Based on an updated meta-analysis of exclusive adjusted HRs from 20 observational studies enrolling more than 70,000 patients, BITA grafting seems to significantly reduce long-term mortality. As the proportion of men increases, BITA grafting is more beneficial in reducing mortality.

To summarize the present evidence for an association between matrix metalloproteinase-9 (MMP-9) and abdominal aortic aneurysm (AAA) presence, we performed a meta-analysis of case-control studies that compared circulating MMP-9 concentrations between patients with AAA and subjects without AAA. MEDLINE database was searched to identify all case-control studies. For each study, data regarding serum or plasma MMP-9 concentrations in both the AAA and control groups were used to generate standardized mean differences (SMDs) and 95% confidence intervals (CIs). Study-specific estimates were combined using inverse variance-weighted average of logarithmic SMDs in both fixed- and random-effects models. Our search identified eight eligible studies including 580 patients with AAA and 258 subjects without AAA. Pooled analysis demonstrated significantly higher circulating MMP-9 concentrations in the AAA group than those in the control group in random-effect models (SMD, 0.70; 95% CI, 0.23-1.17; P=0.004). There was significant study heterogeneity of results (P<0.00001) but no evidence of significant publication bias (P=0.1376). We found that, based on a systematic review and meta-analysis, circulating MMP-9 concentrations are higher in patients with AAA than those in subjects without AAA. Higher circulating MMP-9 concentrations are associated with AAA presence.

T he most recent meta-analysis 1 of 37 randomized trials of off-pump coronary artery bypass (OPCAB) versus conventional coronary artery bypass grafting (CABG) demonstrated that mortality, stroke, myocardial infarction, and renal failure were not reduced in OPCAB; however, selected short-term and midterm clinical and resource outcomes were improved compared with CABG. The previous cumulative analysis (by Parolari and associates 2 ) of 5 prospective randomized studies (by Nathoe, 3 Khan, 4 Puskas, 5 Widimsky, 6 Lingaas, 7 and their associates) then available in the literature, however, documented a reduction in postoperative patency of bypass grafts performed during OPCAB procedures. Since the meta-analysis by Parolari and associates 2 was conducted, Lingaas and colleagues 8 have updated the 3-month patency, 7 and Kobayashi and coworkers 9 and Al-Ruzzeh and associates 10 have reported results of other randomized controlled trials. In these trials, 8-10 OPCAB provided the same angiographic graft patency as CABG, despite the conclusion of the meta-analysis by Parolari and colleagues. 2 To reassess differences in graft patency between OPCAB and CABG, we performed a meta-analysis of currently available randomized controlled trials of OPCAB versus CABG. DiscussionThe present meta-analysis demonstrated a significant increase in overall graft "occlusion," especially in venous graft "occlusion," with OPCAB relative to CABG. On the one hand, OPCAB de-From the

We found that plasma fibrinogen and D-dimer concentrations are likely to be higher in cases with AAA than control subjects. Higher plasma fibrinogen and D-dimer concentrations may be associated with the presence of AAA.

results of extensive primary repair of the thoracic aorta by means of total arch replacement for an acute type A aortic dissection.

We examined the effect of a simple intraoperative intrathoracic hyperthermotherapy (IIH) and a simple intraoperative intrathoracic hyperthermo-chemotherapy (IIHC) on malignant pleural effusion and/or dissemination with primary non-small lung cancer. This study included 19 patients who had malignant pleural effusion and/or dissemination recognized for the first time at the time of surgery. We performed surgical procedures on the primary lesions and then the additional therapies followed. Seven patients received IIH (group A), five patients underwent IIHC (group B), and seven patients did not have any additional therapy (group C). There was no death during the follow-up period (9-35 months) in the group A. The median survival time was 41 months in the group B and 25 months in the group C. The group A was completely free of pleural effusion and one patient in the group B suffered from pleural effusion 26 months after surgery, although the median term of freedom from pleural effusion was three months in the group C. In patients with malignant pleural effusion and/or dissemination with primary non-small lung cancer, not only IIHC but also IIH might be beneficial in the prevention of pleural effusion instead of the improvement in prognosis.

No abstract

To determine whether coronary artery bypass grafting (CABG) with complete revascularization improves survival in patients with multivessel disease (MVD) over CABG with incomplete revascularization, we performed a meta-analysis of adjusted (but not unadjusted) risk estimates from observational studies. Databases including MEDLINE and EMBASE were searched through October 2013 using Web-based search engines (PubMed, OVID). Eligible studies were observational studies of complete- versus incomplete-revascularization CABG enrolling ≥ 100 patients with MVD in each treatment arm and reporting an adjusted hazard ratio for follow-up mortality. Mixed-effects meta-regression analyses were performed to determine whether the effects of complete-revascularization CABG on survival were modulated by the prespecified factors. Fourteen observational studies enrolling 30 389 patients were identified and included. A pooled analysis demonstrated a statistically significant 37% reduction in follow-up mortality with complete- relative to incomplete-revascularization CABG (hazard ratio, 0.63; 95% confidence interval, 0.53-0.75; P < 0.00001). Although meta-regression coefficients were not statistically significant for mean follow-up duration and age and proportion of men and patients undergoing off-pump CABG, that for proportion of patients with diabetes was significantly negative (P = 0.03), which would indicate that as patients with diabetes increase, complete-revascularization CABG is more beneficial for survival. In conclusion, complete-revascularization CABG appears to improve survival over incomplete-revascularization CABG in patients with MVD.