
Cardiovasculares (CIBERCV), Madrid, Spain
(Burri) Cardiology Department, Geneva University Hospital, Geneva,
Switzerland
(Glikson) Cardiology Department, Shaare Zedek Hospital, affiliated to the
Hebrew University, Jerusalem, Israel
(Meyer) University Heart Center, Hamburg, Cardiac Neuro- and
Electrophysiology Research Consortium, EVK Dusseldorf, Dusseldorf, Germany
(Nielsen) Department of Cardiology, Aarhus University Hospital, Aarhus,
Denmark
(Nielsen) Department of Clinical Medicine, Aarhus University, Aarhus,
Denmark
(Vernooy) Department of Cardiology, Cardiovascular Research Institute
Maastricht (CARIM), Maastricht University Medical Center, Maastricht,
Netherlands
(Vernooy) Radboud University Medical Center, Nijmegen, Netherlands
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Right ventricular pacing (RVP) may cause electrical and
mechanical desynchrony leading to impaired left ventricular ejection
fraction (LVEF). We investigated the outcomes of RVP with His bundle
pacing (HBP) and left bundle branch pacing (LBBP) for patients requiring a
de novo permanent pacemaker (PPM) for bradyarrhythmia. Methods and
Results: Systematic review of randomized clinical trials and observational
studies comparing HBP or LBP with RVP for de novo PPM implantation between
01 January 2013 and 17 November 2020 was performed. Random and fixed
effects meta-analyses of the effect of pacing technology on outcomes were
performed. Study outcomes included all-cause mortality, heart failure
hospitalization (HFH), LVEF, QRS duration, lead revision, atrial
fibrillation, procedure parameters, and pacing metrics. Overall, 9 studies
were included (6 observational, 3 randomised). HBP compared with RVP was
associated with decreased HFH (risk ratio [RR] 0.68, 95% confidence
interval [CI] 0.49-0.94), preservation of LVEF (mean difference [MD] 0.81,
95% CI - 1.23 to 2.85 vs. - 5.72, 95% CI - 7.64 to -3.79), increased
procedure duration (MD 15.17 min, 95% CI 11.30-19.04), and increased lead
revisions (RR 5.83, 95% CI 2.17-15.70, p = 0.0005). LBBP compared with RVP
was associated with shorter paced QRS durations (MD 5.6 ms, 95% CI - 6.4
to 17.6) vs. (51.0 ms, 95% CI 39.2-62.9) and increased procedure duration
(MD 37.78 min, 95% CI 20.04-55.51). Conclusion(s): Of the limited
studies published, this meta-analysis found that HBP and LBBP were
superior to RVP in maintaining physiological ventricular activation as an
initial pacing strategy. Copyright © 2021, The Author(s).

<46>
Accession Number
2019504861
Title
The physiological insight of Coenzyme-Q10 administration in preventing the
incidence of reperfusion arrhythmia among patients undergoing coronary
artery bypass grafting surgery.
Source
Journal of Basic and Clinical Physiology and Pharmacology. 33(6) (pp
695-701), 2022. Date of Publication: 01 Nov 2022.
Author
Wardhani L.F.K.; Dewi I.P.; Putra K.N.S.; Andrianto A.; Soemantri D.
Institution
(Wardhani, Dewi, Putra, Andrianto, Soemantri) Faculty of Medicine,
Airlangga University, Surabaya, Indonesia
(Wardhani, Dewi, Putra, Andrianto, Soemantri) Department of Cardiology and
Vascular Medicine, Dr. Soetomo General Hospital, Surabaya, Indonesia
(Dewi) Faculty of Medicine, Duta Wacana Christian University, Yogyakarta,
Indonesia
Publisher
De Gruyter Open Ltd
Abstract
Reperfusion arrhythmia following cardiac surgery has long been studied as
part of myocardial damage. Reperfusion injury is thought to be exacerbated
by oxygen-free radicals, whereas arrhythmogenic oscillations in membrane
potential are mediated by reactive oxygen. Coenzyme Q10 is a lipid-soluble
antioxidant that inhibits lipid peroxidation in biological membranes and
supplies ATP cell synthesis, required as the organism's primary energy
source. This process explains how Coenzyme Q10 helps stabilize membranes
and avoids critical metabolite depletion that may relate to reperfusion
arrhythmia. There is a reduction of iatrogenic Coenzyme Q10 after coronary
artery bypass surgery (CABG). On the other hand, there is an increased
inflammatory process and cellular demand post CABG procedure. It leads to
ischemia that can be manifested as arrhythmia. Reperfusion arrhythmia was
less common in patients who took Coenzyme Q10. These findings suggest that
Coenzyme Q10 supplementation might help patients with heart surgery avoid
reperfusion arrhythmia. However, a higher-quality randomized controlled
study is needed to determine the effect of Coenzyme Q10 in preventing
reperfusion arrhythmia in cardiac surgery patients. Copyright ©
2022 Walter de Gruyter GmbH, Berlin/Boston.

<47>
Accession Number
639655259
Title
High versus low blood pressure targets for cardiac surgery while on
cardiopulmonary bypass.
Source
Cochrane Database of Systematic Reviews. 2022(11) (no pagination), 2022.
Article Number: CD013494. Date of Publication: 30 Nov 2022.
Author
Kotani Y.; Kataoka Y.; Izawa J.; Fujioka S.; Yoshida T.; Kumasawa J.;
Kwong J.S.W.
Institution
(Kotani) Department of Intensive Care Medicine, Kameda Medical Center,
Kamogawa, Japan
(Kataoka) Department of Internal Medicine, Kyoto Min-iren Asukai Hospital,
Kyoto, Japan
(Kataoka) Scientific Research Works Peer Support Group (SRWS-PSG), Osaka,
Japan
(Kataoka) Section of Clinical Epidemiology, Department of Community
Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
(Kataoka) Department of Healthcare Epidemiology, Kyoto University Graduate
School of Medicine/School of Public Health, Kyoto, Japan
(Izawa) Division of Critical Care Medicine, Department of Internal
Medicine, Okinawa Prefectural Chubu Hospital, Uruma, Okinawa, Japan
(Izawa) Department of Preventive Services, Kyoto University Graduate
School of Public Health, Kyoto, Japan
(Fujioka) Department of Anesthesiology, Jikei University School of
Medicine, Tokyo, Japan
(Yoshida) Intensive Care Unit, Jikei University Kashiwa Hospital,
Department of Emergency Medicine, Jikei University School of Medicine,
Tokyo, Japan
(Yoshida) Department of Health Data Science, Graduate School of Data
Science, Yokohama City University, Yokohama, Japan
(Kumasawa) Department of Critical Care Medicine, Sakai City Medical
Center, Sakai City, Japan
(Kumasawa) Human Health Sciences, Kyoto University Graduate School of
Medicine, Kyoto, Japan
(Kwong) Global Health Nursing, Graduate School of Nursing Science, St
Luke's International University, Tokyo, Japan
Publisher
John Wiley and Sons Ltd
Abstract
Background: Cardiac surgery is performed worldwide. Most types of cardiac
surgery are performed using cardiopulmonary bypass (CPB). Cardiac surgery
performed with CPB is associated with morbidities. CPB needs an
extracorporeal circulation that replaces the heart and lungs, and performs
circulation, ventilation, and oxygenation of the blood. The lower limit of
mean blood pressure to maintain blood flow to vital organs increases in
people with chronic hypertension. Because people undergoing cardiac
surgery commonly have chronic hypertension, we hypothesised that
maintaining a relatively high blood pressure improves desirable outcomes
among the people undergoing cardiac surgery with CPB. Objective(s):
To evaluate the benefits and harms of higher versus lower blood pressure
targets during cardiac surgery with CPB. Search Method(s): We used
standard, extensive Cochrane search methods. The latest search of
databases was November 2021 and trials registries in January 2020.
 Selection Criteria: We included randomised controlled trials (RCTs)
comparing a higher blood pressure target (mean arterial pressure 65 mmHg
or greater) with a lower blood pressure target (mean arterial pressure
less than 65 mmHg) in adults undergoing cardiac surgery with CPB.
 Data Collection and Analysis: We used standard Cochrane methods.
Primary outcomes were 1. acute kidney injury, 2. cognitive deterioration,
and 3. all-cause mortality. Secondary outcomes were 4. quality of life, 5.
acute ischaemic stroke, 6. haemorrhagic stroke, 7. length of hospital
stay, 8. renal replacement therapy, 9. delirium, 10. perioperative
transfusion of blood products, and 11. perioperative myocardial
infarction. We used GRADE to assess certainty of evidence. Main
Result(s): We included three RCTs with 737 people compared a higher blood
pressure target with a lower blood pressure target during cardiac surgery
with CPB. A high blood pressure target may result in little to no
difference in acute kidney injury (risk ratio (RR) 1.30, 95% confidence
interval (CI) 0.81 to 2.08; I2 = 72%; 2 studies, 487 participants;
low-certainty evidence), cognitive deterioration (RR 0.82, 95% CI 0.45 to
1.50; I2 = 0%; 2 studies, 389 participants; low-certainty evidence), and
all-cause mortality (RR 1.33, 95% CI 0.30 to 5.90; I2 = 49%; 3 studies,
737 participants; low-certainty evidence). No study reported haemorrhagic
stroke. Although a high blood pressure target may increase the length of
hospital stay slightly, we found no differences between a higher and a
lower blood pressure target for the other secondary outcomes. We also
identified one ongoing RCT which is comparing a higher versus a lower
blood pressure target among the people who undergo cardiac surgery with
CPB. Authors' conclusions: A high blood pressure target may result in
little to no difference in patient outcomes including acute kidney injury
and mortality. Given the wide CIs, further studies are needed to confirm
the efficacy of a higher blood pressure target among those who undergo
cardiac surgery with CPB. Copyright © 2022 The Cochrane
Collaboration. Published by John Wiley & Sons, Ltd.

<48>
Accession Number
2021570254
Title
Influence of Dexmedetomidine on Myocardial Injury in Patients with
Simultaneous Pancreas-Kidney Transplantation.
Source
Evidence-based Complementary and Alternative Medicine. 2022 (no
pagination), 2022. Article Number: 7196449. Date of Publication: 2022.
Author
Dong A.; Zhang Y.; Lu S.; Yu W.
Institution
(Dong, Lu, Yu) Tianjin First Center Hospital, Tianjin 300192, China
(Zhang) First Teaching Hospital, Tianjin University of Traditional Chinese
Medicine, National Clinical Research Center for Chinese Medicine
Acupuncture and Moxibustion, Tianjin 300193, China
Publisher
Hindawi Limited
Abstract
Background. Diabetes is one of the most common chronic diseases in the
world. End-stage renal disease (ESRD) caused by diabetes is the most
serious long-term complication. The main cause of death in patients with
simultaneous pancreas-kidney transplantation (SPKT) is cardiovascular
disease. Although dexmedetomidine (Dex) has unique advantages in heart
protection against ischaemic/reperfusion injury, few clinical studies have
been conducted on its cardioprotective effect in SPKT. This study aimed to
explore the influence of Dex on myocardial injury in patients undergoing
SPKT and to analyze its possible mechanism. Methods. A randomized
controlled trial (RCT) was performed from July 1, 2018 to December 1,
2020. Eighty patients, regardless of gender, scheduled for SPKT were
randomly allocated into a Dex group (D group) receiving Dex at a rate of 1
mug/kg for 10 minutes before anaesthesia induction and then continuous
infusion at 0.5 mug/kg/hour until the end of surgery and control group (C
group) receiving equivalent capacity of saline. Serum cardiac troponin I
(cTnI), creatine kinase isoenzyme (CK-MB), tumour necrosis factor-alpha
(TNF-alpha), and interleukin-6 (IL-6) were recorded at 5 minutes after
anaesthesia induction (baseline,T0), 5 minutes before renal arteriovenous
opening (T1), 30 minutes after renal arteriovenous opening (T2), 30
minutes after pancreatic related arteriovenous opening (T3), immediately
after surgery (T4), 4 hours after surgery (T5), and 24 hours after surgery
(T6). Adverse cardiovascular events were recorded during the perioperative
period. Changes in ECG S-T segments and T waves were monitored at T0-T6.
Myocardial infarction and percutaneous coronary intervention were recorded
with an average follow-up of one year. Results. Compared with T0,
TNF-alpha and IL-6 concentrations significantly increased at T1-T6 in the
C and D groups (P<0.05). IL-6 concentration increased significantly after
renal artery opening and reached the peak after the opening of pancreatic
blood vessels. Compared with the C group, TNF-alpha, and IL-6
concentrations were significantly reduced in group D at T2-T6 (P<0.05).
Compared with T0, cTnI and CK-MB concentrations were significantly
increased at T3-T6 in the C and D groups (P<0.05). cTnI and CK-MB
concentrations increased significantly after the opening of renal artery,
and reached the peak after the opening of pancreatic blood vessels.
Compared with the C group, cTnI and CK-MB concentrations were
significantly reduced in the D group at T3-T6 (P<0.05). There was no
significant difference in patient characteristics amongst groups,
including the proportion of intraoperative vasoactive drug use and adverse
cardiovascular events during the follow-up period. Heart rate, mean blood
pressure, central venous pressure, and cardiac output were not remarkably
different between the two groups at any time point. Conclusions.
Perioperative reperfusion could aggravate myocardial injury in SPKT. Dex
may be considered a way to reduce myocardial injury caused by inflammatory
action by decreasing the release of inflammatory factors. Trial
Registration Number: Chinese Clinical Trial Registry ID: ChiCTR2200060084.
 Copyright © 2022 Aili Dong et al.

<49>
[Use Link to view the full text]
Accession Number
2021414189
Title
The effect of tranexamic acid on myocardial injury in cardiac surgical
patients: a systematic review and meta-analysis.
Source
Blood Coagulation and Fibrinolysis. 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, Chinese Academy
of Medical Sciences, Beijing, China
Publisher
Lippincott Williams and Wilkins
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. Copyright © 2022 Wolters
Kluwer Health, Inc. All rights reserved.

<50>
Accession Number
2020227833
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:
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
John Wiley and Sons Inc
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. 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). 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. 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. Copyright © 2022 Wiley Periodicals
LLC.

<51>
Accession Number
2020135218
Title
Effect of personalized perioperative blood pressure management on
postoperative complications and mortality in high-risk patients having
major abdominal surgery: protocol for a multicenter randomized trial
(IMPROVE-multi).
Source
Trials. 23(1) (no pagination), 2022. Article Number: 946. Date of
Publication: December 2022.
Author
Bergholz A.; Meidert A.S.; Flick M.; Krause L.; Vettorazzi E.; Zapf A.;
Brunkhorst F.M.; Meybohm P.; Zacharowski K.; Zarbock A.; Sessler D.I.;
Kouz K.; Saugel B.
Institution
(Bergholz, Flick, Kouz, Saugel) Department of Anesthesiology, Center of
Anesthesiology and Intensive Care Medicine, University Medical Center
Hamburg-Eppendorf, Martinistrasse 52, Hamburg 20246, Germany
(Meidert) Department of Anaesthesiology, University Hospital LMU Munich,
Munich, Germany
(Krause, Vettorazzi, Zapf) Institute of Medical Biometry and Epidemiology,
University Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Brunkhorst) Center for Clinical Studies, Jena University Hospital, Jena,
Germany
(Brunkhorst) Center for Sepsis Control and Care, Jena University Hospital,
Jena, Germany
(Meybohm) Department of Anesthesiology, Intensive Care, Emergency and Pain
Medicine, University Hospital Wurzburg, Wurzburg, Germany
(Zacharowski) Department of Anaesthesiology, Intensive Care Medicine and
Pain Therapy, University Hospital Frankfurt, Goethe University, Frankfurt,
Germany
(Zarbock) Department of Anesthesiology, Intensive Care, and Pain Medicine,
University Hospital Munster, Munster, Germany
(Sessler) Department of Outcomes Research, Anesthesiology Institute,
Cleveland Clinic, Cleveland, OH, United States
(Sessler, Saugel) Outcomes Research Consortium, Cleveland, OH, United
States
Publisher
BioMed Central Ltd
Abstract
Background: Intraoperative hypotension is common in patients having
non-cardiac surgery and is associated with serious complications and
death. However, optimal intraoperative blood pressures for individual
patients remain unknown. We therefore aim to test the hypothesis that
personalized perioperative blood pressure management-based on preoperative
automated blood pressure monitoring-reduces the incidence of a composite
outcome of acute kidney injury, acute myocardial injury, non-fatal cardiac
arrest, and death within 7 days after surgery compared to routine blood
pressure management in high-risk patients having major abdominal surgery.
 Method(s): IMPROVE-multi is a multicenter randomized trial in 1272
high-risk patients having elective major abdominal surgery that we plan to
conduct at 16 German university medical centers. Preoperative automated
blood pressure monitoring using upper arm cuff oscillometry will be
performed in all patients for one night to obtain the mean of the
nighttime mean arterial pressures. Patients will then be randomized either
to personalized blood pressure management or to routine blood pressure
management. In patients assigned to personalized management,
intraoperative mean arterial pressure will be maintained at least at the
mean of the nighttime mean arterial pressures. In patients assigned to
routine management, intraoperative blood pressure will be managed per
routine. The primary outcome will be a composite of acute kidney injury,
acute myocardial injury, non-fatal cardiac arrest, and death within 7 days
after surgery. Discussion(s): Our trial will determine whether
personalized perioperative blood pressure management reduces the incidence
of major postoperative complications and death within 7 days after surgery
compared to routine blood pressure management in high-risk patients having
major abdominal surgery. Trial registration: ClinicalTrials.gov
NCT05416944. Registered on June 14, 2022. Copyright © 2022, The
Author(s).

<52>
Accession Number
2020305300
Title
Data are data: Do we need a randomized trial of transcatheter aortic valve
replacement for bicuspid valves?.
Source
Catheterization and Cardiovascular Interventions. 100(6) (pp 1132-1133),
2022. Date of Publication: 15 Nov 2022.
Author
Ueyama H.; Block P.C.
Institution
(Ueyama, Block) Division of Cardiology, Emory University School of
Medicine, Atlanta, GA, United States
Publisher
John Wiley and Sons Inc

<53>
Accession Number
2018431506
Title
Prognostic value of cardiac magnetic resonance derived global longitudinal
strain analysis in patients with ischaemic and non-ischaemic dilated
cardiomyopathy: a systematic review and meta-analysis.
Source
International Journal of Cardiovascular Imaging. (no pagination), 2022.
Date of Publication: 2022.
Author
Fong L.C.W.; Lee N.H.C.; Poon J.W.L.; Chin C.W.L.; He B.; Luo L.; Chen C.;
Wan E.Y.F.; Pennell D.J.; Mohiaddin R.; Ng M.-Y.
Institution
(Fong, Lee, Ng) Department of Diagnostic Radiology, School of Clinical
Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong,
Queen Mary Hospital Hong Kong, Hong Kong
(Poon) Department of Medicine, Ruttonjee and Tang Shiu Kin Hospitals, Hong
Kong
(Chin) Department of Cardiology, National Heart Centre Singapore,
Singapore, Singapore
(He, Luo, Chen, Ng) Department of Medical Imaging, The University of Hong
Kong-Shenzhen Hospital, Shenzhen, China
(Wan) Department of Family Medicine and Primary Care, Li Ka Shing Faculty
of Medicine, The University of Hong Kong, Hong Kong
(Pennell, Mohiaddin) Royal Brompton Hospital, Guy's and St Thomas' NHS
Foundation Trust, London, United Kingdom
(Pennell, Mohiaddin) Imperial College, London, United Kingdom
(Wan) Centre for Safe Medication Practice and Research, Department of
Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University
of Hong Kong, Hong Kong
(Wan) Laboratory of Data Discovery for Health (D24H), Hong Kong
(Chin) Cardiovascular ACP, Duke-NUS Medical School, Singapore, Singapore
Publisher
Springer Science and Business Media B.V.
Abstract
Cardiac magnetic resonance (CMR) derived left ventricular global
longitudinal strain (LV-GLS) for evaluating dilated cardiomyopathy
patients has been addressed in studies with contradictory results. We
therefore performed the first systematic review evaluating evidence on the
prognostic value of CMR derived LV-GLS for ischaemic (IDCM) and
non-ischaemic dilated cardiomyopathy (NDCM) patients. Systematic review
(PROSPERO CRD42020171582) identified studies up to January 2021 that
measured LV-GLS for predicting major adverse cardiac events among dilated
cardiomyopathy patients. Studies were identified from MEDLINE, Embase and
PubMed by two independent reviewers. 2099 studies were screened. Three
prospective and three retrospective observational studies comprising of
1758 patients (29% IDCM patients; 71% NDCM patients) with a weighted mean
follow up of 3 years (SD = 1 year) were identified. All six studies
included mortality in the primary composite outcome. LV-GLS was associated
with increase primary composite outcome among mild to moderately impaired
left ventricular ejection fraction (LVEF) IDCM and NDCM patients (> 30%)
in univariable and multivariable analysis. Association was lost among
severely impaired LVEF patients (< 30%). From sensitivity analysis, LV-GLS
showed significant association with death among NDCM patients (HR 1.27;
95% CI 1.10-1.46; p = 0.001; I2 = 59%) but insignificant for
heart transplant outcome (HR 1.23; 95% CI 0.46-3.33; p = 0.68,
I2 = 44%). LV-GLS threshold for effectively stratifying
patients is - 12.5% to - 13.5%. LVEF in IDCM and NDCM became an
insignificant prognostic marker in multivariable analysis. CMR LV-GLS
shows promise as an independent predictor of mortality in IDCM and NDCM
patients. However, in patients with LVEF < 30% LV-GLS may have less
prognostic value. Prospero Registration: CRD42020171582. Copyright
© 2022, The Author(s), under exclusive licence to Springer Nature
B.V.

<54>
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. 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). 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. Copyright © 2022 American
Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights
reserved.

<55>
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. Copyright © The Author(s) 2022. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<56>
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.
 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.
 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). 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. Copyright © The Author(s)
2022. Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery. All rights reserved.

<57>
Accession Number
639654009
Title
Psychosocial assessment in heart transplant. A literature review and a
case report.
Source
European Psychiatry. Conference: 28th European Congress of Psychiatry, EPA
2020. Virtual. 63(Supplement 1) (pp S350), 2020. Date of Publication: July
2020.
Author
Lopez Alvarez I.; Palao A.; Torrijos M.; Curto Ramos J.; Svintitckaia A.
Institution
(Lopez Alvarez, Svintitckaia) Hospital Universitario Lac PAZ, Psychiatry,
Clinical Psychology and Mental Health, Madrid, Spain
(Palao) Hospital Universitario la Paz, Psiquiatria, MADRID, Spain
(Torrijos) Psychiatry and Mental Health Department la Paz Hospital.,
Psychiatry, MADRID, Spain
(Curto Ramos) La Paz University Hospital, Psychiatry, Clinical Psychology
and Mental Health, Madrid, Spain
Publisher
Cambridge University Press
Abstract
Introduction: Psychosocial assessment plays a key role along the whole
process of heart transplant. This assessment provides the chance to early
identify patients in risk of suffering psychopathological issues that may
endanger the rehabilitation process. SIPAT Scale (Stanford Integrated
Assessment for Transplant) has been proved to be a valid tool to evaluate
patients undergoing a heart transplant process. SIPAT assess 20 different
and relevant components about patients, classifying candidates with a
final score of eligibility. Objective(s): The aim of this poster it
to review the use of SIPAT Scales in heart transplant, as well as
presenting a case of a young woman suffering from congenital heart disease
awaiting to be transplantated describing the assessment process that took
place by the Mental health Service in liaison with Cardiology Service of a
General Hospital. Method(s): We review recent literature in medical
database PubMed with keywords 'heart transplant' AND 'assessment'. We
selected papers for their relevance to the topic. We describe the liaison
process between clinical services and explain the assessment process of
the patient using SIPAT and clinical tools such as nonstructured Clinical
and family interviews. Result(s): A comprehensive full assessment was
carried out by Mental Health Clinicians so the patient could be included
in the transplant waiting list. Conclusion(s): SIPAT is a reliable
tool for psychosocial assessment in patients waiting for a heart
transplant, although a comprehensive clinical assesment should also be
carried out. Liaison among different clinical services in general
hospitals is key to the wellbeing and attention to patients.

<58>
Accession Number
2020305514
Title
Procedural complications associated with percutaneous mitral balloon
valvotomy: A systematic review.
Source
Expert Review of Cardiovascular Therapy. (no pagination), 2022. Date of
Publication: 2022.
Author
Rashid H.; Haq Z.U.; Alam S.; Nazir M.; Nadir M.; Fakhar T.; Zaidi S.M.J.;
Mustafa B.; Malik J.
Institution
(Rashid) Department of Critical Care, Wythenshawe Hospital, Manchester,
United Kingdom
(Haq) Lahore Medical and Dental College, Lahore, Pakistan
(Alam) Department of Cardiology, Mardan Medical Complex, Mardan, Pakistan
(Nazir) Rawalpindi Medical University, Rawalpindi, Pakistan
(Nadir) Department of Cardiology, Rawalpindi Institute of Cardiology,
Rawalpindi, Pakistan
(Fakhar) Shifa College of Medicine, Islamabad, Pakistan
(Zaidi) Department of Medicine, Rawalpindi Medical University, Rawalpindi,
Pakistan
(Mustafa) Department of Cardiology, Akbar Niazi Teaching Hospital,
Islamabad, Pakistan
(Malik) Department of Electrophysiology, Armed Forces Institute of
Cardiology, Rawalpindi, Pakistan
Publisher
Taylor and Francis Ltd.
Abstract
Background: As Percutaneous mitral balloon valvotomy (PMBV) remains the
keystone in treating mitral stenosis, we conducted this review to
elucidate the cumulative frequency and predictors of complications
following PMBV and their occurrence in various patient populations. Areas
covered: We searched digital databases for relevant studies covering
complications of PMBV and retrieved articles using the Medical Subject
Heading (MeSH) keywords. Expert opinion: A total of 37 articles (8 RCTs, 7
nonrandomized clinical trials, 22 observational studies) were selected for
qualitative analysis. A total of 11,803 patients undergoing PMBV among 37
studies were included, with a mean success rate of 84.54%. The most common
complication was mitral regurgitation (8.2%) followed by an atrial septal
defect (2.4%). Other relevant complications like stroke, pericardial
tamponade, rupture of mitral leaflets, and conduction abnormalities were
present in <1% of the patients. Copyright © 2022 Informa UK
Limited, trading as Taylor & Francis Group.

<59>
Accession Number
639658766
Title
Outcome of Pregnancy in Women With D-Transposition of the Great Arteries:
A Systematic Review.
Source
Journal of the American Heart Association. (pp e026862), 2022. Date of
Publication: 29 Nov 2022.
Author
Pizula J.; Devera J.; Ng T.M.H.; Yeung S.L.; Thangathurai J.; Herrick N.;
Chatfield A.J.; Mehra A.; Elkayam U.
Institution
(Pizula, Devera, Ng, Thangathurai, Herrick, Mehra, Elkayam) Division of
Cardiovascular Medicine, Department of Medicine University of Southern
California Los Angeles CA
(Ng, Yeung, Chatfield) School of Pharmacy University of Southern
California Los Angeles CA
(Elkayam) Department of Obstetrics and Gynecology University of Southern
California Los Angeles CA
Publisher
NLM (Medline)
Abstract
Background Information on maternal and fetal outcomes of pregnancy in
women with D-transposition of the great arteries is limited. We conducted
a systematic literature review on pregnancies in women with transposition
of the great arteries after atrial and arterial switch operations to
better define maternal and fetal risk. Methods and Results A systematic
review was performed on studies between 2000 and 2021 that identified 676
pregnancies in 444 women with transposition of the great arteries. A total
of 556 pregnancies in women with atrial switch operation were tolerated by
most cases with low mortality (0.6%). Most common maternal complications,
however, were arrhythmias (9%) and heart failure (8%) associated with
serious morbidity in some patients. Worsening functional capacity, right
ventricular function, and tricuspid regurgitation occurred in =20% of the
cases. Rate of fetal and neonatal mortality was 1.4% and 0.8%,
respectively, and rate of prematurity was 32%. A total of 120 pregnancies
in women with arterial switch operation were associated with no maternal
mortality, numerically lower rates of arrhythmias and heart failure (6%
and 5%, respectively), significantly lower rate of prematurity (11%;
P<0.001), and only 1 fetal loss. Conclusions Pregnancy is tolerated by
most women with transposition of the great arteries and atrial switch
operation with low mortality but important morbidity. Most common maternal
complications were arrhythmias, heart failure, worsening of right
ventricular function, and tricuspid regurgitation. There was also a high
incidence of prematurity and increased rate of fetal loss and neonatal
mortality. Outcome of pregnancy in women after arterial switch operations
is more favorable, with reduced incidence of maternal complications and
fetal outcomes similar to women without underlying cardiac disease.

<60>
Accession Number
639658562
Title
Supplemental Regional Block Anesthesia Reduces Opioid Utilization
Following Free Flap Reconstruction of the Oral Cavity: A Prospective,
Randomized Clinical Trial.
Source
Journal of oral and maxillofacial surgery : official journal of the
American Association of Oral and Maxillofacial Surgeons. (no pagination),
2022. Date of Publication: 01 Nov 2022.
Author
Le J.M.; Gigliotti J.; Sayre K.S.; Morlandt A.B.; Ying Y.P.
Institution
(Le) Resident, Department of Oral and Maxillofacial Surgery, University of
Alabama at Birmingham, Birmingham, AL, United States
(Gigliotti) Faculty of Dental Medicine and Oral Health Sciences, McGill
University, Montreal, QC, Canada
(Sayre) Department of Oral and Maxillofacial Surgery, Boston University
School of Dental Medicine, Boston, MA, United States
(Morlandt) Section of Oral Oncology, Department of Oral and Maxillofacial
Surgery, University of Alabama at Birmingham, Birmingham, AL, United
States
(Ying) Section of Oral Oncology, Department of Oral and Maxillofacial
Surgery, University of Alabama at Birmingham, Birmingham, AL, United
States
Publisher
NLM (Medline)
Abstract
PURPOSE: Regional anesthesia has been shown to effectively manage acute
pain and reduce opioid utilization in the early postoperative period
following colorectal, orthopedic, and thoracic surgeries. The same effect,
however, has not been demonstrated in major head and neck surgery. The
purpose of this study is to determine whether supplemental regional
anesthesia reduces opioid utilization following microvascular free flap
reconstruction of the oral cavity. METHOD(S): A prospective,
randomized clinical trial was conducted for patients undergoing oral
cavity reconstruction using microvascular free tissue transfer between
January 2020 and March 2022. The predictor variable was a regional
anesthetic nerve block, delivered preoperatively, at the flap donor site.
The primary and secondary outcomes were opioid utilization, measured in
oral morphine equivalent (OME), from postoperative day 1 to 5, and length
of hospital stay (LOS), respectively. Covariates included age, sex,
tobacco and alcohol history, prior radiation therapy, pathology, oral
site, flap type, tracheostomy, and neck dissection. Student's t test, chi2
test, and linear regression models were computed using correlations with
95% confidence intervals (CIs). For all statistical tests, P values of
<.05 were regarded as statistically significant. RESULT(S):
Ninety-eight participants completed the study. The mean age was 56 years
with 55% male. Forty-eight patients received a presurgical regional
anesthesia block, and 50 patients served as control subjects. Bivariate
analysis demonstrated an even distribution of all study variables. Total
OME utilization was significantly less in the treatment group compared to
the control group, (166.32 vs 118.43 OME; 95% CI, 1.32 to 94.45; P = .04).
The LOS was comparable (6.60 vs 6.48 days; 95% CI, -0.53 to 0.77; P =
.71). Tobacco use had a positive effect (B = 0.28; 95% CI, 21.63 to
115.31; P = .005) while the block had a negative effect with total OME, (B
= -0.19; 95% CI, -90.39 to -0.59; P = .047). The extent of the neck
dissection (B = 0.207; 95% CI, 0.026 to 1.403; P = .042) was a positive
predictor for LOS. Overall, there were no adverse events associated with
the regional block throughout the study period. CONCLUSION(S):
Supplemental regional anesthesia is safe and associated with reduced
opioid utilization in patients undergoing vascularized free flap
reconstruction of composite oral cavity defects and does not prolong the
length of hospitalization. Copyright © 2022. Published by
Elsevier Inc.

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