EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

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<1>
Accession Number
638638037
Title
Patch angioplasty versus primary closure for carotid endarterectomy.
Source
Cochrane Database of Systematic Reviews. 2022(8) (no pagination), 2022.
Article Number: CD000160. Date of Publication: 03 Aug 2022.
Author
Orrapin S.; Benyakorn T.; Siribumrungwong B.; Rerkasem K.
Institution
(Orrapin, Benyakorn, Siribumrungwong) Division of Vascular Surgery,
Department of Surgery, Faculty of Medicine, Thammasat University (Rangsit
Campus), Pathum Thani, Thailand
(Rerkasem) Environmental - Occupational Health Sciences and
Non-Communicable Diseases Research Group, Research Institute of Health
Sciences, Chiang Mai University, Chiang Mai, Thailand
(Rerkasem) Department of Surgery, Faculty of Medicine, Chiang Mai
University, Chiang Mai, Thailand
(Rerkasem) Clinical Surgical Research Center, Faculty of Medicine, Chiang
Mai University, Chiang Mai, Thailand
Publisher
John Wiley and Sons Ltd
Abstract
Background: Carotid patch angioplasty may reduce the risk of acute
occlusion or long-term restenosis of the carotid artery and subsequent
ischaemic stroke in people undergoing carotid endarterectomy (CEA). This
is an update of a Cochrane Review originally published in 1995 and updated
in 2008. <br/>Objective(s): To assess the safety and efficacy of routine
or selective carotid patch angioplasty with either a venous patch or a
synthetic patch compared with primary closure in people undergoing CEA. We
wished to test the primary hypothesis that carotid patch angioplasty
results in a lower rate of severe arterial restenosis and therefore fewer
recurrent strokes and stroke-related deaths, without a considerable
increase in perioperative complications. <br/>Search Method(s): We
searched the Cochrane Stroke Group trials register, CENTRAL, MEDLINE,
Embase, two other databases, and two trial registries in September 2021.
<br/>Selection Criteria: Randomised controlled trials and quasi-randomised
trials comparing carotid patch angioplasty with primary closure in people
undergoing CEA. <br/>Data Collection and Analysis: Two review authors
independently assessed eligibility and risk of bias; extracted data; and
determined the certainty of evidence using the GRADE approach. Outcomes of
interest included stroke, death, significant complications related to
surgery, and artery restenosis or occlusion during the perioperative
period (within 30 days of the operation) or during long-term follow-up.
<br/>Main Result(s): We included 11 trials involving 2100 participants
undergoing 2304 CEA operations. The quality of trials was generally poor.
Follow-up varied from hospital discharge to five years. Compared with
primary closure, carotid patch angioplasty may make little or no
difference to reduction in risk of any stroke during the perioperative
period (odds ratio (OR) 0.57, 95% confidence interval (CI) 0.31 to 1.03; P
= 0.063; 8 studies, 1769 participants; very low-certainty evidence), but
may lower the risk of any stroke during long-term follow-up (OR 0.49, 95%
CI 0.27 to 0.90; P = 0.022; 7 studies, 1332 participants; very
low-certainty evidence). In the included studies, carotid patch
angioplasty resulted in a lower risk of ipsilateral stroke during the
perioperative period (OR 0.31, 95% CI 0.15 to 0.63; P = 0.001; 7 studies,
1201 participants; very low-certainty evidence), and during long-term
follow-up (OR 0.32, 95% CI 0.16 to 0.63; P = 0.001; 6 studies, 1141
participants; very low-certainty evidence). The intervention was
associated with a reduction in the risk of any stroke or death during
long-term follow-up (OR 0.59, 95% CI 0.42 to 0.84; P = 0.003; 6 studies,
1019 participants; very low-certainty evidence). In addition, the included
studies suggest that carotid patch angioplasty may reduce the risk of
perioperative arterial occlusion (OR 0.18, 95% CI 0.08 to 0.41; P <
0.0001; 7 studies, 1435 participants; low-certainty evidence), and may
reduce the risk of restenosis during long-term follow-up (OR 0.24, 95% CI
0.17 to 0.34; P < 0.00001; 8 studies, 1719 participants; low-certainty
evidence). The studies recorded very few arterial complications, including
haemorrhage, infection, cranial nerve palsies and pseudo-aneurysm
formation, with either patch or primary closure. We found no correlation
between the use of patch angioplasty and the risk of either perioperative
or long-term stroke-related death or all-cause death rates. Authors'
conclusions: Compared with primary closure, carotid patch angioplasty may
reduce the risk of perioperative arterial occlusion and long-term
restenosis of the operated artery. It would appear to reduce the risk of
ipsilateral stroke during the perioperative and long-term period and
reduce the risk of any stroke in the long-term when compared with primary
closure. However, the evidence is uncertain due to the limited quality of
included trials.<br/>Copyright &#xa9; 2022 The Cochrane Collaboration.
Published by John Wiley & Sons, Ltd.

<2>
Accession Number
2021854381
Title
Efficacy of perioperative intravenous lidocaine infusion on postoperative
pulmonary complications in patients undergoing video-assisted
thoracoscopic lung resection surgery: protocol for a randomised controlled
trial.
Source
BMJ Open. 12(12) (no pagination), 2022. Article Number: e066828. Date of
Publication: 12 Dec 2022.
Author
Wang F.; He Y.; Zhou M.; Luo Q.; Zeng Z.; Liu L.; Zeng S.; Lei Q.
Institution
(Wang, He, Zhou, Luo, Zeng, Zeng, Lei) Department of Anesthesiology,
Sichuan Academy of Medical Sciences and Sichuan People's Hospital,
University of Electronic Science and Technology of China, Sichuan,
Chengdu, China
(Liu) Department of Anesthesiology, Chengdu University of Traditional
Chinese Medicine, Sichuan, Chengdu, China
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative pulmonary complications (PPCs) are the most
common complications following thoracoscopic surgery, resulting in
increased hospital costs and perioperative mortality. Studies have shown
that intravenous lidocaine infusion can exert its anti-inflammatory
properties by reducing the release of proinflammatory cytokines. This
study is designed to investigate whether intraoperative intravenous
lidocaine infusion can reduce the incidence of PPCs in adult patients
undergoing video-assisted thoracoscopic lung resection surgery. Methods
and analysis This single-centre, double-blinded study will enrol 366
patients scheduled for video-assisted thoracoscopic lung resection
surgery. Patients will be randomly assigned to the lidocaine or placebo
infusion group in a 1: 1 ratio. The lidocaine group will receive lidocaine
intravenously during the intraoperative period, while the placebo group
will be administered normal saline at an equal volume, infusion rate and
timing. The primary outcome is the incidence of PPCs within 7 days
following surgery. The secondary outcomes are quality of postoperative
recovery 40 scores; length of hospital stay (determined by the number of
days from admission to discharge); incidence of moderate to severe pain
within 24 and 48 hours at rest and when coughing; incidence of additional
rescue analgesics use and incidence of adverse events. Ethics and
dissemination The study was reviewed and approved by the Ethics Committee
of Sichuan Provincial People's Hospital (approval no. 20222241). Written
informed consent will be obtained from all patients before randomisation.
The results of this trial will be disseminated in a peer-reviewed journal.
Trial registration number ChiCTR2200061979.<br/>Copyright &#xa9; Author(s)
(or their employer(s)) 2022.

<3>
Accession Number
2017978537
Title
Elevated Cardiac Troponin to Detect Acute Cellular Rejection After Cardiac
Transplantation: A Systematic Review and Meta-Analysis.
Source
Transplant International. 35 (no pagination), 2022. Article Number: 10362.
Date of Publication: 08 Jun 2022.
Author
Liu Z.; Perry L.A.; Penny-Dimri J.C.; Handscombe M.; Overmars I.; Plummer
M.; Segal R.; Smith J.A.
Institution
(Liu, Perry, Handscombe, Segal) Department of Anaesthesia, Royal Melbourne
Hospital, Parkville, VIC, Australia
(Penny-Dimri, Smith) Department of Surgery, School of Clinical Sciences at
Monash Health, Monash University, Clayton, VIC, Australia
(Overmars) Infection and Immunity Theme, Murdoch Children's Research
Institute, Parkville, VIC, Australia
(Plummer) Department of Intensive Care Medicine, Royal Melbourne Hospital,
Parkville, VIC, Australia
(Plummer, Segal) Department of Medicine, University of Melbourne,
Parkville, VIC, Australia
Publisher
European Society for Organ Transplantation
Abstract
Cardiac troponin is well known as a highly specific marker of
cardiomyocyte damage, and has significant diagnostic accuracy in many
cardiac conditions. However, the value of elevated recipient troponin in
diagnosing adverse outcomes in heart transplant recipients is uncertain.
We searched MEDLINE (Ovid), Embase (Ovid), and the Cochrane Library from
inception until December 2020. We generated summary sensitivity,
specificity, and Bayesian areas under the curve (BAUC) using bivariate
Bayesian modelling, and standardised mean differences (SMDs) to quantify
the diagnostic relationship of recipient troponin and adverse outcomes
following cardiac transplant. We included 27 studies with 1,684 cardiac
transplant recipients. Patients with acute rejection had a statistically
significant late elevation in standardised troponin measurements taken at
least 1 month postoperatively (SMD 0.98, 95% CI 0.33-1.64). However,
pooled diagnostic accuracy was poor (sensitivity 0.414, 95% CrI
0.174-0.696; specificity 0.785, 95% CrI 0.567-0.912; BAUC 0.607, 95% CrI
0.469-0.723). In summary, late troponin elevation in heart transplant
recipients is associated with acute cellular rejection in adults, but its
stand-alone diagnostic accuracy is poor. Further research is needed to
assess its performance in predictive modelling of adverse outcomes
following cardiac transplant. Systematic Review Registration: identifier
CRD42021227861<br/>Copyright &#xa9; 2022 Liu, Perry, Penny-Dimri,
Handscombe, Overmars, Plummer, Segal and Smith.

<4>
Accession Number
2016604055
Title
Meta-Analysis of Randomized Controlled Trials Evaluating the Efficacy of
Polymer-Free Amphilimus-Eluting Stents in Coronary Artery Disease.
Source
American Journal of Cardiology. 167 (pp 149-151), 2022. Date of
Publication: 15 Mar 2022.
Author
Patoulias D.; Kassimis G.; Doumas M.; Papadopoulos C.
Institution
(Patoulias, Doumas) Second Propedeutic Department of Internal Medicine,
Aristotle University of Thessaloniki, General Hospital "Hippokration",
Thessaloniki, Greece
(Kassimis) Second Department of Cardiology, Aristotle University of
Thessaloniki, General Hospital "Hippokration", Thessaloniki, Greece
(Doumas) Veterans Affairs Medical Center, George Washington University,
District of Columbia, Washington
(Papadopoulos) Third Department of Cardiology, Aristotle University of
Thessaloniki, General Hospital "Hippokration", Thessaloniki, Greece
Publisher
Elsevier Inc.

<5>
Accession Number
2018639000
Title
Humoral and cellular response of COVID-19 vaccine among solid organ
transplant recipients: A systematic review and meta-analysis.
Source
Transplant Infectious Disease. 24(6) (no pagination), 2022. Article
Number: e13926. Date of Publication: December 2022.
Author
Meshram H.S.; Kute V.; Rane H.; Dave R.; Banerjee S.; Mishra V.; Chauhan
S.
Institution
(Meshram, Kute, Dave, Banerjee, Chauhan) Department of Nephrology,
IKDRC-ITS, Ahmedabad, India
(Rane) Department of Anaesthesia, IKDRC-ITS, Ahmedabad, India
(Mishra) Department of Gynaecology, IKDRC-ITS, Ahmedabad, India
Publisher
John Wiley and Sons Inc
Abstract
Background: We aimed to analyze the humoral and cellular response to
standard and booster (additional doses) COVID-19 vaccination in solid
organ transplantation (SOT) and the risk factors involved for an impaired
response. <br/>Method(s): We did a systematic review and meta-analysis of
studies published up until January 11, 2022, that reported immunogenicity
of COVID-19 vaccine among SOT. The study is registered with PROSPERO,
number CRD42022300547. <br/>Result(s): Of the 1527 studies, 112 studies,
which involved 15391 SOT and 2844 healthy controls, were included. SOT
showed a low humoral response (effect size [ES]: 0.44 [0.40-0.48]) in
overall and in control studies (log-Odds-ratio [OR]: -4.46 [-8.10 to
-2.35]). The humoral response was highest in liver (ES: 0.67 [0.61-0.74])
followed by heart (ES: 0.45 [0.32-0.59]), kidney (ES: 0.40 [0.36-0.45]),
kidney-pancreas (ES: 0.33 [0.13-0.53]), and lung (0.27 [0.17-0.37]). The
meta-analysis for standard and booster dose (ES: 0.43 [0.39-0.47] vs. 0.51
[0.43-0.54]) showed a marginal increase of 18% efficacy. SOT with prior
infection had higher response (ES: 0.94 [0.92-0.96] vs. ES: 0.40
[0.39-0.41]; p-value <.01). The seroresponse with mRNA-12723 mRNA was
highest 0.52 (0.40-0.64). Mycophenolic acid (OR: 1.42 [1.21-1.63]) and
Belatacept (OR: 1.89 [1.3-2.49]) had highest risk for nonresponse. SOT had
a parallelly decreased cellular response (ES: 0.42 [0.32-0.52]) in overall
and control studies (OR: -3.12 [-0.4.12 to -2.13]).
<br/>Interpretation(s): Overall, SOT develops a suboptimal response
compared to the general population. Immunosuppression including
mycophenolic acid, belatacept, and tacrolimus is associated with decreased
response. Booster doses increase the immune response, but further
upgradation in vaccination strategy for SOT is required. (Figure
presented.).<br/>Copyright &#xa9; 2022 Wiley Periodicals LLC.

<6>
Accession Number
2019634082
Title
Meta-Analysis of Provisional Versus Systematic Double-Stenting Strategy
for Left Main Bifurcation Lesions.
Source
Cardiovascular Revascularization Medicine. 45 (pp 53-62), 2022. Date of
Publication: December 2022.
Author
Abdelfattah O.M.; Radwan A.; Sayed A.; Elbadawi A.; Derbas L.A.; Saleh Y.;
Ahmad Y.; ElJack A.; Masoumi A.; Karmpaliotis D.; Elgendy I.Y.; Alfonso F.
Institution
(Abdelfattah, Radwan) Department of Medicine, Morristown Medical Center,
Atlantic Health System, Morristown, NJ, United States
(Sayed) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Elbadawi) Division of Cardiology, University of Texas Southwestern
Medical Center, Dallas, TX, United States
(Derbas) Division of Cardiology, Rush University Medical Center, Chicago,
IL, United States
(Saleh) Department of Cardiovascular Medicine, Debakey Heart and Vascular
Institute, Houston Methodist Hospital, Houston, TX, United States
(Ahmad) Section of Cardiovascular Medicine, Yale School of Medicine, Yale
University, New Haven, CT, United States
(ElJack) Department of Cardiovascular Medicine, Baylor Scott & White, The
Heart Hospital, Plano, TX, United States
(Masoumi, Karmpaliotis) Department of Cardiovascular Medicine, Gagnon
Cardiovascular Institute, Morristown Medical Center, Atlantic Health
System, Morristown, NJ, United States
(Elgendy) Division of Cardiovascular Medicine, Gill Heart Institute,
University of Kentucky, Lexington, KY, United States
(Alfonso) Cardiology Department, Hospital Universitario de La Princesa,
IIS-IP, CIBER-CV, Madrid, Spain
Publisher
Elsevier Inc.
Abstract
Objective: We sought to compare the clinical outcomes with provisional
versus double-stenting strategy for left main (LM) bifurcation
percutaneous coronary intervention (PCI). <br/>Background(s): Despite two
recent randomized controlled trials (RCTs) and several observational
reports, the optimal LM bifurcation PCI technique remains controversial.
<br/>Method(s): PubMed, Cochrane Central Register of Controlled-Trials
(CENTRAL), Clinicaltrials.gov, International Clinical Trial Registry
Platform were leveraged for studies comparing PCI bifurcation techniques
for LM coronary lesions using second-generation drug eluting stents (DES).
The primary outcome was major adverse cardiovascular events (MACE).
Secondary outcomes of interest were all-cause mortality, cardiovascular
mortality, myocardial infarction (MI), target vessel or lesion
revascularization, and stent thrombosis. <br/>Result(s): Two RCTs and 10
observational studies with 7105 patients were included. Median follow-up
duration was 42 months (IQR: 25.7). Double stenting was associated with a
trend towards higher incidence of MACE (odds ratio [OR] 1.20; 95 %
confidence interval [CI] 0.94 to 1.53) compared with provisional stenting.
This was mainly driven by higher rates of target lesion revascularization
(TLR) (OR 1.50; 95 % CI 1.07 to 2.11). There were no statistically
significant differences in the incidence of all-cause mortality,
cardiovascular mortality, MI, or stent thrombosis. On subgroup analysis
according to the study type, provisional stenting was associated with
lower MACE and TLR in observational studies, but not in RCTs.
<br/>Conclusion(s): For LM bifurcation PCI using second-generation DES, a
provisional stenting strategy was associated with a trend towards lower
incidence of MACE driven by statistically significant lower rates of TLR,
compared with systematic double stenting. These differences were primarily
driven by observational studies. Further RCTs are warranted to confirm
these findings.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<7>
Accession Number
2018908918
Title
Systematic review of programmed cell death-1 inhibitor therapy for
advanced-stage cutaneous squamous cell carcinoma in solid-organ transplant
recipients.
Source
Journal of Dermatological Treatment. 33(8) (pp 3119-3126), 2022. Date of
Publication: 2022.
Author
Hanania H.L.; Lewis D.J.
Institution
(Hanania) Baylor College of Medicine, School of Medicine, Houston, TX,
United States
(Lewis) Department of Dermatology, Perelman School of Medicine at the
University of Pennsylvania, Philadelphia, PA, United States
Publisher
Taylor and Francis Ltd.
Abstract
Background: Programmed cell death-1 (PD-1) inhibitors represent an
effective treatment option for advanced cutaneous squamous cell carcinoma
(cSCC). However, solid organ transplant (SOT) recipients with cSCC have
traditionally been excluded from clinical trials. <br/>Objective(s): To
assess the safety and efficacy of PD-1 inhibitors for stage III-IV cSCC in
SOT recipients. <br/>Material(s) and Method(s): A systematic review was
performed using the PubMed, EMBASE, and Scopus databases. <br/>Result(s):
We identified 21 articles describing 33 SOT recipients (26 kidney, four
liver, two lung, and one heart) with stage III-IV cSCC treated with PD-1
inhibitors. Eleven patients (33.3%) experienced allograft rejection. Of
the 25 cases with iRECIST scores, twelve patients (48.0%) had a complete
response (CR), eight (32.0%) showed a partial response (PR), three (12.0%)
progressive disease, and two (8.0%) stable disease (SD). Including
patients without available iRECIST scores, 21 patients (63.6%) showed
tumor response. Eleven patients died, with six (54.5%) due to tumor
progression and one (9.1%) due to allograft rejection after foregoing
dialysis. <br/>Conclusion(s): PD-1 inhibitors demonstrate efficacy for
advanced cSCC and confer a risk of allograft rejection in SOT recipients,
requiring careful assessment of risks and benefits. If anti-PD-1 therapy
is pursued, use of mTOR inhibitors, prophylactic steroids, and
donor-derived cell-free DNA monitoring may mitigate the risk of
rejection.<br/>Copyright &#xa9; 2022 Taylor & Francis Group, LLC.

<8>
Accession Number
2018891905
Title
Bariatric Surgery and Myocardial Mechanics: A Meta-Analysis of Speckle
Tracking Echocardiographic Studies.
Source
Journal of Clinical Medicine. 11(16) (no pagination), 2022. Article
Number: 4655. Date of Publication: August 2022.
Author
Gherbesi E.; Cuspidi C.; Faggiano A.; Sala C.; Carugo S.; Tadic M.
Institution
(Gherbesi, Faggiano, Sala) Department of Clinical Sciences and Community
Health, University of Milano and Fondazione Ospedale Maggiore IRCCS
Policlinico di Milano, Milan 20122, Italy
(Cuspidi, Carugo) Department of Medicine and Surgery, University of
Milano-Bicocca, Milan 20126, Italy
(Tadic) Department of Cardiology, University Clinical Hospital Centre
"Dragisa Misovic", Heroja Milana Tepica 1, Belgrade 11000, Serbia
Publisher
MDPI
Abstract
Aim: Current evidence on the effects of bariatric surgery on cardiac
mechanics in patients with obesity is based on a few single studies. We
investigated this issue through a meta-analysis of speckle tracking
echocardiography (STE) studies that reported data on changes in left
ventricular (LV) mechanics as assessed by global longitudinal strain
(GLS). <br/>Method(s): The PubMed, OVID-MEDLINE and Cochrane library
databases were systematically analysed to search English-language articles
published from inception to 31 May 2022. Studies were identified by using
Me-SH terms and crossing the following terms: "obesity", "bariatric
surgery", "left ventricular mechanics", "left ventricular hypertrophy",
"systolic dysfunction", "global longitudinal strain", "echocardiography"
and "STE echocardiography". <br/>Result(s): The meta-analysis, including a
total of 512 patients with obesity from 13 studies (follow-up 1-23
months), showed a significant GLS improvement after bariatric procedures,
with standard mean difference (SMD) being 0.50 +/- 0.08, CI: 0.34/0.65, p
< 0.0001. Corresponding SMD value for LV ejection fraction (LVEF) was 0.15
+/- 0.09, CI: -0.04/0.34, p = 0.11. A sensitivity analysis restricted to
11 studies with follow-up >= 6 months confirmed that GLS (SMD: 0.47 +/-
0.08, CI: 0.30/0.63, p < 0.0001) but not LVEF (SMD: 0.14 +/- 0.11, CI:
-0.08/0.37, p = 0.21) improved after surgery. <br/>Conclusion(s): Our
meta-analysis adds a new piece of information on the beneficial effects of
bariatric surgery on LV systolic function and, more importantly, suggests
that the assessment of myocardial strain should be routinely implemented
for a comprehensive evaluation of cardiac functional changes associated
with bariatric procedures.<br/>Copyright &#xa9; 2022 by the authors.

<9>
Accession Number
2011342120
Title
Efficacy and safety of edoxaban in patients early after surgical
bioprosthetic valve implantation or valve repair: A randomized clinical
trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 165(1) (pp 58-67.e4),
2023. Date of Publication: January 2023.
Author
Shim C.Y.; Seo J.; Kim Y.J.; Lee S.H.; De Caterina R.; Lee S.; Hong G.-R.;
Lee C.J.; Shin D.-H.; Ha J.-W.; Suh Y.J.; Choi J.Y.; Cho I.-J.; Roh Y.H.
Institution
(Shim, Seo, Hong) Division of Cardiology, Severance Cardiovascular
Hospital, Yonsei University College of Medicine, Seoul, South Korea
(Kim) Department of Radiology, Research Institute of Radiological Science,
Severance Hospital, Yonsei University College of Medicine, Seoul, South
Korea
(Lee, Lee) Division of Cardiovascular Surgery, Department of Thoracic and
Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei
University College of Medicine, Seoul, South Korea
(De Caterina) Cardio-Thoracic and Vascular Department, Pisa University
Hospital and University of Pisa, Pisa, Italy
Publisher
Elsevier Inc.
Abstract
Objective: Early warfarin anticoagulation is recommended in patients
undergoing surgical bioprosthetic valve implantation or valve repair. It
is unclear whether non-vitamin K antagonist oral anticoagulants can be a
full alternative to warfarin. This study aimed to compare efficacy and
safety of edoxaban with warfarin in patients early after surgical
bioprosthetic valve implantation or valve repair. <br/>Method(s): The
Explore the Efficacy and Safety of Edoxaban in Patients after Heart Valve
Repair or Bioprosthetic Valve Replacement study was a prospective,
randomized (1:1), open-label, clinical trial conducted from December 2017
to September 2019. Patients were randomly assigned to receive edoxaban (60
mg or 30 mg once daily) or warfarin for the first 3 months after surgical
bioprosthetic valve implantation or valve repair. The primary efficacy
outcome was a composite of death, clinical thromboembolic events, or
asymptomatic intracardiac thrombosis. The primary safety outcome was the
occurrence of major bleeding. <br/>Result(s): Of 220 participants, 218
(109 per group) were included in the modified intention-to-treat analysis.
The primary efficacy outcome occurred in 4 patients (3.7%) taking warfarin
and none taking edoxaban (risk difference, -0.0367; 95% confidence
interval, -0.0720 to -0.0014; P < .001 for noninferiority). The primary
safety outcome occurred in 1 patient (0.9%) taking warfarin and 3 patients
(2.8%) taking edoxaban (risk difference, 0.0183; 95% confidence interval,
-0.0172 to 0.0539; P = .013 for noninferiority). <br/>Conclusion(s):
Edoxaban is noninferior to warfarin for preventing thromboembolism and is
potentially comparable for risk of major bleeding during the first 3
months after surgical bioprosthetic valve implantation or valve
repair.<br/>Copyright &#xa9; 2021 The American Association for Thoracic
Surgery

<10>
Accession Number
639858106
Title
Postoperative pain and pain management and neurocognitive outcomes after
non-cardiac surgery: a protocol for a series of systematic reviews.
Source
Systematic reviews. 11(1) (pp 280), 2022. Date of Publication: 24 Dec
2022.
Author
Khaled M.; Sabac D.; Marcucci M.
Institution
(Khaled) Department of Health Research Methods, Evidence and Impact,
McMaster University, 1280 Main Street W, Hamilton, ON, L8S4L8, Canada.
khalem3@mcmaster.ca
(Khaled) Perioperative and Surgery Research Program, Population Health
Research Institute, Hamilton, ON, Canada. khalem3@mcmaster.ca
(Sabac) Bachelor of Health Sciences, McMaster University, Hamilton, ON,
Canada
(Marcucci) Department of Health Research Methods, Evidence and Impact,
McMaster University, 1280 Main Street W, Hamilton, ON, L8S4L8, Canada
(Marcucci) Perioperative and Surgery Research Program, Population Health
Research Institute, Hamilton, ON, Canada
(Marcucci) Department of Medicine, McMaster University, Hamilton, ON,
Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: Postoperative delirium (POD) is common after non-cardiac
surgery in older adults and can result in increased risk of adverse
outcomes including postoperative cognitive dysfunction (POCD). Pain after
surgery is also frequent and can persist as chronic postsurgical pain
(CPSP). Evidence is inconsistent and controversial on whether acute and
chronic postsurgical pain, and different postoperative pain management
strategies (including opioid versus opioid-sparing strategies), is
associated with the occurrence of POD and POCD. In this protocol, we
propose a series of systematic reviews to answer the following research
questions: In adults undergoing non-cardiac surgery, (1) is acute
postsurgical pain associated with POD and/or POCD? (2) Are
opioid-sparing/avoidance strategies of acute postoperative pain management
associated with lower incidence and/or severity of POD and POCD, compared
to predominantly opioid-based strategies? (3) Is CPSP associated with
POCD? (4) Are opioid-sparing management strategies of CPSP associated with
lower incidence and/or severity of POCD compared to standard of care or
strategies not aiming at reduced opioid use? METHODS: We will search
MEDLINE, EMBASE, Cochrane (CENTRAL), CINAHL, and PSYCHINFO. According to
the research question, we will include cohort and case-control studies
(questions 1 and 3) or randomized controlled trials and non-randomized
studies (questions 2 and 4). The risk of bias will be assessed
independently and in duplicate using the revised Cochrane risk-of-bias
tool, the Newcastle-Ottawa Scale, and the Joanna-Briggs Institute critical
appraisal checklist. Disagreements will be resolved by a third reviewer.
Findings will be reported narratively, and where possible and appropriate,
meta-analyses will be performed. Certainty of evidence will be assessed
using the Grading of Recommendations Assessment, Development, and
Evaluation approach. We will conduct the reviews in accordance with the
guideline of the Preferred Reporting Items for Systematic Review and
Meta-Analyses Protocols. DISCUSSION: Our systematic reviews will summarize
available evidence to date on the association of postoperative pain and
its management strategies with the incidence of POD and POCD in
non-cardiac surgery. We will evaluate the existing evidence and its
limitations and inform the design of future interventional studies
comparing the effects of different pain management strategies on
postoperative neurocognitive outcomes. SYSTEMATIC REVIEW REGISTRATION:
PROSPERO CRD42021192105.<br/>Copyright &#xa9; 2022. The Author(s).

<11>
Accession Number
639862947
Title
Quality of Life in Patients Undergoing Lung Cancer Surgery: A Qualitative
Review of the Literature.
Source
Quality of Life Research. Conference: 29th Annual Conference of the
International Society for Quality of Life Research, ISOQOL 2022. Prague
Czechia. 31(Supplement 2) (pp S131-S132), 2022. Date of Publication:
November 2022.
Author
Mody G.; Carlson R.; Espey J.; Williams B.; Balakrishnan P.; Chen S.;
Dawson L.; Johnson D.; Brickey J.; Pompili C.; Merlo A.
Institution
(Mody, Carlson, Espey, Williams, Dawson, Johnson, Brickey, Merlo)
University of North Carolina, Chapel Hill, NC, United States
(Balakrishnan) Kasturba Medical College, Karnataka, India
(Chen) Medical University of South Carolina, Charleston, SC, United States
(Pompili) Leeds Institute for Medical Research at St James's, Leeds,
United Kingdom
Publisher
Springer International Publishing
Abstract
Aims: To perform a systematic review of the literature that provides an
up-to-date evaluation of studies that measure quality of life (QOL) and
related concepts in patients undergoing pulmonary resection for lung
cancer. Previous systematic reviews evaluating QOL in lung cancer surgery
patients focused on specific instruments (the Short Form Health Survey
(SF-12/36), European Organisation for Research and Treatment of Cancer
(EORTC) QOL questionnaire, European Quality of Life 5 Dimensions (EQ-5D),
and St. George's Respiratory Questionnaire (SGRQ)).Wesought to evaluate
studies that utilized questionnaires and assessments of symptoms, physical
function, and well-being as well as global QOL. <br/>Method(s): Studies of
patients undergoing pulmonary resection for lung cancer who were assessed
with QOL measures were evaluated for inclusion. A medical librarian
developed search terms related to QOL and related concepts in lung cancer
and thoracic surgery patients. Examples of terms that were used to capture
symptoms were with "dyspnea", "pain", "sleep"; functional status with
"activities of daily living"; and well-being with "return to work".
Validated instruments such as the Visual Analog Scale (VAS) and common
general and cancer-specific QOL questionnaires were also included. A total
of 4253 unique citations were found; 286 articles were included and
further categorized into topic groups (Fig. 1). <br/>Result(s): The 286
grouped papers included twenty randomized controlled trials, and the
remainder were observational studies. The publication of articles on QOL
for patients with lung cancer undergoing surgery is increasing
exponentially over time (Fig. 2). Out of the 153 texts focusing on
long-termQOLafter lung cancer surgery, the most commonly used QOL measures
were the SF- 12/36 and the EORTC. Over forty other distinct QOL assessment
tools were identified. <br/>Conclusion(s): QOL is increasingly measured to
better understand outcomes after lung cancer surgery. Measurement
approaches are myriad and heterogenous. More research is needed to
standardize QOL measurement both as a sensitive research tool and as a
clinically relevant outcomes for patients and clinicians. Having an
understanding of the available QOL assessment instruments is important to
continue to develop clinically relevant studies evaluating patientcentered
outcomes in patients undergoing surgery for lung cancer. (Figure
Presented).

<12>
Accession Number
2020843675
Title
Comparative Outcomes of TAVR in Mixed Aortic Valve Disease and Aortic
Stenosis: A Meta-analysis.
Source
Cardiology and Therapy. (no pagination), 2022. Date of Publication: 2022.
Author
Ugwu J.K.; Kandah D.R.; Ndulue J.K.; Ebiem O.P.; Ugwu-Erugo J.N.; Hamilton
R.; Osei K.; Taskesen T.; Shivapour D.M.; Chawla A.; Marcus R.H.
Institution
(Ugwu, Hamilton, Osei, Taskesen, Shivapour, Chawla, Marcus) Department of
Cardiovascular Medicine, MercyOne Des Moines Medical Center, 1111 6Th Ave,
Des Moines, IA 50314, United States
(Kandah) Internal Medicine Residency, MercyOne Des Moines Medical Center,
Des Moines, IA, United States
(Ndulue) Providence Medical Group, Chehalis Family Medicine, Chehalis, WA,
United States
(Ebiem) Department of Hospital Medicine, Miami Valley Hospital, Dayton,
OH, United States
(Ugwu-Erugo) Ebonyi State University Teaching Hospital, Abakaliki, Nigeria
Publisher
Adis
Abstract
Introduction: Transcatheter aortic valve replacement (TAVR) has become a
suitable alternative to surgical aortic valve replacement (SAVR) for the
treatment of symptomatic severe aortic stenosis (AS). A high proportion of
patients with AS have mixed aortic valve disease (MAVD) with mild or more
concurrent aortic regurgitation (AR). Differential outcomes of TAVR among
patients with AS and MAVD have not been well characterized. We compared
1-year mortalities following TAVR among patients with MAVD and AS.
<br/>Method(s): We conducted a meta-analysis of studies published in
PubMed/Medline. The primary outcome was 1-year all-cause mortality
following TAVR among patients with MAVD vs. AS. Secondary endpoints were:
(1) incidence of AR within 30 days following TAVR (post TAVR AR); and (2)
1-year all-cause mortality within each group stratified according to
severity of post TAVR AR. <br/>Result(s): Nine studies involving 9505
participants were included in the analysis. At 1 year following TAVR,
mortality was lower in MAVD than in AS; HR 0.89, 95% CI 0.81-0.98. The
mortality advantage increased when pre-TAVR AR was moderate or more; HR
0.84, 95% CI 0.72-0.99. The mortality advantage was attenuated after
correction for publication bias. There was a higher risk of post TAVR AR
in the MAVD group; OR 1.51, 95% CI 1.20-1.90 but the impact on mortality
of moderate vs. mild post TAVR AR was greater among patients with AS than
in patients with MAVD HR 1.67 95% CI 0.89-3.14 vs. 0.93 95% CI 0.47-1.85.
<br/>Conclusion(s): Patients with MAVD have similar or improved survival 1
year after TAVR compared to those with AS.<br/>Copyright &#xa9; 2022, The
Author(s).

<13>
Accession Number
639869980
Title
H1 and H2 antihistamines pretreatment for attenuation of protamine
reactions after cardiopulmonary bypass: a randomized-controlled study.
Source
Annals of palliative medicine. (no pagination), 2022. Date of
Publication: 16 Dec 2022.
Author
Suksompong S.; Wongsripuemtet P.; Srinoulprasert Y.; Khamtuikrua C.;
Chaikittisilpa N.
Institution
(Suksompong, Wongsripuemtet, Khamtuikrua, Chaikittisilpa) Department of
Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University,
Bangkok, Thailand
(Srinoulprasert) Department of Immunology, Faculty of Medicine, Siriraj
Hospital, Mahidol University, Bangkok, Thailand
Publisher
NLM (Medline)
Abstract
BACKGROUND: Protamine administration post-cardiopulmonary bypass (CPB) can
potentially cause hemodynamic instability. Histamine released from mast
cells is believed to be responsible for hypotension after protamine
administration. The aim of this study was to examine the effects of
pretreatment with H1 and H2 antihistamines on changes in systemic arterial
pressure following protamine administration. <br/>METHOD(S): This study
was a randomized, triple-blinded, placebo-controlled study, conducted at a
university hospital. Forty adult patients undergoing elective coronary
bypass graft surgery (CABG) or single valve surgery were included. The
patients were randomly allocated (20 patients in each group) to receive a
single dose of combined chlorpheniramine 10 mg and ranitidine 50 mg or
normal saline intravenously immediately after separation from CPB prior to
protamine administration. Trajectory changes in systolic blood pressure
(SBP), mean arterial pressure (MAP), and vasoactive-inotropic score (VIS)
from baseline until 35 minutes following protamine administration (24-time
points) were compared between the two groups. Serial serum tryptase levels
were also obtained at baseline, 30 and 60 minutes after protamine was
given. <br/>RESULT(S): Forty patients were included in the analysis.
Demographic and baseline blood pressure were similar between the two
groups. At 30 minutes after protamine administration, there were no
significant differences in both crude SBP [mean difference: -7.1 mmHg, 95%
confidence interval (CI), -1.1 to 15.3 mmHg, P=0.09] and SBP after
adjustment for the European System for Cardiac Operative Risk Evaluation
(EuroSCORE II), CPB time, and VIS (mean difference: -3.9 mmHg, 95% CI,
-11.9 to 4.0 mmHg, P=0.33). There were also no significant differences in
crude MAP (mean difference: -2.1 mmHg, 95% CI, -6.9 to 2.7 mmHg, P=0.39)
and adjusted MAP (mean difference: -0.7 mmHg, -5.9 to 4.4 mmHg, P=0.78)
between the two groups. None of the patients in both groups had a
significant increase in serum tryptase from baseline. No differences in
median serum tryptase levels at baseline, 30 and 60 minutes were
demonstrated between the two groups. <br/>CONCLUSION(S): Pretreatment with
H1 and H2 antihistamines does not attenuate blood pressure responses to
protamine administration in patients after CPB. Mechanisms other than
histamine release from mast cells might be responsible for
protamine-induced cardiovascular changes. TRIAL REGISTRATION:
ClinicalTrials.gov NCT03583567.

<14>
Accession Number
2019430506
Title
In vivo molecular imaging of cardiac angiogenesis in persons with and
without type 2 diabetes: A cross-sectional ⁶⁸ Ga-RGD-PET study.
Source
Diabetic Medicine. 40(1) (no pagination), 2023. Article Number: e14960.
Date of Publication: January 2023.
Author
Laursen J.C.; Rasmussen I.K.B.; Zobel E.H.; Hasbak P.; Holmvang L.; Hansen
C.S.; von Scholten B.J.; Frimodt-Moller M.; Rossing P.; Hansen T.W.; Kjaer
A.; Ripa R.S.
Institution
(Laursen, Rasmussen, Zobel, Hansen, Frimodt-Moller, Rossing, Hansen) Steno
Diabetes Center Copenhagen, Herlev, Denmark
(Zobel, Kjaer, Ripa) Novo Nordisk, Bagsvaerd, Denmark
(Hasbak, von Scholten) Department of Clinical Physiology, Nuclear Medicine
and PET & Cluster for Molecular Imaging, Copenhagen University Hospital -
Rigshospitalet & Department of Biomedical Sciences, University of
Copenhagen, Copenhagen, Denmark
(Holmvang) Department of Cardiology, Copenhagen University Hospital -
Rigshospitalet, Copenhagen, Denmark
(Rossing) Department of Clinical Medicine, University of Copenhagen,
Copenhagen, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Aims: To assess cardiac angiogenesis in type 2 diabetes by positron
emission tomography (PET) tracer
[⁶⁸Ga]Ga-NODAGA-E[(cRGDyK)]<inf>2</inf> (⁶⁸Ga-RGD)
imaging. <br/>Method(s): Cross-sectional study including 20 persons with
type 2 diabetes and 10 non-diabetic controls (CONs). Primary prespecified
outcome was difference in cardiac angiogenesis (cardiac
⁶⁸Ga-RGD mean target-to-background ratio [TBR<inf>mean</inf>])
between type 2 diabetes and CONs. Secondary outcome was to investigate
associations between cardiac angiogenesis and kidney function and other
risk factors. <br/>Result(s): Participants with type 2 diabetes had a mean
+/- SD age of 61 +/- 9 years, 30% were women, median (IQR) diabetes
duration of 11 (6-19) years and 3 (15%) had a history of cardiovascular
disease. The CONs had comparable age and sex distribution to the
participants with type 2 diabetes, and none had a history of coronary
artery disease. Myocardial flow reserve was lower in type 2 diabetes (2.7
+/- 0.6) compared with CONs (3.4 +/- 1.2) (p = 0.03) and coronary artery
calcium score was higher (562 [142-905] vs. 1 [0-150] p = 0.04). Cardiac
⁶⁸Ga-RGD TBR<inf>mean</inf> was similar in participants with
type 2 diabetes (0.89 +/- 0.09) and CONs (0.89 +/- 0.10) (p = 0.92).
Cardiac ⁶⁸Ga-RGD TBR<inf>mean</inf> was not associated with
estimated glomerular filtration rate, urine albumin creatinine ratio,
cardiovascular disease, coronary artery calcium score or baroreflex
sensitivity, neither in pooled analyses nor in type 2 diabetes.
<br/>Conclusion(s): Cardiac angiogenesis, evaluated with
⁶⁸Ga-RGD PET, was similar in type 2 diabetes and CONs. Cardiac
angiogenesis was not associated with kidney function or other risk markers
in pooled analyses or in analyses restricted to type 2
diabetes.<br/>Copyright &#xa9; 2022 Diabetes UK.

<15>
Accession Number
2020479961
Title
Efficacy and safety of remimazolam for non-obese patients during
anesthetic induction in cardiac surgery: study protocol for a multicenter
randomized trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 984. Date of
Publication: December 2022.
Author
Liu H.-M.; Li P.; Yu H.; Liu B.; Liang P.
Institution
(Yu, Liu, Yu, Liu, Liang) Department of Anesthesiology, West China
Hospital, Sichuan University, No.37 Guoxue Alley, Sichuan, Chengdu 610041,
China
(Li) Department of Anesthesiology, Wu'an First People's Hospital, Wu'an
056300, China
(Liang) Day Surgery Center, West China Hospital, Sichuan University, No.37
Guoxue Alley, Sichuan, Chengdu 610041, China
Publisher
BioMed Central Ltd
Abstract
Background: Valvular heart disease remains common in both developed and
developing countries, and it requires timely surgical treatment when
necessary. However, the stability of hemodynamics during anesthesia
induction in patients undergoing valve replacement surgery is difficult to
maintain due to their impaired cardiac function. Remimazolam, a novel and
ultrashort-acting intravenous sedative-hypnotic, may be beneficial to
stable hemodynamics, but the evidence is limited. Therefore, this study
aims to evaluate the effect of remimazolam induction on hemodynamics
compared with midazolam and etomidate in patients undergoing valve
replacement surgery. <br/>Method(s): This is a prospective, multicenter
randomized controlled trial (RCT). Three hundred and sixty-three non-obese
adult patients aged 45 to 80 years old undergoing valve surgery with
cardiopulmonary bypass will be randomly allocated to receive remimazolam
tosilate, midazolam, or etomidate during anesthetic induction. The primary
outcome is the incidence of hypotension within 20 min after the
administration of investigated drugs. The hypotension is defined as
systolic blood pressure (SBP) < 90 mmHg or a 30% reduction in SBP from
baseline or the application of vasoactive drugs. Secondary outcomes
include incidence of successful sedation, time to successful sedation,
incidence of delirium and postoperative low cardiac output syndrome within
7 days after surgery, hospital mortality, mechanical ventilation time, ICU
length of stay, and hospital length of stay. <br/>Discussion(s): To our
knowledge, this is the first prospective RCT to investigate the efficacy
and safety of remimazolam induction in adult cardiac surgery compared with
midazolam and etomidate. This study will provide important information on
the application of remimazolam in cardiac surgery in the future. Trial
registration: Chinese Clinical Trial Registry chictr.org.cn
ChiCTR2100050122. Registered on August 16, 2021.<br/>Copyright &#xa9;
2022, The Author(s).

<16>
Accession Number
2020198818
Title
Caregiver Distress and Coronary Artery Disease: Prevalence, Risk,
Outcomes, and Management.
Source
Current Cardiology Reports. 24(12) (pp 2081-2096), 2022. Date of
Publication: December 2022.
Author
Bouchard K.; Dans M.; Higdon G.; Quinlan B.; Tulloch H.
Institution
(Bouchard, Dans, Higdon, Quinlan, Tulloch) Division of Cardiac Prevention
and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin
Street, Ottawa, ON K1Y4W7, Canada
Publisher
Springer
Abstract
Purpose of Review: Caregivers of patients with coronary artery disease
(CAD) are integral to the health care system and contribute substantially
to patients' management. The purpose of this review is to provide a
narrative synthesis of existing research on caregiving for patients who
experienced an acute coronary syndrome (MI/unstable angina) and/or
coronary revascularization (PCI/CABG). Recent Findings: Thirty-one
articles are included in this review. Overall, caregiver distress is low
to moderate, ranging from 6 to 67% of caregivers, and seems to dissipate
over time for most caregivers. Interventions have demonstrated success in
reducing the distress of caregivers of patients with CAD. Due to the
heterogeneity in study samples, measurements used, and timing of
assessments and programming, these results are far from definitive.
<br/>Summary: Although evidence is accumulating, further advancement in
caregiving science and clinical care is required to adequately understand
and respond to the needs of caregivers throughout the patient's illness
trajectory.<br/>Copyright &#xa9; 2022, The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature.

<17>
Accession Number
2018794383
Title
Predictors of sirolimus pharmacokinetic variability identified using a
nonlinear mixed effects approach: a systematic review.
Source
Journal of Population Therapeutics and Clinical Pharmacology. 29(4) (pp
11-29), 2022. Date of Publication: 09 Dec 2022.
Author
Methaneethorn J.; Art-Arsa P.; Kosiyaporn R.; Leelakanok N.
Institution
(Methaneethorn, Art-Arsa, Kosiyaporn) Department of Pharmacy Practice,
Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok,
Thailand
(Methaneethorn) Center of Excellence for Environmental Health and
Toxicology, Naresuan University, Phitsanulok, Thailand
(Leelakanok) Department of Clinical Pharmacy, Faculty of Pharmaceutical
Sciences, Burapha University, Chonburi, Thailand
Publisher
Codon Publications
Abstract
Several sirolimus (SRL) population pharmacokinetics (PopPK) were conducted
to explain its pharmaco-kinetic variability, and the results varied across
studies. Thus, we conducted a systematic review to sum-marize significant
predictors influencing SRL pharmacokinetic variability. Moreover,
discrepancies in model methodologies across studies were also reviewed and
discussed. Four databases (PubMed, CINAHL Complete, Science Direct, and
Scopus) were systematically searched. The PICO framework was used to
identify eligible studies conducted in humans and employ a nonlinear-mixed
effects strategy. Based on the inclusion and exclusion criteria, 20
studies were included. SRL pharmacokinetics were explained using 1-or
2-compartment models. Only one study assessed the model using an external
approach, while the rest employed basic or advanced internal approaches.
Significant covariates influencing SRL pharmacokinetics were bodyweight,
age, CYP3A5 polymorphism, gender, BSA, height, cyclosporine dose or trough
concen-tration, triglyceride, total cholesterol, hematocrit, albumin,
aspartate aminotransferase, alanine amino-transferase, and total
bilirubin. Of these, bodyweight, age, and CYP3A5 polymorphism were the
three most identified significant predictors for SRL clearance. This
review summarizes significant predictors to pre-dict SRL clearance, which
can subsequently be used to individualize SRL maintenance dose. However,
the PopPK model selected for such prediction should be based on the
resemblance of population characteristics between the target population
and those used to conduct the model. Moreover, the predictability of the
models in the target population should be assessed before implementation
in clinical practice.<br/>Copyright &#xa9; 2022, Codon Publications. All
rights reserved.

<18>
Accession Number
2019414839
Title
Combined atrial fibrillation ablation and balloon mitral commissurotomy in
patients with rheumatic mitral stenosis.
Source
Journal of Cardiovascular Electrophysiology. 33(12) (pp 2485-2495), 2022.
Date of Publication: December 2022.
Author
Diez-Delhoyo F.; Sanchez De La Nava A.M.; Sanz-Ruiz R.; Avila P.;
Gonzalez-Torrecilla E.; Delgado-Montero A.; Lopez J.; Bermejo J.; Arenal
A.; Atienza F.; Fernandez-Aviles F.
Institution
(Diez-Delhoyo, Sanchez De La Nava, Sanz-Ruiz, Avila, Gonzalez-Torrecilla,
Delgado-Montero, Lopez, Bermejo, Arenal, Atienza, Fernandez-Aviles)
Department of Cardiology, Hospital General Universitario Gregorio Maranon,
Instituto de Investigacion Sanitaria Gregorio Maranon (IiSGM), Madrid,
Spain
(Diez-Delhoyo, Sanchez De La Nava, Sanz-Ruiz, Avila, Gonzalez-Torrecilla,
Delgado-Montero, Lopez, Bermejo, Arenal, Atienza, Fernandez-Aviles)
CIBERCV, Centro de Investigacion Biomedica en Red de Enfermedades
Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
(Diez-Delhoyo, Sanz-Ruiz, Avila, Gonzalez-Torrecilla, Delgado-Montero,
Lopez, Bermejo, Arenal, Atienza, Fernandez-Aviles) Facultad de Medicina,
Universidad Complutense de, Madrid, Spain
(Sanchez De La Nava) Universitat Politecnica de Valencia, Valencia, Spain
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Ablation of atrial fibrillation (AF) is usually not
considered in patients with rheumatic mitral stenosis (RMS). We analyzed
the results of a combined procedure of AF ablation and percutaneous
balloon mitral commissurotomy (PBMC). <br/>Method(s): We prospectively
included 22 patients with severe RMS to undergo a combined PBMC + AF
ablation procedure. Noninvasive mapping of the atria was also performed. A
historical sample of propensity-scored matched patients who underwent PBMC
alone was used as controls. The primary endpoint was freedom from AF/AT at
1-year. Multivariate analysis evaluated sinus rhythm (SR) predictors.
<br/>Result(s): Successful pulmonary vein isolation and
electrocardiographic imaging-based drivers ablation was performed in 20
patients following PBMC. At 1-year, 75% of the patients in the combined
group were in SR compared to 40% in the propensity-score matched group (p
= 0.004). The composite of AF recurrence, need for mitral surgery and
all-cause mortality was also more frequent in the control group (65% vs.
30%; p = 0.005). Catheter ablation (odds ratio [OR] 1.58; 95% confidence
interval [CI] [1.17-17.37]; p = 0.04) and AF type (OR 1.46; 95% CI
[1.05-82.64]; p < 0.001) were the only independent predictors of SR at
1-year. Noninvasive mapping in the combined group showed that the number
of simultaneous rotors (OR 2.10; 95% CI [1.41-10.2]; p = 0.04) was the
only independent predictor of AF. <br/>Conclusion(s): A combined procedure
of AF ablation and PBMC significantly increased the proportion of patients
in sinus rhythm at 1-year. Noninvasive mapping may help to improve AF
characterization and guide personalized AF treatment.<br/>Copyright &#xa9;
2022 Wiley Periodicals LLC.

<19>
Accession Number
2021116418
Title
Shannon entropy as a reliable score to diagnose human fibroelastic
degenerative mitral chords: A micro-ct ex-vivo study.
Source
Medical Engineering and Physics. 110 (no pagination), 2022. Article
Number: 103919. Date of Publication: December 2022.
Author
Ferreno D.; Revuelta J.M.; Sainz-Aja J.A.; Wert-Carvajal C.; Casado J.A.;
Diego S.; Carrascal I.A.; Silva J.; Gutierrez-Solana F.
Institution
(Ferreno, Revuelta, Sainz-Aja, Casado, Diego, Carrascal, Gutierrez-Solana)
LADICIM (Laboratory of Materials Science and Engineering), University of
Cantabria. E.T.S. de Ingenieros de Caminos, Canales y Puertos, Av/Los
Castros 44, Santander 39005, Spain
(Revuelta) Cardiovascular Surgery, Hospital Universitario Marques de
Valdecilla, Av/Valdecilla, s/n, Santander 39008, Spain
(Wert-Carvajal) Universidad Carlos III de Madrid, Avda. de la Universidad,
30, Madrid 28911, Spain
(Wert-Carvajal) University of California, San Diego, 9500 Gilman Drive,
MC, La Jolla, California 0412
(Silva) Hospital Universitario Central de Asturias, Av. Roma, s/n,
Asturias, Oviedo 33011, Spain
Publisher
Elsevier Ltd
Abstract
This paper is aimed at identifying by means of micro-CT the
microstructural differences between normal and degenerative mitral
marginal chordae tendineae. The control group is composed of 21 normal
chords excised from 14 normal mitral valves from heart transplant
recipients. The experimental group comprises 22 degenerative fibroelastic
chords obtained at surgery from 11 pathological valves after mitral repair
or replacement. In the control group the superficial endothelial cells and
spongiosa layer remained intact, covering the wavy core collagen. In
contrast, in the experimental group the collagen fibers were arranged as
straightened thick bundles in a parallel configuration. 100 cross-sections
were examined by micro-CT from each chord. Each image was randomized
through the K-means machine learning algorithm and then, the global and
local Shannon entropies were obtained. The optimum number of clusters, K,
was estimated to maximize the differences between normal and degenerative
chords in global and local Shannon entropy; the p-value after a nested
ANOVA test was chosen as the parameter to be minimized. Optimum results
were obtained with global Shannon entropy and 2<=K<=7, providing p < 0.01;
for K=3, p = 2.86.10^-3. These findings open the door to novel
perioperative diagnostic methods in order to avoid or reduce postoperative
mitral valve regurgitation recurrences.<br/>Copyright &#xa9; 2022 The
Author(s)

<20>
Accession Number
2020749432
Title
Advanced and Invasive Cardiopulmonary Resuscitation (CPR) Techniques as an
Adjunct to Advanced Cardiac Life Support.
Source
Journal of Clinical Medicine. 11(24) (no pagination), 2022. Article
Number: 7315. Date of Publication: December 2022.
Author
Obermaier M.; Katzenschlager S.; Kofler O.; Weilbacher F.; Popp E.
Institution
(Obermaier, Katzenschlager, Kofler, Weilbacher, Popp) Department of
Anaesthesiology, Heidelberg University Hospital, Heidelberg 69120, Germany
Publisher
MDPI
Abstract
Background: Despite numerous promising innovations, the chance of survival
from sudden cardiac arrest has remained virtually unchanged for decades.
Recently, technological advances have been made, user-friendly portable
devices have been developed, and advanced invasive procedures have been
described that could improve this unsatisfactory situation.
<br/>Method(s): A selective literature search in the core databases with a
focus on randomized controlled trials and guidelines. <br/>Result(s):
Technical aids, such as feedback systems or automated mechanical
cardiopulmonary resuscitation (CPR) devices, can improve chest compression
quality. The latter, as well as extracorporeal CPR, might serve as a
bridge to treatment (with extracorporeal CPR even as a bridge to
recovery). Sonography may be used to improve thoracic compressions on the
one hand and to rule out potentially reversible causes of cardiac arrest
on the other. Resuscitative endovascular balloon occlusion of the aorta
might enhance myocardial and cerebral perfusion. Minithoracostomy,
pericardiocentesis, or clamshell thoracotomy might resolve reversible
causes of cardiac arrest. <br/>Conclusion(s): It is crucial to identify
those patients who may benefit from an advanced or invasive procedure and
make the decision to implement the intervention in a timely manner. As
with all infrequently performed procedures, sound education and regular
training are paramount.<br/>Copyright &#xa9; 2022 by the authors.

<21>
Accession Number
2021904072
Title
A Randomized Trial of Clopidogrel vs Ticagrelor After Off-Pump Coronary
Bypass.
Source
Annals of Thoracic Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Kim H.-H.; Yoo K.-J.; Youn Y.-N.
Institution
(Kim, Yoo, Youn) Division of Cardiovascular Surgery, Severance
Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei
University Health System, Seoul, South Korea
Publisher
Elsevier Inc.
Abstract
Background: This study aimed to compare the outcomes of aspirin in
combination with either ticagrelor or clopidogrel after off-pump coronary
artery bypass (OPCAB) in patients with clopidogrel resistance.
<br/>Method(s): Between November 2014 and November 2020, 1739 patients
underwent OPCAB. Aspirin and clopidogrel treatment was initiated the day
after surgery. On postoperative days 7 to 9, clopidogrel resistance was
evaluated using a point-of-care assay. A total of 278 (18.9%) patients had
clopidogrel resistance ( platelet reaction unit >208) and were enrolled in
the study. The study investigators excluded patients with coresistance to
aspirin (n = 74) and divided the remaining patients (mean age, 67.4 +/-
8.5 years) into 2 groups (an aspirin and ticagrelor group [AT group; n =
102] and an aspirin and clopidogrel group [AC group; n = 102]), randomly
assigned using a 1:1 ratio block table. The primary end point was graft
patency and major adverse cardiovascular events (MACEs; defined as the
composite of cardiovascular mortality, myocardial infarction, and repeat
revascularization at 1 year after OPCAB), and the coprimary end point was
the graft patency rate. The data were analyzed using the intent-to-treat
method. <br/>Result(s): The graft occlusion rates in the AT and AC groups
were 3.9% and 5.9%, respectively (P = .52). Neither death from
cardiovascular causes (1.0% vs 2.9%; P = .32) nor myocardial infarction
showed significant differences (1.0% vs 3.9%; P = .18). No significant
difference in the rates of major bleeding were found between the 2 groups
(P = .75). However, the AT group was associated with a lower rate of MACEs
after OPCAB (hazard ratio, 0.77; 95% CI, 0.684-0.891; P = .01).
<br/>Conclusion(s): These results suggest that ticagrelor may be
associated with reducing MACEs in patients with clopidogrel resistance
after OPCAB.<br/>Copyright &#xa9; 2022 The Society of Thoracic Surgeons

<22>
Accession Number
2021903999
Title
Risk of bleeding after percutaneous coronary intervention and its impact
on further adverse events in clinical trial participants with comorbid
peripheral arterial disease.
Source
International Journal of Cardiology. (no pagination), 2022. Date of
Publication: 2022.
Author
Pinxterhuis T.H.; Ploumen E.H.; Zocca P.; Doggen C.J.M.; Schotborgh C.E.;
Anthonio R.L.; Roguin A.; Danse P.W.; Benit E.; Aminian A.; Stoel M.G.;
Linssen G.C.M.; Geelkerken R.H.; von Birgelen C.
Institution
(Pinxterhuis, Ploumen, Zocca, Stoel, von Birgelen) Department of
Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede,
Netherlands
(Pinxterhuis, Ploumen, Doggen, von Birgelen) Health Technology and
Services Research, Faculty BMS, Technical Medical Centre, University of
Twente, Enschede, Netherlands
(Schotborgh) Department of Cardiology, Haga Hospital, The Hague,
Netherlands
(Anthonio) Department of Cardiology, Treant Zorggroep, Scheper Hospital,
Emmen, Netherlands
(Roguin) Department of Cardiology, Hillel Yaffe Medical Center, Hadera and
B. Rappaport-Faculty of Medicine, Israel, Institute of Technology, Haifa,
Israel
(Danse) Department of Cardiology, Rijnstate Hospital, Arnhem, Netherlands
(Benit) Department of Cardiology, Jessa Hospital, Hasselt, Belgium
(Aminian) Department of Cardiology, Centre Hospitalier Universitaire de
Charleroi, Charleroi, Belgium
(Linssen) Department of Cardiology, Ziekenhuisgroep Twente, and Hengelo,
Almelo, Netherlands
(Geelkerken) Department of Vascular Surgery, Medisch Spectrum Twente,
Enschede, Netherlands
(Geelkerken) Multi-modality Medical Imaging (M3I) group, Faculty of
Science and Technology, Technical Medical Centre, University of Twente,
Enschede, Netherlands
Publisher
Elsevier Ireland Ltd
Abstract
Background: Both patients with obstructive coronary artery disease (CAD)
and patients with peripheral arterial disease (PADs) have an increased
bleeding risk. Information is scarce on bleeding in CAD patients, treated
with percutaneous coronary intervention (PCI), who have comorbid PADs. We
assessed whether PCI patients with PADs have a higher bleeding risk than
PCI patients without PADs. Furthermore, in PCI patients with PADs we
evaluated the extent by which bleeding increased the risk of further
adverse events. <br/>Method(s): Three-year pooled patient-level data of
two randomized PCI trials (BIO-RESORT, BIONYX) with drug-eluting stents
were analyzed to assess mortality and the composite endpoint major adverse
cardiac events (MACE: all-cause mortality, any myocardial infarction,
emergent coronary artery bypass surgery, or target lesion
revascularization). <br/>Result(s): Among 5989 all-comer patients,
followed for 3 years, bleeding occurred in 7.7% (34/440) with comorbid
PADs and 5.0% (279/5549) without PADs (HR: 1.59, 95%CI: 1.11-2.23, p =
0.010). Of all PADs patients, those with a bleeding had significantly
higher rates of all-cause mortality (HR: 4.70, 95%CI: 2.37-9.33, p <
0.001) and MACE (HR: 2.39, 95%CI: 1.23-4.31, p = 0.003). Furthermore, PADs
patients with a bleeding were older (74.4 +/- 6.9 vs. 67.4 +/- 9.5, p <
0.001). After correction for age and other potential confounders, bleeding
remained independently associated with all-cause mortality (adj.HR: 2.97,
95%CI: 1.37-6.43, p = 0.006) while the relation of bleeding with MACE
became borderline non-significant (adj.HR: 1.85, 95%CI: 0.97-3.55, p =
0.06). <br/>Conclusion(s): PCI patients with PADs had a higher bleeding
risk than PCI patients without PADs. In PADs patients, bleeding was
associated with all-cause mortality, even after adjustment for potential
confounders.<br/>Copyright &#xa9; 2022 The Author(s)

<23>
Accession Number
639859689
Title
External validation of the PROGRESS-CTO complication risk scores:
Individual patient data pooled analysis of 3 registries.
Source
International journal of cardiology. (no pagination), 2022. Date of
Publication: 21 Dec 2022.
Author
Simsek B.; Tajti P.; Carlino M.; Ojeda S.; Pan M.; Rinfret S.; Vemmou E.;
Kostantinis S.; Nikolakopoulos I.; Karacsonyi J.; Dens J.A.; Agostoni P.;
Alaswad K.; Megaly M.; Avran A.; Choi J.W.; Jaffer F.A.; Doshi D.;
Karmpaliotis D.; Khatri J.J.; Knaapen P.; La Manna A.; Spratt J.C.; Tanabe
M.; Walsh S.; Mastrodemos O.C.; Allana S.; Rempakos A.; Rangan B.V.;
Goktekin O.; Gorgulu S.; Poommipanit P.; Kearney K.E.; Lombardi W.L.;
Grantham J.A.; Mashayekhi K.; Brilakis E.S.; Azzalini L.
Institution
(Simsek, Kostantinis, Karacsonyi, Mastrodemos, Allana, Rempakos, Rangan,
Brilakis) Minneapolis Heart Institute, Minneapolis Heart Institute
Foundation, Minneapolis, MN, United States
(Tajti) Gottsegen National Cardiovascular Center, Budapest, Hungary
(Carlino) Interventional Cardiology Division, Cardio-Thoracic-Vascular
Department, San Raffaele Scientific Institute, Milan, Italy
(Ojeda, Pan) Division of Interventional Cardiology, Reina Sofia Hospital,
University of Cordoba, Maimonides Institute for Research in Biomedicine of
Cordoba (IMIBIC), Cordoba, Spain
(Rinfret) Emory Heart and Vascular Center, Emory University School of
Medicine, Atlanta, GA, United States
(Vemmou, Nikolakopoulos) Department of Internal Medicine, Yale University
School of Medicine, New Haven, CT, United States
(Dens) Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium
(Agostoni) Ziekenhuis Netwerk Antwerpen Middelheim, Antwerp, Belgium
(Alaswad) Henry Ford Health System, Detroit, MI, United States
(Megaly) Division of Cardiology, Shreveport, LA, United States
(Avran) Department of Interventional Cardiology, Clinique Pasteur, France
(Choi) Presbyterian Hospital, Dallas, TX, United States
(Jaffer, Doshi) Massachusetts General Hospital, Harvard Medical School,
Boston, MA, United States
(Karmpaliotis) Morristown Medical Center, Morristown, NJ, United States
(Khatri) Cleveland Clinic Foundation, Cleveland, OH, United States
(Knaapen) Department of Cardiology, VU University Medical Center,
Amsterdam, Netherlands
(La Manna) University of Catania, Catania, Italy
(Spratt) St. George's University Healthcare NHS Trust, London, United
Kingdom
(Tanabe) Department of Cardiology, Nozaki Tokushukai Hospital, Osaka,
Japan
(Walsh) Belfast Health, Belfast, United Kingdom
(Goktekin) Division of Cardiology, Memorial Bahcelievler Hospital,
Istanbul, Turkey
(Gorgulu) Division of Cardiology, Biruni University School of Medicine,
Istanbul, Turkey
(Poommipanit) University Hospitals, Cleveland, OH, United States
(Kearney, Lombardi, Azzalini) Division of Cardiology, Department of
Medicine, University of Washington, Seattle, WA, United States
(Grantham) Saint Luke's Mid America Heart Institute, Kansas City, MO,
United States
(Mashayekhi) Heart Center Lahr, Department for Internal Medicine and
Cardiology, Germany
Publisher
NLM (Medline)
Abstract
BACKGROUND: Chronic total occlusion (CTO) percutaneous coronary
intervention (PCI) is associated with a considerable risk of
complications, and risk stratification is of utmost importance. AIMS: To
assess the clinical usefulness of the recently developed PROGRESS-CTO
(NCT02061436) complication risk scores in an independent cohort.
<br/>METHOD(S): Individual patient data pooled analysis of 3 registries
was performed. <br/>RESULT(S): Of the 4569 patients who underwent CTO PCI,
102 (2.2%) had major adverse cardiovascular events (MACE). Patients with
MACE were older (69+/-11 vs. 65+/-10, p<0.001), more likely to have a
history of prior coronary artery bypass graft surgery, and unfavorable
angiographic characteristics J-CTO score (2.4+/-1.2 vs. 2.1+/-1.3,
p=0.007), including blunt stump (59% vs. 49%, p=0.047). Technical success
was lower in patients with MACE (59% vs. 86%, p<0.001). The area under the
receiver operating characteristic curve of the PROGRESS-CTO complication
risk models were as follows: MACE 0.72 (95% confidence interval [CI],
0.67-0.76), mortality 0.73 (95% CI, 0.61-0.85), and pericardiocentesis
0.69 (95% CI, 0.62-0.77) in the validation dataset. The observed
complication rates increased with higher PROGRESS-CTO complication scores.
The PROGRESS-CTO MACE score showed good calibration in this external
cohort, with MACE rates similar to the original study: 0.7% (score 0-1),
1.5% (score 2), 2.2% (score 3), 3.8% (score 4), 4.9% (score 5), 5.8%
(score 6-7). <br/>CONCLUSION(S): Given the good discriminative
performance, calibration, and ease of calculation, the PROGRESS-CTO
complication scores could help assess the risk of complications in
patients undergoing CTO PCI.<br/>Copyright &#xa9; 2022. Published by
Elsevier B.V.

<24>
Accession Number
639858565
Title
Ross Procedure Versus Mechanical Versus Bioprosthetic Aortic Valve
Replacement: A Network Meta-Analysis.
Source
Journal of the American Heart Association. (pp e8066), 2022. Date of
Publication: 24 Dec 2022.
Author
Yokoyama Y.; Kuno T.; Toyoda N.; Fujisaki T.; Takagi H.; Itagaki S.;
Ibrahim M.; Ouzounian M.; El-Hamamsy I.; Fukuhara S.
Institution
(Yokoyama) Department of Surgery St. Luke's University Health Network
Bethlehem PA
(Kuno) Department of Cardiology, Montefiore Medical Center Albert Einstein
College of Medicine New York NY
(Toyoda, Itagaki, El-Hamamsy) Department of Cardiovascular Surgery Icahn
School of Medicine at Mount Sinai New York NY
(Fujisaki) Department of Medicine Icahn School of Medicine at Mount Sinai,
Mount Sinai Morningside and West New York NY
(Takagi) Department of Cardiovascular Surgery Shizuoka Medical Center
Shizuoka Japan, Japan
(Ibrahim) Division of Cardiovascular Surgery Hospital of the University of
Pennsylvania Philadelphia PA
(Ouzounian) Division of Cardiovascular Surgery Peter Munk Cardiac Centre,
Toronto General Hospital and the University of Toronto, Canada
(Fukuhara) Department of Cardiac Surgery University of Michigan Ann Arbor
MI
Publisher
NLM (Medline)
Abstract
Background The Ross operation appears to restore normal survival in young
and middle-aged adults with aortic valve disease. However, there are
limited data comparing it with conventional aortic valve replacement.
Herein, we compared outcomes of the Ross procedure with mechanical and
bioprosthetic aortic valve replacement (M-AVR and B-AVR, respectively).
Methods and Results MEDLINE and EMBASE were searched through March 2022 to
identify randomized controlled trials and propensity score-matched studies
that investigated outcomes of patients aged >=16years undergoing the Ross
procedure, M-AVR, or B-AVR. The systematic literature search identified 2
randomized controlled trials and 8 propensity score-matched studies
involving a total of 4812 patients (Ross: n=1991; M-AVR: n=2019; and
B-AVR: n=802). All-cause mortality was significantly lower in the Ross
procedure group compared with M-AVR (hazard ratio [HR] [95% CI], 0.58
[0.35-0.97]; P=0.035) and B-AVR (HR [95% CI], 0.32 [0.18-0.59]; P<0.001)
groups. The reintervention rate was lower after the Ross procedure and
M-AVR compared with B-AVR, whereas it was higher after the Ross procedure
compared with M-AVR. Major bleeding rate was lower after the Ross
procedure compared with M-AVR. Long-term stroke rate was lower following
the Ross procedure compared with M-AVR and B-AVR. The rate of endocarditis
was also lower after the Ross procedure compared with B-AVR. Conclusions
Improved long-term outcomes of the Ross procedure are demonstrated
compared with conventional M-AVR and B-AVR options. These results
highlight a need to enhance the recognition of the Ross procedure and
revisit current guidelines on the optimal valve substitute for young and
middle-aged patients.

<25>
Accession Number
2020127723
Title
Efficacy and safety of degludec U100 versus glargine U300 for the early
postoperative management of patients with type 2 diabetes mellitus
undergoing coronary artery bypass graft surgery: A non-inferiority
randomized trial.
Source
Diabetic Medicine. 40(1) (no pagination), 2023. Article Number: e15002.
Date of Publication: January 2023.
Author
Kuchay M.S.; Mathew A.; Mishra M.; Surendran P.; Kaur P.; Wasir J.S.; Gill
H.K.; Jain R.; Gagneja S.; Kohli C.; Kumari P.; Singh M.K.; Mishra S.K.
Institution
(Kuchay, Mathew, Mishra, Kaur, Wasir, Gill, Jain, Gagneja, Kohli, Kumari,
Mishra) Division of Endocrinology and Diabetes, Medanta-The Medicity
Hospital, Gurugram, India
(Surendran, Singh) Department of Clinical Research and Studies,
Medanta-The Medicity Hospital, Gurugram, India
Publisher
John Wiley and Sons Inc
Abstract
Aims: To compare the efficacy and safety of degludec U100 versus glargine
U300 for the early postoperative management of patients with type 2
diabetes mellitus (T2D) undergoing coronary artery bypass graft (CABG)
surgery. <br/>Method(s): A total of 239 patients were randomly assigned
(1:1) to receive a basal-bolus regimen in the early postoperative period
using degludec U100 (n = 122) or glargine U300 (n = 117) as basal and
glulisine before meals. The primary outcome was mean differences between
groups in their daily BG concentrations. The major safety outcome was the
occurrence of hypoglycemia. <br/>Result(s): There were no differences in
mean daily BG concentrations (157 vs. 162 mg/dl), mean percentage of
readings within target BG of 70-180 mg/dl (74% vs. 73%), daily basal
insulin dose (19 vs. 21 units/day), length of stay (median [IQR]: 9 vs. 9
days), or hospital complications (21.3% vs. 21.4%) between treatment
groups. There were no differences in the proportion of patients with BG
<70 mg/dl (15.6% vs. 23.1%) or <54 mg/dl (1.6% vs. 4.3%) between
degludec-100 and glargine-300 groups. <br/>Conclusion(s): Treatment with
degludec U100 is as effective and safe as glargine U300 for the early
postoperative hospital management of patients with T2D undergoing
CABG.<br/>Copyright &#xa9; 2022 Diabetes UK.

<26>
Accession Number
2021047801
Title
Sternotomy Wound Infiltration With Liposomal Versus Plain Bupivacaine for
Postoperative Analgesia After Elective Cardiac Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(1) (pp 42-49), 2023.
Date of Publication: January 2023.
Author
Subramaniam K.; Sciortino C.M.; Boisen M.L.; La Colla L.; Dickson A.;
Nowakowski E.; Prangley K.; Ruppert K.M.
Institution
(Subramaniam, Boisen, La Colla, Dickson, Nowakowski, Prangley, Ruppert)
Department of Anesthesiology and Perioperative Medicine, University of
Pittsburgh, Pittsburgh, Panama
(Sciortino) Sentara Mid-Atlantic Cardiothoracic Surgeons, Sentara Medical
Group, Norfolk, VA
(Ruppert) Department of Epidemiology, University of Pittsburgh,
Pittsburgh, PA, United States
Publisher
W.B. Saunders
Abstract
Objectives: Poor pain control after cardiac surgery can be associated with
postoperative complications, longer recovery, and development of chronic
pain. The authors hypothesized that adding liposomal bupivacaine (LB) to
plain bupivacaine (PB) will provide better and long-lasting analgesia when
used for wound infiltration in median sternotomy. <br/>Study Design:
Prospective, randomized, and double-blinded clinical trial.
<br/>Setting(s): Single institution, tertiary care university hospital.
<br/>Participant(s): Adult patients who underwent elective cardiac surgery
through median sternotomy. <br/>Intervention(s): A single surgeon
performed wound infiltration of LB plus PB or PB into the sternotomy
wound, chest, and mediastinal tube sites. <br/>Measurements and Main
Results: Patients were followed up for 72 hours for pain scores, opioid
consumption, and adverse events. Sixty patients completed the study for
analysis (LB group [n = 29], PB group [n = 31]). Patient characteristics,
procedural variables, and pain scores measured at specific intervals from
4 hours until 72 hours postoperatively did not reveal any significant
differences between the groups. Mixed-model regression showed that the
trend of mean pain scores at movement in the LB group was significantly (p
= 0.01) lower compared with the PB group. Opioid consumption over 72 hours
was not significantly different between the 2 groups (oral morphine
equivalents; median [interquartile range], 139 [73, 212] mg in LB v 105
[54, 188] mg in PB, p = 0.29). Recovery characteristics and adverse events
were comparable. <br/>Conclusion(s): LB added to PB for sternotomy wound
infiltration during elective cardiac surgery did not significantly improve
the quality of postoperative analgesia.<br/>Copyright &#xa9; 2022 Elsevier
Inc.

<27>
[Use Link to view the full text]
Accession Number
2021813812
Title
AI-based classification algorithms in SPECT myocardial perfusion imaging
for cardiovascular diagnosis: A review.
Source
Nuclear Medicine Communications. 44(1) (pp 1-11), 2023. Date of
Publication: 01 Jan 2023.
Author
Papandrianos N.I.; Apostolopoulos I.D.; Feleki A.; Moustakidis S.;
Kokkinos K.; Papageorgiou E.I.
Institution
(Papandrianos, Feleki, Moustakidis, Kokkinos, Papageorgiou) Department of
Energy Systems, University of Thessaly, Larisa, Greece
(Apostolopoulos) Department of Medical Physics, School of Medicine,
University of Patras, Patras, Greece
(Moustakidis) AIDEAS OU, Tallinn, Estonia
Publisher
Wolters Kluwer Health
Abstract
In the last few years, deep learning has made a breakthrough and
established its position in machine learning classification problems in
medical image analysis. Deep learning has recently displayed remarkable
applicability in a range of different medical applications, as well as in
nuclear cardiology. This paper implements a literature review protocol and
reports the latest advances in artificial intelligence (AI)-based
classification in SPECT myocardial perfusion imaging in heart disease
diagnosis. The representative and most recent works are reported to
demonstrate the use of AI and deep learning technologies in medical image
analysis in nuclear cardiology for cardiovascular diagnosis. This review
also analyses the primary outcomes of the presented research studies and
suggests future directions focusing on the explainability of the deployed
deep-learning systems in clinical practice.<br/>Copyright &#xa9; 2023
Lippincott Williams and Wilkins. All rights reserved.

<28>
Accession Number
2020482063
Title
Extracorporeal membrane oxygenation support in oncological thoracic
surgery.
Source
Frontiers in Oncology. 12 (no pagination), 2022. Article Number: 1005929.
Date of Publication: 25 Nov 2022.
Author
Mangiameli G.; Testori A.; Cioffi U.; Alloisio M.; Cariboni U.
Institution
(Mangiameli, Testori, Alloisio, Cariboni) Division of Thoracic Surgery,
IRCCS Humanitas Research Hospital, Milan, Rozzano, Italy
(Mangiameli, Alloisio) Department of Biomedical Sciences, Humanitas
University, Milan, Italy
(Cioffi) Department of Surgery, University of Milan, Milan, Italy
Publisher
Frontiers Media S.A.
Abstract
The use of extracorporeal lung support (ECLS) during thoracic surgery is a
recent concept that has been gaining increasing approval. Firstly
introduced for lung transplantation, this technique is now increasingly
adopted also in oncological thoracic surgical procedures. In this review,
we focus on the cutting-edge application of extracorporeal membrane
oxygenation (ECMO) during oncological thoracic surgery. Therefore, we
report the most common surgical procedures in oncological thoracic surgery
that can benefit from the use of ECMO. They will be classified and
discussed according to the aim of ECMO application. In particular, the use
of ECMO is usually limited to certain lung surgery procedures that can be
resumed such as in procedures in which an adequate ventilation is not
possible such as in single lung patients, procedures where conventional
ventilation can cause conflict with the surgical field such as tracheal or
carinal surgery, and conventional procedures requiring both ventilators
and hemodynamic support. So far, all available evidence comes from centers
with large experience in ECMO and major thoracic surgery
procedures.<br/>Copyright &#xa9; 2022 Mangiameli, Testori, Cioffi,
Alloisio and Cariboni.

<29>
[Use Link to view the full text]
Accession Number
2021813640
Title
Prognosis and the Effect of De-Escalation of Antiplatelet Therapy after
Nuisance Bleeding in Patients with Myocardial Infarction.
Source
Circulation: Cardiovascular Interventions. 15(12) (pp E012157), 2022. Date
of Publication: 01 Dec 2022.
Author
Choo E.H.; Choi I.J.; Lim S.; Moon D.; Kim C.J.; Park M.-W.; Kim M.C.;
Hwang B.-H.; Lee K.Y.; Seok Choi Y.; Kim H.-Y.; Yoo K.-D.; Jeon D.S.; Ahn
Y.; Chang K.
Institution
(Choo, Hwang, Lee, Seok Choi, Chang) Division of Cardiology, Seoul St.
Mary's Hospital, The Catholic University of Korea, South Korea
(Choi, Jeon) Division of Cardiology, Incheon St. Mary's Hospital, The
Catholic University of Korea, South Korea
(Lim, Kim) Division of Cardiology, Uijeongbu St. Mary's Hospital, The
Catholic University of Korea, South Korea
(Moon, Yoo) Division of Cardiology, St. Vincent's Hospital, The Catholic
University of Korea, Suwon, South Korea
(Park) Division of Cardiology, Daejeon St. Mary's Hospital, The Catholic
University of Korea, South Korea
(Kim, Ahn) Department of Cardiology, Chonnam National University Hospital,
Gwangju, South Korea
(Seok Choi) Division of Cardiology, Yeouido St. Mary's Hospital, The
Catholic University of Korea, Seoul, South Korea
(Kim) Division of Cardiology, Bucheon St. Mary's Hospital, The Catholic
University of Korea, South Korea
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Data regarding prognosis and management after nuisance
bleeding (NB) is limited. The purpose was to examine the prognostic
significance of NB in patients receiving potent dual antiplatelet
treatment (DAPT) after acute myocardial infarction and the impact of
de-escalation of DAPT on clinical outcomes thereafter. <br/>Method(s):
From the TALOS-AMI trial (Ticagrelor Versus Clopidogrel in Stabilized
Patients With Acute Myocardial Infarction) 2583 patients were used to
investigate the clinical impact of NB (defined as Bleeding Academic
Research Consortium [BARC] 1 bleeding) during 1-month treatment with
ticagrelor-based DAPT after acute myocardial infarction. We assessed the
associations between NB within 1 month and BARC 2, 3, or 5 bleeding and
major adverse cardiovascular event (a composite of cardiovascular death,
myocardial infarction, stroke) from 1 to 12 months. We also evaluated the
effect of de-escalation to clopidogrel in patients with or without NB.
<br/>Result(s): NB occurred in 416 patients (16.7%) after 1 month of
ticagrelor-based DAPT. At 1 year, NB was not associated with increase in
BARC 2, 3, or 5 bleeding (hazard ratio [HR] 1.29 [95% CI 0.7-2.14]) and
major adverse cardiovascular event (HR 1.72 [95% CI 0.87-3.39]). However,
patients with NB had an increased risk of BARC 2, 3, or 5 bleeding at 6
months (HR, 1.94 [95% CI, 1.08-3.48]; P=0.026), which diminished over the
next 6 months. De-escalation from ticagrelor to clopidogrel reduced the
incidence of BARC 2, 3, or 5 bleeding compared with ticagrelor plus
aspirin in NB (HR 0.31 [95% CI 0.10-0.92]) and non-NB patients (HR 0.58
[95% CI 0.37-0.90]) without heterogeneity (P interaction=0.291). There was
no increase in major adverse cardiovascular event after DAPT
de-escalation, irrespective of NB. <br/>Conclusion(s): NB was frequent in
patients with acute myocardial infarction on 1-month ticagrelor-based DAPT
and was associated with an early increase of bleeding. DAPT de-escalation
after NB may reduce bleeding without increasing ischemic events.
Registration: URL: https://www.clinicaltrials.gov; Unique identifier:
NCT02018055.<br/>Copyright &#xa9; 2022 Lippincott Williams and Wilkins.
All rights reserved.

<30>
Accession Number
2019582687
Title
Two-lung ventilation in video-assisted thoracoscopic esophagectomy in
prone position: a systematic review.
Source
Anaesthesia Critical Care and Pain Medicine. 41(5) (no pagination), 2022.
Article Number: 101134. Date of Publication: October 2022.
Author
Daghmouri M.A.; Chaouch M.A.; Depret F.; Cattan P.; Plaud B.; Deniau B.
Institution
(Daghmouri, Depret, Plaud, Deniau) Assistance Publique-Hopitaux de Paris
(AP-HP), Groupe Hospitalier St Louis-Lariboisiere, Department of
Anaesthesiology and Critical Care and Burn Unit, Paris, France
(Chaouch) Fattouma Bourguiba Hospital, Department of Visceral Surgery,
Monastir, Tunis
(Depret, Deniau) Institut National de la Sante et de la Recherche Medicale
(INSERM), INSERM UMR-S 942 Mascot, Lariboisiere Hospital, Paris, France
(Cattan) Assistance Publique-Hopitaux de Paris (AP-HP), Groupe Hospitalier
St Louis-Lariboisiere, Department of Digestive Surgery, Paris, France
Publisher
Elsevier Masson s.r.l.
Abstract
Esophageal cancer surgery is still carrying a high risk of morbidity and
mortality. That is why some anesthesia strategies have tried to reduce
those postoperative complications. In this systematic review performed in
accordance with the PRISMA-S guidelines (PROSPERO (ID: CRD42022310385)),
we aimed to investigate the safety and advantages of two-lung ventilation
(TLV) over one-lung ventilation (OLV) in minimally invasive esophagectomy
(MIE) in the prone position. Seven trials, with a total number of 1710
patients (765 patients with TLV versus 945 patients with OLV) were
included. Postoperative mortality and morbidity rates were similar between
TLV and OLV when realised for esophagectomy. Interestingly, we observed no
difference in changes in intraoperative respiratory parameters, operative
duration, thoraco-conversion rate, number of harvested lymph nodes,
postoperative heart rate and respiratory rate between TLV and OLV. TLV
brings better results in terms of intraoperative oxygen arterial pressure
(PaO<inf>2</inf>) during the thoracic time, postoperative oxygenation,
PaO<inf>2</inf> on inspired fraction of oxygen (FiO<inf>2</inf>) ratio,
duration of thoracic surgery, preoperative time, blood loss, temperature
on postoperative day-1, and C-reactive protein dosage. Our study
highlighted the safety of TLV for MIE in prone position when compared to
OLV. Interestingly, we found better intra and postoperative ventilation
parameters. The choice of ventilation modality did not influence clinical
outcome after surgery and the quality of oncological resection. Large
randomised controlled trials are needed to confirm these
results.<br/>Copyright &#xa9; 2022 Societe francaise d'anesthesie et de
reanimation (Sfar)

<31>
Accession Number
2015582218
Title
Intensive exercise therapy for restenosis after superficial femoral artery
stenting: the REASON randomized clinical trial.
Source
Heart and Vessels. 37(9) (pp 1596-1603), 2022. Date of Publication:
September 2022.
Author
Miura T.; Yamamoto S.; Miyashita Y.; Hashizume N.; Shoin K.; Sasaki S.;
Kanzaki Y.; Yui H.; Maruyama S.; Nagae A.; Sakai T.; Saigusa T.; Ebisawa
S.; Okada A.; Motoki H.; Ikeda U.; Kuwahara K.; Kato T.
Institution
(Kato, Miura, Miyashita, Kanzaki, Yui, Maruyama, Nagae, Sakai, Saigusa,
Ebisawa, Okada, Motoki, Ikeda, Kuwahara) Department of Cardiovascular
Medicine, Shinshu University Hospital, Shinshu University School of
Medicine, 3-1-1 Ashahi, Matsumoto 390-8621, Japan
(Miura, Ikeda) Department of Cardiology, Nagano Municipal Hospital,
Nagano, Japan
(Yamamoto) Department of Rehabilitation, Shinshu University Hospital,
Matsumoto, Japan
(Miyashita) Department of Cardiology, Nagano Red Cross Hospital, Nagano,
Japan
(Hashizume) Department of Cardiology, Shinonoi General Hospital, Nagano,
Japan
(Shoin) Department of Cardiology, Aizawa Hospital, Matsumoto, Japan
(Sasaki) Department of Cardiology, Saka General Hospital, Tagajyo, Japan
Publisher
Springer
Abstract
Endovascular treatment (EVT) is the main treatment for peripheral artery
disease (PAD). Despite advances in device development, the restenosis rate
remains high in patients with femoropopliteal lesions (FP). This study
aimed to evaluate the effectiveness of exercise training in reducing the
1-year in-stent restenosis rate of bare metal nitinol stents for FPs. This
prospective, randomized, open-label, multicenter study was conducted from
January 2017 to March 2019. We randomized 44 patients who had claudication
with de novo stenosis or occlusion of the FP into an intensive exercise
group (n = 22) and non-intensive exercise group (n = 22). Non-intensive
exercise was defined as walking for less than 30 min per session, fewer
than three times a week. We assessed exercise tolerance using an activity
meter at 1, 3, 6, and 12 months, and physiotherapists ensured maintenance
of exercise quality every month. The primary endpoint was instant
restenosis defined as a peak systolic velocity ratio > 2.5 on duplex
ultrasound imaging. Kaplan-Meier analysis was used to evaluate the data.
There were no significant differences in background characteristics
between the groups. Six patients dropped out of the study within 1 year.
In terms of the primary endpoint, intensive exercise significantly
improved the patency rate of bare nitinol stents at 12 months. The 1-year
freedom from in-stent restenosis rates were 81.3% in the intensive
exercise group and 47.6% in the non-intensive exercise group (p = 0.043).
No cases of stent fracture were observed in the intensive exercise group.
Intensive exercise is safe and reduces in-stent restenosis in FP lesions
after endovascular therapy for PAD. Clinical trial registration:
University Hospital Medical Information Network Clinical Trials Registry
(No. UMIN 000025259).<br/>Copyright &#xa9; 2022, The Author(s).

<32>
Accession Number
2014647315
Title
The use of a vascular occlusion test combined with near-infrared
spectroscopy in perioperative care: a systematic review.
Source
Journal of Clinical Monitoring and Computing. 36(4) (pp 933-946), 2022.
Date of Publication: August 2022.
Author
Niezen C.K.; Massari D.; Vos J.J.; Scheeren T.W.L.
Institution
(Niezen, Massari, Vos, Scheeren) Department of Anesthesiology, University
Medical Center Groningen, University of Groningen, PO Box 30 001,
Groningen 9700 RB, Netherlands
Publisher
Springer Science and Business Media B.V.
Abstract
In the perioperative phase oxygen delivery and consumption can be
influenced by different factors, i.e. type of surgery, anesthetic and
cardiovascular drugs, or fluids. By combining near-infrared spectroscopy
(NIRS) monitoring of regional tissue oxygen saturation (StO<inf>2</inf>)
with an ischemic provocation test, the vascular occlusion test (VOT),
local tissue oxygen consumption and vascular reactivity at the
microcirculatory level can be assessed. This systematic review aims to
give an overview of the clinical information that VOT-derived NIRS values
can provide in the perioperative period. After performing a systematic
literature search, we included 29 articles. It was not possible to perform
a meta-analysis because of the lack of comparable data and the
observational nature of the majority of the included articles. We have
clustered the found articles in two groups: non-cardiac surgery and
cardiac surgery. We found that VOT-derived NIRS values show a wide
variability and are influenced by the effects of anesthetics,
cardiovascular drugs, fluids, and by the type of surgery. Additionally,
deviations in VOT-derived NIRS values are also associated with adverse
patients' outcomes, such as postoperative complications, prolonged
mechanical ventilation and prolonged hospital length of stay. However,
given the variability in VOT-derived NIRS values, clinical applicability
remains elusive. Future clinical interventional trials might provide
additional insight into the potential of VOT associated with NIRS to
optimize perioperative care by targeting specific interventions to
optimize the function of the microvasculature.<br/>Copyright &#xa9; 2022,
The Author(s), under exclusive licence to Springer Nature B.V.

<33>
Accession Number
2014243457
Title
Radial versus femoral access in patients with coronary artery bypass
surgery: Frequentist and Bayesian meta-analysis.
Source
Catheterization and Cardiovascular Interventions. 99(2) (pp 462-471),
2022. Date of Publication: February 1, 2022.
Author
Nikolakopoulos I.; Vemmou E.; Xenogiannis I.; Karacsonyi J.; Rao S.V.;
Romagnoli E.; Tsigkas G.; Milkas A.; Velagapudi P.; Alaswad K.; Rangan
B.V.; Garcia S.; Burke M.N.; Brilakis E.S.
Institution
(Nikolakopoulos, Vemmou, Xenogiannis, Karacsonyi, Rangan, Garcia, Burke,
Brilakis) Minneapolis Heart Institute and Minneapolis Heart Institute
Foundation, Abbott Northwestern Hospital, Minneapolis, MN, United States
(Rao) Duke Clinical Research Institute, Durham, NC, United States
(Romagnoli) Department of Cardiovascular and Thoracic Sciences, Institute
of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS,
Universita Cattolica del Sacro Cuore, Rome, Italy
(Tsigkas) Department of Cardiology, University of Patras Medical School,
Patras, Greece
(Milkas) Acute Cardiac Care Unit, Athens Naval and Veterans Hospital,
Athens, Greece
(Velagapudi) University of Nebraska Medical Center, Omaha, NE, United
States
(Alaswad) Department of Cardiology, Henry Ford Hospital, Detroit, MI,
United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The optimal access site for cardiac catheterization in
patients with prior coronary artery bypass surgery (CABG) continues to be
debated. <br/>Method(s): We performed a random effects frequentist and
Bayesian meta-analysis of 4 randomized trials and 18 observational
studies, including 60,192 patients with prior CABG (27,236 in the radial
group; 32,956 in the femoral group) that underwent cardiac
catheterization. Outcomes included (1) access-site complications, (2)
crossover to a different vascular access, (3) procedure time, and (4)
contrast volume. Mean differences (MD) and 95% confidence interval (CI)
were calculated for continuous outcomes and odds ratios (OR) and 95% CI
for binary outcomes. <br/>Result(s): Among randomized trials, crossover
(OR: 7.63; 95% CI: 2.04, 28.51; p = 0.003) was higher in the radial group,
while access site complications (OR: 0.96; 95% CI: 0.34, 2.87; p = 0.94)
and contrast volume (MD: 15.08; 95% CI: -10.19, 40.35; p = 0.24) were
similar. Among observational studies, crossover rates were higher (OR:
5.09; 95% CI: 2.43, 10.65; p < 0.001), while access site complication
rates (OR: 0.52; 95% CI: 0.30, 0.89; p = 0.02) and contrast volume (MD:
-7.52; 95% CI: -13.14, -1.90 ml; p = 0.009) were lower in the radial
group. Bayesian analysis suggested that the odds of a difference existing
between radial and femoral are small for all endpoints except crossover to
another access site. <br/>Conclusion(s): In a frequentist and Bayesian
meta-analysis of patients with prior CABG undergoing coronary
catheterization, radial access was associated with lower incidence of
vascular access complications and lower contrast volume but also higher
crossover rate.<br/>Copyright &#xa9; 2021 Wiley Periodicals LLC.

<34>
Accession Number
2021411462
Title
Comparison of Transfemoral versus Transsubclavian/Transaxillary access for
transcatheter aortic valve replacement: A systematic review and
meta-analysis.
Source
IJC Heart and Vasculature. 43 (no pagination), 2022. Article Number:
101156. Date of Publication: December 2022.
Author
Abusnina W.; Machanahalli Balakrishna A.; Ismayl M.; Latif A.; Reda
Mostafa M.; Al-abdouh A.; Junaid Ahsan M.; Radaideh Q.; Haddad T.M.;
Goldsweig A.M.; Ben-Dor I.; Mamas M.A.; Dahal K.
Institution
(Abusnina, Machanahalli Balakrishna, Ismayl, Latif, Radaideh, Haddad,
Dahal) Division of Cardiology, Creighton University School of Medicine,
NE, United States
(Reda Mostafa) Rochester Regional Health/Unity Hospital, Rochester, NY,
United States
(Al-abdouh) Department of Medicine, University of Kentucky, Lexington, KY,
United States
(Junaid Ahsan) Division of Cardiovascular Medicine, Iowa Heart Center, Des
Moines, IA, United States
(Goldsweig) Division of Cardiovascular Medicine, University of Nebraska
Medical Center, Omaha, NE, United States
(Ben-Dor) Section of Interventional Cardiology, MedStar Washington
Hospital Center, Washington, DC, United States
(Mamas) Keele Cardiovascular Research Group, Keele University, United
Kingdom
Publisher
Elsevier Ireland Ltd
Abstract
Femoral access is the gold standard for transcatheter aortic valve
replacement (TAVR). Safe alternative access, that represents about 15 % of
TAVR cases, remains important for patients without adequate transfemoral
access. We aimed to perform a systematic review and meta-analysis of
studies comparing transfemoral (TF) access versus transsubclavian or
transaxillary (TSc/TAx) access in patients undergoing TAVR. We searched
PubMed, Cochrane CENTRAL Register, EMBASE, Web of Science, Google Scholar
and ClinicalTrials.gov (inception through May 24, 2022) for studies
comparing (TF) to (TSc/TAx) access for TAVR. A total of 21 studies with
75,995 unique patients who underwent TAVR (73,203 transfemoral and 2,792
TSc/TAx) were included in the analysis. There was no difference in the
risk of in-hospital and 30-day all-cause mortality between the two groups
(RR 0.64, 95 % CI 0.36-1.13, P = 0.12) and (RR 0.95, 95 % CI 0.64-1.41, P
= 0.81), while 1-year mortality was significantly lower in the TF TAVR
group (RR 0.79, 95 % CI 0.67-0.93, P = 0.005). No significant differences
in major bleeding (RR 0.82, 95 % CI 0.65-1.03, P = 0.09), major vascular
complications (RR 1.14, 95 % CI 0.75-1.72, P = 0.53), and stroke (RR 0.66,
95 % CI 0.42-1.02, P = 0.06) were observed. In patients undergoing TAVR,
TF access is associated with significantly lower 1-year mortality compared
to TSc/TAx access without differences in major bleeding, major vascular
complications and stroke. While TF is the preferred approach for TAVR,
TSc/TAx is a safe alternative approach. Future studies should confirm
these findings, preferably in a randomized setting.<br/>Copyright &#xa9;
2022 The Authors

<35>
Accession Number
2021047305
Title
COMPETENCE Trial: The EVAHEART 2 continuous flow left ventricular assist
device.
Source
Journal of Heart and Lung Transplantation. 42(1) (pp 33-39), 2023. Date of
Publication: January 2023.
Author
Allen S.R.; Slaughter M.S.; Ahmed M.M.; Bartoli C.R.; Dhingra R.; Egnaczyk
G.F.; Gulati S.K.; Kiernan M.S.; Mahr C.; Meyer D.M.; Motomura T.; Ono M.;
Ravichandran A.; Shafii A.; Smith J.; Soleimani B.; Toyoda Y.; Yarboro
L.T.; Dowling R.D.
Institution
(Allen, Soleimani) Penn State Health, Milton S. Hershey Medical Center,
Hershey, Pennsylvania, United States
(Slaughter) University of Louisville, Louisville, Kentucky
(Ahmed) University of Florida, Gainesville, FL, United States
(Bartoli) Geisinger Medical Center, Danville, Pennsylvania, United States
(Dhingra, Smith) University of Wisconsin Hospitals and Clinics, Madison,
WI, United States
(Egnaczyk, Dowling) The Christ Hospital, Cincinnati, Ohio, United States
(Gulati) Atrium Health Sanger Heart and Vascular Institute, Charlotte,
North Carolina
(Kiernan) Tufts Medical Center, Boston, Massachusetts, United States
(Mahr) University of Washington, Seattle, WA, United States
(Meyer) Baylor Scott and White, Dallas, Texas, United States
(Motomura) Evaheart, Inc, Houston, Texas, United States
(Ono) Methodist Healthcare, San Antonio, Texas, United States
(Ravichandran) Saint Vincent Health, Indianapolis, IN, United States
(Shafii) Baylor College of Medicine St. Luke's Medical Center, Houston,
Texas, United States
(Toyoda) Temple University Medical Center, Philadelphia, Pennsylvania,
United States
(Yarboro) University of Virginia, Charlottesville, VA, United States
Publisher
Elsevier Inc.
Abstract
Background: Continuous flow left ventricular assist devices have improved
outcomes in patients with end-stage heart failure that require mechanical
circulatory support. Current devices have an adverse event profile that
has hindered widespread application. The EVAHEART2 left ventricular assist
device (EVA2) has design features such as large blood gaps, lower pump
speeds and an inflow cannula that does not protrude into the left
ventricle that may mitigate the adverse events currently seen with other
continuous flow devices. <br/>Method(s): A prospective, multi-center
randomized non-inferiority study, COMPETENCE Trial, is underway to assess
non-inferiority of the EVA2 to the HeartMate 3 LVAS when used for the
treatment of refractory advanced heart failure. The primary end-point is a
composite of the individual primary outcomes: Survival to cardiac
transplant or device explant for recovery; Free from disabling stroke;
Free from severe Right Heart Failure after implantation of original
device. Randomization is in a 2:1 (EVA2:HM3) ratio. <br/>Result(s): The
first patient was enrolled into the COMPETENCE Trial in December of 2020,
and 25 subjects (16 EVA2 and 9 HM3) are currently enrolled. Enrollment of
a safety cohort is projected to be completed by third quarter of 2022 at
which time an interim analysis will be performed. Short-term cohort (92
EVA2 subjects) and long-term cohort is expected to be completed by the end
of 2023 and 2024, respectively. <br/>Conclusion(s): The design features of
the EVA2 such as a novel inflow cannula and large blood gaps may improve
clinical outcomes but require further study. The ongoing COMPETENCE trial
is designed to determine if the EVA2 is non-inferior to the
HM3.<br/>Copyright &#xa9; 2022 International Society for Heart and Lung
Transplantation

<36>
Accession Number
2021841677
Title
FOCUS-PDCA CAN EFFECTIVELY OPTIMIZE THE CRITICAL VALUE OF TEST ITEMS.
Source
Journal of Medical Biochemistry. 41(3) (pp 347-354), 2022. Date of
Publication: 2022.
Author
Xie C.; Zhang J.; Luo J.; Jian M.; Zhao T.; Wang J.; Dai C.; Wei Y.; Jiang
L.; Shi Y.
Institution
(Xie, Zhang) Department of Laboratory Medicine, Sichuan Provincial
People's Hospital, University of Electronic Science and Technology of
China, Chengdu 611731, China
(Luo) Department of Operation Management, Sichuan Provincial People's
Hospital, University of Electronic Science and Technology of China,
Chengdu 610072, China
(Jian, Zhao, Wang, Jiang) Department of Laboratory Medicine, Sichuan
Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu
610072, China
(Jiang, Dai, Wei, Shi) Sichuan Provincial Key Laboratory for Human Disease
Gene Study, Institute of Laboratory Medicine, Sichuan Provincial People's
Hospital, University of Electronic Science and Technology of China,
Chengdu 610072, China
Publisher
Society of Medical Biochemists of Serbia
Abstract
Background: To optimize the critical value of test items using FOCUS-PDCA
(find, organize, clarify, understand, select, plan, do, check and act),
and to set the personalized critical value of the test for different
departments. <br/>Method(s): We searched for literature reporting on the
critical value and FOCUS-PDCA published over recent 5 years in order to
understand the significance and status quo of critical value and
FOCUS-PDCA. We also collected and analyzed the critical value data of
hospital tests performed in Sichuan province hospitals in 2019, which were
later compared to data from 2020 to determine the FOCUS-PDCA cycle.
<br/>Result(s): The proportion of critical values in the whole hospital
decreased from 3.5% before optimization to 2.5% to 3% after optimization.
The critical values of ICU, hematology, nephrology, urology, and neonatal
departments after optimization significantly decreased compared with those
before optimization, while the critical values of cardiac surgery,
emergency ICU, cardiology, and neurosurgery ICU showed no significant
difference before and after optimization. Contrary, the critical values of
the infection department after optimization significantly increased before
optimization. <br/>Conclusion(s): FOCUS-PDCA can effectively optimize the
critical value of test items, which is beneficial for rational utilization
of medical resources.<br/>Copyright &#xa9; 2022 Sciendo. All rights
reserved.

<37>
Accession Number
2020749333
Title
Central versus Peripheral Postcardiotomy Veno-Arterial Extracorporeal
Membrane Oxygenation: Systematic Review and Individual Patient Data
Meta-Analysis.
Source
Journal of Clinical Medicine. 11(24) (no pagination), 2022. Article
Number: 7406. Date of Publication: December 2022.
Author
Biancari F.; Kaserer A.; Perrotti A.; Ruggieri V.G.; Cho S.-M.; Kang J.K.;
Dalen M.; Welp H.; Jonsson K.; Ragnarsson S.; Hernandez Perez F.J.; Gatti
G.; Alkhamees K.; Loforte A.; Lechiancole A.; Rosato S.; Spadaccio C.;
Pettinari M.; Fiore A.; Makikallio T.; Sahli S.D.; L'Acqua C.; Arafat
A.A.; Albabtain M.A.; AlBarak M.M.; Laimoud M.; Djordjevic I.; Krasivskyi
I.; Samalavicius R.; Puodziukaite L.; Alonso-Fernandez-Gatta M.; Wilhelm
M.J.; Mariscalco G.
Institution
(Biancari) Heart and Lung Center, Helsinki University Hospital,
Haartmaninkatu 4, P.O. Box 340, Helsinki 00029, Finland
(Biancari, Makikallio) Department of Medicine, South-Karelia Central
Hospital, University of Helsinki, Lappeenranta 53130, Finland
(Kaserer, Sahli) Institute of Anesthesiology, University and University
Hospital Zurich, Zurich 8091, Switzerland
(Perrotti) Department of Thoracic and Cardio-Vascular Surgery, University
Hospital Jean Minjoz, Besancon 25030, France
(Ruggieri) Division of Cardiothoracic and Vascular Surgery, Robert Debre
University Hospital, Reims 51100, France
(Cho, Kang) Divisions of Neurosciences, Critical Care and Cardiac Surgery,
Departments of Neurology, Anesthesiology and Critical Care Medicine, Johns
Hopkins University School of Medicine, Baltimore, MD 21201, United States
(Dalen) Department of Molecular Medicine and Surgery, Department of
Cardiac Surgery, Karolinska Institutet, Karolinska University Hospital,
Stockholm 17176, Sweden
(Welp) Department of Cardiothoracic Surgery, Munster University Hospital,
Munster 48149, Germany
(Jonsson) Department of Cardiac Surgery, Sahlgrenska University Hospital,
Gothenburg 41345, Sweden
(Ragnarsson) Department of Cardiothoracic Surgery, University of Lund,
Lund 10392, Sweden
(Hernandez Perez) Puerta de Hierro University Hospital, Madrid 29222,
Spain
(Gatti) Division of Cardiac Surgery, Cardio-Thoracic and Vascular
Department, University Hospital of Trieste, Trieste 34128, Italy
(Alkhamees) Prince Sultan Cardiac Center, Al Hassa 36441, Saudi Arabia
(Loforte) Department of Cardiothoracic, Transplantation and Vascular
Surgery, S. Orsola Hospital, University of Bologna, Bologna 40138, Italy
(Lechiancole) Cardiothoracic Department, University Hospital of Udine,
Udine 33100, Italy
(Rosato) Center for Global Health, Italian National Institute, Rome 00161,
Italy
(Spadaccio) Department of Cardiovascular Surgery, Mayo Clinic, Rochester,
MN 13400, United States
(Pettinari) Department of Cardiovascular Surgery, Ziekenhuis Oost-Limburg,
Genk 3600, Belgium
(Fiore) Department of Cardiac Surgery, Hopitaux Universitaires Henri
Mondor, Assistance Publique-Hopitaux de Paris, Creteil 94000, France
(L'Acqua) Anesthesia and Intensive Care Unit, Centro Cardiologico Monzino,
Milan 20138, Italy
(L'Acqua) Anesthesia and Intensive Care Unit, Fondazione IRCCS Istituto
Nazionale dei Tumori, Milan 20133, Italy
(Arafat) Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh
12611, Saudi Arabia
(Arafat) Cardiothoracic Surgery Department, Tanta University, Tanta 31527,
Egypt
(Albabtain) Cardiology Clinical Pharmacy, Prince Sultan Cardiac Center,
Riyadh 12611, Saudi Arabia
(AlBarak) Intensive Care Department, Prince Sultan Cardiac Center, Riyadh
12611, Saudi Arabia
(Laimoud) Cardiac Surgical Intensive Care Department, King Faisal
Specialist Hospital and Research Center, Riyadh 11564, Saudi Arabia
(Laimoud) Critical Care Medicine Department, Cairo University, Cairo
12613, Egypt
(Djordjevic, Krasivskyi) Department of Cardiothoracic Surgery, University
Hospital Cologne, Cologne 50937, Germany
(Samalavicius, Puodziukaite) 2nd Department of Anesthesia, Vilnius
University Hospital Santaros Klinikos, Vilnius 08410, Lithuania
(Samalavicius) Clinic of Emergency Medicine, Medical Faculty, Vilnius
University, Vilnius 03101, Lithuania
(Alonso-Fernandez-Gatta) Cardiology Department, University Hospital of
Salamanca, Instituto de Investigacion Biomedica de Salamanca, Salamanca
37007, Spain
(Alonso-Fernandez-Gatta) CIBER-CV Instituto de Salud Carlos III, Madrid
28029, Spain
(Wilhelm) Clinic for Cardiac Surgery, University Heart Center, University
and University Hospital Zurich, Zurich 8091, Switzerland
(Mariscalco) Department of Intensive Care Medicine and Cardiac Surgery,
Glenfield Hospital, University Hospitals of Leicester, Leicester LE2 9QP,
United Kingdom
Publisher
MDPI
Abstract
Background: It is unclear whether peripheral arterial cannulation is
superior to central arterial cannulation for postcardiotomy veno-arterial
extracorporeal membrane oxygenation (VA-ECMO). <br/>Method(s): A
systematic review was conducted using PubMed, Scopus, and Google Scholar
to identify studies on postcardiotomy VA-ECMO for the present individual
patient data (IPD) meta-analysis. Analysis was performed according to the
intention-to-treat principle. <br/>Result(s): The investigators of 10
studies agreed to participate in the present IPD meta-analysis. Overall,
1269 patients were included in the analysis. Crude rates of in-hospital
mortality after central versus peripheral arterial cannulation for VA-ECMO
were 70.7% vs. 63.7%, respectively (adjusted OR 1.38, 95% CI 1.08-1.75).
Propensity score matching yielded 538 pairs of patients with balanced
baseline characteristics and operative variables. Among these matched
cohorts, central arterial cannulation VA-ECMO was associated with
significantly higher in-hospital mortality compared to peripheral arterial
cannulation VA-ECMO (64.5% vs. 70.8%, p = 0.027). These findings were
confirmed by aggregate data meta-analysis, which showed that central
arterial cannulation was associated with an increased risk of in-hospital
mortality compared to peripheral arterial cannulation (OR 1.35, 95% CI
1.04-1.76, I² 21%). <br/>Conclusion(s): Among patients
requiring postcardiotomy VA-ECMO, central arterial cannulation was
associated with an increased risk of in-hospital mortality compared to
peripheral arterial cannulation. This increased risk is of limited
magnitude, and further studies are needed to confirm the present findings
and to identify the mechanisms underlying the potential beneficial effects
of peripheral VA-ECMO.<br/>Copyright &#xa9; 2022 by the authors.

<38>
Accession Number
2021812922
Title
Pre-Operative Forced Air Warming and In Preventing Incidence of
Perioperative Hypothermia in Patients Undergoing General Anaesthesia- a
Randomised Comparative Prospective Study.
Source
Journal of Pharmaceutical Negative Results. 13 (pp 160-165), 2022. Date of
Publication: 2022.
Author
Amit K.; Mahima L.; Ritesh K.
Institution
(Amit, Mahima, Ritesh) Department Of Anaesthesiology and Critical Care,
Santosh Medical College, Ghaziabad, India
Publisher
ResearchTrentz Academy Publishing Education Services
Abstract
Background and Aims: Inadvertent perioperative hypothermia (IPH) is
defined as a peri-operative core temperature of less than 36degreeC. IPH
is known to increase the risk of blood loss, prolonged and altered drug
effects, post-operative shivering, and adverse cardiac events.
Pre-operative warming with forced air reduces post-induction
redistribution hypothermia and prevents complications associated with
hypothermia. The present study was conducted to compare the effect of
preoperative forced-air warming on the incidence of perioperative
hypothermia in patients undergoing general anaesthesia, who are pre-warmed
versus those who are not pre-warmed. <br/>Material(s) and Method(s): This
randomized comparative prospective study was carried out on 170 adult
persons of either sex, ASA (American Society of Anesthesiologists)
physical status I -III scheduled for different surgeries under general
anaesthesia who met eligibility criteria were randomly assigned either to
group A in which preoperative forced-air warming was done for 30 minutes
or to group B in which pre-operative forced-air warming was not done. The
incidence of hypothermia was compared between the two groups.
<br/>Result(s): The incidence of hypothermia was significantly higher in
the non-pre-warmed group as compared to the pre-warmed group. The
incidence of postoperative shivering was significantly higher in the
non-pre-warmed group. However, the incidence of an adverse cardiac event
and increased blood loss was insignificant between the two groups.
Conclusion-Based on observations and results of this study, the incidence
of perioperative hypothermia was reduced in patients who were pre-warmed
for 30 minutes before general anaesthesia in comparison to patients who
were not pre-warmed.<br/>Copyright &#xa9; 2022 Wolters Kluwer Medknow
Publications. All rights reserved.

<39>
Accession Number
2020749519
Title
Clinicopathological Features of Intrathoracic Liposarcoma-A Systematic
Review with an Illustrative Case.
Source
Journal of Clinical Medicine. 11(24) (no pagination), 2022. Article
Number: 7353. Date of Publication: December 2022.
Author
Kielbowski K.; Ruszel N.; Skrzyniarz S.A.; Wojtys M.E.; Becht R.;
Ptaszynski K.; Gajic D.; Wojcik J.
Institution
(Kielbowski, Wojtys, Gajic, Wojcik) Department of Thoracic Surgery and
Transplantation, Pomeranian Medical University in Szczecin, Alfreda
Sokolowskiego 11, Szczecin 70-891, Poland
(Ruszel) Department of Internal Medicine and Hypertension with
Subdepartment of Cardiology, Independent Public Provincial Hospital in
Szczecin, Alfreda Sokolowskiego 11, Szczecin 70-891, Poland
(Skrzyniarz) Dietrich-Bonhoeffer-Klinikum, Neubrandenburg 17036, Germany
(Becht) Department of Clinical Oncology, Chemotherapy and Cancer
Immunotherapy, Pomeranian Medical University in Szczecin, Unii Lubelskiej
1, Szczecin 71-252, Poland
(Ptaszynski) Department of Pathology, Faculty of Medicine, Collegium
Medicum, University of Warmia and Mazury in Olsztyn, Olsztyn 10-561,
Poland
Publisher
MDPI
Abstract
Background: Liposarcoma (LPS) is one of the most common soft-tissue
sarcomas. However, intrathoracic LPS is rare, as only 1% of all LPS cases
are found in the thorax. <br/>Method(s): A systematic literature review
through PubMed and Embase databases was performed. Only eligible case
reports and case series reporting intrathoracic LPS in adult patients were
included. Kaplan-Meier curves were calculated to evaluate the survival
rate of included patients based on the histological subtype of LPS.
<br/>Result(s): 123 studies reporting 197 patients were included. We added
a case of a 69-year-old female patient with recurrent giant intrathoracic
LPS. The primary tumor measured 15.1cm x 22.9 cm x 21.9 cm and weighed
3100 g. Six months later, the patient was admitted to the hospital with
another intrathoracic tumor measuring 9.5 cm x 9 cmx 1.4 cm. The
immunohistochemical studies showed expression of murine double minute 2
(MDM2) antigen in both primary and recurrent tumor cells.
<br/>Conclusion(s): Dyspnea, chest pain, and cough were the most common
symptoms reported in included studies. Overall, the 5-year survival rate
was 62%. The highest survival was observed in well-differentiated LPS
patients (80%) and the lowest in myxoid LPS (31%).<br/>Copyright &#xa9;
2022 by the authors.

<40>
Accession Number
2021915804
Title
Association of liver dysfunction with outcomes after cardiac surgery - a
meta-analysis.
Source
Interactive Cardiovascular and Thoracic Surgery. 35(6) (no pagination),
2022. Article Number: ivac280. Date of Publication: 01 Dec 2022.
Author
Kirov H.; Caldonazo T.; Audisio K.; Rahouma M.; Bryce Robinson N.;
Cancelli G.; Soletti G.J.; Demetres M.; Ibrahim M.; Faerber G.; Gaudino
M.; Doenst T.
Institution
(Kirov, Caldonazo, Faerber, Doenst) Department of Cardiothoracic Surgery,
Friedrich-Schiller-University Jena, Germany
(Audisio, Rahouma, Bryce Robinson, Cancelli, Soletti, Gaudino) Department
of Cardiothoracic Surgery, New York Presbyterian, Weill Cornell Medical
Center, United States
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Center, Weill Cornell Medicine, New York, NY, United States
(Ibrahim) Department of General Surgery, Maimonides Medical Center,
Brooklyn, NY, United States
(Ibrahim) Nuffield Department of Surgical Sciences, University of Oxford,
Oxford, United Kingdom
Publisher
Oxford University Press
Abstract
OBJECTIVES: The aim of this study was to perform a meta-analysis of
studies reporting outcomes in patients with liver dysfunction addressed by
the model of end-stage liver disease and Child-Turcotte-Pugh scores
undergoing cardiac surgery. <br/>METHOD(S): A systematic literature search
was conducted to identify contemporary studies reporting short- and
long-term outcomes in patients with liver dysfunction compared to patients
with no or mild liver dysfunction undergoing cardiac surgery (stratified
in high and low score group based on the study cut-offs). Primary outcome
was perioperative mortality. Secondary outcomes were perioperative
neurological events, prolonged ventilation, sepsis, bleeding and/or need
for transfusion, acute kidney injury and long-term mortality.
<br/>RESULT(S): A total of 33 studies with 48 891 patients were included.
Compared with the low score group, being in the high score group was
associated with significantly higher risk of perioperative mortality [odds
ratio (OR) 3.72, 95% confidence interval (CI) 2.75-5.03, P < 0.001]. High
score group was also associated with a significantly higher rate of
perioperative neurological events (OR 1.49, 95% CI 1.30-1.71, P < 0.001),
prolonged ventilation (OR 2.45, 95% CI 1.94-3.09, P < 0.001), sepsis (OR
3.88, 95% CI 2.07-7.26, P < 0.001), bleeding and/or need for transfusion
(OR 1.95, 95% CI 1.43-2.64, P < 0.001), acute kidney injury (OR 3.84, 95%
CI 2.12-6.98, P < 0.001) and long-term mortality (incidence risk ratio
1.29, 95% CI 1.14-1.46, P < 0.001) <br/>CONCLUSION(S): The analysis
suggests that liver dysfunction in patients undergoing cardiac surgery is
independently associated with higher risk of short and long-term mortality
and also with an increased occurrence of various perioperative adverse
events. <br/>Copyright &#xa9; 2022 The Author(s). Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery.

<41>
Accession Number
2021915797
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. Article Number: ivac272. Date of Publication: 01 Dec 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
Oxford University Press
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 1 s. The previous meta-analysis and a recent cohort study also
found that the division of IPL might lead to increased bronchus angle
change or torsion. Moreover, 2 cohort studies found that the division of
IPL could not improve the long-term survival of patients undergoing upper
lobectomy. Current evidence showed that dividing the IPL could not result
in clinical benefits but might lead to decreased pulmonary function
instead. Therefore, we recommended not dissecting the IPL routinely during
upper lobectomy. <br/>Copyright &#xa9; 2022 The Author(s). Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<42>
Accession Number
2021901588
Title
Custodiol-N versus Custodiol: a prospective randomized double-blind
multicentre phase III trial in patients undergoing elective coronary
bypass surgery.
Source
European Journal of Cardio-thoracic Surgery. 62(5) (no pagination), 2022.
Article Number: ezac287. Date of Publication: 01 Nov 2022.
Author
Szabo G.; Brlecic P.; Loganathan S.; Wagner F.; Rastan A.; Doenst T.;
Karck M.; Veres G.
Institution
(Szabo, Brlecic, Loganathan, Karck, Veres) Department of Cardiac Surgery,
University of Heidelberg, Heidelberg, Germany
(Szabo, Loganathan, Veres) Department of Cardiac Surgery, University of
Halle, Halle (Saale), Germany
(Wagner) Department of Cardiac Surgery, University of Hamburg, Hamburg,
Germany
(Rastan) Department of Cardiac and Vascular Surgery, Heart Center
Rotenburg, Rotenburg, Germany
(Doenst) Department of Cardiac Surgery, University of Jena, Jena, Germany
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: HTK-Solution (Custodiol) is a well-established cardioplegic
and organ preservation solution. We currently developed a novel HTK-based
solution, Custodiol-N, which includes iron chelators to reduce oxidative
injury, as well as l-arginine, to improve endothelial function. In this
first-in-human study, Custodiol-N was compared to Custodiol in patients
undergoing elective coronary artery bypass surgery. The aim of this
comparison was to evaluate the safety and ability of Custodiol-N to
protect cardiac tissue. <br/>METHOD(S): The study was designed as a
prospective randomized double-blind non-inferiority trial. Primary end
point was area under the curve (AUC) of creatine kinase muscle-brain
(CK-MB) within the first 24 h after surgery. Secondary end points included
peak CK-MB and troponin-T and AUC of troponin-T release, cardiac index,
cumulative catecholamine dose, intensive care unit stay and mortality. All
values in the abstract are given as mean +/- SD, P < 0.05 was considered
statistically significant. <br/>RESULT(S): Early termination of the trial
was performed per protocol as the primary non-inferiority end-point was
reached after inclusion of 101 patients. CK-MB AUC (878+/-549 vs 779+/-439
h U/l, non-inferiority P < 0.001, Custodiol vs Custodiol-N) and troponin-T
AUC (12990+/-8347 vs 13498+/-6513 h pg/ml, noninferiority P < 0.001,
Custodiol vs Custodiol-N) were similar in both groups. Although the trial
was designed for non-inferiority, peak CK-MB (52+/-40 vs 42+/-28 U/l,
superiority P < 0.03, Custodiol vs Custodiol-N) was significantly lower in
the Custodiol-N group. <br/>CONCLUSION(S): This study shows that
Custodiol-N is safe and provides similar cardiac protection as the
established HTK-Custodiol solution. Significantly reduced peak CK-MB
levels in the Custodiol-N group in the full analysis set may implicate a
beneficial effect on ischaemia/reperfusion injury in the setting of
coronary bypass surgery. <br/>Copyright &#xa9; 2022 The Author(s).
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery. All rights reserved.

<43>
Accession Number
2021901583
Title
Preoperative oral magnesium loading to prevent postoperative atrial
fibrillation following coronary surgery: a prospective randomized
controlled trial.
Source
European Journal of Cardio-thoracic Surgery. 62(5) (no pagination), 2022.
Article Number: ezac269. Date of Publication: 01 Nov 2022.
Author
Tohme J.; Sleilaty G.; Jabbour K.; Gergess A.; Hayek G.; Jebara V.;
Madi-Jebara S.
Institution
(Tohme, Jabbour, Gergess, Hayek, Madi-Jebara) Department of Anesthesia and
Critical Care, Hotel-Dieu de France Hospital, Universite Saint-Joseph,
Beirut, Lebanon
(Sleilaty, Jebara) Department of Cardiovascular and Thoracic Surgery,
Hotel-Dieu de France Hospital, Universite Saint-Joseph, Beirut, Lebanon
(Sleilaty) Clinical Research Center, Faculty of Medicine, Universite
Saint-Joseph, Beirut, Lebanon
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Postoperative atrial fibrillation (POAF) is common following
coronary artery bypass grafting (CABG) surgery. Hypomagnesemia is frequent
after CABG surgery. No previous trials have assessed the effect of
preoperative magnesium (Mg) loading on POAF incidence. <br/>METHOD(S):
This was a single-centre, double-blind, placebo-controlled, parallel-group
trial, with balanced randomization [1:1]. The participants were recruited
from November 2018 until May 2019. Patients received either 3.2 g of Mg
daily (4 tablets of 0.4 g each twice daily) for 72 h preoperatively and
1.6 g of Mg (4 tablets) on the day of surgery or placebo tablets.
<br/>RESULT(S): The primary outcome was the incidence of POAF. Secondary
outcomes included time to extubation, transfusion rate, critical care unit
and hospital length of stay. Of the 210 randomized participants, 200 (100
in each group) completed the study. A total of 10 (10%) and 22 (22%)
subjects developed POAF in the Mg and placebo groups, respectively (RR =
0.45, 95% confidence interval: 0.23-0.91). Hospital and critical care unit
length of stay were comparable between the 2 groups. No side effects
related to Mg administration were documented. <br/>CONCLUSION(S): In this
randomized controlled trial, preoperative loading with oral administration
of Mg for 3 days in patients admitted for CABG surgery decreases the
incidence of POAF compared to placebo. Clinical trial registration number:
NCT03703349. <br/>Copyright &#xa9; 2022 The Author(s). Published by Oxford
University Press on behalf of the European Association for Cardio-Thoracic
Surgery. All rights reserved.

<44>
Accession Number
2021901582
Title
Effects of postoperative cognitive training on neurocognitive decline
after heart surgery: a randomized clinical trial.
Source
European Journal of Cardio-thoracic Surgery. 62(5) (no pagination), 2022.
Article Number: ezac251. Date of Publication: 01 Nov 2022.
Author
Butz M.; Gerriets T.; Sammer G.; El-Shazly J.; Tschernatsch M.; Huttner
H.B.; Braun T.; Boening A.; Mengden T.; Choi Y.-H.; Schoenburg M.;
Juenemann M.
Institution
(Butz, Gerriets, Sammer, Tschernatsch, Braun, Schoenburg, Juenemann) Heart
and Brain Research Group, Kerckhoff Heart and Thorax Center, Bad Nauheim,
Germany
(Butz, Gerriets, Tschernatsch, Huttner, Braun, Juenemann) Department of
Neurology, University Hospital Giessen and Marburg, Giessen, Germany
(Sammer) Cognitive Neuroscience at the Center of Psychiatry, University
Giessen, Giessen, Germany
(Sammer) Department of Psychology, Justus-Liebig University, Giessen,
Germany
(El-Shazly) Department of Psychocardiology, Kerckhoff Heart and Thorax
Center, Bad Nauheim, Germany
(Boening) Department of Cardiovascular Surgery, University Hospital
Giessen and Marburg, Giessen, Germany
(Mengden) Department of Rehabilitation, Kerckhoff Heart and Thorax Center,
Bad Nauheim, Germany
(Choi, Schoenburg) Department of Cardiac Surgery, Kerckhoff Heart and
Thorax Center, Bad Nauheim, Germany
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Following cardiac surgery, postoperative cognitive decline
(POCD) is a common complication that can impair the quality of life and
increase mortality. The aim of this study was to investigate whether early
postoperative cognitive training can decrease POCD after cardiac surgery.
<br/>METHOD(S): The study was a multi-centred, two-arm, randomized (1:1
ratio), controlled trial involving older patients undergoing elective
heart valve surgery with extracorporeal circulation. Recruitment took
place at the Department of Cardiac Surgery of the Kerckhoff-Clinic in Bad
Nauheim (Germany) and the University-Hospital in Giessen (Germany). The
patients were randomized to either a paper-and-pencil-based cognitive
training group or a standard rehabilitation care control group. The
cognitive training started 1 week after surgery and lasted about 3 weeks
until discharge from rehabilitation. To detect POCD, neuropsychological
functions were assessed prior to surgery, upon discharge from
rehabilitation (primary outcome), and 3 months after discharge (secondary
outcome). Data were primarily analysed in a per-protocol fashion.
<br/>RESULT(S): The frequency of POCD at discharge from rehabilitation
(training group, n = 37; control group, n = 44) was 50% in the control
group and 19% in the training group (chi2[1] = 8.45, P = 0.004; odds ratio
= 4.29, 95% confidence interval [1.56-11.80]). Three months after the
cognitive training (training group, n = 33; control group, n = 34), POCD
frequency was 29% in the control group and 6% in the training group
(chi2[1] = 6.21, P = 0.013; odds ratio = 6.46, 95% confidence interval
[1.29-32.28]). <br/>CONCLUSION(S): Since our cognitive training showed
beneficial effects, it could be a promising method to prevent POCD.
<br/>Copyright &#xa9; 2022 The Author(s). Published by Oxford University
Press on behalf of the European Association for Cardio-Thoracic Surgery.
All rights reserved.

<45>
Accession Number
2021901539
Title
Pacemaker implantation after sutureless or stented valve: results from a
controlled randomized trial.
Source
European Journal of Cardio-thoracic Surgery. 62(4) (no pagination), 2022.
Article Number: ezac164. Date of Publication: 01 Oct 2022.
Author
Lorusso R.; Ravaux J.M.; Pollari F.; Folliguet T.A.; Kappert U.; Meuris
B.; Shrestha M.L.; Roselli E.E.; Bonaros N.; Fabre O.; Corbi P.; Troise
G.; Andreas M.; Pinaud F.; Pfeiffer S.; Kueri S.; Tan E.; Voisine P.;
Girdauskas E.; Rega F.; Garcia-Puente J.; Fischlein T.; Folliguet T.;
Shrestha M.; Roselli E.; Kappetein A.P.; Gaggianesi S.
Institution
(Lorusso, Ravaux) Cardio-Thoracic Surgery Department, Heart and Vascular
Centre, Maastricht University Medical Center+ (MUMC+), Maastricht,
Netherlands
(Lorusso, Ravaux) Cardiovascular Research Institute Maastricht (CARIM),
Maastricht, Netherlands
(Pollari, Pfeiffer, Fischlein) Department of Cardiac Surgery,
Cardiovascular Center, Paracelsus Medical University-Klinikum Nurnberg,
Nuremberg, Germany
(Folliguet) Department of Cardiac Surgery and Transplantation, Assistance
Publique, Hopital Henri Mondor, Universite Paris 12 Upec, Paris, France
(Kappert) Department of Cardiac Surgery, Dresden Heart Centre University
Hospital, Dresden University of Technology, Dresden, Germany
(Meuris, Rega) Cardiac Surgery Department, Universitaire Ziekenhuizen
Leuven, Leuven, Belgium
(Shrestha) Department of Thoracic and Cardiovascular Surgery, Hannover
Medical School, Hannover, Germany
(Roselli) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Bonaros) Department of Cardiac Surgery, Innsbruck Medical University,
Innsbruck, Austria
(Fabre) Department of Cardiac Surgery of Artois, Hospital Center of Lens,
Lens, France
(Fabre) Department of Cardiac Surgery, Bois Bernard Private Hospital,
Ramsay Generale de Sante, Lens, France
(Corbi) Department of Thoracic and Cardiovascular Surgery, Cardio-Vascular
Center, University Hospital of Poitiers, Poitiers, France
(Troise) Division of Cardiac Surgery, Poliambulanza Foundation, Brescia,
Italy
(Andreas) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Pinaud) Department of Cardiac Surgery, Chu d'Angers, University Hospital
Angers, Angers, France
(Kueri) Department of Cardiovascular Surgery, University Heart Center
Freiburg Bad Krozingen, Bad Krozingen, Germany
(Kueri) Department of Cardiovascular Surgery, University Heart Center,
Albert-Ludwigs-Universitat Freiburg, Bad Krozingen, Germany
(Tan) Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven,
Netherlands
(Voisine) Department of Surgery, Universite Laval, Quebec, QC, Canada
(Voisine) Division of Cardiac Surgery, Department of Cardiology, Institut
Universitaire de Cardiologie et de Pneumologie de Quebec (IUCPQ), Quebec,
QC, Canada
(Girdauskas) Department of Cardiovascular Surgery, University Heart and
Vascular Center Hamburg, Hamburg, Germany
(Rega) Division of Experimental Cardiac Surgery, Department of
Cardiovascular Sciences, University of Leuven, Leuven, Belgium
(Garcia-Puente) Department of Cardiac Surgery, Hospital Universitario
Virgen de la Arraixaca, Murcia, Spain
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Sutureless aortic valves demonstrated non-inferiority to
standard stented valves for major cardiovascular and cerebral events at 1
year after aortic valve replacement. We aim to assess the factors
correlating with permanent pacemaker implantation (PPI) in both cohorts.
<br/>METHOD(S): PERSIST-AVR is a prospective, randomized, open-label
trial. Patients undergoing aortic valve replacement were randomized to
receive a sutureless aortic valve replacement (Su-AVR) or stented sutured
bioprosthesis (SAVR). Multivariable analysis was performed to identify
possible independent risk factors associated with PPI. A logistic
regression analysis was performed to estimate the risk of PPI associated
to different valve size. <br/>RESULT(S): The 2 groups (Su-AVR; n = 450,
SAVR n = 446) were well balanced in terms of preoperative risk factors.
Early PPI rates were 10.4% in the Su-AVR group and 3.1% in the SAVR. PPI
prevalence correlated with valve size XL (P = 0.0119) and preoperative
conduction disturbances (P = 0.0079) in the Su-AVR group. No predictors
were found in the SAVR cohort. Logistic regression analysis showed a
significantly higher risk for PPI with size XL compared to each individual
sutureless valve sizes [odds ratio (OR) 0.272 vs size S (95%confidence
interval 0.07-0.95), 0.334 vs size M (95% CI 0,16-0; 68), 0.408 vs size L
(95% CI 0,21-0.81)] but equivalent risk of PPI rates for all other
combination of valve sizes. <br/>CONCLUSION(S): Su-AVR is associated with
higher PPI rate as compared to SAVR. However, the increased PPI rate
appears to be size-dependent with significant higher rate only for size
XL. The combination of preoperative conduction disorder and a size XL can
lead to a higher probability of early PPI in Su-AVR. Clinical trial
registration number: NCT02673697. <br/>Copyright &#xa9; 2022 The
Author(s). Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery. All rights reserved.

<46>
Accession Number
2021901031
Title
Evaluation of rhomboid intercostal and subserratus plane block under
direct vision for postoperative analgesia in thoracic surgeries: a
prospective, randomized controlled trial, thoracic non-oncologic.
Source
European Journal of Cardio-thoracic Surgery. 62(6) (no pagination), 2022.
Article Number: ezac532. Date of Publication: 01 Dec 2022.
Author
West D.
Institution
(West) Department of Thoracic Surgery, University Hospitals Bristol and
Weston, Bristol BS2 8HW, United Kingdom
Publisher
European Association for Cardio-Thoracic Surgery

<47>
Accession Number
2021901016
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. 62(6) (no pagination), 2022.
Article Number: ezac498. Date of Publication: 01 Dec 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
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: This study is designed to evaluate the efficacy of rhomboid
intercostal and subserratus plane (RISS) block under the surgeon's direct
vision for providing postoperative pain relief after thoracic surgeries.
<br/>METHOD(S): Forty patients who underwent thoracotomy were
prospectively recruited and randomly assigned to group R (intravenous
patient-controlled analgesia + continued RISS block; n = 20) and group C
(intravenous patient-controlled analgesia; n = 20). Numeric rating scale
at rest and cough, at post-anaesthetic care unit, 1, 2, 6, 9, 12, 24 and
48 h, was used as the primary outcome measure. Secondary outcome measures
were the amount of tramadol consumption, the number of patients required
rescue analgesia, the occurrence of postoperative adverse effects,
pulmonary functions and the overall satisfaction with pain management.
<br/>RESULT(S): Numeric rating scale scores both at rest and during
coughing were significantly lower in group R than in group C at all time
intervals (P < 0.001 in each). Tramadol consumption at 24 and 48 h was
significantly lower in the group R block than in group C (P < 0.001 for
each). None of the patients in group R requires rescue analgesia. The
incidence of nausea and vomiting was similar among the groups. Compared
with group C, change in lung function from baseline levels was
significantly less in group R (P = 0.047 and P = 0.04 for FEV1 and FVC,
respectively). The satisfaction scores in group R were significantly
higher than that in group C (P < 0.001). <br/>CONCLUSION(S): Continuous
RISS block improved postoperative outcomes of thoracic surgery in terms of
reduced postoperative pain scores, sparing opioid consumption, pulmonary
function and patient satisfaction. <br/>Copyright &#xa9; 2022 The
Author(s). Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery. All rights reserved.

<48>
Accession Number
2019599662
Title
Use of vasoactive agents in non-cardiac surgery: Protocol for a scoping
review.
Source
Acta Anaesthesiologica Scandinavica. 67(1) (pp 120-122), 2023. Date of
Publication: January 2023.
Author
Baekgaard E.S.; Moller M.H.; Vester-Andersen M.; Krag M.
Institution
(Baekgaard, Krag) Department of Anaesthesia and Intensive Care, Holbaek
Hospital, Zealand, Denmark
(Moller) Department of Intensive Care, Rigshospitalet, Copenhagen, Denmark
(Moller, Vester-Andersen, Krag) Collaboration for Research in Intensive
Care (CRIC), Copenhagen, Denmark
(Moller, Krag) Department of Clinical Medicine, University of Copenhagen,
Copenhagen, Denmark
(Vester-Andersen) Department of Anaesthesia and Intensive Care,
Herlev-Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Background: An increasing number of patients undergo surgical procedures
worldwide each year, and despite advances in quality and care, morbidity
and mortality rates remain high. Perioperative hypotension is a
well-described condition, and is associated with adverse outcomes. Both
fluids and vasoactive agents are commonly used to treat hypotension,
however, whether one vasoactive agent is preferable over another has yet
to be explored. <br/>Method(s): In accordance with the Preferred Reporting
Items for Systematic Reviews and Meta-Analyses extension for Scoping
Reviews (PRISMA-ScR) statement, we plan to conduct a scoping review of
studies assessing the use of vasoactive agents in patients undergoing
non-cardiac surgery. We will provide an overview of indications, agents
used and outcomes assessed. We will assess and report the certainty of
evidence according to the Grading of Recommendations Assessment,
Development and Evaluation (GRADE) approach. <br/>Result(s): We will
provide descriptive analyses of the included studies accompanied by
tabulated results. <br/>Conclusion(s): The outlined scoping review will
provide a summary of the body of evidence on the use of vasoactive agents
in the non-cardiac surgical population.<br/>Copyright &#xa9; 2022 The
Authors. Acta Anaesthesiologica Scandinavica published by John Wiley &
Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

<49>
Accession Number
2018890406
Title
Valve-in-Valve Transcatheter Aortic Valve Replacement Versus Redo Surgical
Aortic Valve Replacement for Failed Surgical Aortic Bioprostheses: A
Systematic Review and Meta-Analysis.
Source
Journal of the American Heart Association. 11(24) (no pagination), 2022.
Article Number: e7965. Date of Publication: 20 Dec 2022.
Author
Raschpichler M.; de Waha S.; Holzhey D.; Schwarzer G.; Flint N.; Kaewkes
D.; Brauchle P.T.; Dvir D.; Makkar R.; Ailawadi G.; Abdel-Wahab M.; Thiele
H.; Borger M.A.
Institution
(Raschpichler, de Waha, Brauchle, Abdel-Wahab, Borger) Heart Center
Leipzig at University of Leipzig, Department of Cardiac Surgery, Leipzig,
Germany
(Raschpichler, Flint, Kaewkes, Makkar) Smidt Heart Institute, Department
of Interventional Cardiology, Cedars-Sinai Medical Center, Los Angeles,
CA, United States
(Holzhey) Department of Cardiac Surgery, University Hospital Wuppertal,
Wuppertal, Germany
(Schwarzer) Institute of Medical Biometry and Statistics, Faculty of
Medicine and Medical Center, University of Freiburg, Germany
(Flint) Tel Aviv Sourasky Medical Center affiliated to the Sackler faculty
of Medicine, Department of Cardiology, Tel Aviv University, Tel Aviv,
Israel
(Kaewkes) Department of Medicine, Khon Kaen University, Khon Kaen,
Thailand
(Dvir) Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel
(Ailawadi) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, MI, United States
(Abdel-Wahab, Thiele) Heart Center Leipzig at University of Leipzig,
Department of Cardiology, Leipzig, Germany
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: In the absence of randomized controlled trials, reports from
nonrandomized studies comparing valve-in-valve implantation (ViV) to redo
surgical aortic valve replacement (rAVR) have shown inconsistent results.
METHODS AND RESULTS: PubMed/MEDLINE, Google Scholar, and CENTRAL (Cochrane
Central Register of Controlled Trials) were searched through December
2021. Meta-Analysis of Observational Studies in Epidemiology guidelines
were followed. The protocol was registered at the International
Prospective Register of Systematic Reviews. Random effects models were
applied. The primary outcomes of interest were short-term and midterm
mortality. Secondary outcomes included stroke, myocardial infarction,
acute renal failure, and permanent pacemaker implantation, as well as
prosthetic aortic valve regurgi-tation, mean transvalvular gradient, and
severe prosthesis-patient mismatch. Of 8881 patients included in 15
studies, 4458 (50.2%) underwent ViV and 4423 (49.8%) rAVR. Short-term
mortality was 2.8% in patients undergoing ViV compared with 5.0% in
patients undergoing rAVR (risk ratio [RR] 0.55 [95% CI, 0.34-0.91],
P=0.02). Midterm mortality did not differ in patients undergoing ViV
compared with patients undergoing rAVR (hazard ratio, 1.27 [95% CI,
0.72-2.25]). The rate of acute kidney failure was lower following ViV,
(RR, 0.54 [95% CI, 0.33-0.88], P=0.02), whereas prosthetic aortic valve
regurgitation (RR, 4.18 [95% CI, 1.88-9.3], P=0.003) as well as severe
patient-prothesis mismatch (RR, 3.12 [95% CI, 2.35-4.1], P<0.001) occurred
more frequently. The mean transvalvular gradient was higher following ViV
(standard mean difference, 0.44 [95% CI, 0.15- 0.72], P=0.008). There were
no significant differences between groups with respect to stroke (P=0.26),
myocardial infarction (P=0.93), or pacemaker implantation (P=0.21).
<br/>CONCLUSION(S): Results of this meta-analysis demonstrate better
short-term mortality after ViV compared with rAVR. Midterm mortality was
similar between groups. Given the likely selection bias in these
individual reports, an adequately powered mul-ticenter randomized clinical
trial with sufficiently long follow-up in patients with
low-to-intermediate surgical risk is warranted.<br/>Copyright &#xa9; 2022
The Authors.

<50>
Accession Number
2020719371
Title
Design and logistical considerations for the randomized adaptive
non-inferiority storage-duration-ranging CHIlled Platelet Study.
Source
Clinical Trials. (no pagination), 2022. Date of Publication: 2022.
Author
Zantek N.D.; Steiner M.E.; VanBuren J.M.; Lewis R.J.; Berry N.S.; Viele
K.; Krachey E.; Dean J.M.; Nelson S.; Spinella P.C.
Institution
(Zantek) Department of Laboratory Medicine and Pathology, University of
Minnesota, Minneapolis, MN, United States
(Steiner) Department of Pediatrics, University of Minnesota, Minneapolis,
MN, United States
(VanBuren, Dean) Department of Pediatrics, University of Utah, Salt Lake
City, UT, United States
(Lewis) Harbor-UCLA Medical Center, Torrance, CA, United States
(Lewis) David Geffen School of Medicine at UCLA, Los Angeles, CA, United
States
(Lewis, Berry, Viele, Krachey) Berry Consultants, Austin, TX, United
States
(Nelson) Fine Point Pharma LLC, Durham, NC, United States
(Spinella) Department of Surgery and Critical Care Medicine, University of
Pittsburgh, Pittsburgh, PA, United States
Publisher
SAGE Publications Ltd
Abstract
Background: Platelet transfusion is a potentially life-saving therapy for
actively bleeding patients, ranging from those undergoing planned surgical
procedures to those suffering unexpected traumatic injuries. Platelets are
currently stored at room temperature (20degreeC-24degreeC) with a maximum
storage duration of 7 days after donation. The CHIlled Platelet Study
trial will compare the efficacy and safety of standard room
temperature-stored platelets with platelets that are cold-stored
(1degreeC-6degreeC), that is, chilled, with a maximum of storage up to 21
days in adult and pediatric patients undergoing complex cardiac surgical
procedures. Methods/Results: CHIlled Platelet Study will use a Bayesian
adaptive design to identify the range of cold storage durations for
platelets that are non-inferior to standard room temperature-stored
platelets. If cold-stored platelets are non-inferior at durations greater
than 7 days, a gated superiority analysis will identify durations for
which cold-stored platelets may be superior to standard platelets. We
present example simulations of the CHIlled Platelet Study design and
discuss unique challenges in trial implementation. The CHIlled Platelet
Study trial has been funded and will be implemented in approximately 20
clinical centers. Early randomization to enable procurement of cold-stored
platelets with different storage durations will be required, as well as a
platelet tracking system to eliminate platelet wastage and maximize trial
efficiency and economy. <br/>Discussion(s): The CHIlled Platelet Study
trial will determine whether cold-stored platelets are non-inferior to
platelets stored at room temperature, and if so, will determine the
maximum duration (up to 21 days) of storage that maintains
non-inferiority. Trial registration: ClinicalTrials.gov,
NCT04834414.<br/>Copyright &#xa9; The Author(s) 2022.

<51>
Accession Number
639842816
Title
Cardiopulmonary bypass parameters improve the prediction of 30-day
mortality following cardiac surgery.
Source
Perfusion. (pp 2676591221146505), 2022. Date of Publication: 22 Dec 2022.
Author
Newland R.F.; Baker R.A.
Institution
(Newland, Baker) 14351Cardiothoracic Surgery, Division of Surgery &
Perioperative Medicine, Flinders Medical Centre & Cardiothoracic Surgery,
Department of Surgery, College of Medicine and Public Health, Flinders
University, Bedford Park, SA, Australia
Publisher
NLM (Medline)
Abstract
Currently 30-day mortality is commonly used as a quality indicator for
cardiac surgery; however, prediction models have not included the role of
cardiopulmonary bypass (CPB). We hypothesized that reproducing currently
utilised prediction model methods of 30-day mortality using the Australian
and New Zealand Collaborative Perfusion Registry (ANZCPR) would identify
relevant CPB predictors. Nine centers in Australia and New Zealand
collected data using the ANZCPR between 2011-2020. CPB parameter selection
was determined by evaluating association with 30-day mortality. Data were
divided into model creation (n = 15,073) and validation sets (n = 15,072).
Bootstrap sampling and automated variable selection methods were used to
develop candidate models. The final model was selected using prediction
mean square error and Bayesian Information Criteria. The average receiver
operating characteristic (ROC), p-value for Hosmer-Lemeshow chi-squared
test and MSE were obtained from multifold validation. In total, 30,145
patients were included, of which 735 (2.4%) died within 30 day of surgery.
The area under the ROC curve for the model including CPB parameters was
significantly greater than preoperative risk factors only (0.829 vs 0.783,
p < 0.001). CPB parameters included in the predictive model were CPB time,
red blood cell transfusion, mean arterial pressure <50 mmHg, minimum
oxygen delivery, cardiac index <1.6 L/min/m2. CPB parameters improve the
prediction of 30-day mortality. Randomised trials designed to evaluate
modifiable CPB parameters will determine their impact on mortality.

<52>
Accession Number
639841610
Title
Oral Hygiene Prior to Cardiac Surgery to Prevent Infections: Randomized
Clinical Trial.
Source
International journal of dental hygiene. (no pagination), 2022. Date of
Publication: 22 Dec 2022.
Author
Nunez M.D.R.R.; Engel F.D.; Cardoso M.; Castro R.G.; Gil Montoya J.A.;
Ferreira de Mello A.L.S.
Institution
(Nunez, Cardoso, Castro, Ferreira de Mello) Graduation Program in
Dentistry. Federal University of Santa Catarina, Florianopolis, Brazil
(Engel) Graduation Program in Nursing. Federal University of Santa
Catarina, Florianopolis, Brazil
(Gil Montoya) Facultad de Odontologia. Universidad de Granada, Granada,
Spain
Publisher
NLM (Medline)
Abstract
CONTEXT: It is not clear if an oral hygiene protocol to control biofilm
applied before cardiac surgery can reduce infection rates.
<br/>OBJECTIVE(S): We aim to verify the effectiveness of an oral hygiene
protocol in reducing postoperative infections when compared to usual
practices, in patients admitted to a cardiology unit, prior to cardiac
surgery. DESIGN, SETTING, AND PARTICIPANTS: Randomized, blind, controlled
clinical trial, with 107 participants who expected to undergo cardiac
surgery, randomized into two groups: Experimental Group (EG) standardized
oral hygiene protocol (54) and Control Group (CG), usual practices
performed in patients admitted (53). INTERVENTION: a standardized oral
hygiene protocol, one day before surgery: professional prophylaxis with a
portable ultrasound device, tooth brushing, and flossing plus a 0.12%
chlorhexidine gluconate solution (0.12% CHX) mouth rinsing. When
applicable, removable prostheses cleaning. PRIMARY OUTCOME: the presence
of infection. <br/>RESULT(S): The occurrence of postoperative infection
was higher in CG = 7 (13.2%) than in EG = 5 (9.3%); but no statistical
difference was found between protocols (p=0.518). The length of stayed
from surgery to discharge presented a statistical difference
(p=0.047;RR=4.9;CI=1.01-24.33); the percentage of postoperative infection
was almost five times higher in those participants who stayed 11 or more
days. <br/>CONCLUSION(S): The standardized oral hygiene protocol with
mechanical and chemical cleaning, one day before cardiac surgery, was not
more effective than the usual practices performed regarding the reduction
of postoperative infections. Other interventions regarding oral hygiene
procedures before cardiac surgery must be studied to contribute to the
reduction of adverse post-surgical events.<br/>Copyright This article is
protected by copyright. All rights reserved.

<53>
Accession Number
639840218
Title
Conventional aortic root vs valve-sparing root replacement surgery in
aortic dilatation syndromes: a comparison of mortality and postoperative
complications.
Source
Expert review of cardiovascular therapy. (no pagination), 2022. Date of
Publication: 21 Dec 2022.
Author
Rashid H.N.; Chehab O.; Hurrell H.; Androshchuk V.; Sularz A.; Patterson
T.; Lucchese G.; Redwood S.
Institution
(Rashid, Chehab, Hurrell, Androshchuk, Sularz, Patterson, Lucchese,
Redwood) Department of Cardiology and Cardiac Surgery, Guy's & St. Thomas'
Hospital, London, United Kingdom
(Rashid, Chehab, Hurrell, Androshchuk, Patterson, Redwood) School of
Cardiovascular Medicine & Sciences, King's College London, London, United
Kingdom
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Conventional aortic root and valve-sparing root replacement
surgery are two current surgical treatments for aortic dilatation
syndromes. This review article aims to review the current literature
surrounding these two established techniques. AREAS COVERED: This review
article will address the current indications for valve-sparing root
replacement surgery, technical considerations in surgical planning and a
comparison of clinical outcomes between these two surgical techniques.
EXPERT OPINION: Valve-sparing root replacement surgery is a safe and
established treatment for aortic syndromes. Valve-sparing surgery
procedure avoids the inherent risk of prosthetic valve dysfunction and
prosthesis infection by preserving the native aortic valve compared to
conventional aortic root surgery. This has been demonstrated in various
observational studies and should be considered in clinically and
anatomically appropriate patients. Other technical considerations, such as
reimplantation versus remodelling technique and aortic cusp repair in
select patients, may impact in short-term procedural and long-term
clinical success with valve-sparing surgery.

<54>
Accession Number
2018283879
Title
Incidental findings on routine preoperative noncontrast chest computed
tomography and chest radiography prior to cardiac surgery in the
multicenter randomized controlled CRICKET study.
Source
European Radiology. 33(1) (pp 294-301), 2023. Date of Publication: January
2023.
Author
Knol W.G.; den Harder A.M.; de Heer L.M.; Benke K.; Maurovich-Horvat P.;
Leiner T.; Merkely B.; Krestin G.P.; Bogers A.J.J.C.; Budde R.P.J.
Institution
(Knol, Bogers) Department of Cardiothoracic Surgery, Erasmus MC,
Rotterdam, Netherlands
(Knol, Krestin, Budde) Department of Radiology & Nuclear Medicine, Erasmus
MC, PO BOX 2040, ND-547, CA, Rotterdam 3000, Netherlands
(den Harder, Leiner) Department of Radiology, University Medical Center
Utrecht and Utrecht University, Utrecht, Netherlands
(de Heer) Department of Cardiothoracic Surgery, University Medical Center
Utrecht and Utrecht University, Utrecht, Netherlands
(Benke) Department of Cardiovascular Surgery, Heart and Vascular Center,
Semmelweis University, Budapest, Hungary
(Maurovich-Horvat, Merkely) Department of Cardiology, Heart and Vascular
Center, Semmelweis University, Budapest, Hungary
(Maurovich-Horvat) Department of Radiology, Medical Imaging Center,
Semmelweis University, Budapest, Hungary
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objective: To describe the prevalence and consequences of incidental
findings when implementing routine noncontrast CT prior to cardiac
surgery. <br/>Method(s): In the multicenter randomized controlled CRICKET
study, 862 adult patients scheduled for cardiac surgery were randomized
1:1 to undergo standard of care (SoC), which included a chest-radiograph,
or an additional preoperative noncontrast chest CT-scan (SoC+CT). In this
subanalysis, all incidental findings detected on the chest radiograph and
CT-scan were analyzed. The influence of smoking status on incidental
findings was also evaluated, adjusting for sex, age, and group allocation.
<br/>Result(s): Incidental findings were observed in 11.4% (n = 49) of
patients in the SoC+CT group and in 3.7% (n = 16) of patients in the
SoC-group (p < 0.001). The largest difference was observed in findings
requiring follow-up (SoC+CT 7.7% (n = 33) vs SoC 2.3% (n = 10), p <
0.001). Clinically relevant findings changing the surgical approach or
requiring specific treatment were observed in 10 patients (1.2%, SoC+CT:
1.6% SoC: 0.7%), including lung cancer in 0.5% of patients (n = 4) and
aortic dilatation requiring replacement in 0.2% of patients (n = 2).
Incidental findings were more frequent in patients who stopped smoking (OR
1.91, 1.03-3.63) or who actively smoked (OR 3.91, 1.85-8.23).
<br/>Conclusion(s): Routine CT-screening increases the rate of incidental
findings, mainly by identifying more pulmonary findings requiring
follow-up. Incidental findings are more prevalent in patients with a
history of smoking, and preoperative CT might increase the yield of
identifying lung cancer in these patients. Incidental findings, but not
specifically the use of routine CT, are associated with delay of surgery.
Key Points: * Clinically relevant incidental findings are identified more
often after a routine preoperative CT-scan, when compared to a standard of
care workup, with some findings changing patient management. * Patients
with a history of smoking have a higher rate of incidental findings and a
lung cancer rate comparable to that of lung cancer screening trials. * We
observed no clear delay in the time to surgery when adding routine CT
screening.<br/>Copyright &#xa9; 2022, The Author(s).

<55>
Accession Number
2021754919
Title
Hepatitis B in Heart Transplant Donors and Recipients: A Systematic Review
and Meta-Analysis.
Source
Journal of Surgical Research. 283 (pp 1078-1090), 2023. Date of
Publication: March 2023.
Author
Yost C.C.; Jimenez D.C.; Weber M.P.; Maynes E.J.; Belden K.A.;
Tchantchaleishvili V.; Massey H.T.; Sass D.A.; Rame J.E.; Zurlo J.J.;
Aburjania N.
Institution
(Yost, Jimenez, Weber, Maynes, Tchantchaleishvili, Massey) Division of
Cardiac Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania
(Belden, Zurlo, Aburjania) Division of Infectious Diseases, Thomas
Jefferson University, Philadelphia, Pennsylvania
(Sass) Division of Gastroenterology and Hepatology, Thomas Jefferson
University, Philadelphia, Pennsylvania
(Rame) Division of Cardiology, Thomas Jefferson University, Philadelphia,
Pennsylvania
Publisher
Academic Press Inc.
Abstract
Introduction: Expanding the heart donor pool to include patients with
hepatitis B virus (HBV) could help ameliorate the organ shortage in heart
transplantation. We performed a systematic review and meta-analysis to
evaluate the management and recipient outcomes of D+/R- and D-/R+ heart
transplants. <br/>Method(s): An electronic search was performed to
identify all relevant studies published on heart transplants involving
HBV+ donors and/or HBV+ recipients. A comparison was performed between two
groups where heart transplants were performed a) D+/R- (n = 98) versus b)
D-/R+ (n = 65). <br/>Result(s): Overall, 13 studies were selected,
comprising 163 patients. Mean patient age was 55 y (95% CI: 39, 78) and
79% (69, 86) were male. Active post-transplant HBV infection requiring
antiviral treatment occurred in 11% (1, 69) of D+/R- recipients and 33%
(9, 71) of D-/R+ recipients. Post-transplant antiviral therapy was given
to 80% (6, 100) of D+/R- recipients compared to 72% (42, 90) of D-/R+
recipients (P = 0.84). Hepatitis-related mortality was observed in no
D+/R- recipients and 7% (2, 27) of D-/R+ recipients. Survival 1-y
post-transplant was comparable between both groups at 83% (83, 92) and 81%
(61, 92) for D+/R- and D-/R+ transplants, respectively.
<br/>Conclusion(s): Our review found that HBV D+/R- heart transplantation
was associated with fewer active hepatitis infections and lower
hepatitis-related mortality than D-/R+ transplantation, with comparable
survival at 1 y. Additional studies utilizing HBV nucleic acid testing
(NAT) to compare outcomes with HBsAg+ and anti-HBc+ donors are crucial to
reach more definitive conclusions about the risk of donor-derived
infections in this context.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<56>
Accession Number
2020896091
Title
The Anti-Inflammatory and Antioxidant Effects of Propofol and Sevoflurane
in Children With Cyanotic Congenital Heart Disease.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(1) (pp 65-72), 2023.
Date of Publication: January 2023.
Author
Karacaer F.; Biricik E.; Ilginel M.; Tunay D.L.; Dogus Y.; Ozturk O.G.;
Guzel Y.; Benli O.; Gunes Y.
Institution
(Karacaer, Biricik, Ilginel, Tunay, Gunes) Balcali Hospital, Cukurova
University, Anesthesiology and Reanimation Department, Adana, Turkey
(Dogus, Ozturk) Balcali Hospital, Cukurova University, Biochemistry
Department, Adana, Turkey
(Guzel) Balcali Hospital, Cukurova University, Cardiovascular Surgery
Department, Adana, Turkey
(Benli) Ministry of Health University, Adana City Training and Research
Hospital, Cardiovascular Surgery Department, Adana, Turkey
Publisher
W.B. Saunders
Abstract
Objective: The authors aimed to compare the anti-inflammatory and
antioxidant effects of propofol and sevoflurane in children with cyanotic
congenital heart disease (CCHD) undergoing cardiac surgery with
cardiopulmonary bypass. <br/>Design(s): Prospective, randomized,
double-blind study. <br/>Setting(s): Single center, university hospital.
<br/>Participant(s): Children ages 1-10 years with CCHD undergoing
elective cardiac surgery with cardiopulmonary bypass.
<br/>Intervention(s): Children were randomized to receive general
anesthesia with either sevoflurane (group S) or propofol (group P).
Systemic inflammatory response syndrome (SIRS) occurrence was assessed at
the end of the surgery and at the sixth, 12th, and 24th postoperative
hours. Blood samples were obtained at 4 times: after anesthesia induction
(T0), after release of the aortic cross-clamp (T1), at the end of the
surgery (T2), and at the postoperative 24th hour (T3). The serum levels of
interleukin 6 and tumor necrosis factor alpha, and the total antioxidant
status (TAS) and total oxidant status, were analyzed. <br/>Result(s): SIRS
was more common in group S than in group P at all times (p = 0.020, p =
0.036, p = 0.004, p = 0.008). There were no significant differences
between the groups in the mean tumor necrosis factor alpha and interleukin
6 levels at any time. The TAS level at T2 was higher in group P than group
S (p = 0.036). The serum TAS level increased at T2 compared with T0 in
group P, but it decreased in group S (p = 0.041). <br/>Conclusion(s): The
results showed that propofol provided a greater antioxidant effect and
reduced SIRS postoperatively more than sevoflurane in children with CCHD
undergoing cardiac surgery.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<57>
Accession Number
2020550828
Title
Detailed statistical analysis plan for the neurological complications in
endoscopic versus open radial artery harvest (NEO) randomised clinical
trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 990. Date of
Publication: December 2022.
Author
Carranza C.L.; Ballegaard M.; Werner M.U.; Hasbak P.; Kjaer A.; Kofoed K.;
Olsen M.H.; Gluud C.; Jakobsen J.C.
Institution
(Carranza) Department of Cardio-Thoracic Surgery, The Heart Centre,
Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
(Ballegaard) Department of Neurology, Zealand University Hospital,
Roskilde, Denmark
(Werner) Multidisciplinary Pain Centre, Department of Anesthesia, Pain and
Respiratory Support, Neuroscience Center, Copenhagen University Hospital -
Rigshospitalet, Copenhagen, Denmark
(Hasbak, Kjaer) Department of Clinical Physiology, Nuclear Medicine and
PET and Cluster for Molecular Imaging, Copenhagen University Hospital -
Rigshospitalet, Copenhagen, Denmark
(Hasbak, Kjaer) Department of Biomedical Sciences, University of
Copenhagen, Copenhagen, Denmark
(Kofoed) Department of Cardiology and Radiology, Copenhagen University
Hospital - Rigshospitalet, Copenhagen, Denmark
(Olsen, Gluud, Jakobsen) Centre for Clinical Intervention Research,
Copenhagen Trial Unit, The Capital Region, Copenhagen University Hospital
- Rigshospitalet, Copenhagen, Denmark
(Olsen) Department of Neuroanaesthesiology, The Neuroscience Centre,
Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
(Gluud, Jakobsen) Department of Regional Health Research, The Faculty of
Health Sciences, University of Southern Denmark, Odense, Denmark
Publisher
BioMed Central Ltd
Abstract
Introduction: Coronary artery bypass grafting can be conducted using the
radial artery as a bypass graft. However, it remains unclear which
harvesting method is superior, i.e. endoscopic or open radial artery, and
which site for proximal anastomosis of the radial artery has the greatest
benefits? Methods: The NEO Trial is a single site randomised clinical
trial with a 2 x 2 factorial design. The first comparison assesses
endoscopic versus open radial artery harvest with a primary outcome of
hand function and secondary outcomes of neurological deficits through
clinical exams and neurophysiological studies. The primary outcome is
postoperatively hand function at three months. We anticipate a mean
difference of 3 points with a standard deviation of 8 points, a power of
90%, and a type I error of 5%, resulting in a required sample size of 300
participants randomised 1:1. Secondary outcomes are neurological deficits
(based on nerve conduction measurements, algometry test and von Frey hair
test), clinical neurological examination of cutaneous sensibility, and
registration of complications in the donor arm (haematoma formation, wound
dehiscence, and/or infection). The second comparison assesses two
different proximal anastomotic sites, i.e. aorto-radial anastomosis versus
mammario-radial anastomosis. The primary outcome is a composite of
cerebrovascular events and the secondary outcome is graft patency
evaluation by multi-slice computer tomography-scan. These outcomes will be
assessed at 1 year postoperatively, and the results of this comparison
will be exploratory only. Both comparisons will be analysed using
intention-to-treat and intervention groups will be compared using linear
regression, logistic regression, or Mann-Whitney U test depending on data
type. Two independent statisticians will follow the present plan and
conduct the analyses which will hereafter be fused into a final analysis
based on consensus. <br/>Conclusion(s): This detailed analysis plan will
increase the validity of the NEO trial results by predefining the
statistical analysis in detail. Trial registration: ClinicalTrials.gov
identifier: NCT01848886. Registered 25 February 2013. Danish Ethics
committee number: H-3-2012-116. Danish Data Protection Agency:
2007-58-0015/jr. n:30-0838.<br/>Copyright &#xa9; 2022, The Author(s).

<58>
Accession Number
2020463798
Title
Antiplatelet efficacy of ticagrelor versus clopidogrel in Mediterranean
patients with diabetes mellitus and chronic coronary syndromes: A
crossover pharmacodynamic investigation.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 1057331. Date of Publication: 22 Nov 2022.
Author
Marcano A.L.; Gracida M.; Roura G.; Gomez-Lara J.; Romaguera R.; Teruel
L.; Fuentes L.; Muntane-Carol G.; Merono O.; Sosa S.G.; Gomez-Hospital
J.A.; Comin-Colet J.; Ferreiro J.L.
Institution
(Marcano, Gracida, Roura, Gomez-Lara, Romaguera, Teruel, Fuentes,
Muntane-Carol, Merono, Sosa, Gomez-Hospital) Department of Cardiology,
Bellvitge University Hospital, Barcelona, L'Hospitalet de Llobregat, Spain
(Marcano, Gracida, Roura, Gomez-Lara, Romaguera, Teruel, Fuentes,
Muntane-Carol, Merono, Sosa, Gomez-Hospital, Comin-Colet, Ferreiro)
Bio-Heart Cardiovascular Diseases Research Group, Bellvitge Biomedical
Research Institute (IDIBELL), Barcelona, L'Hospitalet de Llobregat, Spain
(Merono) Faculty of Medicine, University of Vic-Central University of
Catalonia, Barcelona, Spain
(Comin-Colet, Ferreiro) Department of Cardiology, Bellvitge University
Hospital, Centro de Investigacion Biomedica en Red de Enfermedades
Cardiovasculares, L'Hospitalet de Llobregat, Barcelona, Spain
Publisher
Frontiers Media S.A.
Abstract
Introduction: Patients with diabetes mellitus (DM) have augmented platelet
reactivity and diminished responsiveness to clopidogrel. Ticagrelor, a
more potent P2Y<inf>12</inf> inhibitor, is clinically superior to
clopidogrel in acute coronary syndromes, although its role in chronic
coronary syndromes (CCS) is still the subject of debate. The aim of this
investigation was to compare the pharmacodynamic effectiveness of
ticagrelor and clopidogrel in Mediterranean DM patients with CCS.
<br/>Material(s) and Method(s): In this prospective, randomized, crossover
study, patients (n = 20) were randomized (1:1) to receive, on top of
aspirin therapy, either ticagrelor 180 mg loading dose (LD)/90 mg
maintenance dose (MD) b.i.d. or clopidogrel 600 mg LD/75 mg MD o.d. for 1
week in a crossover fashion with a 2-4 week washout period between
regimens. Platelet function measurements were performed at 4 timepoints in
each period (baseline, 2 h and 24 h after LD, and 1 week), including light
transmission aggregometry (LTA, primary endpoint), VASP assay, Multiplate
and VerifyNow P2Y<inf>12</inf>. <br/>Result(s): The ticagrelor LD achieved
greater platelet inhibitory effect than clopidogrel LD, assessed with LTA
(20 muM ADP as agonist), at 2 h (34.9 +/- 3.9% vs. 63.6 +/- 3.9%; p <
0.001) and 24 h (39.4 +/- 3.5% vs. 52.3 +/- 3.8%; p = 0.014). After 1 week
of therapy, platelet reactivity was again significantly inferior with
ticagrelor compared to clopidogrel (30.7 +/- 3.0% vs. 54.3 +/- 3.0%; p <
0.001). The results were consistent with the other platelet function
assays employed. <br/>Conclusion(s): In Mediterranean patients with DM and
CCS, ticagrelor provides a more potent antiplatelet effect than
clopidogrel after the LD and during the maintenance phase of therapy.
Clinical trial registration: [ClinicalTrials.gov], identifier
[NCT02457130].<br/>Copyright &#xa9; 2022 Marcano, Gracida, Roura,
Gomez-Lara, Romaguera, Teruel, Fuentes, Muntane-Carol, Merono, Sosa,
Gomez-Hospital, Comin-Colet and Ferreiro.

<59>
Accession Number
2021686500
Title
Randomized Comparison of Transcatheter Edge-to-Edge Repair for
Degenerative Mitral Regurgitation in Prohibitive Surgical Risk Patients.
Source
JACC: Cardiovascular Interventions. 15(24) (pp 2523-2536), 2022. Date of
Publication: 26 Dec 2022.
Author
Lim D.S.; Smith R.L.; Gillam L.D.; Zahr F.; Chadderdon S.; Makkar R.; von
Bardeleben R.S.; Kipperman R.M.; Rassi A.N.; Szerlip M.; Goldman S.;
Inglessis-Azuaje I.; Yadav P.; Lurz P.; Davidson C.J.; Mumtaz M.; Gada H.;
Kar S.; Kodali S.K.; Laham R.; Hiesinger W.; Fam N.P.; Kessler M.; O'Neill
W.W.; Whisenant B.; Kliger C.; Kapadia S.; Rudolph V.; Choo J.; Hermiller
J.; Morse M.A.; Schofer N.; Gafoor S.; Latib A.; Koulogiannis K.; Marcoff
L.; Hausleiter J.
Institution
(Lim) University of Virginia Health System Hospital, Charlottesville, VA,
United States
(Smith, Szerlip) Baylor Scott and White: The Heart Hospital Plano, Plano,
TX, United States
(Gillam, Kipperman, Koulogiannis, Marcoff) Atlantic Health System
Morristown Medical Center, Morristown, NJ, United States
(Zahr, Chadderdon) Oregon Health & Science University, Portland, OR,
United States
(Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(von Bardeleben) University Medical Centre Mainz, Mainz, Germany
(Rassi) Kaiser Permanente San Francisco Medical Center, San Francisco, CA,
United States
(Goldman) Lankenau Medical Center, Wynnewood, PA, United States
(Inglessis-Azuaje) Massachusetts General Hospital, Boston, MA, United
States
(Yadav) Piedmont Heart Institute, Atlanta, GA, United States
(Lurz) University of Leipzig, Leipzig, Germany
(Davidson) Northwestern University, Chicago, IL, United States
(Mumtaz, Gada) UPMC Pinnacle, Harrisburg, PA, United States
(Kar) Los Robles Regional Medical Center, Thousand Oaks, CA, United States
(Kodali) Columbia University Medical Center, New York, NY, United States
(Laham) Beth Israel Deaconess Medical Center, Boston, MA, United States
(Hiesinger) Stanford University Medical Center, Palo Alto, CA, United
States
(Fam) St. Michael's Hospital, Toronto, ON, Canada
(Kesler) University of Ulm, Ulm, Germany
(O'Neill) Henry Ford Hospital, Detroit, MI, United States
(Whisenant) Intermountain Medical Center, Salt Lake City, UT, United
States
(Kliger) Northwell-Lenox Hill, New York, NY, United States
(Kapadia) Cleveland Clinic Foundation, Cleveland, OH, United States
(Rudolph) Ruhr-Universitat Bochum, Bad Oeynhausen, Bochum, Germany
(Choo) The Christ Hospital, Cincinnati, OH, United States
(Hermiller) St. Vincent Heart Center of Indiana, Indianapolis, IN, United
States
(Morse) Ascension Saint Thomas Hospital, Nashville, TN, United States
(Schofer) University Heart and Vascular Center Hamburg, Hamburg, Germany
(Gafoor) Swedish Medical Center, Seattle, WA, United States
(Latib) Montefiore Medical Center, Bronx, NY, United States
(Hausleiter) Klinikum der Universitat Munchen, Munich, Germany
Publisher
Elsevier Inc.
Abstract
Background: Severe symptomatic degenerative mitral regurgitation (DMR) has
a poor prognosis in the absence of treatment, and new transcatheter
options are emerging. <br/>Objective(s): The CLASP IID (Edwards PASCAL
Transcatheter Valve Repair System Pivotal Clinical Trial) randomized trial
(NCT03706833) is the first to evaluate the safety and effectiveness of the
PASCAL system compared with the MitraClip system in patients with
significant symptomatic DMR. This report presents the primary safety and
effectiveness endpoints for the trial. <br/>Method(s): Patients with 3+ or
4+ DMR at prohibitive surgical risk were assessed by a central screening
committee and randomized 2:1 (PASCAL:MitraClip). Study oversight also
included an echocardiography core laboratory and a clinical events
committee. The primary safety endpoint was the composite major adverse
event rate at 30 days. The primary effectiveness endpoint was the
proportion of patients with mitral regurgitation (MR) <=2+ at 6 months.
<br/>Result(s): A prespecified interim analysis in 180 patients
demonstrated noninferiority of the PASCAL system vs the MitraClip system
for the primary safety and effectiveness endpoints of major adverse event
rate (3.4% vs 4.8%) and MR <=2+ (96.5% vs 96.8%), respectively. Functional
and quality-of-life outcomes significantly improved in both groups (P <
0.05). The proportion of patients with MR <=1+ was durable in the PASCAL
group from discharge to 6 months (PASCAL, 87.2% and 83.7% [P = 0.317 vs
discharge]; MitraClip, 88.5% and 71.2% [P = 0.003 vs discharge]).
<br/>Conclusion(s): The CLASP IID trial demonstrated safety and
effectiveness of the PASCAL system and met noninferiority endpoints,
expanding transcatheter treatment options for prohibitive surgical risk
patients with significant symptomatic DMR.<br/>Copyright &#xa9; 2022
American College of Cardiology Foundation

<60>
[Use Link to view the full text]
Accession Number
2021677661
Title
The Effects of Angiotensin Receptor-Neprilysin Inhibition on Major
Coronary Events in Patients with Acute Myocardial Infarction: Insights
from the PARADISE-MI Trial.
Source
Circulation. 146(23) (pp 1749-1757), 2022. Date of Publication: 06 Dec
2022.
Author
Mehran R.; Steg P.G.; Pfeffer M.A.; Jering K.; Claggett B.; Lewis E.F.;
Granger C.; Kober L.; Maggioni A.; Mann D.L.; McMurray J.J.V.; Rouleau
J.-L.; Solomon S.D.; Ducrocq G.; Berwanger O.; De Pasquale C.G.;
Landmesser U.; Petrie M.; Leng D.S.K.; Van Der Meer P.; Lefkowitz M.; Zhou
Y.; Braunwald E.
Institution
(Mehran) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, United States
(Steg) Universite Paris-Cite, AP-HP (Assistance Publique-Hopitaux de
Paris), FACT (French Alliance for Cardiovascular Trials), INSERM U-1148,
France
(Pfeffer, Jering, Claggett, Solomon, Braunwald) Cardiovascular Division,
Brigham and Women's Hospital and Harvard Medical School, Boston, MA,
United States
(Lewis) Division of Cardiovascular Medicine, Stanford University, School
of Medicine, Stanford University, Palo Alto, CA, United States
(Granger) Duke University Medical Center, Durham, NC, United States
(Kober) Department of Clinical Medicine, University of Copenhagen, Denmark
(Maggioni) ANMCO Research Center, Heart Care Foundation, Florence, Italy
(Mann) Washington University Medical Center, St Louis, MO, United States
(McMurray, Petrie) British Heart Foundation Cardiovascular Research
Centre, University of Glasgow, United Kingdom
(Rouleau) Montreal Heart Institute, University of Montreal, QC, Canada
(Ducrocq) Departement de Cardiologie, Hopital Bichat Assistance Publique
Hopitaux de Paris, France
(Berwanger) Academic Research Organization (ARO), Hospital Israelita
Albert Einstein, Sao Paulo-SP, Brazil
(De Pasquale) Department of Cardiovascular Medicine, Flinders Medical
Centre, Adelaide, Australia
(Landmesser) Department of Cardiology, Charite-Universitatsmedizin Berlin,
Germany
(Leng) National Heart Centre Singapore, Singapore
(Van Der Meer) Department of Cardiology, University Medical Center
Groningen, University of Groningen, Netherlands
(Lefkowitz, Zhou) Novartis Pharmaceutical Corporation, East Hanover, NJ,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: In patients who survive an acute myocardial infarction (AMI),
angiotensin-converting enzyme inhibitors decrease the risk of subsequent
major cardiovascular events. Whether angiotensin-receptor blockade and
neprilysin inhibition with sacubitril/valsartan reduce major coronary
events more effectively than angiotensin-converting enzyme inhibitors in
high-risk patients with recent AMI remains unknown. We aimed to compare
the effects of sacubitril/valsartan on coronary outcomes in patients with
AMI. <br/>Method(s): We conducted a prespecified analysis of the
PARADISE-MI trial (Prospective ARNI vs ACE Inhibitors Trial to Determine
Superiority in Reducing Heart Failure Events After MI), which compared
sacubitril/valsartan (97/103 mg twice daily) with ramipril (5 mg twice
daily) for reducing heart failure events after myocardial infarction in
5661 patients with AMI complicated by left ventricular systolic
dysfunction, pulmonary congestion, or both. In the present analysis, the
prespecified composite coronary outcome was the first occurrence of death
from coronary heart disease, nonfatal myocardial infarction,
hospitalization for angina, or postrandomization coronary
revascularization. <br/>Result(s): Patients were randomly assigned at a
median of 4.4 [3.0-5.8] days after index AMI (ST-segment-elevation
myocardial infarction 76%, non-ST-segment-elevation myocardial infarction
24%), by which time 89% of patients had undergone coronary reperfusion.
Compared with ramipril, sacubitril/valsartan decreased the risk of
coronary outcomes (hazard ratio, 0.86 [95% CI, 0.74-0.99], P=0.04) over a
median follow-up of 22 months. Rates of the components of the composite
outcomes were lower in patients on sacubitril/valsartan but were not
individually significantly different. <br/>Conclusion(s): In survivors of
an AMI with left ventricular systolic dysfunction and pulmonary
congestion, sacubitril/valsartan - compared with ramipril - reduced the
risk of a prespecified major coronary composite outcome. Dedicated studies
are necessary to confirm this finding and elucidate its mechanism.
Registration: URL: https://www.clinicaltrials.gov; Unique identifier:
NCT02924727.<br/>Copyright &#xa9; 2022 Lippincott Williams and Wilkins.
All rights reserved.

<61>
Accession Number
2021831893
Title
The Effect of Mechanical Ventilation Mode on Blood Loss in Endoscopic
Sinus Surgery, A Randomized Clinical Study.
Source
Journal of Pharmaceutical Negative Results. 13 (pp 221-226), 2022. Date of
Publication: 2022.
Author
Masoud Farzadfar S.A.; Hajijafari M.; Karbasi Z.
Institution
(Masoud Farzadfar) Faculty of Medicine, Kashan University of Medical
Sciences, Kashan, Iran, Islamic Republic of
(Hajijafari) Trauma Research Center, Kashan University of Medical
Sciences, Kashan, Iran, Islamic Republic of
(Karbasi) Department of ENT, School of Medicine, Kashan University of
Medical Science, Kashan, Iran, Islamic Republic of
Publisher
ResearchTrentz Academy Publishing Education Services
Abstract
Background: One of the important problem during endoscopic sinus surgery
is bleeding. Bleeding causes disruption of the surgical field and damages
the base of the skull and the eye cavity and consequently increases the
duration of surgery vasopressor drugs may cause instability of
hemodynamic, specially, in hypertension patients or patients with ischemic
heart. Hypotension induction with various drugs causes to use a greater
amount of anesthetic drugs and its side effects. Therefore, it is
necessary to find a treatment for this complication. We decided to do a
study on two modes of ventilation to reduce bleeding and increasing
surgery satisfaction. <br/>Method(s): This investigation was performed on
134 patients. They were candidates of endoscopic sinus surgery 67 in
volume mechanical ventilation group and 67 in pressure mechanical
ventilation group. Patients were divided randomly in two groups and were
recorded vital signs, complications, and bleeding. We used ANOVA and
Chi-square tests to compare the data. <br/>Result(s): The findings
indicated that there is not significant difference between VCV and PCV in
duration of surgery, intraoperative bleeding, heart rate, mean arterial
blood pressure and surgeon satisfaction (P>0.05). <br/>Conclusion(s):
Various methods of ventilation did not show significant difference in
bleeding and due to inconsistencies in the results of the current study
and some studies and due to the limitations of the studies, further
studies with higher numbers of specimens are recommended.<br/>Copyright
&#xa9; 2022 Wolters Kluwer Medknow Publications. All rights reserved.

<62>
Accession Number
2019339455
Title
Point-of-Care Ultrasound-Guided Procedures in the Pediatric Cardiac
Intensive Care Unit.
Source
Current Treatment Options in Pediatrics. 8(4) (pp 334-345), 2022. Date of
Publication: December 2022.
Author
Persson J.N.; Good R.J.; Gitomer S.A.; Kim J.S.
Institution
(Persson, Kim) Division of Cardiology, Department of Pediatrics,
University of Colorado School of Medicine, Children's Hospital Colorado,
13123 East 16th Avenue, Box 100, Aurora, CO 80045, United States
(Persson, Good) Division of Critical Care Medicine, Department of
Pediatrics, University of Colorado School of Medicine, Children's Hospital
Colorado, Aurora, CO, United States
(Gitomer) Division of Pediatric Otolaryngology, Department of
Otolaryngology, University of Colorado School of Medicine, Children's
Hospital Colorado, Aurora, CO, United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose of Review: This publication will review the numerous uses for
procedural point-of-care ultrasound (POCUS), and its supporting
literature, specifically for pediatric patients admitted to the cardiac
intensive care unit. Recent Findings: Procedural POCUS can be applied
broadly to critically ill children with congenital and acquired heart
disease and there is longstanding, supporting evidence for procedures such
as central venous catheter placement and thoracentesis. Recently, studies
have demonstrated the success of innovative POCUS-guided procedures,
including transpyloric enteric tube placement and endotracheal intubation,
which are frequently performed in this high-risk population. <br/>Summary:
POCUS, a non-invasive, bedside imaging modality, can be used to guide
high-risk procedures in vulnerable populations, such as critically ill
children with congenital and acquired heart disease. The use of POCUS
guidance for procedures in the pediatric cardiac intensive care unit is
associated with increased procedural success and fewer complications,
thereby enhancing patient safety and, ultimately, outcomes.<br/>Copyright
&#xa9; 2022, The Author(s), under exclusive licence to Springer Nature
Switzerland AG.

<63>
Accession Number
2018789287
Title
Outcome of Pregnancy in Women With D-Transposition of the Great Arteries:
A Systematic Review.
Source
Journal of the American Heart Association. 11(23) (no pagination), 2022.
Article Number: e026862. Date of Publication: 06 Dec 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, United States
(Elkayam) Department of Obstetrics and Gynecology, University of Southern
California, Los Angeles, CA, United States
(Ng, Yeung, Chatfield) School of Pharmacy, University of Southern
California, Los Angeles, CA, United States
Publisher
American Heart Association Inc.
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. <br/>CONCLUSION(S): 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.<br/>Copyright &#xa9; 2022 The Authors. Published on
behalf of the American Heart Association, Inc., by Wiley.

<64>
Accession Number
2018759178
Title
Comparative Efficacy and Impact on Quality of Life with Add-on Therapy of
Emerging Newer Anti Anginal Drugs in Stable Angina - A Meta-Analysis.
Source
International Journal of Toxicological and Pharmacological Research.
12(12) (pp 6-7), 2022. Date of Publication: 2022.
Author
Dutt H.K.; Pratik; Hasan A.; Dhapola V.S.
Institution
(Dutt, Pratik, Dhapola) Department of Pharmacology, Soban Singh Jeena
Government Institute of Medical Sciences and Research, Uttarakhand, Almora
263601, India
(Hasan) Department of Pharmacology, Madhubani Medical College, Madhubani,
Bihar, Keshopur 847212, India
Publisher
Dr. Yashwant Research Labs Pvt. Ltd.
Abstract
Introduction: Myocardial ischemia, brought on by a discrepancy between
myocardial perfusion and oxygen demand, is the usual culprit in cases of
angina pectoris. Beta-blockers (BBs) and calcium channel blockers (CCBs)
are the drugs of choice for initial treatment of stable angina, with other
classes of drugs used in case the first two are insufficient. The
development of methods to enhance care for patients with chronic stable
angina is ongoing. It was anticipated that this systematic review will
help quantify the therapeutic benefit of using Ivabradine, Ranolazine,
Trimetazidine, and Nicorandil in addition to first-line monotherapy for
stable coronary artery disease. <br/>Material(s) and Method(s): The PICOS
framework, a standardised worldwide method for defining inclusion and
exclusion criteria, was used, as indicated by the PRISMA guidelines.
Individuals that were a part of the research population. <br/>Result(s):
After an initial literature search, 36 out of 45 studies that could be
fully analysed were deemed ineligible for further consideration because
either they did not provide any results or their entire texts were
unavailable. Each of the prescription medications for adjunctive treatment
proved to be efficient, risk-free, and well-tolerated. The frequency of
angina events decreased, and so did the need for nitrates, suggesting that
angina pectoris symptoms had improved. Add-on Trimetazidine is a
fast-acting, low-risk method of lowering both angina episodes and nitrate
use in the real-world clinical environment. Moreover, it improves physical
fitness and overall health. When combined to regular antianginal
medication, nicorandil significantly reduced the frequency of ischemia
episodes in coronary heart disease (CHD) patients with stable angina. It
has a favourable safety profile, with no unexpected adverse effects found.
Quality of life (QoL) was shown to improve in individuals with stable
angina and coronary artery disease (CAD) when Ivabradine was coupled with
metoprolol. The positive effects seen with this combination are likely the
cause of its high rate of adherence. <br/>Conclusion(s): The results of
the current research indicate that adjunctive therapy is an effective and
safe method of lowering the frequency of angina episodes and the need for
nitrates. In addition, evidence suggests that therapy for angina should be
tailored to each individual patient, their comorbidities, and the
underlying cause of their condition.<br/>Copyright &#xa9; 2022, Dr.
Yashwant Research Labs Pvt. Ltd.. All rights reserved.

<65>
Accession Number
2019572525
Title
Balloon- vs Self-Expanding Valve Systems for Failed Small Surgical Aortic
Valve Bioprostheses.
Source
Journal of the American College of Cardiology. 80(7) (pp 681-693), 2022.
Date of Publication: 16 Aug 2022.
Author
Rodes-Cabau J.; Abbas A.E.; Serra V.; Vilalta V.; Nombela-Franco L.;
Regueiro A.; Al-Azizi K.M.; Iskander A.; Conradi L.; Forcillo J.; Lilly
S.; Calabuig A.; Fernandez-Nofrerias E.; Mohammadi S.; Panagides V.;
Pelletier-Beaumont E.; Pibarot P.
Institution
(Rodes-Cabau, Mohammadi, Panagides, Pelletier-Beaumont, Pibarot) Quebec
Heart and Lung Institute, Laval University, Quebec City, QC, Canada
(Abbas) Beaumont Hospital, Royal Oak, MI, United States
(Serra, Calabuig) Hospital Universitari Vall d'Hebron, Barcelona, Spain
(Vilalta, Fernandez-Nofrerias) Hospital Universitari Germans Trias i
Pujol, Badalona, Spain
(Nombela-Franco) Cardiovascular Institute, Hospital Clinico San Carlos,
IdISSC, Madrid, Spain
(Regueiro) Hospital Clinic Barcelona, Barcelona, Spain
(Al-Azizi) Baylor Scott and White The Heart Hospital Plano, Plano, TX,
United States
(Iskander) SJH Cardiology Associates, Syracuse, NY, United States
(Conradi) University Heart and Vascular Center, Hamburg, Germany
(Forcillo) Centre Hospitalier Universitaire de Montreal, Montreal, QC,
Canada
(Lilly) OSU Heart and Vascular Research Organization, Richard M Ross
Hospital, Columbus, OH, United States
Publisher
Elsevier Inc.
Abstract
Background: Data comparing valve systems in the valve-in-valve
transcatheter aortic valve replacement (ViV-TAVR) field have been obtained
from retrospective studies. <br/>Objective(s): The purpose of this study
was to compare the hemodynamic results between the balloon-expandable
valve (BEV) SAPIEN (3/ULTRA, Edwards Lifesciences) and self-expanding
valve (SEV) Evolut (R/PRO/PRO+, Medtronic) in ViV-TAVR. <br/>Method(s):
Patients with a failed small (<=23 mm) surgical valve were randomized to
receive a BEV or an SEV. The primary endpoint was valve hemodynamics
(maximal/mean residual gradients, severe prosthesis patient mismatch
[PPM], or moderate-severe aortic regurgitation) at 30 days as evaluated by
Doppler echocardiography. <br/>Result(s): A total of 102 patients were
randomized, and of these, 98 patients finally underwent a ViV-TAVR
procedure (BEV: n = 46, SEV: n = 52). The procedure was successful in all
cases, with no differences in clinical outcomes at 30 days between groups
(no death or stroke events). Patients in the SEV group exhibited lower
mean and maximal transvalvular gradient values (15 +/- 8 mm Hg vs 23 +/- 8
mm Hg; P 0.001; 28 +/- 16 mm Hg vs 40 +/- 13 mm Hg, P 0.001), and a
tendency toward a lower rate of severe PPM (44% vs 64%; P = 0.07). There
were no cases of moderate-severe aortic regurgitation. In total, 55
consecutive patients (SEV: n = 27; BEV: n = 28) underwent invasive valve
hemodynamic evaluation during the procedure, with no differences in mean
and peak transvalvular gradients between both groups (P = 0.41 and P =
0.70, respectively). <br/>Conclusion(s): In patients with small failed
aortic bioprostheses, ViV-TAVR with an SEV was associated with improved
valve hemodynamics as evaluated by echocardiography. There were no
differences between groups in intraprocedural invasive valve hemodynamics
and 30-day clinical outcomes (Comparison of the Balloon-Expandable Edwards
Valve and Self-Expandable CoreValve Evolut R or Evolut PRO System for the
Treatment of Small, Severely Dysfunctional Surgical Aortic Bioprostheses.
The 'LYTEN' Trial; NCT03520101)<br/>Copyright &#xa9; 2022 American College
of Cardiology Foundation

<66>
Accession Number
2016363359
Title
A Systematic Review of Studies Describing the Effectiveness,
Acceptability, and Potential Harms of Place-Based Interventions to Address
Loneliness and Mental Health Problems.
Source
International Journal of Environmental Research and Public Health. 19(8)
(no pagination), 2022. Article Number: 4766. Date of Publication: April-2
2022.
Author
Hsueh Y.-C.; Batchelor R.; Liebmann M.; Dhanani A.; Vaughan L.; Fett
A.-K.; Mann F.; Pitman A.
Institution
(Hsueh, Liebmann, Mann, Pitman) Division of Psychiatry, University College
London (UCL), London W1T 7NF, United Kingdom
(Batchelor) Sussex Partnership NHS Foundation Trust, Worthing BN13 3EP,
United Kingdom
(Dhanani, Vaughan) Bartlett School of Architecture, University College
London (UCL), London WC1H 0AY, United Kingdom
(Fett) Department of Psychology, City, University of London, London EC1V
0HB, United Kingdom
(Mann, Pitman) Camden and Islington NHS Foundation Trust, London NW1 0PE,
United Kingdom
Publisher
MDPI
Abstract
Given the links between the built environment and loneliness, there is
interest in using place-based approaches (addressing built environment
characteristics and related socio-spatial factors) in local communities to
tackle loneliness and mental health problems. However, few studies have
described the effectiveness, acceptability, or potential harms of such
interventions. This review aimed to synthesize the literature describing
local community-based interventions that target place-based factors to
address loneliness and mental health problems, informing the development
of future public health approaches. We searched PsycINFO, Medline, and
Embase using a structured search strategy to identify English-language
studies evaluating the effectiveness, acceptability, and potential harms
of place-based community interventions in addressing loneliness and mental
health problems, both in general and clinical populations. Seven studies
met the inclusion criteria, classified as evaluating provision of
community facilities (such as clubhouses), active engagement in local
green spaces, and housing regeneration. None were randomised trials.
Quantitative and qualitative findings suggested promising effects and/or
acceptability of six interventions, with minimal potential harms. There is
a clear need for randomised trials or quasi-experimental studies of
place-based interventions to describe their effectiveness in addressing
loneliness and mental health problems, as well as complementary
qualitative work investigating acceptability. This will inform future
policy development.<br/>Copyright &#xa9; 2022 by the authors. Licensee
MDPI, Basel, Switzerland.

<67>
Accession Number
2021647138
Title
The intubating laryngeal tube (iLTS-D) versus Ambu AuragainTM as a conduit
facilitating fiberoptic tracheal intubation in adult population: results
from a prospective randomized controlled trial.
Source
Minerva Anestesiologica. 88(12) (pp 1074-1076), 2022. Date of Publication:
December 2022.
Author
Somri M.; Hochman O.; Gaitini L.; Hossein J.; Gomez-Rios M.A.
Institution
(Somri, Gaitini, Hossein) Department of Anesthesia, Bnai Zion Medical
Center, Haifa, Israel
(Somri, Gaitini) Faculty of Medicine, Technion, Israel Institute of
Technology, Haifa, Israel
(Hochman) Bnai of the Zion Medical Center, Haifa, Israel
(Gomez-Rios) Department of Anesthesiology and Perioperative Medicine,
ACoruna University Hospital, La Coruna, Spain
(Gomez-Rios) Spanish Difficult Airway Group (GEVAD), Madrid, Spain
Publisher
Edizioni Minerva Medica

<68>
Accession Number
2021647104
Title
Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve
Replacement in Low-risk Patients: A Meta-Analysis Based on a 2-Year
Follow-Up.
Source
Anatolian Journal of Cardiology. 26(11) (pp 802-809), 2022. Date of
Publication: November 2022.
Author
Chen C.-G.; Xi B.-B.; Deng Q.-F.; Zhang X.-Y.; Lin W.-C.; Chen L.-W.; Qiu
Z.-H.
Institution
(Chen, Xi, Deng, Zhang, Lin, Chen, Qiu) Department of Cardiovascular
Surgery, Union Hospital, Fujian Medical University, Fujian, China
(Chen, Xi, Deng, Zhang, Lin, Chen, Qiu) Key Laboratory of Cardio-Thoracic
Surgery, Fujian Medical University, Fujian Province University, Fujian,
China
Publisher
Turkish Society of Cardiology
Abstract
Background: Previous studies have shown that transcatheter aortic valve
implantation is the best alternative therapy to surgical aortic valve
replacement in high-risk surgical patients with aortic stenosis. However,
it is not clear whether transcatheter aortic valve implantation can be
utilized in low-risk surgical patients with aortic stenosis. This study
aimed to evaluate the safety and efficacy of transcatheter aortic valve
implantation in low-risk patients. <br/>Method(s): From the outset of our
initiative until April 2022, PubMed, EMBASE, and the Cochrane database
were thoroughly searched, yielding the selection of 3 randomized
controlled trials including 2644 patients with aortic stenosis, to assess
outcome measures at distinct follow-up time. <br/>Result(s): The mean
Society of Thoracic Surgeons Predicted Risk of Mortality score of patients
was 2.2. At the 30-day and 1-year follow-up, transcatheter aortic valve
implantation was associated with a lower incidence of all-cause mortality,
cardiovascular mortality, acute kidney injury (stage 2 or 3),
life-threatening or significant bleeding, and new atrial fibrillation but
an increased risk of permanent pacemaker implantation. At the 2-year
follow-up, transcatheter aortic valve implantation only had an advantage
in new atrial fibrillation (relative risk, 0.27; 95% CI, 0.14-0.51; P <
.0001), with no significant difference in all-cause mortality or
cardiovascular mortality. <br/>Conclusion(s): For low-risk surgical
patients with aortic stenosis, compared to surgical aortic valve
replacement, transcatheter aortic valve implantation was associated with
lower all-cause mortality at 30-day follow-up and lower cardiovascular
mortality at 1-year follow-up. Except for the advantages in new atrial
fibrillation, transcatheter aortic valve implantation had no significant
impact on mortality at 2-year follow-up.<br/>Copyright &#xa9; 2022 Turkish
Society of Cardiology. All rights reserved.

<69>
Accession Number
2021644807
Title
Revascularization strategies in patients with multivessel coronary artery
disease: A Bayesian network meta-analysis.
Source
Interactive Cardiovascular and Thoracic Surgery. 34(6) (pp 947-957), 2022.
Date of Publication: 01 Jun 2022.
Author
Van Den Eynde J.; Bomhals K.; NoCrossed D SignCopyright D.; Jacquemyn X.;
McCutcheon K.; Bennett J.; Puskas J.D.; Oosterlinck W.
Institution
(Van Den Eynde) Helen B. Taussig Heart Center, Johns Hopkins Hospital and
School of Medicine, Baltimore, MD, United States
(Van Den Eynde, Bomhals, NoCrossed D Sign&#xa9;, Jacquemyn, McCutcheon,
Bennett, Oosterlinck) Department of Cardiovascular Diseases, University
Hospitals Leuven, Leuven, Belgium
(Van Den Eynde, Bomhals, NoCrossed D Sign&#xa9;, Jacquemyn, McCutcheon,
Bennett, Oosterlinck) Department of Cardiovascular Sciences, KU Leuven,
Leuven, Belgium
(Puskas) Department of Cardiovascular Surgery, Mount Sinai Morningside
Hospital, New York, NY, United States
Publisher
Oxford University Press
Abstract
Treatment modalities for multivessel disease have rapidly evolved, yet the
preferred strategy remains controversial. This meta-analysis compared
outcomes after on-pump (ONCAB), off-pump coronary artery bypass grafting
(OPCAB), percutaneous coronary intervention (PCI) or hybrid coronary
revascularization. A comprehensive search for observational studies and
randomized controlled trials published by August 2020 was performed. A
Bayesian network meta-analysis was conducted for early (<30 days) and late
(>12 months) outcomes. A total of 119 studies were included (n = 700 458
patients). The main analysis was confined to 31 randomized controlled
trials (n = 24 932 patients). PCI was associated with lower early
mortality [odds ratio (OR) 0.50, 95% confidence interval (CI) 0.31-0.79]
and stroke (OR 0.22, 95% CI 0.06-0.60) rates compared with ONCAB, whereas
a reduced risk of early myocardial infarction was observed with OPCAB
compared with ONCAB (OR 0.53, 95% CI 0.32-0.83). Late target vessel
revascularization and major adverse cardiac and cerebrovascular events
were both increased with PCI compared with ONCAB, OPCAB and hybrid
coronary revascularization (by 127-203% and 59-64%, respectively), and
late major adverse cardiac events were increased in PCI compared with
ONCAB and OPCAB (by 64% and 59%). However, PCI was associated with a
significantly lower risk of late stroke compared with ONCAB (OR 0.70, 95%
CI 0.52-0.89). Sensitivity analyses (i) including observational studies
and (ii) limiting to studies with recent cohorts confirmed the findings of
the main analysis. Surgical approaches for revascularization remain
superior to PCI in patients with multivessel disease. Hybrid coronary
revascularization might be viable for some patients, although more
evidence from randomized controlled trials is warranted.<br/>Copyright
&#xa9; 2021 The Author(s). Published by Oxford University Press on behalf
of the European Association for Cardio-Thoracic Surgery.

<70>
Accession Number
2015759742
Title
Clinical Characteristics of Individuals Receiving Intrathecal Bupivacaine
with Clonidine or Bupivacaine with Fentanyl Spinal Anaesthesia.
Source
International Journal of Pharmaceutical and Clinical Research. 13(5) (pp
446-451), 2021. Date of Publication: 2021.
Author
Kumar D.; Das R.N.; Sinha P.K.
Institution
(Kumar, Das, Sinha) Department of Anaesthesiology, Anugrah Narayan Magadh
Medical College and Hospital, Bihar, Gaya, India
Publisher
Dr Yashwant Research Labs Pvt Ltd
Abstract
Aim: The aim of this study to assess the clinical characteristics of
individuals receiving intrathecal bupivacaine with clonidine or
bupivacaine with fentanyl spinal anaesthesia. <br/>Method(s): A
prospective double blind randomized controlled study was conducted in the
Department of Anaesthesiology, Anugrah Narayan Magadh Medical College and
Hospital, Gaya, Bihar, India, for 1 year. 100 adult patients were randomly
divided on an alternative basis into two groups of 50 each. Group
"A"-Bupivacaine plus clonidine group. Group "B"-Bupivacaine plus fentanyl
group. Patients with ASA grade 1 and 2 patients and age group of 18 -70
yrs. Those patients scheduled to undergo elective lower abdominal, lower
extremity, gynaecological or urological surgeries under subarachnoid block
were included in this study. Patients belonging to group 'A' received 3 ml
(15 mg) of hyperbaric bupivacaine 0.5% plus 1 microg.kg^-1 of
clonidine. Patients of group 'B' received 3 ml (15 mg) of hyperbaric
bupivacaine 0.5% plus (25 microg) of fentanyl. After injection, patient
was immediately turned to supine position. <br/>Result(s): Majority of
patients in the both the groups belonged to the group 30 to 40 years. The
number of males 42% and females 58%. Majority of female patients in the
both the groups belonged to the group 160 to 170 cms and males 171 to 175
cms, Samples were height matched. Most of the patient's 40 percent from
gynaecology surgery followed by lower limb surgery 35 percent and Lower
Abdominal Surgery 25 percent. <br/>Conclusion(s): We concluded that the
administration of local anaesthetics in combination with opioids
intrathecally is an established technique for managing postoperative pain
following abdominal, pelvic, thoracic or orthopaedic procedures on lower
extremities. Local anaesthetics with opioids demonstrate significant
synergy.<br/>Copyright &#xa9; 2021, Dr Yashwant Research Labs Pvt Ltd. All
rights reserved.

<71>
Accession Number
2021644703
Title
Mitral valve surgery after a failed MitraClip procedure.
Source
Interactive Cardiovascular and Thoracic Surgery. 32(3) (pp 380-385), 2021.
Date of Publication: 01 Mar 2021.
Author
Melillo F.; Baldetti L.; Beneduce A.; Agricola E.; Margonato A.; Godino C.
Institution
(Melillo, Baldetti, Beneduce, Agricola, Margonato, Godino)
Cardio-Thoracic-Vascular Department, San Raffaele Hospital, Milan, Italy
(Agricola, Margonato) Vita-Salute San Raffaele University, Milan, Italy
Publisher
Oxford University Press
Abstract
OBJECTIVES: Among patients undergoing transcatheter mitral valve repair
with the MitraClip device, a relevant proportion (2-6%) requires open
mitral valve surgery within 1 year after unsuccessful clip implantation.
The goal of this review is to pool data from different reports to provide
a comprehensive overview of mitral valve surgery outcomes after the
MitraClip procedure and estimate in-hospital and follow-up mortality.
<br/>METHOD(S): All published clinical studies reporting on surgical
intervention for a failed MitraClip procedure were evaluated for inclusion
in this meta-analysis. The primary study outcome was in-hospital
mortality. Secondary outcomes were in-hospital adverse events and
follow-up mortality. Pooled estimate rates and 95% confidence intervals
(CIs) of study outcomes were calculated using a DerSimionian-Laird binary
random-effects model. To assess heterogeneity across studies, we used the
Cochrane Q statistic to compute I2 values. <br/>RESULT(S): Overall, 20
reports were included, comprising 172 patients. Mean age was 70.5 years
(95% CI 67.2-73.7 years). The underlying mitral valve disease was
functional mitral regurgitation in 50% and degenerative mitral
regurgitation in 49% of cases. The indication for surgery was persistent
or recurrent mitral regurgitation (grade >2) in 93% of patients, whereas
6% of patients presented with mitral stenosis. At the time of the
operation, 80% of patients presented in New York Heart Association
functional class III-IV. Despite favourable intraoperative results,
in-hospital mortality was 15%. The rate of periprocedural cerebrovascular
accidents was 6%. At a mean follow-up of 12 months, all-cause death was
26.5%. Mitral valve replacement was most commonly required because the
possibility of valve repair was jeopardized, likely due to severe valve
injury after clip implantation. <br/>CONCLUSION(S): Surgical intervention
after failed transcatheter mitral valve intervention is burdened by high
in-hospital and 1-year mortality, which reflects reflecting the high-risk
baseline profile of the patients. Mitral valve replacement is usually
required due to leaflet injury.<br/>Copyright &#xa9; 2020 The Author(s).

<72>
Accession Number
639388663
Title
Volatile Versus Total Intravenous Anesthesia on Postoperative Delirium in
Adult Patients Undergoing Cardiac Valve Surgery: A Randomized Clinical
Trial.
Source
Anesthesia and analgesia. 136(1) (pp 60-69), 2023. Date of Publication: 01
Jan 2023.
Author
Jiang J.-L.; Zhang L.; He L.-L.; Li X.-F.; Dai S.-H.; Yu H.
Institution
(Jiang, Zhang, Yu, Li, Dai, Yu) From the Department of Anesthesiology,
West China Hospital, Sichuan University, Chengdu, China
(He) Department of Anesthesiology, Sichuan Jinxin Women and Children's
Hospital, Chengdu, Sichuan, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: The effect of anesthesia regimens on postoperative delirium
after on-pump cardiac valve surgery is yet undetermined. This study aimed
to evaluate the effect of volatile anesthesia compared with propofol-based
total intravenous anesthesia (TIVA) on the occurrence of delirium after
on-pump cardiac valve surgery. <br/>METHOD(S): This randomized clinical
trial was conducted at a university academic hospital in China, from
February 2019 to January 2021. Patients scheduled for on-pump cardiac
valve surgery or combined valve with coronary artery bypass grafting
(CABG) surgeries were randomly assigned to receive anesthesia maintenance
with either a volatile anesthetic (sevoflurane or desflurane) or
propofol-based TIVA. The primary outcome was the incidence of delirium
during the first 7 days after surgery, assessed using the confusion
assessment method for the intensive care unit (ICU). The secondary
outcomes included duration of delirium, subtypes of delirium, 30-day
mortality, pain score, major morbidity (including cerebral infarction,
respiratory failure, and pneumonia), duration of mechanical ventilation,
and lengths of ICU and hospital stay. The statistical analysis of the
primary outcome variable was by Pearson's chi 2 test. <br/>RESULT(S):
Among the 684 patients analyzed (mean age, 53.8 years; 381 [55.7%] women),
676 were assessed for the primary outcome. Postoperative delirium occurred
in 63 of 337 (18.7%) patients receiving volatile anesthesia versus 76 of
339 (22.4%) patients receiving propofol-based TIVA (relative risk, 0.80;
95% confidence interval [CI], 0.55-1.16; P = .231). There were no
significant differences between the groups in any of the secondary
outcomes. <br/>CONCLUSION(S): Among patients undergoing on-pump cardiac
valve surgery, anesthesia maintenance with a volatile agent did not result
in significantly fewer occurrences of postoperative delirium than
propofol-based TIVA.<br/>Copyright &#xa9; 2022 International Anesthesia
Research Society.

<73>
Accession Number
2019099878
Title
Heart failure during the COVID-19 pandemic: clinical, diagnostic,
management, and organizational dilemmas.
Source
ESC Heart Failure. 9(6) (pp 3713-3736), 2022. Date of Publication:
December 2022.
Author
Palazzuoli A.; Metra M.; Collins S.P.; Adamo M.; Ambrosy A.P.; Antohi
L.E.; Ben Gal T.; Farmakis D.; Gustafsson F.; Hill L.; Lopatin Y.;
Tramonte F.; Lyon A.; Masip J.; Miro O.; Moura B.; Mullens W.; Radu R.I.;
Abdelhamid M.; Anker S.; Chioncel O.
Institution
(Palazzuoli, Tramonte) Cardiovascular Diseases Unit, Cardio Thoracic and
Vascular Department, S. Maria alle Scotte Hospital, University of Siena,
Siena 53100, Italy
(Metra, Adamo) Cardiology, Cardio-Thoracic Department, Civil Hospitals,
Brescia, Italy; Department of Medical and Surgical Specialties,
Radiological Sciences, and Public Health, University of Brescia, Brescia,
Italy
(Collins) Department of Emergency Medicine, Vanderbilt University Medical
Centre, Nashville, TN, United States
(Ambrosy) Department of Cardiology, Kaiser Permanente San Francisco
Medical Center, San Francisco, CA, United States
(Ambrosy) Division of Research, Kaiser Permanente Northern California,
Oakland, CA, United States
(Antohi, Radu) Emergency Institute for Cardiovascular Diseases "Prof. Dr.
C.C.Iliescu" Bucharest, Bucharest, Romania
(Ben Gal) Department of Cardiology, Rabin Medical Center, Sackler Faculty
of Medicine, Tel Aviv University, Beilinson Campus, Tel Aviv, Israel
(Farmakis) Cardio-Oncology Clinic, Heart Failure Unit, "Attikon"
University Hospital, National and Kapodistrian University of Athens
Medical School, Athens, Greece
(Farmakis) University of Cyprus Medical School, Nicosia, Cyprus
(Gustafsson) Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
(Hill) School of Nursing and Midwifery, Queen's University, Belfast,
United Kingdom
(Lopatin) Volgograd Medical University, Cardiology Centre, Volgograd,
Russian Federation
(Lyon) Cardio-Oncology Service, Royal Brompton Hospital and Imperial
College London, London, United Kingdom
(Masip) Intensive Care Department, Consorci Sanitari Integral, University
of Barcelona, Barcelona, Spain
(Masip) Department of Cardiology, Hospital Sanitas CIMA, Barcelona, Spain
(Miro) Emergency Department, Hospital Clinic de Barcelona, University of
Barcelona, Barcelona, Spain
(Moura) Armed Forces Hospital, Porto, & Faculty of Medicine, University of
Porto, Porto, Portugal
(Mullens) Cardiovascular Physiology, Hasselt University, Belgium, & Heart
Failure and Cardiac Rehabilitation Specialist, Ziekenhuis Oost-Limburg,
Genk, Belgium
(Abdelhamid) Cardiology Department, Kasr Alainy School of Medicine, Cairo
University, New Cairo, 5th settlement, Cairo 11865, Egypt
(Anker) Department of Cardiology (CVK), Berlin Institute of Health Center
for Regenerative Therapies (BCRT), German Centre for Cardiovascular
Research (DZHK) partner site Berlin, Charite Universitatsmedizin Berlin,
Berlin, Germany
(Chioncel) Emergency Institute for Cardiovascular Diseases "Prof. Dr. C.C.
Iliescu" Bucharest; University for Medicine and Pharmacy "Carol Davila"
Bucharest, Bucharest, Romania
Publisher
John Wiley and Sons Inc
Abstract
The coronavirus 2019 (COVID-19) infection pandemic has affected the care
of patients with heart failure (HF). Several consensus documents describe
the appropriate diagnostic algorithm and treatment approach for patients
with HF and associated COVID-19 infection. However, few questions about
the mechanisms by which COVID can exacerbate HF in patients with high-risk
(Stage B) or symptomatic HF (Stage C) remain unanswered. Therefore, the
type of HF occurring during infection is poorly investigated. The
diagnostic differentiation and management should be focused on the
identification of the HF phenotype, underlying causes, and subsequent
tailored therapy. In this framework, the relationship existing between
COVID and onset of acute decompensated HF, isolated right HF, and
cardiogenic shock is questioned, and the specific management is mainly
based on local hospital organization rather than a standardized model.
Similarly, some specific populations such as advanced HF, heart
transplant, patients with left ventricular assist device (LVAD), or valve
disease remain under investigated. In this systematic review, we examine
recent advances regarding the relationships between HF and COVID-19
pandemic with respect to epidemiology, pathogenetic mechanisms, and
differential diagnosis. Also, according to the recent HF guidelines
definition, we highlight different clinical profile identification,
pointing out the main concerns in understudied HF
populations.<br/>Copyright &#xa9; 2022 The Authors. ESC Heart Failure
published by John Wiley & Sons Ltd on behalf of European Society of
Cardiology.

<74>
Accession Number
2018817098
Title
Neuroinvasive West Nile virus infections after solid organ
transplantation: Single center experience and systematic review.
Source
Transplant Infectious Disease. 24(6) (no pagination), 2022. Article
Number: e13929. Date of Publication: December 2022.
Author
Abbas A.; Qiu F.; Sikyta A.; Fey P.D.; Florescu D.F.
Institution
(Abbas, Sikyta, Florescu) Infectious Diseases Division, University of
Nebraska Medical Center, Omaha, NE, United States
(Qiu) Department of Biostatistics, College of Public Health, University of
Nebraska Medical Center, Omaha, NE, United States
(Fey) Department of Pathology and Microbiology, University of Nebraska
Medical Center, Omaha, NE, United States
Publisher
John Wiley and Sons Inc
Abstract
Abstract: West Nile virus (WNv) is a major cause of viral encephalitis in
the United States. WNv infection is usually asymptomatic or a limited
febrile illness in the immunocompetent hosts, although a small percentage
can develop neuroinvasive disease. Neuroinvasive disease due to WNv in
solid organ transplant recipients occurs at higher rates than observed in
the general population and can have long term neurological sequalae.
<br/>Method(s): We retrospectively reviewed medical records of all solid
organ transplant recipients at our institution who tested positive for WNv
from 2010 to 2018. Two reviewers performed electronic searches of Medline,
Embase, Cochrane Library of literature of WNv infections in SOT.
Descriptive statistics were performed on key variables. <br/>Result(s):
Eight recipients (mean age 54, five males) were diagnosed with
neuroinvasive WNv infection at our institution. Distribution of infection
was as follows: five kidney transplants, one in each kidney-pancreas,
liver, and lung. Diagnoses included meningitis (3), encephalitis (1),
meningo-encephalitis (4). Median time from transplant to infection was
49.8 months (2.7-175.4). No infections were considered donor-derived. Five
patients received treatment with IVIG. Six patients were alive at median
follow-up of 49.5 months (21.7-116.8). We identified 29 studies published
from 2002 to 2019. Median time from transplant to infection was 14.2
months, with similar allograft distribution; 53% were donor-derived
infections. <br/>Conclusion(s): WNv infections in solid organ transplant
recipients can be a consequence of organ donation or can be acquired via
the community. Infections can be more severe in SOT recipients and lead to
neuroinvasive disease.<br/>Copyright &#xa9; 2022 The Authors. Transplant
Infectious Disease published by Wiley Periodicals LLC.

<75>
Accession Number
2020014242
Title
CytoSorb haemoadsorption for removal of apixaban-A proof-of-concept pilot
case for a randomized controlled trial.
Source
Journal of Clinical Pharmacy and Therapeutics. 47(12) (pp 2373-2375),
2022. Date of Publication: December 2022.
Author
Buonocore M.; Rex S.; Degezelle K.; Meyns B.
Institution
(Buonocore, Degezelle, Meyns) Department of Cardiac Surgery, University
Hospitals Leuven, Leuven, Belgium
(Rex) Department of Anesthesiology, University Hospitals Leuven, Leuven,
Belgium
Publisher
John Wiley and Sons Inc
Abstract
What is known and objective: Emergent cardiac surgery in patients under
anticoagulant therapy is still a major point of concern. Recently approved
reversal agents are often not available or not suitable in the cardiac
surgery setting, and timely discontinuation of the drug is not always
feasible. CytoSorb haemoadsorption therapy has been approved in Europe for
intraoperative ticagrelor and rivaroxaban removal during cardiopulmonary
bypass (CPB), but thus far the efficacy of CytoSorb haemoadsorber on other
anticoagulants (apixaban, dabigatran, edoxaban) has only been tested in
vitro, and some signals of clinical benefits have reported in a few case
reports. Case summary: We describe a case of CPB implementation with
CytoSorb in a haemodynamic unstable patient with prosthetic aortic valve
endocarditis on apixaban therapy. What is new and conclusion: CytoSorb
proved to be effective for removal of apixaban in emergency surgery
setting by direct measurements of drug levels before and during CPB
circulation.<br/>Copyright &#xa9; 2022 John Wiley & Sons Ltd.

<76>
Accession Number
639816869
Title
Long-term analysis of ventricular function in patients with symptomatic
coronary disease who underwent on-pump or off-pump coronary artery bypass
grafting.
Source
Journal of cardiothoracic surgery. 17(1) (pp 326), 2022. Date of
Publication: 19 Dec 2022.
Author
Silva R.R.M.; Hueb W.; Lima E.G.; Rezende P.C.; Soares P.R.; Ramires
J.A.F.; Filho R.K.
Institution
(Silva, Hueb, Lima, Rezende, Soares, Ramires, Filho) Instituto do Coracao
(InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina,
Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar 44 - AB 1 S114
Cerqueira Cesar, Sao Paulo - 05403-000, Brazil
Publisher
NLM (Medline)
Abstract
BACKGROUND: Systemic deleterious effects of cardiopulmonary bypass have
been observed in the postprocedural period. Long-term assessment,
including ventricular function (VF), is unclear. The objective of this
study was to compare the change of left ventricular ejection fractions
(LVEFs) during a long-term follow-up of coronary artery disease (CAD)
patients who underwent off-pump (OPCAB) or on-pump coronary artery bypass
grafting (ONCAB). <br/>METHOD(S): This study is a prespecified analysis of
the MASS III trial, which was a single-center and prospective study that
enrolled stable CAD patients with preserved VF. The CAD patients in our
study were randomized to OPCAB or ONCAB. A transthoracic echocardiogram
was performed during follow-up and a LVEF value was obtained. The primary
endpoint was the difference between the final LVEF and the baseline LVEF.
<br/>RESULT(S): Of the 308 randomized patients, ventricular function were
observed in 225 over a mean of 5.9 years of follow-up: 113 in the ONCAB
group and 112 in the OPCAB group. Baseline characteristics were similar
between the two groups, but there was a larger proportion of subjects with
3-vessel disease in the ONCAB group. There was no difference in the LVEF
at the beginning (P=0.08), but there was a slight decrease in the LVEF in
the ONCAB and OPCAB groups (P<0.001 in both groups) at 5.9 years. The
decline was not significantly different between the two groups (delta of
-6% for ONCAB and -5% for OPCAB; P=0.78). In a multivariate analysis,
myocardial infarction in the follow-up was a predictor of an LVEF<40%.
<br/>CONCLUSION(S): There was no difference in the long-term development
of ventricular function between the surgical techniques, despite a decline
in the LVEF in both groups. Trial registration Clinical Trial Registration
Information-URL: http://www.controlled-trials.com . REGISTRATION NUMBER:
ISRCTN59539154. Date of first registration: 10/03/2008.<br/>Copyright
&#xa9; 2022. The Author(s).

<77>
Accession Number
639816695
Title
The comparison of del nido cardioplegia and crystalloid-based blood
cardioplegia in adult isolated coronary bypass surgery: A randomized
controlled trial.
Source
Nigerian journal of clinical practice. 25(12) (pp 1998-2004), 2022. Date
of Publication: 01 Dec 2022.
Author
Demir D.; Balci A.B.; Kahraman N.; Sunbul S.A.; Gucu A.; Seker I.B.; Badem
S.; Yuksel A.; Ozyazicioglu A.F.; Goncu M.T.
Institution
(Demir, Kahraman, Badem, Yuksel) Department of Cardiovasculary Surgery,
Bursa City Hospital, Bursa, Turkey
(Balci) Department of Cardiovasculary Surgery, Sirnak State Hospital,
Turkey
(Sunbul, Gucu, Seker, Ozyazicioglu, Goncu) Department of Cardiovasculary
Surgery, Bursa Yuksek Ihtisas Hospital, Bursa, Turkey
Publisher
NLM (Medline)
Abstract
Background and Aim: In our study, patients who underwent isolated coronary
artery bypass surgery (CABG) using Del Nido cardioplegia (DNC) and
crystalloid-based cold blood cardioplegia (CBC) were compared. Subject and
Methods: In this study, two groups of patients who underwent isolated CABG
using DNC (n = 106) and CBC (n = 107) were prospectively randomized.
Groups were compared in terms of many results such as troponin T,
returning spontaneous rhythm, and cardioplegia volume. Results and
<br/>Conclusion(s): Median troponin T levels of the DNC and CBC groups
were compared for the 0th hour (baseline), 12th, 36th, and 60th hours.
There was no statistical difference between groups in troponin T levels of
the baseline 0th hour (18[33] vs. 22[27] pg/ml; P = 0.724). Troponin T
levels at the 12th hour were less in the DNC group than the CBC group but
no statistical difference between the groups (790[735] vs. 826[820] pg/ml;
P = 0.068), respectively. Troponin T levels at 36th and 60th hours were
higher in the CBC group compared to the DNC group, and a statistical
difference was observed (580[546] vs. 650[550] pg/ml; P = 0.030) and
(359[395] vs. 421[400] pg/ml; P = 0.020), respectively. After X-clamping,
the spontaneous rhythm rate was statistically higher in the DNC group than
the CBC group (72.60% vs. 37.40%; P < 0.001). There was no statistical
difference between the groups in terms of postoperative arrhythmia,
hospital stay, and mortality rates (P > 0.05). Based on data we acquired
from the study, we think that DNC is at least as safe and effective as CBC
in adult CABG cases.

<78>
Accession Number
2021104074
Title
(128) Bupropion/Hydroxybupropion Therapeutic Drug Monitoring: A Case of
Elevated Hydroxybupropion Serum Levels in a Patient with Major Depressive
Disorder and Chronic Kidney Disease.
Source
Journal of the Academy of Consultation-Liaison Psychiatry. Conference:
Annual Meeting of the Academy of Consultation-Liaison Psychiatry. Virtual,
Online. 63(Supplement 2) (pp S175-S176), 2022. Date of Publication: 01 Nov
2022.
Author
Bryant C.A.; Baumgart P.
Institution
(Bryant) Keck Medicine of USC & LAC+USC Medical Center
(Baumgart) University of Southern California
Publisher
Elsevier B.V.
Abstract
Background: Bupropion is a unique antidepressant medication, acting as a
dopamine and norepinephrine reuptake inhibitor, with no direct action on
serotonin receptors (Khan, 2015). Bupropion is extensively broken down by
CYP2B6, with only 1% being eliminated in the urine unchanged, and a mean
half-life of 3.5h. Hydroxybupropion, the major active metabolite of
bupropion, has a longer half-life, reaches higher concentrations, and is
renally cleared with significantly reduced clearance in renal failure
patients (Costa, 2019). The authors present a patient with chronic kidney
disease (CKD) and major depressive disorder (MDD), treated with bupropion
for many years. He was found to have significantly reduced clearance of
hydroxybupropion while maintaining normal bupropion serum levels, which
raised concerns regarding safety with use. Case: A 69-year-old male with a
history of coronary artery disease, ischemic cardiomyopathy, CKD stage 3,
and MDD treated with bupropion and vortioxetine for decades was
hospitalized for orthotopic heart transplantation. Hospital course was
complicated by encephalopathy, acute kidney injury, and cardiac arrest
requiring cardioversion. Psychiatry was consulted and recommended
continuing vortioxetine 15mg once daily and converting bupropion SR 100mg
three times daily to bupropion XL 300mg once daily. At his first
outpatient psychiatry appointment following hospitalization, he reported
no active symptoms of MDD or encephalopathy. MDD had remained in remission
for decades and was historically aggravated by heavy alcohol use. He
expressed desire to downtitrate his antidepressant medications due to
concerns of CKD and polypharmacy. Creatine clearance was noted to be
39mL/min, so serum levels of bupropion and hydroxybupropion were obtained.
Bupropion level was found to be 15ng/mL (normal range 10-100), and
hydroxybupropion level was 1,730ng/mL (normal range 850-1500). Bupropion
downtitration was thus initiated. <br/>Discussion(s): Therapeutic drug
monitoring of bupropion appears to be rarely used clinically, but may play
an important role in patients with CKD. While this patient had a normal
bupropion level, the hydroxybupropion level was elevated and near the
toxic range, consistent with normal hepatic function and significantly
reduced renal function. Prior literature has advised dose reduction and
raised concerns regarding the benefit of antidepressant use in patients
with CKD (Nagler 2012). <br/>Conclusion(s): Bupropion should be used with
caution in patients with renal failure, and psychiatrists should consider
obtaining serum drug levels when appropriate. References: 1. Khan SR et al
(2016). Bupropion Hydrochloride. Profiles of drug substances, excipients,
and related methodology, 41, 1-30. 2. Costa R et al (2019).
Pharmacokinetic and pharmacodynamic of bupropion: integrative overview of
relevant clinical and forensic aspects. Drug metabolism reviews, 51(3),
293-313. 3. Nagler EV et al (2012), Antidepressants for depression in
stage 3-5 chronic kidney disease: a systematic review of pharmacokinetics,
efficacy and safety with recommendations by European Renal Best Practice
(ERBP), Nephrology Dialysis Transplantation, 27(10), 3736-3745.
<br/>Copyright &#xa9; 2022

<79>
Accession Number
2020813067
Title
CONTINUOUS FORMS OF INTRA-OPERATIVE ULTRAFILTRATION ENHANCE RECOVERY AFTER
ADULT CARDIAC SURGERY WITH CARDIOPULMONARY BYPASS: A SYSTEMATIC REVIEW AND
META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS.
Source
Canadian Journal of Cardiology. Conference: Canadian Cardiovascular
Congress 2022. Ottawa Canada. 38(10 Supplement 2) (pp S200-S201), 2022.
Date of Publication: October 2022.
Author
Bierer J.; Horne D.; Stanzel R.; Henderson M.; Boulos L.; Hayden J.
Institution
(Bierer, Horne, Stanzel, Henderson, Boulos, Hayden) Halifax, Nova Scotia
Publisher
Elsevier Inc.
Abstract
Background: Cardiac surgery with cardiopulmonary bypass (CPB) is
associated with complement-mediated systemic inflammation, endothelial
leak syndrome and cardiopulmonary dysfunction, which can prolong
post-operative recovery. Ultrafiltration has been used during cardiac
surgery to extract pro-inflammatory mediators, prevent volume overload and
hemoconcentrate both coagulation factors and circulating hematologic
cells. Continuous forms of ultrafiltration, which are used throughout the
entire CPB time, could potentially maximize the many therapeutic effects
of this technique. This systematic review and meta-analysis of randomized
controlled trials aims to investigate if continuous ultrafiltration
enhances clinical outcomes and recovery after adult cardiac surgery with
CPB. <br/>Methods and Results: We performed a pre-specified systematic
review and meta-analysis (PROSPERO: CRD42020219309) and reported the
results following PRISMA guidelines. MEDLINE, Embase, CENTRAL and Scopus
were systematically searched on November 3, 2021. Randomized controlled
trials investigating continuous forms of ultrafiltration during adult
cardiac surgery were identified and included. Each study was assessed for
risk of bias using the Cochrane RoB2 instrument. The primary endpoint was
operative mortality, and secondary outcomes included Intensive Care Unit
Length of Stay (ICU LOS), Ventilation Time, Acute Kidney Injury (AKI) or
Renal Failure and Pneumonia. All outcomes were analyzed with an
inverse-variance random-effects model and assessed for GRADE Quality of
Evidence. <br/>Result(s): Twelve single centre randomized controlled
trials consisting of 989 adult patients undergoing coronary, valvular or
concomitant cardiac procedures were included. Compared to controls,
patients receiving continuous ultrafiltration had a substantial but
imprecise reduction of operative mortality (risk ratio = 0.32; 95% CI:
0.10 - 1.03; p=0.06; number needed to treat=30 ), reduction in ICU LOS of
7.01 hours (95% CI: 1.86 - 12.15; p=0.008), reduction in Ventilation Time
of 2.11 hours (95% CI: 0.71 - 3.51; p=0.003), and a reduction of
post-operative Pneumonia (risk ratio = 0.33; 95% CI: 0.15 - 0.75; p=0.008;
number needed to treat =15). There was no difference in rates of AKI or
Renal Failure between ultrafiltration and control groups (risk ratio =
0.84; 95% CI: 0.48 - 1.48; p=0.55). The GRADE Quality of Evidence for
these outcomes ranged from very low to low. <br/>Conclusion(s): Continuous
forms of ultrafiltration reduced ICU LOS, Ventilation Time, the risk of
post-operative Pneumonia and suggested a potential reduction in operative
mortality for adults undergoing cardiac surgery with CPB. These results
present equipoise for a well-powered multi-center randomized controlled
trial to confirm the efficacy and generalizability of continuous
ultrafiltration to enhance recovery after adult cardiac surgery. [Formula
presented]<br/>Copyright &#xa9; 2022

<80>
Accession Number
2020434150
Title
22 Efficacy of Emergency Department-Initiated 14-Day Ambulatory ECG Patch
Monitors in Patients With Unexplained Syncope.
Source
Annals of Emergency Medicine. Conference: ACEP Research Forum. Moscone
Convention Center, San Francisco United States. 80(4 Supplement) (pp S10),
2022. Date of Publication: October 2022.
Author
Moore A.; Fiske C.; Gershon C.; Nazer B.; Kea B.
Institution
(Moore, Fiske, Gershon, Nazer, Kea) Virginia Tech Carilion School of
Medicine, Roanoke, Virginia, United States
Publisher
Elsevier Inc.
Abstract
Study Objectives: Syncope is a common and costly emergency department (ED)
chief complaint. Unfortunately, more than 50% of high-risk syncope
patients do not follow up for further outpatient cardiac monitoring
following ED or hospital discharge. Leadless and wireless ECG patch
monitors are now widely available for ambulatory cardiac monitoring. We
initiated a protocol in which ED physicians were given the option of
discharging patients with a diagnosis of syncope with a 14-day ambulatory
ECG monitor (AEM) placed by ED staff. The objective of this study is to
evaluate the efficacy of our ED AEM protocol as defined by a change in
medical management. <br/>Study Design: This is a retrospective chart
review of all ED patients, including both the ED and ED observation unit
(with less than a 48-hour stay), with unexplained syncope who were
discharged wearing an AEM between February 2019 and May 2021. Medical
management was a priori defined as the initiation of new cardiovascular
medications, further diagnostic testing, or cardiac-related procedures. We
provide descriptive statistics and use chi-square for comparison of
groups. <br/>Result(s): 126 patients with unexplained syncope and AEM
placement at the time of discharge were identified during the study
period. 115 patients (53% female, age 58.5 +/- 17.4 years) complied with
wearing and returning the AEM and were included in the final analysis. 51
patients (44.0%) were directly discharged from the ED and 65 patients
(56%) were discharged from the ED observation unit. 11 patients (9.6%)
required ED provider calls to discuss AEM findings, 4 (3.5%) of which
required emergent call back to the ED based on diagnoses of sustained
ventricular tachycardia, sinus pause >6 seconds, or complete heart block.
Ultimately, 12 patients (10.3%) had AEM findings that resulted in a change
in medical management of: initiation of medications (58%), pacemaker
implantation (25%), implantable or other loop recorder monitoring (25%),
diagnostic cardiac catheterization (16.7%), and arrhythmia catheter
ablation (8.3%). Change in medical management was not statistically
significant when comparing patients with ED discharge to ED observation
discharge (6.3% vs. 14.1%, p=0.15). No patients experienced sudden death
or injury due to arrhythmia after ED discharge with AEM.
<br/>Conclusion(s): ED-placed AEMs for patients with unexplained syncope
show high compliance rates and led to clinically important changes in
medical management. Future prospective trials should assess time to change
in medical management and time to arrhythmia diagnosis and incorporate a
control group. No, authors do not have interests to disclose<br/>Copyright
&#xa9; 2022

<81>
Accession Number
2019958275
Title
Major adverse cardiovascular events in homozygous familial
hypercholesterolemia: A systematic review and meta-analysis.
Source
Atherosclerosis. Conference: EAS 2022. Valencia Spain. 355 (pp 140), 2022.
Date of Publication: August 2022.
Author
Brunham L.; Kramer A.; Akioyamen L.; Genest J.; Lee S.
Institution
(Brunham) Centre For Heart Lung Innovation, University of British
Columbia, Vancouver, Canada
(Kramer) Medicine, University of British Columbia, Vancouver, Canada
(Akioyamen) Medicine, University of Toronto, Toronto, Canada
(Genest, Lee) Muhc, McGill University, montreal, Canada
Publisher
Elsevier Ireland Ltd
Abstract
Background and Aims : Homozygous familial hypercholesterolemia (HoFH) is a
genetic condition characterized by extremely elevated levels of
low-density lipoprotein cholesterol and premature atherosclerotic
cardiovascular disease (ASCVD) and death. Due to its rarity, accurate
assessment of cardiovascular outcomes associated with HoFH and how they
have changed over time has been challenging. The goal of this study was to
assess the prevalence and age-of-onset of major adverse cardiovascular
events (MACE) among patients with HoFH. <br/>Method(s): We searched
MEDLINE, EMBASE, Pubmed, Cochrane Central Register of Controlled Trials,
Scopus, Africa-Wide, Google Scholar, Open Grey, and various clinical trial
registries from inception to February 2020 to identify studies reporting
on MACE in HoFH patients. We determined the pooled prevalence and mean
age-of-onset of MACE outcomes individually using a random effects inverse
variance model. <br/>Result(s): We identified 94 studies that met our
eligibility criteria. Myocardial infarction and coronary revascularization
were common with a prevalence of 15.1% (95% CI 10.7% - 20.0%) and 28.3%
(95% CI 22.5% - 34.3%), respectively. Mean age-of-onset was 24.5 (95% CI
19.2 - 29.8) years for myocardial infarction, and 32.2 (95% CI 26.6 -
37.8) years for revascularization. Subgroup analyses based on year of
publication revealed significant delays in the onset of MACE outcomes
post-1990 compared to pre-1990. <br/>Conclusion(s): ASCVD is common among
HoFH patients and occurs at a young age. Age-of-onset of myocardial
infarction was delayed by more than a decade pre-1990 post-1990, likely
attributable to widespread use of statin therapy and other therapies,
reflecting substantial progress in the management of this rare but severe
disorder.<br/>Copyright &#xa9; 2022

<82>
Accession Number
2021901570
Title
Five-year results of Amaze: a randomized controlled trial of adjunct
surgery for atrial fibrillation.
Source
European Journal of Cardio-thoracic Surgery. 62(5) (no pagination), 2022.
Article Number: ezac181. Date of Publication: 01 Nov 2022.
Author
Sharples L.D.; Mills C.; Chiu Y.-D.; Fynn S.; Holcombe H.M.; Nashef S.A.M.
Institution
(Sharples, Mills, Chiu, Fynn, Holcombe, Nashef) Royal Papworth Hospital,
Cambridge, United Kingdom
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: The Amaze trial showed that adding atrial fibrillation (AF)
surgery to cardiac operations increased return to sinus rhythm (SR)
without impact on quality of life or survival at 2 years. We report
outcomes to 5 years. <br/>METHOD(S): In a multicentre, phase III,
pragmatic, double-blind, randomized controlled superiority trial, cardiac
surgery patients with >3 months of AF were randomized 1:1 to adjunct AF
surgery or control. Primary outcomes of 1-year SR restoration and 2-year
quality-adjusted survival were already reported. This study reports on
rhythm, survival, quality-adjusted survival, stroke, medication and safety
to 5 years. <br/>RESULT(S): Between 2009 and 2014, 352 patients were
randomized. By 5 years 79 died, 58 withdrew, 34 were lost to follow-up and
the remaining 182 provided data. AF surgery significantly increased the
odds of remaining in SR at 5 years {odds ratio = 2.98 [95% confidence
interval (CI) 1.23, 7.17], P = 0.015}. There was a non-significant
decrease in stroke incidence [odds ratio = 0.605 (95% CI 0.284, 1.287), P
= 0.19], but no improved survival [5-year survival: AF surgery 77.3% (95%
CI 71.1%, 83.5%), controls 77.8% (95% CI 71.7%, 84.0%), P = 0.85].
Quality-adjusted survival difference was negligible (-0.03; 95% CI -0.33,
0.27, P = 0.85). The composite of survival free of stroke and AF was
better in the AF surgery group [odds ratio = 2.34 (95% CI 1.03, 5.31)].
There were no other differences. <br/>CONCLUSION(S): Adjunct AF surgery
confers a higher rate of SR to 5 years and a better composite outcome of
survival free of stroke and AF but has no impact on overall or
quality-adjusted survival or other clinical outcomes. Clinical trial
registration number: ISRCTN82731440. <br/>Copyright &#xa9; 2022 The
Author(s). Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery.

<83>
Accession Number
2021816629
Title
Comparison of Demographic, Clinical, Biochemical, and Imaging Findings in
Hypertrophic Cardiomyopathy Prognosis: A Network Meta-Analysis.
Source
JACC: Heart Failure. 11(1) (pp 30-41), 2023. Date of Publication: January
2023.
Author
Georgiopoulos G.; Figliozzi S.; Pateras K.; Nicoli F.; Bampatsias D.;
Beltrami M.; Finocchiaro G.; Chiribiri A.; Masci P.G.; Olivotto I.
Institution
(Georgiopoulos, Finocchiaro, Chiribiri, Masci) School of Biomedical
Engineering and Imaging Sciences, King's College London, United Kingdom
(Georgiopoulos, Bampatsias) Department of Clinical Therapeutics, National
and Kapodistrian University of Athens, Greece
(Figliozzi) Humanitas Research Hospital IRCCS, Rozzano, Milan, Italy
(Pateras) Department of Biostatistics, Julius Center for Health Sciences
and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
(Nicoli) Humanitas Gavazzeni, Bergamo, Italy
(Beltrami, Olivotto) Department of Experimental and Clinical Medicine,
University of Florence, Meyer Children's Hospital and Careggi University
Hospital, Florence, Italy
Publisher
Elsevier Inc.
Abstract
Background: Despite hypertrophic cardiomyopathy (HCM) being the most
common inherited heart disease and conferring increased risk for heart
failure (HF) and sudden cardiac death (SCD), risk assessment in HCM
patients is still largely unresolved. <br/>Objective(s): This study aims
to synthesize and compare the prognostic impact of demographic, clinical,
biochemical, and imaging findings in patients with HCM. <br/>Method(s):
The authors searched PubMed, Embase, and Cochrane Library for studies
published from 1955 to November 2020, and the endpoints were: 1) all-cause
death; 2) an arrhythmic endpoint including SCD, sustained ventricular
tachycardia, ventricular fibrillation, or aborted SCD; and 3) a composite
endpoint including (1) or (2) plus hospitalization for HF or cardiac
transplantation. The authors performed a pairwise meta-analysis obtaining
the pooled estimate separately for the association between baseline
variables and study endpoints. A random-effects network meta-analysis was
subsequently used to comparatively assess the prognostic value of outcome
associates. <br/>Result(s): A total of 112 studies with 58,732 HCM
patients were included. Among others, increased brain natriuretic
peptide/N-terminal pro-B-type natriuretic peptide, late gadolinium
enhancement (LGE), positive genotype, impaired global longitudinal strain,
and presence of apical aneurysm conferred increased risk for the composite
endpoint. At network meta-analysis, LGE showed the highest prognostic
value for all endpoints and was superior to all other associates except
New York Heart Association functional class >class II. A multiparametric
imaging-based model was superior in predicting the composite endpoint
compared to a prespecified model based on conventional risk factors.
<br/>Conclusion(s): This network meta-analysis supports the development of
multiparametric risk prediction algorithms, including advanced imaging
markers additively to conventional risk factors, for refined risk
stratification in HCM. (Long-term prognosis of hypertrophic cardiomyopathy
according to genetic, clinical, biochemical and imaging findings: a
systemic review and meta-analysis; CRD42020185219)<br/>Copyright &#xa9;
2023 American College of Cardiology Foundation

<84>
Accession Number
2021850541
Title
Cardiac Rehabilitation After TAVI -A Systematic Review and Meta-Analysis.
Source
Current Problems in Cardiology. 48(3) (no pagination), 2023. Article
Number: 101531. Date of Publication: March 2023.
Author
Oz A.; Tsoumas I.; Lampropoulos K.; Xanthos T.; Karpettas N.; Papadopoulos
D.
Institution
(Oz, Tsoumas, Lampropoulos, Xanthos, Karpettas, Papadopoulos) European
University Cyprus, School of medicine, Nicosia, Cyprus
Publisher
Elsevier Inc.
Abstract
Despite the increasing popularity of Transcatheter aortic valve
implantation (TAVI) in patients with high surgical risk, there is no
current guideline for the management of patients following the
intervention. This systematic review and meta-analysis aims to summarize
and analyse all clinical data and evidence regarding the effectiveness and
outcomes of CR following TAVI. The first meta-analysis measured the walked
distance in the Six-Minute Walk Test (6MWT) and the second meta-analysis
included studies that showed the Barthel Index (BI) before and after CR.
The mean distance walked prior to CR was 235.88 +/- 69.36 m increased to
292.12 +/- 54.92 m after rehabilitation, signifying a moderate clinically
relevant effect size (0.593 (0.42, 0.76); P=0.00). The mean BI score
before CR was 76.6 +/- 11.5 which increased to 89.8 +/- 5.5 after the
programme and similarly demonstrated a significant standardized mean
improvement (0.75 (0.57, 0.93); I= 0.00). Exercise-based CR in patients
with aortic stenosis treated with TAVI demonstrated a significant
improvement in exercise tolerance and functional independence shown by the
6MWT and BI.<br/>Copyright &#xa9; 2022 Elsevier Inc.

<85>
Accession Number
2020645167
Title
Efficacy and Safety of NOACs Compared With VKAs for Patients With Atrial
Fibrillation After Transcatheter Aortic Valve Implantation: A System
Review and Meta-Analysis.
Source
Clinical and Applied Thrombosis/Hemostasis. 28 (no pagination), 2022. Date
of Publication: January-December 2022.
Author
Ge J.; Han W.; Ma C.; Maduray K.; Chen T.; Zhong J.
Institution
(Ge, Han, Ma, Maduray, Chen, Zhong) The Key Laboratory of Cardiovascular
Remodeling and Function Research, Chinese Ministry of Education, Chinese
National Health Commission and Chinese Academy of Medical Sciences, The
State and Shandong Province Joint Key Laboratory of Translational
Cardiovascular Medicine, Department of Cardiology, Qilu Hospital, Cheeloo
College of Medicine, Shandong University, Jinan, China
(Zhong) Department of Cardiology, Qilu Hospital (Qingdao), Cheeloo College
of Medicine, Shandong University, Qingdao, China
Publisher
SAGE Publications Inc.
Abstract
Novel oral anticoagulants (NOACs) are preferentially recommended in
patients with nonvalvular atrial fibrillation (AF) for stroke prevention
over vitamin K antagonists (VKAs). However, the evidence regarding the
efficacy and safety of NOACs versus VKAs after transcatheter aortic valve
implantation (TAVI) in patients with AF is very rare. Pubmed, Embase, Web
of science, and Cochrane Databases were searched for eligible studies
published before May 19, 2022. A total of 11 studies were included in this
meta-analysis involving 27 107 patients. Regarding primary outcomes, there
were no differences between NOACs and VKAs in all-cause mortality (RR:
0.84, 95% CI: (0.69, 1.02)) and stroke (RR: 1.00, 95% CI: (0.85, 1.19)).
With respect to secondary outcomes, NOACs were associated with reduced
incidence of bleeding (RR: 0.77, 95% CI: (0.71, 0.83)) and intracranial
bleeding (RR: 0.57, 95% CI: (0.39, 0.83)), whereas no significant
differences were found in major or life-threatening bleeding (RR: 0.98,
95% CI: (0.82, 1.17)) and myocardial infarction (RR: 1.37, 95% CI: (0.83,
2.26)). Our meta-analysis revealed the safety and efficacy of NOACs may be
superior to VKAs in AF patients undergoing TAVI.<br/>Copyright &#xa9; The
Author(s) 2022.

<86>
Accession Number
2020574475
Title
Effect of remimazolam tosilate versus etomidate on hemodynamics in
patients undergoing valve replacement surgery: study protocol for a
randomized controlled trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 992. Date of
Publication: December 2022.
Author
Hu B.; Zhou H.; Zou X.; Tan L.; Song T.; Zellmer L.; Li X.
Institution
(Hu, Zou, Tan, Song, Li) Department of Anesthesiology, The Affiliated
Hospital of Guizhou Medical University, 28 Guiyi Rd, Guizhou Province,
Guiyang 550004, China
(Zhou) Department of Cardiology, The Affiliated Hospital of Guizhou
Medical University, 28 Guiyi Rd, Guizhou Province, Guiyang 550004, China
(Zou) College of Anesthesiology, Guizhou Medical University, 9 Beijing Rd,
Guizhou Province, Guiyang 550004, China
(Zellmer) Department of Medicine, Hennepin County Medical Center, 730
South 8th St, Minneapolis, MN 55415, United States
Publisher
BioMed Central Ltd
Abstract
Background: Patients with a history of cardiac disease are prone to
develop cardiovascular adverse events such as hypotension, hypertension,
and tachycardia during anesthesia induction. Therefore, hemodynamic
stability is one of the most important concerns for induction of
anesthesia in patients undergoing cardiac surgery. Remimazolam tosilate is
a new, ultra-short-acting benzodiazepine agent, with the advantages of
rapid onset, rapid offset, and minimal cardiorespiratory depression. We
aim to compare the effect of remimazolam tosilate and etomidate on
hemodynamics during anesthesia induction in patients undergoing valve
replacement surgery. Methods/design: The trial is a prospective,
randomized, double-blinded, controlled, single-center trial to compare the
effect of remimazolam tosilate and etomidate on hemodynamics in patients
undergoing valve replacement surgery. One hundred seventeen patients
undergoing selective valve replacement surgery between January 1, 2022,
and December 31, 2023, will be enrolled and randomly allocated into one of
three groups: low-dose remimazolam group (Group LR), high-dose remimazolam
group (Group HR), or etomidate group (Group E). The primary outcome is
hemodynamic fluctuations during anesthesia induction (the difference
between mean arterial pressure [MAP] to baseline, MAP; and the difference
between maximum or minimum heart rate [HR] and baseline, HR). Secondary
outcomes include the incidence of adverse cardiovascular events
(hypotension, severe bradycardia, hypertension, tachycardia, and
arrhythmia), the cumulative doses of vasoactive drugs used per patient,
incidence and degree of injection pain and myoclonus, blood glucose
values, and vital signs at different time points. <br/>Discussion(s): This
research will determine the effectiveness and safety of remimazolam
tosilate induction on hemodynamics in patients undergoing valve
replacement surgery. Trial registration: www.chictr.org.cn identifier
ChiCTR2100052535. Registered on 17th Dec 2021,
http://www.chictr.org.cn/).<br/>Copyright &#xa9; 2022, The Author(s).

<87>
[Use Link to view the full text]
Accession Number
2021813702
Title
2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease:
A Report of the American Heart Association/American College of Cardiology
Joint Committee on Clinical Practice Guidelines.
Source
Circulation. 146(24) (pp E334-E482), 2022. Date of Publication: 13 Dec
2022.
Author
Isselbacher E.M.; Preventza O.; Black J.H.; Augoustides J.G.; Beck A.W.;
Bolen M.A.; Braverman A.C.; Bray B.E.; Brown-Zimmerman M.M.; Chen E.P.;
Collins T.J.; DeAnda A.; Fanola C.L.; Girardi L.N.; Hicks C.W.; Hui D.S.;
Jones W.S.; Kalahasti V.; Kim K.M.; Milewicz D.M.; Oderich G.S.; Ogbechie
L.; Promes S.B.; Ross E.G.; Schermerhorn M.L.; Times S.S.; Tseng E.E.;
Wang G.J.; Joseph Woo Y.
Publisher
Lippincott Williams and Wilkins
Abstract
AIM: The "2022 ACC/AHA Guideline for the Diagnosis and Management of
Aortic Disease" provides recommendations to guide clinicians in the
diagnosis, genetic evaluation and family screening, medical therapy,
endovascular and surgical treatment, and long-term surveillance of
patients with aortic disease across its multiple clinical presentation
subsets (ie, asymptomatic, stable symptomatic, and acute aortic
syndromes). <br/>METHOD(S): A comprehensive literature search was
conducted from January 2021 to April 2021, encompassing studies, reviews,
and other evidence conducted on human subjects that were published in
English from PubMed, EMBASE, the Cochrane Library, CINHL Complete, and
other selected databases relevant to this guideline. Additional relevant
studies, published through June 2022 during the guideline writing process,
were also considered by the writing committee, where appropriate.
STRUCTURE: Recommendations from previously published AHA/ACC guidelines on
thoracic aortic disease, peripheral artery disease, and bicuspid aortic
valve disease have been updated with new evidence to guide clinicians. In
addition, new recommendations addressing comprehensive care for patients
with aortic disease have been developed. There is added emphasis on the
role of shared decision making, especially in the management of patients
with aortic disease both before and during pregnancy. The is also an
increased emphasis on the importance of institutional interventional
volume and multidisciplinary aortic team expertise in the care of patients
with aortic disease.<br/>Copyright &#xa9; 2022 by the American College of
Cardiology Foundation and the American Heart Association, Inc.

<88>
Accession Number
2021592156
Title
Cardioprotective Effects of Glucose-Insulin-Potassium Infusion in Patients
Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Seminars in Thoracic and Cardiovascular Surgery. (no pagination), 2022.
Date of Publication: 2022.
Author
Hagerman A.; Schorer R.; Putzu A.; Keli-Barcelos G.; Licker M.
Institution
(Hagerman, Schorer, Putzu, Keli-Barcelos) Dept. of Acute Medicine, Geneva
University Hospitals, Geneva, Switzerland
(Licker) University of Geneva, Faculty of Medicine, Geneva, Switzerland
Publisher
W.B. Saunders
Abstract
The infusion of glucose-insulin-potassium (GIK) has yielded conflicting
results in terms of cardioprotective effects. We conducted a meta-analysis
to examine the impact of perioperative GIK infusion in early outcome after
cardiac surgery. Randomized controlled trials (RCTs) were eligible if they
examined the efficacy of GIK infusion in adults undergoing cardiac
surgery. The main study endpoint was postoperative myocardial infarction
(MI) and secondary outcomes were hemodynamics, any complications and
hospital resources utilization. Subgroup analyses explored the impact of
the type of surgery, GIK composition and timing of administration. Odds
ratio (OR) or mean difference (MD) with 95% confidence interval (CI) were
calculated with a random-effects model. Fifty-three studies (n=6129) met
the inclusion criteria. Perioperative GIK infusion was effective in
reducing MI (k=32 OR 0.66[0.48, 0.89] P=0.0069), acute kidney injury (k=7
OR 0.57[0.4, 0.82] P=0.0023) and hospital length of stay (k=19 MD
-0.89[-1.63, -0.16] days P=0.0175). Postoperatively, the GIK-treated group
presented higher cardiac index (k=14 MD 0.43[0.29, 0.57] L/min P<0.0001)
and lesser hyperglycemia (k=20 MD -30[-47, -13] mg/dL P=0.0005) than in
the usual care group. The GIK-associated protection for MI was effective
when insulin infusion rate exceeded 2 mUI/kg/min and after coronary artery
bypass surgery. Certainty of evidence was low given imprecision of the
effect estimate, heterogeneity in outcome definition and risk of bias.
Perioperative GIK infusion is associated with improved early outcome and
reduced hospital resource utilization after cardiac surgery. Supporting
evidence is heterogenous and further research is needed to standardize the
optimal timing and composition of GIK solutions.<br/>Copyright &#xa9; 2022
The Author(s)

<89>
Accession Number
2020725047
Title
Approaches and outcomes of Robotic-Assisted Thoracic Surgery (RATS) for
lung cancer: a narrative review.
Source
Journal of Robotic Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Mattioni G.; Palleschi A.; Mendogni P.; Tosi D.
Institution
(Mattioni, Palleschi, Mendogni, Tosi) Thoracic Surgery and Lung
Transplantation Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore
Policlinico, Milan 20122, Italy
(Mattioni) School of Thoracic Surgery, University of Milan, Milan 20122,
Italy
Publisher
Springer Nature
Abstract
Robotic-Assisted Thoracic Surgery (RATS) is considered one of the main
issues of present thoracic surgery. RATS is a minimally invasive surgical
technique allowing enhanced view, accurate and complex movements, and high
ergonomics for the surgeon. Despite these advantages, its application in
lung procedures has been limited, mainly by its costs. Since now many
different approaches have been proposed and the experience in RATS for
lungs ranges from wedge resection to pneumonectomy and is mainly related
to lung cancer. The present narrative review explores main approaches and
outcomes of RATS lobectomy for lung cancer. A non-systematic review of
literature was conducted using the PubMed search engine. An overview of
lung robotic surgery is given, and main approaches of robotic lobectomy
for lung cancer are exposed. Initial experiences of biportal and uniportal
RATS are also described. So far, retrospective analysis reported
satisfactory robotic operative outcomes, and comparison with VATS might
suggest a more accurate lymphadenectomy. Some Authors might even suggest
better perioperative outcomes too. From an oncological standpoint, no
definitive prospective study has yet been published but several
retrospective analyses report oncological outcomes comparable to those of
VATS and open surgery. Literature suggests that RATS for lung procedures
is safe and effective and should be considered as a valid additional
surgical option.<br/>Copyright &#xa9; 2022, The Author(s).

<90>
Accession Number
2020699980
Title
Outcomes of concomitant aortic valve procedures and left ventricular
assist device implantation: A systematic review and meta-analysis.
Source
Artificial Organs. (no pagination), 2022. Date of Publication: 2022.
Author
Iqbal K.; Arif T.B.; Rathore S.S.; Ahmed J.; Kumar P.; Shahid I.; Iqbal
A.; Shariff M.; Kumar A.
Institution
(Iqbal, Arif, Ahmed, Kumar, Iqbal) Department of Internal Medicine, Dow
Medical College, Dow University of Health Sciences, Karachi, Pakistan
(Rathore) Department of Internal Medicine, Dr. Sampurnanand Medical
College, Jodhpur, India
(Shahid) Department of Internal Medicine, Ziauddin Medical University,
Karachi, Pakistan
(Shariff) Department of Surgery, Mayo Clinic, Rochester, NY, United States
(Kumar) Department of Internal Medicine, Cleveland Clinic Akron General,
Akron, OH, United States
(Kumar) Section of Cardiovascular Research, Heart, Vascular and Thoracic
Department, Cleveland Clinic Akron General, Akron, OH, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Left ventricular assist device (LVAD) implantation is
frequently employed in patients with end-stage heart failure. The outcomes
of addressing the repair of all substantial aortic valvular disease at the
time of LVAD implantation remain unclear. We sought to assess the clinical
outcomes in patients undergoing LVAD implantation concomitant with aortic
valve procedures (AVPs) compared with isolated LVAD implantation.
<br/>Method(s): A literature search was performed using PubMed, Embase,
and Cochrane library from inception till June 2022. Primary outcomes
included short-term mortality and long-term survival. Random effects
models were used to compute mean differences and odds ratios with 95%
confidence intervals (CIs). <br/>Result(s): A total of 14 observational
studies (N = 52 693) met our inclusion criteria. Concomitant LVAD
implantation and AVPs were associated with higher short-term mortality (OR
= 1.61 [95% CI, 1.06-2.42]; p = 0.02) and mean CPBt (MD = 43.25 [95% CI,
22.95-63.56]; p < 0.0001), and reduced long-term survival (OR = 0.70 [95%
CI, 0.55-0.88]; p = 0.003) compared with isolated LVAD implantation. No
difference in the odds of cerebrovascular accident (OR = 1.05 [95% CI,
0.79-1.39]; p = 0.74) and mean length of hospital stay (MD = 2.89 [95% CI,
-4.04 to 9.82]; p = 0.41) was observed between the two groups. On adjusted
analysis, short-term mortality was significantly higher in the LVAD group
with concurrent AVPs when compared with the isolated LVAD group (aHR =
1.50 [95% CI, 1.20-1.87]; p = 0.0004). <br/>Conclusion(s): Concurrent AVPs
were associated with higher short-term mortality and reduced long-term
survival in patients undergoing LVAD implantation compared with isolated
LVAD implantation.<br/>Copyright &#xa9; 2022 The Authors. Artificial
Organs published by International Center for Artificial Organ and
Transplantation (ICAOT) and Wiley Periodicals LLC.

<91>
Accession Number
2020509523
Title
Should moderate ischemic mitral regurgitation be corrected during coronary
artery bypass grafting? a systematic review and meta-analysis.
Source
Perfusion (United Kingdom). (no pagination), 2022. Date of Publication:
2022.
Author
Wu H.; Zhang W.
Institution
(Wu, Zhang) Department of Cardiothoracic Surgery, Changzhi People's
Hospital, Changzhi, China
Publisher
SAGE Publications Ltd
Abstract
Objective: Ischemic mitral regurgitation (IMR) is associated with
increased risks of mortality and heart failure. However, the optimal
management of moderate IMR remains controversial. We conducted a
meta-analysis to appraise whether moderate IMR should be corrected during
coronary artery bypass grafting (CABG). <br/>Method(s): We searched
PubMed, Embase, and Cochrane databases from its inception up to 15 October
2022 for studies that assessed CABG alone versus CABG with mitral valve
(MV) surgery in patients with moderate IMR. The primary outcome was
perioperative mortality. <br/>Result(s): Four randomized controlled trials
and three observational studies with propensity-matched data including
1209 patients assessing CABG alone (n = 598) versus CABG with MV surgery
(n = 611) were included. Compared to CABG alone, the addition of MV
surgery did not significantly increase perioperative mortality (RR, 1.01;
95% CI, 0.52-1.96; p = 0.98) and stroke (RR, 2.14; 95% CI, 0.97-4.72; p =
0.06), whereas a longer cardiopulmonary bypass duration (MD, 54.91; 95%
CI, 42.13-67.68; p < 0.01) and an increased incidence of renal failure
were observed in the combined-procedure group. At follow-up, the addition
of MV surgery was significantly associated with reduced rates of residual
MR (RR, 0.26; 95% CI, 0.13-0.51; p < 0.01) and NYHA class III-IV (RR,
0.54; 95% CI, 0.37-0.78; p < 0.01). However, there was no difference in
either mid-term mortality (RR, 1.05; 95% CI, 0.65-1.70; p = 0.82) or late
mortality (RR, 91; 95% CI, 0.49-1.71; p = 0.78) between the CABG alone
group and the combined-procedure group. <br/>Conclusion(s): In patients
with moderate IMR, the addition of MV surgery to CABG did not increase
perioperative mortality. Despite the reduced rates of moderate MR and NYHA
class III-IV at follow-up, the addition of MV surgery did not translate in
a reduction in mid-term or late mortality.<br/>Copyright &#xa9; The
Author(s) 2022.

<92>
Accession Number
639832282
Title
Post-Operative Outcomes of Pre-Thoracic Surgery Respiratory Muscle
Training Vs. Aerobic Exercise Training: A Systematic Review and Network
Meta-analysis.
Source
Archives of physical medicine and rehabilitation. (no pagination), 2022.
Date of Publication: 17 Dec 2022.
Author
Kunadharaju R.; Saradna A.; Ray A.; Yu H.; Ji W.; Zafron M.; Mador M.J.
Institution
(Kunadharaju, Saradna) University at Buffalo, Jacobs School of Medicine
and Biomedical Sciences, Department of Pulmonary, Critical Care, Sleep
Medicine
(Ray) Department of Cancer Prevention & Control, Roswell Park
Comprehensive Cancer Center
(Yu) Department of Biostatistics and Bioinformatics, Roswell Park
Comprehensive Cancer Center
(Ji) Virginia Polytechnic Institute and State University, Center for
Biostatistics and Health Data Science
(Zafron) University at Buffalo, Jacobs School of Medicine and Biomedical
Sciences, Reference and Education Services
(Mador) University at Buffalo, Jacobs School of Medicine and Biomedical
Sciences, Department of Pulmonary, Critical Care, and Sleep Medicine; VA
WNY Healthcare System, Buffalo, NY, USA
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To compare the postoperative outcomes of preoperative
respiratory muscle training with a device (RMT) to preoperative aerobic
exercise training (AET) in patients undergoing thoracic surgeries (cardiac
and lung). DATA SOURCES: PubMed, EMBASE, Cochrane, and Web of Science were
comprehensively searched upon inception to 9/2020. STUDY SELECTION: All
randomized control studies, including preoperative RMT and preoperative
AET compared to a non-training control group, were included. DATA
EXTRACTION: The meta-analysis was performed for outcomes including
postoperative pulmonary complications (PPC), pneumonia, postoperative
respiratory failure (PRF), hospital length of stay (HLOS), and mortality.
We performed a network meta-analysis based on Bayesian random-effects
regression models. DATA SYNTHESIS: A total of 25 studies, 2070 patients
were included in this meta-analysis. Pooled data for the patients who
performed RMT with a device showed a reduction in PPCs, pneumonia, PRF
with OR (Odds ratio) of 0.35 (P-value 0.006), 0.38 (P-value 0.002), and
0.22 (P-value 0.008), respectively. Pooled data for the patients who
performed AET showed reduction in PPC, pneumonia with a OR of 0.33
(P-value <0.00001) and OR of 0.54 (P-value 0.01) respectively. HLOS was
decreased by 1.69 days (P-value <0.00001) by performing RMT and 1.79 days
(P-value 0.0008) by performing AET compared to the usual group. No
significant difference in all-cause mortality compared to usual care in
both RMT and AET intervention groups. No significant difference in the
incidence of PRF compared to usual group in RMT+AET and AET alone
intervention groups (OR 0.32; p= 0.21; OR 0.94; p= 0.87). Based on rank
probability plots analysis, on network meta-analysis, RMT and AET ranked
similarly on the primary outcome of PPC and secondary outcomes of
pneumonia, PRF and HLOS. <br/>CONCLUSION(S): In thoracic surgeries,
preoperative RMT is comparable to preoperative AET to prevent PPC,
pneumonia, and PRF and reduce HLOS. It can be considered in patients in
resource-limited settings.<br/>Copyright &#xa9; 2022. Published by
Elsevier Inc.

<93>
Accession Number
2021657249
Title
BAlloon expandable vs. SElf expanding transcatheter vaLve for degenerated
bioprosthesIs: design and rationale of the BASELINE trial.
Source
American Heart Journal. 256 (pp 139-147), 2023. Date of Publication:
February 2023.
Author
Nuis R.-J.; van Belle E.; Teles R.; Blackman D.; Veulemans V.; Santos
I.A.; Pilgrim T.; Tarantini G.; Saia F.; Iakovou I.; Mascherbauer J.;
Vincent F.; Geleijnse M.; Sathananthan J.; Wood D.; Makkar R.; Van Mieghem
N.M.
Institution
(Nuis, Geleijnse, Van Mieghem) Department of Cardiology, Erasmus
University Medical Center, Rotterdam, Netherlands
(van Belle, Vincent) Department of Cardiology, Institut Coeur Poumon,
Lille, France
(Teles) Hospital de Santa Cruz, CHLO; Nova Medical School, Lisbon,
Portugal
(Blackman) Department of Cardiology, Leeds Teaching Hospitals NHS Trust,
Leeds, United Kingdom
(Veulemans) Division of Cardiology, Heinrich Heine University Medical
Center Dusseldorf, Dusseldorf, Germany
(Santos) Departamento de Cardiologia, Hospital Clinico Universitario,
Valladolid, Spain
(Pilgrim) Department of Cardiology, Bern University Hospital, University
of Bern, Bern, Switzerland
(Tarantini) Department of Cardiac, Thoracic, Vascular Science and Public
Health, University of Padova, Padua, Italy
(Saia) U.O. Cardiologia, Dipartimento Cardio-Toraco-Vascolare, Azienda
Ospedaliero-Universitaria di Bologna, Bologna, Italy
(Iakovou) Department of Cardiology, Onassis Cardiac Surgery Center,
Athens, Greece
(Mascherbauer) Department of Cardiology, University Hospital St. Polten,
Sankt Polten, Austria
(Sathananthan, Wood) Centre for Cardiovascular and Heart Valve Innovation,
St. Paul's and Vancouver General Hospital, Vancouver, Canada
(Makkar) Department of Cardiology, Cedars-Sinai Medical Center, Los
Angeles, Canada
Publisher
Elsevier Inc.
Abstract
Background: Surgical aortic valve bioprostheses may degenerate over time
and require redo intervention. Transcatheter aortic valve replacement
(TAVR) is a less invasive alternative to redo surgery. The BAlloon
Expandable vs. SElf Expanding Transcatheter VaLve for Degenerated
BioprosthesIs (BASELINE) trial was designed to compare the performance of
the balloon-expandable SAPIEN-3 Ultra and the self-expanding EVOLUT PRO+
valve systems in symptomatic patients with a failing surgical
bioprosthesis. <br/>Method(s): The BASELINE trial is an
investigator-initiated, non-funded, prospective, randomized, open-label,
superiority trial enrolling a total of 440 patients in up to 50 sites in
12 countries in Europe and North-America. The primary endpoint is device
success at 30-days defined by the Valve Academic Research Consortium-3
Criteria as the composite of technical success, freedom from mortality,
freedom for surgery or intervention related to the device or to a major
vascular or access-related or cardiac structural complication with an
intended performance of the valve (mean gradient <20 mmHg and less than
moderate aortic regurgitation). The co-primary endpoint at 1 year is
defined as the composite of all-cause death, disabling stroke,
rehospitalization for heart failure or valve related problems. Independent
Core Laboratories will conduct uniform analyses of echocardiography (pre-,
post-, 1-year post-procedure), multi-sliced computed tomography (pre-, and
if available post-procedure) and cine-fluoroscopy studies.
<br/>Conclusion(s): The BASELINE trial is a head-to-head comparative trial
investigating the 2 most used contemporary transcatheter heart valves for
the treatment of a failing surgical aortic bioprosthesis.
(ClinicalTrials.gov number NCT04843072).<br/>Copyright &#xa9; 2022 The
Author(s)

<94>
Accession Number
2021604280
Title
Long-term clinical impact of permanent pacemaker implantation in patients
undergoing transcatheter aortic valve implantation: a systematic review
and meta-analysis.
Source
Europace. 24(7) (pp 1127-1136), 2022. Date of Publication: 01 Jul 2022.
Author
Zito A.; Princi G.; Lombardi M.; D'amario D.; Vergallo R.; Aurigemma C.;
Romagnoli E.; Pelargonio G.; Bruno P.; Trani C.; Burzotta F.; Crea F.
Institution
(Zito, Princi, Lombardi, D'amario, Vergallo, Aurigemma, Romagnoli,
Pelargonio, Bruno, Trani, Burzotta, Crea) Department of Cardiovascular and
Thoracic Sciences, Universita Cattolica del Sacro Cuore, L.go A. Gemelli
1, Rome 00168, Italy
(D'amario, Vergallo, Aurigemma, Romagnoli, Pelargonio, Bruno, Trani,
Burzotta, Crea) Department of Cardiovascular Medicine, Fondazione
Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Publisher
Oxford University Press
Abstract
Aims: The aims of this study is to assess by an updated meta-analysis the
clinical outcomes related to permanent pacemaker implantation (PPI) after
transcatheter aortic valve implantation (TAVI) at long-term (>=12 months)
follow-up (LTF). <br/>Methods and Results: A comprehensive literature
research was performed on PubMed and EMBASE. The primary endpoint was
all-cause death. Secondary endpoints were rehospitalization for heart
failure, stroke, and myocardial infarction. A subgroup analysis was
performed according to the Society of Thoracic Surgeon - Predicted Risk of
Mortality (STS-PROM) score. This study is registered with PROSPERO
(CRD42021243301). A total of 51 069 patients undergoing TAVI from 31
observational studies were included. The mean duration of follow-up was 22
months. At LTF, PPI post-TAVI was associated with a higher risk of
all-cause death [risk ratio (RR) 1.18, 95% confidence interval (CI)
1.10-1.25; P < 0.001] and rehospitalization for heart failure (RR 1.32,
95% CI 1.13-1.52; P < 0.001). In contrast, the risks of stroke and
myocardial infarction were not affected. Among the 20 studies that
reported procedural risk, the association between PPI and all-cause death
risk at LTF was statistically significant only in studies enrolling
patients with high STS-PROM score (RR 1.25, 95% CI 1.12-1.40), although
there was a similar tendency of the results in those at medium and low
risk. <br/>Conclusion(s): Patients necessitating PPI after TAVI have a
higher long-term risk of all-cause death and rehospitalization for heart
failure as compared to those who do not receive PPI.<br/>Copyright &#xa9;
2022 The Author(s).

<95>
Accession Number
2020575085
Title
Feasibility to estimate mean systemic filling pressure with inspiratory
holds at the bedside.
Source
Frontiers in Physiology. 13 (no pagination), 2022. Article Number:
1041730. Date of Publication: 29 Nov 2022.
Author
Wijnberge M.; Jansen J.R.C.; Pinsky M.R.; Klanderman R.B.; Terwindt L.E.;
Bosboom J.J.; Lemmers N.; Vlaar A.P.; Veelo D.P.; Geerts B.F.
Institution
(Wijnberge, Klanderman, Terwindt, Bosboom, Lemmers, Veelo) Amsterdam UMC
Location Academic Medical Center, Department of Anesthesiology, Amsterdam,
Netherlands
(Wijnberge, Klanderman, Bosboom, Vlaar) Amsterdam UMC Location Academic
Medical Center, Department of Intensive Care Medicine, Amsterdam,
Netherlands
(Jansen) Leiden University Medical Center, Department of Intensive Care
Medicine, Leiden, Netherlands
(Pinsky) Department of Critical Care Medicine, University of Pittsburgh,
Pittsburgh, PA, United States
(Geerts) Healthplus.ai, Amsterdam, Netherlands
Publisher
Frontiers Media S.A.
Abstract
Background: A decade ago, it became possible to derive mean systemic
filling pressure (MSFP) at the bedside using the inspiratory hold
maneuver. MSFP has the potential to help guide hemodynamic care, but the
estimation is not yet implemented in common clinical practice. In this
study, we assessed the ability of MSFP, vascular compliance (Csys), and
stressed volume (Vs) to track fluid boluses. Second, we assessed the
feasibility of implementation of MSFP in the intensive care unit (ICU).
Exploratory, a potential difference in MSFP response between colloids and
crystalloids was assessed. <br/>Method(s): This was a prospective cohort
study in adult patients admitted to the ICU after cardiac surgery. The
MSFP was determined using 3-4 inspiratory holds with incremental pressures
(maximum 35 cm H<inf>2</inf>O) to construct a venous return curve. Two
fluid boluses were administered: 100 and 500 ml, enabling to calculate Vs
and Csys. Patients were randomized to crystalloid or colloid fluid
administration. Trained ICU consultants acted as study supervisors, and
protocol deviations were recorded. <br/>Result(s): A total of 20 patients
completed the trial. MSFP was able to track the 500 ml bolus (p < 0.001).
In 16 patients (80%), Vs and Csys could be determined. Vs had a median of
2029 ml (IQR 1605-3164), and Csys had a median of 73 ml mmHg^-1
(IQR 56-133). A difference in response between crystalloids and colloids
was present for the 100 ml fluid bolus (p = 0.019) and in a post hoc
analysis, also for the 500 ml bolus (p = 0.010). <br/>Conclusion(s): MSFP
can be measured at the bedside and provides insights into the hemodynamic
status of a patient that are currently missing. The clinical feasibility
of Vs and Csys was judged ambiguously based on the lack of required
hemodynamic stability. Future studies should address the clinical
obstacles found in this study, and less-invasive alternatives to determine
MSFP should be further explored. Clinical Trial Registration:
ClinicalTrials.gov Identifier NCT03139929.<br/>Copyright &#xa9; 2022
Wijnberge, Jansen, Pinsky, Klanderman, Terwindt, Bosboom, Lemmers, Vlaar,
Veelo and Geerts.

<96>
Accession Number
2020549281
Title
Safety and efficacy of direct cardiac shockwave therapy in patients with
ischemic cardiomyopathy undergoing coronary artery bypass grafting (the
CAST-HF trial): study protocol for a randomized controlled trial-an
update.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 988. Date of
Publication: December 2022.
Author
Nagele F.; Polzl L.; Graber M.; Hirsch J.; Mayr A.; Pamminger M.; Troger
F.; Theurl M.; Schreinlechner M.; Sappler N.; Dorfmuller C.; Mitrovic M.;
Ulmer H.; Grimm M.; Gollmann-Tepekoylu C.; Holfeld J.
Institution
(Nagele, Polzl, Graber, Hirsch, Grimm, Gollmann-Tepekoylu, Holfeld)
Department of Cardiac Surgery, Medical University of Innsbruck, Innsbruck,
Austria
(Mayr, Pamminger, Troger) Department of Radiology, Medical University of
Innsbruck, Innsbruck, Austria
(Theurl, Schreinlechner, Sappler) Department of Internal Medicine III,
Medical University of Innsbruck, Innsbruck, Austria
(Dorfmuller, Mitrovic) Heart Regeneration Technologies, Innsbruck, Austria
(Ulmer) Department of Medical Statistics, Informatics and Health
Economics, Innsbruck, Austria
Publisher
BioMed Central Ltd
Abstract
Background: Coronary artery disease (CAD) remains a severe socio-economic
burden in the Western world. Coronary obstruction and subsequent
myocardial ischemia result in the progressive replacement of contractile
myocardium with dysfunctional, fibrotic scar tissue. Post-infarctional
remodelling is causal for the concomitant decline of left-ventricular
function and the fatal syndrome of heart failure. Available neurohumoral
treatment strategies aim at the improvement of symptoms. Despite extensive
research, therapeutic options for myocardial regeneration, including
(stem)-cell therapy, gene therapy, cellular reprogramming or tissue
engineering, remain purely experimental. Thus, there is an urgent clinical
need for novel treatment options for inducing myocardial regeneration and
improving left-ventricular function in ischemic cardiomyopathy. Shockwave
therapy (SWT) is a well-established regenerative tool that is effective
for the treatment of chronic tendonitis, long-bone non-union and
wound-healing disorders. In preclinical trials, SWT regenerated ischemic
myocardium via the induction of angiogenesis and the reduction of fibrotic
scar tissue, resulting in improved left-ventricular function.
<br/>Method(s): In this prospective, randomized controlled, single-blind,
monocentric study, 80 patients with reduced left-ventricular ejection
fraction (LVEF<= 40%) are subjected to coronary-artery bypass-graft
surgery (CABG) surgery and randomized in a 1:1 ratio to receive additional
cardiac SWT (intervention group; 40 patients) or CABG surgery with sham
treatment (control group; 40 patients). This study aims to evaluate (1)
the safety and (2) the efficacy of cardiac SWT as adjunctive treatment
during CABG surgery for the regeneration of ischemic myocardium. The
primary endpoints of the study represent (1) major cardiac events and (2)
changes in left-ventricular function 12 months after treatment. Secondary
endpoints include 6-min walk test distance, improvement of symptoms and
assessment of quality of life. <br/>Discussion(s): This study aims to
investigate the safety and efficacy of cardiac SWT during CABG surgery for
myocardial regeneration. The induction of angiogenesis, decrease of
fibrotic scar tissue formation and, thus, improvement of left-ventricular
function could lead to improved quality of life and prognosis for patients
with ischemic heart failure. Thus, it could become the first clinically
available treatment strategy for the regeneration of ischemic myocardium
alleviating the socio-economic burden of heart failure. Trial
registration: ClinicalTrials.gov NCT03859466. Registered on 1 March
2019.<br/>Copyright &#xa9; 2022, The Author(s).

<97>
Accession Number
2021177317
Title
Design and Rationale of Routine UltrasouNd GuIdance for Vascular AccEss
foR Cardiac Procedures: A Randomized TriaL (UNIVERSAL).
Source
CJC Open. 4(12) (pp 1074-1080), 2022. Date of Publication: December 2022.
Author
Alrashidi S.; d'Entremont M.-A.; Alansari O.; Winter J.; Brochu B.; Heenan
L.; Skuriat E.; Tyrwhitt J.; Raco M.; Tsang M.B.; Valettas N.; Velianou
J.; Sheth T.; Sibbald M.; Mehta S.R.; Pinilla-Echeverri N.; Schwalm J.D.;
Natarajan M.K.; Kelly A.; Akl E.; Tawadros S.; Camargo M.; Faidi W.; Dutra
G.; Jolly S.S.
Institution
(Alrashidi, Alansari, Raco, Tsang, Valettas, Velianou, Sheth, Sibbald,
Mehta, Pinilla-Echeverri, Schwalm, Natarajan, Kelly, Dutra, Jolly)
McMaster University, Hamilton, ON, Canada
(Alrashidi, Alansari, Raco, Tsang, Valettas, Velianou, Sheth, Sibbald,
Mehta, Pinilla-Echeverri, Schwalm, Natarajan, Kelly, Tawadros, Camargo,
Faidi, Dutra, Jolly) Hamilton Health Sciences, Hamilton, ON, Canada
(Alrashidi, Alansari, Raco, Tsang, Valettas, Velianou, Sheth, Sibbald,
Mehta, Pinilla-Echeverri, Schwalm, Natarajan, Kelly, Jolly) Niagara
Health, St. Catharines, ON, Canada
(d'Entremont, Heenan, Skuriat, Tyrwhitt, Sheth, Mehta, Pinilla-Echeverri,
Schwalm, Natarajan, Jolly) Population Health Research Institute, Hamilton,
ON, Canada
(d'Entremont) Centre Hospitalier Universitaire de Sherbrooke (CHUS),
Sherbrooke, QC, Canada
(Winter) Clinica Alemana de Santiago, Santiago, Chile
(Brochu) CK Hui Heart Centre, Royal Alexandra Hospital, Edmonton, AB,
Canada
(Akl) McGill University Health Centre, Montreal, QC, Canada
Publisher
Elsevier Inc.
Abstract
Background: A significant limitation of femoral artery access for cardiac
interventions is the increased risk of vascular complications and bleeding
compared to radial access. Ultrasound (US)-guided femoral access may
reduce major vascular complications and bleeding. We aim to determine
whether routinely using US guidance for femoral arterial access for
coronary angiography or intervention will reduce Bleeding Academic
Research Consortium (BARC) 2, 3, or 5 bleeding or major vascular
complications. <br/>Method(s): The Ultrasound Guidance for Vascular Access
for Cardiac Procedures: A Randomized Trial (UNIVERSAL) is a multicentre,
prospective, open-label, randomized trial with blinded outcomes
assessment. Patients undergoing coronary angiography with or without
intervention via a femoral approach with fluoroscopic guidance will be
randomized 1:1 to US-guided femoral access, compared to no US. The primary
outcome is the composite of major bleeding based on the BARC 2, 3, or 5
criteria or major vascular complications within 30 days. The trial is
designed to have 80% power and a 2-sided alpha level of 5% to detect a 50%
relative risk reduction for the primary outcome based on a control event
rate of 14%. <br/>Result(s): We completed enrollment on April 29, 2022,
with 621 randomized patients. The patients had a mean age of 71 years
(25.4% female), with a high rate of comorbidities, as follows: 45% had a
prior percutaneous coronary intervention; 57% had previous coronary artery
bypass surgery; and 18% had peripheral vascular disease.
<br/>Conclusion(s): The UNIVERSAL trial will be one of the largest
randomized trials of US-guided femoral access and has the potential to
change guidelines and increase US uptake for coronary procedures
worldwide.<br/>Copyright &#xa9; 2022 The Authors

<98>
Accession Number
639503985
Title
High-Sensitivity Cardiac Troponin I and T Kinetics Differ following
Coronary Bypass Surgery: A Systematic Review and Meta-Analysis.
Source
Clinical chemistry. 68(12) (pp 1564-1575), 2022. Date of Publication: 06
Dec 2022.
Author
Denessen E.J.; Heuts S.; Daemen J.H.; van Doorn W.P.; Vroemen W.H.; Sels
J.-W.; Segers P.; Van't Hof A.W.; Maessen J.G.; Bekers O.; Van Der Horst
I.C.; Mingels A.M.
Institution
(Denessen, van Doorn, Vroemen, Bekers, Mingels) Central Diagnostic
Laboratory, Maastricht University Medical Center+, Maastricht, Netherlands
(Denessen, van Doorn, Sels, Van't Hof, Maessen, Bekers, Van Der Horst,
Mingels) Cardiovascular Research Institute Maastricht (CARIM), Maastricht
University, Maastricht, Netherlands
(Heuts, Segers, Maessen) Department of Cardiothoracic Surgery, Maastricht
University Medical Center+, Maastricht, Netherlands
(Daemen) Department of Surgery, Division of General Thoracic Surgery,
Zuyderland Medical Center, Heerlen, Netherlands
(Sels, Van Der Horst) Department of Intensive Care Medicine, Maastricht
University Medical Center+, Maastricht, Netherlands
(Sels, Van't Hof) Department of Cardiology, Maastricht University Medical
Center+, Maastricht, Netherlands
(Van't Hof) Department of Cardiology, Zuyderland Medical Center, Heerlen,
Netherlands
Publisher
NLM (Medline)
Abstract
BACKGROUND: Cardiac troponin I and T are both used for diagnosing
myocardial infarction (MI) after coronary artery bypass grafting (CABG),
also known as type 5 MI (MI-5). Different MI-5 definitions have been
formulated, using multiples of the 99th percentile upper reference limit
(10x, 35x, or 70x URL), with or without supporting evidence. These
definitions are arbitrarily chosen based on conventional assays and do not
differentiate between troponin I and T. We therefore investigated the
kinetics of high-sensitivity cardiac troponin I (hs-cTnI) and T (hs-cTnT)
following CABG. <br/>METHOD(S): A systematic search was applied to MEDLINE
and EMBASE databases including the search terms "coronary artery bypass
grafting" AND "high-sensitivity cardiac troponin." Studies reporting
hs-cTnI or hs-cTnT on at least 2 different time points were included.
Troponin concentrations were extracted and normalized to the
assay-specific URL. <br/>RESULT(S): For hs-cTnI and hs-cTnT, 17 (n = 1661
patients) and 15 studies (n = 2646 patients) were included, respectively.
Preoperative hs-cTnI was 6.1x URL (95% confidence intervals: 4.9-7.2) and
hs-cTnT 1.2x URL (0.9-1.4). Mean peak was reached 6-8 h postoperatively
(126x URL, 99-153 and 45x URL, 29-61, respectively). Subanalysis of
hs-cTnI illustrated assay-specific peak heights and kinetics, while
subanalysis of surgical strategies revealed 3-fold higher hs-cTnI than
hs-cTnT for on-pump CABG and 5-fold for off-pump CABG. <br/>CONCLUSION(S):
Postoperative hs-cTnI and hs-cTnT following CABG surpass most current
diagnostic cutoff values. hs-cTnI was almost 3-fold higher than hs-cTnT,
and appeared to be highly dependent on the assay used and surgical
strategy. There is a need for assay-specific hs-cTnI and hs-cTnT cutoff
values for accurate, timely identification of MI-5.<br/>Copyright @
American Association for Clinical Chemistry 2022.

<99>
Accession Number
639804564
Title
Effect of Acupressure on Dental Anxiety in Children: a Pilot Study for a
Randomized Clinical Trial.
Source
Journal of acupuncture and meridian studies. 15(5) (pp 307-313), 2022.
Date of Publication: 31 Oct 2022.
Author
Soares M.E.C.; Araujo A.S.; Pinto I.C.L.; Barbosa L.S.A.; Borsatto M.C.;
Galo R.
Institution
(Soares, Araujo, Pinto, Barbosa) Department of Dentistry, School of
Biological and Health Sciences, Universidade Federal dos Vales do
Jequitinhonha e Mucuri, Diamantina, Brazil
(Borsatto) Clinical Pediatric Dentistry Department, Ribeirao Preto School
of Dentistry, Universidade de Sao Paulo, Ribeirao Preto, Brazil
(Galo) Department of Dental Materials and Prosthesis, Ribeirao Preto
School of Dentistry, Universidade de Sao Paulo, Ribeirao Preto, Brazil
Publisher
NLM (Medline)
Abstract
Background: Anxiety is an important problem in children in dental clinics.
Acupressure may be a useful tool to assist in dental procedures in anxious
children. <br/>Objective(s): This pilot study was performed to examine the
effects of acupressure on dental anxiety in children undergoing
restorative procedures. <br/>Method(s): Fourteen children aged 7-10 years
and with at least one primary molar with caries on the dentine were
included in the study. The participants also needed to score at least one
point on the modified Venham Picture Test (VPTm) for the determination of
anxiety. The children were randomly allocated to two groups: group A -
non-documented points for the reduction of anxiety and induction of
relaxation; group B - documented points (EX-HN3, Shen Men of auricular
acupuncture). The anxiety scale was administered on three occasions: prior
to the application of acupressure; immediately after sitting in the dental
chair to undergo restorative treatment; and after removal of acupressure
at the end of the restorative procedure. Heart rate (HR) was measured when
each child sat in the dental chair, after the removal of carious tissue,
and after the removal of acupressure. <br/>Result(s): After the procedure,
HR (as an indicator of anxiety) was statistically significantly lower in
group B than group A (p = 0.02). However, there was no significant
difference between the groups regarding anxiety before and during the
restorative procedure (VPTm and HR: p > 0.05). <br/>Conclusion(s): The
children who received acupressure on documented points for the reduction
of anxiety had a significantly lower HR after the restorative procedure.
No significant between-group difference was found regarding anxiety
measured using a psychometric evaluation (VPTm).

<100>
Accession Number
639806273
Title
Impact of video-assisted thoracoscopic lobectomy versus open lobectomy for
lung cancer on recovery assessed using self-reported physical function:
VIOLET RCT.
Source
Health technology assessment (Winchester, England). 26(48) (pp 1-162),
2022. Date of Publication: 01 Dec 2022.
Author
Lim E.; Harris R.A.; McKeon H.E.; Batchelor T.J.; Dunning J.; Shackcloth
M.; Anikin V.; Naidu B.; Belcher E.; Loubani M.; Zamvar V.; Dabner L.;
Brush T.; Stokes E.A.; Wordsworth S.; Paramasivan S.; Realpe A.; Elliott
D.; Blazeby J.; Rogers C.A.
Institution
(Lim, Anikin) Academic Division of Thoracic Surgery, Royal Brompton and
Harefield Hospitals, London, United Kingdom
(Harris, McKeon, Dabner, Brush, Rogers) Clinical Trials and Evaluation
Unit, Bristol Trials Centre, Bristol Medical School, University of
Bristol, Bristol, United Kingdom
(Batchelor) Thoracic Surgery, University Hospitals Bristol and Weston NHS
Foundation Trust, Bristol Royal Infirmary, Bristol, United Kingdom
(Dunning) Department of Cardiothoracic Surgery, James Cook University
Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, United
Kingdom
(Shackcloth) Department of Thoracic Surgery, Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
(Naidu) Department of Thoracic Surgery, Institute of Inflammation and
Ageing, University of Birmingham, Birmingham, United Kingdom
(Belcher) Cardiothoracic Surgery, John Radcliffe Hospital, Oxford
University Hospitals NHS Foundation Trust, Oxford, United Kingdom
(Loubani) Department of Cardiothoracic Surgery, Castle Hill Hospital,
Cottingham, United Kingdom
(Zamvar) Department of Cardiothoracic Surgery, Edinburgh Royal Infirmary,
Edinburgh, United Kingdom
(Stokes, Wordsworth) Health Economics Research Centre, Nuffield Department
of Population Health, University of Oxford, Oxford, United Kingdom
(Stokes, Wordsworth) National Institute for Health and Care Research
Oxford Biomedical Research Centre, Oxford, United Kingdom
(Paramasivan, Realpe) Population Health Sciences, Bristol Medical School,
University of Bristol, Bristol, United Kingdom
(Elliott, Blazeby) National Institute for Health and Care Research Bristol
and Weston Biomedical Research Centre, Surgical Innovation Theme, Centre
for Surgical Research, Bristol Medical School, University of Bristol,
Bristol, United Kingdom
Publisher
NLM (Medline)
Abstract
BACKGROUND: Lung cancer is the leading cause of cancer death. Surgery
remains the main method of managing early-stage disease. Minimal-access
video-assisted thoracoscopic surgery results in less tissue trauma than
open surgery; however, it is not known if it improves patient outcomes.
<br/>OBJECTIVE(S): To compare the clinical effectiveness and
cost-effectiveness of video-assisted thoracoscopic surgery lobectomy with
open surgery for the treatment of lung cancer. DESIGN, SETTING AND
PARTICIPANTS: A multicentre, superiority, parallel-group, randomised
controlled trial with blinding of participants (until hospital discharge)
and outcome assessors conducted in nine NHS hospitals. Adults referred for
lung resection for known or suspected lung cancer, with disease suitable
for both surgeries, were eligible. Participants were followed up for 1
year. INTERVENTIONS: Participants were randomised 1:1 to video-assisted
thoracoscopic surgery lobectomy or open surgery. Video-assisted
thoracoscopic surgery used one to four keyhole incisions without rib
spreading. Open surgery used a single incision with rib spreading, with or
without rib resection. MAIN OUTCOME MEASURES: The primary outcome was
self-reported physical function (using the European Organisation for
Research and Treatment of Cancer Quality of Life Questionnaire Core 30) at
5 weeks. Secondary outcomes included upstaging to pathologic node stage 2
disease, time from surgery to hospital discharge, pain in the first 2
days, prolonged pain requiring analgesia at >5 weeks, adverse health
events, uptake of adjuvant treatment, overall and disease-free survival,
quality of life (Quality of Life Questionnaire Core 30, Quality of Life
Questionnaire Lung Cancer 13 and EQ-5D) at 2 and 5 weeks and 3, 6 and 12
months, and cost-effectiveness. <br/>RESULT(S): A total of 503 patients
were randomised between July 2015 and February 2019 (video-assisted
thoracoscopic surgery, n=247; open surgery, n=256). One participant
withdrew before surgery. The mean age of patients was 69 years; 249
(49.5%) patients were men and 242 (48.1%) did not have a confirmed
diagnosis. Lobectomy was performed in 453 of 502 (90.2%) participants and
complete resection was achieved in 429 of 439 (97.7%) participants.
Quality of Life Questionnaire Core 30 physical function was better in the
video-assisted thoracoscopic surgery group than in the open-surgery group
at 5 weeks (video-assisted thoracoscopic surgery, n=247; open surgery,
n=255; mean difference 4.65, 95% confidence interval 1.69 to 7.61;
p=0.0089). Upstaging from clinical node stage 0 to pathologic node stage 1
and from clinical node stage 0 or 1 to pathologic node stage 2 was similar
(p>=0.50). Pain scores were similar on day 1, but lower in the
video-assisted thoracoscopic surgery group on day 2 (mean difference
-0.54, 95% confidence interval -0.99 to -0.09; p=0.018). Analgesic
consumption was 10% lower (95% CI -20% to 1%) and the median hospital stay
was less (4 vs. 5 days, hazard ratio 1.34, 95% confidence interval 1.09,
1.65; p=0.006) in the video-assisted thoracoscopic surgery group than in
the open-surgery group. Prolonged pain was also less (relative risk 0.82,
95% confidence interval 0.72 to 0.94; p=0.003). Time to uptake of adjuvant
treatment, overall survival and progression-free survival were similar
(p>=0.28). Fewer participants in the video-assisted thoracoscopic surgery
group than in the open-surgery group experienced complications before and
after discharge from hospital (relative risk 0.74, 95% confidence interval
0.66 to 0.84; p<0.001 and relative risk 0.81, 95% confidence interval 0.66
to 1.00; p=0.053, respectively). Quality of life to 1 year was better
across several domains in the video-assisted thoracoscopic surgery group
than in the open-surgery group. The probability that video-assisted
thoracoscopic surgery is cost-effective at a willingness-to-pay threshold
of 20,000 per quality-adjusted life-year is 1. LIMITATIONS: Ethnic
minorities were under-represented compared with the UK population (<5%),
but the cohort reflected the lung cancer population. <br/>CONCLUSION(S):
Video-assisted thoracoscopic surgery lobectomy was associated with less
pain, fewer complications and better quality of life without any
compromise to oncologic outcome. Use of video-assisted thoracoscopic
surgery is highly likely to be cost-effective for the NHS. FUTURE WORK:
Evaluation of the efficacy of video-assisted thoracoscopic surgery with
robotic assistance, which is being offered in many hospitals. TRIAL
REGISTRATION: This trial is registered as ISRCTN13472721. FUNDING: This
project was funded by the National Institute for Health and Care Research
( NIHR ) Health Technology Assessment programme and will be published in
full in Health Technology Assessment; Vol. 26, No. 48. See the NIHR
Journals Library website for further project information.

<101>
Accession Number
639810176
Title
Single-blind, randomized study comparing clinical equivalence of trulene
and prolene polypropylene sutures in elective primary coronary artery
bypass graft surgery.
Source
Journal of cardiothoracic surgery. 17(1) (pp 315), 2022. Date of
Publication: 16 Dec 2022.
Author
Shetty R.S.; Kaul A.; Goyal A.; Konda G.R.; Srivastava S.; Moharana A.K.;
Deepak T.S.
Institution
(Shetty, Konda) Department of Cardio-Thoracic and Vascular Surgery, S
Ramaiah Medical College and Hospitals, Bangalore, Karnataka 560054, India
(Kaul, Goyal, Srivastava) Department of Cardio-Thoracic and Vascular
Surgery, BLK-Max Super Speciality Hospital, New Delhi 110005, India
(Moharana, Deepak) Clinical Affairs, Healthium Medtech Limited, Bangalore,
Karnataka 560064, India
Publisher
NLM (Medline)
Abstract
BACKGROUND: Coronary artery bypass graft surgery (CABG) is one of the
principle therapies for coronary artery disease, as it improves survival
rate and quality of life (QoL). Polypropylene suture is commonly used in
vascular and cardiac surgeries for anastomosis due to its long-term
tensile strength and minimal tissue trauma. This study compared the
clinical equivalence of Trulene (Healthium Medtech Limited) and Prolene
(Ethicon-Johnson & Johnson) polypropylene sutures regarding incidence of
myocardial infarction, stroke, renal failure and cardiac death (MACCE)
occurring up to 26 weeks' period post-CABG surgery. <br/>METHOD(S): This
multicenter, prospective, two-arm, parallel-group, randomized (1:1),
single-blind study (n=89) was conducted between August 2020 and September
2021. The primary endpoint, post-surgery cumulative incidence of MACCE was
evaluated. In addition, anastomotic revision, surgical site infection
(SSI), operative time, length of post-operative hospital stay, repeat
revascularization, intraoperative suture handling characteristics, time
taken to return to work and resume normal day to day activities, subject
satisfaction score and QoL, and other adverse events were also recorded.
<br/>RESULT(S): A total of 80 (89.89%) males and 9 (10.11%) females
participated in the study. No incidence of MACCE was recorded in any of
the study participants. Non-significant difference was observed in
anastomotic revision, SSI, operative time, post-operative hospital stay,
revascularization, return to work and normal day-to-day activities,
subject satisfaction score and QoL, and intraoperative handling parameters
(except ease of passage) between the treatment groups, Trulene and
Prolene. Compared to screening visit, proportion of subjects with 'no
problems' for each QoL dimension and the mean visual analogue scale
increased with each subsequent follow-up visit. <br/>CONCLUSION(S):
Trulene polypropylene suture is clinically equivalent to Prolene
polypropylene suture and is safe and effective for anastomosis
construction in CABG surgery during a routine clinical procedure. Trial
registration CTRI Registration No.: CTRI/2020/05/025157 (Registered on:
13/05/2020).<br/>Copyright &#xa9; 2022. The Author(s).

<102>
Accession Number
2020664617
Title
Dexmedetomidine for adult cardiac surgery: a systematic review,
meta-analysis and trial sequential analysis.
Source
Anaesthesia. (no pagination), 2022. Date of Publication: 2022.
Author
Poon W.H.; Ling R.R.; Yang I.X.; Luo H.; Kofidis T.; MacLaren G.; Tham C.;
Teoh K.L.K.; Ramanathan K.
Institution
(Poon, Ling, Yang) Yong Loo Lin School of Medicine, National University of
Singapore, Singapore
(Luo, Kofidis, MacLaren, Teoh, Ramanathan) Department of Cardiac, Thoracic
and Vascular Surgery, National University Hospital, Singapore
(Tham) Department of Anesthesiology, National University Hospital,
Singapore
Publisher
John Wiley and Sons Inc
Abstract
The effects of dexmedetomidine in adults undergoing cardiac surgery are
inconsistent. We conducted a systematic review and meta-analysis to
analyse the effects of peri-operative dexmedetomidine in adults undergoing
cardiac surgery. We searched MEDLINE via Pubmed, EMBASE, Scopus and
Cochrane for relevant randomised controlled trials between 1 January 1990
and 1 March 2022. We used the Joanna Briggs Institute methodology
checklist to assess study quality and the GRADE approach to certainty of
evidence. We assessed the sensitivity of results to false data. We used
random-effects meta-analyses to analyse the primary outcomes: durations of
intensive care and tracheal intubation. We included 48 trials of 6273
participants. Dexmedetomidine reduced the mean (95%CI) duration of
intensive care by 5.0 (2.2-7.7) h, p = 0.001, and tracheal intubation by
1.6 (0.6-2.7) h, p = 0.003. The relative risk (95%CI) for postoperative
delirium was 0.58 (0.43-0.78), p = 0.001; 0.76 (0.61-0.95) for atrial
fibrillation, p = 0.015; and 0.49 (0.25-0.97) for short-term mortality, p
= 0.041. Bradycardia and hypotension were not significantly affected.
Trial sequential analysis was consistent with the primary meta-analysis.
Adjustments for possible false data reduced the mean (95%CI) reduction in
duration of intensive care and tracheal intubation by dexmedetomidine to
3.6 (1.8-5.4) h and 0.8 (0.2-1.4) h, respectively. Binary adjustment for
methodological quality at a Joanna Briggs Institute score threshold of 10
did not alter the results significantly. In summary, peri-operative
dexmedetomidine reduced the durations of intensive care and tracheal
intubation and the incidence of short-term mortality after adult cardiac
surgery. The reductions in intensive care stay and tracheal intubation may
or may not be considered clinically useful, particularly after adjustment
for possible false data.<br/>Copyright &#xa9; 2022 Association of
Anaesthetists.

<103>
Accession Number
2020657805
Title
Outcomes of coronary artery bypass grafting with coronary endarterectomy:
A systematic review and meta-analysis of recent studies.
Source
Perfusion (United Kingdom). (no pagination), 2022. Date of Publication:
2022.
Author
Zhang W.; Wu H.
Institution
(Zhang, Wu) Department of Cardiothoracic Surgery, Changzhi People's
Hospital, Changzhi, China
Publisher
SAGE Publications Ltd
Abstract
Objective: The aim of this systematic review and meta-analysis was to
evaluate the short-term and long-term outcomes of coronary artery bypass
grafting (CABG) with coronary endarterectomy (CE) versus isolated CABG.
<br/>Method(s): Studies evaluating outcomes of CABG with CE (CE-CABG) were
searched from 1 January 2000 to 30 September 2022, on PubMed, Embase, and
Cochrane databases. The primary outcome was 30 -days mortality. Secondary
outcomes were postoperative myocardial infraction, low output syndrome,
cardiac arrhythmia, renal dysfunction, and 5 years survival.
<br/>Result(s): A total of 12 observational studies including 114,319
patients assessing CE-CABG (n = 35,174) versus isolated CABG (n = 79,145)
were included. Compared to isolated CABG alone, CE-CABG was significantly
associated with increased incidences of 30-days mortality (RR, 1.87; 95%
CI, 1.73-2.07; p < 0.01), postoperative myocardial infraction (RR, 1.61;
95% CI, 1.26-2.05; p < 0.01), low output syndrome (RR, 1.54; 95% CI,
1.17-2.02; p < 0.01), and renal dysfunction (RR, 1.56; 95% CI, 1.44-1.69;
p < 0.01). However, there was no difference in either rate of cardiac
arrhythmia (RR, 1.06; 95% CI, 0.97-1.15; p = 0.20) or 5 years survival
(RR, 1.05; 95% CI, 0.95-1.16; p = 0.34) between the CE-CABG group and the
control group. Subgroup analysis on CE technique showed that CE-CABG was
also associated with 30 days mortality in patients undergoing closed CE
(RR, 1.49; 95% CI, 1.09-2.03), whereas this association between CE and 30
days mortality was not observed in patients undergoing open CE (RR, 1.76;
95% CI, 0.58-5.32). <br/>Conclusion(s): Despite poor short-term outcomes,
CE-CABG appeared to offer satisfactory long-term survival in patients with
diffuse coronary artery disease.<br/>Copyright &#xa9; The Author(s) 2022.

<104>
Accession Number
2020657803
Title
A Systematic Review and Meta-Analysis of Robot-Assisted Mitral Valve
Repair.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. (no pagination), 2022. Date of Publication: 2022.
Author
Fatehi Hassanabad A.; Nagase F.N.I.; Basha A.M.; Hammal F.; Menon D.; Kent
W.D.T.; Ali I.S.; Nagendran J.; Stafinski T.
Institution
(Fatehi Hassanabad, Basha, Kent, Ali) Section of Cardiac Surgery,
Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming
School of Medicine, University of Calgary, AB, Canada
(Nagase, Menon, Stafinski) Health Technology Policy Unit (HTPU), School of
Public Health, University of Alberta, Edmonton, AB, Canada
(Hammal) School of Public Health, University of Alberta, Edmonton, AB,
Canada
(Nagendran) Division of Cardiac Surgery, Department of Surgery,
Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, AB,
Canada
Publisher
SAGE Publications Ltd
Abstract
Objective: Robot-assisted surgery is a minimally invasive approach for
repairing the mitral valve. This study aimed to assess its safety and
clinical efficacy when compared with conventional sternotomy, partial
sternotomy, and right minithoracotomy. <br/>Method(s): A systematic review
of peer-reviewed studies comparing robot-assisted mitral valve repair with
conventional sternotomy, partial sternotomy, and right minithoracotomy was
conducted following Cochrane Collaboration guidelines. Meta-analyses were
performed where possible. <br/>Result(s): The search strategy yielded 15
primary studies, of which 12 compared robot-assisted with conventional
sternotomy, 2 compared robot-assisted with partial sternotomy, and 6
compared robot-assisted with right minithoracotomy. The overall quality of
evidence was low, and there was a lack of data on long-term outcomes.
Individual studies and pooled data demonstrated that robotic procedures
were comparable to conventional sternotomy and other minimally invasive
approaches with respect to the rates of stroke, renal failure, reoperation
for bleeding, and mortality. Robot-assisted mitral valve repair was
superior to conventional sternotomy with reduced atrial fibrillation,
intensive care unit and hospital stay, pain, time to return to normal
activities, and physical functioning at 1 year. However, robot-assisted
mitral valve repair had longer cardiopulmonary, aortic cross-clamp, and
procedure times compared with all other surgical approaches.
<br/>Conclusion(s): Based on current evidence, robot-assisted mitral valve
repair is comparable to other approaches for safety and early
postoperative outcomes, despite being associated with longer operative
times. Ideally, future studies will be randomized controlled trials that
compare between robot-assisted surgery, conventional surgery, and other
minimally surgery approaches focusing on hard clinical outcomes and
patient-reported outcomes.<br/>Copyright &#xa9; The Author(s) 2022.

<105>
Accession Number
2020655150
Title
Comprehensive collection of COVID-19 related prosthetic valve failure: a
systematic review.
Source
Journal of Thrombosis and Thrombolysis. (no pagination), 2022. Date of
Publication: 2022.
Author
Trieu T.K.; Birkeland K.; Kimchi A.; Kedan I.
Institution
(Trieu) College of Medicine, California Northstate University, Elk Grove,
CA, United States
(Birkeland) Enterprise Data Intelligence, Cedars-Sinai Medical Center, Los
Angeles, CA, United States
(Kimchi, Kedan) Smidt Heart Institute, Cedars-Sinai Hospital, 8501
Wilshire Blvd Suite 200, Beverly Hills, Los Angeles, CA, United States
Publisher
Springer
Abstract
Since the beginning of the SARS-CoV-2 (COVID-19) pandemic, correlation of
venous thromboembolism (VTE) and COVID-19 infection has been well
established. Increased inflammatory response in the setting of COVID-19
infection is associated with VTE and hypercoagulability. Venous and
arterial thrombotic events in COVID-19 infection have been well
documented; however, few cases have been reported involving cardiac valve
prostheses. In this review, we present a total of eight cases involving
COVID-19-related prosthetic valve thrombosis (PVT), as identified in a
systematic review. These eight cases describe valve position (mitral
versus aortic) and prosthesis type (bioprosthetic versus mechanical), and
all cases demonstrate incidents of PVT associated with simultaneous or
recent COVID-19 infection. None of these eight cases display obvious
non-adherence to anticoagulation; five of the cases occurred greater than
three years after the most recent valve replacement. Our review offers
insights into PVT in COVID-19 infected patients including an indication
for increased monitoring in the peri-infectious period. We explore valve
thrombosis as a mechanism for prosthetic valve failure. We describe
potential differences in antithrombotic strategies that may offer added
antithrombotic protection during COVID-19 infection. With the growing
population of valve replacement patients and recurring COVID-19 infection
surges, it is imperative to explore relationships between COVID-19 and
PVT.<br/>Copyright &#xa9; 2022, The Author(s).

<106>
Accession Number
2021132741
Title
Study Of Clinical Characteristics, Management Practices And Risk Factor
Control In Stable Cad Patients: A Tertiary Care Hospital-Based
Observational Study.
Source
Indian Heart Journal. Conference: CSICON 2022. Las Vegas United States.
74(Supplement 1) (pp S3), 2022. Date of Publication: November 2022.
Author
Negi P.; Nijhawan R.
Publisher
Elsevier B.V.
Abstract
Introduction: Atherosclerotic coronary artery disease (CAD) is the major
cause of cardiovascular disease (CVD) globally. It is the result of
complex interaction of traditional acquired risk factors in genetically
susceptible individuals. The acquired risk factors are related to health
risk behavior; consumption of tobacco, non-consumption of required
quantity of vegetables, fruits, physical inactivity and resultant cardio
metabolic risk factors; diabetes, hypertension and dyslipidemia. The
mortality due to coronary heart disease has declined by about 50% due to
evidenced based management of acute coronary syndrome and effective
implementation of evidence based primary and secondary prevention in
developed countries. There are limited data about clinical
characteristics, use of evidence based risk management in patients with
CAD from India. <br/>Aim(s): To report demographic, risk factors, clinical
characterestics and treatment practices at tertiary care centre in
patients with established CAD from northern state of India.
<br/>Material(s) and Method(s): A total of 3369 consecutive patients with
established CAD visiting outpatient clinic and or admitted inpatient of
Tertiary care hospital were enrolled after obtaining informed consent.
This was a single centre hospital based prospective registry study and
patients were enrolled from March 2018 till March 2022. The patients were
diagnosed to have established CAD if had history of document myocardial
infarction, Percutaneous Coronary Intervention (PCI), Coronary Artery
Bypass surgery (CABG), and or angiography proven CAD with luminal
obstruction of any one or more of epicardial coronary arteries >=50%. Data
of self-reported socio-demographic, CV risk factors, the practice of
health behaviour, history of typical angina, breathlessness and their New
York Heart Association Functional (NYHA) class, history of symptoms of
peripheral vascular disease, cerebrovascular accident (CVA), use of
evidence-based drugs were recorded as per structured data recording format
after obtaining informed consent. <br/>Result(s): The study population of
SCAD from the hill state of the northern India is characterized by the
middle-aged population with male preponderance affecting rural population
predominantly. The large proportion of the SCAD patient population had a
past history of myocardial infarction (MI). One-fourth of the SCAD
patients had symptoms of angina while about 40% had effort intolerance of
varied class. About half of the population had LV systolic dysfunction and
single-vessel disease. The large proportion of the patients had undergone
coronary angiography in the past. One-third of patients had undergone PCI
based revascularization in the past while only 5% had undergone CABG.
Obesity, hypertension, diabetes, and tobacco consumption were the common
risk factors. The holter based evaluation for spontaneous ventricular
arrhythmias was very low in high-risk SCAD population. The use of evidence
based disease-modifying drugs; antiplatelets, statins were reported in
majority of patients while B Blockers and RAAS inhibitors were used in
more than 80% patients. Adherence to medications was almost 100%.
<br/>Conclusion(s): Clinicians advising lifestyle preventive management
strategies are ideal and use of evidence-based medicine is optimal. But
there is underutilization of diagnostic testing especially for evaluation
for risk of SCD. There is a considerable scope of taking initiatives to
improve the practices of risk stratification, control of risk factors.
What is known: Studies indicate that the Indians are more susceptible to
CAD and manifest higher mortality rate than their western counterparts.
Large datasets are available from randomized trials in stable CAD.
However, although these are the gold standard to evaluate new therapies,
they are generally performed in highly selected populations that often do
not reflect patients encountered in daily practice in terms of their
clinical characteristics, comorbidities, socioeconomic status, management,
and outcomes. How this study adds to literature: This is a contemporary
prospective observational registry based study done in Northern Indian
which included established CAD patients. This study provides demographic,
risk factors, clinical characteristics and treatment practices at tertiary
care center. Keywords: Stable angina, coronary artery disease, treatment
practices, risk factor, India.<br/>Copyright &#xa9; 2022

<107>
Accession Number
2021840185
Title
Outcomes of isolated tricuspid valve replacement: a systematic review and
meta-analysis of 5,316 patients from 35 studies.
Source
EuroIntervention. 18(10) (pp 840-851), 2022. Date of Publication: November
2022.
Author
Scotti A.; Sturla M.; Granada J.F.; Kodali S.K.; Coisne A.; Mangieri A.;
Godino C.; Ho E.; Goldberg Y.; Chau M.; Jorde U.P.; Garcia M.J.; Maisano
F.; Bapat V.N.; Ailawadi G.; Latib A.
Institution
(Scotti, Sturla, Granada, Coisne, Ho, Goldberg, Chau, Jorde, Garcia,
Latib) Montefiore-Einstein Center for Heart and Vascular Care, Montefiore
Medical Center, Albert Einstein College of Medicine, Bronx, NY, United
States
(Scotti, Granada, Coisne) Cardiovascular Research Foundation, New York,
NY, United States
(Kodali) Division of Cardiology, New York-Presbyterian Hospital, Columbia
University Irving Medical Center, New York, NY, United States
(Mangieri) Department of Biomedical Sciences, Humanitas University, Pieve
Emanuele, Italy
(Mangieri) Cardio Center, Humanitas Research Hospital IRCCS, Rozzano,
Italy
(Godino, Maisano) Cardio-Thoracic-Vascular Department, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Bapat) Minneapolis Heart Institute, Abbott Northwestern Hospital,
Minneapolis, MN, United States
(Ailawadi) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, MI, United States
Publisher
Europa Group
Abstract
Background: Transcatheter tricuspid valve replacement (TTVR) is rapidly
emerging as a therapeutic option amongst patients with secondary tricuspid
regurgitation. Historical data from surgical tricuspid valve replacement
(TVR) studies may serve as a benchmark for the development of TTVR trials.
<br/>Aim(s): The aim of the study was to investigate the early and late
outcomes following isolated surgical TVR. <br/>Method(s): Multiple
electronic databases were searched to identify studies on isolated
surgical TVR. The prespecified primary endpoint was operative mortality;
secondary endpoints were early and late outcomes. Overall estimates of
proportions and incidence rates with 95% confidence intervals (CI) were
calculated using random-effects models. Multiple sensitivity analyses
accounting for baseline characteristics, country and the operative period
were applied. <br/>Result(s): A total of 35 studies (5,316 patients) were
included in this meta-analysis. The operative period ranged from 1974 to
2019. The overall rate of operative mortality was 12% (95% CI: 9-15), with
higher mortality for patients who were operated on before 1995, who had
prior cardiac surgeries, or who had liver disease. The most frequent
clinical events were pacemaker implantation (10% [95% CI: 6-16]), bleeding
(12% [95% CI: 8-17]), acute kidney injury (15% [95% CI: 9-24]) and
respiratory complications (15% [95% CI: 12-20]). At follow-up analysis of
the bioprosthetic TVR, there was an incidence rate per 100 person-years of
6 (95% CI: 2-13) for death and 8 (95% CI: 5-13) for recurrence of
significant tricuspid regurgitation. <br/>Conclusion(s): This
meta-analysis provides an overview of the historical clinical outcomes
following isolated surgical TVR. These findings can support the
development of future clinical trials in the tricuspid space by providing
thresholds for clinical outcomes.<br/>Copyright &#xa9; Europa Digital &
Publishing 2022. All rights reserved.

<108>
Accession Number
2021842140
Title
Comparative efficacy of quadratus lumborum type-II and erector spinae
plane block in patients undergoing caesarean section under spinal
anaesthesia: a randomised controlled trial.
Source
International Journal of Obstetric Anesthesia. (no pagination), 2022.
Article Number: 103614. Date of Publication: 2022.
Author
Priya T.K.; Singla D.; Talawar P.; Sharma R.S.; Goyal S.; Purohit G.
Institution
(Priya, Singla, Talawar, Sharma, Goyal, Purohit) Department of
Anaesthesiology, AIIMS, Uttarakhand, Rishikesh, India
Publisher
Churchill Livingstone
Abstract
Background: Quadratus lumborum and erector spinae plane blocks have been
used to provide analgesia in patients undergoing thoracic or abdominal
surgeries. Our study compared the analgesic efficacy of the quadratus
lumborum type-II block (QLB-II) and the erector spinae plane block (ESPB)
in parturients who underwent caesarean section under spinal anaesthesia.
<br/>Method(s): Fifty-two patients with comparable demographic profiles
were randomised into two groups, QLB-II (n = 26) and ESPB (n = 26). After
the surgery, patients received either ultrasound-guided QLB-II or ESPB
using 0.25% bupivacaine 0.3 mL/kg. Comparison of analgesic efficacy was in
terms of fentanyl consumption (primary outcome), pain scores, incidence of
complications in the 24-h postoperative period, and quality of recovery
(QoR-15) on postoperative days one and two, and day of discharge.
<br/>Result(s): There was no significant difference in cumulative number
of fentanyl doses (W = 349.000, P = 0.840), numerical rating score at rest
(P = 0.648) or with movement (P = 0.520), QoR-15 scores on postoperative
day one (P = 0.549), day two (P = 0.927) or day of discharge (P = 0.676).
<br/>Conclusion(s): We concluded that patients who underwent QLB-II or
ESPB reported similar analgesic efficacy, complications, and quality of
recovery in the postoperative period.<br/>Copyright &#xa9; 2022 Elsevier
Ltd

<109>
Accession Number
2021591676
Title
Outcomes of cardiac arrest with valve surgery among infective endocarditis
patients: A United States National cohort study.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2022. Date of
Publication: 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, Uddin, Shanah, Hussain) Internal Medicine, Wayne State University,
Detroit, MI, United States
(Mir, Parajuli) Internal Medicine, Baptist Health System, Montgomery, AL,
United States
(Hussain) Critical Care Medicine, Summa Health System, Akron, OH, 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, and Life Sciences, OH, United States
Publisher
Elsevier Inc.
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. <br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9; 2022
Elsevier Inc.

<110>
Accession Number
639819276
Title
The effect of applying telehealth education to home care of infants after
congenital heart disease surgery.
Source
International journal for quality in health care : journal of the
International Society for Quality in Health Care. (no pagination), 2022.
Date of Publication: 20 Dec 2022.
Author
Zhang Q.-L.; Lin S.-H.; Lin W.-H.; Chen Q.; Cao H.
Institution
(Zhang, Lin, Lin, Chen, Cao) Department of Cardiac Surgery, Fujian
Children's Hospital (Fujian Branch of Shanghai Children's Medical Center),
College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics,
Fujian Medical University, Fuzhou, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: The purpose of this study was to investigate the effect of
applying telehealth education to home care of infants after congenital
heart disease surgery. <br/>METHOD(S): A prospective randomized controlled
study was conducted from July 2020 to February 2021 in our hospital to
compare the home care condition of infants after congenital heart disease
surgery between intervention group and control group. <br/>RESULT(S): At 3
months after discharge, parents' caring ability and congenital heart
disease knowledge in the intervention group were significantly better than
those in the control group, and were significantly improved compared with
those at discharge time (P<0.05). The parental care burden in the
intervention group was significantly lower than that in the control group,
and was significantly lower than that at discharge time (P<0.05). During
the follow-up period, the rate of loss of follow-up and complications in
the intervention group were significantly lower than those in the control
group (P<0.05). <br/>CONCLUSION(S): Telehealth education via WeChat can
effectively improve the knowledge of disease and home care ability of
parents of infants after CHD surgery and reduce their home care burden,
which can effectively reduce the incidence of complications and lost to
follow-up rate after discharge.<br/>Copyright &#xa9; The Author(s) 2022.
Published by Oxford University Press on behalf of International Society
for Quality in Health Care. All rights reserved. For permissions, please
e-mail: journals.permissions@oup.com.

<111>
Accession Number
639819274
Title
Role of supplemental regional blocks on postoperative neurocognitive
dysfunction after major non-cardiac surgeries: a systematic review and
meta-analysis of randomized controlled trials.
Source
Regional anesthesia and pain medicine. (no pagination), 2022. Date of
Publication: 19 Dec 2022.
Author
Singh N.P.; Makkar J.K.; Borle A.; Singh P.M.
Institution
(Singh) Department of Anesthesiology, Maharishi Markandeshwar Institute of
Medical Sciences and Research, Ambala, Haryana, India
(Makkar) Department of Anaesthesia and Intensive care, Post Graduate
Institute of Medical Education and Research, Chandigarh, India
(Borle, Singh) Department of Anesthesiology, Washington University in St
Louis School of Medicine, St Louis, MO, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND/IMPORTANCE: Postoperative neurocognitive dysfunction (PNCD) is
a frequent and preventable complication after surgery. The large
high-quality evidence for the efficacy of supplemental regional analgesia
blocks (RAB) for preventing PNCD is still elusive. <br/>OBJECTIVE(S): The
objective of this meta-analysis was to evaluate the effect of RAB versus
standard anesthesia care on the incidence of PNCD in adult patients
undergoing major non-cardiac surgery. EVIDENCE REVIEW: PubMed, EMBASE,
Scopus, and the Cochrane Central Registers of Controlled Trials (CENTRAL)
were searched for randomized controlled trials (RCTs) from 2017 until June
2022. The primary outcome was the incidence of PNCD within 1month of
surgery. A random-effects model with an inverse variance method was used
to pool results, and OR and mean differences were calculated for
dichotomous and continuous outcomes. Various exploratory subgroup analyses
were performed to explore the possibility of the association between the
various patient, technique, and surgery-related factors. Grading of
Recommendation, Assessment, Development, and Evaluation guidelines were
used to determine the certainty of evidence. FINDINGS: Twenty-six RCTs
comprizing 4414 patients were included. The RAB group was associated with
a significant reduction in the incidence of PNCD with an OR of 0.46 (95%
CI 0.35 to 0.59; p<0.00001; I2=28%) compared with the control group
(moderate certainty). Subgroup analysis exhibited that the prophylactic
efficacy of RAB persisted for both delirium and delayed neurocognitive
recovery. <br/>CONCLUSION(S): Current evidence suggests that supplemental
RAB are beneficial in preventing PNCD in patients after major non-cardiac
surgery. PROSPERO REGISTRATION NUMBER: CRD42022338820.<br/>Copyright
&#xa9; American Society of Regional Anesthesia & Pain Medicine 2022. No
commercial re-use. See rights and permissions. Published by BMJ.

<112>
Accession Number
639818497
Title
Long-term survival in coronary artery bypass grafting surgery depending on
the second conduit used.
Source
Trends in cardiovascular medicine. (no pagination), 2022. Date of
Publication: 16 Dec 2022.
Author
Nezic D.
Institution
(Nezic) "Dedinje" Cardiovascular Institute, Belgrade, Serbia
Publisher
NLM (Medline)
Abstract
There is still debate whether radial artery (RA) conduits are better
grafts then saphenous vein grafts (SVG) as a second conduit in coronary
artery bypass grafting (CABG) surgery. Although it has been confirmed that
RA grafts have significantly better patency over years, only some
observational studies have associated RA use with reduced all-cause
mortality. So far, no randomized controlled trial (CRT) has confirmed
significantly better survival for RA graft recipients versus SVG
recipients. Therefore, we have to wait for the results of the ongoing ROMA
(CRT) study, to draw relevant conclusions about the impact of the second
graft on long-term survival in patients undergoing CABG
surgery.<br/>Copyright &#xa9; 2022. Published by Elsevier Inc.

<113>
Accession Number
639812441
Title
Assessment of Repeat Revascularization in Percutaneous Coronary
Intervention Randomized Controlled Trials as a Surrogate for Mortality:A
Meta-Regression Analysis.
Source
Current problems in cardiology. (pp 101555), 2022. Date of Publication:
15 Dec 2022.
Author
Khan S.U.; Lone A.N.; Akbar U.A.; Arshad H.B.; Arshad A.; Arora S.;
Kaluski E.; Aoun J.; Goel S.S.; Shah A.R.; Kleiman N.S.
Institution
(Khan, Arshad, Aoun, Goel, Shah, Kleiman) Department of Cardiology,
Houston Methodist DeBakey Heart & Vascular Center, Houston TX
(Lone, Kaluski) Guthrie Health System/Robert Packer Hospital, Sayre, PA,
United States
(Akbar) Division of infectious disease, University of Louisville,
Louisville, KY, United States
(Arshad) Department of Medical Oncology, Ohio State University
Comprehensive Cancer Care Center, Columbus, OH, United States
(Arora) Department of Cardiology, Case Western Reserve University,
Cleveland, OH, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: The association of repeat revascularization after percutaneous
coronary intervention (PCI) with mortality is uncertain.
<br/>OBJECTIVE(S): To assess the association of repeat revascularization
after PCI with mortality in patients with coronary artery disease (CAD).
<br/>METHOD(S): We identified randomized controlled trials comparing PCI
with coronary artery bypass graft (CABG) or optimal medical therapy (OMT)
using electronic databases through January 1, 2022. We performed a
random-effects meta-regression between repeat revascularization rates
after PCI (absolute risk difference [%] between PCI and CABG or OMT) with
the relative risks (RR) of mortality. We assessed surrogacy of repeat
revascularization for mortality using the coefficient of determination
(R2), with threshold of 0.80. <br/>RESULT(S): In 33 trials (21,735
patients), at median follow-up of 4 (2-7) years, repeat revascularization
was higher after PCI than CABG [RR: 2.45 (95% confidence interval,
1.99-3.03)], but lower vs. OMT [RR: 0.64 (0.46-0.88)]. Overall,
meta-regression showed that repeat revascularization rates after PCI had
no significant association with all-cause [RR: 1.01 (0.99-1.02); R2=0.10)
or cardiovascular mortality [RR: 1.01 (CI: 0.99-1.03); R2=0.09]. In PCI
vs. CABG (R2=0.0) or PCI vs. OMT trials (R2=0.28), repeat
revascularization did not meet the threshold for surrogacy for all-cause
or cardiovascular mortality (R2=0.0). We observed concordant results for
subgroup analyses (enrollment time, follow-up, sample size, risk of bias,
stent types, and coronary artery disease), and multivariable analysis
adjusted for demographics, comorbidities, risk of bias, MI, and follow-up
duration. <br/>CONCLUSION(S): This meta-regression did not establish
repeat revascularization after PCI as a surrogate for all-cause or
cardiovascular mortality.<br/>Copyright &#xa9; 2022. Published by Elsevier
Inc.

<114>
Accession Number
639811438
Title
A Randomized Trial of an Exclusive Human Milk Diet in Neonates with Single
Ventricle Physiology.
Source
The Journal of pediatrics. (no pagination), 2022. Date of Publication: 14
Dec 2022.
Author
Blanco C.; Hair A.; Justice L.B.; Roddy D.; Bonagurio K.; Williams P.K.;
Machado D.; Marino B.S.; Chi A.; Takao C.; Gordon E.; Ashrafi A.; Cacho
N.; Pruetz J.D.; Costello J.M.; Cooper D.S.
Institution
(Blanco, Bonagurio) University of Texas Health Science Center
(Hair, Roddy) Texas Children's Hospital, Baylor College of Medicine
(Justice, Cooper) Heart Institute, Cincinnati Children's Hospital Medical
Center, Cincinnati, OH, United States
(Williams) Oklahoma University
(Machado, Cacho) University of Florida
(Marino) Ann & Robert H. Lurie Children's Hospital of Chicago
(Chi) Cook Children's Medical Center
(Takao, Pruetz) Children's Hospital of Los Angeles; University of Southern
California
(Gordon) UT Southwestern Medical Center
(Ashrafi) Children's Hospital of Orange County
(Costello) Ann & Robert H. Lurie Children's Hospital of Chicago; Shawn
Jenkins Children's Hospital, Medical University of South Carolina
Publisher
NLM (Medline)
Abstract
OBJECTIVE: To determine whether weight gain velocity (g/kg/day) 30 days
after initiation of feeds following cardiac surgery and other clinical
outcomes improve in infants with single ventricle physiology fed an
exclusive human milk diet compared with a mixed human and bovine diet.
STUDY DESIGN: In this multicenter, randomized, single blinded, controlled
trial, term neonates <=7 days of age with SVP and anticipated cardiac
surgical palliation within 30 days of birth were enrolled at 10 US
centers. Both groups received human milk if fed preoperatively. During the
30 days after feeds were started postoperatively, infants in the
intervention group () received human milk fortified once enteral intake
reached 60 mL/kg/day with a human milk-based fortifier designed for term
neonates. The control group received standard fortification with formula
once enteral intake reached 100 mL/kg/day. Perioperative feeding and
parenteral nutrition study algorithms were followed. <br/>RESULT(S): 107
neonates were enrolled (EHM=55, control=52). Baseline demographics and
characteristics were similar between groups. Median weight gain velocity
at study completion was higher in EHM vs control group (25 [IQR, 11-43] vs
17 [2-26] g/day, respectively; p=0.008). Other growth measures were
similar between groups. Necrotizing enterocolitis of all Bell stages was
higher in the control group (15.4 % vs 3.6%, respectively, p=0.04).
Incidence of other major morbidities, surgical complications, length of
hospital stay, and hospital mortality were similar between groups.
<br/>CONCLUSION(S): Neonates with SVP have improved short-term growth and
decreased risk of NEC when receiving an exclusive human milk diet
following stage 1 surgical palliation.<br/>Copyright &#xa9; 2022 Elsevier
Inc. All rights reserved.

<115>
Accession Number
639810939
Title
Direct intramyocardial injection of VEGF mRNA in patients undergoing
coronary artery bypass grafting.
Source
Molecular therapy : the journal of the American Society of Gene Therapy.
(no pagination), 2022. Date of Publication: 17 Dec 2022.
Author
Anttila V.; Saraste A.; Knuuti J.; Hedman M.; Jaakkola P.; Laugwitz K.-L.;
Krane M.; Jeppsson A.; Sillanmaki S.; Rosenmeier J.; Zingmark P.; Rudvik
A.; Garkaviy P.; Watson C.; Pangalos M.N.; Chien K.R.; Fritsche-Danielson
R.; Collen A.; Gan L.-M.
Institution
(Anttila) Heart Centre, Turku University Hospital and University of Turku,
Turku, Finland
(Saraste) Heart Centre, Turku University Hospital and University of Turku,
Turku, Finland; Turku PET Centre, Turku University Hospital and University
of Turku, Turku, Finland
(Knuuti) Turku PET Centre, Turku University Hospital and University of
Turku, Turku, Finland
(Hedman) Heart Centre, Kuopio University Hospital, Kuopio, Finland;
Institute of Clinical Medicine, University of Eastern Finland, Kuopio,
Finland
(Jaakkola) Heart Centre, Kuopio University Hospital, Kuopio, Finland
(Laugwitz) First Medical Department (Cardiology, Angiology and
Pneumology), Klinikum rechts der Isar, Technical University of Munich,
Munich, Germany
(Krane) German Centre for Cardiovascular Research (DZHK), Munich Heart
Alliance, Munich, Germany; Department of Cardiovascular Surgery, German
Heart Centre Munich, Technical University of Munich, Munich, Germany;
Division of Cardiac Surgery, Yale School of Medicine, Yale University, New
Haven, CT, USA
(Jeppsson) Department of Molecular and Clinical Medicine, Institute of
Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg,
Sweden; Department of Cardiothoracic Surgery, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Sillanmaki) Department of Clinical Physiology and Nuclear Medicine,
Kuopio University Hospital, Kuopio, Finland
(Rosenmeier, Zingmark, Garkaviy, Fritsche-Danielson, Collen) Research and
Early Clinical Development, Cardiovascular, Renal and Metabolism,
BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
(Rudvik) Early Biometrics & Statistical Innovation, Data Science &
Artificial Intelligence, R&D, AstraZeneca, Gothenburg, Sweden
(Watson) Study Management Early, Cardiovascular, Renal, Metabolism,
BioPharmaceuticals R&D, AstraZeneca, Cambridge, United Kingdom
(Pangalos) BioPharmaceuticals Research and Development, AstraZeneca,
Cambridge, United Kingdom
(Chien) Department of Cell and Molecular Biology, Karolinska Institutet,
Stockholm, Sweden
(Gan) Department of Molecular and Clinical Medicine, Institute of
Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg,
Sweden; Research and Early Clinical Development, Cardiovascular, Renal and
Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden;
Department of Cardiology, Sahlgrenska University Hospital, Gothenburg,
Sweden
Publisher
NLM (Medline)
Abstract
Vascular endothelial growth factor A (VEGF-A) has therapeutic
cardiovascular effects but delivery challenges have impeded clinical
development. We report the first clinical study of naked mRNA encoding
VEGF-A (AZD8601) injected into the human heart. EPICCURE (NCT03370887) was
a randomized, double-blind study of AZD8601 in patients with left
ventricular ejection fraction (LVEF) of 30-50% undergoing elective
coronary artery bypass surgery. Thirty epicardial injections of AZD8601
(total 3 mg) or placebo in citrate-buffered saline were targeted to
ischemic but viable myocardial regions mapped using quantitative
[15O]-water positron emission tomography. Seven patients received AZD8601
and four received placebo and were followed for 6 months. There were no
deaths or treatment-related serious adverse events, and no
AZD8601-associated infections, immune reactions or arrhythmias.
Exploratory outcomes indicated potential improvement in LVEF, Kansas City
Cardiomyopathy Questionnaire scores and N-terminal pro-B-type natriuretic
peptide levels but the study is very limited in size and significant
efficacy conclusions are not possible from the data set. Naked mRNA
without lipid encapsulation may provide a safe delivery platform for
introducing genetic material to cardiac muscle, but further studies are
needed to confirm efficacy and safety in a larger patient
pool.<br/>Copyright &#xa9; 2022. Published by Elsevier Inc.