EPICORE Embase Updates: EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

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<1>
Accession Number
634470428
Title
Effectiveness of social network interventions to support cardiac
rehabilitation and secondary prevention in the management of people with
heart disease.
Source
Cochrane Database of Systematic Reviews. 2020(12) (no pagination), 2021.
Article Number: CD013820. Date of Publication: 05 Jan 2021.
Author
Purcell C.; Smillie S.; Hilton Boon M.; Simpson S.A.; Taylor R.S.
Institution
(Purcell, Smillie, Hilton Boon, Simpson) MRC/CSO Social and Public Health
Sciences Unit, University of Glasgow, Glasgow, United Kingdom
(Taylor) MRC/CSO Social and Public Health Sciences Unit & Robertson Centre
for Biostatistics, Institute of Health and Well Being, University of
Glasgow, Glasgow, United Kingdom
Publisher
John Wiley and Sons Ltd
Abstract
Objectives: This is a protocol for a Cochrane Review (intervention). The
objectives are as follows:. To assess the effectiveness of social network
and social support interventions to support cardiac rehabilitation and
secondary prevention in the management of people with heart disease. As a
secondary output of this review, and to assist in conceptualising future
research focused on social network and social support interventions, we
aim to develop a logic model theorising the relationship between social
networks or social support and heart disease outcomes. We will draw on
existing models of social support for health (e.g. Berkman 2000), as well
as established approaches to theorising and implementing behaviour change
(e.g. Michie 2011). Copyright © 2020 The Cochrane Collaboration.
Published by John Wiley & Sons, Ltd.

<2>
Accession Number
369755173
Title
Drug-Eluting Stents for Acute Coronary Syndrome: A Meta-Analysis of
Randomized Controlled Trials.
Source
PLoS ONE. 8(9) (no pagination), 2013. Article Number: e72895. Date of
Publication: 05 Sep 2013.
Author
Wang L.
Institution
(Wang) FengHe (ShangHai) Information Technology Co., Ltd, Shanghai, China
Publisher
Public Library of Science
Abstract
Background:Drug-eluting stents (DES) are increasingly used for treatment
of acute coronary syndrome (ACS). However, clinical efficacy and safety of
various types of DES is not well established in these subjects. We
therefore evaluated clinical utility of second-generation and
first-generation DES in patients with ACS by conducting a meta-analysis.
 Method(s):A search of Medline, Embase, the Cochrane databases, and
Web of Science was made. Randomized controlled trials (RCTs) which
compared second-generation DES (everolimus-eluting stents [EES] or
zotarolimus-eluting stents [ZES]) versus first-generation DES
(sirolimus-eluting stents [SES] or paclitaxe-eluting stents [PES]) in
patients with ACS and provided data on clinical efficacy or safety
endpoints were included. Pooled estimates were calculated using
random-effects model. Result(s):A total of 2,757 participants with
ACS in 6 RCTs were included. Compared with first-generation one,
second-generation DES trended to be associated with the decreased
incidence of definite or probable stent thrombosis in ACS patients (risk
ratio [RR] = 0.60, 95% confidence intervals [CI] 0.33 to 1.07, p = 0.09).
However, the rate of target lesion revascularization (TLR) significantly
increased in second-generation DES (RR = 2.08, 95%CI 1.25 to 3.47, p =
0.005). There were no significant differences in the incidence of major
adverse cardiac events (MACEs), all-cause death, cardiac death, and
recurrent myocardial infarction between the two arms (all p>0.10). The
second-generation EES showed a tendency towards lower risk of MACEs (p =
0.06) and a beneficial effect on reducing stent thrombosis episodes (p =
0.009), while the second-generation ZES presented an increased occurrence
of MACEs (p = 0.02) and TLR (p = 0.003).
 Conclusion(s):Second-generation DES, especially EES, appeared to
present a lower risk of stent thrombosis, whereas second-generation ZES
might increase the need for repeat revascularization in ACS patients.
During coronary interventional therapy, DES class should be adequately
considered in order to maximize clinical benefit of DES implantation in
these specific subjects. © 2013 Wang et al.

<3>
Accession Number
2019114543
Title
Incorporating Insulin Growth Factor-1 into Regenerative and Personalized
Medicine for Cardiovascular Disease: A Systematic Review.
Source
Current Stem Cell Research and Therapy. 18(2) (pp 202-215), 2023. Date of
Publication: February 2023.
Author
Gan Q.F.; Lim Y.T.; Foo C.N.; Yu C.W.; Woon C.K.; Cheong S.K.; Leong P.P.
Institution
(Gan, Leong) Pre-Clinical Department, Faculty of Medicine and Health
Science, UTAR Sg Long Campus, Selangor, Malaysia
(Lim) Intensive Care Unit, Assunta Hospital, Jalan Templer, Selangor,
Petaling Jaya, Malaysia
(Foo) Population Medicine De-partment, Faculty of Medicine and Health
Science, UTAR Sg Long Campus, Selangor, Malaysia
(Yu) Faculty of Allied Health Science, AIMST, Kedah, Bedong, Malaysia
(Woon) Department of Anatomy, Faculty of Medicine, Universiti Teknologi
MARA, Selangor, Sungai Buloh, Malaysia
(Cheong) Medicine Department, Faculty of Medicine and Health Sciences,
UTAR Sg Long Campus, Selangor, Malaysia
Publisher
Bentham Science Publishers
Abstract
Background: Cardiovascular disease (CVD) is one of the world's leading
causes of increased morbidity and mortality. Current interventions for
CVD, including percutaneous transluminal coronary angioplasty (PTCA) and
coronary artery bypass grafting (CABG), carry certain risks and
complications, which may also affect the patient's quality of life. It is
important to minimize those risks and complications while speeding up the
recovery. Insulin Growth Factor-1 (IGF-1) is a growth factor responsible
for cellular migration, proliferation, differentiation, and angiogenesis,
which supports cardiovascular regen-eration. Method(s): In light of
the current trend of regenerative medicine, the present review aims to
pool data relat-ing to the incorporation of IGF-1 in regenerative medicine
and provide input on the current research gaps and concerns arising on
translating this approach from benchwork into clinical settings.
 Result(s): Using the keywords IGF-1 'OR' Insulin Growth Factor 1
'AND' Mesenchymal Stem Cells 'AND' Tissue Healing from 2009 to 2020, we
identified 160 and 52 from Medline and PubMed, screen-ing out 202 articles
due to non-fulfilment of the inclusion criteria. Conclusion(s):
Incorporating IGF-1 into regenerative and personalized medicine may be
promising for treating CVD; however, the concerns include the role of
IGF-1 in inducing cancer growth and its ability to migrate to the specific
site of injury, especially for those who present with multiple pathologies
should be addressed prior to its translation from bench work into clinical
settings. Copyright © 2023 Bentham Science Publishers.

<4>
Accession Number
2022471445
Title
Comparison of glucose control by added liraglutide to only insulin
infusion in diabetic patient undergoing cardiac surgery: A preliminary
randomized-controlled trial.
Source
Annals of Cardiac Anaesthesia. 26(1) (pp 63-71), 2023. Date of
Publication: January 2023.
Author
Sindhvananda W.; Poopuangpairoj W.; Jaiprasat T.; Ongcharit P.
Institution
(Sindhvananda, Poopuangpairoj, Jaiprasat, Ongcharit) Department of
Anesthesiology, Faculty of Medicine, Chulalongkorn University, Rama Iv,
Bangkok, Thailand
(Ongcharit) Department of Surgery, Faculty of Medicine, Chulalongkorn
University, Rama Iv, Bangkok, Thailand
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Liraglutide, glucagon-like peptide-1 (GLP-1) receptor agonist,
has been investigated for safety and effectiveness for blood glucose (BG)
control in a surgical setting. However, there are only a few studies
specific to cardiac surgery patients. Aim(s): To primarily compare
perioperative 1) BG and 2) glycemic variability (GV) between added
liraglutide and only insulin infusion in diabetes mellitus (DM) patients
undergoing cardiac surgery. Setting and Design: A randomized control trial
was conducted in DM patients undergoing cardiac surgery with
cardiopulmonary bypass (CPB). Inclusion criteria were age 20-80 years and
DM Type 2. Material(s) and Method(s): The recruited patients were
randomly assigned to Group 1 (added liraglutide with insulin infusion) and
Group 2 (insulin infusion). Insulin infusion was based on institutional
protocol. Point of care testing (POCT) glucose was used for the adjustment
of insulin and BG analysis. Continuous glucose monitor (CGM) was for GV
analysis (using Standard deviation: SD). Statistics: t-test, Chi-square or
Fisher-exact test, or Mann-Whitney U test. Result(s): Finally, 60
patients were in our study (Group 1 = 32 vs Group 2 = 28). Perioperative
mean BG levels of Group 1 were significantly lower than Group 2 with a
mean difference of 15.9 mg/dL. Nine patients (18.7% vs 10.7%, P = 0.384)
had BG of 60-70 with mean BGs (109.1 vs 147.9, P = 0.001) in the morning.
Thirteen patients (9.4% vs 35.7%, P = 0.025) had BG >180 mg/dL at the 1 st
operative hour. SDs were increasing, but lower SD of Group 1 were observed
at the postoperative period. Mean of SDs at postoperative day 2 were 23.65
vs 32.79 mg/dL, P = 0.018. Conclusion(s): Liraglutide added with
insulin infusion can attenuate perioperative BG and is beneficial in the
aspect of lowering GV together with BG at the postoperative period in DM
patients. Liraglutide can be applied in cardiac surgery but a
rearrangement of time and dosage should be further
investigated. Copyright © 2023 Wolters Kluwer Medknow
Publications. All rights reserved.

<5>
Accession Number
2020154981
Title
Postoperative cardiac troponin I as an indicator of surgical outcomes: A
systematic review.
Source
Journal of Cardiac Surgery. 37(12) (pp 5351-5361), 2022. Date of
Publication: December 2022.
Author
Ahmed S.H.; Pervez N.; Rehan S.T.; Shaikh T.G.; Waseem S.
Institution
(Ahmed, Pervez, Rehan, Shaikh, Waseem) Dow University of Health Sciences,
Karachi, Pakistan
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Cardiac surgeries are generally associated with high
morbidity and mortality. To prevent any adverse outcomes, it is crucial to
identify patients at risk of developing postoperative complications and
initiate relevant therapeutic interventions. Several biomarkers are used
to determine postoperative myocardial injury but they either lack
sensitivity and specificity or are elevated for a short time. In this
systematic review, we evaluate postoperative troponin I as a predictor of
postoperative myocardial infarction, mortality, and hospital and Intensive
Care Unit stay. Method(s): This systematic review was conducted in
accordance with the Preferred Reporting Items for Systematic Review and
Meta-Analysis guidelines. A thorough literature search was conducted over
PubMed, clinicaltrials. gov, and the Cochrane library from inception till
May 24, 2022 using relevant keywords, and only articles that met the
pre-defined criteria were recruited. Result(s): Following a
comprehensive literature search, a total of 359 articles were obtained.
Following a rigid screening and full-length review, only 13 studies met
our inclusion criteria and were included. The recruited studies evaluated
data from a total of 12,483 individuals and assessed troponin I as a
predictor of at least one outcome. Conclusion(s): Troponin I has the
potential to be used as a stand-alone predictor of surgical outcomes
following coronary artery bypass grafting and valvular surgeries. However,
supplementing it with other markers and scores offers the best chance at
timely diagnosing any complications. Copyright © 2022 Wiley
Periodicals LLC.

<6>
Accession Number
2020586108
Title
Diaphragmatic Function in Cardiovascular Disease: JACC Review Topic of the
Week.
Source
Journal of the American College of Cardiology. 80(17) (pp 1647-1659),
2022. Date of Publication: 25 Oct 2022.
Author
Salah H.M.; Goldberg L.R.; Molinger J.; Felker G.M.; Applefeld W.; Rassaf
T.; Tedford R.J.; Mirro M.; Cleland J.G.F.; Fudim M.
Institution
(Salah) Department of Medicine, University of Arkansas for Medical
Sciences, Little Rock, AR, United States
(Goldberg) Perelman School of Medicine at The University of Pennsylvania,
Philadelphia, PA, United States
(Molinger, Felker, Applefeld, Fudim) Division of Cardiology, Duke
University Medical Center, Durham, NC, United States
(Felker, Fudim) Duke Clinical Research Institute, Duke University School
of Medicine, Durham, NC, United States
(Rassaf) Department of Cardiology and Vascular Medicine, West German Heart
and Vascular Center, University Hospital Essen, Essen, Hufelandstrase,
Germany
(Tedford) Division of Cardiology, Department of Medicine, Medical
University of South Carolina, Charleston, SC, United States
(Mirro) Parkview Mirro Center for Research and Innovation, Parkview
Health, Fort Wayne, IN, United States
(Mirro) Department of BioHealth Informatics, Indiana University-Purdue
University Indianapolis School of Informatics and Computing, Indianapolis,
IN, United States
(Mirro) Department of Medicine, Indiana University School of Medicine,
Indianapolis, IN, United States
(Cleland) Robertson Centre for Biostatistics, Institute of Health and
Wellbeing, University of Glasgow, Glasgow, United Kingdom
(Cleland) National Heart and Lung Institute, Imperial College, London,
United Kingdom
Publisher
Elsevier Inc.
Abstract
In addition to the diaphragm's role as the primary respiratory muscle, it
also plays an under-recognized role in cardiac function. It serves as a
pump facilitating venous and lymph return, modulating left ventricular
afterload hemodynamics and pericardial pressures, as well as regulating
autonomic tone. Heart failure (HF) is associated with diaphragmatic
changes (ie, muscle fiber atrophy and weakness, increased ratio of type I
to type II muscle fibers, and altered muscle metaboreflex) that lead to
diaphragmatic dysfunction with subsequent symptomatic manifestations of
HF. Herein, it is proposed that targeting the diaphragm in patients with
HF via inspiratory muscle training or device-based stimulation can provide
a novel treatment pathway for HF. Reviewed are several potential
mechanisms through which therapies targeting the diaphragm can be
beneficial in HF (ie, improving preload reserve, atrial and ventricular
synchrony, and metaboreflex activity; reducing pericardial restraint; and
restoring diaphragm strength). Copyright © 2022 The Authors

<7>
Accession Number
2017224048
Title
The Use of Thromboelastography in Percutaneous Coronary Intervention and
Acute Coronary Syndrome in East Asia: A Systematic Literature Review.
Source
Journal of Clinical Medicine. 11(13) (no pagination), 2022. Article
Number: 3652. Date of Publication: July-1 2022.
Author
Xu O.; Hartmann J.; Tang Y.-D.; Dias J.
Institution
(Xu, Hartmann, Dias) Department of Medical Affairs, Clinical Development
and Medical Safety, Haemonetics Corporation, Boston, MA 02110, United
States
(Tang) Department of Cardiology and Institute of Vascular Medicine, Peking
University Third Hospital, Key Laboratory of Molecular Cardiovascular
Science, Ministry of Education, Beijing 100083, China
Publisher
MDPI
Abstract
Dual antiplatelet therapy (DAPT), alongside percutaneous coronary
intervention (PCI), is central to the prevention of ischemic events
following acute coronary syndrome (ACS). However, response to therapy can
vary due to several factors including CYP2C19 gene variation, which shows
increased prevalence in East Asian populations. DAPT responsiveness can be
assessed using tech-niques such as light transmission aggregometry (LTA),
VerifyNow and thromboelastography with the PlateletMapping assay, and
there is increasing focus on the utility of platelet function testing to
guide individualized treatment. This systematic literature review of one
English and three Chinese language databases was conducted to evaluate the
evidence for the utility of thromboelastography in ACS/PCI in East Asia.
The search identified 42 articles from the English language and 71
articles from the Chinese language databases which fulfilled the
pre-determined inclusion criteria, including 38 randomized controlled
trials (RCTs). The identified studies explored the use of
thromboelastog-raphy compared to LTA and VerifyNow in monitoring patient
responsiveness to DAPT, as well as predicting ischemic risk, with some
studies suggesting that thromboelastography is better able to detect low
DAPT response than LTA. Other studies, including one large RCT, described
the use of thromboelastography in guiding the escalation of DAPT, with
some evidence suggesting that such protocols reduce ischemic events
without increasing the risk of bleeding. There was also evidence
suggesting that thromboelastography can be used to identify individuals
with DAPT hyporespon-siveness genotypes and could potentially guide
treatment by adjusting therapy in patients depending on
responsiveness. Copyright © 2022 by the authors. Licensee MDPI,
Basel, Switzerland.

<8>
Accession Number
2018846168
Title
Renal outcomes in valve-in-valve transcatheter versus redo surgical aortic
valve replacement: A systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. 37(11) (pp 3743-3753), 2022. Date of
Publication: November 2022.
Author
Arjomandi Rad A.; Naruka V.; Vardanyan R.; Salmasi M.Y.; Tasoudis P.T.;
Kendall S.; Casula R.; Athanasiou T.
Institution
(Arjomandi Rad, Vardanyan) Department of Medicine, Imperial College
London, Faculty of Medicine, London, United Kingdom
(Naruka, Casula, Athanasiou) Department of Cardiothoracic Surgery,
Imperial College NHS Trust, Hammersmith Hospital, London, United Kingdom
(Salmasi, Athanasiou) Department of Surgery and Cancer, Imperial College
London, London, United Kingdom
(Tasoudis) Department of Cardiothoracic Surgery, University of Thessaly,
Biopolis, Larissa, Greece
(Kendall) Department of Cardiothoracic Surgery, James Cook University
Hospital, Middlesborough, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Postoperative acute kidney injury (AKI) and the requirement
for renal replacement therapy (RRT) remain common and significant
complications of both transcatheter valve-in-valve aortic valve
replacement (ViV-TAVR) and redo surgical aortic valve replacement (SAVR).
Nevertheless, the understanding of renal outcomes in the population
undergoing either redo SAVR or ViV-TAVR remains controversial.
 Method(s): A systematic database search with meta-analysis was
conducted of comparative original articles of ViV-TAVR versus redo SAVR in
EMBASE, MEDLINE, Cochrane database, and Google Scholar, from inception to
September 2021. Primary outcomes were AKI and RRT. Secondary outcomes were
stroke, major bleeding, pacemaker implantation rate, operative mortality,
and 30-day mortality. Result(s): Our search yielded 5435 relevant
studies. Eighteen studies met the inclusion criteria with a total of
11,198 patients. We found ViV-TAVR to be associated with lower rates of
AKI, postoperative RRT, major bleeding, pacemaker implantation, operative
mortality, and 30-day mortality. No significant difference was observed in
terms of stroke rate. The mean incidence of AKI in ViV-TAVR was 6.95%
(+/-6%) and in redo SAVR was 15.2% (+/-9.6%). For RRT, our data showed
that VIV-TAVR to be 1.48% (+/-1.46%) and redo SAVR to be 8.54% (+/-8.06%).
 Conclusion(s): Renoprotective strategies should be put into place to
prevent and reduce AKI incidence regardless of the treatment modality.
Patients undergoing re-intervention for the aortic valve constitute a
high-risk and frail population in which ViV-TAVR demonstrated it might be
a feasible option for carefully selected patients. Long-term follow-up
data and randomized control trials will be needed to evaluate mortality
and morbidity outcomes between these 2 treatments. Copyright ©
2022 The Authors. Journal of Cardiac Surgery published by Wiley
Periodicals LLC.

<9>
Accession Number
2018735532
Title
A survey of cardiac surgeons to evaluate the use of sutureless aortic
valve replacement in Canada.
Source
Journal of Cardiac Surgery. 37(11) (pp 3543-3549), 2022. Date of
Publication: November 2022.
Author
Makhdoum A.; Kim K.; Koziarz A.; Reza S.; Alsagheir A.; Pandey A.; Teoh
K.; Alhazzani W.; Lamy A.; Yanagawa B.; Belley-Cote E.P.; Whitlock R.
Institution
(Makhdoum, Kim, Reza, Alsagheir, Alhazzani, Lamy, Belley-Cote, Whitlock)
Population Research Health Institute, McMaster University, Hamilton,
Canada
(Makhdoum, Yanagawa) Division of Cardiac Surgery, St. Michael's Hospital,
University of Toronto, Toronto, Canada
(Kim) Department of Health Research Methodology, Evidence, and Impact,
McMaster University, Hamilton, ON, Canada
(Koziarz) Faculty of Medicine, University of Toronto, Toronto, ON, Canada
(Pandey) Department of Medicine, McMaster University, Hamilton, ON, Canada
(Teoh) Southlake Regional Health Sciences Centre, Newmarket, ON, Canada
(Alhazzani, Belley-Cote) Division of Critical Care, Department of
Medicine, McMaster University, Hamilton, ON, Canada
(Whitlock) Division of Cardiac Surgery, Department of Surgery, McMaster
University, Hamilton, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: Sutureless aortic valve replacement (SuAVR) is gaining
popularity for the treatment of aortic stenosis. We aimed to describe
Canadian cardiac surgeons' practice patterns and perceptions regarding
SuAVR. Method(s): Content experts (clinicians and methodologists)
developed the survey. Domains in the questionnaire include: respondent
characteristics, factors influencing the decision to implant a SuAVR,
barriers to SuAVR use, and interest in participating in a trial.
 Result(s): A total of 66 cardiac surgeons (median duration of
practice: 15 years; range 8-20 years) from 18 hospitals across Canada
responded to the survey for a response rate of 84%. Surgeons reported that
the following patient characteristics increased the likelihood they would
choose SuAVR: hostile root (73%), small annular size (55%), high Society
of Thoracic Surgery risk score (42%), older age (40%), to support
minimally invasive surgery (25%) and redo-operation (23%). The following
patient characteristics made surgeons less likely to pursue SuAVR: young
age (73%), low STS score (40%), and large annular size (30%). Reported
barriers to SuAVR use included: cost (33%), permanent pacemaker risk (27%)
and uncertain durability (12%). Of respondents, 73% were interested in
participating in a randomized controlled trial comparing SuAVR with
transcatheter aortic valve replacement. Conclusion(s): The primary
reasons for surgeons selecting SuAVR were high surgical risk and
anatomical challenges. Cost is a primary factor limiting SuAVR
use. Copyright © 2022 Wiley Periodicals LLC.

<10>
Accession Number
2018722866
Title
Etiology, clinical presentation, and management of left main coronary
artery aneurysms.
Source
Journal of Cardiac Surgery. 37(11) (pp 3675-3686), 2022. Date of
Publication: November 2022.
Author
Negro F.; Gentile F.; Rizza A.; Giannoni A.; Bianchi G.; Clemente A.;
Emdin M.; Palmieri C.
Institution
(Negro, Gentile) Division of Cardiology, Pisa University Hospital, Pisa,
Italy
(Negro, Gentile, Rizza, Giannoni, Emdin, Palmieri) Division of Cardiology
and Cardiovascular Medicine, Fondazione Toscana "G. Monasterio", Pisa,
Italy
(Giannoni, Emdin) Health Science Interdisciplinary Research Center, Scuola
Superiore Sant'Anna, Pisa, Italy
(Bianchi) Division of Adult Cardiac Surgery, Fondazione Toscana "G.
Monasterio", Massa, Italy
(Clemente) Division of Radiology, Fondazione Toscana "G. Monasterio",
Pisa, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background and Aim of the Study: The widespread use of
noninvasive/invasive coronary imaging increased the probability of
recognition of coronary aneurysms. Left main coronary aneurysms (LMCA),
though rare, are potentially life-threatening but in the absence of
controlled studies, guidelines do not provide any specific recommendation
for their management. We, therefore, aimed to investigate the
epidemiology, clinical presentation, therapeutic strategies, and
prognostic implication of LMCA. Method(s): A systematic review of the
literature was performed to retrieve all the reported cases of LMCA as of
December 2021, which were summarized and classified according to their
etiology, clinical presentation, and therapeutic management.
 Result(s): Out of 1997 works retrieved, 180 studies were analyzed,
describing 209 LMCA cases (aged 51 +/- 19 years, 68% males).
Atherosclerosis was the most common etiology (40%), followed by
inflammatory (12%), congenital (9%), or degenerative (6%) conditions.
Stable angina (43%) and acute coronary syndromes (32%) were more often the
first clinical manifestations, while 29 (14%) LMCA were incidental
findings. Most cases were treated surgically (53%), while percutaneous
intervention was rarely adopted (7%). Data about antithrombotic therapies
were scarce and heterogeneous. Finally, when longitudinal data were
reported (n = 81), LMCA resulted associated with a severe prognosis, with
a 15% mortality over an 8-month median follow-up. Conclusion(s): LMCA
are most frequently, but not exclusively, caused by advanced
atherosclerosis. Irrespective of their etiology and clinical presentation,
LMCA may be associated with high short-term mortality. In absence of
controlled studies, a careful evaluation of each case is warranted to
optimize therapeutic strategies. Copyright © 2022 Wiley
Periodicals LLC.

<11>
Accession Number
2018722858
Title
Malperfusion syndrome in acute type A aortic dissection: Thinking beyond
the proximal repair.
Source
Journal of Cardiac Surgery. 37(11) (pp 3827-3834), 2022. Date of
Publication: November 2022.
Author
Bayamin K.; Power A.; Chu M.W.A.; Dubois L.; Valdis M.
Institution
(Bayamin, Chu, Valdis) Division of Cardiac Surgery, Department of Surgery,
Western University, London Health Sciences Center, London, ON, Canada
(Power, Dubois) Division of Vascular Surgery, Department of Surgery,
Western University, London Health Sciences Center, London, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background and Objective: Malperfusion syndrome (MPS) is associated with
the highest mortality and major morbidity risk in patients with acute Type
A aortic dissection (TAAD). The timing of the open proximal aortic repair
in the presence of MPS remains debatable given variability in clinical
presentation and different local treatment algorithms. This paper provides
an up to date and comprehensive overview of published outcomes and
available techniques for addressing malperfusion in the setting of acute
TAAD. Method(s): We have reviewed published data from the major
aortic dissection registries including the International Registry of Acute
Aortic Dissection, the German Registry for Acute Aortic Dissection In Type
A, and the Nordic Consortium for Acute Type A Aortic Dissection, as well
as the most up to date literature involving malperfusion in the setting of
acute TAAD. This data highlights unique strategies that have been adopted
at aortic centers internationally to address malperfusion in this setting
pre-, intra-, and postoperatively, which are summarized here and may be of
great clinical benefit to other centers treating this disease with more
traditional methods. Result(s): The review of the available data has
definitively shown an increased mortality up to 43% and morbidity in
patients presenting with MPS in the setting of acute TAAD. More
specifically, preoperative MPS has been shown to be an independent
predictor of mortality with mesenteric malperfusion associated with the
worst mortality outcomes from 70% to 100%. Addressing MPS pre or
intraoperatively is associated with significantly reduced mortality
outcomes down to 4%-13%. Conclusion(s): Adapting a dynamic and easily
accessible diagnostic method for the comprehensive assessment of different
forms of malperfusion (dynamic/static) and incorporating it within the
surgical plan is the first step toward early diagnosis and prevention of
malperfusion related complications. Copyright © 2022 Wiley
Periodicals LLC.

<12>
Accession Number
2018277105
Title
Proton pump inhibitor in the prevention of upper gastrointestinal mucosal
injury associated with dual antiplatelet therapy after coronary artery
bypass grafting (DACAB-GI-2): study protocol for a randomized controlled
trial.
Source
Trials. 23(1) (no pagination), 2022. Article Number: 569. Date of
Publication: December 2022.
Author
Zhu Y.; Wang X.; Yang Y.; Liu L.; Zhao Q.; Yu L.
Institution
(Zhu, Yang, Zhao) Department of Cardiovascular Surgery, Ruijin Hospital,
Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
(Wang, Liu, Yu) Department of Gastroenterology, Ruijin Hospital, Shanghai
Jiao Tong University School of Medicine, Shanghai 200025, China
Publisher
BioMed Central Ltd
Abstract
Background: Dual antiplatelet therapy (DAPT) is recommended in secondary
prevention after coronary artery bypass grafting (CABG), but it is
inevitably associated with the risk of bleeding, of which gastrointestinal
bleeding accounts for more than half. Proton pump inhibitors (PPIs) may
increase the risk of major cardiovascular adverse events when reducing the
risk of upper gastrointestinal bleeding. Therefore, the optimal duration
of a PPI in combination with DAPT is unclear. Method(s): The "Proton
Pump Inhibitor Preventing Upper Gastrointestinal Injury in Patients on
Dual Antiplatelet Therapy after CABG" (DACAB-GI-2) study is a prospective,
single-center, open-label, parallel, randomized controlled trial. A total
of 232 eligible subjects who are scheduled or initiated on DAPT
(clopidogrel plus aspirin or ticagrelor plus aspirin) for 12 months
immediately after CABG will be enrolled and be randomized in a 1:1 ratio
to either a 12-month pantoprazole treatment arm or a 1-month treatment
arm. The primary outcome is to assess the rate of gastroduodenal erosions
and ulcers evaluated by esophagogastroduodenoscopy (EGD) within 12 months
after randomization, based on the modified Lanza score. Secondary outcomes
include reflux esophagitis and upper gastrointestinal bleeding. Other
pre-specified outcomes include major adverse cardiovascular events, graft
failure, and all-cause death. Discussion(s): This study aims to
compare the efficacy and safety of 12 months and 1 month of pantoprazole
treatment in preventing DAPT-related upper gastrointestinal mucosal injury
after CABG. Trial registration: ClinicalTrials.gov
NCT03908593. Copyright © 2022, The Author(s).

<13>
Accession Number
2021027313
Title
Regression-based estimation of heterogeneous treatment effects when
extending inferences from a randomized trial to a target population.
Source
European Journal of Epidemiology. 38(2) (pp 123-133), 2023. Date of
Publication: February 2023.
Author
Robertson S.E.; Steingrimsson J.A.; Dahabreh I.J.
Institution
(Robertson, Dahabreh) CAUSALab, Harvard T.H. Chan School of Public Health,
Boston, MA, United States
(Robertson, Dahabreh) Department of Epidemiology, Harvard T.H. Chan School
of Public Health, Boston, MA 02115, United States
(Steingrimsson) Department of Biostatistics, Brown University School of
Public Health, Providence, RI, United States
(Dahabreh) Department of Biostatistics, Harvard T.H. Chan School of Public
Health, Boston, MA, United States
Publisher
Springer Science and Business Media B.V.
Abstract
Most work on extending (generalizing or transporting) inferences from a
randomized trial to a target population has focused on estimating average
treatment effects (i.e., averaged over the target population's covariate
distribution). Yet, in the presence of strong effect modification by
baseline covariates, the average treatment effect in the target population
may be less relevant for guiding treatment decisions. Instead, the
conditional average treatment effect (CATE) as a function of key effect
modifiers may be a more useful estimand. Recent work on estimating target
population CATEs using baseline covariate, treatment, and outcome data
from the trial and covariate data from the target population only allows
for the examination of heterogeneity over distinct subgroups. We describe
flexible pseudo-outcome regression modeling methods for estimating target
population CATEs conditional on discrete or continuous baseline covariates
when the trial is embedded in a sample from the target population (i.e.,
in nested trial designs). We construct pointwise confidence intervals for
the CATE at a specific value of the effect modifiers and uniform
confidence bands for the CATE function. Last, we illustrate the methods
using data from the Coronary Artery Surgery Study (CASS) to estimate CATEs
given history of myocardial infarction and baseline ejection fraction
value in the target population of all trial-eligible patients with stable
ischemic heart disease. Copyright © 2023, Springer Nature B.V.

<14>
Accession Number
2020664617
Title
Dexmedetomidine for adult cardiac surgery: a systematic review,
meta-analysis and trial sequential analysis.
Source
Anaesthesia. 78(3) (pp 371-380), 2023. Date of Publication: March 2023.
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. Copyright © 2022 Association of
Anaesthetists.

<15>
Accession Number
2019980943
Title
Do Patients With Non-Viable Myocardium From Ischemic Cardiomyopathy
Benefit From Revascularization? A Systematic Review And Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. 47 (pp 27-32), 2023. Date of
Publication: February 2023.
Author
Davoudi F.; Miyashita S.; Yoo T.K.; Imahira U.; Kimmelstiel C.; Huggins
G.S.; Downey B.C.
Institution
(Davoudi) Department of Medicine, Mass General Brigham-Salem Hospital, MA,
United States
(Miyashita, Kimmelstiel, Huggins, Downey) Cardiology Division, Tufts
Medical Center and Tufts University School of Medicine, MA, United States
(Yoo) Department of Medicine, MetroWest Medical Center, MA, United States
(Imahira) Inpatient Psychiatry, Tufts Medical Center, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: Myocardial viability assessment is used to select patients who
will derive the greatest benefit from revascularization. It remains
controversial whether revascularization only benefits patients with
ischemic cardiomyopathy who have viable myocardium. The objective of this
meta-analysis was to compare mortality between patients with ischemic
cardiomyopathy and non-viable myocardium who underwent revascularization
and those who underwent medical therapy alone. Method(s): The MEDLINE
database was searched using PubMed to retrieve studies published up to
December 2021. Inclusion criteria were 1. studies that evaluated the
impact of revascularization (revascularization group) versus medical
therapy alone (control group) following myocardial viability assessment;
2. patients who had coronary artery disease that was amenable to coronary
artery bypass grafting or percutaneous coronary intervention; and 3.
patients who had non-viable myocardium. The main outcome measure was
all-cause mortality. Result(s): A total of 12 studies were included,
evaluating 1363 patients with non-viable myocardium, of whom 501 patients
underwent revascularization and 862 patients received medical therapy
alone. There was a significant reduction in all-cause mortality (RR 0.76,
95 % CI: 0.62-0.93, I2 = 0) in the revascularization group
compared to the control group. There was no association between the type
of viability imaging modality and the risk of all-cause mortality
(P-interaction = 0.58). Conclusion(s): The findings of this
meta-analysis suggest a benefit from revascularization compared to medical
therapy in patients with ischemic cardiomyopathy despite the lack of
myocardial viability. Copyright © 2022 Elsevier Inc.

<16>
Accession Number
2017868182
Title
PCSK9 inhibitors safely and effectively lower LDL after heart
transplantation: a systematic review and meta-analysis.
Source
Heart Failure Reviews. 28(1) (pp 149-156), 2023. Date of Publication:
January 2023.
Author
Jennings D.L.; Sultan L.; Mingov J.; Choe J.; Latif F.; Restaino S.;
Clerkin K.; Habal M.V.; Colombo P.C.; Yuzefpulskaya M.; Sayer G.; Uriel
N.; Baker W.L.
Institution
(Jennings, Sultan, Mingov) Department of Pharmacy Practice, Long Island
University College of Pharmacy, New York, NY, United States
(Jennings, Choe) Department of Pharmacy, New York-Presbyterian Hospital,
Columbia University Medical Center, 622 W. 168th Street, New York, NY,
United States
(Latif, Restaino, Clerkin, Habal, Colombo, Yuzefpulskaya, Sayer, Uriel)
Division of Cardiology, Department of Medicine, New York-Presbyterian
Hospital, Columbia University, New York, NY, United States
(Baker) Department of Pharmacy Practice, University of Connecticut School
of Pharmacy, Storrs, CT, United States
Publisher
Springer
Abstract
Coronary allograft vasculopathy (CAV) continues to afflict a high number
of heart transplant (HT) recipients, and elevated LDL is a key risk
factor. Many patients cannot tolerate statin medications after HT;
however, data for alternative agents remains scarce. To address this key
evidence gap, we evaluated the safety and efficacy of the PCSK9i after HT
through systematic review and meta-analysis. We searched Medline, Cochrane
Central, and Scopus from the earliest date through July 15th, 2021.
Citations were included if they were a report of PCSK9i use in adults
after HT and reported an outcome of interest. Outcomes included change in
LDL cholesterol from baseline, incidence of adverse events, and evidence
of CAV. Changes from baseline and outcome incidences were pooled using
contemporary random-effects model methodologies. A total of six studies
including 97 patients were included. Over a mean follow-up of 13 months
(range 3-21), PCSK9i use lowered LDL by 82.61 mg/dL (95% CI - 119.15 to -
46.07; I2 = 82%) from baseline. Serious adverse drug reactions
were rarely reported, and none was attributable to the PCSK9i therapy.
Four studies reported stable calcineurin inhibitor levels during PCSK9i
initiation. One study reported outcomes in 33 patients with serial
coronary angiography and intravascular ultrasound, and PCSK9i were
associated with stable coronary plaque thickness and lumen area. One study
reported on immunologic safety, showing no DSA development within 1 month
of therapy. Preliminary data suggest that long-term PCSK9i therapy is
safe, significantly lowers LDL, and may attenuate CAV after HT. Additional
study on larger cohorts is warranted to confirm these
findings. Copyright © 2022, The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature.

<17>
Accession Number
2013992742
Title
Transition to heart transplantation in post-myocardial infarction
ventricular septal rupture: a systematic review.
Source
Heart Failure Reviews. 28(1) (pp 217-227), 2023. Date of Publication:
January 2023.
Author
Perez-Villa B.; Cubeddu R.J.; Brozzi N.; Sleiman J.R.; Navia J.;
Hernandez-Montfort J.
Institution
(Perez-Villa, Brozzi, Sleiman, Navia, Hernandez-Montfort) Heart, Vascular
and Thoracic Institute, Cleveland Clinic Florida, Weston, FL, United
States
(Cubeddu) Naples Heart Institute, NCH Healthcare System, Naples, FL,
United States
Publisher
Springer
Abstract
Post-myocardial infarction ventricular septal rupture (MI-VSR) remains a
dreadful complication with dismal prognosis. Surgical repair is the
primary treatment strategy, whereas the role of heart transplantation (HT)
as a primary option in MI-VSR is limited to case reports (CRs). We
performed a systematic review of CRs to describe in-hospital mortality,
and survival at 6 and 12 months in adult patients with MI-VSR treated with
HT as a primary or bailout strategy. We performed a comprehensive search
of Web of Science, PubMed, and Ovid Medline. The last search was completed
on March 10, 2020. An aggregated score based on the CARE case report
guideline was used to assess the quality of the CRs. We included CRs that
described adult patients with MI-VSR treated with HT as a primary or
bailout strategy. A total of 14 CRs between 1994 and 2015 were included,
retrieving and analyzing the characteristics of 17 patients. A total of 12
patients underwent HT, with HT being the primary strategy in 8 patients
and a bailout strategy for 4 patients following initial surgical repair,
while 5 patients died awaiting HT under mechanical circulatory support
(MCS), accounting for the total in-hospital mortality of this series
(29%). Regarding long-term outcomes, 6 patients were reported to be alive
at 6 months and 1 year after HT, while information was missing in the
remaining 6 patients. In conclusion, HT supported by the use of temporary
and durable MCS as a bridge to HT could be a feasible primary or bailout
strategy to reduce the high in-hospital mortality of patients with
MI-VSR. Copyright © 2021, The Author(s), under exclusive licence
to Springer Science+Business Media, LLC, part of Springer Nature.

<18>
Accession Number
639782098
Title
Plasma Renin Activity Increases With Cardiopulmonary Bypass and is
Associated With Vasoplegia After Cardiac Surgery.
Source
Journal of cardiothoracic and vascular anesthesia. 37(3) (pp 367-373),
2023. Date of Publication: 01 Mar 2023.
Author
Montgomery M.L.; Gross C.R.; Lin H.-M.; Ouyang Y.; Levin M.A.; Corkill
H.E.; El-Eshmawi A.; Adams D.H.; Weiner M.M.
Institution
(Montgomery, Gross, Levin, Corkill, Weiner) Department of Anesthesiology,
Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai,
New York, NY
(Lin, Ouyang) Department of Population Health Science and Policy, Icahn
School of Medicine at Mount Sinai, New York, NY
(El-Eshmawi, Adams) Department of Cardiovascular Surgery, Icahn School of
Medicine at Mount Sinai, New York, NY
Publisher
NLM (Medline)
Abstract
OBJECTIVES: To describe the trend in plasma renin activity over time in
patients undergoing cardiac surgery on cardiopulmonary bypass, and to
investigate if increased plasma renin activity is associated with
postcardiopulmonary bypass vasoplegia. DESIGN: A prospective cohort study.
SETTING: Patients were enrolled from June 2020 to May 2021 at a tertiary
cardiac surgical institution. PATIENTS: A cohort of 100 adult patients
undergoing cardiac surgery on cardiopulmonary bypass.None. MEASUREMENTS
AND MAIN RESULTS: Plasma renin activity was measured at 5 time points:
baseline, postoperatively, and at midnight on postoperative days 1, 2, and
3. Plasma renin activity and delta plasma renin activity were correlated
with the incidence of vasoplegia and clinical outcomes. The median plasma
renin activity increased approximately 3 times from baseline immediately
after cardiac surgery, remained elevated on postoperative days 0, 1, and
2, and began to downtrend on postoperative day 3. Plasma renin activity
was approximately 3 times higher at all measured time points in patients
who developed vasoplegia versus those who did not. CONCLUSION(S): In
patients undergoing cardiac surgery on cardiopulmonary bypass, plasma
renin activity increased postoperatively and remained elevated through
postoperative day 2. Additionally, patients with vasoplegic syndrome after
cardiac surgery on cardiopulmonary bypass had more robust elevations in
plasma renin activity than nonvasoplegic patients. These findings support
the need for randomized controlled trials to determine if patients
undergoing cardiac surgery with high plasma renin activity may benefit
from targeted treatment with therapies such as synthetic angiotensin
II. Copyright © 2022 Elsevier Inc. All rights reserved.

<19>
Accession Number
638071672
Title
Infective Endocarditis After Transcatheter Aortic Valve Implantation: A
Systematic Review.
Source
Cardiology in review. 31(2) (pp 93-98), 2023. Date of Publication: 01 Mar
2023.
Author
Hassanin A.; Afify H.; Zook S.; Frishman W.H.; Aronow W.S.
Institution
(Hassanin, Frishman, Aronow) From the Department of Cardiology,
Westchester Medical Center and New York Medical College, Valhalla, NY,
United States
(Afify) Department of Internal Medicine, University of Central Florida
College of Medicine, Orlando, FL, Puerto Rico
(Afify) Division of Cardiovascular Medicine, Department of Medicine,
University of Louisville School of Medicine, Louisville, KY, United States
(Zook) Houston Methodist DeBakey Heart & Vascular Center, Houston, TX,
United States
Publisher
NLM (Medline)
Abstract
Infective endocarditis (IE) after transcatheter aortic valve implantation
(TAVI) is a rare but potentially fatal event. In this systematic review,
we searched PubMed and Embase for large TAVI studies and registries to
identify the incidence, presentation, microbiology, risk factors, and
outcomes of IE in this population. After application of the selection
criteria and quality assessment, 8 studies representing 255,310 TAVR cases
and 4218 cases of IE qualified for this review. IE following TAVI is
uncommon with an incidence of 0.87 to 1.7 events per 100 person-years.
Most events occur in the first year following valve implantation.
Staphylococcus , Enterococcus , and Streptococcus species are the most
common pathogens. Risk factors include age, sex, concomitant
comorbidities, and procedural factors. Outcomes are dismal, and surgical
intervention is rare in this population. Copyright © 2022 Wolters
Kluwer Health, Inc. All rights reserved.

<20>
Accession Number
637663711
Title
Study Level Meta-Analysis of Transcatheter Aortic Valve Implantation With
the ACURATE neo Self-Expanding Transcatheter Heart Valve.
Source
Cardiology in review. 31(2) (pp 108-114), 2023. Date of Publication: 01
Mar 2023.
Author
Koliastasis L.; Doundoulakis I.; Kokkinidis D.G.; Milkas A.; Kostopoulos
G.; Drakopoulou M.; Latsios G.; Synetos A.; Benetos G.; Lampropoulos K.;
Economou F.; Tsioufis K.; Toutouzas K.
Institution
(Koliastasis, Doundoulakis, Drakopoulou, Latsios, Synetos, Benetos,
Tsioufis, Toutouzas) From the First Department of Cardiology, National and
Kapodistrian University, "Hippokration" Hospital, Athens, Greece
(Koliastasis, Milkas) Athens Naval and Veterans Hospital, Athens, Greece
(Doundoulakis, Economou) Department of Cardiology, 424 General Military
Training Hospital, Thessaloniki, Greece
(Kokkinidis) Section of Cardiovascular Medicine, Yale University School of
Medicine, Yale New Haven Hospital, New Haven, CT, United States
(Kostopoulos) Department of Endocrinology, 424 General Military Training
Hospital, Thessaloniki, Greece
(Lampropoulos) Department of Cardiology, Evangelismos General Hospital,
Athens, Greece
Publisher
NLM (Medline)
Abstract
The ACURATE neo transcatheter aortic valve is a self-expanding device.
Several studies have investigated safety and efficacy, but meta-analysis
and pooled data are lacking. We aimed to provide a comprehensive
systematic review and meta-analysis on the clinical outcomes of
transcatheter aortic valve implantation with the ACURATE neo valve. A
systematic literature search for eligible records was conducted. The
primary endpoint was device success as designated by Valve Academic
Research Consortium-2 criteria. The secondary endpoints (time frame: 30
days) were all-cause mortality, stroke, myocardial infarction, need for
new permanent pacemaker, major vascular complications, major bleeding,
acute kidney injury stage II or III, and paravalvular regurgitation grade
moderate or severe (II or III). Our search yielded a total of 355 records,
20 of those (n = 5858 ACURATE neo receivers) were included in our
meta-analysis. Device success was achieved in 94.5% (95% confidence
interval [CI], 91.4-96.5%) of the patients. The 30-day all-cause mortality
incidence proportion was 1.8% (95% CI, 1.3-2.4%). New pacemaker
implantation was required in 7.7% (95% CI, 6.4-9.2%) of the patients,
stroke occurred in 1.9% (95% CI, 1.6-2.3%), myocardial infarction in 0.5%
(95% CI, 0.3-0.7%), major bleeding in 5.0% (95% CI, 3.9-6.5%), major
vascular complication in 5.6% (95% CI, 4.0-7.8%), acute kidney injury
stage >=2 in 2.5% (95% CI, 1.8-3.4%), and paravalvular leak grade
>=moderate was observed in 4.3% (95% CI, 3.0-6.2%). Balloon predilatation
and postdilatation incidence was 93.9% (95% CI, 87.0-97.3%) and 43.2% (95%
CI, 37.9-48.6%), respectively. ACURATE neo appears to be safe and
effective in our analysis with high device success incidence, low
mortality, and low new pacemaker implantations. Copyright © 2023
Wolters Kluwer Health, Inc. All rights reserved.

<21>
Accession Number
640245877
Title
Ten-year outcomes after percutaneous coronary intervention versus coronary
artery bypass grafting for multivessel or left main coronary artery
disease: a systematic review and meta-analysis.
Source
Journal of cardiothoracic surgery. 18(1) (pp 54), 2023. Date of
Publication: 02 Feb 2023.
Author
Feng S.; Li M.; Fei J.; Dong A.; Zhang W.; Fu Y.; Zhao Y.
Institution
(Feng, Li, Fei, Dong, Zhang, Fu) Department of Geriatrics, Fifth
Affiliated Hospital of Zhengzhou University, 3 Kang fu Qian Street ,Er Qi
District, Zhengzhou, Henan 450052, China
(Zhao) Department of Geriatrics, Fifth Affiliated Hospital of Zhengzhou
University, 3 Kang fu Qian Street ,Er Qi District, Zhengzhou, Henan
450052, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Short-term and long-term comparative outcomes after
percutaneous coronary intervention (PCI) and coronary artery bypass
grafting (CABG) for multivessel coronary artery (MVCA) or left main
coronary artery (LMCA) disease are highly debated. GOALS: We performed a
meta-analysis to evaluate the difference between PCI and CABG for the
treatment of patients with MVCA or LMCA in long-term follow-up.
 METHOD(S): Literatures were searched in PubMed, EMBASE and The
Cochrane Library from January 1, 2000 to January 1, 2021, including RCTs
and observational studies (OSs). The primary outcome was all-cause
mortality at 10 years follow-up, and the secondary outcomes included
cardiac mortality, repeated revascularization, myocardial infarction, and
stroke. RESULT(S): A total of 5 RCTs reporting data from 3013
participants and 4 OSs of 5608 participants were included for analysis.
There was no significant difference between PCI and CABG in all-cause
mortality (Odds Ratio (OR) 1.03 [95% confidence interval (CI) 0.89 to
1.19]), whereas PCI was associated with higher cardiac mortality (OR 0.76
[95% CI 0.65 to 0.90]) and repeated revascularization rate comparing to
CABG (OR 1.77 [95% CI 1.08 to 2.89]; I2=94.61%). The difference between
PCI and CABG in repeated revascularization in either RCTs or OSs, in
myocardial infarction in either RCTs or OSs were not significant. In OSs,
stroke rate in PCI group was lower than those in CABG, but not in RCTs.
There was a significant increase of stroke rate in CABG comparing to PCI
(OR 0.65 [95% CI 0.53 to 0.80]; I2=0.00%). No significant difference
between PCI and CABG in myocardial infarction was not observed (OR 0.92
[95% CI 0.64 to 1.31]; I2=57.84%). CONCLUSION(S): Evidence from our
study and prior studies suggested the superiority of CABG over PCI in
improving 5- but not 10-year survival among patients with MVCA. In the
contrast, there was no significant difference between CABG and PCI for
treating patients with LMCA in either 5- or 10-year survival rate. More
long-term trials are needed to better define differences of outcome
between 2 techniques. Copyright © 2023. The Author(s).

<22>
Accession Number
2021351790
Title
Association of renin-angiotensin system inhibitors use with short- and
long-term mortality in patients with aortic stenosis: A systematic review
and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2023. Article
Number: 917064. Date of Publication: 23 Jan 2023.
Author
Guan Y.; Kong X.; Zhu H.; Li H.; Zhao L.; Guo F.; Lv Q.
Institution
(Guan, Zhu, Li, Guo, Lv) Department of Cardiology, Beijing Anzhen
Hospital, Capital Medical University, Beijing, China
(Kong, Zhao) Department of General Medicine, Beijing Luhe Hospital,
Capital Medical University, Beijing, China
Publisher
Frontiers Media S.A.
Abstract
Purpose: The present study aimed to investigate the association of
renin-angiotensin system inhibitors (RASi) with short- and long-term
mortality in patients with aortic stenosis (AS). Method(s): A
systematic search was performed in PubMed, Embase, and Cochrane library
databases for relevant studies published before March 2022. Studies
meeting the inclusion criteria were included to assess the effect of RASi
on short-term (<=30 days) and long-term (>=1 year) mortality in patients
with AS. Result(s): A total of 11 studies were included in the
meta-analysis. Our results demonstrated that RASi reduced short-term
mortality (OR = 0.76, 95% CI 0.63-0.93, p = 0.008) after aortic valve
replacement (AVR). Subgroup analysis revealed that RASi was still
associated with lower short-term mortality after transcatheter aortic
valve replacement (TAVR); however, the association was relatively weak in
patients who underwent surgical aortic valve replacement (SAVR). For
long-term mortality, the pooled OR was 1.04 (95% CI 0.88-1.24, p = 0.63)
after sensitivity analysis in patients who did not undergo AVR. In
addition, our study confirmed that RASi significantly reduced long-term
mortality (OR = 0.57, 95% CI 0.44-0.74, p < 0.0001) in patients who
underwent AVR. Subgroup analysis showed that both TAVR and SAVR groups
treated with RASi had lower long-term mortality. Conclusion(s):
Renin-angiotensin system inhibitors did not change long-term mortality in
AS patients who did not undergo AVR. However, RASi reduced short- and
long-term mortality in patients who underwent AVR. Copyright ©
2023 Guan, Kong, Zhu, Li, Zhao, Guo and Lv.

<23>
Accession Number
2022552419
Title
Hemostatic effects of a dextran-based priming solution for cardiopulmonary
bypass: A secondary analysis of a randomized clinical trial.
Source
Thrombosis Research. 223 (pp 139-145), 2023. Date of Publication: March
2023.
Author
Barbu M.; Kolsrud O.; Radulovic V.; Dellgren G.; Bjork K.; Thoren A.;
Pivodic A.; Ricksten S.-E.; Jeppsson A.
Institution
(Barbu, Kolsrud, Dellgren, Jeppsson) Department of Molecular and Clinical
Medicine, Institute of Medicine, Sahlgrenska Academy, University of
Gothenburg, Gothenburg, Sweden
(Barbu) Department of Cardiology, Karlskrona Hospital, Karlskrona, Sweden
(Kolsrud, Bjork, Jeppsson) Department of Cardiothoracic Surgery,
Sahlgrenska University Hospital, Gothenburg, Sweden
(Radulovic) Department of Haematology and Coagulation Disorders,
Sahlgrenska University Hospital, Gothenburg, Sweden
(Dellgren) Transplant Institute, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Thoren, Ricksten) Department of Cardiothoracic Anesthesiology and
Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden
(Pivodic) APNC Sweden, Gothenburg, Sweden
(Pivodic) Department of Clinical Neuroscience, Institute of Neuroscience
and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg,
Sweden
Publisher
Elsevier Ltd
Abstract
Introduction: Intravascular fluids administered to patients may influence
hemostasis. In patients undergoing cardiac surgery with cardiopulmonary
bypass, the heart-lung machine is primed with 1300 ml of fluid. We
assessed postoperative coagulation and platelet function in patients
randomized to two different priming solutions, one colloid-based (dextran
40) and one crystalloid-based. Material(s) and Method(s): Eighty-four
elective cardiac surgery patients were randomized to either a
dextran-based prime or Ringer's acetate with added mannitol. Blood samples
were collected before, and 2 and 24 h after cardiopulmonary bypass.
Coagulation was assessed by standard coagulation tests and rotational
thromboelastometry. Platelet function was assessed with impedance
aggregometry. Bleeding volumes and transfusion requirements were recorded.
 Result(s): Comparing the groups 2 h after bypass, the dextran group
showed lower hemoglobin concentration, hematocrit, platelet count, and
fibrinogen concentration, and higher INR and aPTT, as well as longer clot
formation time (+41 +/- 21 % vs. +8 +/- 18 %, p < 0.001) and a larger
reduction in fibrinogen-dependent clot strength (-37 +/- 12 % vs. -7 +/-
20 %, p < 0.001). Adenosine diphosphate-dependent platelet activation was
reduced in the dextran group but not in the crystalloid group 2 h after
bypass (-14 +/- 29 % vs. -1 +/- 41 %, p = 0.041). No significant
between-group differences in hemostatic variables remained after 24 h, and
no significant differences in perioperative bleeding volumes,
re-explorations for bleeding, or transfusion rates were observed.
 Conclusion(s): Compared to a crystalloid solution, a dextran-based
prime had measurable negative impact on hemostatic variables but no
detectable increase in bleeding volume or transfusion requirements in
cardiac surgery patients. Copyright © 2023 The Authors

<24>
Accession Number
640257113
Title
Thoracic paravertebral versus interpleural catheter for post-thoracotomy
pain control in minimally invasive cardiac surgery.
Source
Asian cardiovascular & thoracic annals. (pp 2184923231154497), 2023. Date
of Publication: 05 Feb 2023.
Author
Pujara J.; Singh G.; Prajapati M.; Ninama S.; Rajesh V.S.P.; Trivedi V.;
Pandya H.
Institution
(Pujara, Singh, Prajapati, Ninama, Rajesh, Trivedi) Department of Cardiac
Anesthesia, 161213U. N. Mehta Institute of Cardiology and Research Centre,
Affiliated to B. J. Medical College Ahmedabad, Ahmedabad, Gujarat, India
(Pandya) Department of Research, 161213U. N. Mehta Institute of Cardiology
and Research Centre, Affiliated to B. J. Medical College Ahmedabad,
Ahmedabad, Gujarat, India
Publisher
NLM (Medline)
Abstract
OBJECTIVE: The aim of this study was to compare efficacy and safety of
paravertebral block (PVB) and interpleural analgesia (IPA) after minimally
invasive cardiac surgery through thoracotomy in terms of quality of
analgesia, post-operative mechanical ventilation time, intensive care unit
(ICU) and hospital length of stay (LOS) and complications. DESIGN: A
randomized, prospective study. PARTICIPANTS: A total of 50 adult patients
(18-50 years old) undergoing minimally invasive cardiac surgery via
thoracotomy. INTERVENTION: Patients were randomized for group A:
paravertebral epidural catheter (n=25), group B: interpleural catheter
(n=25). All patients were given Inj. Bupivacaine 0.125%, 8 ml and Inj.
Tramadol 100 mg as an adjuvant, total volume 10 ml. RESULT(S): After
obtaining institutional review board approval, data collected and analysed
- visual analogue score (VAS) at rest and on coughing, haemodynamic and
respiratory parameters, time to extubation, supplementary analgesia
requirement, LOS and complications. VAS was recorded at 0, 2, 3, 4, 8, 12
and 24 h post-extubation, while blood gases at-after shifting, 4, 8, 12
and 24 h. There were no significant differences in haemodynamic or
respiratory parameters, VAS at rest and on coughing, ventilation duration,
ICU and hospital LOS between two groups. The requirement of rescue
analgesia was in one patient of mini coronary artery bypass in group B,
while one patient in group A required reintubation due to respiratory
acidosis and got successfully extubated on next day morning.
 CONCLUSION(S): PVB and IPA both are safe and effective techniques for
minimally invasive cardiac surgery with thoracotomy. It allows optimal
pain control and safe ICU fast-track post-operative course.

<25>
Accession Number
2021281738
Title
Neuromarkers which can predict neurodevelopmental impairment among
children with congenital heart defects after cardiac surgery: A systematic
literature review.
Source
Developmental Neurorehabilitation. (no pagination), 2023. Date of
Publication: 2023.
Author
Chiperi L.E.; Tecar C.; Toganel R.
Institution
(Chiperi) Department of Pediatric Cardiology, Emergency Institute for
Cardiovascular Diseases and Heart Transplant, Targu Mures, Romania
(Chiperi) Doctoral School of I.O.S.U.D, George Emil Palade University of
Medicine, Pharmacy, Sciences and Technology, Targu Mures, Romania
(Tecar) Department of Neurosciences, Iuliu Hatieganu University of
Medicine and Pharmacy, Cluj-Napoca, Romania
(Toganel) Department of Pediatrics, George Emil Palade University of
Medicine, Pharmacy, Sciences and Technology, Targu Mures, Romania
Publisher
Taylor and Francis Ltd.
Abstract
The aim of this systematic literature review was to assess the data
regarding neuromarkers used to evaluate the impact of cardiovascular
surgery on neurodevelopmental pattern of children with congenital heart
defects. A systematic search was performed on PubMed and Google Scholar
databases. Out of 713 publications screened, 10 studies (471 patients) met
the inclusion criteria. The included studies were coded on several
variables: number and heterogeneity of patients (age, congenital heart
defects), exclusion of patients with conditions that predispose to
neurological impairment, neuroimaging workup pre- and post-surgery,
neurodevelopmental assessment, interventions (part of a different study),
and follow-up period. Results were reported according to PRISMA
guidelines. Findings include: neuron-specific enolase and brain-derived
neurotrophic factor are not reliable neuromarkers, for protein S100B
different results were reported, for activin A there is lack of evidence,
and glial fibrillary acidic protein could represent a reliable neuromarker
for acute brain-injury. Directions for future research are
discussed. Copyright © 2023 Taylor & Francis Group, LLC.

<26>
[Use Link to view the full text]
Accession Number
2022329898
Title
A New Era in Cardiac Rehabilitation Delivery: Research Gaps, Questions,
Strategies, and Priorities.
Source
Circulation. 147(3) (pp 254-266), 2023. Date of Publication: 17 Jan 2023.
Author
Beatty A.L.; Beckie T.M.; Dodson J.; Goldstein C.M.; Hughes J.W.; Kraus
W.E.; Martin S.S.; Olson T.P.; Pack Q.R.; Stolp H.; Thomas R.J.; Wu W.-C.;
Franklin B.A.
Institution
(Beatty) Department of Epidemiology and Biostatistics, University of
California, San Francisco, United States
(Beatty) Department of Medicine, Division of Cardiology, University of
California, San Francisco, United States
(Beckie) College of Nursing, University of South Florida, Tampa, United
States
(Beckie) College of Medicine, Division of Cardiovascular Sciences,
University of South Florida, Tampa, United States
(Dodson) Leon H. Charney Division of Cardiology, Department of Medicine,
New York University, School of Medicine, New York, United States
(Dodson) Department of Population Health, New York University, School of
Medicine, New York, United States
(Goldstein) The Weight Control and Diabetes Research Center, The Miriam
Hospital, Providence, RI, United States
(Goldstein) Department of Psychiatry and Human Behavior, The Warren Alpert
Medical School, Brown University, Providence, RI, United States
(Wu) Lifespan Cardiovascular Institute, Brown University, Providence, RI,
United States
(Hughes) Department of Psychological Sciences, Kent State University, OH,
United States
(Kraus) Department of Medicine, Division of Cardiology, Duke University,
Durham, NC, United States
(Martin) Department of Medicine, Division of Cardiology, Ciccarone Center
for the Prevention of Cardiovascular Disease, Johns Hopkins University,
School of Medicine, Baltimore, MD, United States
(Olson, Thomas) Department of Cardiovascular Medicine, Division of
Preventive Cardiology, Mayo Clinic, Rochester, MN, United States
(Pack) Department of Healthcare Delivery and Population Science,
University of Massachusetts Medical School-Baystate, Springfield, United
States
(Stolp) ASRT, Inc, Atlanta, GA, United States
(Stolp) Centers for Disease Control and Prevention, Atlanta, GA, United
States
(Wu) Division of Cardiology, Providence VA Medical Center, RI, United
States
(Franklin) William Beaumont Hospital, Royal Oak, MI, United States
(Franklin) Oakland University, William Beaumont School of Medicine,
Rochester, MI, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Cardiac rehabilitation (CR) is a guideline-recommended, multidisciplinary
program of exercise training, risk factor management, and psychosocial
counseling for people with cardiovascular disease (CVD) that is beneficial
but underused and with substantial disparities in referral, access, and
participation. The emergence of new virtual and remote delivery models has
the potential to improve access to and participation in CR and ultimately
improve outcomes for people with CVD. Although data suggest that new
delivery models for CR have safety and efficacy similar to traditional
in-person CR, questions remain regarding which participants are most
likely to benefit from these models, how and where such programs should be
delivered, and their effect on outcomes in diverse populations. In this
review, we describe important gaps in evidence, identify relevant research
questions, and propose strategies for addressing them. We highlight 4
research priorities: (1) including diverse populations in all CR research;
(2) leveraging implementation methodologies to enhance equitable delivery
of CR; (3) clarifying which populations are most likely to benefit from
virtual and remote CR; and (4) comparing traditional in-person CR with
virtual and remote CR in diverse populations using multicenter studies of
important clinical, psychosocial, and cost-effectiveness outcomes that are
relevant to patients, caregivers, providers, health systems, and payors.
By framing these important questions, we hope to advance toward a goal of
delivering high-quality CR to as many people as possible to improve
outcomes in those with CVD. Copyright © 2023 American Heart
Association, Inc.

<27>
[Use Link to view the full text]
Accession Number
2022329894
Title
Indobufen or Aspirin on Top of Clopidogrel after Coronary Drug-Eluting
Stent Implantation (OPTION): A Randomized, Open-Label, End Point-Blinded,
Noninferiority Trial.
Source
Circulation. 147(3) (pp 212-222), 2023. Date of Publication: 17 Jan 2023.
Author
Wu H.; Xu L.; Zhao X.; Zhang H.; Cheng K.; Wang X.; Chen M.; Li G.; Huang
J.; Lan J.; Wei G.; Zhang C.; Wang Y.; Qian J.; Ge J.
Institution
(Wu, Xu, Zhao, Zhang, Wang, Qian, Ge) Department of Cardiology, Zhongshan
Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases,
National Clinical Research Center for Interventional Medicine, China
(Zhang) Department of Cardiology, Taian City Central Hospital, Shandong,
China
(Cheng) Department of Cardiology, Xi'An No. 3 Hospital, Affiliated
Hospital of Northwest University, Shanxi, Xi'an, China
(Wang) Department of Cardiology, Affiliated Hospital of Jiangnan
University, Jiangsu, Wuxi, China
(Chen) Department of Cardiology, Central Hospital of Wuhan, Hubei, China
(Li) Department of Cardiology, Second Hospital of Tianjin Medical
University, China
(Huang) Department of Cardiology, First Affiliated Hospital of Guangxi
Medical University, Nanning, China
(Lan) Department of Cardiology, Dongguan Third People's Hospital,
Guangdong, China
(Wei) Department of Cardiology, Affiliated Hospital of Jining Medical
University, Shandong, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Dual antiplatelet therapy (DAPT) with aspirin as a background
therapy has become the standard care after percutaneous coronary
intervention. However, some adverse noncardiac effects limited the use of
aspirin in clinical practice. Thus, evaluation of pharmacological
alternatives to aspirin is attractive. Previous data indicated that
indobufen could lessen the unwanted side effects of aspirin while
retaining the antithrombotic efficacy, but its combination with a
P2Y12inhibitor still lacks randomized clinical trial evidence.
 Method(s): In this randomized, open-label, noninferiority trial,
patients with negative cardiac troponin undergoing coronary drug-eluting
stent implantation were randomly assigned in a 1:1 ratio to receive either
indobufen-based DAPT (indobufen 100 mg twice a day plus clopidogrel 75
mg/d for 12 months) or conventional DAPT (aspirin 100 mg/d plus
clopidogrel 75 mg/d for 12 months). The primary end point was a 1-year
composite of cardiovascular death, nonfatal myocardial infarction,
ischemic stroke, definite or probable stent thrombosis, or Bleeding
Academic Research Consortium criteria type 2, 3, or 5 bleeding. The end
points were adjudicated by an independent Clinical Event Committee.
 Result(s): Between January 11, 2018, and October 12, 2020, 4551
patients were randomized in 103 cardiovascular centers: 2258 patients to
the indobufen-based DAPT group and 2293 to the conventional DAPT group.
The primary end point occurred in 101 patients (4.47%) in the
indobufen-based DAPT group and 140 patients (6.11%) in the conventional
DAPT group (absolute difference, -1.63%; Pnoninferiority<0.001;
hazard ratio, 0.73 [95% CI, 0.56-0.94]; P=0.015). Cardiovascular death,
nonfatal myocardial infarction, ischemic stroke, and stent thrombosis were
observed in 0.13%, 0.40%, 0.80%, and 0.22% of patients in the
indobufen-based DAPT group and 0.17%, 0.44%, 0.83%, and 0.17% of patients
in the conventional DAPT group (all P>0.05). The occurrence of Bleeding
Academic Research Consortium criteria type 2, 3, or 5 bleeding events was
lower in the indobufen-based DAPT group compared with the conventional
DAPT group (2.97% versus 4.71%; hazard ratio, 0.63 [95% CI, 0.46-0.85];
P=0.002), with the main decrease in type 2 bleeding (1.68% versus 3.49%;
hazard ratio, 0.48 [95% CI, 0.33-0.70]; P<0.001). Conclusion(s): In
Chinese patients with negative cardiac troponin undergoing drug-eluting
stent implantation, indobufen plus clopidogrel DAPT compared with aspirin
plus clopidogrel DAPT significantly reduced the risk of 1-year net
clinical outcomes, which was driven mainly by a reduction in bleeding
events without an increase in ischemic events. Registration: URL:
https://www.chictr.org.cn; Unique identifier:
ChiCTR-IIR-17013505. Copyright © 2023 Lippincott Williams and
Wilkins. All rights reserved.

<28>
Accession Number
2022471443
Title
The effect of levosimendan on the right ventricular function in patients
with right ventricular dysfunction undergoing mitral valve surgery.
Source
Annals of Cardiac Anaesthesia. 26(1) (pp 50-56), 2023. Date of
Publication: January 2023.
Author
Bharathi K.S.; Pruthi G.; Dhananjaya M.; Simha P.P.
Institution
(Bharathi, Pruthi, Dhananjaya, Simha) Department of Cardiac
Anaesthesiology, Sri Jayadeva Institute of Cardiovascular Sciences and
Research, K.R.S. Road, , Karnataka, Mysore, India
(Pruthi, Dhananjaya, Simha) Department of Cardiac Anaesthesiology, Sri
Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore,
Karnataka, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Right ventricular (RV) dysfunction is an important predictor
of both immediate and long-term outcomes in valve surgeries. Levosimendan
has proven beneficial in improving RV function. Aim(s): The objective
was to study the effect of the addition of levosimendan to the
conventional treatment on RV function in patients with RV dysfunction
undergoing mitral valve (MV) surgeries. Setting and Design: Prospective
randomized double-blinded controlled study at a tertiary care institution.
 Material(s) and Method(s): Sixty adult patients aged 15-65 years,
with preoperative transthoracic echocardiography (TTE) findings of RV
dysfunction posted for elective MV surgery, were randomized into
levosimendan (L) group and placebo (P) group. Patients in the L group were
administered levosimendan at a rate of 0.1 mcg/kg/min after induction for
24 hrs, whereas patients in the P group were given multivitamin infusion
at the same rate. Both the groups received standard inotropic therapy. The
hemodynamic and echocardiographic parameters of RV function (RV size,
Inferior vena cava (IVC) diameter, RV fractional area change (RVFAC)
Tricuspid annular plane systolic excursion (TAPSE), and Systolic Pulmonary
Artery Pressure (SPAP) were compared between the groups at 6 hrs, 24 hrs,
and 7 th day postoperatively. Result(s): All hemodynamic and
echocardiographic parameters of RV function like RV size, IVC diameter,
RVFAC, TAPSE, and SPAP improved from baseline to 24 hrs in both groups.
Levosimendan caused a significant improvement in RV function compared to
the P group at 24 hrs and 7 th day postoperatively. Conclusion(s):
The present study concludes that levosimendan is a promising option in
patients with RV dysfunction undergoing MV surgeries. Copyright ©
2023 Wolters Kluwer Medknow Publications. All rights reserved.

<29>
Accession Number
2020219751
Title
Hypothermia as an Adjunctive Therapy to Percutaneous Intervention in
ST-Elevation Myocardial Infarction: A Systematic Review and Meta-Analysis
of Randomized Control Trials.
Source
Cardiovascular Revascularization Medicine. 47 (pp 8-15), 2023. Date of
Publication: February 2023.
Author
Mhanna M.; Ranabothu M.; Al-Abdouh A.; Jabri A.; Sharma V.; Beran A.;
Sajdeya O.; Barbarawi M.; Hanna E.B.
Institution
(Mhanna, Sharma, Hanna) Division of Cardiology, Department of Medicine,
University of Iowa, Iowa City, IA, United States
(Ranabothu) University of Toledo College of Medicine and Life Sciences,
Toledo, OH, United States
(Al-Abdouh) Department of Internal Medicine, University of Kentucky,
Lexington, KY, United States
(Jabri) Department of Cardiology, Case Western Reserve
University/MetroHealth Medical Center, Cleveland, OH, United States
(Beran) Department of Gastroenterology, Indiana University, Indianapolis,
IN, United States
(Sajdeya) Department of Internal Medicine, The University of Toledo,
Toledo, OH, United States
(Barbarawi) Department of Cardiology, University of Connecticut,
Farmington, CT, United States
Publisher
Elsevier Inc.
Abstract
Introduction: In the setting of acute ST-elevation myocardial infarction
(STEMI), several randomized control trials (RCTs) suggested a potential
benefit with the use of therapeutic hypothermia (TH). However, results
from previous studies are contradictory. Method(s): We performed a
comprehensive literature search for studies that evaluated the efficacy
and safety of adjunctive TH compared to the standard percutaneous coronary
intervention (PCI) in awake patients with STEMI. The primary outcomes were
the infarct size (IS) and microvascular obstruction (MVO) assessed by
cardiac imaging at the end of follow-up. The secondary outcomes were major
adverse cardiovascular events (MACE), procedure-related complications, and
door-to-balloon time. Relative risk (RR) or the mean difference (MD) and
corresponding 95 % confidence intervals (CIs) were calculated using the
random-effects model. Result(s): A total of 10 RCTs, including 706
patients were included. As compared to standard PCI, TH was not associated
with a statistically significant improvement in the IS (MD: -0.87 %,
95%CI: -2.97, 1.23; P = 0.42) or in the MVO (MD: 0.11 %, 95%CI: -0.06,
0.27; P = 0.21). MACE and its components were comparable between the two
groups. However, the TH approach was associated with an increased risk of
infection and prolonged door-to-balloon time. Furthermore, there was a
trend in the TH group toward an increased incidence of stent thrombosis
and paroxysmal atrial fibrillation. Conclusion(s): According to our
meta-analysis of published RCTs, TH is not beneficial in awake patients
with STEMI and has a marginal safety profile with potential for care
delays. Larger-scale RCTs are needed to further clarify our
results. Copyright © 2022 Elsevier Inc.

<30>
Accession Number
2019398719
Title
Point-of-care platelet function testing for guided transfusion in
neurosurgical management of intracranial hemorrhage: a systematic review.
Source
European Journal of Medical Research. 27(1) (no pagination), 2022. Article
Number: 191. Date of Publication: December 2022.
Author
Xu F.W.X.; Lim N.-A.; Sim M.A.; Lean L.L.; Loh N.-H.W.; Ng K.T.; Chua
V.T.Y.; Chew S.T.H.; Ti L.K.
Institution
(Xu, Lim) Yong Loo Lin School of Medicine, National University of
Singapore, Singapore, Singapore
(Lean) Department of Anesthesia, Ng Teng Fong General Hospital, Singapore,
Singapore
(Ng) Department of Anesthesiology, Faculty of Medicine, University of
Malaya, Kuala Lumpur, Malaysia
(Sim, Chua, Chew) Department of Anesthesia, Singapore General Hospital,
Singapore, Singapore
(Loh, Chua, Ti) Department of Anesthesia, National University Hospital,
Singapore, Singapore
(Ti) Department of Anesthesia, Yong Loo Lin School of Medicine, National
University of Singapore, Singapore, Singapore
Publisher
BioMed Central Ltd
Abstract
Given the rising prevalence of antiplatelet therapy, rapid preoperative
identification of patients with bleeding diathesis is necessary for the
guidance of blood product administration. This is especially relevant in
neurosurgery for intracranial hemorrhage (ICH), where indiscriminate
transfusions may lead to further hemorrhagic or thromboembolic injury.
Point-of-care (POC) testing of platelet function is a promising solution
to this dilemma, as it has been proven effective in cardiac surgery.
However, to date, POC platelet function testing in neurosurgery has not
been extensively evaluated. This systematic review appraises the use of
POC platelet function test (PFT) in emergency neurosurgery in terms of its
impact on patient outcomes. A comprehensive search was conducted on four
electronic databases (Pubmed, MEDLINE, Embase, and Cochrane) for relevant
English language articles from their respective inceptions until 1 June
2022. We included all randomized controlled trials and cohort studies that
met the following inclusion criteria: (i) involved adult patients
undergoing neurosurgery for ICH; (ii) evaluated platelet function via POC
PFT; (iii) reported a change in perioperative blood loss; and/or (iv)
reported data on treatment-related adverse events and mortality.
Assessment of study quality was conducted using the Newcastle Ottawa
Quality Assessment Scale for Cohort Studies and Case-Control Studies, and
the JBI Critical Appraisal Checklist for Case Series. The search yielded
2,835 studies, of which seven observational studies comprising 849
patients met the inclusion criteria for this review. Overall, there is
evidence that the use of POC PFT to assess bleeding risk reduced bleeding
events, thromboembolic adverse outcomes, and the length of
hospitalization. However, there is currently insufficient evidence to
suggest that using POC PFT improves blood product use, functional outcomes
or mortality. Copyright © 2022, The Author(s).

<31>
Accession Number
2019974965
Title
Early surgery or conservative management for asymptomatic severe aortic
stenosis: Meta-analysis of RECOVERY and AVATAR.
Source
Journal of Cardiac Surgery. 37(12) (pp 5336-5340), 2022. Date of
Publication: December 2022.
Author
Changal K.; Devarasetty P.P.; Royfman R.; Veria S.; Yassen M.; Vyas R.;
Gossl M.
Institution
(Changal, Devarasetty, Royfman, Veria, Yassen, Vyas) Cardiovascular
Medicine, University of Toledo College of Medicine and Life Sciences, OH,
United States
(Gossl) Valve Science Center, Minneapolis Heart Institute, Abbott
Northwestern Hospital, part of Allina Health, Minneapolis, United States
Publisher
John Wiley and Sons Inc
Abstract
The standard practice for management for asymptomatic severe aortic
stenosis with a normal left ventricular systolic function is conservative
management with a few exceptions. This practice is challenged by two
recent randomized controlled trials (RCT). All the prior data is
observational. We performed a meta-analysis of these 2 RCTs to determine
if early surgical aortic valve replacement in this patient population is
beneficial compared with the standard conservative therapy. Copyright
© 2022 Wiley Periodicals LLC.

<32>
Accession Number
2021198506
Title
Fractional flow reserve versus angiography alone in guiding myocardial
revascularisation: a systematic review and meta-analysis of randomised
trials.
Source
Heart. 108(21) (pp 1699-1706), 2022. Date of Publication: 13 May 2022.
Author
Elbadawi A.; Sedhom R.; Dang A.T.; Gad M.M.; Rahman F.; Brilakis E.S.;
Elgendy I.Y.; Jneid H.
Institution
(Elbadawi, Rahman, Jneid) Cardiology, Baylor College of Medicine, Houston,
TX, United States
(Sedhom) Internal Medicine, Albert Einstein Medical Center, Philadelphia,
PA, United States
(Dang) Internal Medicine, The University of Texas Medical Branch at
Galveston, Galveston, TX, United States
(Gad) Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH,
United States
(Brilakis) Cardiology, Minneapolis Heart Institute and Minneapolis Heart
Institute Foundation, Minneapolis, MN, United States
(Elgendy) Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
Publisher
BMJ Publishing Group
Abstract
Background Randomised trials evaluating the efficacy and safety of
fractional flow reserve (FFR)-guided versus angiography-guided
revascularisation among patients with obstructive coronary artery disease
(CAD) have yielded mixed results. Aims To examine the comparative efficacy
and safety of FFR-guided versus angiography-guided revascularisation among
patients with obstructive CAD. Methods An electronic search of MEDLINE,
SCOPUS and Cochrane databases without language restrictions was performed
through November 2021 for randomised controlled trials that evaluated the
outcomes of FFR-guided versus angiography-guided revascularisation. The
primary outcome was major adverse cardiac events (MACE). Data were pooled
using a random-effects model. Results The final analysis included seven
trials with 5094 patients. The weighted mean follow-up duration was 38
months. Compared with angiography guidance, FFR guidance was associated
with fewer number of stents during revascularisation (standardised mean
difference=-0.80; 95% CI -1.33 to -0.27), but no difference in total
hospital cost. There was no difference between FFR-guided and
angiography-guided revascularisation in long-term MACE (13.6% vs 13.9%;
risk ratio (RR) 0.97, 95% CI 0.85 to 1.11). Meta-regression analyses did
not reveal any evidence of effect modification for MACE with acute
coronary syndrome (p=0.36), proportion of three-vessel disease (p=0.88) or
left main disease (p=0.50). There were no differences between FFR-guided
and angiography-guided revascularisation in the outcomes all-cause
mortality (RR 1.16, 95% CI 0.80 to 1.68), cardiovascular mortality (RR
1.27, 95% CI 0.50 to 3.26), repeat revascularisation (RR 0.99, 95% CI 0.81
to 1.21), recurrent myocardial infarction (RR 0.92, 95% CI 0.74 to 1.14)
or stent thrombosis (RR 0.61, 95% CI 0.31 to 1.21). Conclusion Among
patients with obstructive CAD, FFR-guided revascularisation did not reduce
the risk of long-term adverse cardiac events or the individual outcomes.
However, FFR-guided revascularisation was associated with fewer number of
stents. PROSPERO registration number CRD42021291596. Copyright ©

<33>
Accession Number
2019072045
Title
Median sternotomy pain after cardiac surgery: To block, or not? A
systematic review and meta-analysis.
Source
Journal of Cardiac Surgery. 37(11) (pp 3729-3742), 2022. Date of
Publication: November 2022.
Author
King M.; Stambulic T.; Hassan S.M.A.; Norman P.A.; Derry K.; Payne D.M.;
El Diasty M.
Institution
(King, Stambulic, Hassan) Queen's School of Medicine, Kingston, ON, Canada
(Norman) Kingston General Health Research Institute, Kingston, ON, Canada
(Derry) Department of Anesthesiology, Queen's University, Kingston, ON,
Canada
(Payne, El Diasty) Division of Cardiac Surgery, Queen's University,
Kingston, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: Inadequate pain control after median sternotomy leads to
reduced mobilization, increased respiratory complications, and longer
hospital stays. Typically, postoperative pain is controlled by opioid
analgesics that may have several adverse effects. Parasternal intercostal
block (PSB) has emerged as part of a multimodal strategy to control pain
after median sternotomy. However, the effectiveness of this intervention
on postoperative pain control and analgesic use has not been fully
established. Methods and Results: We conducted a meta-analysis to
assess the effect of PSB on postoperative pain and analgesic use in adult
cardiac surgery patients undergoing median sternotomy. PubMed, Embase,
Google Scholar, and the Cochrane database were searched with the following
search strategy: ([postoperative pain] or [pain relief] OR [analgesics] or
[analgesia] or [nerve block] or [regional block] or [local block] or
[regional anesthesia] or [local anesthetic] or [parasternal block] and
[sternotomy]) and (humans [filter]). Inclusion criteria were: patients who
underwent cardiac surgery via median sternotomy, age >18 and parasternal
block (continuous and single dose). Exclusion criteria were: noncardiac
surgery, nonparasternal nerve blocks, and the use of NSAIDS in parasternal
block. Quality assessment was performed by three independent reviewers via
the Cochrane risk of bias assessment tool. Of 1165 total citations, 18
were found to be relevant. Of these 18 citations, 7 citations (N = 2223
patients) reported postoperative pain scores in an extractable format and
11 citations (N = 2155 patients) reported postoperative opioid use in an
extractable format. For postoperative opioid use, morphine equivalent
doses were calculated for all studies and postoperative pain scores were
standardized to a 10-point visual analog scale for comparison between
studies; both these were reported as total opioid use or cumulative score
ranging from 24 to 72 h postoperative. All data analyses were run using a
random effects model, using a restricted maximum likelihood estimator, to
obtain summary standardized mean differences with 95% confidence interval
(CI's). For studies which only reported median and interquatile range
(IQR), the median was standard deviation was estimated by IQR/1.35.
Following median sternotomy both postoperative pain (SMD [95% CI] -0.49
[-0.92 to -0.06]) and postoperative morphine equivalent use (SMD [95% CI]
-1.68 [-3.11 to -0.25]) were significantly less in the PSB group.
 Conclusion(s): Our meta-analysis suggests that parasternal nerve
block significantly reduces postoperative pain and opioid
use. Copyright © 2022 Wiley Periodicals LLC.

<34>
Accession Number
2018722852
Title
The evolving treatment of congenital heart disease in patient with Down
syndrome: Current state of knowledge.
Source
Journal of Cardiac Surgery. 37(11) (pp 3760-3768), 2022. Date of
Publication: November 2022.
Author
Alkattan H.N.; Ardah H.I.; Arifi A.A.; Yelbuz T.M.
Institution
(Alkattan, Arifi, Yelbuz) Department of Cardiac Sciences, Ministry of the
National Guard - Health Affairs, Riyadh, Saudi Arabia
(Alkattan, Ardah, Arifi, Yelbuz) Department of Cardiac Science, King
Abdulaziz Medical City, King Abdullah International Medical Research
Center, Riyadh, Saudi Arabia
(Alkattan, Ardah, Arifi, Yelbuz) Department of Cardiac Science, King
Abdulaziz Medical City, King Saud bin Abdulaziz University for Health
Sciences, Riyadh, Saudi Arabia
Publisher
John Wiley and Sons Inc
Abstract
Objectives: Children with Down syndrome are usually seen as not worthy of
high-risk cardiac surgery. Through this review, we try to show the results
of curative and palliative surgery for functional single ventricle
syndrome in patients with Down syndrome, as there is currently no standard
protocol for the treatment of this category of patients. Method(s):
An exhaustive search of all related published medical literature included
the following domains: Down syndrome and diagnosis, Down syndrome and
taxonomy, Down syndrome, and natural history, Down syndrome and
cardiovascular abnormalities, Down syndrome and pulmonary hypertension,
Down syndrome and institutionalization, Down syndrome and surgical repair,
Down syndrome, and single ventricle palliation, Down syndrome and Glenn,
Down syndrome, and Fontan. Result(s): 12 articles were included from
775 identified. Low-risk cardiac surgery procedure should be provided for
Down syndrome with a balanced ventricular septal defect. There is no
universal agreement about the surgical approach for Down syndrome with
unbalanced ventricular septal defects, but it can be performed at
relatively low risk. Conclusion(s): TCPC in Down syndrome patients
could be a relatively low-risk procedure if patients are prepared well and
their pulmonary vascular resistance is low. Randomized prospective studies
are required to show the long-term impact of TCPC palliation and develop a
better understanding of standardized care of these patients. Copyright
© 2022 Wiley Periodicals LLC.

<35>
[Use Link to view the full text]
Accession Number
634805002
Title
Evaluating the Impact of Pulmonary Artery Obstruction After Lung
Transplant Surgery: A Systematic Review and Meta-analysis.
Source
Transplantation. 105(4) (pp 711-722), 2021. Date of Publication: 01 Apr
2021.
Author
Kumar N.; Hussain N.; Kumar J.; Essandoh M.K.; Bhatt A.M.; Awad H.; Perez
W.J.; Whitson B.A.; Ganapathi A.M.; Mokadam N.A.; Gorelik L.; Turner K.;
Iyer M.H.
Institution
(Kumar, Hussain, Kumar, Essandoh, Bhatt, Awad, Perez, Gorelik, Turner,
Iyer) Department of Anesthesiology, Wexner Medical Center, Ohio State
University, Columbus, OH, United States
(Whitson, Ganapathi, Mokadam) Division of Cardiac Surgery, Department of
Surgery, Wexner Medical Center, Ohio State University, Columbus, OH,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background. Pulmonary artery obstruction is an uncommon but significant
complication after lung transplantation. Although numerous reports have
documented its occurrence, the hemodynamic parameters associated with its
presentation and diagnostic considerations remain ill-defined. This
systematic review summarizes evidence in the literature surrounding
pulmonary artery obstruction after lung transplantation surgery. Methods.
Databases were searched for all articles and abstracts reporting on
pulmonary artery obstruction. Data collected included the number of
patients studied, patient characteristics, incidences of pulmonary artery
obstruction, and timing and imaging modality used for diagnosis. Results.
Thirty-four full-text citations were included in this review. The point
prevalence of pulmonary artery obstruction was 3.66%. The peak pulmonary
artery velocity associated with obstruction was found to be 2.60 +/- 0.58
m/s. The diameter of the obstructed pulmonary artery predictive of poor
outcomes was noted to be 0.78 +/- 0.40 cm. The majority of diagnoses were
made in the late postoperative period using pulmonary angiogram and
transesophageal echocardiography. Overall, 76% of patients (47 of 62)
required emergent procedural reintervention, and 23% of patients (14 of
62) diagnosed with pulmonary artery obstruction died during their hospital
stay. Conclusions. This systematic review underscores the importance of
identifying pulmonary artery obstruction immediately after lung transplant
surgery. The clinical implications of these results warrant the
development of identification and management strategies for early
detection of irregularities in pulmonary artery anastomosis in lung
transplant patients. Copyright © 2020 Wolters Kluwer Health, Inc.
All rights reserved.

<36>
Accession Number
2020551543
Title
Effect of high-energy and/or high-protein feeding in children with
congenital heart disease after cardiac surgery: a systematic review and
meta-analysis.
Source
European Journal of Pediatrics. 182(2) (pp 513-524), 2023. Date of
Publication: February 2023.
Author
Ni P.; Wang X.L.; Xu Z.M.; Luo W.
Institution
(Ni, Xu) Department of Thoracic and Cardiovascular Surgery, Shanghai
Children's Medical Center, School of Medicine, Shanghai Jiao Tong
University, Shanghai, China
(Wang) Department of Cardiology, Shanghai Children's Medical Center,
School of Medicine, Shanghai Jiao Tong University, Shanghai, China
(Luo) Nursing Department, Shanghai Children's Medical Center, School of
Medicine, Shanghai Jiao Tong University, 1678 Dong-fang Road, Shanghai
200127, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
High-energy or high-protein feeding offers a promising approach to
improving malnutrition in children after congenital heart surgery.
However, the effect of high-energy or high-protein feeding in this
population has not yet been systematically reviewed. Therefore, we aimed
to assess the safety and effectiveness of high-energy or high-protein
feeding in children after congenital heart surgery. Five electronic
databases (PubMed, Embase, CENTRAL, CINAHL, and Scopus) were searched from
inception to April 23, 2022. After screening the literature according to
inclusion and exclusion criteria, a risk of bias assessment was performed
using version 2 of the Cochrane risk-of-bias tool for randomized trials,
and the certainty of the evidence was assessed using the Grading of
Recommendations, Assessment, Development and Evaluations system. Finally,
the random effects model was used to perform a meta-analysis of all data.
A total of 609 subjects from 9 studies were included for qualitative
analysis, and meta-analyses were performed on data from 8 of these
studies. The results showed that high-energy and/or high-protein feeding
did not increase feeding intolerance (RR = 1.09, 95% CI: 0.80, 1.48) or
fluid intake (MD = - 12.50 ml/kg/d, 95% CI: - 36.10, 11.10); however, the
intervention was beneficial in increasing weight (MD = 0.5 kg, 95% CI:
0.23, 0.77) and reducing the duration of mechanical ventilation (MD = -
17.45 h, 95% CI: - 27.30, - 7.60), intensive care unit (ICU) stay (MD = -
1.45 days, 95% CI: - 2.36, - 0.54) and hospital stay (MD = - 2.82 days,
95% CI: - 5.22, - 0.43). However, high-energy and/or protein feeding did
not reduce the infection rate (RR = 0.68, 95% CI: 0.25, 1.87) or mortality
(RR = 1.50, 95% CI: 0.47, 4.82). Conclusion(s): The certainty of the
evidence was graded as moderate to high, which suggests that high-energy
and/or high-protein feeding may be safe in children after congenital heart
surgery. Furthermore, this intervention improves nutrition and reduces the
duration of mechanical ventilation, length of ICU stay, and length of
hospital stay. However, the overall conclusion of this meta-analysis will
need to be confirmed in a cohort of patients with different cardiac
physiologies.What is Known:* Malnutrition is highly prevalent in children
with congenital heart disease (CHD) and can negatively affect the
prognosis of these children.* High-energy and/or high-protein feeding can
improve nutrition status and facilitate recovery; however, evidence on its
safety and efficacy is lacking. What is New:* Pooled data suggest that
high-energy and/or high-protein feeding does not increase fluid intake or
feeding intolerance in children with CHD.* High-energy and/or high-protein
feeding may reduce the duration of mechanical ventilation, length of
intensive care unit stay, and length of hospital stay. Copyright
© 2022, The Author(s), under exclusive licence to Springer-Verlag
GmbH Germany, part of Springer Nature.

<37>
Accession Number
2020479974
Title
Justification of empiric methodology to determine dexmedetomidine dose for
the TREX study.
Source
Paediatric Anaesthesia. 33(3) (pp 236-242), 2023. Date of Publication:
March 2023.
Author
Disma N.; Goffredo B.M.; Cairoli S.; Cirillo G.; Morse J.; Anderson B.J.;
Bonfiglio R.; Cordani R.; Garrone M.; Patrone E.; Iengo A.; Bocca P.; Izzo
F.; Diotto V.; Lenares E.; Robino C.; Neri S.; Colantonio L.; Calderini
E.; Picardo S.; Tucci I.; Di Persio A.; Montagnini L.; Blesi L.; Pistone
B.; Kuppers B.; De Lorenzo B.; Caramelli F.; Pasini L.
Institution
(Disma, Cirillo) Unit for Research and Innovation, Department of
Anaesthesia, IRCCS Istituto Giannina Gaslini, Genova, Italy
(Goffredo, Cairoli) Division of Metabolic Disease and Drug Biology, IRCCS
Ospedale Bambino Gesu, Rome, Italy
(Morse, Anderson) Department Anesthesiology, Faculty Medicine and Health
Science, University of Auckland, Auckland, New Zealand
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Dexmedetomidine is the sedative agent administered in
combination with remifentanil and low dose of sevoflurane in the
interventional arm of the ongoing TREX trial (Trial Remifentanil
DExmedetomidine). The TREX pilot study (published in Paediatr Anaesth
2019;29:59-67) established infusion rates higher than those initially
proposed. This could be attributed to an inappropriate target
concentration for sedation or incorrect initial pharmacokinetic parameter
estimates. Method(s): The TREX study is a Phase III, randomized,
active controlled, parallel group, blinded evaluator, multicenter,
superiority trial comparing neurological outcome after standard
sevoflurane anesthesia with dexmedetomidine/remifentanil, and low dose
sevoflurane anesthesia in children aged less than 2 years undergoing
anesthesia of 2 h or longer. In this report, dexmedetomidine
pharmacokinetics were analyzed in the interventional arm of the Italian
population. Result(s): There were 162 blood samples from 32 infants
(22 male and 10 female). The median (IQR) age was 12 (5.2-15.5) months,
weight 9.9 (7.3-10.8) kg. Duration of anesthesia ranged from 2 to 6 h.
None of the children were born premature (median postnatal age 39 weeks,
IQR 38-40 weeks). A 3-compartment PK model that incorporated allometric
scaling and a maturation function demonstrated plasma concentration
observations from the current Italian arm of the TREX study were
consistent with those predicted by a "universal" model using pooled data
obtained from neonates to adults. Conclusion(s): This current PK
analysis from the Italian arm of the TREX study confirms that plasma
concentration of dexmedetomidine is predictable using known covariates
such as age and size. The initial target concentration (0.6
mug.L-1) used to sedate children cared for in the intensive
care after cardiac surgery was inadequate for infants in the current TREX
study. A target concentration 1 mcg.L-1, corresponding to a
loading dose of 1 mcg.kg-1 followed by an infusion of 1
mcg.kg-1.h-1, provided adequate
sedation. Copyright © 2022 The Authors. Pediatric Anesthesia
published by John Wiley & Sons Ltd.

<38>
Accession Number
2022465560
Title
Factors affecting extubating time of postoperative patients who underwent
congenital cardiac surgery: a randomized prospective study.
Source
European Review for Medical and Pharmacological Sciences. 27(2) (pp
763-772), 2023. Date of Publication: 2023.
Author
Onur T.; Karaca U.; Onur A.; Engin M.; Demirel A.; Sayan H.E.; Ozgunay
S.E.; Kilicarslan N.; Secici S.; Yirtimci S.
Institution
(Onur, Karaca, Onur, Demirel, Sayan, Ozgunay, Kilicarslan, Yirtimci)
Department of Anesthesiology and Reanimation, University of Health
Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Bursa,
Turkey
(Engin) Department of Cardiovascular Surgery, University of Health
Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Bursa,
Turkey
(Secici) Pediatric Cardiac Surgery, Medicana Hospital, Bursa, Turkey
Publisher
Verduci Editore s.r.l
Abstract
OBJECTIVE: Anesthesia management in pediatric cardiac surgery using health
resources sparingly focuses on reducing morbidity and mortality and
increasing patients' quality of life. The duration of postoperative
mechanical ventilation (MV) heavily influences pediatric cardiac surgery
recovery. Thus, in this study we aimed to determine factors influencing
extubation times after pediatric cardiac surgery. PATIENTS AND
METHODS: A total of 72 pediatric patients with an ASA score of III or
above undergoing cardiac surgery were included in the study. As a result
of their extubation time, the patients were divided into three groups as
follows: those who were extubated immediately after surgery or in the
operating room (OR) were recorded as Immediate Extubators (IE); those who
were extubated within 6 to 48 hours of entering the intensive care unit
were recorded as Early Extubators (EE), and those who were extubated after
48 hours or not extubated were recorded as Delayed Extubators (DE).
 RESULT(S): A logistic regression analysis showed that anomalies and
need of MV before surgery, airway difficulty, and prolonged cross-clamp
(CC) time were observed as factors affecting DE. The risk of DE was
significantly correlated with the presence of abnormality [Odds ratio
(OR): 20.3, 95% Confident interval (CI): 2.8-142.7], with the need of MV
before surgery (OR: 1,844, 95% CI: 1.8-1,790,461.9), and with the presence
of airway difficulty (OR: 44.7, 95% CI: 4.4-445.0). In addition, it was
determined that CC time increased the probability of DE 1.038 times per
minute (95% CI: 1.004-1.072). CONCLUSION(S): Early and immediate
extubation in children who underwent congenital heart surgery was
successfully performed in our clinic. Early and immediate extubation in
pediatric cardiac surgery can be completed safely and successfully when
suitable conditions are provided. Copyright © 2023 Verduci
Editore s.r.l. All rights reserved.

<39>
Accession Number
640242068
Title
The Experience of Perioperative Spinal Cord Stimulation to Prevent
Post-CABG Atrial Fibrillation.
Source
Stereotactic and Functional Neurosurgery. Conference: 19th Biennial
Meeting of the World Society for Stereotactic and Functional Neurosurgery,
WSSFN 2022. Seoul South Korea. 100(Supplement 1) (pp 58), 2022. Date of
Publication: September 2022.
Author
Murtazin V.; Romanov A.; Kiselev R.; Lomivorotov V.; Chernyavskiy A.
Institution
(Murtazin, Kiselev) Neurosurgery, National Medical Research Center n. a.
acad. E. N. Meshalkin, Russian Federation
(Romanov) Arythmology, National Medical Research Center n. a. acad. E. N.
Meshalkin, Russian Federation
(Lomivorotov) ICU, National Medical Research Center n. a. acad. E. N.
Meshalkin, Russian Federation
(Chernyavskiy) Cardiac Surgery, National Medical Research Center n. a.
acad. E. N. Meshalkin, Russian Federation
Publisher
S. Karger AG
Abstract
Objectives: Spinal cord stimulation (SCS) is effective in the treatment of
chronic pain and intractable angina pectoris. Recently, animal studies
have demonstrated that SCS can also suppress atrial fibrillation (AF). Our
study aimed to test the safety and efficacy of temporary SCS to prevent
the occurrence of AF in the early postoperative period in patients
undergoing elective coronary artery bypass grafting (CABG).
 Method(s): 52 patients with indications for CABG and history of
paroxysmal AF were randomized to 2 groups: CABG plus standard medical
therapy (MED) with beta-blockers (n=26, Control group) and CABG plus MED
plus the percutaneous lead placement for temporary SCS (n=26, SCS group).
In the SCS group under local anaesthesia and with fluoroscopic guidance,
temporary leads were placed at C7-T4 level according to the patient's
sense of paresthesia and connected to a trial stimulator. Temporary SCS
was begun 3 days before elective CABG, deactivated during surgery,
reactivated in the intensive care unit after CABG, and continued for 7
days at which time the leads were removed. Continuous external ECG
monitoring was performed for 30 days after CABG in all patients. These
primary objectives were tested over the 30-day postoperative period: 1)
occurrence of adverse events, including death, stroke or TIA, myocardial
infarction and kidney injury; and 2) occurrence of AF or any atrial
tachyarrhythmia lasting more than 30 seconds. Result(s): Percutaneous
lead placement for temporary SCS was successfully performed in all 26
patients before CABG without any complications. There were no adverse
events related to temporary SCS in any patient throughout follow-up. There
were no significant differences in CKMB and creatinine levels between
groups (p=0.1 and 0.2, respectively) as well as other typical CABG-related
complications (p>0.05). Postoperative AF occurred in 8 (30.7%) of 26
patients in the Control group versus only 1 (3.8%) of 26 patients in the
SCS group (p=0.012, log-rank test). Conclusion(s): Temporary SCS was
effective in suppressing postoperative AF after CABG without any adverse
events in this study. Further studies of SCS with larger samples are
indicated to test its clinical value as a perioperative intervention.

<40>
Accession Number
2022503200
Title
Comparison of transcatheter aortic valve replacement with the ACURATE neo2
versus Evolut PRO/PRO+ devices.
Source
EuroIntervention. 18(12) (pp 977-986), 2023. Date of Publication: January
2023.
Author
Baggio S.; Pagnesi M.; Kim W.-K.; Scotti A.; Barbanti M.; Costa G.; Adamo
M.; Kornowski R.; Vaknin-Assa H.; Estevez-Loureiro R.; Cedeno R.A.; De
Marco F.; Casenghi M.; Toggweiler S.; Veulemans V.; Mylotte D.; Lunardi
M.; Regazzoli D.; Reimers B.; Sondergaard L.; Vanhaverbeke M.; Nuyens P.;
Maffeo D.; Buono A.; Saccocci M.; Giannini F.; Di Ienno L.; Ferlini M.;
Lanzillo G.; Ielasi A.; Schofer J.; Brinkmann C.; Van Der Heyden J.;
Buysschaert I.; Eitan A.; Wolf A.; Adamaszek M.M.; Colombo A.; Latib A.;
Mangieri A.
Institution
(Baggio, Regazzoli, Reimers, Colombo, Mangieri) Department of Biomedical
Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
(Baggio) Cardio Center, Humanitas Research Hospital IRCCS, Rozzano, Milan,
Italy
(Pagnesi, Adamo) Cardiothoracic Department, ASST Spedali Civili di
Brescia, University of Brescia, Brescia, Italy
(Pagnesi) Department of Medical Surgical Specialties, Radiological
Sciences, and Public Health, University of Brescia, Brescia, Italy
(Kim) Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
(Scotti, Latib) Montefiore-Einstein Center for Heart and Vascular Care,
Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY,
United States
(Barbanti, Costa) Division of Cardiology, A.O.U. Policlinico "G.
Rodolico-San Marco", Catania, Italy
(Kornowski, Vaknin-Assa) Department of Cardiology, Rabin Medical Center,
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
(Estevez-Loureiro, Cedeno) Cardiology Department, University Hospital
Alvaro Cunqueiro, Galicia Sur Health Research Institute, Vigo, Spain
(De Marco, Casenghi) Department of Clinical and Interventional Cardiology,
IRCCS Policlinico San Donato, Milan, Italy
(Toggweiler) Department of Cardiology, Heart Center Lucerne, Luzerner
Kantonsspital, Lucerne, Switzerland
(Veulemans) Division of Cardiology, Pulmonology and Vascular Medicine,
Heinrich Heine University, Medical Faculty, Dusseldorf, Germany
(Mylotte, Lunardi) Galway University Hospital, SAOLTA Health Care Group,
National University of Ireland, Galway, Ireland
(Sondergaard, Vanhaverbeke, Nuyens) Department of Cardiology,
Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
(Maffeo, Buono, Saccocci) Fondazione Poliambulanza, Brescia, Italy
(Giannini, Di Ienno) Interventional Cardiology Unit, GVM Care & Research,
Maria Cecilia Hospital, Cotignola, Italy
(Ferlini, Lanzillo) Division of Cardiology, Fondazione IRCCS Policlinico
San Matteo, Pavia, Italy
(Ielasi) Clinical and Interventional Cardiology Unit, Clinical Institute
Saint Ambrogio, Milan, Italy
(Schofer, Brinkmann) Medizinisches Versorgungszentrum, Hamburg, Germany
(Van Der Heyden, Buysschaert) Interventional Cardiology Unit, AZ Sint-Jan
Hospital, Brugge, Belgium
(Eitan) Department of Cardiology, Carmel Medical Center, Haifa, Israel
(Wolf, Adamaszek) Klinik fur Kardiologie, Elisabeth-Krankenhaus Essen,
Essen, Germany
Publisher
Europa Group
Abstract
Background: The ACURATE neo2 (NEO2) and Evolut PRO/PRO+ (PRO)
bioprostheses are new-generation self-expanding valves developed for
transcatheter aortic valve replacement (TAVR). Aim(s): We sought to
compare the performance of the ACURATE neo2 and Evolut PRO/PRO+ devices.
 Method(s): The NEOPRO-2 registry retrospectively included patients
who underwent TAVR for severe aortic stenosis with either the NEO2 or PRO
devices between August 2017 and December 2021 at 20 centres. In-hospital
and 30-day Valve Academic Research Consortium (VARC)-3 defined outcomes
were evaluated. Propensity score (PS) matching and binary logistic
regression were performed to adjust the treatment effect for PS quintiles.
A subgroup analysis assessed the impact of aortic valve calcification.
 Result(s): A total of 2,175 patients (NEO2: n=763; PRO: n=1,412) were
included. The mean age was 82+/-6.2 years and the mean Society of Thoracic
Surgeons score was 4.2%. Periprocedural complications were low, and both
groups achieved high rates of technical success (93.1% vs 94.1%; p=0.361)
and predischarge intended valve performance (96.0% vs 94.1%; p=0.056),
both in the unmatched and matched analysis (452 pairs). Device success at
30 days was comparable (84.3% vs 83.6%; p=0.688), regardless of aortic
valve calcification severity (p>0.05 for interaction). A suggestion for
higher VARC-3 early safety in the NEO2 group was mainly driven by reduced
rates of new permanent pacemaker implantation (7.7% vs 15.6%; p<0.001).
 Conclusion(s): This retrospective analysis reports a similar
short-term performance of the ACURATE neo2 platform compared with the
new-generation Evolut PRO/PRO+ devices. Randomised studies are needed to
confirm our exploratory findings. Copyright © Europa Digital &
Publishing 2023. All rights reserved.

<41>
Accession Number
2022528371
Title
Prognostic value of N-terminal pro-form B-type natriuretic peptide
(NT-proBNP) in patients with congenital heart disease undergoing cardiac
surgery: a systematic review and meta-analysis of cohort studies.
Source
Cardiovascular Diagnosis and Therapy. 12(6) (pp 853-867), 2022. Date of
Publication: December 2022.
Author
Gong Z.; Xing D.; Wu R.; Zhang S.; Ye C.; Chen Y.; Liu X.; Chen L.; Wang
T.
Institution
(Gong, Wu, Zhang, Ye, Chen, Liu, Chen, Wang) Department of Epidemiology
and Health Statistics, Xiangya School of Public Health, Central South
University, Changsha, China
(Xing) Medical Records Statistics Room of Medical Affair Department, Hunan
Provincial People's Hospital, The First Affiliated Hospital of Hunan
Normal University, Changsha, China
(Chen) Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha,
China
(Wang) National Health Commission Key Laboratory for Birth Defect Research
and Prevention, Hunan Provincial Maternal and Child Health Care Hospital,
Changsha, China
Publisher
AME Publishing Company
Abstract
Background: To perform an updated and comprehensive meta-analysis on the
prognostic value of N-terminal pro-form B-type natriuretic peptide
(NT-proBNP) in patients with congenital heart disease (CHD) undergoing
cardiac surgery. Method(s): A systematic search was conducted until
September 2021 for relevant studies published in PubMed, Web of Science
Database and Embase. Based on the average values, NT-proBNP concentrations
were classified as high and low levels. The outcomes of interest were
mortality, cardiovascular events, and other postoperative outcomes. A
random-effects model was used to calculate composite risk estimates and
corresponding 95% confidence intervals (CIs). Possible sources of
heterogeneity and stability of results were analyzed using subgroup and
sensitivity analyses. Result(s): A total of 32 studies published
between 2008 and 2021 involving 7,571 participants were included. Results
showed CHD patients at high NT-proBNP levels yielded an increased risk of
mortality [risk ratio (RR) =1.14; 95% CI: 1.08-1.20] and cardiovascular
events (RR =2.02; 95% CI: 1.26-3.24) compared with those at low NT-proBNP
levels. No significant association was found between NT-proBNP and risks
for other postoperative outcomes in CHD patients undergoing cardiac
surgery (RR =1.73; 95% CI: 0.86-3.47). Significant heterogeneity was
detected across studies regarding these risk estimates. Subgroup analysis
found heterogeneity in the risk estimate of mortality was explained by
geographic region, type of CHD, and assay method of NT-proBNP. Sensitivity
analysis supported the robustness of results. Conclusion(s): Compared
with CHD patients at low NT-proBNP levels, CHD patients at high NTproBNP
levels had elevated risks of mortality and cardiovascular events. Further
large-scale and well-controlled studies are needed to confirm our
findings. Copyright © Cardiovascular Diagnosis and Therapy. All
rights reserved.

<42>
Accession Number
2019170101
Title
Effect of Dexmedetomidine with Adjuvants (Fentanyl and Butorphanol) on
Postoperative Analgesia and Cognitive Dysfunction Following Cardiac
Surgery: A Prospective, DoubleBlinded Randomized Controlled Trial.
Source
International Journal of Pharmaceutical and Clinical Research. 14(11) (pp
138-146), 2022. Date of Publication: 2022.
Author
Mistry K.; Sharma A.; Verma A.; Patel D.; Patel K.
Institution
(Mistry, Patel, Patel) Department of Anaesthesia, Geetanjali Medical
College and Hospital, Rajasthan, Udaipur, India
(Sharma) Jaslok Hospital and Research Centre, Maharashtra, Mumbai, India
(Verma) Department of Anaesthesia, American International Institute of
Medical Sciences, Rajasthan, Udaipur, India
Publisher
Dr Yashwant Research Labs Pvt Ltd
Abstract
Background: Painafter cardiac surgery has various sites of origin and is
caused by several factors. Postoperative analgesia improves patient
satisfaction, reduces the incidence of postoperative complications and
shortens the duration of hospital stay. Objective(s): To evaluate and
compare the effect of intravenous infusion of dexmedetomidine and fentanyl
versus intravenous infusion of dexmedetomidine and butorphanol on
postoperative analgesia and postoperative cognitive dysfunction in
patients undergoing cardiac surgery. Material(s) and Method(s): This
study was conducted at tertiary care teaching hospital of Rajasthan from
February 2019 to June 2020. Patients in the two groups received
intravenous infusion of Dexmedetomidine 0.15mug/kg/h and Fentanyl
0.5mug/kg/h immediately postoperatively (Group DF) and intravenous
infusion of Dexmedetomidine 0.15mug/kg/h and Butorphanol 2 mug/kg/h
immediately postoperatively (Group DB) respectively. Both groups were
compared for demographic data, postoperative hemodynamic data, Ramsay
sedation scale, visual analogue scale (VAS) for pain and Montreal
Cognitive assessment (MoCA) for cognitive function. Result(s): There
was no statistical difference in the VAS score of the patients between the
group DB and DF at post extubation intervals of 12, 18, 24 and 48 Hours
(p>0.05) except at 4 hours and 8 hours post extubation (p<0.05). Time to
first rescue analgesic was significantly earlier for DF as compared to DB
group (p<0.05). There was no statistical significant difference found in
the mean of MoCA score between both the groups for both 1 day prior to
surgery and 24hrs Post extubation (p>0.05). Drowsiness had the highest
incidence in both the groups among all the adverse effects. There was no
significant difference in terms of adverse effects (p>0.05) except
drowsiness which was significantly higher in group DB (p<0.05).
 Conclusion(s): The present study concluded that Dexmedetomidine in
combination with Butorphanol is more effective as an analgesic than
Dexmedetomidine with Fentanyl but no significant cognitive dysfunction was
found among the patients in both groups. Copyright © 2022, Dr
Yashwant Research Labs Pvt Ltd. All rights reserved.

<43>
Accession Number
640247085
Title
Clinical Outcome of Revascularization Deferral With Instantaneous
Wave-Free Ratio and Fractional Flow Reserve: A 5-Year Follow-Up Substudy
From the iFR-SWEDEHEART Trial.
Source
Journal of the American Heart Association. (pp e028423), 2023. Date of
Publication: 03 Feb 2023.
Author
Berntorp K.; Rylance R.; Yndigegn T.; Koul S.; Frobert O.; Christiansen
E.H.; Erlinge D.; Gotberg M.
Institution
(Berntorp, Rylance, Yndigegn, Koul, Erlinge, Gotberg) Department of
Cardiology Skane University Hospital, Clinical Sciences, Lund University
Lund Sweden, Sweden
(Frobert) Faculty of Health, Department of Cardiology Orebro University
Hospital Orebro Sweden, Sweden
(Christiansen) Department of Cardiology Aarhus University Hospital Skejby
Denmark, Denmark
Publisher
NLM (Medline)
Abstract
Background Although physiology-based assessment of coronary artery
stenosis using instantaneous wave-free ratio (iFR) and fractional flow
reserve (FFR) are established methods of guiding coronary
revascularization, its clinical outcome in long-term deferral needs
further evaluation, especially with acute coronary syndrome as a clinical
presentation. The aim was to evaluate the long-term clinical outcome of
deferral of revascularization based on iFR or FFR. Methods and Results
This is a substudy of the iFR-SWEDEHEART (Instantaneous Wave-Free Ratio
Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or
Acute Coronary Syndrome) randomized clinical trial, where patients
deferred from revascularization from each study arm were selected. Nine
hundred eight patients deferred from coronary revascularization with iFR
(n=473) and FFR (n=435) were followed for 5years. The national quality
registry, SWEDEHEART (Swedish Web-System for Enhancement and Development
of Evidence-Based Care in Heart Disease Evaluated According to Recommended
Therapies), was used for patient data collection and clinical follow-up.
The end point was major adverse cardiac events and their individual
components all-cause death, cardiovascular death, noncardiovascular death,
nonfatal myocardial infarction, and unplanned revascularization. No
significant difference was found in major adverse cardiac events (iFR
18.6% versus FFR 16.8%; adjusted hazard ratio, 1.08 [95% CI, 0.79-1.48];
P=0.63) or their individual components. Conclusions No differences in
clinical outcomes after 5-year follow-up were noted when comparing iFR
versus FFR as methods for deferral of coronary revascularization in
patients presenting with stable angina pectoris and acute coronary
syndrome. Registration URL: https://www.clinicaltrials.gov; Unique
identifier: NCT02166736.

<44>
Accession Number
640246149
Title
New Cerebral Microbleeds After Catheter-Based Structural Heart
Interventions: An Exploratory Analysis.
Source
Journal of the American Heart Association. (pp e8189), 2023. Date of
Publication: 03 Feb 2023.
Author
Braemswig T.B.; Kusserow M.; Bellmann B.; Beckhoff F.; Reinthaler M.; von
Rennenberg R.; Erdur H.; Scheitz J.F.; Galinovic I.; Villringer K.;
Leistner D.M.; Audebert H.J.; Endres M.; Landmesser U.; Haeusler K.G.;
Fiebach J.B.; Lauten A.; Rillig A.; Nolte C.H.
Institution
(Braemswig, von Rennenberg, Erdur, Scheitz, Audebert, Endres, Nolte)
Klinik und Hochschulambulanz fur Neurologie Charite - Universitatsmedizin
Berlin, corporate member of Freie Universitat Berlin and
Humboldt-Universitat zu Berlin Berlin Germany, Germany
(Braemswig, Scheitz, Leistner, Landmesser, Nolte) Berlin Institute of
Health (BIH) at Charite - Universitatsmedizin Berlin Berlin Germany,
Germany
(Braemswig, von Rennenberg, Erdur, Scheitz, Galinovic, Villringer,
Audebert, Endres, Fiebach, Nolte) Center for Stroke Research Berlin (CSB)
Charite - Universitatsmedizin Berlin, corporate member of Freie
Universitat Berlin and Humboldt-Universitat zu Berlin Berlin Germany,
Germany
(Braemswig, Scheitz, Leistner, Endres, Landmesser, Nolte) German Centre
for Cardiovascular Research (DZHK), partner site Berlin Berlin Germany,
Germany
(Kusserow) Klinik fur Innere Medizin Bundeswehrkrankenhaus Berlin Berlin
Germany, Germany
(Kusserow) Charite - Universitatsmedizin Berlin corporate member of Freie
Universitat Berlin and Humboldt-Universitat zu Berlin Berlin Germany,
Germany
(Bellmann) MEDIAN Klinik AGZ Dusseldorf Dusseldorf Germany, Germany
(Bellmann, Beckhoff, Reinthaler, Leistner, Landmesser, Lauten, Rillig)
corporate member of Freie Universitat Berlin and Humboldt-Universitat zu
Berlin Berlin Germany, Department of Cardiology Campus Benjamin Franklin
Charite - Universitatsmedizin Berlin
(Reinthaler) Institute of Active Polymers and Berlin-Brandenburg Center
for Regenerative Therapies Helmholtz-Zentrum Hereon Teltow Germany,
Germany
(Reinthaler, Landmesser) Klinik fur Kardiologie Angiologie und
Intensivmedizin Berlin Germany, Germany
(von Rennenberg, Endres, Nolte) German Center for Neurodegenerative
Diseases (DZNE), partner site Berlin Berlin Germany, Germany
(Leistner) Department of Medicine III, Cardiology Goethe University
Frankfurt am Main Germany, Germany
(Leistner) German Centre for Cardiovascular Research (DZHK), partner site
Rhine-Main Frankfurt Germany, Germany
(Endres) ExcellenceCluster NeuroCure Berlin Germany, Germany
(Haeusler) Department of Neurology Universitatsklinikum Wurzburg Wurzburg
Germany, Germany
(Lauten) Department of General and Interventional Cardiology Helios
Klinikum Erfurt Erfurt Germany, Germany
(Rillig) Universitares Herz- und Gefasszentrum Hamburg-Eppendorf Hamburg
Germany, Germany
Publisher
NLM (Medline)
Abstract
Background Cerebral microbleeds (CMBs) are increasingly recognized as
"covert" brain lesions indicating increased risk of future neurological
events. However, data on CMBs in patients undergoing catheter-based
structural heart interventions are scarce. Therefore, we assessed
occurrence and predictors of new CMBs in patients undergoing
catheter-based left atrial appendage closure and percutaneous mitral valve
repair using the MitraClip System. Methods and Results We conducted an
exploratory analysis using data derived from 2 prospective, observational
studies. Eligible patients underwent cerebral magnetic resonance imaging
(3Tesla) examinations and cognitive tests (using the Montreal Cognitive
Assessment) before and after catheter-based left atrial appendage closure
and percutaneous mitral valve repair. Forty-seven patients (53% men;
median age, 77years) were included. New CMBs occurred in 17 of 47 patients
(36%) following catheter-based structural heart interventions. Occurrences
of new CMBs did not differ significantly between patients undergoing
catheter-based left atrial appendage closure and percutaneous mitral valve
repair (7/25 versus 10/22; P=0.348). In univariable analysis, longer
procedure time was significantly associated with new CMBs. Adjustment for
heparin attenuated this association (adjusted odds ratio [per 30minutes]:
1.77 [95% CI, 0.92-3.83]; P=0.090). Conclusions New CMBs occur in
approximately one-third of patients after catheter-based left atrial
appendage closure and percutaneous mitral valve repair using the MitraClip
System. Our data suggest that longer duration of the procedure may be a
risk factor for new CMBs. Future studies in larger populations are needed
to further investigate their clinical relevance. Clinical Trial
Registration German Clinical Trials Register: DRKS00010300
(https://drks.de/search/en/trial/DRKS00010300); ClinicalTrials.gov :
NCT03104556
(https://clinicaltrials.gov/ct2/show/NCT03104556?term=NCT03104556&draw=2&r
ank=1).

<45>
Accession Number
2021281992
Title
Effect of chest ultrasound compared with pericardial window for the
diagnosis of occult penetrating cardiac wounds in hemodynamically stable
subjects with penetrating thoracic trauma: A meta-analysis.
Source
International Wound Journal. (no pagination), 2023. Date of Publication:
2023.
Author
Yan T.; Xie W.; Xu M.
Institution
(Yan, Xu) Department of Liver Surgery, West China Hospital, Sichuan
University, Chengdu, China
(Yan, Xie) Department of Emergency, People's Hospital of Deyang, Deyang,
China
Publisher
John Wiley and Sons Inc
Abstract
We conducted a meta-analysis to assess the diagnostic performance of chest
ultrasound compared with a pericardial window for the detection of occult
penetrating cardiac wounds in patients with penetrating thoracic trauma
who were hemodynamically stable. A systematic literature search up to
December 2022 was performed and 567 related studies were evaluated. The
chosen studies comprised 629 penetrating thoracic trauma subjects who
participated in the selected studies' baseline. Odds ratio (OR) with 95%
confidence intervals (CIs) were calculated to assess the effect of
different chest ultrasounds on wound infection after penetrating thoracic
trauma by the dichotomous methods with a random or fixed effect model. The
chest ultrasound resulted in significantly lower occult penetrating
cardiac wounds detection (OR, 0.02; 95% CI, 0.01-0.08, P < 0.001), higher
false positive (OR, 33.85; 95% CI, 9.21-124.39, P < 0.001), and higher
false negative (OR, 27.31; 95% CI, 7.62-97.86, P < 0.001) compared with
the pericardial window in penetrating thoracic trauma. The chest
ultrasound resulted in significantly lower occult penetrating cardiac
wound detection, higher false positives, and higher false negatives
compared with the pericardial window in penetrating thoracic trauma.
Although care should be taken when dealing with the results because all of
the studies had less than 200 subjects as a sample size. Copyright
© 2023 The Authors. International Wound Journal published by
Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<46>
Accession Number
640238770
Title
Postoperative Outcomes in Elderly Patients Undergoing Cardiac Surgery With
Preoperative Cognitive Impairment: A Systematic Review and Meta-Analysis.
Source
Anesthesia and analgesia. (no pagination), 2023. Date of Publication: 11
Jan 2023.
Author
Au E.; Thangathurai G.; Saripella A.; Yan E.; Englesakis M.; Nagappa M.;
Chung F.
Institution
(Au, Saripella, Yan, Chung) From the Department of Anesthesia and Pain
Management, Toronto Western Hospital ,University Health Network, Toronto,
ON, Canada
(Thangathurai) Department of Medicine, McGill University, Montreal, QC,
Canada
(Yan) Department of Medical Science, University of Toronto, Toronto, ON,
Canada
(Englesakis) Department of Library & Information Services, University
Health Network, Toronto, ON, Canada
(Nagappa) Department of Anesthesia and Perioperative Medicine, London
Health Sciences Centre and St Joseph Health Care, Schulich School of
Medicine and Dentistry, Western University, London, ON, Canada
Publisher
NLM (Medline)
Abstract
BACKGROUND: Older patients with preoperative cognitive impairment are at
risk for increased postoperative complications after noncardiac surgery.
This systematic review and meta-analysis aimed to determine the
association between preoperative cognitive impairment and dementia and
postoperative outcomes in older surgical patients after cardiac surgery.
 METHOD(S): Eight electronic databases were searched from inception to
January 4, 2022. Inclusion criteria were cardiac surgery patients >=60
years of age; preoperative cognitive impairment; >=1 postoperative
complication reported; comparator group with no preoperative cognitive
impairment; and written in English. Using a random-effects model, we
calculated effect sizes as odds ratio (OR) and standardized mean
differences (SMDs). Risk of random error was assessed by applying trial
sequential analysis. RESULT(S): Sixteen studies (62,179 patients)
were included. Preoperative cognitive impairment was associated with
increased risk of delirium in older patients after cardiac surgery (70.0%
vs 20.5%; OR, 8.35; 95% confidence interval [CI], 4.25-16.38; I2, 0%; P <
.00001). Cognitive impairment was associated with increased hospital
length of stay (LOS; SMD, 0.36; 95% CI, 0.20-0.51; I2, 22%; P < .00001)
and intensive care unit (ICU) LOS (SMD, 0.39; 95% CI, 0.09-0.68; I2, 70%;
P = .01). No significant association was seen for 30-day mortality (1.7%
vs 1.1%; OR, 2.58; 95% CI, 0.64-10.44; I2, 55%; P = .18).
 CONCLUSION(S): In older patients undergoing cardiac surgery,
cognitive impairment was associated with an 8-fold increased risk of
delirium, a 5% increase in absolute risk of major postoperative bleeding,
and an increase in hospital and ICU LOS by approximately 0.4 days. Further
research on the feasibility of implementing routine neurocognitive testing
is warranted. Copyright © 2023 International Anesthesia Research
Society.

<47>
Accession Number
640239666
Title
Enhanced Pain Control after Reduction Mammaplasty with Combination
Bupivacaine and Dexamethasone Regional Block: A Double-Blind Randomized
Controlled Trial (NCT04919317).
Source
Plastic and reconstructive surgery. (no pagination), 2023. Date of
Publication: 13 Jan 2023.
Author
Taylor G.A.; Panichella J.C.; Neusner A.; Lo A.; Vazquez D.; Zhao H.;
Trehan G.; Livelsberger J.; Gassman A.A.
Institution
(Taylor) Department of Surgery, PA 19140, Temple University Hospital 3401
N Broad Street, Philadelphia, United States
(Panichella, Vazquez, Zhao) PA 19140, Lewis Katz School of Medicine at
Temple University 3500 N Broad Street, Philadelphia, United States
(Neusner) Division of Plastic and Reconstructive Surgery, Department of
Surgery, Lahey Hospital & Medical Center 41 Mall Road, Burlington, MA
01805, United States
(Lo) Division of Plastic Surgery, Department of Surgery, Penn State Milton
S. Hershey Medical Center 500 University Drive, Hershey PA 17033, United
States
(Trehan, Livelsberger) Department of Anesthesiology, PA 19140, Lewis Katz
School of Medicine at Temple University 3401 N Broad Street, Philadelphia,
United States
(Gassman) PRMA Plastic Surgery 9635 Huebner Road, San Antonio, Mexico
Publisher
NLM (Medline)
Abstract
BACKGROUND: There are many approaches to pain control in reduction
mammaplasty. Preoperative bupivacaine regional blocks control pain
relatively inexpensively ($0.07/mL), but last only 8-hours. A liposomal
bupivacaine formulation lasts 72-hours but can be costly ($17.21/mL).
Orthopedic and thoracic surgeries have demonstrated that dexamethasone
($0.44/mL) plus bupivacaine can prolong analgesia. We conducted a
double-blind, randomized controlled trial to determine if dexamethasone
plus bupivacaine regional block improves postoperative pain control,
reduces inpatient narcotic usage, and improves patient satisfaction
(ClinicalTrials.gov NCT04919317). METHOD(S): Female patients were
randomized into control and experimental groups. Both groups received
preoperative PECS2 blocks: bupivacaine plus saline (control) or
bupivacaine plus dexamethasone (experimental). Postoperative pain regimens
were standardized. Vital signs, pain scores, narcotic consumption, and
anti-emetic usage were recorded throughout the hospitalization. Quality of
life surveys were distributed at the first postoperative visit.
 RESULT(S): 51 patients completed the study: 25 control and 26
experimental group patients. The experimental group averaged lower pain
scores, although there was no statistically significant difference overall
or at each 4-hour interval. Postoperative narcotic usage was significantly
lower in the experimental group (mean 23.2 versus 36.6 oral morphine
equivalents per patient, p=0.026). There were no differences in 4-hour
interval vital signs, antiemetic usage, or length of stay. Survey results
showed enhanced quality of life in the experimental group, but this was
not statistically significant. CONCLUSION(S): The addition of
dexamethasone to bupivacaine in the PECS2 block prior to bilateral
reduction mammoplasty resulted in significantly less narcotic consumption
in the hospital. This can be a cost-effective adjunct for postoperative
pain control. Copyright © 2023 by the American Society of Plastic
Surgeons.

<48>
Accession Number
640239352
Title
Effects of anesthetic depth on postoperative pain and delirium: a
meta-analysis of randomized controlled trials with trial sequential
analysis.
Source
Chinese medical journal. (no pagination), 2023. Date of Publication: 03
Jan 2023.
Author
Long Y.; Feng X.; Liu H.; Shan X.; Ji F.; Peng K.
Institution
(Long, Shan, Ji, Peng) Department of Anesthesiology, First Affiliated
Hospital of Soochow University, Suzhou, Jiangsu 215006, China
(Long, Shan, Ji, Peng) Institute of Anesthesiology, Soochow University,
Suzhou, Jiangsu 215006, China
(Feng) Department of Anesthesiology, University of Utah Health, Salt Lake
City, UT, United States
(Liu) Department of Anesthesiology and Pain Medicine, University of
California Davis Health, Sacramento, CA, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Whether anesthetic depth affects postoperative outcomes
remains controversial. This meta-analysis aimed to evaluate the effects of
deep vs. light anesthesia on postoperative pain, cognitive function,
recovery from anesthesia, complications, and mortality. METHOD(S):
PubMed, EMBASE, and Cochrane CENTRAL databases were searched until January
2022 for randomized controlled trials comparing deep and light anesthesia
in adult surgical patients. The co-primary outcomes were postoperative
pain and delirium (assessed using the confusion assessment method). We
conducted a meta-analysis using a random-effects model. We assessed
publication bias using the Begg's rank correlation test and Egger's linear
regression. We evaluated the evidence using the trial sequential analysis
and Grading of Recommendations Assessment, Development and Evaluation
(GRADE) methodology. We conducted subgroup analyses for pain scores at
different postoperative time points and delirium according to cardiac or
non-cardiac surgery. RESULT(S): A total of 26 trials with 10,743
patients were included. Deep anesthesia compared with light anesthesia (a
mean difference in bispectral index of -12 to -11) was associated with
lower pain scores at rest at 0 to 1 h postoperatively (weighted mean
difference = -0.72, 95% confidence interval [CI] = -1.25 to -0.18, P =
0.009; moderate-quality evidence) and an increased incidence of
postoperative delirium (24.95% vs. 15.92%; risk ratio = 1.57, 95% CI =
1.28-1.91, P < 0.0001; high-quality evidence). No publication bias was
detected. For the exploratory secondary outcomes, deep anesthesia was
associated with prolonged postoperative recovery, without affecting
neurocognitive outcomes, major complications, or mortality. In the
subgroup analyses, the deep anesthesia group had lower pain scores at rest
and on movement during 24 h postoperatively, without statistically
significant subgroup differences, and deep anesthesia was associated with
an increased incidence of delirium after non-cardiac and cardiac
surgeries, without statistically significant subgroup differences.
 CONCLUSION(S): Deep anesthesia reduced early postoperative pain but
increased postoperative delirium. The current evidence does not support
the use of deep anesthesia in clinical practice. Copyright © 2023
The Chinese Medical Association, produced by Wolters Kluwer, Inc. under
the CC-BY-NC-ND license.

<49>
Accession Number
640239276
Title
Prevention of Atrial Fibrillation After Cardiac Surgery: A Review of
Literature and Comparison of Different Treatment Modalities.
Source
Cardiology in review. (no pagination), 2022. Date of Publication: 20 Dec
2022.
Author
Halonen J.; Karkkainen J.; Jantti H.; Martikainen T.; Valtola A.; Ellam
S.; Valiaho E.; Santala E.; Rasanen J.; Juutilainen A.; Mahlamaki V.;
Vasankari S.; Vasankari T.; Hartikainen J.
Institution
(Halonen, Karkkainen, Valtola, Valiaho, Santala, Rasanen, Hartikainen)
From the Heart Center, Kuopio University Hospital, Kuopio, Finland
(Halonen, Karkkainen, Jantti, Valiaho, Santala, Rasanen, Juutilainen,
Mahlamaki, Hartikainen) Institute of Clinical Medicine, School of
Medicine, University of Eastern Finland, Kuopio, Finland
(Jantti) Centre for Prehospital Emergency Care, Kuopio University
Hospital, Kuopio, Finland
(Martikainen, Ellam) Department of Anesthesiology and Operative Services,
Kuopio University Hospital, Kuopio, Finland
(Vasankari) Department of Clinical Medicine, University of Turku, Turku,
Finland
(Vasankari) UKK Institute for Health Promotion Research, Tampere, Finland
(Vasankari) Faculty of Medicine and Health Technology, Tampere University,
Tampere, Finland
Publisher
NLM (Medline)
Abstract
Atrial fibrillation is the most common arrhythmia to occur after cardiac
surgery, with an incidence of 10% to 50%. It is associated with
postoperative complications including increased risk of stroke, prolonged
hospital stays and increased costs. Despite new insights into the
mechanisms of atrial fibrillation, no specific etiologic factor has been
identified as the sole perpetrator of the arrhythmia. Current evidence
suggests that the pathophysiology of atrial fibrillation in general, as
well as after cardiac surgery, is multifactorial. Studies have also shown
that new-onset postoperative atrial fibrillation following cardiac surgery
is associated with a higher risk of short-term and long-term mortality.
Furthermore, it has been demonstrated that prophylactic medical therapy
decreases the incidence of postoperative atrial fibrillation after cardiac
surgery. Of note, the incidence of postoperative atrial fibrillation has
not changed during the last decades despite the numerous preventive
strategies and operative techniques proposed, although the perioperative
and postoperative care of cardiac patients as such has
improved. Copyright © 2022 Wolters Kluwer Health, Inc. All rights
reserved.

<50>
Accession Number
640239629
Title
Association Between Length of Storage of Transfused Packed RBC Units and
Outcome of Surgical Critically Ill Adults: A Subgroup Analysis of the Age
of Blood Evaluation Randomized Trial.
Source
Critical care medicine. (no pagination), 2022. Date of Publication: 26
Dec 2022.
Author
Lehr A.R.; Hebert P.; Fergusson D.; Sabri E.; Lacroix J.
Institution
(Lehr) Department of Pediatrics, Montreal Children Hospital, McGill
University, Montreal, QC, Canada
(Hebert) Department of Medicine, Bruyere Research Institute, University of
Ottawa, Ottawa, ON, Canada
(Fergusson, Sabri) Ottawa Hospital Research Institute, Department of
Clinical Epidemiology Program and University of Ottawa, Ottawa, ON, Canada
(Fergusson) Departments of Medicine, Surgery, Epidemiology and Community
Medicine, University of Ottawa, Ottawa, ON, Canada
(Lacroix) Centre Hospitalier Universitaire Sainte Justine, Departement de
Pediatrie de l'Universite de Montreal, Montreal, QC, Canada
Publisher
NLM (Medline)
Abstract
OBJECTIVES: The Age of Blood Evaluation (ABLE) study reported no clinical
benefit in fresher compared with standard delivery RBC units (length of
storage: 6.9+/-4.1 vs 22.0+/-8.4 d, respectively). Perioperative patients
are often anemic, at risk of blood loss, and more exposed to RBC
transfusions. We address the question whether fresh RBC units are safer
than standard delivery RBC units in perioperative ICU patients. DESIGN:
Subgroup analysis of surgical nontrauma adults enrolled in the ABLE
randomized controlled trial.ICUs. PATIENTS: Three hundred twenty surgical
patients among the 2,510 ICU adults recruited in the ABLE study who had a
request for a first RBC transfusion in the first week in ICU stay and an
anticipated length of mechanical ventilation greater than or equal to 48
hours. We included perioperative patients but excluded elective cardiac
surgery and trauma. INTERVENTIONS: Surgical participants were allocated to
receive either RBC units stored less than or equal to 7 days or standard
issue RBC. MEASUREMENTS AND MAIN RESULTS: The primary outcome was 90-day
all-cause mortality.One hundred seventy-two perioperative patients were
allocated to the fresh and 148 to the standard group. Baseline data were
similar. The length of storage was 7.2+/-6.4 in fresh and 20.6+/-8.4 days
in standard group (p < 0.0001). The 90-day mortality was 29.7% and 28.4%,
respectively (absolute risk difference: 0.01; 95% CI -0.09 to 0.11; p =
0.803). No significant differences were observed for all secondary
outcomes, including 6-month mortality, even after adjustment for age,
country, and Acute Physiology and Chronic Health Evaluation score.
 CONCLUSION(S): There was no evidence that fresh red cells improved
outcomes as compared to standard issue red cells in critically ill
surgical patients, consistent with other patients enrolled in the ABLE
trial. Copyright © 2022 by the Society of Critical Care Medicine
and Wolters Kluwer Health, Inc. All Rights Reserved.

<51>
Accession Number
640239136
Title
Perioperative dexmedetomidine administration does not reduce the risk of
acute kidney injury after non-cardiac surgery: a meta-analysis.
Source
Chinese medical journal. (no pagination), 2022. Date of Publication: 26
Dec 2022.
Author
Hu B.; Tian T.; Li X.; Liu W.; Chen Y.; Jiang T.; Chen P.; Xue F.
Institution
(Hu) Department of Anesthesiology, Beijing Friendship Hospital, Capital
Medical University, Beijing 100050, China
Publisher
NLM (Medline)
Abstract
BACKGROUND: Post-operative acute kidney injury (AKI) is one of the most
common and serious complications after major surgery and is significantly
associated with increased risks of morbidity and mortality. This
meta-analysis was conducted to evaluate the effects of perioperative
dexmedetomidine (Dex) administration on the occurrence of AKI and the
outcomes of recovery after non-cardiac surgery. METHOD(S): The
PubMed, Embase, Web of Science, and Cochrane Library databases were
systematically searched for studies comparing the effects of Dex vs.
placebo on kidney function after non-cardiac surgery, and a pooled
fixed-effect meta-analysis of the included studies was performed. The
primary outcome was the occurence of post-operative AKI. The secondary
outcomes included the occurence of intra-operative hypotension and
bradycardia, intensive care unit (ICU) admission, duration of ICU stay,
and hospital length of stay (LOS). RESULT(S): Six studies, including
four randomized controlled trials (RCTs) and two observational studies,
with a total of 2586 patients were selected. Compared with placebo, Dex
administration could not reduce the odds of post-operative AKI (odds ratio
(OR), 0.44; 95% confidence interval (CI), 0.18-1.06; P = 0.07; I2 = 0.00%,
P = 0.72) in RCTs, but it showed a significant renoprotective effect (OR,
0.67; 95% CI, 0.48-0.95; P = 0.02; I2 = 0.00%, P = 0.36) in observational
studies. Besides, Dex administration significantly increased the odds of
intra-operative bradycardia and shortened the duration of ICU stay.
However, there was no significant difference in the odds of
intra-operative hypotension, ICU admission, and hospital LOS.
 CONCLUSION(S): This meta-analysis suggests that perioperative Dex
administration does not reduce the risk of AKI after non-cardiac surgery.
However, the quality of evidence for this result is low due to imprecision
and inconsistent types of non-cardiac operations. Thus, large and
high-quality RCTs are needed to verify the real effects of perioperative
Dex administration on the occurrence of AKI and the outcomes of recovery
after non-cardiac surgery. Copyright © 2022 The Chinese Medical
Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND
license.

<52>
Accession Number
640239740
Title
Aortic Valve Replacement: Is Minimally Invasive Really Better? A
Contemporary Systematic Review and Meta-Analysis.
Source
Cardiology in review. (no pagination), 2022. Date of Publication: 28 Dec
2022.
Author
El-Andari R.; Fialka N.M.; Shan S.; White A.; Manikala V.K.; Wang S.
Institution
(El-Andari, Shan, White, Manikala, Wang) From the Division of Cardiac
Surgery, Department of Surgery, University of Alberta, Edmonton, AB,
Canada
(Fialka) Faculty of Medicine and Dentistry, University of Alberta,
Edmonton, AB, Canada
Publisher
NLM (Medline)
Abstract
In recent years, minimally invasive cardiac surgery has increased in
prevalence. There has been significant debate regarding the optimal
approach to isolated aortic valve replacement between conventional midline
sternotomy and minimally invasive approaches. We performed a systematic
review of the contemporary literature comparing minimally invasive to full
sternotomy aortic valve replacement. PubMed and Embase were systematically
searched for articles published from 2010-2021. A total of 1215 studies
were screened and 45 studies (148,606 patients total) met the inclusion
criteria. This study found rates of in-hospital mortality were higher with
full sternotomy than ministernotomy (P = 0.02). 30-day mortality was
higher with full sternotomy compared to right anterior thoracotomy (P =
0.006). Renal complications were more common with full sternotomy versus
ministernotomy (P < 0.00001) and right anterior thoracotomy (P < 0.0001).
Rates of wound infections were greater with full sternotomy than
ministernotomy (P = 0.02) and right anterior thoracotomy (P < 0.00001).
Intensive care unit length of stay (P = 0.0001) and hospital length of
stay (P < 0.0001) were shorter with ministernotomy compared to full
sternotomy. This review found that minimally invasive approaches to
isolated aortic valve replacement result in reduced early mortality and
select measures of postoperative morbidity; however, long-term mortality
is not significantly different based on surgical approach. An analysis of
mortality alone is not sufficient for the selection of the optimal
approach to isolated aortic valve replacement. Surgeon experience,
individual patient characteristics, and preference require thorough
consideration, and additional studies investigating quality of life
measures will be imperative in identifying the optimal approach to
isolated aortic valve replacement. Copyright © 2022 Wolters
Kluwer Health, Inc. All rights reserved.

<53>
Accession Number
640244831
Title
Efficacy and Safety of Oral Hydration 1 Hour After Extubation of Patients
Undergoing Cardiac Surgery: A Randomized Controlled Trial.
Source
The Journal of cardiovascular nursing. (no pagination), 2022. Date of
Publication: 17 Oct 2022.
Author
Liang T.; Li S.-L.; Peng Y.-C.; Chen Q.; Chen L.-W.; Lin Y.-J.
Publisher
NLM (Medline)
Abstract
BACKGROUND: Thirst is one of the most common and uncomfortable symptoms in
patients after cardiac surgery. The postextubation time for early oral
hydration (EOH) remains unclear, and there is a lack of studies on its
safety and effectiveness. OBJECTIVE(S): The aim of this study was to
investigate the effects of oral hydration 1 hour after extubation on
thirst, salivary pH, salivary flow, oral mucosa, halitosis,
gastrointestinal adverse reactions, aspiration pneumonia, and satisfaction
in patients undergoing cardiac surgery. METHOD(S): Eighty-four
patients who underwent cardiac surgery were randomly assigned into 2
groups, for either conventional oral hydration (COH) or EOH. The EOH group
drank 30 mL of warm water 1 hour post extubation and thereafter 50 mL
hourly for 4 hours. The COH group had nil per os for 4 hours after
extubation. If no dysphagia was evident after 4 hours, the patients were
instructed to slowly drink water. Thirst intensity was evaluated every
hour before the intervention. Nausea and vomiting were recorded after
drinking water. The salivary pH, unstimulated salivary flow rate, oral
odor, and oral mucosal moisture were evaluated at 1 hour post extubation,
immediately before the intervention, and at 4 hour post intervention.
Aspiration pneumonia data were collected within 72 hours post
intervention. Satisfaction was assessed before leaving the intensive care
unit. RESULT(S): The scores for thirst (3.38 +/- 1.04; F = 306.21, P
< .001), oral mucosa (2.03 +/- 0.74; P < .001), and halitosis (2.77 +/-
0.63; P < .001) in the EOH group were significantly lower than those in
the COH group. The EOH group had significantly higher salivary pH (6.44
+/- 1.06; P < .001), unstimulated salivary flow rates (0.18 +/- 0.08; P <
.001), and patient satisfaction (4.28 +/- 0.45; P < .001) than the COH
group. Nausea and vomiting did not differ significantly between groups (P
= .60). Aspiration pneumonia was not observed in either group.
 CONCLUSION(S): Oral hydration 1 hour after extubation significantly
alleviated thirst and stabilized the oral environment without
gastrointestinal adverse reactions or aspiration pneumonia, and with
increased patient satisfaction. Copyright © 2022 Wolters Kluwer
Health, Inc. All rights reserved.

<54>
Accession Number
640240461
Title
Effect of Glutamine Administration After Cardiac Surgery on Kidney Damage
in Patients at High Risk for Acute Kidney Injury: A Randomized Controlled
Trial.
Source
Anesthesia and analgesia. (no pagination), 2022. Date of Publication: 29
Nov 2022.
Author
Weiss R.; Meersch M.; Gerke M.; Wempe C.; Schafers M.; Kellum J.A.;
Zarbock A.
Institution
(Weiss, Meersch, Gerke, Wempe, Zarbock) From the Department of
Anesthesiology, Intensive Care and Pain Medicine
(Schafers) Department of Nuclear Medicine, University Hospital Munster,
Munster, Germany
(Kellum) Center for Critical Care Nephrology, Department of Critical Care
Medicine, University of Pittsburgh, Pittsburgh, PA, United States
Publisher
NLM (Medline)
Abstract
BACKGROUND: Acute kidney injury (AKI) is a common complication after
cardiac surgery and is associated with increased morbidity and mortality.
However, no specific treatment options are available, emphasizing the need
for preventive measures. The aim of this study was to clarify the effect
of glutamine on [TIMP2]*[IGFBP7] levels at the end of the intervention
period. METHOD(S): In a randomized clinical, double-blind pilot
study, 64 eligible cardiac surgery patients at high risk for AKI
identified by high urinary [TIMP2]*[IGFBP7] were randomized, and body
weight-adapted intravenous glutamine or saline-control was administered
continuously for 12 hours postoperatively. The primary outcome was urinary
[TIMP2]*[IGFBP7] at the end of the 12-hour study period. Secondary
outcomes included kidney injury molecule-1 (KIM-1) and neutrophil
gelatinase-associated lipocalin (NGAL) at 12 hours, overall AKI rates at
72 hours, free days through day 28 of mechanical ventilation and
vasoactive medication, renal recovery at day 90, requirement of renal
replacement therapy and mortality each at days 30, 60, and 90, length of
intensive care unit (ICU) and hospital stay, and major adverse kidney
events consisting of mortality, dialysis dependency, and persistent renal
dysfunction (serum creatinine >=2x compared to baseline value) at day 90
(major adverse kidney event; MAKE90). RESULT(S): Sixty-four patients
(mean age, 68.38 [standard deviation {SD} +/- 10.48] years; 10 of 64
women) were enrolled and randomized. Patients received coronary artery
bypass graft surgery (32/64), valve surgery (18/64), coronary artery
bypass graft and valve surgery (6/64), or other procedures (8/64). Mean
on-pump time was 68.38 (standard deviation +/- 10.48) minutes. After
glutamine administration, urinary [TIMP-2]*[IGFBP7] was significantly
lower in the glutamine compared to the control group (primary end point,
intervention: median, 0.18 [Q1, Q3; 0.09, 0.29], controls: median, 0.44
[Q1, Q3; 0.14, 0.79]; P = .01). In addition, [KIM-1] and [NGAL] were also
significantly lower in the glutamine group. The overall AKI rate within 72
hours was not different among groups: (intervention 11/31 [35.5%] versus
control 8/32 [25.0%]; P = .419; relative risk [RR], 0.86% [95% confidence
interval {CI}, 0.62-1.20]). There were no differences regarding secondary
end points. CONCLUSION(S): Glutamine significantly decreased markers
of kidney damage in cardiac surgery patients at high risk for AKI. Future
trials have to be performed to investigate whether the administration of
glutamine might be able to reduce the occurrence of AKI after cardiac
surgery. Copyright © 2022 International Anesthesia Research
Society.

<55>
Accession Number
2021704282
Title
Supplemental Regional Block Anesthesia Reduces Opioid Utilization
Following Free Flap Reconstruction of the Oral Cavity: A Prospective,
Randomized Clinical Trial.
Source
Journal of Oral and Maxillofacial Surgery. 81(2) (pp 140-149), 2023. Date
of Publication: February 2023.
Author
Le J.M.; Gigliotti J.; Sayre K.S.; Morlandt A.B.; Ying Y.P.
Institution
(Le) Resident, Department of Oral and Maxillofacial Surgery, University of
Alabama at Birmingham, Birmingham, AL
(Gigliotti) Assistant Professor, Faculty of Dental Medicine and Oral
Health Sciences, McGill University, Montreal, QC, Canada
(Sayre) Assistant Professor, Department of Oral and Maxillofacial Surgery,
Boston University School of Dental Medicine, Boston, MA
(Morlandt) Professor, Section of Oral Oncology, Department of Oral and
Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, AL
(Ying) Associate Professor, Section of Oral Oncology, Department of Oral
and Maxillofacial Surgery, University of Alabama at Birmingham,
Birmingham, AL
Publisher
W.B. Saunders
Abstract
Purpose: Regional anesthesia has been shown to effectively manage acute
pain and reduce opioid utilization in the early postoperative period
following colorectal, orthopedic, and thoracic surgeries. The same effect,
however, has not been demonstrated in major head and neck surgery. The
purpose of this study is to determine whether supplemental regional
anesthesia reduces opioid utilization following microvascular free flap
reconstruction of the oral cavity. Method(s): A prospective,
randomized clinical trial was conducted for patients undergoing oral
cavity reconstruction using microvascular free tissue transfer between
January 2020 and March 2022. The predictor variable was a regional
anesthetic nerve block, delivered preoperatively, at the flap donor site.
The primary and secondary outcomes were opioid utilization, measured in
oral morphine equivalent (OME), from postoperative day 1 to 5, and
hospital length of stay (LOS), respectively. Covariates included age, sex,
tobacco and alcohol history, prior radiation therapy, pathology, oral
site, flap type, tracheostomy, and neck dissection. Student's t test,
chi2 test, and linear regression models were computed using
correlations with 95% confidence intervals (CIs). For all statistical
tests, P values of <.05 were regarded as statistically significant.
 Result(s): Ninety-eight participants completed the study. The mean
age was 56 years with 55% male. Forty-eight patients received a
presurgical regional anesthesia block, and 50 patients served as control
subjects. Bivariate analysis demonstrated an even distribution of all
study variables. Total OME utilization was significantly less in the
treatment group compared to the control group, (166.32 vs 118.43 OME; 95%
CI, 1.32 to 94.45; P = .04). The LOS was comparable (6.60 vs 6.48 days;
95% CI, -0.53 to 0.77; P = .71). Tobacco use had a positive effect (B =
0.28; 95% CI, 21.63 to 115.31; P = .005) while the block had a negative
effect with total OME, (B = -0.19; 95% CI, -90.39 to -0.59; P = .047). The
extent of the neck dissection (B = 0.207; 95% CI, 0.026 to 1.403; P =
.042) was a positive predictor for LOS. Overall, there were no adverse
events associated with the regional block throughout the study period.
 Conclusion(s): Supplemental regional anesthesia is safe and
associated with reduced opioid utilization in patients undergoing
vascularized free flap reconstruction of composite oral cavity defects and
does not prolong the length of hospitalization. Copyright © 2022

<56>
Accession Number
2020930942
Title
Myocarditis associated with COVID-19 and its vaccines - a systematic
review.
Source
Progress in Cardiovascular Diseases. 74 (pp 111-121), 2022. Date of
Publication: 01 Sep 2022.
Author
Rout A.; Suri S.; Vorla M.; Kalra D.K.
Institution
(Rout, Suri, Vorla, Kalra) Division of Cardiology, University of
Louisville, Louisville, KY, United States
Publisher
W.B. Saunders
Abstract
Since the beginning of the COVID-19 (Coronavirus Disease of 2019)
pandemic, myocarditis has received much attention and controversy as one
of the more worrisome cardiovascular complications. After the availability
of highly effective COVID-19 mRNA vaccines in late 2020, myocarditis was
also appreciated as an important vaccine-related adverse event. Though the
overall frequency of clinically evident viral myocarditis is rare in the
general population, young males show a higher predilection for COVID
vaccine-induced myocarditis. The severity of COVID-19 viral myocarditis is
variable, ranging from very mild to severe, while vaccine-induced
myocarditis is usually mild, and rarely a severe or fatal disease. The
diagnosis of either COVID-19 or vaccine-induced myocarditis is based on
typical clinical features, laboratory investigations, and imaging,
preferably with cardiac magnetic resonance. The management of COVID-19
myocarditis is supportive care for mild or moderate disease. For the rare
patient who develops severe disease, advanced heart failure therapies such
as mechanical circulatory support devices may have to be employed and can
be lifesaving. Avoidance of strenuous exercise during the bout of
myocarditis and its recovery phase is important. Despite the small but
finite risk of vaccine-induced myocarditis, the benefits of protection
against COVID-19 disease and its attendant complications far outweigh the
risks. Copyright © 2022 Elsevier Inc.

<57>
Accession Number
2019795820
Title
Added Sugar, Sugar-Sweetened Beverages, and Artificially Sweetened
Beverages and Risk of Cardiovascular Disease: Findings from the Women's
Health Initiative and a Network Meta-Analysis of Prospective Studies.
Source
Nutrients. 14(20) (no pagination), 2022. Article Number: 4226. Date of
Publication: October 2022.
Author
Yang B.; Glenn A.J.; Liu Q.; Madsen T.; Allison M.A.; Shikany J.M.; Manson
J.E.; Chan K.H.K.; Wu W.-C.; Li J.; Liu S.; Lo K.
Institution
(Yang, Li, Liu, Lo) Global Health Research Center, Guangdong Provincial
People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou
510030, China
(Yang, Liu, Chan, Wu, Li, Liu, Lo) Centre for Global Cardiometabolic
Health, Departments of Epidemiology and Medicine, Brown University,
Providence, RI 02912, United States
(Glenn) Department of Nutritional Sciences, University of Toronto,
Toronto, ON M5S 1A8, Canada
(Glenn) Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical
Nutrition and Risk Factor Modification Centre, St. Michael's Hospital,
Toronto, ON M5C 2T2, Canada
(Glenn) Department of Nutrition, Harvard T.H. Chan School of Public
Health, Boston, MA 02115, United States
(Madsen) Department of Emergency Medicine, Brown University, Providence,
RI 02912, United States
(Allison) Department of Family Medicine, University of California San
Diego, La Jolla, CA 92093, United States
(Shikany) Division of Preventive Medicine, University of Alabama at
Birmingham, Birmingham, AL 35294, United States
(Manson) Division of Preventive Medicine, Department of Medicine, Brigham
and Women's Hospital, Harvard Medical School, Boston, MA 02115, United
States
(Chan) Department of Biomedical Sciences, Department of Electrical
Engineering, City University of Hong Kong, Hong Kong
(Lo) Research Institute for Smart Ageing, The Hong Kong Polytechnic
University, Hong Kong
(Lo) Department of Applied Biology and Chemical Technology, The Hong Kong
Polytechnic University, Hung Hom, Hong Kong
Publisher
MDPI
Abstract
Much remains unknown about the role of added sugar in relation to
cardiovascular disease (CVD) and the relative contributions of
sugar-sweetened beverages (SSB) or artificially sweetened beverages (ASB)
to CVD risk. Among the 109,034 women who participated in Women's Health
Initiative, we assessed average intakes of added sugar, SSB and ASB, and
conducted Cox regression to estimate the hazard ratios (HRs) and their 95%
confidence intervals for CVD risk. The consistency of findings was
compared to a network meta-analysis of all available cohorts. During an
average of 17.4 years of follow-up, 11,597 cases of total CVD (nonfatal
myocardial infarction, coronary heart disease (CHD) death, stroke,
coronary revascularization, and/or incident heart failure) were confirmed.
Added sugar as % energy intake daily (%EAS) at >=15.0% was positively
associated with total CVD (HR = 1.08 [1.01, 1.15]) and CHD (HR = 1.20
[1.09, 1.32]). There was also a higher risk of total CVD associated with
>=1 serving of SSB intake per day (HR = 1.29 [1.17, 1.42]), CHD (1.35
[1.16, 1.57]), and total stroke (1.30 [1.10, 1.53]). Similarly, ASB intake
was associated with an increased risk of CVD (1.14 [1.03, 1.26]) and
stroke (1.24 [1.04, 1.48]). According to the network meta-analysis, there
was a large amount of heterogeneity across studies, showing no consistent
pattern implicating added sugar, ASB, or SSB in CVD outcomes. A diet
containing %EAS >=15.0% and consuming >=1 serving of SSB or ASB may be
associated with a higher CVD incidence. The relative contribution of added
sugar, SSB, and ASB to CVD risk warrants further
investigation. Copyright © 2022 by the authors.

<58>
Accession Number
2020400214
Title
Short- and long-term mortality after bariatric surgery in children and
adolescents: A systematic review.
Source
Obesity Medicine. 35 (no pagination), 2022. Article Number: 100406. Date
of Publication: October 2022.
Author
Hakiminezhad M.; Alemrajabi M.; Hosseini Siyanaki M.R.; Moradi M.; Moazami
M.; Khaleghian M.; Khalaj A.; Jahangiri F.
Institution
(Hakiminezhad, Moradi) Department of General Surgery, Firoozgar Hospital,
Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Alemrajabi) Firoozgar Hospital, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Hosseini Siyanaki) Shahed Medical Faculty, Tehran, Iran, Islamic Republic
of
(Moazami) Department of Internal Medicine, Firoozgar Hospital, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Khaleghian) Rasool Akram Hospital, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Khalaj) Minimally Invasive Research Center, Rasool-E-Akram Hospital, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Jahangiri) Ali-Asghar Hospital, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
Publisher
Elsevier Ltd
Abstract
Introduction: In this study, we reviewed mortality rate and its causes
after bariatric surgeries in children and adolescents. Methods &
materials: This was a systematic review according to the PRISMA
guidelines. All human studies as cohort, observational, randomized
clinical trial (RCT) and cross-sectional in children and adolescents that
reported long and short-term mortality after bariatric surgery were
considered for initial evaluations. Result(s): in total, 8 articles
were eligible for inclusion in the study. The all-cause mortality rate was
0.02% which is lower than what reported in adults. Conclusion(s): The
overall results of this systematic review suggest that bariatric surgery
is safe for weight loss in children and adolescents with morbid obesity.
Causes of death in the literature were mostly cardiac events (infarction,
failure or collapse), hypoglycaemia, overdose and suicide. Copyright
© 2022 Elsevier Ltd

<59>
Accession Number
2020219754
Title
Meta-Analysis Comparing Fractional Flow Reserve and Angiography-Guided
Complete Revascularization of Nonculprit Artery for ST-Elevation
Myocardial Infarction.
Source
American Journal of Cardiology. 183 (pp 8-15), 2022. Date of Publication:
15 Nov 2022.
Author
Omar A.; Senguttuvan N.B.; Ueyama H.; Kuno T.; Beerkens F.; Rahim M.;
Elmariah H.; Takagi H.; Abdulkader R.S.; Yallanki H.P.; Pelliccia F.;
Mylavarapu D.P.; Claessen B.; Pasceri V.; Dangas G.
Institution
(Omar, Ueyama, Beerkens, Elmariah) Department of Medicine, Icahn School of
Medicine at Mount Sinai, New York, New York, United States
(Senguttuvan) Department of Cardiology, Sri Ramachandra Institute of
Higher Education and Research (SRIHER), Chennai, India
(Kuno) Division of Cardiology, Montefiore Medical Center, Albert Einstein
Medical College, New York, New York, United States
(Rahim) Department of Medicine, Hackensack University Medical Center,
Hackensack, NJ, United States
(Takagi) Division of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Abdulkader) Scientist-D, ICMR- National Institute of Epidemiology,
Chennai, India
(Yallanki, Mylavarapu) Department of Medicine, Sri Ramachandra Institute
of Higher Education and Research (SRIHER), India, Chennai, India
(Pelliccia, Pasceri) Department of Cardiology, University Sapienza of
Rome, Rome, Italy
(Claessen) Department of Cardiology, Amsterdam University Medical Centres,
Amsterdam, Netherlands
(Dangas) Department of Zena and Michael A. Wiener Cardiovascular
Institute, Icahn School of Medicine at Mount Sinai, New York, New York,
United States
Publisher
Elsevier Inc.
Abstract
This study aimed to compare complete revascularization (CR) guided by
angiography with a fractional flow reserve (FFR)-guided strategy in
patients presenting with ST-segment elevation myocardial infarction
(STEMI) and multivessel disease (MVD). CR is preferred to culprit-only
revascularization for patients with STEMI and MVD. However, whether
FFR-guided CR is superior to angiography-guided CR is unclear in patients
presenting with STEMI who have MVD. Randomized controlled trials comparing
CR with an FFR- or angiography-guided strategy to culprit-only
revascularization in patients with STEMI and MVD were systematically
identified. A random-effects network meta-analysis was performed comparing
clinical outcomes in the 3 arms. A total of 13 studies with a total of
8,927 patients were included in our analysis. Compared with culprit-only
revascularization, angiography-guided CR was associated with a
significantly decreased risk of myocardial infarction (MI) (hazard ratio
[HR] 0.55, 95% confidence interval [CI] 0.37 to 0.82), all-cause death (HR
0.69, 95% CI 0.49 to 0.97), and cardiovascular death (HR 0.54, 95% CI 0.34
to 0.85) but FFR-guided CR was not (MI: HR 0.77, 95% CI 0.53 to 1.12;
cardiovascular death: HR 0.89, 95% CI 0.64 to 1.24; all-cause death: HR
0.93, 95% CI 0.72 to 1.18). The network meta-analysis comparison of
angiography- versus FFR-guided CR showed an HR of 0.75 (95% CI 0.50 to
1.11) for all-cause death and an HR of 0.71 (95% CI 0.54 to 1.17) for MI.
In conclusion, for patients with MVD presenting with STEMI,
angiography-guided CR may provide additional benefits compared with
FFR-guided CR. Copyright © 2022 Elsevier Inc.

<60>
Accession Number
2018053084
Title
Balloon Angioplasty vs. Stenting for Symptomatic Intracranial Arterial
Stenosis.
Source
Frontiers in Neurology. 13 (no pagination), 2022. Article Number: 878179.
Date of Publication: 14 Jun 2022.
Author
Sun Y.; Li X.; Ding Y.; Han B.; Wang J.; Meng K.; Han Y.
Institution
(Sun, Li, Han, Wang, Meng, Han) Department of Neurology, Shanxi Provincial
People's Hospital, Taiyuan, China
(Sun, Li) The Fifth Clinical Medical College, Shanxi Medical University,
Taiyuan, China
(Ding) College of Nursing, Shanxi Medical University, Taiyuan, China
Publisher
Frontiers Media S.A.
Abstract
Aims: We performed a meta-analysis to indirectly compare the treatment
effectiveness of balloon angioplasty and stenting for patients with
intracranial arterial stenosis. Method(s): Literature searches were
performed in well-known databases to identify eligible studies published
before January 04, 2021. The incidence of restenosis, transient ischemic
attack (TIA), stroke, death, and dissection after balloon angioplasty or
stenting were pooled. An indirect comparison of balloon angioplasty vs.
stenting was performed, and the ratios of incidence (RIs) with 95%
confidence intervals (CIs) were calculated using the random-effects model.
 Result(s): 120 studies that recruited 10,107 patients with
intracranial arterial stenosis were included. The pooled incidence of
restenosis after balloon angioplasty and stenting were 13% (95%CI: 8-17%)
and 11% (95%CI: 9-13%), respectively, with no significant difference
between them (RI: 1.18; 95%CI: 0.78-1.80; P = 0.435). Moreover, the pooled
incidence of TIA after balloon angioplasty and stenting was 3% (95%CI:
0-6%) and 4% (95%CI: 3%-5%), and no significant difference was observed
(RI: 0.75; 95%CI: 0.01-58.53; P = 0.897). The pooled incidence of stroke
after balloon angioplasty and stenting was 7% (95%CI: 5-9%) and 8% (95%CI:
7-9%), respectively, and the difference between groups was found to be
statistically insignificant (RI: 0.88; 95%CI: 0.64-1.20; P = 0.413).
Additionally, the pooled incidence of death after balloon angioplasty and
stenting was 2% (95%CI: 1-4%) and 2% (95%CI: 1-2%), with no significant
difference between groups (RI: 1.00; 95%CI: 0.44-2.27; P = 1.000).
Finally, the pooled incidence of dissection after balloon angioplasty and
stenting was 13% (95%CI: 5-22%) and 3% (95%CI: 2-5%), respectively, and
balloon angioplasty was associated with a higher risk of dissection than
that with stenting for patients with intracranial arterial stenosis (RI:
4.33; 95%CI: 1.81-10.35; P = 0.001). Conclusion(s): This study found
that the treatment effectiveness of balloon angioplasty and stenting were
similar for patients with symptomatic intracranial arterial
stenosis. Copyright © 2022 Sun, Li, Ding, Han, Wang, Meng and
Han.

<61>
Accession Number
2021198500
Title
Heartbeat: medical therapy, not just mechanical intervention, for optimal
outcomes in patients with secondary mitral regurgitation.
Source
Heart. 108(21) (pp 1665-1667), 2022. Date of Publication: 13 Oct 2022.
Author
Otto C.M.
Institution
(Otto) Division of Cardiology, University of Washington, Seattle, WA,
United States
Publisher
BMJ Publishing Group

<62>
Accession Number
2019950433
Title
Impact of secondary prevention medical therapies on outcomes of patients
suffering from Myocardial Infarction with NonObstructive Coronary Artery
disease (MINOCA): A meta-analysis.
Source
International Journal of Cardiology. 368 (pp 1-9), 2022. Date of
Publication: 01 Dec 2022.
Author
De Filippo O.; Russo C.; Manai R.; Borzillo I.; Savoca F.; Gallone G.;
Bruno F.; Ahmad M.; De Ferrari G.M.; D'Ascenzo F.
Institution
(De Filippo, Russo, Manai, Borzillo, Savoca, Gallone, Bruno, De Ferrari,
D'Ascenzo) Cardiovascular and thoracic department, A.O.U. Citta della
Salute e della Scienza, Turin, Italy and Department of Medical Sciences,
University of Turin, Italy
(Ahmad) Department of Cardiology, Royal Free Hospital, London, United
Kingdom
Publisher
Elsevier Ireland Ltd
Abstract
Aims: To assess the impact of secondary prevention medical therapies
(statins, ACE-inhibitors/Angiotensin Receptor Blockers (ARB),
beta-blockers (BB) and Dual Antiplatelet Therapy (DAPT)) on outcomes of
patients with myocardial infarction with nonobstructive coronary artery
disease (MINOCA). Method(s): Five adjusted observational studies
encompassing 10,546 were included in this meta-analysis. All-cause death
was the primary endpoint, while Major Adverse Cardiovascular Events (MACE)
and acute myocardial infarction (AMI) were the secondary endpoints.
 Result(s): After 24 months of follow up, statins (tested in 8093
patients) were associated with a reduced risk of all-cause death (HR
0.60:0.45-0.81, p <0,001), while ACE-inhibitors/ARB (on 9666 patients)
were not. Aggregate data from two studies (n = 9720, 7719 on
beta-blockers, 6423 on DAPT) indicated that beta-blockers and DAPT (median
follow-up 34.1 and 15.7 months, respectively) were both associated with a
significant reduction of all-cause death (HR0.81:0.66-0.99, p = 0.04, and
HR0.73:0.55-0.98, p = 0.03, for beta-blockers and DAPT, respectively).
Among the investigated therapies, only ACE-inhibitors/ARBs entailed a
reduced risk of MACE (HR0.65:0.44-0.94, p = 0.02, all CI 95%) over 36.5
months (four studies, n = 10,150). None of the investigated therapies was
associated with a reduced risk of AMI. Conclusion(s): Data from
adjusted observational studies suggest that beta-blockers, statins and
DAPT are associated with a survival benefit among MINOCA patients.
ACE-inhibitors/ARB entail a reduced risk of MACE while none of the
investigated secondary prevention therapies is associated with a reduced
risk of AMI. Randomized controlled trials are warranted to confirm these
findings. Copyright © 2022 Elsevier B.V.

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

<64>
Accession Number
2020564671
Title
Palliative outpatient parenteral antimicrobial therapy (OPAT): A single
center experience and systematic scoping review.
Source
Clinical Infection in Practice. 16 (no pagination), 2022. Article Number:
100205. Date of Publication: November 2022.
Author
Durojaiye O.C.; Jibril I.; Kritsotakis E.I.
Institution
(Durojaiye, Jibril) Department of Infection and Tropical Medicine, Royal
Hallamshire Hospital, Sheffield S10 2JF, United Kingdom
(Durojaiye) Department of Microbiology, Royal Derby Hospital, Derby DE22
3NE, United Kingdom
(Kritsotakis) Laboratory of Biostatistics, School of Medicine, University
of Crete, Heraklion 71003, Greece
(Kritsotakis) School of Health and Related Research, Faculty of Medicine,
Dentistry and Health, University of Sheffield, Sheffield S1 4DA, United
Kingdom
Publisher
Elsevier B.V.
Abstract
Traditionally, outpatient parenteral antimicrobial therapy (OPAT) is used
to treat infections with predictable course and anticipated response to
therapy. However, there has been little consideration of OPAT for
palliation as opposed to cure. This study presents a scoping review of
literature and the experience of palliative OPAT at a tertiary referral
hospital in Derbyshire, UK. Over the 5.5-year study period, six patients
received OPAT for palliation (mean age 61 years). They accounted for 0.6 %
(6/1044) and 3.1 % (1135/36658) of the total numbers of OPAT patients and
bed-days saved, respectively. The literature search yielded 2375 articles,
of which 5 case studies were eligible for review. Palliative OPAT provided
positive experiences and outcomes for patients and their families.
However, delivering palliative OPAT could be complex, time-consuming, and
associated with clinical complications. There is a need for more research
to address significant gaps in knowledge, especially regarding patient
experiences and perspectives. Copyright © 2022 The Author(s)

<65>
Accession Number
2020558235
Title
Allopurinol versus usual care in UK patients with ischaemic heart disease
(ALL-HEART): a multicentre, prospective, randomised, open-label,
blinded-endpoint trial.
Source
The Lancet. 400(10359) (pp 1195-1205), 2022. Date of Publication: 08 Oct
2022.
Author
Mackenzie I.S.; Hawkey C.J.; Ford I.; Greenlaw N.; Pigazzani F.; Rogers
A.; Struthers A.D.; Begg A.G.; Wei L.; Avery A.J.; Taggar J.S.; Walker A.;
Duce S.L.; Barr R.J.; Dumbleton J.S.; Rooke E.D.; Townend J.N.; Ritchie
L.D.; MacDonald T.M.; Ahmed H.; Arthur P.; Aziz J.; Barnes L.; Boyle S.;
Brighton T.; Brown M.; Caulfield M.; Dawson J.; Denvir M.; Doney A.S.;
Doshi S.; Dryburgh M.; Eddleston M.; Finlayson J.; Fuat A.; Furnace J.;
Grieve J.K.; Guthrie G.; Ham S.; Isaard E.; Jennings C.; Johnson R.; Kerr
C.; Khan S.; Krishnan K.; Long S.; Mackintosh A.; Macleod M.J.; McCormack
T.; McEleny P.; Morar M.; Nadir A.; Newby D.; Petrie C.; Preiss D.;
Ralston S.; Randall M.; Routledge H.; Shakir S.; Sharma R.; Shepherd B.;
Sims D.; Snedden G.; Trevelyan J.; Weir C.; Weir R.; Wetherall K.; Wilson
R.; Wilson A.; Zutis K.
Institution
(Mackenzie, Pigazzani, Rogers, Struthers, Begg, Duce, Barr, Rooke,
MacDonald) MEMO Research, Division of Molecular and Clinical Medicine,
University of Dundee, Dundee, United Kingdom
(Hawkey, Dumbleton) Nottingham Digestive Diseases Centre, University of
Nottingham, Nottingham, United Kingdom
(Avery, Taggar) Centre for Academic Primary Care, School of Medicine,
University of Nottingham, Nottingham, United Kingdom
(Ford, Greenlaw) The Robertson Centre for Biostatistics, University of
Glasgow, Glasgow, United Kingdom
(Wei) School of Pharmacy, University College London, London, United
Kingdom
(Walker) Salus Alba, Glasgow, United Kingdom
(Townend) Institute of Cardiovascular Sciences, University of Birmingham,
Birmingham, United Kingdom
(Ritchie) Academic Primary Care, University of Aberdeen, Aberdeen, United
Kingdom
Publisher
Elsevier B.V.
Abstract
Background: Allopurinol is a urate-lowering therapy used to treat patients
with gout. Previous studies have shown that allopurinol has positive
effects on several cardiovascular parameters. The ALL-HEART study aimed to
determine whether allopurinol therapy improves major cardiovascular
outcomes in patients with ischaemic heart disease. Method(s):
ALL-HEART was a multicentre, prospective, randomised, open-label,
blinded-endpoint trial done in 18 regional centres in England and
Scotland, with patients recruited from 424 primary care practices.
Eligible patients were aged 60 years or older, with ischaemic heart
disease but no history of gout. Participants were randomly assigned (1:1),
using a central web-based randomisation system accessed via a web-based
application or an interactive voice response system, to receive oral
allopurinol up-titrated to a dose of 600 mg daily (300 mg daily in
participants with moderate renal impairment at baseline) or to continue
usual care. The primary outcome was the composite cardiovascular endpoint
of non-fatal myocardial infarction, non-fatal stroke, or cardiovascular
death. The hazard ratio (allopurinol vs usual care) in a Cox proportional
hazards model was assessed for superiority in a modified
intention-to-treat analysis (excluding randomly assigned patients later
found to have met one of the exclusion criteria). The safety analysis
population included all patients in the modified intention-to-treat usual
care group and those who took at least one dose of randomised medication
in the allopurinol group. This study is registered with the EU Clinical
Trials Register, EudraCT 2013-003559-39, and ISRCTN, ISRCTN32017426.
 Finding(s): Between Feb 7, 2014, and Oct 2, 2017, 5937 participants
were enrolled and then randomly assigned to receive allopurinol or usual
care. After exclusion of 216 patients after randomisation, 5721
participants (mean age 72.0 years [SD 6.8], 4321 [75.5%] males, and 5676
[99.2%] white) were included in the modified intention-to-treat
population, with 2853 in the allopurinol group and 2868 in the usual care
group. Mean follow-up time in the study was 4.8 years (1.5). There was no
evidence of a difference between the randomised treatment groups in the
rates of the primary endpoint. 314 (11.0%) participants in the allopurinol
group (2.47 events per 100 patient-years) and 325 (11.3%) in the usual
care group (2.37 events per 100 patient-years) had a primary endpoint
(hazard ratio [HR] 1.04 [95% CI 0.89-1.21], p=0.65). 288 (10.1%)
participants in the allopurinol group and 303 (10.6%) participants in the
usual care group died from any cause (HR 1.02 [95% CI 0.87-1.20], p=0.77).
 Interpretation(s): In this large, randomised clinical trial in
patients aged 60 years or older with ischaemic heart disease but no
history of gout, there was no difference in the primary outcome of
non-fatal myocardial infarction, non-fatal stroke, or cardiovascular death
between participants randomised to allopurinol therapy and those
randomised to usual care. Funding(s): UK National Institute for
Health and Care Research. Copyright © 2022 The Author(s).
Published by Elsevier Ltd. This is an Open Access article under the CC BY
4.0 license

<66>
Accession Number
2018480294
Title
Late Infective Endocarditis After Transcatheter Mitral Valve
Reconstruction (MitraClip) :A Case Report and a Review of the Literature.
Source
Angiology. 74(3) (pp 205-215), 2023. Date of Publication: March 2023.
Author
Chourdakis E.; Koniari I.; Osman N.; Kounis N.; Hahalis G.; Werner N.
Institution
(Chourdakis, Osman, Werner) Krankenhaus der Barmherzigen Bruder, Trier,
Germany
(Koniari) University Hospital of South Manchester, Manchester, United
Kingdom
(Kounis, Hahalis) Patras University Hospital, Patras, Greece
Publisher
SAGE Publications Inc.
Abstract
Percutaneous transcatheter mitral valve reconstruction in edge to edge
fashion is a well-established option in inoperable or high peri-operative
risk patients with severe, symptomatic mitral valve regurgitation.
MitraClip in combination with medical treatment improves survival and
reduces hospitalization rates compared with optimal medical therapy alone
in well selected patients. Clip-associated endocarditis is a rare
complication with only few reported cases in the literature. We present a
case of late infective endocarditis post Mitral Clip implantation and also
review the literature regarding this new rare condition. Copyright
© The Author(s) 2022.

<67>
Accession Number
2019659546
Title
Octreotide for Acquired Chylothorax in Pediatric Patients
Post-Cardiothoracic Surgery for Congenital Heart Disease: A Systematic
Review.
Source
Pediatric Cardiology. 44(2) (pp 297-305), 2023. Date of Publication:
February 2023.
Author
Jenkinson A.C.; McGuinness J.; Prendiville T.
Institution
(Jenkinson, Prendiville) Department of Cardiology, Children's Heart
Centre, Children's Health Ireland at Crumlin, Dublin, Ireland
(McGuinness) Department of Cardiothoracic Surgery, Children's Heart
Centre, Children's Health Ireland at Crumlin, Dublin, Ireland
(Prendiville) Department of Pediatric Cardiology, Children's Heart Centre,
Children's Health Ireland at Crumlin Hospital, Dublin, Ireland
Publisher
Springer
Abstract
Chylothorax is a life-threatening complication post-corrective congenital
heart surgery. Octreotide is used for treatment of refractory
chylothoraces, with no standardized treatment protocol and a paucity of
literature describing its efficacy. Our aim was to provide an update on
the safety and efficacy of octreotide for the treatment of refractory
chylothoraces in neonatal and pediatric patients' post-corrective
congenital heart surgery. We performed a systematic review of PubMed,
Medline, CINAHL, and Cochrane Library databases. Only intravenous
octreotide treatment was included. A total of 621 patients across 27
studies were included. Studies included were 11 case series, 5 case
studies, and 11 retrospective cohort studies. Variation in treatment
regimens were reported. Treatment efficacy was reported in 95% (23/27) of
studies. Definitions of treatment efficacy were reported in 33% (9/27) of
studies. No prospective or randomized control trials were available for
inclusion. Octreotide efficacy is widely reported despite a lack of
standardization on criteria for treatment initiation or what defines an
appropriate response to therapy.Please check and confirm whether the edit
made to the article title is in order.Yes. Copyright © 2022, The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature.

<68>
Accession Number
640228811
Title
Buffered Lidocaine as an Endotracheal Tube Cuff Media In Immediate
Postoperative Cardiac Surgery Patients And Its Effect On Sedation
Requirements: A Prospective Feasibility Study.
Source
AANA journal. 91(1) (pp 7-13), 2023. Date of Publication: 01 Feb 2023.
Author
Seelhammer T.; Kressin K.; Borhart E.; Schroeder D.; Amsbaugh A.; Steege
J.; DuBois E.; Wittwer E.
Institution
(Seelhammer) is an Assistant Professor of Anesthesiology and Medical
Director of the Adult Extracorporeal Membrane Oxygenation Service ,Mayo
Clinic College of Medicine, Rochester, MN, United States
(Kressin, Borhart) was a student in the Doctor of Nurse Anesthesia
Practice Program at Mayo Clinic School of Health SciencesMinnesota at the
time this article was written, Rochester, United Kingdom
(Schroeder) is an Assistant Professor of Biostatistics ,Mayo Clinic
College of Medicine, Rochester, MN, United States
(Amsbaugh) Anesthesia Clinical Research Unit, Mayo Clinic, is a Study
Coordinator, Rochester, MN, United States
(Steege) is an Instructor of Anesthesiology ,Mayo Clinic College of
Medicine, Rochester, MN, United States
(DuBois) is a Staff Anesthetist at Associated Anesthesiologists PA,
Plymouth, MN, United States
(Wittwer) is an Assistant Professor of Anesthesiology and Medical Director
of the Post Cardiac Surgical Intensive Care Unit ,Mayo Clinic College of
Medicine, Rochester, MN, United States
Publisher
NLM (Medline)
Abstract
Tracheal mucosal inflammation and irritation caused by the endotracheal
tube (ETT) may exacerbate symptoms of pain and discomfort which create
challenges including ETT tolerance and postintubation emergence phenomena.
Various sedative and analgesic agents are used to mitigate these symptoms,
however, there is concern that such medications may contribute to
prolonged duration of intubation, length of intensive care unit (ICU)
stay, as well as increased morbidity. This randomized control pilot study
explored the feasibility and potential efficacy of instillation of a
buffered lidocaine solution as an ETT cuff medium in adult rapid recovery
eligible cardiac surgical patients. Thirty-two patients were randomized to
the intervention (1.8% lidocaine/0.76% sodium bicarbonate) or control
(air) group. Data were analyzed using median, standard deviation (SD),
Wilcoxon rank sum, mean +/- SD, two-sample t-test, and Fisher's exact
test. The intervention arm demonstrated a trend toward a reduction in the
incidence of cough at ICU arrival (0 versus 22%), incidence of pharyngitis
at all time intervals, and propofol requirement (345 +/- 248 mg versus
1,158 +/- 1,426 mg) with no difference in adverse events between groups.
These results support the development of larger studies to confirm the
efficacy and feasibility of buffered lidocaine as an ETT cuff medium in
this population. Copyright © by the American Association of Nurse
Anesthetists.

<69>
Accession Number
2021592221
Title
Immediate, medium- and long-term outcomes of percutaneous coronary
intervention with very long drug eluting stent : An observational
multicentric study.
Source
Annales de Cardiologie et d'Angeiologie. 72(1) (pp 8-15), 2023. Date of
Publication: February 2023.
Author
Hammami R.; Boughariou A.; Jdidi J.; Cheikhrouhou A.; Abdelmoula Y.;
Thabet H.; Gribaa R.; Kacem M.; Mrad I.B.; Belkahla N.; Abdessalem A.B.;
Ameur Z.B.; Hejri E.; Kraiem S.; Naffeti I.; Abid L.
Institution
(Hammami, Boughariou, Cheikhrouhou, Abdelmoula, Abid) Service de
Cardiologie de Sfax, Hopital Hedi Chaker Sfax, Faculte de medecine de
Sfax, Universite de Sfax 3029, Tunisia
(Jdidi) Service de Medecine preventive, Faculte de medecine de Sfax,
Universite de Sfax, Tunisia
(Thabet, Gribaa, Kacem, Naffeti) Service de Cardiologie, Hopital Sahloul,
Sousse, Tunisia
(Mrad, Belkahla, Kraiem) Service de Cardiologie, Hopital Habib Thameur,
Tunis, Tunisia
(Abdessalem, Ameur, Hejri) Service de Cardiologie, Hopital Farhat Hached,
Sousse, Tunisia
Publisher
Elsevier Masson s.r.l.
Abstract
Introduction: Very long coronary lesions account for 20% of coronary
stenoses in the real world. There are few data on the effectiveness of
angioplasty of these lesions with very long active stents (DES) in the
literature. We conducted this study to assess the long-term outcomes of
angioplasty with DES length >= 40 mm in a population with multiple
cardiovascular risk factors. Patients and Methods: This is a
retrospective, multicenter, descriptive, and prognostic study, conducted
between January 2015 and January 2020, in four Tunisian centers, including
all patients who underwent angioplasty with a DES of length >= 40 mm with
a follow-up of at least one year. The primary outcome was a combined
criteria (major cardiovascular and Cerebral events: MACCE) (stroke, acute
coronary syndrome, revascularization of the target lesion: TLR,
cardiovascular death: CVD). Result(s): We included 480 procedures.
More than half of the patients had at least three risk factors. The
prevalence of high blood pressure, diabetes and smoking were 61.1%, 56.6%
and 60.4%, respectively. The treated lesions were complex: 23.54%
calcified lesions, 8.75% chronic occlusions, 25% bifurcation lesions and
12.08% ostial lesions. The average length of the stents was 47.72 mm. We
noted 17 cases of per-procedural complications (3.55%). The median
follow-up was 35 months (extremes 1-60 months). The rate of stent
thrombosis was 0.83%. The incidence of MACCE, TLR and CVD were
respectively 16.25%, 8.12% and 5.2%. In multivariate analysis, diabetes
(HR = 1.7, 95% CI [1.01-2.9]), dyslipidemia (HR = 2.08, 95% CI [1.3-3.3]),
familial coronary artery disease (HR = 1.9, 95% CI [1.01-3.6]), left
ventricle dysfunction (HR = 2.07, 95% CI [1.1-3.6]) and bifurcation
lesions (HR = 1.9, 95% CI [1.2-3.14]) were the independent predictors of
MACCE, while statin intake (HR = 0.38, 95% CI [0.19-0.78]) was a
protective factor. Conclusion(s): Angioplasty with very long DES is
associated with low levels of MACCE, TLR, stent thrombosis and CVD in our
population. Therefore, it could be an interesting alternative to cardiac
surgery. Randomized comparative studies of the two treatment options are
needed. Copyright © 2022

<70>
Accession Number
2020594490
Title
Early and Late Postoperative Tachyarrhythmias in Children and Young Adults
Undergoing Congenital Heart Disease Surgery.
Source
Pediatric Cardiology. 44(2) (pp 312-324), 2023. Date of Publication:
February 2023.
Author
Joye R.; Beghetti M.; Wacker J.; Malaspinas I.; Bouhabib M.; Polito A.;
Bordessoule A.; Shah D.
Institution
(Joye, Beghetti, Wacker, Malaspinas, Bouhabib) Pediatric Cardiology Unit,
Department of Woman, Child, and Adolescent Medicine, Geneva University
Hospital, Geneva, Switzerland
(Polito, Bordessoule) Pediatric Intensive Care Unit, Department of Woman,
Child, and Adolescent Medicine, Geneva University Hospital, Geneva,
Switzerland
(Shah) Electrophysiology Unit, Cardiology Division, Geneva University
Hospital, Geneva, Switzerland
Publisher
Springer
Abstract
The population of patients with congenital heart disease is constantly
growing with an increasing number of individuals reaching adulthood. A
significant proportion of these children and young adults will suffer from
tachyarrhythmias due to the abnormal anatomy, the hemodynamic burden, or
as a sequela of surgical treatment. Depending on the underlying mechanism,
arrhythmias may arise in the early postoperative period (hours to days
after surgery) or in the late postoperative period (usually years after
surgery). A good understanding of the electrophysiological characteristics
and pathophysiological mechanisms is therefore crucial to guide the
therapeutic approach. Here, we synthesize the current state of knowledge
on epidemiological features, risk factors, pathophysiological insights,
electrophysiological features, and therapy regarding tachyarrhythmias in
children and young adults undergoing reparative surgery for congenital
heart disease. The evolution and latest data on treatment options,
including pharmacological therapy, ablation procedures, device therapy
decision, and thromboprophylaxis, are summarized. Finally, throughout this
comprehensive review, knowledge gaps and areas for future research are
also identified. Copyright © 2022, The Author(s).

<71>
Accession Number
2022449623
Title
Transfusion trigger after operations in high cardiac risk patients (TOP)
trial protocol. Protocol for a multicenter randomized controlled
transfusion strategy trial.
Source
Contemporary Clinical Trials. 126 (no pagination), 2023. Article Number:
107095. Date of Publication: March 2023.
Author
Kougias P.; Mi Z.; Zhan M.; Carson J.L.; Dosluoglu H.; Nelson P.; Sarosi
G.A.; Arya S.; Norman L.E.; Sharath S.; Scrymgeour A.; Ollison J.; Calais
L.A.; Biswas K.
Institution
(Kougias, Sharath, Ollison) Department of Surgery, State University of New
York (SUNY) Downstate Health Sciences University, VA New York Harbor
Healthcare System, Brooklyn, NY 11203, United States
(Mi, Zhan, Norman, Biswas) VA Cooperative Studies Program Coordinating
Center, Perry Point, MD, United States
(Carson) Division of General Internal Medicine, Department of Medicine,
Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United
States
(Dosluoglu) Division of Vascular Surgery, Department of Surgery, SUNY at
Buffalo/VA Western NY Healthcare System, Buffalo, NY, United States
(Nelson) Division of Vascular Surgery, Department of Surgery, University
of Oklahoma School of Community Medicine, Tulsa, OK, United States
(Sarosi) Department of Surgery, University of Florida College of Medicine,
General Surgery Section, Department of Surgery, Malcolm Randall Veterans
Affairs Medical Center, Gainesville, FL, United States
(Arya) Division of Vascular Surgery, Department of Surgery, Stanford
University School of Medicine, Vascular Section, Surgery Service Line,
Palo Alto Veterans Affairs Medical Center, Palo Alto, CA, United States
(Scrymgeour) Cooperative Studies Program Clinical Research Pharmacy
Coordinating Center, Albuquerque, NM, United States
(Calais) Cooperative Studies Program Site Monitoring, Auditing, and
Resource Team (SMART), Albuquerque, NM, United States
Publisher
Elsevier Inc.
Abstract
Background: There is substantial uncertainty regarding the effects of
restrictive postoperative transfusion among patients who have underlying
cardiovascular disease. The TOP Trial's objective is to compare adverse
outcomes between liberal and restrictive transfusion strategies in
patients undergoing vascular and general surgery operations, and with a
high risk of postoperative cardiac events. Method(s): A two-arm,
single-blinded, randomized controlled superiority trial will be used
across 15 Veterans Affairs hospitals with expected enrollment of 1520
participants. Postoperative transfusions in the liberal arm commence when
Hb is <10 g/ dL and continue until Hb is greater than or equal to 10 g/dL.
In the restrictive arm, transfusions begin when Hb is <7 g/dL and continue
until Hb is greater than or equal to 7 g/dL. Study duration is estimated
to be 5 years including a 3-month start-up period and 4 years of
recruitment. Each randomized participant will be followed for 90 days
after randomization with a mortality assessment at 1 year. Result(s):
The primary outcome is a composite endpoint of all-cause mortality,
myocardial infarction (MI), coronary revascularization, acute renal
failure, or stroke occurring up to 90-days after randomization. Events
rates will be compared between restrictive and liberal transfusion groups.
 Conclusion(s): The TOP Trial is uniquely positioned to provide high
quality evidence comparing transfusion strategies among patients with high
cardiac risk. Results will clarify the effect of postoperative transfusion
strategies on adverse outcomes and inform postoperative management
algorithms. TRIAL REGISTRATION: http://clinicaltrials.gov identifier:
NCT03229941 Copyright © 2023

<72>
[Use Link to view the full text]
Accession Number
2022484224
Title
Anticoagulation for rheumatic mitral stenosis, INVICTUS in perspective.
Source
Current Opinion in Cardiology. 38(2) (pp 55-60), 2023. Date of
Publication: 01 Mar 2023.
Author
Verma R.; Latter D.A.
Institution
(Verma) School of Medicine, Royal College of Surgeons in Ireland, Dublin,
Ireland
(Latter) St. Michael's Hospital, University of Toronto, Toronto, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of reviewRheumatic mitral stenosis (MS) while declining in high-
and middle-income countries, continues to be a major cause of death and
disability in low-income countries. Although the nonvitamin-K antagonist
oral anticoagulants (NOACs) have essentially supplanted vitamin K
antagonists (VKA) in patients with nonvalvular atrial fibrillation (AF),
their efficacy for stroke prevention in patients with rheumatic MS and AF
has not been widely studied until recently. The purpose of this review is
to provide a succinct synopsis of the current anticoagulation
recommendations for patients with native and prosthetic heart valve
disease, with a specific focus on patients with rheumatic MS.Recent
findingsThe INVICTUS trial was the first large randomized evaluation of a
NOAC vs. VKA in approximately 4600 patients with moderate to severe
rheumatic MS and AF. The primary outcome of stroke, systemic embolization,
myocardial infarction, vascular and all-cause death, VKA treated patients
exhibited lower event rates (including mortality) compared to rivaroxaban.
We discuss and contextualize these findings as they relate to the broader
use of anticoagulants in patients with valvular heart disease, with and
without concomitant AF.SummaryVKA remains the standard of care for
patients with moderate to severe rheumatic MS who have concomitant AF.
Rates of stroke in anticoagulated patients with rheumatic MS and AF are
lower than what is traditionally held, while nonstroke related deaths
remain the most common mechanism of mortality. Copyright © 2023
Wolters Kluwer Health, Inc. All rights reserved.

<73>
Accession Number
2022494478
Title
Efficacy of Auricular Acupuncture and Lavender Oil Aromatherapy in
Reducing Preinterventional Anxiety in Cardiovascular Patients: A
Randomized Single-Blind Placebo-Controlled Trial.
Source
Journal of Integrative and Complementary Medicine. 28(1) (pp 45-50), 2022.
Date of Publication: 01 Jan 2022.
Author
Patsalis P.C.; Malik-Patsalis A.B.; Rauscher H.G.; Schaefers C.; Useini
D.; Strauch J.T.; Zahn P.K.; Dobos G.J.; Mugge A.; Cramer H.
Institution
(Patsalis, Rauscher, Schaefers, Mugge) Department of Cardiology and
Angiology, University Hospital Bergmannsheil, Ruhr University Bochum,
Bochum, Germany
(Patsalis) Division of Cardiology and Emergency Medicine, Department of
Medicine, Knappschaft University Hospital, Ruhr University Bochum, Bochum,
Germany
(Malik-Patsalis, Dobos, Cramer) Department of Internal and Integrative
Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of
Duisburg-Essen, Essen, Germany
(Useini, Strauch) Department of Cardiothoracic Surgery, University
Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
(Zahn) Department of Anesthesiology, Intensive Care Medicine, Palliative
Care Medicine and Pain Management, University Hospital Bergmannsheil, Ruhr
University Bochum, Bochum, Germany
Publisher
Mary Ann Liebert Inc.
Abstract
Introduction: Auricular acupuncture at the "relaxation point"and lavender
oil aromatherapy can reduce preoperative anxiety associated with increased
mortality and morbidity. Data on the effect of combined auricular
acupuncture and lavender oil aromatherapy in patients undergoing
cardiovascular interventions with the use of local anesthesia or under
conscious sedation are sparse. The authors sought to evaluate the efficacy
of auricular acupuncture and lavender oil aromatherapy in reducing
preinterventional anxiety in cardiovascular patients. Material(s) and
Method(s): Data of 80 consecutive patients undergoing diagnostic coronary
angiography (n = 56) with or without percutaneous coronary intervention (n
= 9) and right heart catheterization (n = 6), transcatheter aortic valve
replacement (n = 17) and percutaneous mitral valve repair (MitraClip; n =
2) were analyzed. Patients were prospectively randomized to receive either
preinterventional auricular acupuncture and lavender oil (Lavandula
angustifolia) aromatherapy (verum group, n = 39) or combined sham
auricular acupuncture and placebo oil aromatherapy (placebo group, n =
41). For the verum group bilateral auricular acupuncture was performed at
the "relaxation point."State anxiety and blood pressure were assessed
before and at 30 min after acupuncture and presternal oil application.
State anxiety was defined as primary outcome measure and assessed using
the Spielberger State Anxiety Inventory (STAI) for Adults form Y6.
Intervention-specific anxiety was assessed by a 10-point numerical rating
scale, and perceived treatment success by a single dichotomous question.
Clinical blood pressure was further assessed. Result(s): After the
intervention, the verum group had significantly decreased anxiety on the
STAI compared with the placebo group (DELTA=-4.18; 95% confidence interval
=-8.31 to-0.05; p = 0.047). Significantly more patients reported
subjective treatment success in the verum group (87.2%) than in the
placebo group (65.9%, p = 0.035). No significant differences were observed
regarding intervention-specific anxiety and blood pressure between the two
groups. No serious adverse events occurred in any group.
 Conclusion(s): Combined auricular acupuncture and lavender oil
aromatherapy can decrease preinterventional anxiety in cardiovascular
patients and requires further investigation. German Clinical Trials
Register (registration no. DRKS00023686). © Copyright 2022, Mary
Ann Liebert, Inc., publishers 2022.

<74>
Accession Number
2022462730
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), 2023.
Date of Publication: 2023.
Author
Kunadharaju R.; Saradna A.; Ray A.; Yu H.; Ji W.; Zafron M.; Mador M.J.
Institution
(Kunadharaju, Saradna, Mador) University at Buffalo, Jacobs School of
Medicine and Biomedical Sciences, Department of Pulmonary, Critical Care,
and Sleep Medicine, Buffalo, NY
(Ray) Roswell Park Comprehensive Cancer Center, Department of Cancer
Prevention & Control, Buffalo, NY
(Yu) Roswell Park Comprehensive Cancer Center, Department of Biostatistics
and Bioinformatics, Buffalo, NY
(Ji) Virginia Polytechnic Institute and State University, Center for
Biostatistics and Health Data Science, Blacksburg, VA, United States
(Zafron) University at Buffalo, Jacobs School of Medicine and Biomedical
Sciences, Reference and Education Services, Buffalo, NY
(Mador) VA WNY Healthcare System, Buffalo, NY
Publisher
W.B. Saunders
Abstract
Objective: To compare the postoperative outcomes of preoperative
respiratory muscle training (RMT) with a device 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 with 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 odds ratio (OR) of 0.35 (P value .006), 0.38 (P
value .002), and 0.22 (P value .008), respectively. Pooled data for the
patients who performed AET showed reduction in PPC, pneumonia with a OR of
0.33 (P value <.00001) and OR of 0.54 (P value .01), respectively. HLOS
was decreased by 1.69 days (P value <.00001) by performing RMT and 1.79
days (P value .0008) by performing AET compared with the usual group. No
significant difference in all-cause mortality compared with usual care in
both RMT and AET intervention groups. No significant difference in the
incidence of PRF compared with usual group in RMT + AET and AET alone
intervention groups (OR 0.32; P=.21; OR 0.94; P=.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. Conclusion(s): In thoracic surgeries,
preoperative RMT is comparable with preoperative AET to prevent PPC,
pneumonia, and PRF and reduce HLOS. It can be considered in patients in
resource-limited settings. Copyright © 2022 American Congress of
Rehabilitation Medicine

<75>
Accession Number
2015941898
Title
One gene, two modes of inheritance, four diseases: A systematic review of
the cardiac manifestation of pathogenic variants in JPH2-encoded
junctophilin-2.
Source
Trends in Cardiovascular Medicine. 33(1) (pp 1-10), 2023. Date of
Publication: January 2023.
Author
Parker L.E.; Kramer R.J.; Kaplan S.; Landstrom A.P.
Institution
(Parker, Kramer, Landstrom) Department of Pediatrics, Division of
Cardiology, Duke University School of Medicine, Durham, NC, United States
(Kaplan) Medical Center Library and Archives, Duke University, Durham, NC,
United States
(Landstrom) Department of Cell Biology, Duke University School of
Medicine, Durham, NC, United States
Publisher
Elsevier Inc.
Abstract
Rare variants in JPH2 have been associated with a range of cardiac
disease, including hypertrophic cardiomyopathy (HCM), dilated
cardiomyopathy (DCM), arrhythmias, and sudden cardiac death (SCD);
however, our understanding of how variants in JPH2 correspond to specific
modes of inheritance and correlate clinical phenotypes has not been
comprehensively explored. In this systematic review, we assess current
case reports and series that describe patients with JPH2 variants and
cardiac disease. We identified a total of 61 variant-positive individuals,
approximately 80% of whom had some form of cardiac disease, including 47%
HCM, 18% DCM, and 14% arrhythmia/SCD. In analyzing the 24 probands
described in the studies, we found that autosomal recessive,
loss-of-function variants are associated with severe, early onset DCM,
while autosomal dominant missense variants are associated with a wider
range of cardiac disease, including HCM, arrhythmia, SCD, and cardiac
conduction disease. Copyright © 2021

<76>
Accession Number
2021155446
Title
Stenting in Brain Hemodynamic Injury of Carotid Origin Caused by Type A
Aortic Dissection: Local Experience and Systematic Literature Review.
Source
Journal of Personalized Medicine. 13(1) (no pagination), 2023. Article
Number: 58. Date of Publication: January 2023.
Author
Aita J.-F.; Agripnidis T.; Testud B.; Barral P.-A.; Jacquier A.; Reyre A.;
Alnuaimi A.; Girard N.; Tradi F.; Habert P.; Gariboldi V.; Collart F.;
Bartoli A.; Hak J.-F.
Institution
(Aita, Agripnidis, Reyre, Girard, Hak) Department of Neuroradiology, APHM
La Timone, Marseille 13005, France
(Aita, Agripnidis, Tradi, Habert, Hak) LIIE, Aix Marseille University,
Marseille 13007, France
(Aita, Agripnidis, Tradi, Habert, Hak) CERIMED, Aix Marseille University,
Marseille 13007, France
(Testud, Barral, Jacquier, Alnuaimi, Tradi, Habert, Bartoli) Department of
Medical Imaging, APHM La Timone, Marseille 13005, France
(Gariboldi, Collart) Department of Cardiac Surgery, La Timone Hospital, La
Timone Hospital 264, Rue Saint Pierre, Marseille 13005, France
Publisher
MDPI
Abstract
In this study, we report our local experience of type A aortic dissections
in patients with cerebral malperfusion treated with carotid stenting
before or after aortic surgery, and present a systematic literature review
on these patients treated either with carotid stenting (CS) before or
after aortic surgery (AS) or with aortic and carotid surgery alone (ACS).
We report on patients treated in our center with carotid stenting for
brain hemodynamic injury of carotid origin caused by type A dissection
since 2018, and a systematic review was conducted in PubMed for articles
published from 1990 to 2021. Out of 5307 articles, 19 articles could be
included with a total of 80 patients analyzed: 9 from our center, 29
patients from case reports, and 51 patients from two retrospective
cohorts. In total, 8 patients were treated by stenting first, 72 by
surgery first, and 7 by stenting after surgery. The mean age; initial
NIHSS score; time from symptom onset to treatment; post-treatment clinical
improvement; post-treatment clinical worsening; mortality rate; follow-up
duration; and follow-up mRS were, respectively, for each group (local
cohort, CS before AS, ACS, CS after AS): 71.2 +/- 5.3 yo, 65.5 +/- 11.0
yo; 65.3 +/- 13.1 yo, 68.7 +/- 5.8 yo; 4 +/- 8.4, 11.3 +/- 8.5, 14.3 +/-
8.0, 0; 11.8 +/- 14.3 h, 21 +/- 39.3 h, 13.6 +/- 17.8 h, 13 +/- 17.2 h;
56%, 71%, 86%, 57%; 11%, 28%, 0%, 14%; 25%, 12.3%, 14%, 33%; 5.25 +/- 2.9
months, 54 months, 6.8 +/- 3.8 months, 14 +/- 14.4 months; 1 +/- 1; 0.25
+/- 0.5, 1.3 +/- 0.8, 0.68 +/- 0.6. Preoperative carotid stenting for
hemodynamic cerebral malperfusion by true lumen compression appears to be
feasible, and could be effective and safe, although there is still a lack
of evidence due to the absence of comparative statistical analysis. The
literature, albeit growing, is still limited, and prospective comparative
studies are needed. Copyright © 2022 by the authors.

<77>
Accession Number
2021155423
Title
Hydrogen Gas Treatment Improves Postoperative Delirium and Cognitive
Dysfunction in Elderly Noncardiac Patients.
Source
Journal of Personalized Medicine. 13(1) (no pagination), 2023. Article
Number: 67. Date of Publication: January 2023.
Author
Lin H.; Du J.; Tian Z.; Yu Y.; Cui Y.; Xie K.
Institution
(Lin, Du, Tian, Yu, Xie) Department of Anesthesiology, Tianjin Institute
of Anesthesiology, Tianjin Medical University General Hospital, Tianjin
300052, China
(Cui) Department of Pathogen Biology, School of Basic Medical Sciences,
Tianjin Medical University, Tianjin 300070, China
(Xie) Department of Critical Care Medicine, Tianjin Medical University
General Hospital, Tianjin 300052, China
Publisher
MDPI
Abstract
Purpose: Postoperative delirium is a state of acute brain dysfunction
characterized by fluctuating mental status that affects millions of
patients each year. We used prophylactic inhalation of hydrogen gas in
elderly patients undergoing elective surgery to compare their occurrence
of postoperative delirium with that of controls. Method(s): A total
of 184 patients aged >= 65 years were enrolled and randomized into either
a control group or a hydrogen inhalation group. The quality of sleep was
assessed 1 day before and 1, 3, and 7 days after surgery at 8 A.M. The
Confusion Assessment Method (CAM) was used as a screening tool for
delirium and assessed the patients' state of consciousness 1-7 days after
surgery. Result(s): Postoperative delirium occurred in 17 (24%) of 70
patients without hydrogen inhalation and in 10 (12%) of 83 patients after
hydrogen inhalation. The incidence of delirium was decreased in the
hydrogen group. No significant differences were found between length of
stay in hospital after surgery and sleep quality at 1, 3, and 7 days
postoperatively between the two groups. The numerical rating scale (NRS)
pain scores were higher in the hydrogen group (4.08 +/- 1.77) than the
control group (3.54 +/- 1.77) on day 1 (p < 0.05); however, the mean
difference between the two groups was small (1 to 1.6). There were no
significant differences on day 3 and 7. The postoperative C-reactive
protein level was significantly lower in the hydrogen group than the
control group. Conclusion(s): This study suggests that hydrogen
inhalation can prevent postoperative delirium in elderly noncardiac
patients by reducing the inflammatory response. Copyright © 2022
by the authors.

<78>
Accession Number
2021150164
Title
Metalloproteinases in Cardiac Surgery: A Systematic Review.
Source
Biomolecules. 13(1) (no pagination), 2023. Article Number: 113. Date of
Publication: January 2023.
Author
Serraino G.F.; Jiritano F.; Costa D.; Ielapi N.; Battaglia D.; Bracale
U.M.; Mastroroberto P.; Andreucci M.; Serra R.
Institution
(Serraino, Jiritano, Battaglia, Mastroroberto) Department of Experimental
and Clinical Medicine, University "Magna Graecia" of Catanzaro, Catanzaro
88100, Italy
(Costa) Department of Law, Economics and Sociology, University "Magna
Graecia" of Catanzaro, Catanzaro 88100, Italy
(Costa, Ielapi, Serra) Interuniversity Center of Phlebolymphology (CIFL),
International Research and Educational Program in Clinical and
Experimental Biotechnology, Department of Surgical and Medical Sciences,
University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro 88100,
Italy
(Ielapi) Department of Public Health and Infectious Disease, "Sapienza"
University of Rome, Roma 00185, Italy
(Bracale) Department of Public Health, University Federico II of Naples,
Naples 80138, Italy
(Andreucci) Department of Health Sciences, University "Magna Graecia" of
Catanzaro, Catanzaro 88100, Italy
(Serra) Department of Medical and Surgical Sciences, University "Magna
Graecia" of Catanzaro, Catanzaro 88100, Italy
Publisher
MDPI
Abstract
The role of matrix metalloproteinases (MMPs) in routine cardiac operations
including cardiopulmonary bypass (CPB) is still poorly explored. The
purpose of this systematic review was to thoroughly summarize and discuss
the existing knowledge of the MMP profile in cardiac surgery. All studies
meeting the inclusion criteria (i.e., those reporting detailed data about
MMP release during and after CPB) were selected after screening the
literature published between July 1975 and August 2022. Fifteen trials
that enrolled a total of 431 participants were included. MMP levels were
found to be significantly correlated with CPB in all included studies. The
gelatinases MMP-2 and MMP-9 were highly released in cardiac surgery with
CPB. MMP-9 levels were found to be increased after CPB start and during
the duration of CPB. Particularly, it is overexpressed both in the
myocardial tissue and circulating in the bloodstream. Also, MMP-2 levels
increased after CPB both in plasma and in myocardial tissue. MMP-7, MMP-8,
and MMP-13 levels increased after CPB start and remained elevated up to 6
h later. Increased levels of MMPs were associated with adverse
post-operative outcomes. Conversely, TIMP-1 decreased with CPB. Mechanical
and pharmacological strategies were applied in two studies to analyze
their effect on the inflammatory response to cardiac surgery and CPB and
on postoperative outcomes. New targeted MMP inhibitor therapies could
protect against systemic inflammatory response syndrome after CPB and
should be the subject of future large prospective multicenter randomized
clinical trials. Copyright © 2023 by the authors.

<79>
Accession Number
2021294036
Title
Outcomes of deferred revascularisation following negative fractional flow
reserve in diabetic and non-diabetic patients: a meta-analysis.
Source
Cardiovascular Diabetology. 22(1) (no pagination), 2023. Article Number:
22. Date of Publication: December 2023.
Author
Ekmejian A.; Sritharan H.; Selvakumar D.; Venkateshka V.; Allahwala U.;
Ward M.; Bhindi R.
Institution
(Ekmejian, Sritharan, Selvakumar, Allahwala, Ward, Bhindi) Department of
Cardiology, Interventional Cardiologist, Royal North Shore Hospital,
Reserve Rd, St Leonards, Sydney 2065, Australia
(Ekmejian, Sritharan, Allahwala, Ward, Bhindi) University of Sydney,
Camperdown, Australia
(Venkateshka) Northern Sydney Local Health District Executive, Hornsby,
Australia
Publisher
BioMed Central Ltd
Abstract
Background: Fractional Flow Reserve (FFR) is a widely applied invasive
physiological assessment, endorsed by major guidelines to aid in the
decision to perform or defer revascularisation. While a threshold of > 0.8
has been applied universally, clinical outcomes may be affected by
numerous factors, including the presence of diabetes. This meta-analysis
aims to investigate the outcomes of diabetic versus non-diabetic patients
in whom revascularisation was deferred based on negative FFR.
 Method(s): We performed a meta-analysis investigating the outcomes of
diabetic and non-diabetic patients in whom revascularisation was deferred
based on negative FFR. A search was performed on MEDLINE, PubMed and
EMBASE, and peer-reviewed studies that reported MACE for diabetic and
non-diabetic patients with deferred revascularisation based on FFR > 0.8
were included. The primary end point was MACE. Result(s): The
meta-analysis included 7 studies in which 4275 patients had
revascularisation deferred based on FFR > 0.8 (1250 diabetic). Follow up
occurred over a mean of 3.2 years. Diabetes was associated with a higher
odds of MACE (OR = 1.66, 95% CI 1.35-2.04, p = < 0.001), unplanned
revascularisation (OR = 1.48, 95% CI 1.06-2.06, p = 0.02), all-cause
mortality (OR = 1.74, 95% CI 1.20-2.52, p = 0.004) and cardiovascular
mortality (OR = 2.08, 95% CI 1.07-4.05, p = 0.03). Conclusion(s): For
patients with stable coronary syndromes and deferred revascularisation
based on FFR > 0.8, the presence of diabetes portends an increased
long-term risk of MACE compared to non-diabetic patients. Trail
registration URL: https://www.crd.york.ac.uk/PROSPERO/; Unique identifier:
CRD42022367312. Copyright © 2023, Crown.

<80>
Accession Number
2013114738
Title
Spontaneous Reperfusion in Patients with Transient ST-Elevation Myocardial
Infarction-Prevalence, Importance and Approaches to Management.
Source
Cardiovascular Drugs and Therapy. 37(1) (pp 169-180), 2023. Date of
Publication: February 2023.
Author
Farag M.; Peverelli M.; Spinthakis N.; Gue Y.X.; Egred M.; Gorog D.A.
Institution
(Farag, Egred) Cardiothoracic Department, Freeman Hospital, Newcastle Upon
Tyne, United Kingdom
(Farag, Spinthakis, Gue, Gorog) School of Life and Medical Sciences,
University of Hertfordshire, Hertfordshire, United Kingdom
(Peverelli) Department of Cardiology, Royal Papworth Hospital, Cambridge,
United Kingdom
Publisher
Springer
Abstract
Patients with transient ST-elevation myocardial infarction (STEMI) or
spontaneous resolution (SpR) of the ST-segment elevation on
electrocardiogram could potentially represent a unique group of patients
posing a therapeutic management dilemma. In this review, we discuss the
potential mechanisms underlying SpR, its relation to clinical outcomes and
the proposed management options for patients with transient STEMI with a
focus on immediate versus early percutaneous coronary intervention. We
performed a structured literature search of PubMed and Cochrane Library
databases from inception to December 2020. Studies focused on SpR in
patients with acute coronary syndrome were selected. Available data
suggest that deferral of angiography and revascularization within 24-48 h
in these patients is reasonable and associated with similar or perhaps
better outcomes than immediate angiography. Further randomized trials are
needed to elucidate the best pharmacological and invasive strategies for
this cohort. Copyright © 2021, Springer Science+Business Media,
LLC, part of Springer Nature.

<81>
[Use Link to view the full text]
Accession Number
2022329887
Title
BioMatrix Versus Orsiro Stents for Coronary Artery Disease: A Multicenter,
Randomized, Open-Label Study.
Source
Circulation: Cardiovascular Interventions. 16(1) (pp E012307), 2023. Date
of Publication: 01 Jan 2023.
Author
Yoon C.-H.; Kwun J.-S.; Choi Y.J.; Park J.J.; Kang S.-H.; Suh J.-W.; Youn
T.-J.; Kim M.-K.; Cha K.S.; Lee S.-H.; Hong B.-K.; Rha S.-W.; Kang W.C.;
Lee J.-H.; Kim S.-H.; Chae I.-H.
Institution
(Yoon, Kwun, Park, Kang, Kim, Suh, Youn, Chae) Cardiovascular Center,
Department of Internal Medicine, Seoul National University, Bundang
Hospital, South Korea
(Choi) Sejong General Hospital, Bucheon, South Korea
(Kim) Catholic Kwandong University International St Mary's Hospital,
Incheon, South Korea
(Cha) Pusan National University Hospital, South Korea
(Lee) Wonju Severance Hospital, Yonsei University, College of Medicine,
South Korea
(Hong) Gangnam Severance Hospital, Yonsei University, College of Medicine,
Seoul, South Korea
(Rha) Korea University Guro Hospital, Seoul, South Korea
(Kang) Gachon University, Gil Medical Center, Incheon, South Korea
(Lee) Chungnam National University Hospital, Daejeon, South Korea
(Kim) Seoul Metropolitan Government Seoul National University Boramae
Medical Center, Seoul, South Korea
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Comparative studies of ultrathin-strut biodegradable polymer
sirolimus-eluting stent (BP-SES) have reported promising results and
validated its excellent outcomes in terms of safety and efficacy. However,
there are limited studies comparing BP drug-eluting stents with struts of
different thicknesses. We compared the long-term clinical outcomes of
patients treated with an ultrathin-strut BP-SES or a thick-strut
biodegradable polymer biolimus-eluting stent (BP-BES). Method(s): The
BIODEGRADE trial (Biomatrix and Orsiro Drug-Eluting Stents in Angiographic
Result in Patients With Coronary Artery Disease) is a multicenter
prospective randomized study comparing coronary revascularization in
patients with ultrathin-strut BP-SES and thick-strut BP-BES with the
primary end point of target lesion failure at 18 months posttreatment. We
performed the prespecified analysis of 3-year clinical outcomes.
 Result(s): In total, 2341 patients were randomized to receive
treatment with ultrathin-strut BP-SES (N=1175) or thick-strut BP-BES
(N=1166). The 3-year incidence rate of target lesion failure was 3.2% for
BP-SES and 5.1% for BP-BES (P=0.023). The difference was primarily due to
differences in ischemia-driven target lesion revascularization (BP-SES,
1.5%; BP-BES, 2.8%; P=0.035) between groups. A landmark analysis of the
late follow-up period showed significant differences in target lesion
failure, with outcomes being better in BP-SES. Cardiac death and target
lesion revascularization were significantly lower in the BP-SES group.
 Conclusion(s): In a large, randomized trial, the long-term clinical
outcome of target lesion failure at 3 years was significantly better among
patients treated with the ultrathin-strut BP-SES. The results indicate the
superiority of the ultrathin-strut BP-SES compared with the thick-strut
BP-BES. Registration: URL: https://clinicaltrials.gov; Unique identifier:
NCT02299011. Copyright © 2023 Lippincott Williams and Wilkins.
All rights reserved.

<82>
Accession Number
2022318304
Title
Clinical Utilization of Multimodality Imaging for Myocarditis and Cardiac
Sarcoidosis.
Source
Circulation: Cardiovascular Imaging. 16(1) (pp E014091), 2023. Date of
Publication: 01 Jan 2023.
Author
Chareonthaitawee P.; Gutberlet M.
Institution
(Chareonthaitawee) Mayo Clinic, Department of Cardiovascular Medicine,
Rochester, MN, United States
(Gutberlet) Heart Center Leipzig, University Leipzig, Germany
Publisher
Lippincott Williams and Wilkins
Abstract
Myocarditis is defined as inflammation of the myocardium according to
clinical, histological, biochemical, immunohistochemical, or imaging
findings. Inflammation can be categorized histologically by cell type or
pattern, and many causes have been implicated, including infectious, most
commonly viral, systemic autoimmune diseases, vaccine-associated
processes, environmental factors, toxins, and hypersensitivity to drugs.
Sarcoid myocarditis is increasingly recognized as an important cause of
cardiomyopathy and has important diagnostic, prognostic, and therapeutic
implications in patients with systemic sarcoidosis. The clinical
presentation of myocarditis may include an asymptomatic, subacute, acute,
fulminant, or chronic course and may have focal or diffuse involvement of
the myocardium depending on the cause and time point of the disease. For
most causes of myocarditis except sarcoidosis, myocardial biopsy is the
gold standard but is limited due to risk, cost, availability, and variable
sensitivity. Diagnostic criteria have been established for both
myocarditis and cardiac sarcoidosis and include clinical and imaging
findings particularly the use of cardiac magnetic resonance and positron
emission tomography. Beyond diagnosis, imaging findings may also provide
prognostic value. This case-based review focuses on the current state of
multimodality imaging for the diagnosis and management of myocarditis and
cardiac sarcoidosis, highlighting multimodality imaging approaches with
practical clinical vignettes, with a discussion of knowledge gaps and
future directions. Copyright © 2023 American Heart Association,
Inc.

<83>
Accession Number
2022318301
Title
Imaging Methods: Magnetic Resonance Imaging.
Source
Circulation: Cardiovascular Imaging. 16(1) (pp E014068), 2023. Date of
Publication: 01 Jan 2023.
Author
Thomas K.E.; Fotaki A.; Botnar R.M.; Ferreira V.M.
Institution
(Thomas, Ferreira) University of Oxford Centre for Clinical Magnetic
Resonance Research (OCMR), Division of Cardiovascular Medicine, Radcliffe
Department of Medicine, University of Oxford, United Kingdom
(Fotaki, Botnar) Department of Biomedical Engineering, School of
Biomedical Engineering and Imaging Sciences, King's College London, St
Thomas' Hospital, United Kingdom
(Botnar) Escuela de Ingenieria, Pontificia Universidad Catolica de Chile,
Santiago, Chile
(Botnar) Millennium Institute for Intelligent Healthcare Engineering,
Santiago, Chile
Publisher
Lippincott Williams and Wilkins
Abstract
Myocardial inflammation occurs following activation of the cardiac immune
system, producing characteristic changes in the myocardial tissue.
Cardiovascular magnetic resonance is the non-invasive imaging gold
standard for myocardial tissue characterization, and is able to detect
image signal changes that may occur resulting from inflammation, including
edema, hyperemia, capillary leak, necrosis, and fibrosis. Conventional
cardiovascular magnetic resonance for the detection of myocardial
inflammation and its sequela include T2-weighted imaging, parametric T1-
and T2-mapping, and gadolinium-based contrast-enhanced imaging. Emerging
techniques seek to image several parameters simultaneously for myocardial
tissue characterization, and to depict subtle immune-mediated changes,
such as immune cell activity in the myocardium and cardiac cell
metabolism. This review article outlines the underlying principles of
current and emerging cardiovascular magnetic resonance methods for imaging
myocardial inflammation. Copyright © 2022 American Heart
Association, Inc.

<84>
Accession Number
2015913408
Title
Beta-blocker use in patients with chronic obstructive pulmonary disease: A
systematic review: A systematic review of betaB in COPD.
Source
Trends in Cardiovascular Medicine. 33(1) (pp 53-61), 2023. Date of
Publication: January 2023.
Author
Ruzieh M.; Baugh A.D.; Al Jebbawi L.; Edwards E.S.; Jia K.Q.; Dransfield
M.T.; Foy A.J.
Institution
(Ruzieh) Division of Cardiovascular Medicine, University of Florida,
Gainesville, FL, United States
(Baugh) Pulmonary, Critical Care, Allergy, and Sleep Medicine, University
of California San Francisco, San Francisco, CA
(Al Jebbawi) Department of Internal Medicine, Henry Ford Allegiance Health
Affiliation, Jackson, MI
(Edwards) Department of Internal Medicine, University of Florida,
Gainesville, FL, United States
(Jia, Foy) Penn State Heart and Vascular Institute, Penn State College of
Medicine, Hershey, Panama
(Dransfield) Pulmonary, Allergy, and Critical Care Medicine, University of
Alabama at Birmingham, BirminghamAL
Publisher
Elsevier Inc.
Abstract
Beta-blockers (betaB) are a frequently used class of medications. Although
betaB have many indications, those related to cardiovascular disease are
among the most common and important. However, in patients with chronic
obstructive pulmonary disease (COPD), betaB are used less often due to
concerns about an unfavorable impact on respiratory morbidity and
mortality. We performed a systematic review to assess the safety of betaB
in patients with COPD. We included a total of 2 randomized controlled
trials and 28 observational studies. The majority found statistically
significant reductions in mortality. The two higher quality observational
studies reported increased mortality with betaB. The risk of COPD
exacerbations was reduced in about half of the studies. Nonetheless, there
were significant biases that confounded the results. The highest quality
RCT found a significant increase in severe and very severe COPD
exacerbations with betaB use. In conclusion, data on the safety of betaB
in patients with COPD are conflicting. However, given higher quality
evidence showed harm with their use, betaB should be prescribed with
caution in patients with COPD, including patients with cardiac indication
for betaB. Copyright © 2021

<85>
Accession Number
2020931239
Title
Impact of pharmacological interventions on intrapulmonary shunt during
one-lung ventilation in adult thoracic surgery: a systematic review and
component network meta-analysis.
Source
British Journal of Anaesthesia. 130(1) (pp e92-e105), 2023. Date of
Publication: January 2023.
Author
Schorer R.; Dombret A.-L.; Hagerman A.; Bedat B.; Putzu A.
Institution
(Schorer, Dombret, Hagerman, Putzu) Department of Acute Medicine, Geneva
University Hospitals, Geneva, Switzerland
(Bedat) Division of Thoracic and Endocrine Surgery, Geneva University
Hospitals, Geneva, Switzerland
Publisher
Elsevier Ltd
Abstract
Background: Intrapulmonary shunt is a major determinant of oxygenation in
thoracic surgery under one-lung ventilation. We reviewed the effects of
available treatments on shunt, PaO<inf>2</inf>/FiO<inf>2</inf> and
haemodynamics through systematic review and network meta-analysis.
 Method(s): Online databases were searched for RCTs comparing
pharmacological interventions and intrapulmonary shunt in thoracic surgery
under one-lung ventilation up to March 30, 2022. Random-effects
(component) network meta-analysis compared 24 treatments and 19 treatment
components. The Confidence in Network Meta-Analysis (CINeMA) framework
assessed evidence certainty. The primary outcome was intrapulmonary shunt
fraction during one-lung ventilation. Result(s): A total of 55 RCTs
were eligible for systematic review (2788 participants). The addition of
N<inf>2</inf>O (mean difference [MD]=-15%; 95% confidence interval [CI],
-25 to -5; P=0.003) or almitrine (MD=-13%; 95% CI, -20 to -6; P<0.001) to
propofol anaesthesia were efficient at decreasing shunt. Combined epidural
anaesthesia (MD=3%; 95% CI, 1-5; P=0.005), sevoflurane (MD=5%; 95% CI,
2-8; P<0.001), isoflurane (MD=6%; 95% CI, 4-9; P<0.001), and desflurane
(MD=9%; 95% CI, 4-14; P=0.001) increased shunt vs propofol. Almitrine
(MD=147 mm Hg; 95% CI, 58-236; P=0.001), dopexamine (MD=88 mm Hg; 95% CI,
4-171; P=0.039), and iloprost (MD=81 mm Hg; 95% CI, 4-158; P=0.038)
improved PaO<inf>2</inf>/FiO<inf>2</inf>. Certainty of evidence ranged
from very low to moderate. Conclusion(s): Adding N<inf>2</inf>O or
almitrine to propofol anaesthesia reduced intrapulmonary shunt during
one-lung ventilation. Halogenated anaesthetics increased shunt in
comparison with propofol. The effects of N<inf>2</inf>O, iloprost, and
dexmedetomidine should be investigated in future research. N<inf>2</inf>O
results constitute a research hypothesis currently not backed by any
direct evidence. The clinical availability of almitrine is limited.
Systematic review protocol: PROSPERO CRD42022310313. Copyright ©
2022 British Journal of Anaesthesia

<86>
Accession Number
2020130708
Title
Speed of cooling after cardiac arrest in relation to the intervention
effect: a sub-study from the TTM2-trial.
Source
Critical Care. 26(1) (no pagination), 2022. Article Number: 356. Date of
Publication: December 2022.
Author
Simpson R.F.G.; Dankiewicz J.; Karamasis G.V.; Pelosi P.; Haenggi M.;
Young P.J.; Jakobsen J.C.; Bannard-Smith J.; Wendel-Garcia P.D.; Taccone
F.S.; Nordberg P.; Wise M.P.; Grejs A.M.; Lilja G.; Olsen R.B.; Cariou A.;
Lascarrou J.B.; Saxena M.; Hovdenes J.; Thomas M.; Friberg H.; Davies
J.R.; Nielsen N.; Keeble T.R.
Institution
(Simpson, Karamasis, Davies, Keeble) Essex Cardiothoracic Centre, MSE
Trust, Essex, Basildon, United Kingdom
(Simpson, Karamasis, Davies, Keeble) MTRC, Anglia Ruskin School of
Medicine, Essex, Chelmsford, United Kingdom
(Dankiewicz) Department of Clinical Sciences Lund, Sections of Cardiology,
Lund, Sweden
(Pelosi) Department of Surgical Sciences and Integrated Diagnostics,
University of Genoa, Genoa, Italy
(Pelosi) Anesthesiology and Critical Care, San Martino Policlinico
Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy
(Haenggi) Department of Intensive Care Medicine, University Hospital Bern,
University of Bern, Bern, Switzerland
(Young) Intensive Care Unit, Wellington Hospital, Wellington, New Zealand
(Young) Medical Research Institute of New Zealand, Wellington, New Zealand
(Young) Australian and New Zealand Intensive Care Research Centre, Monash
University, Melbourne, VIC, Australia
(Young) Department of Critical Care, University of Melbourne, Melbourne,
VIC, Australia
(Jakobsen) Copenhagen Trial Unit, Centre for Clinical Intervention
Research, Capital Region of Denmark, Copenhagen, Denmark
(Jakobsen) Department of Regional Health Research, The Faculty of Health
Sciences, University of Southern Denmark, Copenhagen, Denmark
(Bannard-Smith) Department of Adult Critical Care, Manchester University
NHS Foundation Trust, Manchester, United Kingdom
(Bannard-Smith) Division of Infection, Immunity and Respiratory Medicine,
The University of Manchester, Manchester, United Kingdom
(Wendel-Garcia) Institute of Intensive Care Medicine, University Hospital
of Zurich, Zurich, Switzerland
(Taccone) Department of Intensive Care, Hopital Universitaire de Bruxelles
(HUB), Universite Libre de Bruxelles (ULB), Brussels, Belgium
(Nordberg) Department of Clinical Science and Education, Center for
Resuscitation Science, Karolinska Institute, Solna, Sweden
(Nordberg) Function Perioperative Medicine and Intensive Care, Karolinska
University Hospital, Stockholm, Sweden
(Wise) Adult Critical Care, University Hospital of Wales, Cardiff, United
Kingdom
(Grejs) Department of Intensive Care Medicine, Department of Clinical
Medicine, Aarhus University Hospital, Aarhus, Denmark
(Lilja) Neurology, Department of Clinical Sciences Lund, Skane University
Hospital, Lund University, Lund, Sweden
(Olsen) Department of Anesthesiology, Sorlandet Hospital, Arendal, Norway
(Cariou) Medical Intensive Care Unit, Cochin University Hospital (APHP),
Paris Cite University, Paris, France
(Lascarrou) Medicine Intensive Reanimation, CHU Nantes, Nantes, France
(Saxena) Critical Care Division, The George Institute for Global Health,
University of New South Wales, Sydney, Australia
(Saxena) Department of Intensive Care Medicine, Bansltwon-Lidcombe
Hospital, South Western Sydney, Sydney, NSW, Australia
(Hovdenes) Division of Emergencies and Critical Care, Department of
Anesthesiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
(Thomas) Intensive Care Unit, University Hospitals Bristol and Weston,
Bristol, United Kingdom
(Friberg) Department of Clinical Science, Intensive and Perioperative
Care, Skane University Hospital, Lund University, Malmo, Sweden
(Nielsen) Department of Clinical Sciences Lund, Sections of Anesthesiology
and Intensive Care, Lund, Sweden
Publisher
BioMed Central Ltd
Abstract
Background: Targeted temperature management (TTM) is recommended following
cardiac arrest; however, time to target temperature varies in clinical
practice. We hypothesised the effects of a target temperature of 33
degreeC when compared to normothermia would differ based on average time
to hypothermia and those patients achieving hypothermia fastest would have
more favorable outcomes. Method(s): In this post-hoc analysis of the
TTM-2 trial, patients after out of hospital cardiac arrest were randomized
to targeted hypothermia (33 degreeC), followed by controlled re-warming,
or normothermia with early treatment of fever (body temperature, >= 37.8
degreeC). The average temperature at 4 h (240 min) after return of
spontaneous circulation (ROSC) was calculated for participating sites.
Primary outcome was death from any cause at 6 months. Secondary outcome
was poor functional outcome at 6 months (score of 4-6 on modified Rankin
scale). Result(s): A total of 1592 participants were evaluated for
the primary outcome. We found no evidence of heterogeneity of intervention
effect based on the average time to target temperature on mortality (p =
0.17). Of patients allocated to hypothermia at the fastest sites, 71 of
145 (49%) had died compared to 68 of 148 (46%) of the normothermia group
(relative risk with hypothermia, 1.07; 95% confidence interval 0.84-1.36).
Poor functional outcome was reported in 74/144 (51%) patients in the
hypothermia group, and 75/147 (51%) patients in the normothermia group
(relative risk with hypothermia 1.01 (95% CI 0.80-1.26).
 Conclusion(s): Using a hospital's average time to hypothermia did not
significantly alter the effect of TTM of 33 degreeC compared to
normothermia and early treatment of fever. Copyright © 2022, The
Author(s).

<87>
Accession Number
2020110045
Title
Effects of adding dexmedetomidine to ropivacaine for paravertebral block
in breast cancer surgery.
Source
European Journal of Molecular and Clinical Medicine. 9(5) (pp 210-218),
2022. Date of Publication: June 2022.
Author
Lakshmi K.B.; Gollapalli V.K.; Pativada V.R.
Institution
(Lakshmi, Gollapalli, Pativada) Department Anaesthesia, Andhra Medical
College, Vizag, Andhra Pradesh, India
Publisher
EJMCM, International House
Abstract
Background: Effective pain control after surgery is an important part of
taking care of someone who has had surgery. A paravertebral block (PVB) is
becoming more popular for breast surgery and is thought to be the best
method for anaesthesia and pain relief after surgery. Several local and
regional anaesthetic techniques were looked at to see if they could reduce
post-surgery pain after breast surgery. The thoracic PVB technique looks
promising because it reduces post-surgery pain, reduces opioid use,
reduces side effects like drowsiness and the risk of breathing problems,
and saves money. The goal of this study was to find out how well
dexmedetomidine works with ropivacaine as a paravertebral block in breast
cancer surgery. Material(s) and Method(s): Randomly, 100 women having
breast surgery were split into two groups, Group PR and Group PRD. For
thoracic paravertebral block, Group PR got 0.5% ropivacaine (0.3 ml/kg)
with 1 ml normal saline, while Group PRD got the same amount of
ropivacaine with 1 mcg/ml of dexmedetomidine. The groups were watched to
see how well the block worked, how the hemodynamic parameters changed at
different times, when the sensory block started, how long it lasted and if
there were any complications during or after the surgery. Result(s):
When added to ropivacaine in TPVB as an adjuvant, dexmedetomidine gives
good pain relief during and after surgery and reduces the need for
painkillers after surgery. There were no problems with the technique or
the way the blood flowed and there were no bad effects from the
dexmedetomidine. Conclusion(s): TPVB with ropivacaine and
dexmedetomidine as an add-on can be a better choice for good pain relief
and stable blood flow during breast surgery without complications or side
effects. Copyright © 2022 Ubiquity Press. All rights reserved.

<88>
Accession Number
2019805133
Title
Access to Cardiovascular Care for Indigenous Peoples in Canada: A Rapid
Review.
Source
CJC Open. 4(9) (pp 782-791), 2022. Date of Publication: September 2022.
Author
Vervoort D.; Kimmaliardjuk D.M.; Ross H.J.; Fremes S.E.; Ouzounian M.;
Mashford-Pringle A.
Institution
(Vervoort, Fremes, Ouzounian) Division of Cardiac Surgery, University of
Toronto, Toronto, ON, Canada
(Vervoort, Fremes, Mashford-Pringle) Institute of Health Policy,
Management and Evaluation, University of Toronto, Toronto, ON, Canada
(Kimmaliardjuk) Division of Cardiovascular Surgery, Memorial University of
Newfoundland, Eastern Health, St. John's, NL, Canada
(Ross) Division of Cardiology, Peter Munk Cardiac Centre, Toronto General
Hospital, University of Toronto, Toronto, ON, Canada
(Fremes) Schulich Heart Centre, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, ON, Canada
(Ouzounian) Division of Cardiovascular Surgery, Peter Munk Cardiac Centre,
Toronto General Hospital, University of Toronto, Toronto, ON, Canada
(Mashford-Pringle) Waakebiness-Bryce Institute for Indigenous Health,
Dalla Lana School of Public Health, University of Toronto, Toronto, ON,
Canada
Publisher
Elsevier Inc.
Abstract
Indigenous peoples in Canada are at an increased risk of cardiovascular
disease compared to non-Indigenous people. Contributing factors include
historical oppression, racism, healthcare biases, and disparities in terms
of the social determinants of health. Access to and inequity in
cardiovascular care for Indigenous peoples in Canada remain poorly studied
and understood. A rapid review of the literature was performed using the
PubMed/MEDLINE, Web of Science, and Indigenous Studies Portal (iPortal)
databases to identify articles describing access to cardiovascular care
for Indigenous peoples in Canada between 2002 and 2021. Included articles
were presented narratively in the context of delays in seeking, reaching,
or receiving care, or as disparities in cardiovascular outcomes, and were
assessed for their successful engagement in indigenous health research
using a preexisting framework. Current research suggests that gaps most
prominently present as delays in receiving care and as poorer long-term
outcomes. The literature is concentrated in Alberta, Manitoba, and
Ontario, as well as among First Nations people, and is largely rooted in a
biomedical worldview. Additional community-driven research is required to
better elucidate the gaps in access to holistic cardiovascular care for
Indigenous peoples in Canada. Healthcare professionals, researchers, and
policymakers should reflect further upon their actions and privilege,
educate themselves about historical facts and the Truth and Reconciliation
Commission, tackle prevailing disparities and systemic barriers in the
healthcare systems, and develop culturally safe and ethically appropriate
healthcare interventions to improve the health of all Indigenous peoples
in Canada. Copyright © 2022 The Authors

<89>
Accession Number
2019734816
Title
Risk Factors for Hospital Readmission Post-Transcatheter Aortic Valve
Implantation in the Contemporary Era: A Systematic Review.
Source
CJC Open. 4(9) (pp 792-801), 2022. Date of Publication: September 2022.
Author
Patel R.V.; Ravindran M.; Manoragavan R.; Sriharan A.; Wijeysundera H.C.
Institution
(Patel, Ravindran) Temerty Faculty of Medicine, University of Toronto,
Toronto, ON, Canada
(Patel, Sriharan, Wijeysundera) Institute for Health Policy, Management,
Evaluation, University of Toronto, Toronto, ON, Canada
(Manoragavan, Wijeysundera) Division of Cardiology, Department of
Medicine, Schulich Heart Program, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Wijeysundera) Sunnybrook Research Institute, University of Toronto,
Toronto, ON, Canada
(Wijeysundera) Institute for Clinical Evaluative Sciences, Toronto, ON,
Canada
Publisher
Elsevier Inc.
Abstract
Background: Despite transcatheter aortic valve implantation (TAVI)
becoming a widely accepted therapeutic option for the management of aortic
stenosis, post-procedure readmission rates remain high. Rehospitalization
is associated with negative patient outcomes, as well as increased
healthcare costs, and has therefore been identified as an important target
for quality improvement. Strategies to reduce the post-TAVI readmission
rate are needed but require the identification of patients at high risk
for rehospitalization. Our systematic review aims to identify predictors
of post-procedure readmission in patients eligible for TAVI.
 Method(s): We conducted a comprehensive search of the MEDLINE,
Embase, and Cochrane Central Register of Controlled Trials (CENTRAL)
databases for the time period from 2015 to the present for articles
evaluating risk factors for rehospitalization post-TAVI with a follow-up
period of at least 30 days in adults age >= 70 years with aortic stenosis.
The quality of included studies was evaluated using the Newcastle-Ottawa
Scale. We present the results as a qualitative narrative review.
 Result(s): We identified 49 studies involving 828,528 patients.
Post-TAVI readmission is frequent, and rates vary (14.9% to 54.3% at 1
year). The most-frequent predictors identified for both 30-day and 1-year
post-TAVI readmission are atrial fibrillation, lung disease, renal
disease, diabetes mellitus, in-hospital life-threatening bleeding, and
non-femoral access. Conclusion(s): This systematic review identifies
the most-common predictors for 30-day and 1-year readmission post-TAVI,
including comorbidities and potentially modifiable procedural approaches
and complications. These predictors can be used to identify patients at
high-risk for readmission who are most likely to benefit from increased
support and follow-up post-TAVI. Copyright © 2022 The Authors

<90>
Accession Number
2019657017
Title
Long-term outcomes of percutaneous versus surgical revascularization in
patients with diabetes and left main coronary artery disease: A
meta-analysis of randomized controlled trials.
Source
Journal of Cardiac Surgery. 37(12) (pp 4646-4653), 2022. Date of
Publication: December 2022.
Author
Carvalho P.E.P.; Veiga T.M.A.; Machado F.S.L.; Porto G.V.; Pirez J.;
Rivera M.; Melo P.C.; Braghiroli J.; Cardoso R.
Institution
(Carvalho, Veiga, Machado, Porto) Department of Medicine, Federal
University of Minas Gerais, Belo Horizonte, Brazil
(Pirez) Department of Medicine, Cesumar University, Maringa, Brazil
(Rivera) Division of Cardiology, Washington University in St. Louis, St.
Louis, MO, United States
(Melo) Cardiovascular Research Foundation, New York, NY, United States
(Braghiroli) Jackson Memorial Hospital, Miami, FL, United States
(Cardoso) Heart and Vascular Center, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The efficacy and safety of percutaneous coronary interventions
(PCI) relative to coronary artery bypass grafting (CABG) in patients with
diabetes and unprotected left main coronary artery disease (LMCAD) are not
well established. Objective(s): To perform a meta-analysis evaluating
the long-term outcomes after PCI with drug-eluting stents (DES), as
compared with CABG, in patients with diabetes and unprotected LMCAD.
 Method(s): MEDLINE, Cochrane, and Embase were searched for randomized
controlled trials (RCTs) that reported outcomes after PCI with DES versus
CABG in unprotected LMCAD among patients with diabetes. To evaluate the
long-term effects of these interventions, we restricted this analysis to
studies with a minimum follow-up period of 3 years. Risk ratios (RRs) with
95% confidence intervals (CIs) were pooled with a random-effects model.
Quality assessment and risk of bias were performed according to Cochrane
recommendations. Result(s): Four RCTs with a total of 1080 patients
were included, 553 (51.2%) of whom underwent PCI. There was no difference
for individual outcomes of all-cause mortality (RR: 1.21; 95% CI:
0.86-1.71; p =.27; I2 = 28%), cardiovascular death (RR 1.29;
95% CI: 0.76-2.18; p =.34; I2 = 0%), or myocardial infarction
(MI) (RR: 0.94; 95% CI: 0.61-1.45; p =.79; I2 = 0%). However,
the risk of stroke was reduced with PCI relative to CABG (RR: 0.41; 95%
CI: 0.18-0.94; p =.04; I2 = 0%), whereas the risk of any repeat
revascularization was higher in the PCI group (RR: 1.99; 95% CI:
1.44-2.75; p <.001; I2 = 0%). The risk of the composite outcome
of all-cause mortality, MI, stroke, or repeat revascularization was higher
after PCI compared with CABG (RR: 1.30; 95% CI: 1.09-1.56; p =.004;
I2 = 0%). Conclusion(s): In this meta-analysis with more
than 1000 patients with diabetes and unprotected LMCAD followed for a
minimum of 3 years, the incidence of repeat revascularization was higher
among those treated with PCI, whereas the risk of stroke was higher in
patients treated with CABG. Copyright © 2022 Wiley Periodicals
LLC.

<91>
Accession Number
2021803308
Title
Providing Epidemiological Data in Lumbar Spine Imaging Reports Did Not
Affect Subsequent Utilization of Spine Procedures: Secondary Outcomes from
a Stepped-Wedge Randomized Controlled Trial.
Source
Pain Medicine (United States). 22(6) (pp 1272-1280), 2021. Date of
Publication: 01 Jun 2021.
Author
Suri P.; Meier E.N.; Gold L.S.; Marcum Z.A.; Johnston S.K.; James K.T.;
Bresnahan B.W.; O'reilly M.; Turner J.A.; Kallmes D.F.; Sherman K.J.; Deyo
R.A.; Luetmer P.H.; Avins A.L.; Griffith B.; Heagerty P.J.; Rundell S.D.;
Jarvik J.G.; Friedly J.L.
Institution
(Suri, Meier, Gold, Johnston, James, O'reilly, Turner, Heagerty, Rundell,
Jarvik, Friedly) Clinical Learning, Evidence, and Research Center,
University of Washington, Seattle, WA, United States
(Suri, Turner, Rundell, Friedly) Department of Rehabilitation Medicine,
University of Washington, Seattle, WA, United States
(Suri) Seattle Epidemiologic Research and Information Center, VA Puget
Sound Health Care System, Seattle, WA, United States
(Suri) Rehabilitation Care Services, VA Puget Sound Health Care System,
Seattle, WA, United States
(Meier, Heagerty) Department of Biostatistics, University of Washington,
Seattle, WA, United States
(Gold, Johnston, James, Bresnahan, O'reilly, Jarvik) Department of
Radiology, School of Medicine, University of Washington, Seattle, WA,
United States
(Marcum) Department of Pharmacy, School of Pharmacy, University of
Washington, Seattle, WA, United States
(Turner) Department of Psychiatry and Behavioral Sciences, University of
Washington, Seattle, WA, United States
(Kallmes, Luetmer) Department of Radiology, Mayo Clinic, Rochester, MN,
United States
(Sherman) Kaiser Permanente Washington, Seattle, WA, United States
(Deyo) Departments of Family Medicine and Internal Medicine, Oregon Health
& Science University, Portland, OR, United States
(Avins) Division of Research (ALA), Kaiser Permanente Northern California,
Oakland, CA, United States
(Griffith) Department of Radiology, Henry Ford Hospital, Detroit, MI,
United States
(Jarvik) Department of Neurological Surgery, University of Washington,
Seattle, WA, United States
Publisher
Oxford University Press
Abstract
Objective: To evaluate the effect of inserting epidemiological information
into lumbar spine imaging reports on subsequent nonsurgical and surgical
procedures involving the thoracolumbosacral spine and sacroiliac joints.
 Design(s): Analysis of secondary outcomes from the Lumbar Imaging
with Reporting of Epidemiology (LIRE) pragmatic stepped-wedge randomized
trial. Setting(s): Primary care clinics within four integrated health
care systems in the United States. Subjects: 238,886 patients >=18 years
of age who received lumbar diagnostic imaging between 2013 and 2016.
 Method(s): Clinics were randomized to receive text containing age-
and modality-specific epidemiological benchmarks indicating the prevalence
of common spine imaging findings in people without low back pain, inserted
into lumbar spine imaging reports (the "LIRE intervention"). The study
outcomes were receiving 1) any nonsurgical lumbosacral or sacroiliac spine
procedure (lumbosacral epidural steroid injection, facet joint injection,
or facet joint radiofrequency ablation; or sacroiliac joint injection) or
2) any surgical procedure involving the lumbar, sacral, or thoracic spine
(decompression surgery or spinal fusion or other spine surgery).
 Result(s): The LIRE intervention was not significantly associated
with subsequent utilization of nonsurgical lumbosacral or sacroiliac spine
procedures (odds ratio [OR] = 1.01, 95% confidence interval [CI]
0.93-1.09; P = 0.79) or any surgical procedure (OR = 0.99, 95 CI
0.91-1.07; P = 0.74) involving the lumbar, sacral, or thoracic spine. The
intervention was also not significantly associated with any individual
spine procedure. Conclusion(s): Inserting epidemiological text into
spine imaging reports had no effect on nonsurgical or surgical procedure
utilization among patients receiving lumbar diagnostic
imaging. Copyright © 2021 The Author(s).

<92>
Accession Number
2022448835
Title
P2Y<inf>12</inf> Inhibitor Monotherapy or Dual Antiplatelet Therapy After
Complex Percutaneous Coronary Interventions.
Source
Journal of the American College of Cardiology. 81(6) (pp 537-552), 2023.
Date of Publication: 14 Feb 2023.
Author
Gragnano F.; Mehran R.; Branca M.; Franzone A.; Baber U.; Jang Y.; Kimura
T.; Hahn J.-Y.; Zhao Q.; Windecker S.; Gibson C.M.; Kim B.-K.; Watanabe
H.; Song Y.B.; Zhu Y.; Vranckx P.; Mehta S.; Hong S.-J.; Ando K.; Gwon
H.-C.; Calabro P.; Serruys P.W.; Dangas G.D.; McFadden E.P.; Angiolillo
D.J.; Heg D.; Valgimigli M.
Institution
(Gragnano, Calabro) Department of Translational Medical Sciences,
University of Campania Luigi Vanvitelli, Caserta, Italy
(Mehran, Dangas) Icahn School of Medicine at Mount Sinai, New York, NY,
United States
(Branca, Heg) Clinical Trials Unit, Bern, Switzerland
(Franzone) Department of Advanced Biomedical Sciences, University of
Naples Federico II, Naples, Italy
(Baber) University of Oklahoma Health Sciences Center, Oklahoma City, OK,
United States
(Jang, Kim, Hong) Department of Cardiology, CHA Bundang Medical Center,
CHA University College of Medicine, Seongnam, South Korea
(Kimura, Watanabe) Kyoto University Graduate School of Medicine,
Department of Cardiovascular Medicine, Kyoto, Japan
(Hahn, Song, Gwon) Heart Vascular Stroke Institute, Samsung Medical
Center, Sungkyunkwan University School of Medicine, Korea, Seoul, South
Korea
(Zhao, Zhu) Department of Cardiovascular Surgery, Ruijin Hospital,
Shanghai Jiao Tong University School of Medicine, Shanghai, China
(Windecker, Valgimigli) Department of Cardiology, Bern University
Hospital, University of Bern, Bern, Switzerland
(Gibson) Division of Cardiology, Beth Israel Deaconess Medical Center,
Boston, MA, United States
(Vranckx) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Jessa Ziekenhuis, Belgium
(Vranckx) Faculty of Medicine and Life Sciences, University of Hasselt,
Hasselt, Belgium
(Mehta) Department of Medicine, McMaster University, Hamilton, ON, Canada
(Mehta) Hamilton Health Sciences, Hamilton, ON, Canada
(Ando) Kokura Memorial Hospital, Department of Cardiology, Kitakyushu,
Japan
(Serruys) Department of Cardiology, National University of Ireland Galway,
Galway, Ireland
(Serruys) NHLI, Imperial College London, London, United Kingdom
(McFadden) Cardialysis Core Laboratories and Clinical Trial Management,
Rotterdam, Netherlands
(McFadden) Department of Cardiology, Cork University Hospital, Cork,
Ireland
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine, Jacksonville, FL, United States
(Valgimigli) Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale,
Lugano, Switzerland
Publisher
Elsevier Inc.
Abstract
Background: It remains unclear whether P2Y<inf>12</inf> inhibitor
monotherapy preserves ischemic protection while limiting bleeding risk
compared with dual antiplatelet therapy (DAPT) after complex percutaneous
coronary intervention (PCI). Objective(s): We sought to assess the
effects of P2Y<inf>12</inf> inhibitor monotherapy after 1-month to 3-month
DAPT vs standard DAPT in relation to PCI complexity. Method(s): We
pooled patient-level data from randomized controlled trials comparing
P2Y<inf>12</inf> inhibitor monotherapy and standard DAPT on centrally
adjudicated outcomes after coronary revascularization. Complex PCI was
defined as any of 6 criteria: 3 vessels treated, >=3 stents implanted, >=3
lesions treated, bifurcation with 2 stents implanted, total stent length
>60 mm, or chronic total occlusion. The primary efficacy endpoint was
all-cause mortality, myocardial infarction, and stroke. The key safety
endpoint was Bleeding Academic Research Consortium (BARC) 3 or 5 bleeding.
 Result(s): Of 22,941 patients undergoing PCI from 5 trials, 4,685
(20.4%) with complex PCI had higher rates of ischemic events. The primary
efficacy endpoint was similar between P2Y<inf>12</inf> inhibitor
monotherapy and DAPT among patients with complex PCI (HR: 0.87; 95% CI:
0.64-1.19) and noncomplex PCI (HR: 0.91; 95% CI: 0.76-1.09;
P<inf>interaction</inf> = 0.770). The treatment effect was consistent
across all the components of the complex PCI definition. Compared with
DAPT, P2Y<inf>12</inf> inhibitor monotherapy consistently reduced BARC 3
or 5 bleeding in complex PCI (HR: 0.51; 95% CI: 0.31-0.84) and noncomplex
PCI patients (HR: 0.49; 95% CI: 0.37-0.64; P<inf>interaction</inf> =
0.920). Conclusion(s): P2Y<inf>12</inf> inhibitor monotherapy after
1-month to 3-month DAPT was associated with similar rates of fatal and
ischemic events and lower risk of major bleeding compared with standard
DAPT, irrespective of PCI complexity. (PROSPERO [P2Y12 Inhibitor
Monotherapy Versus Standard Dual Antiplatelet Therapy After Coronary
Revascularization: Individual Patient Data Meta-Analysis of Randomized
Trials]; CRD42020176853) Copyright © 2023 American College of
Cardiology Foundation

<93>
Accession Number
2022483570
Title
Accuracy of stroke volume variation and pulse pressure variation in
predicting fluid responsiveness undergoing one-lung ventilation during
thoracic surgery: a systematic review and meta-analysis.
Source
Annals of Translational Medicine. 11(1) (no pagination), 2023. Article
Number: 19. Date of Publication: January 2023.
Author
Wang C.; Feng Z.; Cai J.; Duan M.; Li H.; Dai Z.; Lv H.; Xu Z.; Wang H.;
Chen Y.
Institution
(Wang, Feng, Cai, Lv, Wang, Chen) Department of Anesthesiology, Sixth
Medical Center, PLA General Hospital, Beijing, China
(Duan) Department of Anesthesiology, Hainan Branch of the General Hospital
of People's Liberation Army, Sanya, China
(Li) Department of Gastroenterology, Sixth Medical Center, PLA General
Hospital, Beijing, China
(Dai) Department of Medical Records, Sixth Medical Center, PLA General
Hospital, Beijing, China
(Xu) Department of Anesthesiology, First Medical Center, PLA General
Hospital, Beijing, China
Publisher
AME Publishing Company
Abstract
Background: Stroke volume variation (SVV) and pulse pressure variation
(PPV) are based on the interaction between the heart and lungs during
mechanical ventilation. However, debate continues as to whether SVV and
PPV can accurately predict fluid responsiveness during the one-lung
ventilation (OLV). We therefore undertook a systematic review and
meta-analysis of clinical trials that investigated the diagnostic value of
SVV and PPV in predicting fluid responsiveness undergoing OLV during
thoracic surgery. Method(s): The MEDLINE, EMBASE, WANFANG, and
CENTRAL databases were systematically searched for studies on the use of
SVV and/or PPV in patients undergoing OLV from 2010 to 2021. Heterogeneity
was assessed using I2 statistics. The funnel diagram analysis
was used to test publication bias. A fixed-effects model was used to
calculate the pooled values of sensitivity, specificity, the diagnostic
odds ratio (DOR), and the relevant 95% confidence intervals (95% CIs). The
summary receiver operating characteristic (SROC) curves were estimated,
and the areas under the SROC curve were calculated. Result(s): In
total nine studies, comprising 452 patients were ultimately included in
this meta-analysis, including 217 (48%) responders and 235 (52%)
nonresponders. After combining the correlation coefficients, a slight
heterogeneity was found between SVV and PPV in these selected studies
(I2<inf>SVV</inf> =19.7%, I2<inf>PPV</inf> =15.3%),
and the funnel diagram also showed that the P values of SVV and PPV were
0.33 and 0.26. After the pooled analysis, the respective sensitivity of
SVV and PPV in predicting fluid responsiveness was 0.66 and 0.61, the
specificity was 0.62 and 0.53, the positive likelihood ratios were 1.7 and
1.3, the negative likelihood ratios were 0.55 and 0.74, and the DORs were
3 and 2. The areas under the SROC curve of SVV and PPV were 0.68 and 0.60,
respectively, according to STATA SE16 software, and the combined areas
under the receiver operating characteristic (ROC) curve of SVV and PPV
were 0.681 and 0.604, respectively, according to MedCalc19.0.4 software.
 Conclusion(s): Current evidence suggests that SVV and PPV are not
suitable for guiding intraoperative fluid therapy due to their poor
ability to predict fluid responsiveness in patients undergoing OLV, and we
need a better indicator instead. Copyright © Annals of
Translational Medicine. All rights reserved.

<94>
Accession Number
2021314790
Title
Transcatheter mitral valve replacement versus redo surgery for mitral
prosthesis failure: A systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2023. Article
Number: 1058576. Date of Publication: 18 Jan 2023.
Author
Zhou J.; Li Y.; Chen Z.; Zhang H.
Institution
(Zhou, Li, Chen, Zhang) Department of Cardiac Surgery, Beijing Anzhen
Hospital, Capital Medical University, Beijing, China
Publisher
Frontiers Media S.A.
Abstract
Background: Transcatheter mitral valve replacement (TMVR) has emerged as
an alternative to redo surgery. TMVR compared with redo surgical mitral
valve replacement (SMVR) in patients with mitral prosthesis failure
remains limited. In this study, we performed a meta-analysis to assess the
outcomes of TMVR (including valve-in-valve and valve-in-ring) versus redo
surgery for mitral prosthesis failure. Method(s): We comprehensively
searched the PubMed, Embase, and Cochrane library databases according to
predetermined inclusion and exclusion criteria, and then we extracted
data. We compared the outcomes of TMVR and redo SMVR for mitral prosthesis
failure in terms of the in-hospital mortality, stroke, renal dysfunction,
vascular complication, pacemaker implantation, exploration for bleeding,
paravalvular leak, mean mitral valve gradient, 30-day mortality, and
1-year mortality. Result(s): Nine retrospective cohort studies and a
total of 3,038 patients were included in this analysis. Compared with redo
SMVR for mitral prosthesis failure, TMVR was associated with lower
in-hospital mortality [odds ratios (OR): 0.44; 95% confidence interval
(CI): 0.30-0.64; P < 0.001], stroke (OR: 0.44; 95% CI: 0.29-0.67; P =
0.0001), renal dysfunction (OR: 0.52; 95% CI: 0.37-0.75; P = 0.0003),
vascular complication (OR: 0.58; 95% CI: 0.43-0.78; P = 0.004), pacemaker
implantation (OR: 0.23; 95% CI: 0.15-0.36; P < 0.00001), and exploration
for bleeding (OR: 0.24; 95% CI: 0.06-0.96; P = 0.04). Conversely, redo
SMVR had lower paravalvular leak (OR: 22.12; 95% CI: 2.81-174.16; P =
0.003). There was no difference in mean mitral valve gradient (MD: 0.04;
95% CI: -0.47 to 0.55; P = 0.87), 30-day mortality (OR: 0.65; 95% CI:
0.36-1.17; P = 0.15), and 1-year mortality (OR: 0.96; 95% CI: 0.63-1.45; P
= 0.84). Conclusion(s): In patients with mitral prosthesis failure,
TMVR is associated with lower in-hospital mortality and lower occurrence
of postoperative complications, except for paravalvular leak. TMVR offers
a viable alternative to the conventional redo surgery in selected
patients. Copyright © 2023 Zhou, Li, Chen and Zhang.

<95>
Accession Number
2022471538
Title
Assessment of the effect of two regimens of milrinone infusion in
paediatric patients with pulmonary artery hypertension undergoing
corrective cardiac procedure: A prospective observational study.
Source
Annals of Pediatric Cardiology. 15(4) (pp 358-363), 2022. Date of
Publication: July 2022.
Author
Prajapati M.; Patel J.; Patel H.; Gandhi H.; Singh G.; Patel P.
Institution
(Prajapati, Patel, Patel, Gandhi, Singh, Patel) Department of Cardiac
Anesthesia, U.N. Mehta Institute of Cardiology and Research Center
(Affiliated to B. J. Medical College), Gujarat, Ahmadabad, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: The aim of the study was to compare the effect of two
different regimens of milrinone in pediatric patients with pulmonary
artery hypertension (PAH) undergoing corrective procedure.
 Material(s) and Method(s): This randomized prospective study included
100 pediatric patients undergoing corrective cardiac surgeries. Group E:
Milrinone was started as infusion 0.5 mug/kg/min without a loading dose
after induction of anesthesia and continued as infusion 0.5-0.75
mug/kg/min in the pediatric cardiac surgical intensive care unit (PSICU).
Group L: Milrinone was started as a loading dose 50 mug/kg over 10 min
before weaning from cardiopulmonary bypass (CPB) followed by infusion
0.5-0.75 mug/kg/min in the PSICU. We compared heart rate, mean arterial
blood pressure, central venous pressure, cardiac index (CI), mean
pulmonary arterial pressure (MPAP), serum lactate level, urine output,
vasoactive inotropic score, mechanical ventilation duration, and intensive
care unit (ICU)- and hospital length of stay between the groups.
 Result(s): There was an increase in mean arterial blood pressure, CI,
and urine output in Group E compared to Group L (P < 0.05). MPAP, serum
lactate level, and requirement of inotropes and vasopressors were lower in
Group E compared to Group L (P < 0.05). Mechanical ventilation duration,
ICU, and hospital length of stay were shorter in Group E than Group L (P <
0.05). Conclusion(s): Early use of milrinone in patients with PAH
undergoing corrective cardiac surgeries improved CI and mean arterial
pressure, decreased MPAP, improved urine output, decreased serum lactate
level, and decreased requirement of inotropes and vasopressors after
weaning from CPB compared to the milrinone bolus group. Copyright
© 2022 Wolters Kluwer Medknow Publications. All rights reserved.

<96>
Accession Number
640226732
Title
Nutritional markers accompanying acquired chylothorax in infants: a
systematic review.
Source
Nutrition reviews. (no pagination), 2023. Date of Publication: 31 Jan
2023.
Author
Marzotto K.N.; Choudhary T.; Wright L.A.; Howell M.P.; Kimball T.R.;
Pigula F.A.; Piggott K.D.
Institution
(Marzotto, Choudhary) Tulane University School of Medicine, New Orleans,
LA, United States
(Wright) Matas Library, Tulane University School of Medicine, New Orleans,
LA, United States
(Howell) Department of Pediatrics, Tulane University School of Medicine,
New Orleans, LA, United States
(Kimball, Piggott) Department of Pediatrics, Louisiana State University
Health, New Orleans, LA, United States
(Pigula) Department of Surgery, Louisiana State University Health, New
Orleans, LA, United States
Publisher
NLM (Medline)
Abstract
CONTEXT: Chylothorax is a well-established acquired complication of
thoracic surgery in infants. Current data suggest acquired chylothorax may
affect infant growth and nutrition because of a loss of essential
nutrients via chylous effusion. OBJECTIVE(S): The 3 objectives for
this study were: (1) identify nutritional markers affected by the
development of acquired chylothorax in infants; (2) highlight the
variability in methods used to assess nutritional status and growth in
this patient population; and (3) highlight nutritional deficits that can
serve as treatment targets during postoperative feeding protocols. DATA
SOURCES: A systematic literature search was conducted between May 31,
2021, and June 21, 2022, using the PubMed, Embase, CINAHL, and Web of
Science databases. Search terms included, but were not limited to,
"chylothorax," "infants," and "nutrition." DATA EXTRACTION: Inclusion
criteria required studies that measured quantitative markers of nutrition
in >=10 participants aged <1 year with acquired chylothorax. A total of
575 studies were screened and all but 4 were eliminated. Nutritional
markers were categorized into 4 different groups: total serum protein
level, triglyceride levels, growth velocity, and weight for length. DATA
ANALYSIS: The variation in methods, time points, interventional groups,
and nutritional markers did not facilitate a meta-analysis. Risk of bias
was assessed using the Cochrane Risk of Bias in Nonrandomized Studies
assessment tool. CONCLUSION(S): This review highlights the need for
reliable quantitative markers of nutrition that will enable providers to
assess the nutritional needs of infants with chylothorax. Future studies
must focus on measuring markers of nutrition at regular intervals in
larger study populations. Copyright © The Author(s) 2023.
Published by Oxford University Press on behalf of the International Life
Sciences Institute. All rights reserved. For permissions, please e-mail:
journals.permissions@oup.com.

<97>
Accession Number
640226359
Title
Corrigendum to: Dual versus single antiplatelet therapy after
transcatheter aortic valve replacement: a systematic review and
meta-analysis.
Source
European heart journal. (no pagination), 2023. Date of Publication: 31
Jan 2023.
Author
Anonymous
Publisher
NLM (Medline)

<98>
Accession Number
2014600509
Title
Heart valve surgery and the obesity paradox: A systematic review.
Source
Clinical Obesity. 12(2) (no pagination), 2022. Article Number: e12506.
Date of Publication: April 2022.
Author
EL-Andari R.; Bozso S.J.; Kang J.J.H.; Bedard A.M.A.; Adams C.; Wang W.;
Nagendran J.
Institution
(EL-Andari) Faculty of Medicine and Dentistry, University of Alberta,
Edmonton, AB, Canada
(Bozso, Kang, Wang, Nagendran) Division of Cardiac Surgery, Department of
Surgery, University of Alberta, Edmonton, AB, Canada
(Bedard) Department of Biological Sciences, Faculty of Science, University
of Alberta, Edmonton, AB, Canada
(Adams) Section of Cardiac Surgery, Department of Cardiac Sciences, Libin
Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB,
Canada
Publisher
John Wiley and Sons Inc
Abstract
Obesity has been associated with increased incidence of comorbidities and
shorter life expectancy, and it has generally been assumed that patients
with obesity should have inferior outcomes after surgery. Previous
literature has often demonstrated equivalent or even improved rates of
mortality after cardiac surgery when compared to their lower-weight
counterparts, coined the obesity paradox. Herein, we aim to review the
literature investigating the impact of obesity on surgical valve
interventions. PubMed and Embase were systematically searched for articles
published from 1 January 2000 to 15 October 2021. A total of 1315 articles
comparing differences in outcomes between patients of varying body mass
index (BMI) undergoing valve interventions were reviewed and 25 were
included in this study. Patients with higher BMI demonstrated equivalent
or reduced rates of postoperative myocardial infarction, stroke,
reoperation rates, acute kidney injury, dialysis and bleeding. Two studies
identified increased rates of deep sternal wound infection in patients
with higher BMI, although the majority of studies found no significant
difference in deep sternal wound infection rates. The obesity paradox has
described counterintuitive outcomes predominantly in coronary artery
bypass grafting and transcatheter aortic valve replacement. Recent
literature has identified similar trends in other heart valve
interventions. While the obesity paradox has been well characterized, its
causes are yet to be identified. Further study is essential in order to
identify the causes of the obesity paradox so patients of all body sizes
can receive optimal care. Copyright © 2021 World Obesity
Federation.

<99>
Accession Number
640022911
Title
Systemic opioid regimens for postoperative pain in neonates.
Source
Cochrane Database of Systematic Reviews. 2023(1) (no pagination), 2023.
Article Number: CD015016. Date of Publication: 16 Jan 2023.
Author
Kinoshita M.; Borges do Nascimento I.J.; Styrmisdottir L.; Bruschettini M.
Institution
(Kinoshita) Department of Pediatrics, Clinical Sciences Lund, Lund
University, Lund, Sweden
(Kinoshita) Fetal Medicine Research Center, University of Barcelona,
Barcelona, Spain
(Borges do Nascimento) School of Medicine and University Hospital,
Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
(Borges do Nascimento) Department of Medicine, Medical College of
Wisconsin, Milwaukee, WI, United States
(Styrmisdottir) Faculty of Medicine, Lund University, Lund, Sweden
(Bruschettini) Department of Clinical Sciences Lund, Paediatrics, Lund
University, Skane University Hospital, Lund, Sweden
(Bruschettini) Cochrane Sweden, Lund University, Skane University
Hospital, Lund, Sweden
Publisher
John Wiley and Sons Ltd
Abstract
Background: Postoperative pain clinical management in neonates has always
been a challenging medical issue. Worldwide, several systemic opioid
regimens are available for pediatricians, neonatologists, and general
practitioners to control pain in neonates undergoing surgical procedures.
However, the most effective and safe regimen is still unknown in the
current body of literature. Objective(s): To determine the effects of
different regimens of systemic opioid analgesics in neonates submitted to
surgery on all-cause mortality, pain, and significant neurodevelopmental
disability. Potentially assessed regimens might include: different doses
of the same opioid, different routes of administration of the same opioid,
continuous infusion versus bolus administration, or 'as needed'
administration versus 'as scheduled' administration. Search
Method(s): Searches were conducted in June 2022 using the following
databases: Cochrane Central Register of Controlled Trials [CENTRAL],
PubMed, and CINAHL. Trial registration records were identified via CENTRAL
and an independent search of the ISRCTN registry. Selection Criteria:
We included randomized controlled trials (RCTs), quasi-randomized,
cluster-randomized, and cross-over controlled trials evaluating systemic
opioid regimens' effects on postoperative pain in neonates (pre-term or
full-term). We considered suitable for inclusion: I) studies evaluating
different doses of the same opioid; 2) studies evaluating different routes
of administration of the same opioid; 3) studies evaluating the
effectiveness of continuous infusion versus bolus infusion; and 4) studies
establishing an assessment of an 'as needed' administration versus 'as
scheduled' administration. Data Collection and Analysis: According to
Cochrane methods, two investigators independently screened retrieved
records, extracted data, and appraised the risk of bias. We stratified
meta-analysis by the type of intervention: studies evaluating the use of
opioids for postoperative pain in neonates through continuous infusion
versus bolus infusion and studies assessing the 'as needed' administration
versus 'as scheduled' administration. We used the fixed-effect model with
risk ratio (RR) for dichotomous data and mean difference (MD),
standardized mean difference (SMD), median, and interquartile range (IQR)
for continuous data. Finally, we used the GRADEpro approach for primary
outcomes to evaluate the quality of the evidence across included studies.
 Main Result(s): In this review, we included seven randomized
controlled clinical trials (504 infants) from 1996 to 2020. We identified
no studies comparing different doses of the same opioid, or different
routes. The administration of continuous opioid infusion versus bolus
administration of opioids was evaluated in six studies, while one study
compared 'as needed' versus 'as scheduled' administration of morphine
given by parents or nurses. Overall, the effectiveness of continuous
infusion of opioids over bolus infusion as measured by the visual analog
scale (MD 0.00, 95% confidence interval (CI) -0.23 to 0.23; 133
participants, 2 studies; I2 = 0); or using the COMFORT scale (MD -0.07,
95% CI -0.89 to 0.75; 133 participants, 2 studies; I2 = 0), remains
unclear due to study designs' limitations, such as the unclear risk of
attrition, reporting bias, and imprecision among reported results (very
low certainty of the evidence). None of the included studies reported data
on other clinically important outcomes such as all-cause mortality rate
during hospitalization, major neurodevelopmental disability, the incidence
of severe retinopathy of prematurity or intraventricular hemorrhage, and
cognitive- and educational-related outcomes. Authors' conclusions: Limited
evidence is available on continuous infusion compared to intermittent
boluses of systemic opioids. We are uncertain whether continuous opioid
infusion reduces pain compared with intermittent opioid boluses; none of
the studies reported the other primary outcomes of this review, i.e.
all-cause mortality during initial hospitalization, significant
neurodevelopmental disability, or cognitive and educational outcomes among
children older than five years old. Only one small study reported on
morphine infusion with parent- or nurse-controlled
analgesia. Copyright © 2023 The Cochrane Collaboration. Published
by John Wiley & Sons, Ltd.

<100>
Accession Number
2022338772
Title
Social App to Improve Warfarin Therapy in Post-MHVR Chinese Patients: A
Randomized Controlled Trial.
Source
Cardiovascular Therapeutics. 2023 (no pagination), 2023. Article Number:
2342111. Date of Publication: 2023.
Author
Zhang L.; Li S.; Li Z.; Yu D.; Wu H.; Hua B.; Xie L.; Yuan X.; Li Y.;
Zhang Z.; Long Y.
Institution
(Zhang, Zhang) Clinical Laboratory, Wuhan Asia General Hospital Affiliated
to Wuhan University of Science and Technology, Wuhan 430056, China
(Zhang, Li, Li, Yu, Wu, Hua, Xie, Yuan, Li, Long) Anticoagulation Clinic,
Wuhan Asia Heart Hospital, Wuhan 430022, China
(Li, Long) Cardiac Surgery, Wuhan Asia Heart Hospital, Wuhan 430022, China
(Li) Administrative Office, Wuhan Asia Heart Hospital, Wuhan 430022, China
(Yu, Wu, Hua, Xie, Yuan, Li) Nursing Department, Wuhan Asia Heart
Hospital, Wuhan 430022, China
(Zhang) Clinical Laboratory, Wuhan Asia Heart Hospital, Wuhan 430022,
China
Publisher
Hindawi Limited
Abstract
Background. Poor anticoagulation quality was a major problem among
warfarin-treated patients, which called for innovative and effective
methods to improve it. Objective. To investigate whether social app could
be used to reduce warfarin-associated adverse events among post-MHVR
Chinese patients. Method. 735 warfarin-treated patients (aged 50.8+/-9.6
years, 59.9% female) were enrolled and randomized to a social app care
group (warfarin therapy was guided by experienced clinicians via a social
app) or a routine care group (warfarin therapy was managed through
traditional in-office visits) at a 1: 1 ratio. Ending points (bleeding and
thrombotic events) were recorded during an 18-month follow-up period.
Results. A total of 718 patients were included in analysis. 57 of them
suffered warfarin-associated adverse events, including 30 major bleedings
and 27 thrombotic events. The time in the therapeutic range (TTR,
Rosendaal method) in the social app group was 71.5%, which was
significantly better than 52.6% in the routine care group (difference:
18.8%, 95% CI: 16.8-20.8). Compared with the patients from the social app
group, patients under routine care experienced more bleeding (hazard ratio
(HR): 2.31, 95% CI: 1.13-4.72). The social app care group had lower
variation (0.55 vs. 0.70) in the international normalized ratio (INR)
values and fewer incidents of extremely high INR (e.g., INR>5.0, 0.87% vs.
3.42%) than the routine care group. Conclusions. Social app management
could significantly improve warfarin control and was associated with a
reduction in bleeding risk. This trial was registered with
NCT03264937. Copyright © 2023 Litao Zhang et al.

<101>
Accession Number
2018703552
Title
Follow-Up of Offspring Born to Parents With a Solid Organ Transplantation:
A Systematic Review.
Source
Transplant International. 35 (no pagination), 2022. Article Number: 10565.
Date of Publication: 05 Aug 2022.
Author
Meinderts J.R.; Prins J.R.; Berger S.P.; De Jong M.F.C.
Institution
(Meinderts, Berger, De Jong) Department of Nephrology, University Medical
Center Groningen, Groningen, Netherlands
(Prins) Department of Obstetrics and Gynecology, University Medical Center
Groningen, Groningen, Netherlands
Publisher
European Society for Organ Transplantation
Abstract
Pregnancy after solid organ transplantation (SOT) has potential risks for
the offspring. Most existing research focused on short-term pregnancy
outcomes. The aim of this systematic review was to evaluate available data
concerning longer term outcomes (>1 year) of these children. A systematic
literature search, following PRISMA guidelines, of PubMed and Embase was
performed from the earliest date of inception through to 6th April 2022.
Publications on all types of (combined) SOT were eligible for inclusion.
In total, 53 articles were included. The majority assessed offspring after
kidney (78% of offspring) or liver transplantation (17% of offspring). 33
studies included offspring aged >4 years and five offspring aged >18
years. One study was included on fathers with SOT. The majority of the
1,664 included children after maternal SOT had normal intellectual,
psychomotor, and behavioral development. Although prematurity and low
birth weight were commonly present, regular growth after 1 year of age was
described. No studies reported opportunistic or chronic infections or
abnormal response to vaccinations. In general, pregnancy after SOT appears
to have reassuring longer term outcomes for the offspring. However,
existing information is predominantly limited to studies with young
children. Longer prospective studies with follow-up into adulthood of
these children are warranted. Copyright © 2022 Meinderts, Prins,
Berger and De Jong.

<102>
Accession Number
2020227844
Title
A comprehensive review of cerebral oximetry in cardiac surgery.
Source
Journal of Cardiac Surgery. 37(12) (pp 5418-5433), 2022. Date of
Publication: December 2022.
Author
Moore C.C.; Yu S.; Aljure O.
Institution
(Moore, Aljure) Jackson Memorial Hospital/University of Miami Miller
School of Medicine, Miami, FL, United States
(Yu) Mayo Clinic, Phoenix, AZ, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Patients who undergo cardiac surgery are at increased risk of
stroke, postoperative cognitive decline, and delirium. These
neurocognitive complications have led to increased costs, intensive care
unit stays, morbidity, and mortality. As a result, there is a significant
push to mitigate any neurological complications in cardiac surgery
patients. Near-infrared spectroscopy to measure regional cerebral oxygen
saturations has gained consideration due to its noninvasive and
user-friendly nature. Cerebral oximetry desaturations during cardiac
surgery have been linked to an array of adverse clinical outcomes.
However, the most effective intraoperative interventions to protect this
vulnerable patient population have yet to be ascertained. Aim of Study: To
provide a comprehensive summary of the intraoperative management for
cerebral oximetry desaturations during cardiac surgery. The review
highlights clinical outcomes from cerebral oximetry use to quantify the
importance of identifying cerebral desaturations during cardiac surgery.
The review then interrogates possible interventions for cerebral oximetry
desaturations in an effort to determine which interventions are most
efficacious and to enlighten possible areas for further research.
 Method(s): A narrative review of randomized controlled trials,
observational studies, and systematic reviews with metanalyses was
performed through August 2021. Result(s): There is significant
heterogeneity among patient populations for which cerebral oximetry
monitoring has been studied in cardiac surgery. Further, the definition of
a clinically significant cerebral desaturation and the assessment of
neurocognitive outcomes varied substantially across studies. As a result,
metanalysis is challenging and few conclusions can be drawn. Cerebral
oximetry use during cardiac surgery has not been associated with
improvements in neurocognitive outcomes, morbidity, or mortality to date.
The evidence to support a particular intervention for an acute
desaturation is equivocal. Conclusion(s): Future research is needed
to quantify a clinically significant cerebral desaturation and to
determine which interventions for an acute desaturation effectively
improve clinical outcomes. Copyright © 2022 Wiley Periodicals
LLC.

<103>
Accession Number
2020107998
Title
Minimally invasive versus conventional aortic valve replacement: The
network meta-analysis.
Source
Journal of Cardiac Surgery. 37(12) (pp 4868-4874), 2022. Date of
Publication: December 2022.
Author
Ogami T.; Yokoyama Y.; Takagi H.; Serna-Gallegos D.; Ferdinand F.D.;
Sultan I.; Kuno T.
Institution
(Ogami, Serna-Gallegos, Ferdinand, Sultan) Department of Cardiothoracic
Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Fountain Hill, PA, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Serna-Gallegos, Ferdinand, Sultan) Department of Cardiothroacic Surgery,
Heart and Vascular Institute, University of Pittsburgh Medical Center,
Pittsburgh, PA, United States
(Kuno) Division of Cardiology, Montefiore Medical Center, Albert Einstein
College of Medicine, New York City, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Outcome comparisons after surgical aortic valve replacement
(SAVR) with minimally invasive approaches including mini-sternotomy (MS)
and right mini-thoracotomy (RMT) and full sternotomy (FS) have been
conflicting. Furthermore, the synthesis of mid-term mortality has not been
performed. Method(s): MEDLINE and EMBASE were searched through April
2022 to identify propensity score matched (PSM) studies or randomized
controlled trial (RCT) which compared outcomes following SAVR among three
incisional approaches: FS, MS, or RMT. The network analysis was performed
to compare these approaches with random effects model. Mid-term mortality
was defined as 1-year mortality. Result(s): A total of 42 studies met
the inclusion criteria enrolling 14,925 patients. RCT and PSM were
performed in 13 and 29 studies, respectively. The operative mortality was
significantly lower with MS compared to FS (risk ratio [RR]: 0.60, 95%
confidence interval [CI]: 0.41-0.90, p =.01, I2 = 25.8%) or RMT
(RR: 0.51, 95% CI: 0.27-0.97, p =.03, I2 = 25.8%). RMT had
significantly higher risk of reoperation for bleeding compared to MS (RR:
1.65, 95% CI: 1.18-2.30, p =.003, I2 = 0%). Hospital length of
stay was significantly shorter with MS compared to FS (mean difference:
-0.89 days, 95% CI: -1.58 to -0.2, p =.01, I2 = 95.5%) while it
was equivocal between FS and RMT. The mid-term mortality was similar among
the three approaches. Conclusion(s): While mid-term mortality was
comparable among approaches, MS may be a safe and potentially more
effective approach than FS and RMT for SAVR in the short
term. Copyright © 2022 Wiley Periodicals LLC.

<104>
Accession Number
2018177589
Title
Surgical site wound infection, and other postoperative problems after
coronary artery bypass grafting in subjects with chronic obstructive
pulmonary disease: A meta-analysis.
Source
International Wound Journal. 20(2) (pp 302-312), 2023. Date of
Publication: February 2023.
Author
Gao J.; Wang H.; Liu X.; Song X.; Zhong X.
Institution
(Gao, Wang, Zhong) Department of Respiratory and Critical Care Medicine,
The First Affiliated Hospital of Guangxi Medical University, Nanning,
China
(Gao, Liu, Song) Department of Rheumatism and Immunology, The Fourth
Affiliated Hospital of Guangxi Medical University, Liuzhou, China
Publisher
John Wiley and Sons Inc
Abstract
We performed a meta-analysis to evaluate the effect of chronic obstructive
pulmonary disease on surgical site wound infection, and other
postoperative problems after coronary artery bypass grafting. A systematic
literature search up to April 2022 was performed and 37 444 subjects with
coronary artery bypass grafting at the baseline of the studies; 4320 of
them were with the chronic obstructive pulmonary disease, and 33 124 were
without chronic obstructive pulmonary disease. Odds ratio (OR), and mean
difference (MD) with 95% confidence intervals (CIs) were calculated to
assess the effect of chronic obstructive pulmonary disease on surgical
site wound infection, and other postoperative problems after coronary
artery bypass grafting using the dichotomous, and contentious methods with
a random or fixed-effect model. The chronic obstructive pulmonary disease
subjects had a significantly higher surgical site wound infection (OR,
1.27; 95% CI, 1.01-1.60, P = 0.04), respiratory failure (OR, 1.84; 95% CI,
1.55-2.18, P < 0.001), mortality (OR, 1.61; 95% CI, 1.37-1.89, P < 0.001),
pneumonia (OR, 2.30; 95% CI, 1.97-2.68, P < 0.001), pleural effusion (OR,
1.78; 95% CI, 1.12-2.83, P = 0.02), stroke (OR, 1.99; 95% CI, 1.17-3.36, P
= 0.01), and length of intensive care unit stay (MD, 0.73; 95% CI,
0.19-1.26, P = 0.008) after coronary artery bypass grafting compared with
subjects without chronic obstructive pulmonary disease. However, chronic
obstructive pulmonary disease subjects did not show any significant
difference in length of hospital stay (MD, 0.83; 95% CI, -0.01 to 1.67, P
= 0.05), and pneumothorax (OR, 1.59; 95% CI, 0.98-2.59, P = 0.06) after
coronary artery bypass grafting compared with subjects without chronic
obstructive pulmonary disease. The chronic obstructive pulmonary disease
subjects had a significantly higher surgical site wound infection,
respiratory failure, mortality, pneumonia, pleural effusion, stroke, and
length of intensive care unit stay, and no significant difference in
length of hospital stay, and pneumothorax after coronary artery bypass
grafting compared with subjects without chronic obstructive pulmonary
disease. The analysis of outcomes should be with caution because of the
low sample size of 1 out of 11 studies in the meta-analysis and a low
number of studies in certain comparisons. Copyright © 2022 The
Authors. International Wound Journal published by Medicalhelplines.com Inc
(3M) and John Wiley & Sons Ltd.

<105>
Accession Number
2022447212
Title
Effects of Thoracic Paravertebral Block on Postoperative Analgesia in
Infants and Small Children undergoing Ultra-Fast Track Cardiac Anesthesia:
A Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2023.
Date of Publication: 2023.
Author
Feng J.; Wang H.; Peng L.; Xu H.; Song X.
Institution
(Feng, Wang, Peng, Xu, Song) Department of Anesthesiology, Guangzhou Women
and Children's Medical Center, Guangdong Provincial Clinical Research
Center for Child Health, Guangzhou, China
Publisher
W.B. Saunders
Abstract
Objectives: To assess whether a preoperative bilateral thoracic
paravertebral block (TPVB) would improve postoperative analgesia in
infants and small children undergoing open cardiac surgery in the protocol
of an ultra-fast track cardiac anesthesia (UFTCA). Design(s): A
single-center, prospective, randomized, controlled study. Setting(s):
At a tertiary children's medical center. Participant(s): A total of
180 children undergoing cardiac surgery, aged 1 month to 3 years.
 Intervention(s): Patients are allocated randomly to TPVB and parent-
and/or nurse-controlled intravenous analgesia (PNCA) group (Group T) or
PNCA group (Group P). Measurements and Main Results: The primary
outcome is the postoperative pain scores. The secondary outcome are
intraoperative consumption of sufentanil, time to extubation, using of
neostigmine, cumulative total and invalid PCA attempts in 24 and 48 hours
after surgery, hospitalization characteristics, perioperative blood
glucose, postoperative arterial oxygen partial pressure, arterial carbon
dioxide partial pressure (PaCO<inf>2</inf>) and brain natriuretic peptide
(BNP). The postoperative pain scores within 24 hours, intraoperative
consumption of sufentanil, total, and invalid PCA attempts in 24 and 48
hours, perioperative blood glucose and BNP on the seventh day in Group T
were all significantly lower than those in Group P (p < 0.001). The time
to extubation, the use of neostigmine, and PaCO<inf>2</inf> on the sixth
hour, postoperatively, were significantly smaller in Group T than those in
Group P (p < 0.05). There were no significant differences in the
hospitalizations between the 2 groups. Conclusion(s): A combination
of bilateral single dose TPVB and PNCA pain management is superior to a
PNCA pain management alone in infants and small children undergoing open
cardiac surgery and contributes to a rapid recovery with preferable
perioperative outcomes in the protocol of UFTCA. Copyright © 2022

<106>
Accession Number
2020581029
Title
The effects of mineralocorticoid receptor antagonists on cardiovascular
outcomes in patients with end-stage renal disease and heart failure.
Source
European Journal of Heart Failure. 25(1) (pp 98-107), 2023. Date of
Publication: January 2023.
Author
Lin D.S.-H.; Lin F.-J.; Lin Y.-S.; Lee J.-K.; Lin Y.-H.
Institution
(Lin, Lee, Lin) Division of Cardiology, Department of Internal Medicine,
National Taiwan University Hospital, Taipei, Taiwan (Republic of China)
(Lin) Division of Cardiology, Department of Internal Medicine, National
Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan (Republic of
China)
(Lin) School of Pharmacy, College of Medicine, National Taiwan University,
Taipei, Taiwan (Republic of China)
(Lin) Department of Pharmacy, National Taiwan University Hospital, Taipei,
Taiwan (Republic of China)
(Lin) Graduate Institute of Clinical Pharmacy, College of Medicine,
National Taiwan University, Taipei, Taiwan (Republic of China)
(Lin) Division of Cardiology, Department of Internal Medicine, Chang Gung
Memorial Hospital, Chiayi, Taiwan (Republic of China)
(Lin) College of Medicine, Graduate Institute of Clinical Medical
Sciences, Chang Gung University, Taoyuan City, Taiwan (Republic of China)
(Lee) Department of Internal Medicine, National Taiwan University College
of Medicine, Taipei, Taiwan (Republic of China)
(Lee, Lin) Department of Laboratory Medicine, National Taiwan University
College of Medicine, Taipei, Taiwan (Republic of China)
(Lee, Lin) Cardiovascular Center, National Taiwan University Hospital,
Taipei, Taiwan (Republic of China)
(Lee) Telehealth Center, National Taiwan University Hospital, Taipei,
Taiwan (Republic of China)
Publisher
John Wiley and Sons Ltd
Abstract
Aims: Mineralocorticoid receptor antagonists (MRAs) have been shown to
provide survival benefits in patients with heart failure; however, MRA use
in patients with chronic kidney disease has been limited by safety
concerns. The effects of MRAs on outcomes in patients with end-stage renal
disease (ESRD) and heart failure remain unknown. The aim of this study was
to evaluate the effects of MRAs on cardiovascular outcomes in patients
with heart failure under maintenance dialysis in a real-world setting.
 Methods and Results: A retrospective cohort study was conducted by
collecting data from the Taiwan National Health Insurance Research
Database (NHIRD). Patients diagnosed with heart failure and ESRD and who
started maintenance dialysis between 1 January 2001 and 31 December 2013
were identified. Patients were grouped according to MRA prescription. The
outcomes of interest included cardiovascular (CV) death, hospitalization
for heart failure (HHF), all-cause mortality, acute myocardial infarction
(AMI), ischaemic stroke, any coronary revascularization procedures, and
new-onset hyperkalaemia. Propensity score matching was performed at a 1:3
ratio between MRA users and non-users to minimize selection bias. A total
of 50 872 patients who satisfied our inclusion and exclusion criteria were
identified. After 1:3 matching, 2176 patients were included in the MRA
group, and 6528 patients were included in the non-MRA group. The risk of
CV death was significantly lower among patients who received MRAs than
those who did not (hazard ratio [HR] 0.88, 95% confidence interval [CI]
0.80-0.95), as was the risk of all-cause mortality (HR 0.88, 95% CI
0.83-0.94). Reductions in the risks of CV death and all-cause mortality
were more prominent among patients undergoing haemodialysis and those with
coronary artery disease. Conclusion(s): In patients undergoing
regular dialysis who are diagnosed with heart failure, the use of MRAs is
associated with lower risks of all-cause mortality and CV death. The
benefits of MRA treatment in heart failure may persist in patients with
ESRD. Further investigations through randomized controlled trials are
needed to assess the efficacy and safety of MRAs in this high-risk
population. Copyright © 2022 European Society of Cardiology.

<107>
Accession Number
2021279375
Title
Neurodevelopmental and functional outcome in hypoplastic left heart
syndrome after Hybrid procedure as stage I.
Source
Frontiers in Pediatrics. 10 (no pagination), 2023. Article Number:
1099283. Date of Publication: 16 Jan 2023.
Author
Knirsch W.; De Silvestro A.; von Rhein M.
Institution
(Knirsch, De Silvestro) Pediatric Cardiology, Pediatric Heart Center,
Department of Surgery, University Children's Hospital Zurich, Switzerland
(Knirsch, De Silvestro, von Rhein) Children's Research Center, University
Children's Hospital Zurich, Switzerland
(Knirsch, De Silvestro, von Rhein) University of Zurich (UZH), Switzerland
(von Rhein) Child Development Center, University Children's Hospital
Zurich, Switzerland
Publisher
Frontiers Media S.A.
Abstract
Background: Patients with hypoplastic left heart syndrome (HLHS)
undergoing staged palliation until Fontan procedure are at risk for
impaired neurodevelopmental (ND) outcome. The Hybrid procedure with
bilateral pulmonary artery banding, ductal stenting, and balloon
atrioseptostomy may offer a less invasive stage I procedure compared to
the Norwood stage I procedure avoiding early neonatal cardiopulmonary
bypass (CPB) surgery. Despite altered fetal cerebral hemodynamics, the
type of stage I procedure may be a covariate influencing ND outcome and
functional outcome may also be altered due to postponing neonatal CPB
surgery. Within this review, we analyzed ND outcome as well as functional
outcome after Hybrid procedure as stage I procedure. Method(s): The
review analyzed original publications (OPs) published before March 15,
2022, identified by Cochrane, EMBASE, OVID, Scopus, and Web of science. An
OP was included if short-to-long-term neurodevelopment outcome, brain
development, somatic, and cardiac outcome in patients for HLHS and
variants treated by Hybrid procedure were analyzed. In addition to
database searches, we reviewed all references of the analyzed OP to obtain
a comprehensive list of available studies. The author, year of
publication, demographic characteristics of study population, study design
(prospective or retrospective), study assessment, and main findings were
summarized. Result(s): Twenty-one OPs were included with data of
patients with ND outcome and functional cardiac outcome. Overall, there is
an impaired mid-term ND outcome in patients with Hybrid procedure as stage
I for HLHS. Only slight differences between stage I procedures (Hybrid vs.
Norwood) in two comparing studies have been determined affecting right
ventricular remodeling, short- and mid-term ND outcome, reduced brain
growth until two years of age, sufficient quality of life, and altered
hemodynamics influencing brain volumes and cerebral perfusion pattern.
 Conclusion(s): Despite some minor differences regarding the mid-term
follow-up in patients with HLHS comparing Hybrid vs. Norwood procedure,
its impact on ND outcome seems rather low. This may be explained by the
large number of covariates as well as the small study populations and the
different selection criteria for patients undergoing Hybrid or Norwood
procedure as stage I. Copyright 2023 Knirsch, De Silvestro and von
Rhein.

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