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<1>
Accession Number
2039714758
Title
Coronary artery bypass grafting versus percutaneous coronary intervention
for patients with left ventricular systolic dysfunction: A meta-analysis.
Source
Asian Journal of Surgery. 48(12) (pp 7353-7355), 2025. Date of
Publication: 01 Dec 2025.
Author
Cao S.; Shen Y.; Li D.
Institution
(Cao) Department of Cardiology, Hangzhou Xiaoshan Hospital of Traditional
Chinese Medicine, Zhejiang, Hangzhou, China
(Shen) Department of Surgery, Hangzhou Xiaoshan Hospital of Traditional
Chinese Medicine, Zhejiang, Hangzhou, China
(Li) Department of Cardiology, The First Affiliated Hospital of Henan
University of Science & Technology, Luoyang Key Laboratory of
Cardiovascular Science, Henan Provincial Key Laboratory of Cardiovascular
Disease Medicine, Henan, Luoyang, China
Publisher
Elsevier (Singapore) Pte Ltd

<2>
Accession Number
2037380756
Title
The Effects of Surface Gastrointestinal Electrical Stimulation on
Gastrointestinal Function Recovery in Patients After Acute Type A Aortic
Dissection Open-Heart Surgery: A Randomized, Controlled Trial.
Source
Reviews in Cardiovascular Medicine. 26(10) (no pagination), 2025. Article
Number: 39847. Date of Publication: 01 Oct 2025.
Author
Duan W.; Luo Z.; Huang W.; Zhang X.; Su J.; Li Z.; Chen M.; Yu P.
Institution
(Duan, Luo, Huang, Zhang, Su, Yu) Rehabilitation Medicine Center, Sichuan
University West China Hospital, Sichuan, Chengdu, China
(Li, Chen) Department of Cardiovascular Surgery, Sichuan University West
China Hospital, Sichuan, Chengdu, China
(Yu) Key Laboratory of Rehabilitation Medicine in Sichuan Province,
Sichuan, Chengdu, China
Publisher
IMR Press Limited
Abstract
Background: Gastrointestinal (GI) dysfunction is a common postoperative
complication in patients after acute type A aortic dissection (ATAAD)
surgery. Recent evidence suggests that, in addition to early nutrition and
feeding strategies, physiotherapy can help to reduce the incidence of
postoperative GI dysfunction. This study aimed to investigate whether GI
function after ATAAD open surgery can be recovered through surface
gastrointestinal electrical stimulation (SGES). <br/>Method(s): This was a
prospective, parallel-group, assessor-blind, randomized controlled trial
(RCT). A total of 74 participants were included and randomly divided into
a control group (CG) and an SGES intervention group (IG) in a 1:1 ratio.
The CG received a standardized perioperative management program developed
by a multidisciplinary team, based on the principles of enhanced recovery
after surgery (ERAS). The IG implemented SGES at ST36, ST25, and two
additional GI pacemakers, as well as ERAS. The primary outcome was GI-2
recovery (tolerance of oral diet and passage of stool). Secondary outcomes
included the Gastrointestinal Symptom Rating Scale (GSRS), acute
gastrointestinal injury ultrasonography (AGIUS), the Gastrointestinal
Quality of Life Index (GIQLI), the incidence of constipation and diarrhea,
length of stay in the intensive care unit (ICU), and duration of
hospitalization. <br/>Result(s): Of the 74 patients in this study, 24.32%
were female, with a mean age of 49.61 years. The time to achieve GI-2 in
the IG was significantly shorter, 1.9 days, than in the CG (log-rank test,
p = 0.01). The GSRS scores in the IG were significantly lower than those
in the CG (total scores: 1.2 vs. 1.6 p = 0.001). Moreover, the GIQLI
values at all three follow-up visits were significantly higher in the IG
group than in the CG group. <br/>Conclusion(s): To our knowledge, this is
the first RCT to investigate the clinical effects of SGES on GI recovery
after open-heart surgery for ATAAD. The results provide preliminary
evidence supporting the feasibility and therapeutic potential of SGES in a
high-risk population. SGES can promote the recovery of GI function, reduce
GI-related symptoms, and improve the GI-related quality of life after open
heart surgery in patients with ATAAD. Clinical Trial Registration: This
trial was based on the Consolidated Standards of Reporting Trials
(CONSORT) guidelines. This trial was registered in the Chinese Clinical
Trial Registry (identifier ChiCTR2300075265,
https://www.chictr.org.cn/showproj.html?proj=205523).<br/>Copyright &#xa9;
2025 The Author(s). Published by IMR Press.

<3>
Accession Number
648302816
Title
The Effect of Specialized Collaborative Nursing on the Awakening Quality
and Stress Status of Elderly Patients Undergoing Coronary Artery Bypass
Surgery: A Randomized Controlled Study.
Source
Journal of perianesthesia nursing : official journal of the American
Society of PeriAnesthesia Nurses. 40(6) (pp 1590-1595), 2025. Date of
Publication: 01 Dec 2025.
Author
Lv L.; Wang M.
Institution
(Lv) Department of Anesthesia, Affiliated Chenggong Hospital of Xiamen
University (73rd Army Group Hospital), Xiamen, Fujian, China
(Wang) Department of Anesthesia, Affiliated Chenggong Hospital of Xiamen
University (73rd Army Group Hospital), Xiamen, Fujian, China
Abstract
PURPOSE: Exploring the effect of specialized collaborative nursing model
during the awakening period for elderly patients undergoing coronary
artery bypass surgery. DESIGN: Prospective randomized controlled trial.
<br/>METHOD(S): A total of 200 elderly patients who underwent coronary
artery bypass surgery at our hospital from January 2020 to January 2023
were selected as study subjects. They were randomly divided into a control
group and an observation group, with 100 patients in each group. The
control group received routine nursing care, while the observation group
received specialized collaborative nursing care during the awakening
period. The stress status during the awakening period [heart rate (HR),
systolic blood pressure (SBP), diastolic blood pressure (DBP), mean
arterial pressure (MAP)], awakening time, awakening quality [Observer
Assessment of Alertness and Sedation (OAAS)], and the incidence of
complications were compared between the two groups. FINDINGS: At the time
of extubation and 2 minutes after extubation, the levels of HR, SBP, DBP,
and MAP in both groups were higher than at the time of eye opening.
However, the levels of these indicators in the observation group were
lower than those in the control group, with statistically significant
differences (P < 0.05). The OAAS scores at different time points after
extubation in the observation group were higher than those in the control
group. The times for the recovery of spontaneous breathing, extubation,
eye opening upon calling, and length of stay in the postanesthesia care
unit were shorter in the observation group compared to the control group,
with statistically significant differences (P < 0.05). The incidence of
complications in the observation group was lower than in the control
group, with statistically significant differences (P < 0.05).
<br/>CONCLUSION(S): Specialized collaborative nursing during the awakening
period can significantly reduce the stress status of elderly patients
undergoing coronary artery bypass surgery, improve the quality of
awakening, and reduce the incidence of related
complications.<br/>Copyright &#xa9; 2025. Published by Elsevier Inc.

<4>
Accession Number
2041475241
Title
Evaluation of the relative benefits of FFR-guided, angiography-guided CR
or culprit-only revascularization in patients with multivessel coronary
disease: a systematic review and meta-analysis.
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
848. Date of Publication: 01 Dec 2025.
Author
Liu X.-Y.; Wu X.-D.; Lin Y.; Lin X.; Li Y.-Y.; Ye B.-H.; Sun J.-C.
Institution
(Liu, Wu, Lin, Lin, Li, Ye) Department of General Medicine, The First
people's hospital of Wenling, Zhejiang, Taizhou, China
(Sun) Department of Cardiology, Taizhou Municipal Hospital, No.381
Zhongshan East Road, Zhejiang, Taizhou, China
Publisher
BioMed Central Ltd
Abstract
Background: At present, the benefits associated with fractional flow
reserve (FFR)-guided complete revascularization (CR) for instances of
non-culprit stenosis in patients of coronary artery disease (CAD) affected
by multivessel disease (MVD) remain poorly understood. This systematic
review and meta-analysis was undertaken to clarify the cardiovascular
benefits associated with FFR-guided and angiography-guided CR in patients
with CAD and MVD. <br/>Method(s): The PubMed, Embase, and Cochrane
databases were searched to locate randomized control trials (RCTs)
comparing FFR-guided CR with angiography-guided CR or culprit-only
percutaneous intervention (PCI). The primary outcome is major adverse
cardiovascular events (MACE), as well as secondary outcomes were all-cause
mortality, cardiac mortality, recurrent myocardial infarction (MI)
incidence. Primary and secondary outcomes were compared among groups using
DerSimonian and Laird random-effects models. <br/>Result(s): Ten RCTs
enrolling 7249 participants were included. No significant differences were
found between FFR- and angiography-guided CR use in patients with CAD and
MVD in terms of MACE (RR: 0.88, 95%CI: 0.69-1.12, P = 0.302), cardiac
mortality (RR: 0.90, 95%CI: 0.45-1.80. P = 1.000), recurrent MI (RR: 0.83,
95%CI: 0.55-1.25, P = 0.376), repeat revascularization (RR: 0.93, 95%CI:
0.71-1.21, P = 0.574), or target lesion revascularization (TLR; RR: 0.90,
95%CI: 0.33-2.48 P = 0.840). All-cause mortality was similar between the
groups (RR: 1.00, 95%CI: 0.57-1.75, P = 1.000). Relative to culprit-only
PCI, FFR-guided CR was associated with reduced risk of repeat
revascularization (RR: 0.50, 95%CI: 0.37-0.68, P < 0.001) and TLR (RR:
0.31, 95%CI: 0.2-0.48, P < 0.001), while MACE incidence did not differ
significantly between the two groups (RR: 0.72, 95%CI: 0.51-1.01, P =
0.006), nor did all-cause mortality (RR: 1.09, 95%CI: 0.84-1.42, P =
0.526), cardiac mortality (RR: 0.82, 95%CI: 0.55-1.21, P = 0.312), or
recurrent MI (RR: 0.85, 95%CI: 0.73-1.24, P = 0.713). <br/>Conclusion(s):
FFR-guided CR was found to linked with reduced repeat revascularization
and TLR in individuals with CAD and MVD in comparison with culprit-only
PCI. While no significant difference was detected between FFR-guided and
angiography-guided CR procedures for the analyzed cardiovascular outcomes,
a lower absolute number of adverse events was noted with FFR-guided CR.
These findings indicate that the FFR-guided CR of non-culprit vessels may
help reduce the need for the implantation of stents in patients with CAD
and MVD without any adverse impact on their prognostic
outcomes.<br/>Copyright &#xa9; The Author(s) 2025.

<5>
Accession Number
2040773683
Title
Perioperative plasma lidocaine concentrations and their impact on pain
control. A systematic review and meta-analysis.
Source
Pain Management. 15(12) (pp 1065-1078), 2025. Date of Publication: 2025.
Author
Foong K.W.; Lo Y.L.; Chaw S.H.; Loh P.S.
Institution
(Foong, Chaw, Loh) Department of Anaesthesiology, Faculty of Medicine,
Universiti Malaya, Kuala Lumpur, Malaysia
(Lo) Department of Pharmacy Practice, School of Pharmacy, IMU University,
Kuala Lumpur, Malaysia
Publisher
Taylor and Francis Ltd.
Abstract
Aim: To review the relationship between drug concentrations of
perioperative intravenous lidocaine and their analgesic effects.
<br/>Method(s): We systematically searched SCOPUS, Medline, EMBASE,
CENTRAL, and Web of Science (inception to March 2024) for randomized
controlled trials comparing intraoperative lidocaine to placebo or control
in adults undergoing non-cardiac surgery. Studies reported pain outcomes
and plasma lidocaine concentrations. Bias was assessed using the Cochrane
risk-of-bias tool, and data was analyzed with a random-effects model to
determine mean difference (MD) and 95% confidence intervals (CI).
<br/>Result(s): Fifteen studies (445 lidocaine, 453 control patients) were
included. Lidocaine lowered post-anesthetic care unit (PACU) opioid use (8
studies, MD: -3.00, 95% CI [-5.00, -1.01], p = 0.0092, I² =
57%), with meta-regression indicating greater reduction at higher plasma
concentrations (regression coefficient: -3.05, 95% CI [-4.48, -1.61], p =
0.002). However, 11 studies found no significant difference in 24-hour
postoperative opioid consumption or pain scores. Nausea and vomiting
incidence were similar between groups, and a few patients experienced
lidocaine-related adverse events. <br/>Conclusion(s): Perioperative
lidocaine infusion reduces PACU opioid consumption, with greater effects
at higher concentrations, although significant heterogeneity was noted.
Further research is needed to identify optimal concentrations for
clinically significant analgesic benefits. <br/>Protocol Registration:
International Platform of Registered Systematic Review and Meta-analysis
Protocols (INPLASY) ID: INPLASY202180046, DOI:
10.37766/inplasy2021.8.0046.<br/>Copyright &#xa9; 2025 Informa UK Limited,
trading as Taylor & Francis Group.

<6>
Accession Number
2041549184
Title
Efficacy of powdered vancomycin in the prophylaxis of surgical site
infections in posterior thoracic and/or lumbar spine surgery: a systematic
review of randomized clinical trials with meta-analysis.
Source
Neurosurgical Review. 49(1) (no pagination), 2026. Article Number: 32.
Date of Publication: 01 Dec 2026.
Author
Barreto A.F.C.; de Jesus J.H.C.; dos Santos J.C.; de Oliveira Santos B.F.
Institution
(Barreto, de Jesus) Universidade Tiradentes, Sergipe, Aracaju, Brazil
(dos Santos) Department of Neurosurgery, Hospital Unimed Sergipe, Sergipe,
Aracaju, Brazil
(de Oliveira Santos) Health Sciences Graduate Program, Federal University
of Sergipe, Sergipe, Aracaju, Brazil
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Surgical site infections (SSIs) occur in 1-14% of spine surgeries,
especially thoracic procedures, with methicillin-resistant Staphylococcus
aureus (MRSA) as a primary pathogen. Due to antibiotic resistance
concerns, powdered vancomycin application offers a promising alternative
by providing high local concentrations with minimal systemic effects.
Despite its potential, efficacy evidence remains controversial, with
concerns about side effects and resistance development. This PRISMA-guided
systematic review evaluates powdered vancomycin's effectiveness in
preventing SSIs in posterior thoracic and lumbar spine surgeries through
analysis of randomized clinical trials. This meta-analysis evaluated
powdered vancomycin in preventing surgical site infections in posterior
thoracic/lumbar spine surgeries using the PICO framework. The study
included randomized trials comparing topical vancomycin to standard
techniques, with searches conducted in PubMed, Cochrane Library, Web of
Science, and Embase databases through 2024. Two independent reviewers
performed study selection and data extraction. The analysis utilized
RevMan 5.4 software to calculate Relative Risk (RR) and 95%
Confidence Interval (95% CI), applying the Mantel-Haenszel fixed-effects
model for results synthesis. Methodological quality was assessed using
Risk of Bias 2.0. The review was registered in PROSPERO (CRD420250655363).
Following PRISMA 2020 guidelines, this meta-analysis included 5 randomized
trials with 1,677 total patients (827 experimental, 850 control). Powdered
vancomycin significantly reduced surgical site infections, with only 16
events versus 34 in the control group (risk ratio 0.48, 95% CI: 0.27-0.86,
p = 0.01). Study heterogeneity was moderate (I2=33%), justifying the
fixed-effect Mantel-Haenszel model. While findings suggest powdered
vancomycin effectively prevents SSIs in posterior thoracic/lumbar spine
surgeries, further validation across diverse populations and clinical
settings remains necessary. Based on these results, the findings indicate
that powdered vancomycin may reduce surgical site infections in spine
surgeries. There was a significant reduction in SSIs; however, long-term
safety requires further studies to validate its clinical
adoption.<br/>Copyright &#xa9; The Author(s), under exclusive licence to
Springer-Verlag GmbH Germany, part of Springer Nature 2025.

<7>
Accession Number
2041910473
Title
Continuing versus Withholding Renin-Angiotensin-Aldosterone System
Antagonists Before Noncardiac Surgery: A Systematic Review and
Meta-Analysis.
Source
Tunisie Medicale. 103(9) (pp 1146-1156), 2025. Date of Publication: 01 Sep
2025.
Author
Daghmouri M.A.; Haddad F.; Kammoun E.; Jebali F.; Jeddou H.; Chaouch M.A.
Institution
(Daghmouri) Department of Anesthesiology, Montreuil Intercommunal Hospital
Center, France
(Haddad, Kammoun) Department of Anesthesiology and Critical Care Medicine,
Faculty of Medicine of Tunis, Mongi Slim Teaching Hospital, University of
Tunis El Manar, Tunis, Tunisia
(Jebali) Department of Anesthesiology B, Monastir Teaching Hospital,
University of Monastir, Monastir, Tunisia
(Jeddou) Department of Hepatobiliary and Digestive Surgery, University
Hospital, Rennes 1 University, Rennes, France
(Jeddou) Inserm, EHESP, Irset (Institut de recherche en sante,
environnement et travail)-UMR_S 1085, Rennes 1 University, Rennes, France
(Chaouch) Department of Visceral and Digestive Surgery, Monastir
University Hospital, Monastir, Tunisia
Publisher
Societe Tunisienne des Sciences Medicales
Abstract
Background: It remains unclear whether to continue or withdraw angiotensin
receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors
(ACEI) before noncardiac surgery to reduce perioperative morbidity. This
systematic review and meta-analysis aimed to analyze the consequences of
continuing ARB or ACEi in the incidence of intraoperative hypotension and
postoperative complications. <br/>Method(s): This systematic review and
meta-analysis followed the PRISMA 2020 guidelines and was registered in
the PROSPERO database. We conducted a comprehensive search in several
bibliographic databases for studies comparing continuing versus
withholding renin angiotensin aldosterone system antagonists before
noncardiac surgery. Primary outcomes included the incidence of
intraoperative hypotension, while secondary outcomes covered the
intraoperative use of the vasoactive agent, the incidence of severe
hypotension, intraoperative and postoperative hypertension, the incidence
of acute kidney injury (AKI), 30-day postoperative all-cause mortality,
and the incidence of major cardiocerebral events (MACCE). <br/>Result(s):
Five randomized controlled trials, three nonrandomized controlled trials,
and four retrospective case-control studies were included that involved
50184 patients. Meta-analysis revealed that continuing ACEI or ARBs before
surgery increased the incidence of intraoperative hypotension (OR = 1.96,
95%CI [1.30, 2.96] p=0.001). Heterogeneity was substantial across studies
but was significantly reduced in subgroup analyses. Furthermore, the use
of vasoactive agents and the incidence of severe hypotension were
significantly higher in the continuing group. No significant differences
in intraoperative hypertension and the incidence of AKI and MACCE at 30
days after the operation. <br/>Conclusion(s): Continued ACEI or ARBs
before non-cardiac surgery increases the incidence of intraoperative
hypotension, without reducing the incidence of both AKI and MACCE
postoperatively. More research is necessary to explore the appropriate
perioperative management of ACE-I and ARB.<br/>Copyright &#xa9; 2025,
Societe Tunisienne des Sciences Medicales. All rights reserved.

<8>
Accession Number
2035123226
Title
Comparing the effect of three levels of end-expiratory pressure during
facemask ventilation on gastric insufflation in patients with obesity: a
randomized controlled trial.
Source
Journal of Anesthesia. 39(6) (pp 887-895), 2025. Date of Publication: 01
Dec 2025.
Author
Mostafa M.; Hasanin A.; Zakaria M.M.; Kandel H.; Hamimy W.; Abougabal A.;
Elshal M.M.
Institution
(Mostafa, Hasanin, Zakaria, Kandel, Hamimy, Abougabal) Department of
Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt
(Elshal) Department of Anesthesia and Critical Care Medicine, National
Cancer Institute, Cairo University, Cairo, Egypt
Publisher
Springer
Abstract
Background: We compared the effect of three levels of end-expiratory
pressure on the incidence of gastric insufflation during face-mask
ventilation in patients with obesity. <br/>Method(s): This randomized
controlled trial included adult obese patients undergoing elective
non-cardiac surgery under general anesthesia with neuromuscular blockade.
Patients were randomized to receive either zero-end-expiratory pressure
(ZEEP group), 4-cmH<inf>2</inf>O positive end-expiratory pressure (PEEP)
(low-PEEP group), or 8-cmH<inf>2</inf>O PEEP (high-PEEP group) during
volume-controlled mask ventilation. Gastric antral cross-sectional area
(CSA) was assessed using ultrasonography before induction of anesthesia
and after intubation. The percentage of change (delta) in the CSA was
calculated and gastric insufflation was considered significant when the
delta CSA was > 30%. The primary outcome was the incidence of gastric
insufflation. Secondary outcomes were antral CSA before induction of
anesthesia and after intubation in addition to ventilatory variables
(end-tidal CO<inf>2</inf>, peak airway pressure, and tidal volume) during
face-mask ventilation. <br/>Result(s): We analyzed data from 160 patients.
The antral CSA increased after intubation in all groups. The incidence of
gastric insufflation was higher in the high-PEEP group (32/54[59%]) than
that in the ZEEP group (6/52[12%]) and low-PEEP group (15/54[28%]). Delta
CSA, antral CSA after intubation, and incidence of gastric insufflation
were not significantly different between the ZEEP and low-PEEP groups.
Ventilatory variables were comparable between the groups.
<br/>Conclusion(s): In obese paralyzed patients, gastric insufflation can
occur during face-mask ventilation whatever the level of end-expiratory
pressure; however, the use of ZEEP or 4-cmH<inf>2</inf>O PEEP was
associated with lower incidence of gastric insufflation compared to
8-cmH<inf>2</inf>O PEEP. Clinical trial registration: Clinical trial
registration at clinicaltrials.gov NCT05979129.
https://classic.clinicaltrials.gov/ct2/show/NCT05979129<br/>Copyright
&#xa9; The Author(s) 2025.

<9>
[Use Link to view the full text]
Accession Number
2039653795
Title
Comparison of the Incidence of Arterial Pressure Line Insufficiency
Between Polyethylene and Polyurethane Catheters in the ICU: A Randomized
Study.
Source
Critical Care Medicine. 53(10) (pp e1973-e1981), 2025. Date of
Publication: 19 Nov 2025.
Author
Minami K.; Kazawa M.; Shimatani T.; Morinaga M.; Shimokawa A.; Maeda T.;
Takeuchi M.
Institution
(Minami, Kazawa, Shimatani, Takeuchi) Department of Critical Care
Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
(Morinaga, Shimokawa, Maeda) Department of Anesthesiology, National
Cerebral and Cardiovascular Center, Osaka, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVES: - Continuous arterial pressure monitoring is crucial for
critically ill patients. However, the impact of catheter type on arterial
line insufficiency remains unexamined. DESIGN: - Double-blinded,
superiority, randomized controlled trial. SETTING: - A cardiovascular
center in Japan. PATIENTS: - Adult patients scheduled for elective
cardiovascular surgery and postoperative admission to the ICU.
INTERVENTIONS: - Patients were randomly assigned either polyethylene or
polyurethane catheters. MEASUREMENTS AND MAIN RESULTS: - The outcome of
interest was arterial line insufficiency, defined by one or more of the
following four criteria: flattened or overdamped blood pressure waveform,
sluggish free backflow of blood (> 2 s) when the stopcock was opened to
the atmosphere, inability to draw blood from the arterial line, and
inability to flush the catheter. The frequency of arterial line
insufficiency was observed at the first noon after ICU admission. An
interim analysis using the chi-square test was performed after half of the
participants were enrolled, with early termination if p value of less than
0.005 based on the O'Brien-Fleming method. Interim analysis of 132
patients revealed significant differences in primary outcomes, leading to
early termination of the trial. Arterial line insufficiency occurred in
four of 69 patients (5.8%) with polyethylene catheters and 18 of 63
patients (28.6%) with polyurethane catheters (relative risk, 0.15; 95% CI,
0.05-0.48; p = 0.001). <br/>CONCLUSION(S): - This study demonstrated a
lower occurrence rate of arterial line insufficiency with polyethylene
arterial catheters than polyurethane catheters.<br/>Copyright &#xa9; 2025

<10>
Accession Number
2041907493
Title
Exploring gender-related disparities in mental health and parenthood among
surgeons: A systematic review and meta-analysis.
Source
American Journal of Surgery. 252 (no pagination), 2026. Article Number:
116732. Date of Publication: 01 Feb 2026.
Author
Lech G.E.; Gerk A.; Viana S.W.; Bicudo Diniz A.M.; Salomao S.L.; Moreira
Melo P.H.; Camargo C.P.; Mooney D.P.; Kratky L.
Institution
(Lech) Pontifical Catholic University of Rio Grande Do Sul, Avenida
Ipiranga 6681, RS, Porto Alegre, Brazil
(Gerk) Faculty of Medicine and Health Sciences, McGill University, 3605
Rue de La Montagne, Montreal, QC, Canada
(Gerk, Kratky) Program in Global Surgery and Social Change, Harvard
Medical School, 641 Huntington Avenue, Boston, MA, United States
(Viana) Kursk State Medical University, Ulitsa Karla Marksa, d.3, Kurskaya
Oblast', Kursk, Russian Federation
(Bicudo Diniz) Ribeirao Preto Medical School, Avenida Bandeirantes 3900,
SP, Ribeirao Preto, Brazil
(Salomao) Postgraduation Program in Sciences of Rehabilitation of the
Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao
Paulo (HRAC-USP), Rua Silvio Marchione, 3-20, Vila Universitaria, SP,
Bauru, Brazil
(Moreira Melo) Federal University of Minas Gerais, Avenida Antonio Carlos
6627, MG, Belo Horizonte, Brazil
(Camargo) Faculty of Medicine, Department of Plastic Surgery, Sao Paulo
University, Avenida. Dr. Arnaldo 455, SP, Sao Paulo, Brazil
(Mooney) Boston Children's Hospital, Harvard Medical School, 300 Longwood
Ave, Boston, MA, United States
(Kratky) Department of Surgery, Dartmouth-Hitchcock Medical Center, 1
Medical Center Drive, Lebanon, NH, United States
Publisher
Elsevier Inc.
Abstract
Background: Gender disparities in surgery can impact personal and
professional life. This meta-analysis aims to examine differences in
well-being and parenting between genders in surgery in the Americas.
<br/>Method(s): Inclusion criteria were cross-sectional studies conducted
in the Americas that compared mental health and parenthood outcomes
between male and female surgeons. <br/>Result(s): We included 37 studies,
comprising 42,434 participants (25,948 (61.15 %) males; 16,486 (38.85 %)
females). Female surgeons had increased burnout rates (OR 1.32; p <
0.0001), depression (OR 1.31; p = 0.03), and exhaustion (OR 1.39; p <
0.0001). Female surgeons were less likely to have children (OR 0.39; p <
0.00001), with no differences across countries (p = 0.06), specialties (p
= 0.93), or career levels (p = 0.22). <br/>Conclusion(s): Female surgeons
experience higher rates of burnout, depression, and exhaustion, and are
less likely to have children than male surgeons. These findings underscore
persistent gender inequities in surgical practice and emphasize the need
for broader representation from underrepresented countries in the region
to better understand and address these disparities.<br/>Copyright &#xa9;
2025

<11>
Accession Number
2041463370
Title
Mitral Valve Surgery with and Without Mitral Annular Disjunction: A
Meta-Analysis.
Source
Journal of Cardiovascular Development and Disease. 12(11) (no pagination),
2025. Article Number: 436. Date of Publication: 01 Nov 2025.
Author
Baudo M.; Cabrucci F.; Di Muro F.M.; Magouliotis D.E.; Bacchi B.;
Arjomandi Rad A.; Xanthopoulos A.; Caldonazo T.; D'Alonzo M.
Institution
(Baudo, Cabrucci, Magouliotis) Department of Cardiac Surgery Research,
Lankenau Institute for Medical Research, Main Line Health, Wynnewood, PA,
United States
(Cabrucci) Division of Cardiovascular Surgery, Peter Munk Cardiac Centre,
Toronto General Hospital, University Health Network, Toronto, ON, Canada
(Di Muro) Department of Medicine, Surgery and Dentistry, University of
Salerno, Salerno, Italy
(Bacchi) Division of Cardiac Surgery, St. Michael's Hospital, University
of Toronto, Toronto, ON, Canada
(Arjomandi Rad) Department of Cardiothoracic Surgery, John Radcliffe
Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United
Kingdom
(Xanthopoulos) Department of Cardiology, University Hospital of Larissa,
Larissa, Greece
(Caldonazo) Department of Cardiothoracic Surgery, Jena University
Hospital, Jena, Germany
(D'Alonzo) Cardiac Surgery Unit, Poliambulanza Foundation Hospital, Via
Bissolati 57, Brescia, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Despite growing awareness of mitral annular
disjunction's (MAD) clinical significance, robust data regarding the
outcomes of surgical interventions on MAD remain sparse. This
meta-analysis aims to systematically evaluate the current evidence on the
efficacy and safety of mitral valve (MV) surgery in patients with MAD.
<br/>Method(s): A systematic review was conducted from inception until May
2025 for studies comparing patients undergoing MV surgery with and without
MAD and was registered in PROSPERO: CRD42025649821. <br/>Result(s):
Patients with MAD were generally younger (59.3 +/- 5.0 vs. 63.4 +/- 2.2
years, standardized mean difference: -0.3073), had fewer comorbidities but
more complex valve lesions (41.0% vs. 13.7%, risk difference: 0.2627)
compared to those without MAD. MV replacement was performed less
frequently in the MAD group than in the No-MAD group (risk ratio, RR:
0.690 [95% confidence interval, CI: 0.508; 0.937], p = 0.017), probably
related to the significant difference in age between the two groups. The
MAD cohort demonstrated a higher incidence of ventricular arrhythmia both
after surgery (RR: 7.255 [95%CI: 1.231; 42.763], p = 0.029) and during
follow-up (incidence rate ratio, IRR: 2.750 [95%CI: 1.372; 5.512], p =
0.004). Although the MAD group experienced more arrhythmic events over
time, this did not translate into a significant difference in overall
mortality compared to patients without MAD (IRR: 0.573 [95%CI: 0.072;
4.555], p = 0.599). <br/>Conclusion(s): This meta-analysis revealed
significant baseline differences between the populations. Our findings
suggest that patients with MAD remained at significantly higher risk for
both postoperative and long-term arrhythmias. These results highlight the
need for close arrhythmic surveillance in this population.<br/>Copyright
&#xa9; 2025 by the authors.

<12>
Accession Number
2041488002
Title
Exercise-Based Prehabilitation Before Cardiac Surgery: A Systematic
Review, Meta-Analysis, Meta-Regression, and Proposal for a Clinical
Implementation Model.
Source
Journal of Clinical Medicine. 14(22) (no pagination), 2025. Article
Number: 8195. Date of Publication: 01 Nov 2025.
Author
Hurtado-Borrego J.C.; Bayonas-Ruiz A.; Bonacasa B.
Institution
(Hurtado-Borrego) Physical Medicine and Rehabilitation Service, Virgen de
la Arrixaca University Hospital, El Palmar, Murcia, Spain
(Bayonas-Ruiz, Bonacasa) Department of Physiology, Human Physiology Area,
Edificio LAIB/Departamental, Campus CC Salud-El Palmar, Campus de
Excelencia Internacional de la Universidad de Murcia, Murcia, Spain
(Bayonas-Ruiz, Bonacasa) Research Group of Physical Exercise and Human
Performance, Edificio LAIB/Departamental, El Palmar, Campus de Excelencia
Internacional de la Universidad de Murcia, Murcia, Spain
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Major cardiac surgery is associated with a high
rate of postoperative complications, particularly in older and frail
patients. Prehabilitation-defined as a preoperative intervention based on
structured exercise-aims to enhance patients' physiological and functional
reserve before surgery. To evaluate the effectiveness of prehabilitation
programs on functional capacity and postoperative complications in cardiac
surgery and to propose a clinical exercise-based intervention model
tailored to these patients. <br/>Method(s): A systematic search was
conducted in PubMed, Cochrane, PEDro, and LILACS (2005-2025). Randomized
controlled trials investigating preoperative exercise interventions in
adults undergoing cardiac surgery were included. Outcomes assessed
included functional measures (6-Minute Walk Test [6MWT], Timed Up and Go
test [TUG], maximal oxygen uptake [VO<inf>2</inf>max], maximal inspiratory
pressure [MIP]), frailty (Clinical Frailty Scale [CFS], Essential Frailty
Toolset [EFT]), postoperative complications and quality of life.
<br/>Result(s): Nine studies comprising a total of 873 patients were
included. Prehabilitation significantly improved functional capacity
(6MWT: +52.4 m; p < 0.001), reduced respiratory complications (pneumonia,
atelectasis) and shortened hospital stay (-15.2 h; p < 0.001). The
greatest benefits were observed in multimodal programs lasting >=4 weeks.
<br/>Conclusion(s): Exercise-based prehabilitation is an effective and
safe strategy in patients awaiting cardiac surgery. Its systematic
implementation should be considered as part of the perioperative pathway,
reinforcing the role of exercise as a therapeutic tool in this clinical
context.<br/>Copyright &#xa9; 2025 by the authors.

<13>
Accession Number
2040585919
Title
Practice changing updates in perioperative medicine literature 2024. A
systematic review.
Source
American Journal of Medicine. 139(1) (pp 33-41.e1), 2026. Date of
Publication: 01 Jan 2026.
Author
Khambaty M.; Silbert R.E.; Stephenson C.R.; Bartlett M.A.; Regan D.W.;
Sanchez J.J.; Sundsted K.K.; Mauck K.F.
Institution
(Silbert, Stephenson, Bartlett, Mauck) Division of General Internal
Medicine, Department of Medicine, Mayo Clinic and Mayo Clinic College of
Medicine, Rochester, MN, United States
(Khambaty, Regan, Sanchez, Sundsted) Division of Hospital Internal
Medicine, Department of Medicine, Mayo Clinic and Mayo Clinic College of
Medicine, Rochester, MN, United States
Publisher
Elsevier Inc.
Abstract
Every year, new publications advance our understanding of perioperative
medicine. These publications are spread over a variety of journals that
require dedicated effort to identify. To aid this task, we have undertaken
a multi-database literature search from January to December of 2024. We
included original research articles, systematic reviews, meta-analyses,
and guidelines. We excluded abstracts, case reports, letters, or
literature pertaining to cardiovascular surgery, pediatrics, and
obstetrics. Two authors reviewed each reference using the Distiller SR
systematic review software (Evidence Partners Inc., Ottawa, Ontario,
Canada). A modified Delphi technique was used to narrow down to seven of
the most impactful publications and another seven tabular summaries. The
purpose of this review is to understand the strength and limitations of
the new literature in order to improve perioperative outcomes for
patients.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<14>
Accession Number
2039776713
Title
A Prospective, Multicentre Randomised Controlled Study of Angiographic and
Clinical Outcomes in Total Arterial Coronary Bypass Grafting: The TA Trial
Protocol.
Source
Heart Lung and Circulation. 34(12) (pp 1478-1486), 2025. Date of
Publication: 01 Dec 2025.
Author
Royse A.; Ren J.; Bowyer A.; Reid C.M.; Bellomo R.; Smith J.A.; Bannon P.;
Eccleston D.; Vallely M.; Lui E.; Ludbrook G.; Clarke S.; Tian D.H.; Royse
C.
Institution
(Royse, Ren, Bowyer, Tian, Royse) Department of Surgery, The University of
Melbourne, Melbourne, VIC, Australia
(Royse) Department of Cardiothoracic Surgery, Royal Melbourne Hospital,
Melbourne, VIC, Australia
(Royse) Department of Surgery, Universiti Kebangsaan Malaysia, Kuala
Lumpur, Malaysia
(Bowyer, Royse) Department of Anesthesia and Pain Management, Royal
Melbourne Hospital, Melbourne, VIC, Australia
(Bowyer, Royse) Outcomes Research, University of Texas Heath, Houston, TX,
United States
(Reid) Population Health, Curtin University, Perth, WA, Australia
(Bellomo) Department of Critical Care, The University of Melbourne,
Melbourne, VIC, Australia
(Bellomo) Department of Anaesthesia, Austin Health, Melbourne, VIC,
Australia
(Smith) Department of Surgery (School of Clinical Sciences at Monash
Health), Monash University, Melbourne, VIC, Australia
(Smith) Department of Cardiothoracic Surgery, Monash Health, Melbourne,
VIC, Australia
(Bannon) Department of Cardiothoracic Surgery, Royal Prince Alfred
Hospital, Sydney, NSW, Australia
(Bannon) Faculty of Medicine and Health, Central Clinical School, The
University of Sydney, Sydney, NSW, Australia
(Eccleston) Department of Cardiology, Royal Melbourne Hospital, Melbourne,
VIC, Australia
(Eccleston) Department of Medicine, The University of Melbourne,
Melbourne, VIC, Australia
(Vallely) Department of Cardiothoracic Surgery, St George Hospital,
Sydney, NSW, Australia
(Vallely) Faculty of Medicine, Macquarie University, Sydney, NSW,
Australia
(Lui) Department of Medical Imaging, Royal Melbourne Hospital, Melbourne,
VIC, Australia
(Lui) Department of Radiology, The University of Melbourne, Melbourne,
VIC, Australia
(Ludbrook) Discipline of Acute Care Medicine, The University of Adelaide,
Adelaide, SA, Australia
(Clarke) Statistical Consulting Centre, The University of Melbourne,
Melbourne, VIC, Australia
(Tian) Department of Anesthesia and Perioperative Medicine, Westmead
Hospital, Sydney, NSW, Australia
Publisher
Elsevier Ltd
Abstract
Background & Aim: Conventional coronary artery bypass grafting (CABG)
procedures typically utilise the left internal mammary artery and
supplementary saphenous vein grafts (SVGs) to re-establish adequate
coronary blood flow to ischaemic territories. However, extensive
observational studies have consistently demonstrated that SVGs are prone
to accelerated atherosclerosis and progressive failure compared to
arterial conduits. These limitations have heightened interest in total
arterial revascularisation (TAR) as a potentially superior strategy.
<br/>Objective(s): The Total Arterial (TA) Trial, fully funded through the
Medical Research Future Fund Cardiovascular Health Mission, aims to
determine the angiographic and clinical outcomes of TAR compared to
conventional non-TAR operations. <br/>Method(s): Design: This study is an
open-label, multicentre, randomised controlled trial including 1,000 CABG
patients from multiple cardiac institutions across Australia, with an
allocation ratio of 1:1. Randomisation occurs at a standardised
perioperative time point via computer-generated sequences with variable
block size The trial does not impose specific procedural requirements
regarding the type of arterial conduit, revascularisation or
reconstruction technique, use of sequential or composite methods, or any
perioperative management. <br/>Intervention(s): Total arterial CABG with
no use of SVG. Control: Non-total-arterial CABG with at least one SVG.
Main outcomes: The primary endpoint will be perfect graft patency at 24
months postoperatively. The secondary endpoints include patency, major
adverse cardiac and cerebrovascular events, quality of life, all-cause and
cardiac mortality. Clinical follow-up visits will be scheduled at 6-month
intervals, and angiographic assessments at 3 months and 24 months.
Subgroup analyses by diabetes, sex, age, and conduit types are proposed to
examine the potential interactions with treatment effects.
<br/>Conclusion(s): The TA Trial is one of the largest multicentre trials
in the field of coronary revascularisation research, evaluating the graft
status and clinical endpoints of TAR versus non-TAR procedures. The study
design will provide valuable insights into whether differences in graft
failure of SVG translate into differences in survival and cardiac
outcomes. Early postoperative coronary angiography may improve
understanding of the impact of competitive flow on graft function. The
findings from this study will contribute to an improved understanding and
help inform the optimal approach for coronary revascularisation,
supporting evidence-based improvements in patient care. Ethics: Ethical
approval has been granted by the Melbourne Health Institutional Review
Board (HREC/92839/MH-2023), Australia. Trial registration: The trial has
been registered under the Australian New Zealand Clinical Trial Registry
(registration number: ACTRN12623000864628). Dissemination of results: The
analysed results will be published in a peer-reviewed journal on
completion of the clinical trial.<br/>Copyright &#xa9; 2025

<15>
Accession Number
2041475434
Title
Influence of diabetes on short-term mortality of patients with acute type
A aortic dissection: a meta-analysis.
Source
European Journal of Medical Research. 30(1) (no pagination), 2025. Article
Number: 1178. Date of Publication: 01 Dec 2025.
Author
Liu Z.; Wu N.; Wu F.; Liu T.; Ren K.
Institution
(Liu, Wu, Wu, Liu) Department of Cardiovascular Surgery, Air Force 986
Hospital, Air Force Medical University, Xi'an, China
(Ren) Department of Cardiovascular Surgery, Xijing Hospital, Air Force
Medical University, 127 Changle West Road, Xi'an, China
Publisher
BioMed Central Ltd
Abstract
Background: Acute type A aortic dissection (ATAAD) is a life-threatening
cardiovascular emergency with substantial early mortality. Whether
diabetes mellitus (DM) independently influences short-term mortality in
ATAAD remains uncertain. We conducted a meta-analysis to synthesize the
available data. <br/>Method(s): PubMed, Embase, and Web of Science were
searched from inception to June 22, 2025, for longitudinal studies
reporting short-term mortality (in-hospital or 30-day) in ATAAD patients
with and without DM. Pooled odds ratios (ORs) with 95% confidence
intervals (CIs) were calculated using a random-effects model accounting
for the influence of heterogeneity. Subgroup, sensitivity, and
meta-regression analyses explored heterogeneity. The study quality was
assessed with the Newcastle-Ottawa Scale (NOS). <br/>Result(s): Twenty-one
retrospective cohort studies involving 19,291 patients were included. DM
was associated with a modestly increased short-term mortality risk (OR =
1.48; 95% CI 1.14 to 1.91; p = 0.003; I² = 44%). The results
were consistent in sensitivity analyses restricted to surgical patients
(OR = 1.52; 95% CI 1.18 to 1.96; p = 0.001). Subgroup analyses showed no
significant differences by region, follow-up duration, analytic model, or
NOS score (all p for subgroup differences > 0.05). Meta-regression
analysis showed that sample size was negatively correlated with the
association (coefficient = - 0.000074, p = 0.02), which fully explained
the source of heterogeneity (adjusted R² = 100%).
<br/>Conclusion(s): This meta-analysis of retrospective studies suggests
that DM may be associated with higher short-term mortality in ATAAD. Given
the observational nature of the evidence, further prospective studies are
needed to clarify this relationship.<br/>Copyright &#xa9; The Author(s)
2025.

<16>
Accession Number
647645918
Title
The Effect of Breathing Exercise With Incentive Spirometer on Pain,
Anxiety, Comfort, and Physiological Parameters Before and After Cardiac
Surgery: A Randomized Controlled Experimental Study.
Source
Journal of perianesthesia nursing : official journal of the American
Society of PeriAnesthesia Nurses. 40(6) (pp 1460-1468), 2025. Date of
Publication: 01 Dec 2025.
Author
Ciftci H.; Korkut S.; Karaca S.
Institution
(Ciftci) Cardiac Surgery Operating Room, Health Sciences University Adana
City Training and Research Hospital, Adana, Turkey
(Korkut) Department of Nursing, Faculty of Health Sciences, Erciyes
University, Kayseri, Turkey
(Karaca) Cardiovascular Surgery Department, Adana City Training and
Research Hospital, Adana, Turkey
Abstract
PURPOSE: This study was conducted to investigate the effect of breathing
exercise with incentive spirometer on pain, anxiety, comfort, and
physiological parameters in cardiac surgery patients before and after
surgery. DESIGN: The research was conducted as a single-center,
prospective, randomized controlled experimental study. <br/>METHOD(S):
Patients in the intervention I group had breathing exercises performed, in
addition to the routine practices of the clinic for 5 days after surgery.
Patients in intervention II group had breathing exercises in addition to
routine practices for 5 days before surgery and 5 days after surgery. In
the control group, only the routine practice of the clinic was performed.
FINDINGS: On postoperative days 1 and 5, the pain and anxiety levels of
the intervention I and II groups were significantly lower, and the comfort
level was significantly higher than the control group. On the post-op
first day, partial oxygen pressure values of the patients in the
intervention II group were significantly higher than the others. The heart
rate of the individuals in the intervention I group on the first post-op
day was significantly lower than the other two groups. Post-op days 1 and
5, SaO2 values were significantly higher in the intervention groups
compared with the control group. <br/>CONCLUSION(S): Breathing exercises
performed with incentive spirometer before and after the operation
decreased the pain and anxiety levels of the patients and increased their
comfort. However, it was determined that this application did not create a
significant difference in vital signs (except heart rate), pulmonary
function test values (except SaO2), and arterial blood gas values (except
partial oxygen pressure).<br/>Copyright &#xa9; 2025 The American Society
of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

<17>
Accession Number
2035129972
Title
Analgesic efficacy and serum ropivacaine concentration of postoperative
programmed intermittent bolus infusion with serratus anterior plane block
in patients undergoing minimally invasive cardiac surgery: A randomized,
double-blind, controlled trial.
Source
Journal of Anesthesia. 39(6) (pp 940-947), 2025. Date of Publication: 01
Dec 2025.
Author
Kumagai M.; Kaiho Y.; Sugino S.; Sekine T.; Taguri M.; Inoue H.; Ito J.;
Sato Y.; Sato T.; Maekawa M.; Yamauchi M.
Institution
(Sato, Kaiho, Sugino, Sekine, Yamauchi) Department of Anesthesiology and
Perioperative Medicine, Tohoku University Graduate School of Medicine,
2-1, Seiryo-Machi, Aoba-Ku, Sendai, Japan
(Kumagai) Department of Anesthesiology, Japan Red Cross Ishinomaki
Hospital, Ishinomaki, Japan
(Taguri) Department of Health Data Science, Tokyo Medical University,
Shinjuku City, Japan
(Inoue) Department of Anesthesiology, Southern Tohoku General Hospital,
Iwanuma, Japan
(Ito) Department of Anesthesiology, Sendai Kousei Hospital, Sendai, Japan
(Sato, Sato, Maekawa) Department of Pharmaceutical Sciences, Tohoku
University Hospital, Sendai, Japan
Publisher
Springer
Abstract
Purpose: Minimally invasive cardiac surgery (MICS) involves fewer
complications than median sternotomy. However, difficulties in post-MICS
analgesia can undermine these advantages. The serratus anterior plane
block (SAPB), an effective analgesic for thoracic surgery, could benefit
post-MICS analgesia using programmed intermittent bolus infusion (PIBI).
We investigated whether PIBI with SAPB can reduce post-MICS fentanyl
administration and evaluated its safety profile. <br/>Method(s): This
randomized, double-blind, controlled trial included 20 patients (age 20-80
years; Eastern Cooperative Oncology Group Performance Status 0-II;
scheduled for elective MICS) randomly allocated to two groups (SAPB or
control). All patients underwent preoperative SAPB with catheterization,
followed by either 20 mL 0.25% ropivacaine or saline bolus every 6 h
postoperatively. All patients received intravenous fentanyl via
patient-controlled analgesia. Blood samples were collected 10, 20, 30, and
60 min after preoperative ropivacaine infusion; during and after
cardiopulmonary bypass; and on postoperative days 1-5. The primary outcome
was cumulative fentanyl consumption up to postoperative day 5. Secondary
outcomes included numerical rating scale scores, rehabilitation
preoperatively and postoperatively, postoperative nausea and vomiting,
ropivacaine toxicity, and PIBI with SAPB complications. <br/>Result(s):
After excluding three patients, data from 17 patients were analyzed. No
significant difference in cumulative fentanyl consumption on postoperative
day 5 was observed (SAPB: median [interquartile range], 512 microg
[457-753] vs. control: 654 microg [439-982], P = 0.96). Serum ropivacaine
concentration remained below the toxicity threshold. <br/>Conclusion(s):
PIBI with SAPB did not reduce post-MICS fentanyl consumption, and serum
ropivacaine concentration did not reach the toxicity
threshold.<br/>Copyright &#xa9; The Author(s) 2025.

<18>
[Use Link to view the full text]
Accession Number
2040098142
Title
Determination of Cerebral Autoregulation at the Bedside: A Narrative
Review.
Source
Critical Care Medicine. 53(10) (pp e2062-e2075), 2025. Date of
Publication: 19 Nov 2025.
Author
Vitt J.R.; Tsetsou S.; Galarza L.; Sarwal A.; Rajagopalan S.
Institution
(Vitt) Department of Neurological Surgery and Neurology, UC Davis Medical
Center, Sacramento, CA, United States
(Tsetsou) Department of Neurology and Neurosurgery, Baylor College of
Medicine, Houston, TX, United States
(Galarza) Department of Intensive Care, Hospital General Universitario de
Castellon, Castellon de la Plana, Spain
(Galarza) Department of Medicine, University Jaume I (UJI), Castellon de
la Plana, Spain
(Sarwal) Department of Neurology, Virginia Commonwealth University School
of Medicine, Richmond, VA, United States
(Rajagopalan) Department of Neurology, Cooper Medical School of Rowan
University, Camden, NJ, United States
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVES: - To summarize the current evidence on cerebral autoregulation
(CAR) monitoring techniques in critical care settings, highlighting their
advantages, limitations, and practical applications at the bedside to
inform understanding and clinical decision-making for various acute brain
injuries and systemic illnesses. DATA SOURCES: - Articles were retrieved
using Ovid MEDLINE, PubMed, and Cochrane library using a comprehensive
combination of subject headings and key words including "cerebral
autoregulation, " "transcranial Doppler, " "near-infrared spectroscopy, "
and "intracranial pressure." See Supplemental Appendix A
(https://links.lww.com/CCM/H763) for complete list of search terms.
Relevant articles as well as those discovered through the review process
(e.g., references in selected articles) were incorporated into the
article. STUDY SELECTION: - Original research, review articles,
commentaries, and guidelines focusing on bedside CAR monitoring
methodologies, their validation, and applications in critically ill
patients were included. The review encompassed both acute brain injury and
systemic critical illness conditions. DATA EXTRACTION: - Data from
included publications were evaluated and synthesized into a comprehensive
narrative review examining CAR monitoring methods and clinical
applications. DATA SYNTHESIS: - Three commonly used bedside approaches for
assessing CAR were identified. Transcranial Doppler ultrasound measures
vessel flow velocity response to blood pressure changes, either through
vasopressor administration or monitoring spontaneous fluctuations.
Near-infrared spectroscopy evaluates regional cerebral oxygenation changes
in response to hemodynamic alterations through continuous, noninvasive
forehead sensors. Intracranial pressure monitoring enables assessment of
pressure reactivity index through analyzing the correlation between
intracranial and arterial blood pressure. CAR impairment is common across
critical illness, from acute brain injury to systemic conditions like
sepsis, cardiac surgery, and hepatic failure, where dysregulation can lead
to secondary brain injury and worse outcomes. While each technique offers
unique insights into CAR status, they vary in invasiveness, continuous
monitoring capability, and technical requirements. Evidence suggests these
methods can help to detect impaired CAR, identify optimal perfusion
targets, and may guide individualized management strategies.
<br/>CONCLUSION(S): - Bedside CAR monitoring represents a promising
approach for personalizing hemodynamic management in critically ill
patients. While current evidence supports its role in prognostication and
management decisions, further research is needed to standardize assessment
methods and validate CAR-guided therapy across different critical care
conditions. Multimodal monitoring approaches may provide complementary
information to optimize patient care.<br/>Copyright &#xa9; 2025

<19>
Accession Number
2041835204
Title
Dexmedetomidine administration is associated with small haemodynamic
changes in children undergoing cardiac procedures: a systematic review and
meta-analysis.
Source
Cardiology in the Young. 35(11) (pp 2321-2326), 2025. Date of Publication:
01 Nov 2025.
Author
Rose N.; Hassanieh M.A.; Jackson W.M.
Institution
(Rose) Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
(Hassanieh, Jackson) Montefiore Medical Center, Bronx, NY, United States
(Hassanieh, Jackson) Albert Einstein College of Medicine, Bronx, United
States
Publisher
Cambridge University Press
Abstract
Introduction: Dexmedetomidine is frequently used in paediatric
anaesthesia. This includes use in patients with CHD, but detailed analysis
of haemodynamics after administration in these patients has not yet been
published. We performed a systematic review and meta-analyses examining
haemodynamic changes immediately after dexmedetomidine administration in
patients with CHD. <br/>Method(s): We conducted a systematic review of
PubMed, Embase, and Medline from inception until May 31, 2024. Inclusion
criteria were studies that contained children with CHD who received
dexmedetomidine for a cardiac procedure and reported at least one
haemodynamic variable before and after administration of dexmedetomidine.
Exclusion criteria were studies of noncardiac procedures. We performed a
meta-analysis on each haemodynamic variable that was reported by at least
four studies. <br/>Result(s): We screened 5383 abstracts. We included 85
studies for review, and 16 studies were accepted for four meta-analyses
(heart rate, 16 studies, n = 408; systolic blood pressure, 11 studies, n =
280; diastolic blood pressure, 10 studies, n = 276; mean arterial
pressure, 5 studies, n = 130). Analysis of heart rate, systolic blood
pressure, and diastolic blood pressure showed a statistically significant
reduction (p < 0.001), while there was no significant change in mean
arterial pressure. The clinical difference was minimal with a decrease in
heart rate of 11.3 beats per minute, and a decrease in systolic blood
pressure/diastolic blood pressure of 5.9 and 6.2 mmHg, respectively.
Heterogeneity was high in all analyses. <br/>Discussion(s):
Dexmedetomidine is associated with small changes in heart rate, systolic
blood pressure, and diastolic blood pressure in children with CHD. Further
study is warranted.<br/>Copyright &#xa9; The Author(s), 2025. Published by
Cambridge University Press.

<20>
Accession Number
2037177951
Title
SIMULTANEOUS PULMONARY EMBOLISM WITH CARDIAC TAMPONADE AND REPETITIVE
ISCHEMIC STROKE AS VASCULAR COMPLICATIONS OF LUNG CANCER: A CASE REPORT
AND SYSTEMATIC LITERATURE REVIEW.
Source
Acta Clinica Croatica. 64(1) (pp 166-173), 2025. Date of Publication:
2025.
Author
Kos N.; Vrsalovic M.
Institution
(Kos, Vrsalovic) Department of Cardiovascular Diseases, Sestre milosrdnice
University Hospital Center, Zagreb, Croatia
(Vrsalovic) University of Zagreb, School of Medicine, Zagreb, Croatia
Publisher
Dr. Mladen Stojanovic University Hospital
Abstract
It is known that patients with lung cancer have a considerably higher
incidence of cardiovascular complications that lead to venous or arterial
events, and malignant pericardial effusion can often be observed due to
pericardial metastases. Simultaneous occurrence of cardiac tamponade and
venous thromboembolism almost always happens in patients with lung
malignancy. Our case report describes a patient with concurrent pulmonary
embolism and cardiac tamponade as the initial manifestation of lung
cancer, which, apart from pericardiocentesis and symptomatic therapy, was
treated at long term with a direct oral anticoagulant (apixaban). Therapy
was well tolerated by the patient and there were no bleeding complications
related to primary disease and anticoagulant treatment. The course of the
disease was complicated by repetitive strokes, which were treated with
mechanical thrombectomy. Because of this scenario, a systematic review of
the literature was conducted, listing all available case reports of
patients with the simultaneous occurrence of cardiac tamponade and
pulmonary embolism. In all patients, the underlying condition was lung
malignancy, often as the first manifestation of the disease. This is a
relatively rare event, and the approach to long-term treatment varied from
case to case in the absence of valid guidelines. Our case demonstrated
that, in the light of new studies and guidelines, apixaban represented a
safe and effective treatment option even in patients at a high risk of
bleeding.<br/>Copyright &#xa9; 2025, Dr. Mladen Stojanovic University
Hospital. All rights reserved.

<21>
Accession Number
2041506557
Title
Study protocol for a randomized controlled trial assessing the effect of
lateral position intubation on bronchial blocker placement during
unilateral video-assisted thoracic surgery.
Source
Trials. 26(1) (no pagination), 2025. Article Number: 553. Date of
Publication: 01 Dec 2025.
Author
Zhang Z.; Liu X.; Zhang X.; Zhou B.; Tang Y.; Tong F.; Hu Y.; Liu F.; Hu
S.; Liu H.; Tan H.
Institution
(Zhang, Zhou, Tang, Tong, Hu, Liu, Hu, Liu) Department of Anesthesiology &
Clinical Research Center for Anesthesia and Perioperative Medicine & Key
Laboratory of Anesthesia and Analgesia Application Technology, Huzhou
Central Hospital, Fifth School of Clinical Medicine of Zhejiang, Chinese
Medical University, Huzhou, China
(Liu) Department of Anesthesiology, Hangzhou Hospital of Traditional
Chinese Medicine, Hangzhou, China
(Zhang) School of Brain Science and Brain Medicine, Zhejiang University
School of Medicine, Hangzhou, China
(Zhang) Interdisciplinary Institute of Neuroscience and Technology,
Zhejiang University School of Medicine, Hangzhou, China
(Tan) Department of Clinical Pharmacy, Huzhou Central Hospital, Fifth
School of Clinical Medicine of Zhejiang, Chinese Medical University,
Huzhou, China
Publisher
BioMed Central Ltd
Abstract
Background: Approximately one-third of patients who undergo bronchial
blocker (BB) intubation in the conventional supine position suffer BB
malposition. This trial aims to explore the efficiency and clinical
application of BB intubation in the lateral position to reduce the
incidence of BB malposition in patients undergoing video-assisted thoracic
surgery (VATS). <br/>Method(s): This single-center, parallel-group,
randomized controlled trial will enroll 110 patients aged 18-80 years who
are scheduled for elective unilateral VATS with BB intubation under
general anesthesia. Participants will be randomly assigned (1:1) to either
the lateral BB intubation group or the conventional supine BB intubation
group. The primary outcome is the incidence of BB malposition observed by
fiberoptic bronchoscopy (FOB). Secondary outcomes include the duration of
intubation, the frequency and duration of FOB usage, whether to
re-intubate, intraoperative vital signs, and postoperative recovery.
<br/>Discussion(s): This trial will confirm the clinical efficacy and
superiority of BB intubation in the lateral position to consolidate the
lateral intubation pattern in thoracic anesthesia. We expect that
performing lateral BB intubation can reduce the BB malposition rate and
result in more stable intraoperative vital signs and fewer postoperative
complications, which is in line with the concept of Enhanced Recovery
After Surgery in thoracic anesthesia. Trial registration: Chinese Clinical
Trial Registry ChiCTR2400081961. Registered on March 18,
2024.<br/>Copyright &#xa9; The Author(s) 2025.

<22>
Accession Number
2007551380
Title
Dexmedetomidine improves early postoperative neurocognitive disorder in
elderly male patients undergoing thoracoscopic lobectomy.
Source
Experimental and Therapeutic Medicine. 20(4) (pp 3867-3876), 2020. Date of
Publication: 01 Oct 2020.
Author
Shi H.; Du X.; Wu F.; Hu Y.; Xv Z.; Mi W.
Institution
(Shi, Xv, Mi) Anesthesia and Operation Center, Chinese PLA General
Hospital, Beijing, China
(Shi, Du, Wu, Hu) Department of Anesthesiology, Affiliated Hospital of
Inner Mongolia Medical University, Hohhot, Inner Mongolia, China
Publisher
Spandidos Publications
Abstract
Perioperative neurocognitive disorder (PND) is a common complication
following thoracic surgery that frequently occurs in patients >=65 years.
PND includes postoperative cognitive dysfunction (POCD) and postoperative
delirium (POD). To investigate whether intravenous dexmedetomidine (DEX)
is able to improve neurocognitive function in elderly male patients
following thoracoscopic lobectomy, a randomized, double-blinded,
placebo-controlled trial was performed at the Affiliated Hospital of Inner
Mongolia Medical University (Hohhot, China). Patients aged >=65 years were
enrolled and were subjected to thoracic surgery under general anesthesia.
A computer-generated randomization sequence was used to randomly assign
patients (at a 1:1 ratio) to receive either intravenous DEX (0.5 microg/kg
per h, from induction until chest closure) or placebo (intravenous normal
saline).TheprimaryendpointwastheresultoftheMini-Mental State Examination
(MMSE). The secondary endpoints were the results of the Montreal Cognitive
Assessment (MoCA) and those obtained with the Confusion Assessment Method
(CAM), as well as the incidence of POCD and POD during the first 7
postoperative days. Other observational indexes included sleep quality at
night, self-anxiety scale prior to the operation and 7 days following the
operation and the visual analogue scale (VAS) score at rest and during
movement on the first and third day following the operation. Furthermore,
at 6 h following surgery, the MMSE score in the DEX group was
significantly higher than that in the saline group. At 6 h and on the
first day postoperatively, the MoCA score in the DEX group was
significantly higher than that in the saline group. The incidence of POCD
and POD in the DEX group was 13.2 and 7.5%, respectively, while that in
the saline group was 35.8 and 11.3%, respectively. There was a significant
difference in the incidence of POCD between the two groups (P<0.01). In
the DEX group, mean sleep quality was increased, whereas the mean VAS was
decreased compared with the corresponding values in the saline group. In
conclusion, elderly male patients who underwent thoracoscopic lobectomy
under continuous infusion of DEX (0.5 microg/kg/h) exhibited a reduced
incidence of POCD during the first 7 postoperative days as compared with
the placebo group. Furthermore, DEX improved the subjective sleep quality
in the first postoperative night, reduced anxiety and alleviated
postoperative pain. In addition, it increased the incidence of
bradycardia. The present study was registered in the Chinese Clinical
Trial Registry (www.chictr.org.cn; registration no.
ChiCTR-IPR-17010958).<br/>Copyright &#xa9; This work is licensed under a
Creative Commons Attribution 4.0 International (CC BY 4.0) License

<23>
Accession Number
2036046527
Title
beta-blocker and clinical outcomes in patients after myocardial
infarction: a systematic review and meta-analysis.
Source
European Journal of Clinical Pharmacology. 81(12) (pp 1807-1817), 2025.
Date of Publication: 01 Dec 2025.
Author
Yang W.; Sun X.; Zhang Y.; Lu Z.; Shu Z.; Zhang K.
Institution
(Yang) Department of Physiology, West China School of Basic Medical
Sciences & Forensic Medicine, Sichuan University, Chengdu, China
(Sun, Zhang, Lu, Shu, Zhang) Department of Forensic Pathology, West China
School of Basic Medical Sciences & Forensic Medicine, Sichuan University,
Chengdu, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background and objective: While current clinical guidelines generally
advocate for beta-blocker therapy following acute myocardial infarction
(AMI), conflicting findings have surfaced through large-scale
observational studies and meta-analyses. We conducted this systematic
review and meta-analysis of published observational studies to quantify
the long-term therapeutic impact of beta-blocker across heterogeneous AMI
populations. <br/>Method(s): We conducted comprehensive searches of the
PubMed, Embase, Cochrane, and Web of Science databases for articles
published from 2000 to 2025 that examine the link between beta-blocker
therapy and clinical outcomes (last search update: March 1, 2025). We used
the odds ratio (OR) with its 95% confidence interval (95% CI) to evaluate
the effect of beta-blocker therapy on all-cause mortality, cardiac death,
or major adverse cardiac events (MACE) in AMI patients. Our analysis
stratified these effects by study type, ejection fraction (EF), sample
size, follow-up duration, and patient characteristics including primary
coronary revascularization, ST-segment elevation status, and
comorbidities. <br/>Result(s): This meta-analysis incorporated 34
observational studies covering 233,303 AMI patients. Our results showed
beta-blockers reduced all-cause (OR = 0.73, 95% CI = 0.64-0.82) and
cardiac mortality (OR = 0.79, 95% CI = 0.70-0.89) in post-AMI patients,
with no significant effect on MACE. In these patients, post-PCI and STEMI
patients, beta-blockers lowered all-cause mortality but not MACE risk.
Subgroup analysis revealed that beta-blockers decreased all-cause death in
post-AMI patients with diabetes and COPD, but not in those with
hypertension and AF. Stratified by EF, beta-blockers were beneficial for
all-cause death (OR = 0.75, 95% CI = 0.60-0.93), cardiac death (OR = 0.72,
95% CI = 0.56-0.92), and MACE (OR = 0.85, 95% CI = 0.76-0.96) in post-AMI
patients with reduced EF and only decreased all-cause death in those with
preserved EF. <br/>Conclusion(s): Our meta-analysis suggests beta-blockers
may offer long-term clinical benefits to AMI patients, particularly those
with reduced EF. However, this is not conclusive for AMI patients with
comorbidities or preserved EF.<br/>Copyright &#xa9; The Author(s), under
exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature
2025.

<24>
Accession Number
2041694505
Title
Age-Stratified Effect of Rivaroxaban Monotherapy for Atrial Fibrillation
in Stable Coronary Artery Disease: A Post Hoc Analysis of the AFIRE
Randomized Clinical Trial.
Source
JAMA Cardiology. 10(10) (pp 990-999), 2025. Date of Publication: 08 Oct
2025.
Author
Yamaguchi J.; Arashi H.; Hagiwara N.; Yasuda S.; Kaikita K.; Akao M.; Ako
J.; Matoba T.; Nakamura M.; Miyauchi K.; Matsui K.; Nakamura A.; Tamiya
E.; Yamamoto T.; Suetake S.; Noguchi T.; Nakamura S.; Kojima J.; Yamaguchi
H.; Suwa S.; Yasu T.; Nakajima A.; Yamada T.; Arai H.; Hata Y.; Sakanashi
T.; Tateishi H.; Nakayama T.; Nozaki Y.; Okumura Y.; Tokue M.; Kuroki N.;
Maruyama Y.; Suzuki H.; Nishida Y.; Ajioka M.; Yumoto K.; Shimizu S.;
Shimomura H.; Takeda T.; Oshiro K.; Sugishita N.; Shibata Y.; Otonari T.;
Shimizu M.; Kihara H.; Ogawa H.; Ono A.; Hazama M.; Tsukahara K.; Haruta
S.; Haruna T.; Ito M.; Fujii K.; Atsuchi N.; Sata M.; Wakeyama T.; Hasebe
N.; Kobayasi Y.; Osato K.; Hironaga K.; Naganuma Y.; Anzaki K.; Okazaki
S.; Nakagawa Y.; Tokuhiro K.; Tanaka K.; Momose T.; Fukushima Y.; Kametani
R.; Kawamitsu K.; Saito Y.; Akashi S.; Kumagai K.; Eshima K.; Tobaru T.;
Seo T.; Okuhara K.; Kozuma K.; Ikari Y.; Takahashi T.; Oiwa K.; Michishita
I.; Fujikura H.; Momomura S.; Yamamoto Y.; Otomo K.; Matsubara T.; Tashiro
H.; Inoue T.; Ishihara M.; Shiojima I.; Tachibana E.; Sumii K.; Yamamoto
N.; Omura N.; Takahashi N.; Morita Y.; Watanabe K.; Fujinaga H.; Maruyama
M.; Oka T.; Shirayama T.; Amano T.; Fukui K.; Ando K.; Oshima S.; Kagiyama
S.; Teragawa H.; Yuge M.; Ono S.; Koga T.; Fujiu K.; Kuwabara M.; Oya Y.;
Yumoto Y.; Kuji N.; Ikemura M.; Kario K.; Chatani K.; Sato K.; Miyagi H.;
Murakami M.; Saito K.; Hoshiga M.; Sato S.; Kubo N.; Sakamoto Y.; Ashida
K.; Sakamoto H.; Murasaki S.; Uehara H.; Akasaka T.; Oba Y.; Nakahara S.;
Hanaoka Y.; Nishimiya T.; Tsunoda R.; Onuma Y.; Higuchi S.; Tani A.; Wada
A.; Kato M.; Obata H.; Higuchi Y.; Endo T.; Kato R.; Matsunaga T.;
Matsuoka T.; Noguchi H.; Usui M.; Hayashi T.; Otsuji Y.; Osaki T.; Zaizen
H.; Yoshihara H.; Kadota K.; Hirose T.; Miyazawa T.; Mori A.; Takano M.;
Shimizu W.; Wake M.; Oriso S.; Yoshiyama M.; Kakinoki S.; Nishioka T.;
Ozaki T.; Nomoto K.; Seki K.; Kawai K.; Ozaki Y.; Miura S.; Kawasaki M.;
Funada R.; Dote K.; Okamoto S.; Owada T.; Doke T.; Matsumura T.; Kubo T.;
Horiuchi M.; Nagano T.; Takaishi A.; Yamamoto M.; Nakashima H.; Murozono
Y.; Munemasa M.; Sakata Y.; Inoue N.; Ota T.; Hamano Y.; Abe N.; Tsubokura
T.; Goto M.; Kubota I.; Yano M.; Umetani K.; Date T.; Morimoto H.; Noda
T.; Goto S.; Hibi K.; Nakano A.; Hiramitsu S.; Kihara Y.; Sugi M.; Shiba
N.; Izumi D.; Sato T.; Ajiki K.; Oishi M.; Kiryu M.; Ko T.; Ando H.;
Miyazaki S.; Kinugawa T.; Otake H.; Kitaoka H.; Tayama S.; Hirata Y.;
Honda S.; Manita M.; Ishii Y.; Oka H.; Nanba Y.; Nishino M.; Sakamoto T.;
Saito T.; Sakai H.; Ichikawa M.; Namiuchi S.; Matsui T.; Inoue K.;
Komiyama N.; Akashi Y.; Matsumura A.; Nakamura Y.; Komaru T.; Hosokawa T.;
Chikamori T.; Tanaka H.; Suzuki A.; Arasaki O.; Aonuma K.; Wakasa Y.;
Yoshizawa T.; Sugano T.; Yokota N.; Kakutani A.; Suzuki T.; Abe Y.;
Kataoka T.; Okayama H.; Yokoi H.; Chin K.; Hasegawa K.; Tomita H.; Honzyo
H.; Kawai H.; Morino Y.; Tsujiyama S.; Yoshimura M.; Hamasaki S.; Niijima
Y.; Aoyama T.; Mizuno Y.; Maki A.; Tanabe K.; Murohara T.; Nakamura T.;
Naomi S.; Matsumoto N.; Minamino T.; Sairenji H.; Miyamoto N.; Arikawa M.;
Ito H.; Matsuura Y.; Hata S.; Nakatsu Y.; Onodera T.; Kato T.; Amano H.;
Tokutake E.; Kasao M.; Moriguchi M.; Yamamoto K.; Tsuji M.; Yamamoto H.;
Yanbe Y.; Iwasawa T.; Suzuki M.; Mori H.; Shibahashi E.; Takita M.; Kimura
K.
Institution
(Yamaguchi, Arashi, Hagiwara) Department of Cardiology, Tokyo Women's
Medical University, Tokyo, Japan
(Yasuda) Department of Cardiovascular Medicine, Tohoku University,
Graduate School of Medicine, Miyagi, Japan
(Yasuda) National Cerebral and Cardiovascular Center, Osaka, Japan
(Kaikita) Department of Cardiovascular Medicine, Graduate School of
Medical Sciences, Kumamoto University, Kumamoto, Japan
(Kaikita) Division of Cardiovascular Medicine and Nephrology, Department
of Internal Medicine, Faculty of Medicine, University of Miyazaki,
Miyazaki, Japan
(Akao) Department of Cardiology, National Hospital Organization, Kyoto
Medical Center, Kyoto, Japan
(Ako) Department of Cardiovascular Medicine, Kitasato University, School
of Medicine, Kanagawa, Japan
(Matoba) Department of Cardiovascular Medicine, Faculty of Medical
Sciences, Kyushu University, Fukuoka, Japan
(Nakamura) Division of Cardiovascular Medicine, Toho University, Ohashi
Medical Center, Tokyo, Japan
(Miyauchi) Department of Cardiovascular Medicine, Juntendo Tokyo Koto
Geriatric Medical Center, Tokyo, Japan
(Matsui) Department of General Medicine and Primary Care, Kumamoto
University Hospital, Kumamoto, Japan
(Ogawa) Kumamoto University, Kumamoto, Japan
(Nakamura) Iwate Prefectural Central Hospital, Japan
(Tamiya) Koto Hospital, Japan
(Yamamoto) Hokkaido Cardiovascular Hospital, Japan
(Suetake) Kaetsu Hospital, Japan
(Noguchi) National Cerebral and Cardiovascular Center, Japan
(Nakamura) Hitoyoshi Medhical Center, Japan
(Matsumura) Kameda Medical Center, Japan
(Kojima) Kojima Clinic, Japan
(Yamaguchi) Hiroshi YamaguchI Clinic, Japan
(Suwa) Juntendo University Shizuoka Hospital, Japan
(Yasu) Dokkyo Medhical University Nikko Medical Center, Japan
(Nakajima) New Tokyo Hospital, Japan
(Yamada) Osaka General Medical Center, Japan
(Arai) Kanoya Heart Center, Japan
(Hata) Minamino Cardiovascular Hospital, Japan
(Sakanashi) Sakanashi Heart Clinic, Japan
(Tateishi) Koyo Newtown Hospital, Japan
(Nakayama) Nakayama Clinic, Japan
(Nozaki) Hokkokinen Hospital, Japan
(Okumura) Nihon University Itabashi Hospital, Japan
(Tokue) Toho University Medical Center Ohashi Hospital, Japan
(Kuroki) Tokyo Metropolitan Bokutoh Hospital, Japan
(Maruyama) Iwatsuki-minami Hospital, Japan
(Suzuki) Showa University Fujigaoka Hospital, Japan
(Nishida) Kouseikai Takai Hospital, Japan
(Ajioka) Tosei General Hospital, Japan
(Yumoto) Yokohama Rosai Hospital, Japan
(Shimizu) Mashiko Hospital, Japan
(Aoyama) Fukui Prefectural Hospital, Japan
(Shimomura) Fukuoka Tokushukai Hospital, Japan
(Takeda) Koto Memorial Hospital, Japan
(Oshiro) Ohama Dai-ichi Hospital, Japan
(Sugishita) Sugishita Clinic, Japan
(Shibata) Miyazaki Medical Association Hospital, Japan
(Otonari) Otonari Clinic, Japan
(Shimizu) International Goodwill Hospital, Japan
(Kihara) Kihara Cardiovascular Clinic, Japan
(Ogawa) Kitaakita Municipal Hospital, Japan
(Ono) Medical Corporation Shoikai Kasai Shoikai Hospital, Japan
(Hazama) Nijigaoka Hospital, Japan
(Tsukahara) Fujisawa City Hospital, Japan
(Haruta) Fukuyama Cardiovascular Hospital, Japan
(Haruna) Kitano Hospital, Tazuke Kofukai Medical Research Institute, Japan
(Ito) Mie University Hospital, Japan
(Fujii) Sakurabashi Watanabe Hospital, Japan
(Atsuchi) Tenyokai Central Clinic, Japan
(Sata) Tokushima University Hospital, Japan
(Wakeyama) Tokuyama Central Hospital, Japan
(Hasebe) Asahikawa Medical University Hospital, Japan
(Kobayasi) Chiba University Hospita, Japan
(Osato) Fukui CardioVascular Center, Japan
(Hironaga) Fukuoka City Hospital, Japan
(Naganuma) Hachinohe Red Cross Hospital, Japan
(Anzaki) Izumi Regional Medical Center, Japan
(Okazaki) Juntendo University Hospital, Japan
(Nakagawa) Kawanishi City Hospital, Japan
(Tokuhiro) Misato Central General Hospital, Japan
(Tanaka) Miyoshi Central Hospital, Japan
(Momose) Nagano Matsushiro General Hospital, Japan
(Fukushima) Nagatsuda Kosei General Hospital, Japan
(Kametani) Nagoya Tokushukai General Hospital, Japan
(Kawamitsu) Nanbu Tokushukai Hospital, Japan
(Saito) Nara Medical University, Japan
(Akashi) National Hospital Organization Hamada Medical Center, Japan
(Kumagai) Odawara Cardiovascular Hospital, Japan
(Eshima) Saga-Ken Medical Centre Koseikan, Japan
(Tobaru) Sakakibara Heart Institute, Japan
(Seo) Seo Heart Clinic, Japan
(Okuhara) Shobara Red Cross Hospital, Japan
(Kozuma) Teikyo University Hospital, Japan
(Ikari) Tokai University Hospital, Japan
(Takahashi) Tokyo Saiseikai Central Hospital, Japan
(Oiwa) Yokohama Chuo Hospital, Japan
(Michishita) Yokohama Sakae Kyosai Hospital, Japan
(Fujikura) Fujikura Clnic, Japan
(Momomura) Jichi Medical University Saitama Medical Center, Japan
(Yamamoto) Kansai Medical University Medical Center, Japan
(Otomo) Ome Municipal Hospital, Japan
(Matsubara) Shinrakuen Hospital, Japan
(Tashiro) St.Mary's Hospital, Japan
(Inoue) Dokkyo Medical University Hospital, Japan
(Ishihara) Hyogo College of Medicine College Hospital, Japan
(Shiojima) Kansai Medical University Hospital, Japan
(Tachibana) Kawaguchi Municipal Medical Center, Japan
(Sumii) MAZDA Hospital, Japan
(Yamamoto) Miyazaki Prefectural Nobeoka Hospita, Japan
(Omura) Nakata Clinic, Japan
(Nakamura) National Hospital Organization Kyushu Medical Center, Japan
(Takahashi) Oita University Hospital, Japan
(Morita) SAGAMIHARA NATIONAL HOSPITAL, Japan
(Watanabe) Saiseikai Matsuyama Hospital, Japan
(Fujinaga) Tokushima Prefectural Central Hospital, Japan
(Maruyama) Toyama Prefectural Central Hospital, Japan
(Oka) Tsuyama Chuo Hospital, Japan
(Shirayama) University Hospital, Kyoto Prefectural University of Medicine,
Japan
(Amano) Aichi Medical University Hospital, Japan
(Fukui) Kanagawa Cardiovascular and Respiratory Center, Japan
(Ando) Kokura Memorial Hospital, Japan
(Oshima) Kumamoto Chuo Hospital, Japan
(Kagiyama) Kyushu Central Hospital of the Mutual Aid Association of
Public, Japan
(Teragawa) Medical Corporation JR Hiroshima Hospital, Japan
(Yuge) Odawara Municipal Hospital, Japan
(Ono) Saiseikai Yamaguchi Hospita, Japan
(Koga) Steel Memorial Yawata Hospital, Japan
(Fujiu) The University of Tokyo Hospital, Japan
(Kuwabara) Toranomon Hospital, Japan
(Oya) University of the Ryukyus Hospital, Japan
(Yumoto) Fuji Hospital, Japan
(Kuji) Good Heart Clinic, Japan
(Ikemura) Ikemura Medical Clinic, Japan
(Kario) Jichi Medical University Hospital, Japan
(Chatani) Kawasaki Municipal Tama Hospital, Japan
(Sato) Kumamoto City Hospital, Japan
(Miyagi) Miyagi Clinic, Japan
(Murakami) Murakami Clinic, Japan
(Saito) Nishiarai Heart Center Hospital, Japan
(Hoshiga) Osaka Medical College Hospital, Japan
(Sato) Saiseikai Imabari Hospital, Japan
(Kubo) Saitama Medhical Center, Japan
(Sakamoto) Sakamoto Cardiovascular Clinic, Japan
(Ashida) Seirei Yokohama Hospital, Japan
(Sakamoto) Shizuoka Prefectural Hospital, Japan
(Murasaki) Tama-Hokubu Medical Center, Japan
(Uehara) Urasoe General Hospital, Japan
(Akasaka) Wakayama Medical University Hospital, Japan
(Oba) Chihaya Hospital, Japan
(Nakahara) Dokkyo Medical University Saitama Medical Center, Japan
(Hanaoka) Hanaoka Cardiovascular Clinic, Japan
(Nishimiya) Japanese Red Cross Asahikawa Hospital, Japan
(Tsunoda) Japanese Red Cross Kumamoto Hospital, Japan
(Onuma) JR Sapporo Hospital, Japan
(Higuchi) Kamiamakusa General Hospital, Japan
(Tani) Kano General Hospital, Japan
(Wada) Kusatsu General Hospital, Japan
(Kato) Mie Heart Center, Japan
(Obata) National Hospital Organization Obihiro Hospital, Japan
(Higuchi) Osaka Police Hospital, Japan
(Endo) Saiseikai Yokohamashi Nanbu Hospital, Japan
(Kato) Saitama Medical University International Medical Center, Japan
(Matsunaga) Suizenji Tohya Hospital, Japan
(Matsuoka) Uji Tokushukai Medical Center, Japan
(Noguchi) Fukuoka Wajiro Hospital, Japan
(Usui) Hamanomachi Hospital, Japan
(Hayashi) Hayashi Medical Clinic, Japan
(Otsuji) Hospital of the University of Occupational and Environmental
Health, Japan
(Osaki) Iwate Prefectual Kuji Hospital, Japan
(Zaizen) JA Oita Koseiren TsurumiI Hospital, Japan
(Yoshihara) JA Toride Medical Center, Japan
(Kadota) Kurashiki Central Hospital, Japan
(Hirose) Minamata City Hospital & Medical Center, Japan
(Miyazawa) Miyazawa Heart Clinic, Japan
(Mori) National Hospital Organization Iwakuni Clinical Center, Japan
(Takano) Nippon Medical School Chiba Hokusoh Hospital, Japan
(Shimizu) Nippon Medical School Hospital, Japan
(Wake) Okinawa Prefectural Chubu Hospital, Japan
(Oriso) Oriso Internal Medicine & Cardiology Clinic, Japan
(Yoshiyama) Osaka City University Hospital, Japan
(Kakinoki) Otaru Kyokai Hospital, Japan
(Nishioka) Saitama-Medhical Center, Japan
(Ozaki) Sapporo Orthopaedics and Cardiovascular Hospital, Japan
(Nomoto) Tokyo Rinkai Hospital, Japan
(Seki) Yamaguchi Rosai Hospital, Japan
(Kawai) Chikamori Hospital, Japan
(Ozaki) Fujita Health University Hospital, Japan
(Miura) Fukuoka University Hospital, Japan
(Kawasaki) Gifu University Hospital, Japan
(Funada) Gunma University Hospital, Japan
(Dote) Hiroshima City Asa Citizens Hospital, Japan
(Okamoto) Iwasaki Hospital, Japan
(Owada) Japanese Red Cross Society Fukushima Hospital, Japan
(Doke) Kohka Public Hospital, Japan
(Matsumura) Kumamoto Rosai Hospital, Japan
(Kubo) Japanese Red Cross Matsuyama Hospital, Japan
(Horiuchi) Medical Association Sugimura Hospital, Japan
(Nagano) Iwasa Hospital Iwasa Maternity, Japan
(Takaishi) Mitoyo General Hospital, Japan
(Yamamoto) National Center for Global Health and Medicine, Japan
(Nakashima) National Hospital Organization Kagoshima Medical Center, Japan
(Murozono) Japanese Red Cross Oita Hospital, Japan
(Munemasa) National Hospital Organization Okayama Medical Center, Japan
(Sakata) Osaka University Hospital, Japan
(Inoue) Sendai Kousei Hospital, Japan
(Ota) Takanohara Central Hospital, Japan
(Hamano) Tawaramachi Hamano Hospital, Japan
(Abe) Tokyo Medical University Ibaraki Medical Center, Japan
(Tsubokura) Tsubokura Cardiovascular Clinic, Japan
(Goto) Watanabe Hospital, Japan
(Kubota) Yamagata University Hospital, Japan
(Yano) Yamaguchi University Hospital, Japan
(Umetani) Yamanashi Prefectural Central Hospital, Japan
(Date) Date Naika Clinic, Japan
(Morimoto) Fukagawa Municipal Hospital, Japan
(Noda) Gifu Prefectural General Medical Center, Japan
(Goto) Goto Clinic, Japan
(Hibi) Gumyoji Eye Heart Clinic, Japan
(Nakano) Hikone Municipal Hospital, Japan
(Hiramitsu) Hiramitsu Heart Clinic, Japan
(Kihara) Hiroshima University Hospital, Japan
(Sugi) Imaki City Medical Center, Japan
(Shiba) International University of Health and Welfare Hospital, Japan
(Izumi) Japanese Red Cross Ise Hospital, Japan
(Sato) Japanese Red Cross Okayama Hospital, Japan
(Ajiki) JR Tokyo General Hospital, Japan
(Oishi) Kagoshima University Hospital, Japan
(Kiryu) Kanagawa Cardiovascular Medicine, Japan
(Ko) Kashima Heart Clinic, Japan
(Ando) Keiai Hospital, Japan
(Miyazaki) Kindai University Hospital, Japan
(Kinugawa) Kinugawa Cardiology Clinic, Japan
(Otake) Kobe University Hospital, Japan
(Kitaoka) Kochi Medical School Hospital, Japan
(Tayama) JCHO Kumamoto General Hospital, Japan
(Hirata) Kumamoto Regional Medical Center, Japan
(Honda) Minami Municipal National Insurance Hospital, Japan
(Manita) Naha City Hospital, Japan
(Ishii) Ogikubo Hospital, Japan
(Oka) Oka Clinic, Japan
(Nanba) Okayama Rosai Hospital, Japan
(Nishino) Osaka Rosai Hospital, Japan
(Sakamoto) Saiseikai Kumamoto Hospital, Japan
(Saito) Saito Clinic, Japan
(Sakai) Sakai Clinic, Japan
(Ichikawa) Sekishindo Hospital, Japan
(Namiuchi) Sendai Open Hospital, Japan
(Matsui) JCHO Shiga Hospital, Japan
(Inoue) South Miyagi Medical Center, Japan
(Komiyama) St. Luke's International Hospital, Japan
(Akashi) St. Marianna University School of Medicine Hospital, Japan
(Matsumura) Awa Regional Medical Center, Japan
(Nakamura) Takeda General Hospital, Japan
(Komaru) Tohoku Medical and Pharmaceutical University Hospital, Japan
(Hosokawa) Tokyo Haert Center, Japan
(Chikamori) Tokyo Medical University Hospital, Japan
(Tanaka) Tokyo Metropolitan Tama Medical Center, Japan
(Suzuki) JCHO Tokyo Yamate Medical Center, Japan
(Arasaki) Tomishiro Central Hospital, Japan
(Aonuma) University of Tsukuba Hospital, Japan
(Wakasa) Wakasa Medical Clinic, Japan
(Yoshizawa) Yamato Municipal Hospital, Japan
(Sugano) Yokohama City University Hospital, Japan
(Yokota) Yokota Naika, Japan
(Kakutani) Yoshinoawa Medical Center, Japan
(Suzuki) Aizawa Hospital, Japan
(Abe) Akeno Clinic, Japan
(Kataoka) Bellland General Hospital, Japan
(Okayama) Ehime Prefectural Central Hospital, Japan
(Yokoi) Fukuoka Sanno Hospital, Japan
(Chin) Hakuai Clinic, Japan
(Hasegawa) Hasegawa Outpatients Clinic for Cardiovascular Disease, Japan
(Tomita) Hirosaki University Hospital, Japan
(Honzyo) Honzyo Medical Hospital, Japan
(Kawai) Hyogo Brain and Heart CenterAt Himeji, Japan
(Yamamoto) Iida Municipal Hospital, Japan
(Morino) Iwate Medical University Hospital, Japan
(Tsujiyama) JA Hiroshima General Hospital, Japan
(Yoshimura) The Jikei University Hospital, Japan
(Hamasaki) Kagoshima City Hospital, Japan
(Niijima) Kan-etsu Chu-oh Hospital, Japan
(Aoyama) Kizawa Memorial Hospital, Japan
(Mizuno) Kumamoto Kinoh Hospital, Japan
(Maki) Maki Clinic, Japan
(Tanabe) Mitsui Memorial Hospital, Japan
(Murohara) Nagoya University Hospital, Japan
(Nakamura) Nakamura Clinic, Japan
(Naomi) Naomi Medicinal Clinic, Japan
(Matsumoto) Nihon University Hospital, Japan
(Minamino) Niigata University Medical & Dental Hospital, Japan
(Sairenji) Nishiyama Ichou Jyunkanki Geka Clinic, Japan
(Miyamoto) NTT-East Sapporo Hospital, Japan
(Arikawa) National Hospital Organization Oita Medical Center, Japan
(Ito) Okayama University Hospital, Japan
(Matsuura) Sakaemachi Clinic, Japan
(Hata) Sasebo City General Hospital, Japan
(Nakatsu) Shioda Memorial Hospital, Japan
(Onodera) Shizuoka City Shizuoka Hospital, Japan
(Kato) National Hospital Organization Tochigi Medical Center, Japan
(Amano) Toho University Omori Medical Center, Japan
(Tokutake) Tokutake Clinic, Japan
(Kasao) Tokyo Metropolitan Police Hospital, Japan
(Moriguchi) Toshiba Rinkan Hospital, Japan
(Yamamoto) Tottori University Hospital, Japan
(Tsuji) Tsuji Internal Medicine and Cardiology and Dental Clinic, Japan
(Yamamoto) Yamamoto Clinic, Japan
(Yanbe) Yokohama General Hospital, Japan
(Iwasawa) Yokohama General Hospital Uwamachi, Japan
(Suzuki) Yokohama Minami Kyousai Hospital, Japan
(Mori) Yokohama Sotetsu Building Clinic, Japan
(Shibahashi) Tokyo Women's Medical University, Japan
(Takita) Mebix, Japan
(Kimura) Yokohama City University Medical Center, Japan
Publisher
American Medical Association
Abstract
Importance: Antithrombotic therapy is crucial for older patients with
coronary artery disease (CAD) and atrial fibrillation (AF) who are at a
high risk of bleeding and thrombotic events. <br/>Objective(s): To examine
the age-stratified effects of rivaroxaban monotherapy compared with those
of rivaroxaban plus antiplatelet agent combination therapy. <br/>Design,
Setting, and Participant(s): This was a post hoc secondary analysis of the
Atrial Fibrillation and Ischemic Events With Rivaroxaban in Patients With
Stable Coronary Artery Disease (AFIRE) open-label randomized clinical
trial. This was a multicenter study conducted in Japan from February 23,
2015, to July 31, 2018. Patients with AF and stable CAD who had undergone
percutaneous coronary intervention or coronary artery bypass grafting 1 or
more years earlier or who had angiographically confirmed CAD that did not
require revascularization were enrolled. Participants were stratified into
4 groups by age (<70 years, 70-74 years, 75-79 years, and >=80 years).
Study data were analyzed from August 2024 to July 2025.
<br/>Intervention(s): Rivaroxaban monotherapy or rivaroxaban plus
antiplatelet agent therapy. <br/>Main Outcomes and Measures: The primary
efficacy end point was a major adverse cardiovascular event, defined as a
composite of stroke, systemic embolism, myocardial infarction, unstable
angina requiring revascularization, or death from any cause. The primary
safety end point was major bleeding. <br/>Result(s): This study included a
total of 2215 participants (mean [SD] age, 74.3 [8.2] years; 1751 male
[79.1%]). The incidence of primary efficacy end points per patient-year
for rivaroxaban monotherapy vs rivaroxaban plus antiplatelet agent therapy
was 3.2% vs 4.3% (<70 years), 3.2% vs 2.8% (70-74 years), 3.8% vs 5.3%
(75-79 years), and 6.2% vs 10.3% (>=80 years). The hazard ratios were 0.74
(95% CI, 0.40-1.37) for those younger than 70 years, 1.16 (95% CI,
0.55-2.45) for those aged 70 to 74 years, 0.72 (95% CI, 0.41-1.26) for
those aged 75 to 79 years, and 0.61 (95% CI, 0.40-0.93) for those 80 years
and older (P for interaction =.51). For the primary safety end points, the
incidence was 0.5% vs 2.3% (<70 years), 2.2% vs 2.4% (70-74 years), 1.1%
vs 2.1% (75-79 years), and 2.9% vs 4.3% (>=80 years). The hazard ratios
were 0.23 (95% CI, 0.06-0.79) for those younger than 70 years, 0.91 (95%
CI, 0.39-2.15) for those aged 70 to 74 years, 0.52 (95% CI, 0.19-1.42) for
those aged 75 to 79 years, and 0.67 (95% CI, 0.35-1.27) for those 80 years
and older (P for interaction =.33). <br/>Conclusions and Relevance:
Results of this post hoc analysis of the AFIRE randomized clinical trial
reveal that rivaroxaban monotherapy reduced the risk of major
cardiovascular events and major bleeding across the broad range of age in
patients with AF and stable CAD. Possible age-related differences in
trends, with more pronounced efficacy in older patients and more
pronounced safety in younger patients, should be considered as hypothesis
generating and require further research.<br/>Copyright &#xa9; 2025
American Medical Association.

<25>
Accession Number
2032392818
Title
Coronary Artery Bypass Grafting versus Percutaneous Coronary Intervention
in Patients with Chronic Total Occlusion.
Source
Thoracic and Cardiovascular Surgeon. 73(8) (pp 609-617), 2025. Date of
Publication: 01 Dec 2025.
Author
Kirov H.; Fischer J.; Caldonazo T.; Tasoudis P.; Runkel A.; Soletti G.J.;
Cancelli G.; Dell'Aquila M.; Mukharyamov M.; Doenst T.
Institution
(Kirov, Fischer, Caldonazo, Runkel, Mukharyamov, Doenst) Department of
Cardiothoracic Surgery, Jena University Hospital, Jena, Germany
(Tasoudis) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, United States
(Soletti, Cancelli, Dell'Aquila) Weill Cornell Medicine, New York, NY,
United States
Publisher
Georg Thieme Verlag
Abstract
Objectives Mechanisms of coronary artery bypass grafting (CABG) and
percutaneous coronary intervention (PCI) differ as CABG provides surgical
collateralization and may prolong life by preventing future myocardial
infarctions (MIs). However, evidence for CABG in patients with chronic
total occlusion (CTO) has not been fully elucidated and the impact of PCI
is discussed controversially. Methods We performed a meta-analysis of
studies comparing outcomes in patients with/without multivessel disease
undergoing CABG or PCI for CTO. The primary outcome was long-term
all-cause mortality (>=5 years). Secondary outcomes were MIs, repeat
revascularization, cardiac mortality, major adverse cardiovascular events,
and stroke, as well as short-term mortality (30 days/in-hospital) and
stroke. A pooled Kaplan-Meier survival curve after reconstruction analysis
was generated. Random-effects models were used. Results Six studies
totaling 12,504 patients were included. In the pooled Kaplan-Meier
analysis, PCI showed a significantly higher risk of death in the follow-up
compared with CABG (hazard ratio [HR]: 2.12, 95% confidence interval [CI]:
1.88-2.38, p < 0.01). During the observation period, PCI was also
associated with higher rates of MI (odds ratio [OR]: 2.86, 95% CI:
1.82-4.48, p < 0.01) and more repeat revascularization (OR: 4.88, 95% CI:
1.99-11.91, p = 0.0005). The other outcomes did not show significant
differences. Conclusion CABG is associated with superior survival to PCI
over time in patients with CTO who are eligible for both PCI and CABG.
This survival advantage is associated with fewer events of MI and repeat
revascularization.<br/>Copyright &#xa9; 2024. Thieme. All rights reserved.
Georg Thieme Verlag KG.

<26>
Accession Number
2041283516
Title
Improvements in cardiac geometry following bariatric surgery in
adolescents help to address important knowledge gaps.
Source
Cardiology in the Young. 35(11) (pp 2334-2335), 2025. Date of Publication:
01 Nov 2025.
Author
Michalsky M.
Institution
(Michalsky) Nationwide Children's Hospital, The Ohio State University,
College of Medicine, Columbus, United States
Publisher
Cambridge University Press
Abstract
US data from the National Health and Nutrition Examination Survey
estimates that the prevalence of obesity among US adolescents (ages 12-19)
has reached 22.9% of the paediatric population, with nearly 9% meeting
criteria for severe obesity (body mass index >=120% of the 95th percentile
or >=35 kg/m²). These alarming figures underscore the
cumulative impact of paediatric obesity, including established
associations with impaired cardiometabolic health. The study "Cardiac
Geometry Alterations Following Bariatric Surgery in Severely Obese
Adolescents: A One-Year Follow-Up Study of a Randomized Controlled Trial"
advances this understanding by comparing lifestyle intervention alone
versus lifestyle therapy in combination with the application of bariatric
surgery (e.g. laparoscopic adjustable gastric banding). As the first
prospective randomised trial to assess cardiac geometric and following
adolescent metabolic and bariatric surgical intervention, the findings
demonstrate significant improvements in cardiac geometry among surgical
participants, suggesting partial reversal of obesity-related cardiac
remodelling. While these short-term results are encouraging, durability
remains uncertain given the study's small sample size and previous reports
of significant weight regain and higher-than-expected complication rates
following gastric banding. Considerations for future investigational
designs should incorporate an expanded age range with regards to overall
eligibility as well as bariatric procedures other than the gastric band,
that offer long-term weight loss (i.e., vertical sleeve gastrectomy and
gastric bypass). Longer-term and comprehensive follow-up will be critical
to delineate the longitudinal cardiometabolic outcomes of surgical versus
medical interventions for severe adolescent obesity.<br/>Copyright &#xa9;
The Author(s), 2025. Published by Cambridge University Press.

<27>
Accession Number
2040515808
Title
Efficacy and Safety of Colchicine for Secondary Prevention of
Cardiovascular Disease: A Systematic Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 106(7) (pp 3675-3689),
2025. Date of Publication: 01 Dec 2025.
Author
Ahmed M.; Fahim M.A.A.; Humayun M.; Sajid B.; Ahmad S.; Asghar M.S.
Institution
(Ahmed) Department of Internal Medicine, Shaheed Mohtarma Benazir Bhutto
Medical College Lyari, Karachi, Pakistan
(Fahim, Humayun) Department of Internal Medicine, Dow University of Health
Sciences, Karachi, Pakistan
(Sajid) Department of Internal Medicine, Jinnah Sindh Medical University,
Karachi, Pakistan
(Ahmad) Department of Internal Medicine, Aga Khan University and Hospital,
Karachi, Pakistan
(Asghar) AdventHealth, Altamonte Springs, FL, United States
Publisher
John Wiley and Sons Inc
Abstract
Colchicine may reduce cardiovascular events in coronary artery disease
(CAD) through its anti-inflammatory effects. PubMed, Scopus, and Cochrane
Library were searched from inception to May 10, 2025, for randomized
controlled trials (RCTs) comparing colchicine with placebo or usual care
in patients with CAD. Eligible trials had >= 30 days of colchicine use and
reported cardiovascular outcomes. The primary outcome was major adverse
cardiovascular events (MACE). Secondary outcomes included extended MACE
(eMACE), myocardial infarction (MI), stroke, all-cause mortality,
cardiovascular mortality, coronary revascularization, gastrointestinal
events, infection, myalgia, arrhythmia, cancer, alopecia, and treatment
discontinuation. Random-effects models were used to calculate risk ratios
with 95% CIs. Heterogeneity was assessed using the I2 statistic, and
meta-regression analysis was conducted to explore heterogeneity and
potential effect modifiers. Eleven studies included 19,618 patients with
9814 and 9804 patients in the colchicine and control groups, respectively.
The colchicine group was significantly associated with a lower rate of
MACE compared to the control group (RR = 0.73, 95% CI = 0.59-0.92, p =
0.006; I2 = 44%). From the secondary outcomes, eMACE (RR = 0.66, 95% CI =
0.52-0.85; p = 0.001; I2 = 73%), MI (RR = 0.82, 95% CI = 0.70-0.96, p =
0.01), and coronary revascularization (RR = 0.60, 95% CI = 0.41-0.87, p =
0.007) were found to be significantly lower in the colchicine group. All
the other secondary outcomes did not reach statistical significance.
Meta-regression analysis for MACE showed a statistically significant
association with diabetes (coefficient: -0.0778, p = 0.0013), indicating a
potential modifying effect. Other covariates, including mean age,
hypertension, smoking, and prior revascularization, did not demonstrate
statistically significant associations. Colchicine reduces MACE, MI, and
revascularization in CAD patients, supporting its use for secondary
prevention.<br/>Copyright &#xa9; 2025 Wiley Periodicals LLC.

<28>
Accession Number
2041401510
Title
The Extended Safety and Efficacy of Indobufen in Conjunction With P2Y12
Receptor Inhibitors Among Patients Undergoing Revascularization: A
Meta-Analysis and Overview.
Source
Cardiovascular Therapeutics. 2025(1) (no pagination), 2025. Article
Number: 5374818. Date of Publication: 2025.
Author
Yi M.; Cao Q.; Sheng Y.-H.; Wu L.; Ke X.
Institution
(Yi, Sheng, Wu) Department of Cardiology, Liuyang Hospital of Traditional
Chinese Medicine, Liuyang, China
(Yi, Ke) Department of Cardiology, Fuwai Hospital, Chinese Academy of
Medical Sciences, Shenzhen, (Shenzhen Sun Yat-sen Cardiovascular
Hospital), Shenzhen, China
(Cao) Department of Cardiology, The Fourth Hospital of Changsha, Changsha
Hospital Affiliated to Hunan Normal University, Changsha, China
Publisher
John Wiley and Sons Inc
Abstract
Background/Objectives: Dual antiplatelet therapy (DAPT), which combines
aspirin with a P2Y12 receptor inhibitor for platelets, is crucial for the
prevention of cardiac and systemic ischemic events in patients with
coronary artery disease who have undergone revascularization procedures.
Although indobufen is suggested as an alternative for individuals who
exhibit intolerance to aspirin, the long-term safety and efficacy of
indobufen-based DAPT treatment for the prevention of cardiac and systemic
ischemic events in these patients remain ambiguous. This meta-analysis
seeks to examine the long-term safety and efficacy of DAPT based on
indobufen in the context of revascularization procedures for patients.
<br/>Method(s): A thorough search was performed across PubMed, Embase, the
Cochrane Library, Web of Science, ClinicalTrials.gov, and CNKI, covering
all records from each database's inception to October 10, 2024. Included
were randomized trials analyzing oral DAPT antiplatelet agents for
coronary artery disease patients who received revascularization. Two
reviewers independently handled the selection process: screening articles,
overview, extracting data, and assessing study quality in accordance with
PRISMA guidelines. The pooled data were later subjected to analysis using
a random-effects model meta-analysis. <br/>Result(s): The final analysis
included three randomized controlled trials, which yielded the following
findings regarding major adverse cardiovascular and cerebrovascular events
(MACCEs): The relative risk (RR) was 1.58 (95% CI, 0.72-3.38); for BARC
Type 2, 3, or 5 bleeding events, the RR was 0.35 (95% CI, 0.18-0.67); and
for gastrointestinal intolerance events, the RR was 0.06 (95% CI,
0.03-0.18). <br/>Conclusion(s): Indobufen-based DAPT may potentially
increase the risk of ischemic events without compromising safety for
revascularization, as its upper RR limit exceeds 1 for
MACCEs.<br/>Copyright &#xa9; 2025 Ming Yi et al. Cardiovascular
Therapeutics published by John Wiley & Sons Ltd.

<29>
Accession Number
2040474621
Title
Impact of preoperative beta-hydroxy-beta-methylbutyrate, arginine, and
glutamine supplementation on inflammation in patients with cardiac
surgery: A secondary analysis of a randomized controlled trial.
Source
Journal of Cardiology. 86(6) (pp 561-567), 2025. Date of Publication: 01
Dec 2025.
Author
Ogawa M.; Satomi-Kobayashi S.; Yoshida N.; Komaki K.; Hirabayashi T.;
Wakida K.; Saitoh S.; Inoue T.; Yamashita T.; Sakai Y.; Takahashi M.;
Hirata K.-I.
Institution
(Ogawa, Sakai) Division of Rehabilitation Medicine, Kobe University
Graduate School of Medicine, Hyogo, Japan
(Ogawa) Department of Public Health, Kobe University Graduate School of
Health Sciences, Hyogo, Japan
(Satomi-Kobayashi, Yoshida, Hirata) Division of Cardiovascular Medicine,
Department of Internal Medicine, Kobe University Graduate School of
Medicine, Hyogo, Japan
(Yoshida) Department of Cardiovascular Aging, National Cerebral and
Cardiovascular Center, Osaka, Japan
(Komaki, Hirabayashi) Division of Rehabilitation Medicine, Kobe University
Hospital, Hyogo, Japan
(Wakida, Saitoh, Takahashi) Department of Nutrition, Kobe University
Hospital, Hyogo, Japan
(Inoue) Department of Cardiac Surgery, Hyogo Prefectural Awaji Medical
Center, Hyogo, Japan
(Yamashita) Department of Advanced Medical Science, Kobe University
Graduate School of Science, Technology and Innovation, Hyogo, Japan
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Background Preoperative physical frailty is a significant predictor of
adverse postoperative outcomes in older patients undergoing cardiac
surgery. Inflammation plays a crucial role in the development of frailty
and contributes to postoperative complications. This study investigated
the effects of preoperative beta-hydroxy-beta-methylbutyrate (HMB),
arginine, and glutamine supplementation on inflammatory markers,
nutritional status, and renal function in older patients undergoing
cardiac surgery. Methods This was a secondary analysis of a single-center,
open-label, randomized controlled trial. Patients aged >=65 years
scheduled for elective cardiac surgery were randomized to receive either
HMB supplementation (1200 mg HMB, 7000 mg l -glutamine, and 7000 mg
L-arginine, twice daily) or routine care for at least two weeks before
surgery. Serum levels of tumor necrosis factor-alpha (TNF-alpha), and
other biochemical markers were measured at baseline, pre-surgery, and two
weeks post-surgery. Results Forty-four patients (mean age 72.5 years, 36 %
women) were analyzed. Preoperative HMB supplementation significantly
reduced pre-surgery serum TNF-alpha levels compared to the control group
(0.85 +/- 0.28 pg/mL vs. 1.10 +/- 0.44 pg/mL, p = 0.039). However, this
difference was not observed two weeks post-surgery. No significant
differences were observed in C-reactive protein levels or other
nutritional markers between the two groups at any time point. Conclusions
Preoperative supplementation with a combination of HMB, glutamine, and
arginine was effective in reducing preoperative TNF-alpha levels in older
patients undergoing cardiac surgery, suggesting a potential
anti-inflammatory effect. This anti-inflammatory effect suggests a
potential mechanism for improving postoperative outcomes and warrants
further investigation. Registration number of Clinical Trial:
UMIN000030490 (
https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R0000347
73 )<br/>Copyright &#xa9; 2025 The Authors.

<30>
Accession Number
2042009449
Title
Evaluating Topical Antifibrinolytics in Cardiac Surgery: A Systematic
Review, Meta-Analysis, and Trial Sequential Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Montoya-Beltran J.S.; Ramirez-Herrera L.; Pinilla J.L.; Herazo-Cubillos
A.; Pena-Blanco L.; Jimenez Ordonez A.F.
Institution
(Montoya-Beltran, Ramirez-Herrera, Pinilla, Herazo-Cubillos, Pena-Blanco)
Anesthesiology Research Group, Fundacion Cardioinfantil - Instituto de
Cardiologia, Bogota, Colombia
(Montoya-Beltran, Ramirez-Herrera, Herazo-Cubillos) Anesthesiology
Department, Fundacion Cardioinfantil - Instituto de Cardiologia, Bogota,
Colombia
(Montoya-Beltran, Ramirez-Herrera, Pinilla, Herazo-Cubillos, Pena-Blanco)
Universidad del Rosario, School of Medicine and Health Sciences, Bogota,
Colombia
(Jimenez Ordonez) Cardiovascular Surgery Department, Fundacion
Cardioinfantil - Instituto de Cardiologia, Bogota, Colombia
Publisher
W.B. Saunders
Abstract
Introduction: Lysine analog antifibrinolytics (LAAF) like tranexamic acid
(TXA) and aminocaproic acid (EACA) reduce intraoperative blood loss,
especially in cardiac surgery where bleeding risks are high. These LAAFs
inhibit fibrinolysis and have been proven to decrease bleeding and
transfusion volume. In cardiac surgery, frequent transfusions raise the
risk of infections, extend hospital stays and reoperations, and carry
higher morbidity and mortality. Current guidelines recommend intravenous
antifibrinolytics; however, the objective of this review was to determine
whether topical administration in cardiac surgery reduces blood loss, with
or without intravenous LAAF. <br/>Method(s): PubMed, Embase, MEDLINE,
Cochrane CENTRAL, and Clarivate WoS were searched from inception to August
31, 2024, for randomized controlled trials and observational studies
comparing topical TXA or EACA to placebo in cardiac surgery. Data
extraction was done independently, and RoB2/ROBINS-I was used for quality
assessment. A derSimmonian-Laird random-effects model was applied. Mean
differences were used for continuous outcomes, and OR/RR was used for
binary. I2 statistics measure heterogeneity. Sensitivity analysis and GOSH
plotting assessed heterogeneity; trial sequential analysis was performed.
The certainty of the evidence followed GRADE guidelines. <br/>Result(s):
The meta-analysis included 26 studies with 2,624 patients, 24 focused on
adults. Given the pragmatic approach to this meta-analysis, a wide variety
of surgical procedures were included, with coronary artery bypass grafting
and valvular procedures being the most prevalent. LAAF administration
reduced postoperative blood loss by 174 mL (MD -173.99, 95% CI -238.20 to
-109.78, p < 0.00001), and the effect remained constant through subgroup
analysis (coronary artery bypass grafting, high- v low-dose, dual-route
administration). No significant differences were found in transfusion
rates for packed red blood cells (PRBC) and platelets, though LAAF reduced
PRBC volume (MD -0.6 units, 95% CI -0.88 to -0.24, p = 0.00006) and fresh
frozen plasma requirements (RR 0.69, 95% CI: 0.5 to 0.95, p = 0.03). No
differences in hematological change scores or complication rates were
observed. The analysis showed high heterogeneity, but the overall effect
remained consistent. A trial sequential analysis suggests there is enough
data to confirm this effect. <br/>Conclusion(s): Topical LAAF
administration reduces postoperative blood loss up to 24 hours
postoperatively. Secondary analyses showed reductions in PRBC transfusion
volume and fresh frozen plasma transfusion rate, without increased
complications. Registration: PROSPERO CRD42024579777, August 27,
2024.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<31>
Accession Number
2041062624
Title
Cardiac geometry alterations following bariatric surgery in severely obese
adolescents: a one-year follow-up study of a randomised controlled trial.
Source
Cardiology in the Young. 35(11) (pp 2276-2282), 2025. Date of Publication:
01 Nov 2025.
Author
Talib A.; Roebroek Y.; Paulus G.; De Boom F.; Winkens B.; Bouvy N.; Van
Heurn E.
Institution
(Talib, Roebroek, Paulus, De Boom, Bouvy, Van Heurn) Department of
Surgery, Maastricht University Medical Center, Maastricht, Netherlands
(Talib, Roebroek, Paulus, De Boom, Bouvy, Van Heurn) NUTRIM School for
Nutrition and Translational Research in Metabolism, Maastricht University,
Maastricht, Netherlands
(Roebroek) Department of General Surgery, Maxima Medical Center,
Veldhoven, Netherlands
(Paulus) Department of General Surgery, Spaarne Gasthuis, Hoofddorp,
Netherlands
(Winkens) Department of Methodology and Statistics, CAPHRI Care and Public
Health Research Institute, Maastricht University, Maastricht, Netherlands
(Bouvy, Van Heurn) Department of Surgery, Leiden University Medical
Center, Leiden, Netherlands
Publisher
Cambridge University Press
Abstract
Background: Severe obesity in adolescents is a public health crisis of
increasing concern. Cardiac maladaptation, such as left ventricular
hypertrophy, increases the risk of future cardiovascular disease. This
study aims to evaluate the impact of weight loss surgery on cardiac
geometry in morbidly obese adolescents. <br/>Method(s): A single-centre,
randomised controlled trial titled comparing laparoscopic adjustable
gastric banding with multidisciplinary lifestyle intervention against a
control group with multidisciplinary lifestyle intervention alone. The
trial included severely obese adolescents aged 14-16 who had not responded
to a minimum of 12 months of multidisciplinary lifestyle intervention. The
primary outcome measured was the percentage change in total body weight
one year after surgery. Left ventricular geometry was evaluated
ultrasonographically before and one year after bariatric surgery.
<br/>Result(s): In the intervention and control group, a total of 10 and 8
patients received both the baseline and follow-up ultrasonographic
examination. BMI significantly decreased in the intervention group
compared to the control group (-6.75; 95% CI: -10.28 - -3.23). Moreover,
left ventricular mass index (-8.21; 95% CI: -15.43 - -0.98) and relative
left ventricular wall thickness (-0.04; 95% CI: -0.07 - 0.00)
significantly decreased within the intervention group, reflecting
amelioration of adverse remodelling, albeit without statistically
significant intervention effect when compared to the control group.
<br/>Conclusion(s): Significant weight loss through bariatric surgery may
improve left ventricular geometry in severely obese adolescents. These
findings support the potential of bariatric surgery not only for reducing
weight loss but also for improving cardiac health.<br/>Copyright &#xa9;
The Author(s), 2025. Published by Cambridge University Press.

<32>
Accession Number
2041416961
Title
Evaluating the comparative efficacy of leg cycle ergometry exercise versus
conventional physiotherapy on scar healing, muscle strength, functional
capacity, and quality of life in coronary artery bypass graft subjects
with saphenous vein graft in phase 1: a protocol for randomised controlled
trial.
Source
Trials. 26(1) (no pagination), 2025. Article Number: 545. Date of
Publication: 01 Dec 2025.
Author
Vinerkar D.; Vardhan V.
Institution
(Vinerkar, Vardhan) Department of Cardiovascular and Respiratory
physiotherapy, Ravi Nair physiotherapy college, Datta Meghe Institute of
Higher Education and Research, Sawangi (Meghe), 442001, Wardha, India
Publisher
BioMed Central Ltd
Abstract
Background: Coronary artery bypass grafting (CABG) is a common surgical
treatment for coronary artery disease. The saphenous vein's advantageous
anatomical features make it a popular choice for graft vessels. However,
saphenous vein harvesting often results in lower limb complications such
as edema, poor scar healing, pain, and reduced functional mobility. These
issues can delay recovery and diminish quality of life. Early
rehabilitation using leg cycle ergometry may improve outcomes, but
comparative evidence with conventional physiotherapy in Phase I post-CABG
care is limited. <br/>Aim(s): To determine the relative benefits of leg
cycle ergometry training for CABG patients with saphenous vein graft in
phase 1 in terms of scar healing, muscle strength, functional ability, and
quality of life. <br/>Objective(s): To evaluate the comparative efficacy
of leg cycle ergometry exercise versus conventional physiotherapy on scar
healing, muscle strength, functional capacity, and quality of life in CABG
subjects with saphenous vein grafts during Phase I rehabilitation.
<br/>Method(s): A randomized controlled trial will be conducted at Shalini
Tai Meghe Super Speciality Centre with 70 CABG patients aged 45-65 years.
Participants will be randomly allocated to Group A (conventional
physiotherapy) and Group B (leg cycle ergometry with physiotherapy) for a
10-day intervention. Outcome measures include the Vancouver Scar Scale,
Manual Muscle Testing, 6-Minute Walk Test, and Patient Health
Questionnaire-9 (PHQ-9). Data will be analysed using the Mann-Whitney U
test and the Wilcoxon signed-rank test; p<0.05 was deemed statistically
significant. <br/>Result(s): As this is a study protocol, no results are
available yet. It is hypothesized that leg cycle ergometry, when added to
conventional physiotherapy, will lead to greater improvements in scar
healing, lower limb strength, functional capacity, and short-term quality
of life during Phase I cardiac rehabilitation following CABG surgery.
Trial registration: Clinical Trial Registry-India (CTRI/2025/03/084291).
Registered on 15 April 2025.<br/>Copyright &#xa9; The Author(s) 2025.

<33>
Accession Number
2018847596
Title
Effect of cocoa flavanol supplementation for the prevention of
cardiovascular disease events: The COcoa Supplement and Multivitamin
Outcomes Study (COSMOS) randomized clinical trial.
Source
American Journal of Clinical Nutrition. 115(6) (pp 1490-1500), 2022. Date
of Publication: 01 Jun 2022.
Author
Manson J.E.; Johnson L.G.; Moorthy M.V.; Carrick W.R.; Anderson G.L.;
Sesso H.D.; Rist P.M.; Bassuk S.S.; Leboff M.S.; Okereke O.I.; Cook N.R.;
Christen W.; Friedenberg G.; Copeland T.; Hanna J.; Clar A.; D'Agostino
D.; Vinayagamoorthy M.; Gibson H.; Kim E.; Van Denburgh M.; Kotler G.; Li
C.; Bubes V.; Sarkissian A.; Smith D.; Pereira E.C.; Okeke M.; Roche E.;
Ridge C.; Phillips A.; Salvo B.; Wilson A.; Hall L.; Baez J.; Sim Y.-H.;
Cardoso H.; Senor G.; Rudnicki C.; Huynh H.; Nguyen V.; Terrell N.; Holman
B.A.; Walter J.; Johnson L.F.; Casarella A.; O'Connell J.; Lagerstrom
S.R.; Djousse L.; Chandler P.D.; Hazra A.; Tobias D.K.; Farukhi Z.M.; Wang
L.; Zhang X.; Breen K.; Menjin Jr G.V.; Rodriguez R.; Curry S.; Arsenault
L.; Solano O.; Weinberg A.; Coates J.; Kilroe M.; Zernicke L.; Hasson K.;
Matthew K.; Mora S.; Pfeffer C.; Duszlak J.; Bates D.; Guzman V.; Falcon
J.; Romero A.; Kupets H.; Cortez F.; Lesuer J.C.; Hrbek A.; Bowes E.;
Quinn P.; Mele M.; Johnson L.; Tinker L.F.; Aragaki A.K.; Herndon M.; Mann
S.L.; Pettinger M.; Hunt R.P.; Carrick B.; Szyperski K.; Proulx-Burns L.;
Burrows E.; Limacher M.; Hsia J.; Asaithambi G.; Khan M.; Nagaraja N.;
Ocava L.C.; Wold J.; Silver B.; Connelly S.; Van Lom G.; Garvida C.;
Hightower K.; Spaulding P.; Lin W.; Schoenberg J.; Olee P.; Cohen L.S.;
Colton T.; Henderson I.C.; Hulley S.; Lichtenstein A.H.; Passamani E.R.;
Silliman R.A.; Wenger N.; Ludlam S.E.; Schroeter H.; Fare M.; Ottawani J.;
Kwik-Uribe C.; Arnaiz C.; Costanza A.; Greene J.; Hennessey P.; Vadlamani
S.; Karmsetty M.; Martini P.; Van Klinken J.-W.; Shah A.; Stern L.
Institution
(Sesso, Manson, Rist, Friedenberg, Copeland, Clar, Mora, Moorthy,
Sarkissian) Division of Preventive Medicine, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Sesso, Manson, Rist) Department of Epidemiology, Harvard T.H. Chan School
of Public Health, Boston, MA, United States
(Aragaki, Johnson, Carrick, Anderson) Division of Public Health Sciences,
Fred Hutchinson Cancer Research Center, Seattle, WA, United States
(Mora) Division of Cardiovascular Medicine, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Arnaiz, Costanza, Greene, Hennessey) Contract Pharmacal Corp, United
States
(Vadlamani, Karmsetty, Martini, Van Klinken, Shah, Stern) Pfizer Consumer
Healthcare, United States
(Manson, Sesso, Rist, Lagerstrom, Bassuk, Wang, Hazra, Gibson, Leboff,
Mora, Okereke, Tobias, Cook, Chandler, Christen, Christen, Friedenberg,
Copeland, Hanna, Clar, D'Agostino, Vinayagamoorthy, Gibson, Kim, Van
Denburgh, Kotler, Li, Bubes, Sarkissian, Smith, Pereira, Okeke, Roche,
Bates, Ridge, Phillips, Salvo, Wilson, Hall, Baez, Sim, Cardoso, Senor,
Rudnicki, Huynh, Nguyen, Terrell, Holman, Walter, Johnson, Casarella,
O'Connell, Lagerstrom, Djousse, Chandler, Hazra, Tobias, Farukhi, Wang,
Zhang, Breen, Menjin Jr, Rodriguez, Curry, Mora, Arsenault, Solano,
Weinberg, Coates, Kilroe, Zernicke, Hasson, Matthew, Mora, Pfeffer,
Duszlak, Bates, Guzman, Falcon, Romero, Kupets, Cortez, Lesuer, Hrbek,
Bowes, Quinn, Mele) Brigham and Women's Hospital, United States
(Anderson, Johnson, Tinker, Aragaki, Herndon, Mann, Pettinger, Hunt,
Carrick, Szyperski, Proulx-Burns, Burrows, Limacher, Hsia, Asaithambi,
Khan, Nagaraja, Ocava, Wold, Silver, Connelly, Van Lom, Garvida,
Hightower, Spaulding, Lin, Schoenberg, Olee) Fred Hutchinson Cancer
Research Center, Women's Health Initiative, United States
Publisher
Elsevier B.V.
Abstract
Background: Cocoa extract is a source of flavanols that favorably
influence vascular risk factors in small and short-term trials, yet
effects on clinical cardiovascular events are untested. <br/>Objective(s):
We examined whether cocoa extract supplementation decreases total
cardiovascular disease (CVD) among older adults. <br/>Method(s): We
conducted a randomized, double-blind, placebo-controlled, 2-by-2 factorial
trial of cocoa extract supplementation and multivitamins for prevention of
CVD and cancer among 21,442 US adults (12,666 women aged >=65 y and 8776
men aged >=60 y), free of major CVD and recently diagnosed cancer. The
intervention phase was June 2015 through December 2020. This article
reports on the cocoa extract intervention. Participants were randomly
assigned to a cocoa extract supplement [500 mg flavanols/d, including 80
mg (-)-epicatechin] or placebo. The primary outcome was a composite of
confirmed incident total cardiovascular events, including myocardial
infarction (MI), stroke, coronary revascularization, cardiovascular death,
carotid artery disease, peripheral artery surgery, and unstable angina.
<br/>Result(s): During a median follow-up of 3.6 y, 410 participants
taking cocoa extract and 456 taking placebo had confirmed total
cardiovascular events (HR: 0.90; 95% CI: 0.78, 1.02; P = 0.11). For
secondary endpoints, HRs were 0.73 (95% CI: 0.54, 0.98) for CVD death,
0.87 (95% CI: 0.66, 1.16) for MI, 0.91 (95% CI: 0.70, 1.17) for stroke,
0.95 (95% CI: 0.77, 1.17) for coronary revascularization, neutral for
other individual cardiovascular endpoints, and 0.89 (95% CI: 0.77, 1.03)
for all-cause mortality. Per-protocol analyses censoring follow-up at
nonadherence supported a lower risk of total cardiovascular events (HR:
0.85; 95% CI: 0.72, 0.99). There were no safety concerns.
<br/>Conclusion(s): Cocoa extract supplementation did not significantly
reduce total cardiovascular events among older adults but reduced CVD
death by 27%. Potential reductions in total cardiovascular events were
supported in per-protocol analyses. Additional research is warranted to
clarify whether cocoa extract may reduce clinical cardiovascular
events.<br/>Copyright &#xa9; 2022 The Author(s) 2022.

<34>
[Use Link to view the full text]
Accession Number
2041698686
Title
Acute Normovolemic Hemodilution in Cardiac Surgery.
Source
New England Journal of Medicine. 393(19) (pp 1963-1964), 2025. Date of
Publication: 13 Nov 2025.
Author
Monaco F.; Bonizzoni M.A.; Landoni G.
Institution
(Monaco, Bonizzoni, Landoni) IRCCS, San Raffaele Scientific Institute,
Milan, Italy
Publisher
Massachussetts Medical Society

<35>
Accession Number
2042010155
Title
The Effects of Nonintubated Anesthesia onNeutrophil-to-Lymphocyte Ratio
and Tumor Markers Among Patients Undergoing Thoracoscopic Lung Resection:
A Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Liu Z.-L.; Zhao Z.-Z.; Xiao Y.-Q.; Zhang Y.; Ge L.-L.; Luo J.; Zhou Y.;
Bao R.; Deng X.-M.; Wang J.-F.
Institution
(Liu) Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical
University, Jiangsu Province, Xuzhou, China
(Liu, Zhao, Xiao, Zhang, Ge, Luo, Zhou, Bao, Deng, Wang) Faculty of
Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai,
China
Publisher
W.B. Saunders
Abstract
Objectives: To assess the influence of nonintubated anesthesia on the
neutrophil-to-lymphocyte ratio (NLR) and tumor marker level in patients
undergoing thoracoscopic resection of lung cancer. <br/>Design(s): A
prospective, randomized, controlled trial. <br/>Setting(s): A tertiary
medical institution. <br/>Participant(s): Fifty-eight patients underwent
video-assisted thoracoscopic lung surgery. <br/>Intervention(s): Patients
were randomly divided into the nonintubated video-assisted thoracic
surgery group (NIVATS group, n = 29) and the traditional video-assisted
thoracic surgery group (VATS group, n = 29) in a 1:1 allocation ratio.
<br/>Measurements and Main Results: The primary outcome was the NLR in
peripheral blood, measured 24 hours postoperatively. Secondary outcomes
included a range of peripheral blood tumor markers (derived neutrophil to
lymphocyte ratio/lactate dehydrogenase (dNLR/LDH), citrullinated histone
H3, matrix metalloproteinase 9, programmed death ligand 1, systemic
inflammatory immune index, vascular endothelial growth factor) at the same
time point, as well as intraoperative minimum blood oxygen saturation,
thoracotomy conversion rate, blood loss, recovery metrics (chest tube
duration, discharge time), and postoperative complications (chest air
leaks, pneumonia, acute respiratory distress syndrome incidence, new-onset
atrial fibrillation, hoarseness, sore throat, dysphonia). Notably, 24
hours after surgery, the NLR and neutrophil percentage were significantly
lower in the NIVATS group compared to the VATS group (p = 0.031, p =
0.006), accompanied by a higher lymphocyte percentage (p = 0.013).
However, enzyme-linked immunosorbent assay results for peripheral blood
tumor markers showed no significant differences between the 2 groups, both
before and 24 hours after surgery. <br/>Conclusion(s): Compared to the
VATS group, the use of nonintubated anesthesia resulted in less
postoperative NLR elevation but had no significant impact on the levels of
tumor biomarkers.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<36>
Accession Number
648951629
Title
The effects of a light and musicial toy on pain, anxiety, and
physiological parameters during venous blood sampling in children aged 3-6
years: A randomized controlled trial.
Source
Journal of pediatric nursing. 85 (pp 742-753), 2025. Date of Publication:
01 Nov 2025.
Author
Kalkan D.; Sezer T.A.
Institution
(Kalkan) Ankara University, Institute of Health Sciences, Department of
Nursing, Ankara, Turkey
(Sezer) Ankara University, Faculty of Nursing, Department of Pediatric
Nursing, Ankara, Turkey
Abstract
PURPOSE: The aim of this study is to evaluate the effect of a light-up toy
with music played during venous blood sampling on pain, anxiety, and
physiological parameters in children aged 3-6 years. <br/>METHOD(S): This
study was conducted as a randomized controlled trial in parallel groups.
It included children aged 3-6 years (n = 56) who visited the blood
collection clinic of the Children's Hospital at a university hospital in
Ankara between July 2024-April 2025. Children in the intervention group (n
= 28) were given light and music toys before, during the procedure, while
children in the control group (n = 28) underwent the hospital's routine
blood collection procedure. The following forms were used to collect data:
"Child and Parent Identification Form," "Child Emotional Expression
Assessment Scale," "Face, Leg Mobility, Activity, Crying, Consolability
Scale" and "Physiological Parameters Form" were used in data collection.
Data evaluation in the study, video recordings were made during the
procedure, and the videos were evaluated by two independent observers
using scales. <br/>RESULT(S): There was no statistically significant
difference between the intervention group and the control group in terms
of pain and anxiety levels before and during the procedure (p > 0.05).
However, when physiological parameters were examined, there was a
significant difference in heart rate between the two groups during the
procedure, with heart rate being lower in the intervention group(p <
0.05). Oxygen saturation remained stable during the procedure in the
intervention group and did not show a significant decrease, whereas it
decreased significantly in the control group. <br/>CONCLUSION(S): The
study found that light and music toys affect physiological conditions such
as heart rate and oxygen saturation but have limited effects on
psychological responses such as pain and anxiety. PRACTICE IMPLICATION:
The light and music toy can be used in clinics and any environment where
venous blood sampling is performed to maintain and improve physiological
parameters.<br/>Copyright &#xa9; 2025 Elsevier Inc. All rights reserved.

<37>
Accession Number
2041962859
Title
Combining topical and intravenous tranexamic acid in cardiac surgery: does
it really matter? - a systematic review and meta-analysis.
Source
IJC Heart and Vasculature. 62 (no pagination), 2026. Article Number:
101848. Date of Publication: 01 Feb 2026.
Author
Onyeji P.C.; Consoli L.; Kaur A.; Dani S.; Momplaisir-Onyeji S.; Passos
F.S.; Kirov H.; Doenst T.; Caldonazo T.
Institution
(Onyeji) All Saints University School of Medicine, Roseau, Dominica
(Consoli) Faculty of Medicine, Federal University of Bahia, Salvador,
Brazil
(Kaur) The University of Chicago, Chicago, IL, United States
(Dani) GMERS Medical College and Hospital, Sola, Ahmedabad, India
(Momplaisir-Onyeji) American University of Barbados, Wildey, Barbados
(Passos) Department of Thoracic Surgery, MaterDei Hospital, Salvador,
Brazil
(Kirov, Doenst, Caldonazo) Department of Cardiothoracic Surgery, Jena
University Hospital, Jena, Germany
(Caldonazo) Department of Cardiothoracic Surgery, Weil Cornell Medicine,
NY, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: The benefit-to-risk ratio of administration of intravenous
(IV) and topical tranexamic acid (TXA) together in cardiac surgery has not
yet been determined. This study aims to evaluate whether the combined
approach (IV plus topical TXA) offers superior bleeding control compared
to IV TXA alone, while maintaining an acceptable safety profile.
<br/>Method(s): We conducted a systematic review and meta-analysis of
randomized controlled trials (RCTs) and observational studies comparing
combined topical and intravenous TXA administration versus IV TXA alone in
patients undergoing cardiac surgery. The primary outcome was cumulative
blood loss. Secondary outcomes included all-cause mortality,
transfusion-free status, and the number of transfused blood products. A
random-effects model was used for all pooled analyses. <br/>Result(s): We
included a total of five studies (four RCTs, one observational; n = 880).
Pooled analysis showed that the combined approach significantly, but
modest, reduced total blood loss when compared to an IV-only TXA strategy
(MD -39.84, 95 %CI -74.80 to -4.88; p = 0.03; I² = 39 %).
However, this benefit did not translate into a significant reduction in
transfusion requirements (OR 1.00, 95 %CI 0.72 to 1.37; p = 0.98;
I² = 0 %), volume of blood products used (MD -0.01, 95 %CI
-0.04 to 0.02; p = 0.51; I² = 0 %), or all-cause mortality (OR
0.85, 95 %CI 0.24 to 3.08; p = 0.81; I² = 0 %).
<br/>Conclusion(s): Combined topical and IV TXA application is associated
with reduced total blood loss after cardiac surgery compared to an IV-only
approach. However, no significant differences were observed in transfusion
rates, blood product utilization, or mortality.<br/>Copyright &#xa9; 2025
The Author(s)

<38>
Accession Number
649013445
Title
The effect of Kangaroo care on vital signs in infants undergoing cardiac
surgery: A randomized controlled study.
Source
Journal of pediatric nursing. 85 (pp 823-834), 2025. Date of Publication:
01 Nov 2025.
Author
Cengizli D.; Albayrak S.
Institution
(Cengizli) Gelisim University Faculty of Health Sciences, Nursing
Department, Istanbul, Turkey
(Albayrak) Istinye University Faculty of Health Sciences, Nursing
Department, Istanbul, Turkey
Abstract
BACKGROUND AND PURPOSE: This study aimed to determine the effect of
kangaroo care on vital signs in infants undergoing cardiac surgery. DESIGN
AND METHODS: This randomized controlled study was conducted in the
pediatrics cardiovascular surgery intensive care unit of a training
research hospital between December 2023 and March 2024. The sample
consisted of 60 infants who had undergone cardiac surgery, with 30
assigned to the experimental group and 30 to the control group. The
experimental group received kangaroo care during the procedure. Data was
collected via the Descriptive Information Form about sample
characteristics and the Vital Signs and Pain Recording Form. The data were
analyzed using descriptive statistics, Chi-square, independent sample
t-tests, ANOVA, and mixed effect model variance analysis. The study was
recorded in the Clinicaltrials.gov PRS system. <br/>RESULT(S): The
mixed-method comparison showed a high level of significance in the
intervention group regarding heart rate and respiratory rate reductions,
pain score reduction, and increased peripheral saturation levels in both
time and group measurements (p < 0.001). Additionally, the decrease in
systolic blood pressure in the intervention group was significant in the
group measurements (p < 0.001), whereas time-based comparisons showed no
significant changes in diastolic blood pressure (p > 0.05). Comparison of
changes in pre-test and post-test vital signs between the intervention and
control groups were significant, except for diastolic blood pressure (p <
0.05). <br/>CONCLUSION(S): The study demonstrated that post-surgical
kangaroo care in infants undergoing cardiac surgery reduced heart rate,
systolic arterial pressure, and respiratory rate, while increasing
peripheral saturation levels and decreasing pain scores. IMPLICATIONS FOR
PRACTICE: The integration of kangaroo care into post-cardiac surgery care
practices may lead to improvements in infants' vital signs and promote
relaxation through mother-infant skin-to-skin contact. This, in turn,
could potentially enhance family-centered care practices in cardiac
surgery units, and, in the future, improve the quality of care outcomes
for both mothers and infants.<br/>Copyright &#xa9; 2025 Elsevier Inc. All
rights reserved.

<39>
Accession Number
649171832
Title
Five-Year Outcomes of Transcatheter Versus Surgical Aortic Valve
Replacement in Women: A Systematic Review and Meta-Analysis.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. 67(12) (no pagination),
2025. Date of Publication: 01 Dec 2025.
Author
Wolf S.E.M.; Kucera J.A.; Gregg A.C.; Di Franco A.; Rahouma M.; Redfors
B.; Reardon M.; Pineda A.M.; Gaca J.G.; Zwischenberger B.A.
Institution
(Wolf, Kucera, Gaca, Zwischenberger) Division of Cardiothoracic Surgery,
Department of Surgery, Duke University Medical Center, Durham, United
States
(Gregg, Di Franco, Rahouma, Redfors) Department of Cardiothoracic Surgery,
Weill Cornell Medicine, New York, NY, 10021, United States
(Redfors) Department of Population Health Sciences, Weill Cornell
Medicine, New York, NY, 10021, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Redfors) Department of Molecular and Clinical Medicine, Gothenburg
University, Gothenburg, Sweden
(Reardon) Department of Cardiovascular Surgery, Houston Methodist
Hospital, Houston, TX, United States
(Pineda) Division of Cardiology, Department of Medicine, Duke University
Medical Center, Durham, NC, United States
Abstract
OBJECTIVES: Women patients with aortic stenosis (AS) exhibit distinct
anatomic and physiologic features that may influence outcomes after valve
replacement. While transcatheter aortic valve replacement (TAVR) has shown
early advantages over surgical aortic valve replacement (SAVR) in women,
long-term sex-specific outcomes remain unclear. To evaluate outcomes at 5
years comparing TAVR versus SAVR a systematic review and meta-analysis was
performed. <br/>METHOD(S): A systematic literature review was conducted,
identifying all randomized controlled trials (RCTs) comparing TAVR with
SAVR which included women with completed 5-year follow-up. The primary
outcome was the composite of all-cause mortality or disabling stroke.
Meta-analysis was performed using both random-effects and fixed-effect
models. The study protocol was registered in PROSPERO (CRD420251004394).
<br/>RESULT(S): Six RCTs were included with a total of 3094 women (1587
TAVR and 1507 SAVR). Overall, no significant difference was observed in
the primary outcome between TAVR and SAVR (incidence rate ratios [IRRs]
1.00, 95% confidence interval [CI]: 0.88-1.13, P = .98). Meta-regression
did not find any association between key clinical covariates and the
primary outcome. Trial sequential analysis demonstrated that the extracted
sample size met the required information size, but a definitive treatment
effect was not confirmed. <br/>CONCLUSION(S): While TAVR shows an
advantage over SAVR at 1-year follow-up in women, all-cause mortality or
disabling stroke is similar in TAVR and SAVR at 5 years. Future studies
must include sex-disaggregated reporting of both primary and secondary
outcomes in order to comprehensively weigh risks and benefits of each
intervention and inform personalized treatment strategies. CLINICAL
REGISTRATION NUMBER: The study protocol was registered in PROSPERO
(CRD420251004394).<br/>Copyright &#xa9; The Author(s) 2025. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. All rights reserved. For commercial re-use,
please contact reprints@oup.com for reprints and translation rights for
reprints. All other permissions can be obtained through our RightsLink
service via the Permissions link on the article page on our site-for
further informat

<40>
Accession Number
2037372605
Title
Mechanical circulatory support in high-risk elective PCI: rationale and
design of the PROTECT IV trial.
Source
EuroIntervention. 21(21) (pp 1244-1258), 2025. Date of Publication: 2025.
Author
Mangner N.; Sharma S.K.; O'connor C.; Kaki A.; Dangas G.D.; Moses J.W.;
Mahmud E.; Tarantini G.; Achenbach S.; Pocock S.J.; O'neill W.W.; Grines
C.L.; Lansky A.J.; Wollmuth J.R.; Narula J.; Karmpaliotis D.I.; Faraz
H.A.; . Basir M.B.; Bharadwaj A.S.; Ali Z.A.; Simonton C.; Bilazarian
S.D.; Kapur N.K.; Chapman R.C.; Bentley D.; Popma J.J.; Maehara A.;
Windecker S.; Stone G.W.
Institution
(Mangner) Department of Internal Medicine and Cardiology, Heart Center
Dresden, Technische Universitat Dresden, Dresden, Germany
(Sharma, Stone) Icahn School of Medicine at Mount Sinai, New York, NY,
United States
(O'connor) Inova Heart and Vascular Institute, Falls Church, VA, United
States
(Kaki) Department of Cardiology, Henry Ford St. John Hospital, Detroit,
MI, United States
(Dangas) Beth Israel Deaconess Medical Center, Boston, MA, United States
(Dangas, Popma, Maehara) Cardiovascular Research Foundation, New York, NY,
United States
(Moses) Division of Cardiology, Columbia University Medical Center, New
York, NY, United States
(Moses) Division of Cardiology, St. Francis Heart Center, Roslyn, NY,
United States
(Mahmud) Division of Cardiovascular Medicine, University of California San
Diego, La Jolla, CA, United States
(Tarantini) Department of Cardiac, Thoracic and Vascular Sciences,
Division of Cardiology, University of Padova, Padua, Italy
(Achenbach) Department of Medicine 2 - Cardiology and Angiology,
Friedrich-Alexander University Erlangen-Nurnberg (FAU)
Universitatsklinikum, Erlangen, Germany
(Pocock) Department of Medical Statistics, London School of Hygiene and
Tropical Medicine, London, United Kingdom
(O'neill, . Basir) Division of Cardiology, Henry Ford Hospital, Detroit,
MI, United States
(Grines) Northside Hospital Heart Institute, Atlanta, GA, United States
(Lansky) Yale New Haven Hospital, New Haven, CT, United States
(Wollmuth) Providence Heart Institute, Portland, OR, United States
(Narula) University of Texas Health Science Center, UTHealth Houston,
Houston, TX, United States
(Karmpaliotis) Division of Cardiology, Morristown Medical Center,
Morristown, NJ, United States
(Faraz) Department of Cardiology and Cardiothoracic Surgery, Hackensack
University Medical Center, Hackensack, NJ, United States
(Bharadwaj) Division of Cardiology, Loma Linda University Medical Center,
Loma Linda, CA, United States
(Ali) St. Francis Hospital, Rosyln, NY, United States
(Simonton, Bilazarian, Kapur, Chapman, Bentley) Abiomed, J&J MedTech Heart
Recovery, Danvers, MA, United States
(Windecker) Department of Cardiology, Inselspital, Bern University
Hospital, University of Bern, Bern, Switzerland
Publisher
Europa Group
Abstract
Coronary artery disease (CAD) is the leading cause of heart failure with
reduced ejection fraction (HFrEF). Coronary artery bypass grafting (CABG)
improves long-term mortality in HFrEF. Percutaneous coronary intervention
(PCI) is often performed as an alternative to CABG in patients at high
surgical risk. However, in patients with HFrEF and limited myocardial
reserve, PCI may result in haemodynamic instability, increasing risk and
precluding optimal revascularisation. Mechanical circulatory support (MCS)
during high-risk PCI may enhance haemodynamic stability during the
procedure and enable complete revascularisation. We thus performed the
PROTECT IV trial to determine whether PCI with routine use of the Impella
CP microaxial flow pump improves early and late outcomes in patients with
HFrEF and complex CAD compared with PCI with or without use of an
intra-aortic balloon pump (IABP). PROTECT IV is a prospective,
multicentre, randomised, parallel-controlled, open-label, superiority
trial with an adaptive design. Patients with complex CAD and left
ventricular ejection fraction <=40% (n=1,252) deemed at excessive surgical
risk for bypass grafting by the Heart Team will be randomised in a 1:1
ratio to PCI with Impella CP versus PCI with or without an IABP. The
primary endpoint is the composite of all-cause death, stroke, myocardial
infarction, unplanned clinically driven revascularisation, durable left
ventricular assist device implant or heart transplant, or other
hospitalisation for cardiovascular causes at 3-year follow-up, with at
least 1-year follow-up in all patients. Prespecified substudies will
evaluate the impact of MCS on renal function, the procedural role of right
heart catheterisation, and the utility of myocardial viability assessment.
The PROTECT IV trial will determine whether routine MCS with Impella CP
during high-risk PCI improves the prognosis of patients with complex CAD
and HFrEF.<br/>Copyright &#xa9; Europa Group 2025. All rights reserved.

<41>
Accession Number
2037523460
Title
Alterations in the intestinal microbiome and immune dysregulation in
infants with CHD undergoing cardiopulmonary bypass: a scoping review.
Source
Cardiology in the Young. 35(3) (pp 444-449), 2025. Date of Publication: 01
Mar 2025.
Author
Prout A.J.; Meert K.L.; Al-Ahmadi M.; Dickson R.P.
Institution
(Prout, Meert) Department of Pediatrics, Central Michigan University
College of Medicine, Mt. Pleasant, MI, United States
(Prout, Meert) Division of Pediatric Critical Care Medicine, Department of
Pediatrics, Children's Hospital of Michigan, Detroit, MI, United States
(Al-Ahmadi) Division of Pediatric Cardiovascular Surgery, Department of
Surgery, Children's Hospital of Michigan, Detroit, MI, United States
(Dickson) Division of Pulmonary and Critical Care Medicine, Department of
Internal Medicine, University of Michigan Medical School, Ann Arbor, MI,
United States
(Dickson) Department of Microbiology and Immunology, University of
Michigan Medical School, Ann Arbor, MI, United States
(Dickson) Weil Institute for Critical Care Research & Innovation, Ann
Arbor, MI, United States
Publisher
Cambridge University Press
Abstract
Background: Infants who require cardiopulmonary bypass for surgical repair
of CHD are at high risk for secondary infections, which cause significant
death and disability. The risk of secondary infection is increased by
immune dysfunction. The intestinal microbiome calibrates immune function.
Infants with CHD have substantial changes in their intestinal microbiome.
We performed this scoping review to describe the current understanding of
the relationship between the intestinal microbiome and immune function
after pediatric cardiac surgery with cardiopulmonary bypass.
<br/>Method(s): We searched the PubMed, Cumulative Index to Nursing and
Allied Health Literature, Cochrane, and Scopus databases with the
assistance of a medical librarian. We included trials that analysed
intestinal microbiome composition and immune function after cardiac
surgery with cardiopulmonary bypass in infants. <br/>Result(s): We found
two observational cohorts and two interventional trials describing
composition of intestinal microbiome and some measures of immune function
after heart surgery with cardiopulmonary bypass in infants. A total of 114
children were analysed. Three trials were exclusively in infants, and one
was in older children and infants. All trials found a differential
composition of the intestinal microbiome in infants with CHD compared to
those without CHD, and one described a robust correlation between
composition of the intestinal microbiome with cytokine profile and adverse
outcomes. <br/>Conclusion(s): Despite robust preclinical data and data
from other disease states, there is minimal data about the correlation
between immune function and intestinal microbiome composition in infants
with CHD after cardiopulmonary bypass.<br/>Copyright &#xa9; The Author(s),
2025.

<42>
Accession Number
2038588211
Title
No-touch versus conventional vein in coronary artery bypass grafting:
Three year follow-up of multicentre randomised PATENCY trial.
Source
BMJ. 389 (no pagination), 2025. Article Number: e082883. Date of
Publication: 2025.
Author
Tian M.; Wang X.; Feng W.; Wang H.; Liu S.; Liu Z.; Chen Y.; Miao Q.; Su
P.; Li X.; Wang Y.; Lu B.; Chen K.; Zhang C.; Hu S.
Institution
(Tian, Wang, Feng, Chen, Zhang, Hu) Department of Surgery, National Center
for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of
Medical Sciences, Peking Union Medical College, Beijing, China
(Wang) Beijing Hospital, Beijing, China
(Liu) The Second Hospital of Hebei Medical University, Hebei Province,
Shijiazhuang, China
(Liu) Teda International Cardiovascular Hospital, Chinese Academy of
Medical Sciences, Peking Union Medical College, Tianjin, China
(Chen) The Second People's Hospital of Anhui Province, Anhui Province,
Hefei, China
(Miao) Peking Union Medical College Hospital, Chinese Academy of Medical
Sciences, Peking Union Medical College, Beijing, China
(Su) Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
(Li) National Clinical Research Center for Cardiovascular Diseases,
National Center for Cardiovascular Disease, China & Fuwai Hospital,
Chinese Academy of Medical Sciences, Peking Union Medical College,
Beijing, China
(Wang) Medical Research & Biometrics Center, National Center for
Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical
Sciences, Peking Union Medical College, Beijing, China
(Lu) Department of Radiology, National Center for Cardiovascular Disease,
China & Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union
Medical College, Beijing, China
Publisher
BMJ Publishing Group
Abstract
OBJECTIVE To assess the three year outcomes of the no-touch vein
harvesting technique in coronary artery bypass grafting surgery compared
with the conventional approach. DESIGN Three year extended follow-up of
the randomised PATENCY (graft patency between the no-touch vein harvesting
technique and conventional approach in coronary artery bypass graft
surgery) trial. SETTING Seven cardiac surgery centres in China; enrolment
between April 2017 and June 2019. PARTICIPANTS 2655 participants aged 18
and older undergoing isolated coronary artery bypass grafting surgery.
INTERVENTIONS Patients were randomly assigned 1:1 to the no-touch vein
harvesting technique group or the conventional approach group during
surgery and followed up. MAIN OUTCOME MEASURES Vein graft occlusion (based
on computed tomography angiography) at three years. RESULTS Mean age of
participants was 61 years (standard deviation +/-8 years) and 22% were
women. 99.4% (2621) attended the three year follow-up visit, while 86.5%
(2281) received computed tomography angiography. At three years, the
no-touch group showed a significantly lower vein graft occlusion rate
(5.7% v 9.0%, P<0.001) than the conventional group (odds ratio 0.62, 95%
confidence interval 0.48 to 0.80), with absolute risk difference of -3.2%
(95% confidence interval -5.0% to -1.4%). The intentionto- treat analysis,
including all 2655 randomised patients with multiple imputations for
missing data, showed consistent findings, with occlusion rates of 6.1% in
the no-touch group versus 9.3% in the conventional group (odds ratio 0.63,
95% confidence interval 0.51 to 0.81; absolute risk difference-3.1%, 95%
confidence interval -4.9% to -1.4%; P<0.001). These results confirm the
robustness of the no-touch technique in reducing vein graft occlusion.
CONCLUSIONS The no-touch technique consistently and robustly reduced the
risk of vein graft occlusion and several cardiac events by one third to
one half within three years after coronary artery bypass grafting
surgery.<br/>Copyright &#xa9; 2025 BMJ Publishing Group. All rights
reserved.

<43>
Accession Number
2039027984
Title
P2Y<inf>12</inf>inhibitor or aspirin after percutaneous coronary
intervention: Individual patient data meta-analysis of randomised clinical
trials.
Source
BMJ. 389 (no pagination), 2025. Article Number: e082561. Date of
Publication: 2025.
Author
Giacoppo D.; Gragnano F.; Watanabe H.; Kimura T.; Kang J.; Park K.-W.; Kim
H.-S.; Pettersen A.-A.; Bhatt D.L.; Pocock S.; Mehran R.; Valgimigli M.
Institution
(Giacoppo) Department of General Surgery and Medical-Surgical Specialties,
University of Catania, Catania, Italy
(Giacoppo) Cardiovascular Research Institute Dublin, Royal College of
Surgeons in Ireland, Dublin, Ireland
(Giacoppo) ISAResearch Zentrum, German Heart Centre, Munich, Germany
(Gragnano) Department of Translational Medical Sciences, University of
Campania Luigi Vanvitelli, Caserta, Italy
(Watanabe, Kimura) Division of Cardiology, Hirakata Kohsai Hospital,
Hirakata, Japan
(Kang, Park, Kim) Cardiovascular Centre, Department of Internal Medicine,
Seoul National University Hospital, Seoul, South Korea
(Pettersen) Department of Cardiology, Ringerike Hospital, Vestre Viken Hf,
Drammen, Norway
(Bhatt, Mehran) Icahn School of Medicine at Mount Sinai, New York, NY,
United States
(Pocock) Department of Medical Statistics, London School of Hygiene and
Tropical Medicine, London, United Kingdom
(Mehran) Cardiovascular Research Foundation, New York, NY, United States
(Valgimigli) Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale,
Lugano, Switzerland
(Valgimigli) Department of Cardiology, Bern University Hospital,
University of Bern, Bern, Switzerland
Publisher
BMJ Publishing Group
Abstract
OBJECTIVE To assess the long term comparative effectiveness of P2Y12
inhibitor monotherapy compared with aspirin monotherapy in patients after
percutaneous coronary intervention (PCI) and discontinuation of dual
antiplatelet therapy (DAPT). DESIGN Individual participant data (IPD)
meta-analysis of randomised clinical trials. DATA SOURCES PubMed/Medline,
Scopus, Web of Science, and Ovid/ Embase. ELIGIBILITY CRITERIA FOR
SELECTING STUDIES Randomised trials investigating monotherapy with a P2Y12
inhibitor or aspirin for secondary prevention of ischaemic events in
patients with coronary artery disease who underwent PCI. DATA EXTRACTION
AND SYNTHESIS Anonymised IPD were extracted and transferred to the
coordinating centre by dedicated electronic spreadsheets. Data were
primarily combined by mixed effects models (one stage analysis) and
complemented with multivariable mixed effects models and two stage
analyses based on random effects models. The primary and co-primary
outcomes were a composite of major adverse cardiac and cerebrovascular
events (MACCE) and major bleeding, respectively. The secondary outcomes
included a net composite of adverse cardiac and cerebrovascular events
(NACCE), derived from the combination of the primary and co-primary
outcomes, and individual ischaemic and bleeding events. RESULTS A total of
16 117 patients assigned to P2Y12 inhibitor or aspirin monotherapy after
PCI and completion of the recommended DAPT regimen (median duration of 12
months) in five randomised trials were included. At a median follow-up of
1351 days (interquartile range 373-1791 days), P2Y12 inhibitor monotherapy
was associated with a lower risk of MACCE compared with aspirin
monotherapy (one stage analysis: hazard ratio 0.77 (95% confidence
interval (CI) 0.67 to 0.89), P<0.001; multivariable one stage analysis:
adjusted hazard ratio 0.77 (0.67 to 0.89), P<0.001; two stage analysis:
hazard ratio 0.77 (0.67 to 0.89), P<0.001), yielding a number needed to
treat to benefit of 45.5 (95% CI 31.4 to 93.6). No significant difference
in major bleeding (one stage analysis: hazard ratio 1.26 (0.78 to 2.04),
P=0.35; multivariable one stage analysis: 1.12 (0.74 to 1.70), P=0.60; two
stage analysis: 1.15 (0.69 to 1.92), P=0.59) was observed. NACCE,
myocardial infarction, and stroke were lower in patients assigned to a
P2Y12 inhibitor compared with those assigned to aspirin. These findings
were confirmed across multiple sensitivity and subgroup analyses.
CONCLUSIONS In patients who had undergone PCI and discontinued DAPT, at a
follow-up of about 5.5 years, P2Y12 inhibitor monotherapy with ticagrelor
or clopidogrel was associated with lower MACCE, owing to reduced rates of
myocardial infarction and stroke compared with aspirin monotherapy,
without a concurrent increased risk of major bleeding.<br/>Copyright
&#xa9; 2025 BMJ Publishing Group. All rights reserved.

<44>
Accession Number
2030657405
Title
Understanding the role of surgical intervention for patients with
concomitant degenerative spinal disease without deformity and Parkinson's
disease: a meta-analysis.
Source
British Journal of Neurosurgery. 39(6) (pp 798-806), 2025. Date of
Publication: 2025.
Author
Osborne-Grinter M.; Copley P.; Khan S.; Kaliaperumal C.
Institution
(Osborne-Grinter, Copley, Khan, Kaliaperumal) Department of Neurosurgery,
Royal Hospital for Children and Young People, Edinburgh BioQuarter,
Edinburgh, United Kingdom
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Parkinson's disease is a common neurodegenerative disease.
With an aging population, co-existent degenerative diseases of the spine
in these patients will become more prevalent. Research Question: This
systematic review and meta-analysis aims to establish the incidence and
risk of adverse outcomes following spinal surgery in patients with
Parkinson's disease. Material and Methods A literature review was carried
out in order to identify studies assessing the outcomes of adult patients
with Parkinson's disease undergoing spinal surgery for degenerative
conditions. Studies with less than ten subjects or those assessing surgery
for spinal deformity or trauma were excluded. <br/>Result(s): Of 74
studies identified, seven were included for meta-analysis. In the 689,578
participants, there was a significantly higher incidence, but not higher
risk, of complications (0.54 95% CI [0.19-0.85] vs 0.07 95% CI
[0.01-0.41]; p = 0.048) and revision surgery (0.6 95% CI [0.25-0.88] vs
0.1 95% CI [0.05-0.19]; p = 0.003) amongst patients with Parkinson's
disease compared to controls. We also demonstrated a significantly lower
incidence but not lower risk of clinical improvement (0.27 95% CI
[0.16-0.41] vs 0.57 95% CI [0.36-0.76]; p = 0.02) after surgery in
patients with Parkinson's disease. There was no difference in the
incidence or risk of death following surgery. Discussion and
<br/>Conclusion(s): Spinal surgery for concomitant degenerative diseases
in patients with Parkinson's disease is associated with a lower incidence
of clinical improvement and a higher incidence of complications. Medical
management should be optimised before an individually tailored and
well-considered surgical intervention is implemented.<br/>Copyright &#xa9;
2024 The Neurosurgical Foundation.

<45>
Accession Number
2041435606
Title
Hybrid procedures in the management of hypoplastic left heart syndrome: A
systematic review.
Source
Cardiology in the Young. 35(11) (pp 2200-2221), 2025. Date of Publication:
01 Nov 2025.
Author
Labartkava N.
Institution
(Labartkava) University of Bergamo, Italy
Publisher
Cambridge University Press
Abstract
Background/Objectives: Hypoplastic left heart syndrome is considered one
of the most severe CHDs and occurs in approximately 2-3% of all CHD cases.
Hybrid procedures have been introduced as an alternative to traditional
surgical techniques, such as the Norwood procedure, particularly for
neonates at high risk. Although hybrid approaches claim to reduce surgical
risks and improve recovery, little is known regarding their comparative
effectiveness and safety. This review aims to describe the contribution of
hybrid procedures in hypoplastic left heart syndrome management regarding
survival rates, postoperative complications, and quality of life, through
recovery outcomes and long-term results, in light of conventional surgical
techniques. <br/>Method(s): A systematic review was carried out following
the PRISMA guidelines. Data were retrieved from PubMed, Scopus, Web of
Science, and Cochrane Library. The search articles were published from
January 2014 to November 2024. Inclusion was focused on paediatric
patients diagnosed with hypoplastic left heart syndrome and studies
comparing hybrid procedures versus traditional surgical methods. All
screening, data extraction, and quality assessment were done by two
independent reviewers. <br/>Result(s): This review analysed data from 11
studies comprising 934 neonates with hypoplastic left heart syndrome, of
whom 371 underwent hybrid procedures (HP) and 563 received the Norwood
procedure. The findings demonstrated that both approaches achieved
comparable survival rates at 1, 3, and 5 years. Hybrid procedures were
linked to slightly earlier interventions (standardised mean difference =
-0.10, 95% confidence interval: -0.61 to 0.41, p = 0.77) and were favored
for high-risk neonates due to reduced invasiveness. However, hybrid
procedures showed a higher rate of interstage events (risk ratio = 0.81),
95% confidence interval: -0.62 to 2.25, p = 0.09) and higher rates of
pulmonary artery stenosis requiring reinterventions (30% vs. 18% for
Norwood). Norwood procedures were associated with fewer reinterventions
and lower interstage event rates, highlighting their effectiveness for
stable patients. <br/>Conclusion(s): Hybrid procedures offer a practical
alternative to the Norwood procedure, especially for high-risk neonates.
Although both approaches show similar long-term survival rates, hybrid
procedures are associated with a higher risk of complications, including
increased interstage mortality. These challenges highlight the need for
continued advancements to refine hybrid techniques and to improve
long-term outcomes. This review emphasises the critical role of tailored
patient selection and calls for further research to enhance hybrid
procedure protocols and optimise their effectiveness for specific patient
populations.<br/>Copyright &#xa9; The Author(s), 2025. Published by
Cambridge University Press.

<46>
Accession Number
2041977675
Title
Temporal Trends in Device-related Thrombosis Following Left Atrial
Appendage Occlusion: A Systematic Review and Meta-Analysis.
Source
Radiology: Cardiothoracic Imaging. 7(5) (no pagination), 2025. Article
Number: e240361. Date of Publication: 01 Oct 2025.
Author
Rajabi T.; Li W.; Nabipoorashrafi S.A.; Chalian H.
Institution
(Rajabi, Li) University of Rochester School of Medicine and Dentistry,
Rochester, NY, United States
(Nabipoorashrafi, Chalian) Department of Radiology, University of
Washington, 1959 NE Pacific St Rm RR215F, Box 357115, Seattle, WA, United
States
Publisher
Radiological Society of North America Inc.
Abstract
Purpose: To perform a systematic review and meta-analysis to evaluate
longitudinal trends in the incidence of device-related thrombosis (DRT)
following left atrial appendage occlusion (LAAO), with the aim of
informing future postprocedural surveillance schedules. <br/>Material(s)
and Method(s): PubMed, Embase, and Cochrane Library databases were
retrospectively searched up to May 2023 for clinical trials and
observational studies with at least 20 adults who underwent LAAO and had a
DRT detected with CT or transesophageal echocardiography. DRT events were
stratified by time since procedure, and cumulative incidence rates were
calculated using random-effects and mixed-effects models. Quality
assessments were completed using the Risk Of Bias In Non-randomized
Studies-of Interventions (ROBINS-I) and Strengthening the Reporting of
Observational Studies in Epidemiology (STROBE) guidelines. <br/>Result(s):
A review of 2181 records resulted in the inclusion of 96 articles,
encompassing 18 024 patients (mean ages ranged from 63.5 years +/- 7.3
[SD] to 92.9 years +/- 2.8; 61.7% male [11 121 of 18 024]). The total DRT
incidence was 2.65% (478 of 18 024; range, 0%-17.5%). The mean cumulative
DRT incidence rates using the random-effects model were 0.83% (n = 996;
95% CI: 0.23, 2.98; I² = 0.0%) at 30 days, 1.24% (n = 10 909;
95% CI: 0.90, 1.70; I² = 37.3%) at 45 days, 2.14% (n = 4559;
95% CI: 1.41, 3.25; I² = 36.9%) at 90 days, 2.06% (n = 8088;
95% CI: 1.45, 2.92; I² = 62.5%) at 180 days, and 2.9% (n =
7346; 95% CI: 2.07, 4.06; I² = 70.6%) beyond 180 days. Similar
results were achieved with the mixed-effects model. <br/>Conclusion(s):
DRT incidence changed over time following LAAO. The greatest rise in the
incidence occurred during the first 90 days after the procedure, although
the cumulative rates continued to increase beyond 180 days.<br/>Copyright
&#xa9; RSNA, 2025.

<47>
Accession Number
2041844441
Title
Comparison of propofol, etomidate and remimazolam on postinduction
hypotension in older adults undergoing non-cardiac surgery: Protocol for a
randomised controlled trial.
Source
BMJ Open. 15(11) (no pagination), 2025. Article Number: e10545. Date of
Publication: 21 Nov 2025.
Author
Jin X.-F.; Shen C.-Y.; Dou W.; Liu H.; Ji F.-H.; Peng K.
Institution
(Jin, Shen, Dou, Ji, Peng) Department of Anaesthesiology, First Affiliated
Hospital of Soochow University, Jiangsu, Suzhou, China
(Jin, Dou, Ji, Peng) Institute of Anaesthesiology, Soochow University,
Jiangsu, Suzhou, China
(Shen) Anaesthesia Nursing Unit, Department of Anaesthesiology, First
Affiliated Hospital of Soochow University, Jiangsu, Suzhou, China
(Liu) Department of Anaesthesiology and Pain Medicine, University of
California Davis Medical Center, Sacramento, CA, United States
Publisher
BMJ Publishing Group
Abstract
Introduction Post-induction hypotension (PIH) is a critical concern in
elderly surgical patients and is associated with adverse postoperative
outcomes. This trial aims to compare the effects of propofol, etomidate
and remimazolam on the incidence of PIH in older adults undergoing
non-cardiac surgery. Methods and analysis In this single-centre,
triple-arm, randomised controlled trial, 210 patients aged >=80 years with
American Society of Anaesthesiologists physical status I-III undergoing
elective non-cardiac surgery will be recruited. All patients will receive
general anaesthesia with endotracheal intubation. Patients will be
randomised (1:1:1) to receive propofol, remimazolam or etomidate for
anaesthesia induction (n=70 per group). The primary outcome is the
incidence of PIH (mean arterial pressure (MAP) <65 mm Hg for 1 min) from
induction initiation to surgical skin incision. Secondary outcomes include
time to successful induction, time to tracheal intubation, MAP reduction
>30% from baseline, vasopressor requirements, bradycardia, injection pain,
myoclonus, postoperative delirium, and cardiac, cerebral and renal
complications during hospitalisation. Ethics and dissemination This trial
was approved by the Ethics Committee of the First Affiliated Hospital of
Soochow University (Approval No. 2024-380). The results will be
peer-reviewed for publication in a scientific journal.<br/>Copyright
&#xa9; Author(s) (or their employer(s)) 2025.

<48>
Accession Number
2040260277
Title
Left atrial appendage closure vs oral anticoagulation for stroke
prevention in atrial fibrillation: Long-term outcomes from 4 randomized
trials.
Source
Heart Rhythm. 22(11) (pp e1086-e1096), 2025. Date of Publication: 01 Nov
2025.
Author
Kaisaier W.; Xu Z.; Guo L.; Dong Y.; Chen Y.; Lip G.Y.H.; Zhu W.
Institution
(Kaisaier, Dong, Chen, Zhu) Department of Cardiology, First Affiliated
Hospital of Sun Yat-Sen University, Guangzhou, China
(Xu) Department of Emergency, Third Affiliated Hospital of Sun Yat-sen
University, Guangzhou, China
(Guo) Department of Cardiology, Jiangxi Provincial People's Hospital,
First Affiliated Hospital of Nanchang Medical College, Nanchang, China
(Lip) Liverpool Centre for Cardiovascular Science, University of
Liverpool, Liverpool John Moores University, Liverpool Heart & Chest
Hospital, Liverpool, United Kingdom
(Lip) Department of Clinical Medicine, Danish Center for Health Services
Research, Aalborg University, Aalborg, Denmark
Publisher
Elsevier B.V.
Abstract
Background Left atrial appendage closure (LAAC) is primarily indicated for
stroke prevention in patients with atrial fibrillation (AF) who have
contraindications to long-term oral anticoagulants (OACs). However, the
long-term comparative benefits of LAAC vs OACs in the broader AF
population remain unclear. Objective To study aimed to assess the
long-term efficacy and safety of LAAC compared with OACs in patients with
AF, we conducted a meta-analysis of randomized controlled trials (RCTs).
Methods We systematically searched PubMed, Embase, and Cochrane Library
for eligible RCTs. Risk ratios (RRs) with 95% confidence intervals (CIs)
were calculated using fixed-effects models. Results Four RCTs involving
3116 patients with AF (1736 assigned to LAAC and 1380 to OACs) and
follow-up durations ranging from 36 to 49.6 months were included. Compared
with OACs, LAAC was associated with reduced risks of all-cause death (RR =
0.78; 95% CI: 0.64-0.95) and cardiovascular or unexplained death (RR =
0.69; 95% CI: 0.51-0.94). There were no significant differences between
the 2 groups in stroke or systemic embolism, ischemic stroke, or systemic
embolism, and non-cardiovascular death. LAAC was associated with
significantly lower risk of hemorrhagic stroke (RR = 0.34; 95% CI:
0.16-0.76) and non-procedural clinically relevant bleeding (RR = 0.49; 95%
CI: 0.40-0.61). Major bleeding (including procedural and non-procedural)
risk did not differ significantly between groups. Conclusion In this
meta-analysis of RCTs, LAAC was associated with significantly lower risks
of all-cause and cardiovascular death, hemorrhagic stroke, and
non-procedural clinically relevant bleeding compared with OACs, without
increasing the risk of thromboembolic events or major bleeding. These
findings support the consideration of LAAC as an alternative to OAC in
selected patients with AF.<br/>Copyright &#xa9; 2025 Heart Rhythm Society.

<49>
Accession Number
2041502110
Title
Long-Term Therapy with Long-Acting Lipoglycopeptide Antibiotics in the
Treatment of Cardiovascular Prosthetic Infections: A Systematic Review.
Source
Antibiotics. 14(11) (no pagination), 2025. Article Number: 1130. Date of
Publication: 01 Nov 2025.
Author
Gavaruzzi F.; Granata G.; Capone A.; Chinello P.; Cicalini S.
Institution
(Gavaruzzi, Granata, Capone, Chinello, Cicalini) Clinical and Research
Department for Infectious Diseases, Systemic and Immune
Depression-Associated Infections Unit, National Institute for Infectious
Diseases "Lazzaro Spallanzani"-IRCCS, Rome, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Dalbavancin and oritavancin are long-acting lipoglycopeptides
increasingly used off-label for a variety of Gram-positive infections.
While their efficacy has been described in osteomyelitis, bacteremia, and
infective endocarditis, evidence specifically addressing cardiovascular
prosthetic infections such as prosthetic valve endocarditis (PVE), cardiac
implantable electronic device (CIED) infections, left ventricular assist
device infections (LVAD), and prosthetic vascular graft infections (PVGI)
remains limited. These conditions are particularly challenging due to
biofilm formation, difficulties in achieving surgical source control, and
the frequent need for prolonged or suppressive therapy. <br/>Objective(s):
This systematic review aimed to summarize the available literature on the
use of dalbavancin and oritavancin in cardiovascular prosthetic
infections, with a focus on therapeutic strategies, clinical outcomes, and
safety. <br/>Method(s): We performed a systematic search of PubMed,
Embase, Scopus, and Cochrane Library up to 24 June 2025 in accordance with
PRISMA guidelines. Eligible studies included adults treated with
dalbavancin or oritavancin for cardiovascular prosthetic infections. Data
on study characteristics, population demographics, causative pathogens,
and microbiological profiles, antibiotic regimens, treatment duration, use
of therapeutic drug monitoring (TDM), indication or non-indication for
chronic suppressive therapy, adverse events, clinical outcomes, and
clinical efficacy were extracted. <br/>Result(s): Twenty studies
comprising 113 patients were identified, of whom 111 received dalbavancin
and 2 oritavancin. The main infections were PVE, CIED, LVAD, and PVGI.
Dalbavancin was most effective as consolidation therapy after surgery or
device removal, with high cure rates. Prolonged regimens were used as
bridging or in partially treated cases, sometimes supported by TDM or
PET/CT. Chronic suppressive therapy, mainly for LVAD and PVGI infections,
achieved variable outcomes with relapses in about one fifth of patients.
Adverse events were infrequent and generally mild. <br/>Conclusion(s): The
included studies were highly diverse, conducted in various settings and
with different objectives. Eight of the twenty included studies were
single case reports on dalbavancin and oritavancin, highlighting the
predominance of individual case descriptions in the available literature.
Long-acting lipoglycopeptides may represent a valuable option for
cardiovascular prosthetic infections. Their role appears most favorable as
consolidation after adequate source control, while chronic suppressive use
showed heterogeneous outcomes. This systematic review was registered on
Open Science Framework. This work was supported by grants from the Italian
Ministry of Health through Ricerca Corrente, Linea 3, Progetto
3.<br/>Copyright &#xa9; 2025 by the authors.

<50>
Accession Number
2041876960
Title
Tricuspid Valve Repair in Pediatric Patients Using Artificial Neochordae:
Systematic Review of Current Evidence.
Source
World Journal for Pediatric and Congenital Heart Surgery. 17(1) (pp
113-119), 2026. Date of Publication: 01 Jan 2026.
Author
Crea D.; Padalino M.; Bortolotti U.; Stellin G.
Institution
(Crea, Stellin) University of Padova, Padova, Italy
(Padalino) Department of Precision and Regenerative Medicine and Jonic
Area, University of Bari "Aldo Moro", Bari, Italy
(Bortolotti) Cardiothoracic and Vascular Department, University of Pisa,
Pisa, Italy
Publisher
SAGE Publications Inc.
Abstract
Artificial neochordae crafted from expanded polytetrafluoroethylene are
commonly utilized in mitral valve repair. Yet their application in
tricuspid valve repair, particularly in the pediatric demographic, remains
relatively unexplored. Upon reviewing the available literature, we have
identified pediatric patients with tricuspid valve regurgitation,
primarily of congenital origin and diagnosed at birth, who underwent
repair procedures involving artificial neochordal implantation.
Postoperatively, trivial-to-mild tricuspid regurgitation was predominantly
observed in most cases. Operative mortality appears to be low, but a
reliable estimate of operative mortality rates, early failure, and
reoperation was not possible due to incomplete data reporting in the
studies reviewed. Moreover, long-term data are not available since in most
reports, postoperative evaluation was obtained early after repair. Our
review suggests that artificial neochordal repair of the tricuspid valve
may be a feasible surgical option to prosthetic valve replacement in
pediatric patients. However, comprehensive data and further late follow-up
are needed to analyze long-term effectiveness and clinical
outcomes.<br/>Copyright &#xa9; The Author(s) 2025

<51>
Accession Number
2039725919
Title
Cardiopulmonary Bypass-Supported Coronary Artery Bypass Surgery: A
Flexible and Effective Alternative to Off-Pump Surgery.
Source
Thoracic and Cardiovascular Surgeon. 73(7) (pp 560-566), 2025. Article
Number: tcs-04-2025-7487-OC. Date of Publication: 01 Oct 2025.
Author
Guven H.; Cetintas D.
Institution
(Guven) Department of Cardiovascular Surgery, Bursa Medical Park Hospital,
Bursa, Turkey
(Cetintas) Department of Cardiovascular Surgery, TC Sagllk Bakanllgl Bursa
Sehir Hastanesi, Nilufer, Turkey
Publisher
Georg Thieme Verlag
Abstract
Objective This study aimed to compare the early postoperative outcomes of
cardiopulmonary bypass-supported beating-heart coronary artery bypass
grafting (CPB-BH CABG) and off-pump coronary artery bypass (OPCAB)
surgery. Methods A total of 589 patients who underwent beating-heart CABG
between October 2021 and January 2025 were retrospectively analyzed.
Patients were categorized into two groups based on CPB usage: CPB-BH CABG
(n = 177) and OPCAB (n = 412). Primary outcomes included mortality and
major complications, while secondary outcomes encompassed complete
revascularization rates, number of distal anastomoses, hospital stay, and
transfusion requirements. Results No significant differences were observed
between the groups regarding preoperative characteristics. The CPB-BH
group had longer operative times (268.7 vs. 223.6 minutes, p < 0.001) and
prolonged hospital stays (7 vs. 5 days, p < 0.001). The rates of complete
revascularization and the number of bypass grafts were slightly higher in
the CPB-BH group, but did not reach statistical significance. The CPB-BH
group required more blood transfusions (p < 0.001) and had a higher
incidence of new-onset atrial fibrillation (33.9% vs. 24.0%, p = 0.016).
No significant differences were found for other major complications.
Conclusion CPB-BH CABG is a viable alternative to OPCAB, offering
comparable revascularization outcomes while allowing the flexibility of
cardiopulmonary bypass support when needed. Surgeons should not hesitate
to utilize CPB when necessary to optimize surgical outcomes. Future
prospective, randomized controlled trials are warranted to assess the
long-term outcomes of both surgical techniques and their effectiveness in
specific patient subgroups.<br/>Copyright &#xa9; 2025. Thieme. All rights
reserved.

<52>
Accession Number
2041609883
Title
Cerebral embolic protection devices in transcatheter aortic valve
implantation: a systematic review and meta-analysis of randomized
controlled trials.
Source
Expert Review of Medical Devices. (no pagination), 2025. Date of
Publication: 2025.
Author
Waseem M.H.; ul Abideen Z.; Cheema A.H.; Osama M.; Javed Khan H.; Farid
R.; Rehman N.; Aimen S.; Thada P.K.
Institution
(Waseem) Department of Medicine, Allama Iqbal Medical College, Lahore,
Pakistan
(ul Abideen, Javed Khan) Department of Medicine, King Edward Medical
University, Lahore, Pakistan
(Cheema) Department of Medicine, UT Southwestern Medical Center, Dallas,
TX, United States
(Osama) Department of Medicine, Hayatabad Medical Complex Peshawar,
Peshawar, Pakistan
(Farid) Department of Medicine, Jinnah Sindh Medical University, Karachi,
Pakistan
(Rehman) Department of Medicine, Dow University of Health Sciences,
Karachi, Pakistan
(Aimen) Department of Medicine, Quetta Institute of Medical Sciences,
Quetta, Pakistan
(Thada) Department of Medicine, Sotang Primary Hospital, Sotang, Nepal
Publisher
Taylor and Francis Ltd.
Abstract
Background: This meta-analysis aimed to assess the efficacy and safety of
cerebral embolic protection devices (CEPDs) in patients undergoing
transcatheter aortic valve implantation (TAVI). <br/>Method(s): PubMed,
Cochrane Central, and ScienceDirect were searched till April 2025. Risk
ratios (RRs) with 95% confidence intervals (CIs) were pooled under a
random-effects model using Review Manager. The Cochrane risk of bias (RoB
2.0) tool was used for quality assessment. Funnel plots were assessed for
publication bias. <br/>Result(s): Eight randomized controlled trials,
including 11,632 patients undergoing TAVI, were analyzed. Use of CEPDs
showed a non-significant reduction in all strokes (RR 0.92, 95% CI:
0.74-1.15, p = 0.48) and disabling stroke (RR 0.80, 95% CI: 0.57-1.12, p =
0.18). There was no significant difference in all-cause mortality (RR
1.09, 95% CI: 0.71-1.67, p = 0.70), acute kidney injury (AKI) (RR 0.96,
95% CI: 0.44-2.11, p = 0.93), disabling bleeding (RR 0.96, 95% CI:
0.28-3.31; p = 0.94) and major vascular complications (RR 1.25, 95% CI:
0.56-2.78, p = 0.59). <br/>Conclusion(s): CEPD did not significantly
reduce the incidence of ischemic lesions or neurocognitive decline.
Current evidence does not support a statistically significant clinical
benefit of CEPD use during TAVI. While trends suggest a potential
reduction in stroke, larger trials are needed to establish the
significance of these results.<br/>Copyright &#xa9; 2025 Informa UK
Limited, trading as Taylor & Francis Group.

<53>
Accession Number
649428222
Title
Intravenous Lidocaine Decreases Pain Scores 24 Hours Post Cardiac Surgery:
Substudy of a Randomized Controlled Trial.
Source
Pain physician. 28(6) (pp 511-518), 2025. Date of Publication: 01 Nov
2025.
Author
Klinger R.; Strickland A.; Wright M.; Mathew J.P.; Gulur P.
Institution
(Klinger, Wright, Mathew, Gulur) Department of Anesthesiology, Duke
University Medical Center, Durham, NC, United States
(Strickland) TSAOG Orthopedics & Spine, San Antonio, TX, United States
Abstract
BACKGROUND: Post cardiac surgery pain remains a problem for a significant
number of patients. While opioids have long been used for cardiac surgery
pain control and hemodynamic stability, methods to improve pain control
while also reducing reliance on opioids are desired. Intravenous lidocaine
has shown promise for pain and opioid reduction in multiple operative
settings, yet its role in cardiac surgery lacks conclusive data.
<br/>OBJECTIVE(S): To determine the effect of intravenous lidocaine on
pain scores and opioid consumption in the first 48 hours post cardiac
surgery. STUDY DESIGN: Preplanned substudy of a single-center,
double-blind, placebo-controlled, randomized controlled trial. SETTING:
This study was conducted in a tertiary/quaternary care academic hospital
in the United States. <br/>METHOD(S): Following institutional review board
approval and informed consent, a total of 449 patients who met the
inclusion criteria were enrolled and randomized to receive either a bolus
of one mg/kg of lidocaine administered after anesthesia induction followed
immediately by a continuous infusion at 48 mu-g/kg/min for the first hour,
24 mu-g/kg/min for the second hour, and 10 mu-g/kg/min for the next 46
hours (lidocaine group) or normal saline (placebo group). Primary outcomes
were Visual Analog Scale (VAS) scores and opioid consumption in of
morphine milligram equivalents at 24 and 48 hours post surgery. Secondary
endpoints included the administration of other nonopiod analgesic
medications, postoperative antiemetic medication use, intensive care unit
length of stay, hospital length of stay, and time to return of bowel
function. Univariable and multivariable regression analyses were
performed. <br/>RESULT(S): A total of 215 patients who received a placebo
and 218 patients who received lidocaine were evaluated. We observed a
statistically significant difference in VAS pain score at postoperative 24
hours (adjusted mean difference -0.68; 95%CI, -1.23 to 0.13; P = 0.016)
between patients treated with lidocaine vs placebo; however, no difference
was observed at postoperative 48 hours. The cumulative opioid use in
morphine milligram equivalents was not significant, both in univariable
and multivariable analysis, at all timepoints between patients receiving
lidocaine vs placebo. Among secondary outcomes, the only significant
effect was a decrease in odds of acetaminophen use in the first
postoperative 48 hours (adj. odds ratio 0.54; 95% CI 0.32 to 0.90, P =
0.018). LIMITATIONS: Although pain scores were a preplanned outcome of the
parent study, opioid consumption was not. Furthermore, postoperative pain
management was not specifically standardized for this study.
<br/>CONCLUSION(S): We found that intravenous lidocaine resulted in a
statistically significant decrease in VAS pain scores at 24 hours post
cardiac surgery, with no difference in opioid consumption. While this pain
benefit has been noted in other surgical patient populations, our findings
are important since patients undergoing cardiac surgery are unique given
the physiologic changes associated with cardiopulmonary bypass graft.

<54>
Accession Number
649390443
Title
The Impact of Music on Patients After Cardiac Surgery.
Source
The Journal of cardiovascular nursing. (no pagination), 2025. Date of
Publication: 02 Dec 2025.
Author
Carroll D.L.; Ait Ali R.L.; Zamora N.H.; LaValle V.; Ommerborn C.; Mancuso
J.M.; Porto F.A.; Hall K.E.; Donahue V.
Institution
(Carroll) Diane L. Carroll, PhD, RN, FAHA, FESC, FAAN, Nurse Researcher,
Munn Center for Nursing Research, Massachusetts General Hospital (MGH),
Boston
(Ait Ali) DNP, APRN, Nurse Practitioner, Cardiac Surgery, MGH, Boston,
United States
(Zamora) Nghi Huynh Zamora, MSN, AGPCNP-BC, RN, Nurse Practitioner,
MGH-Translational and Clinical Research Centers, Boston
(LaValle) Vlasta LaValle, BS, MSN, CNP, RN, Nurse Practitioner,
MGH-Translational and Clinical Research Centers, Boston
(Ommerborn) Christine Ommerborn, MSN, Nurse Practitioner,
MGH-Translational and Clinical Research Centers, Boston, United States
(Mancuso) Julia M. Mancuso, PA-C, Senior Clinical Research Coordinator,
MGH-Translational and Clinical Research Centers, Boston, MS, United States
(Porto) MSN, Nursing Practice Specialist, MGH-Translational and Clinical
Research Centers, Boston, United States
(Hall) Kathryn E. Hall, DNP, MGH-Translational and Clinical Research
Centers, Boston, MS, United States
(Donahue) MSN, ACNS-BC, CCRN, MGH, Cardiac Surgical Intensive Care Unit,
Massachusetts General Hospital, Boston, United States
Abstract
BACKGROUND: Cardiac surgery causes adverse physical and psychological
responses. Listening to music could modulate these responses.
<br/>OBJECTIVE(S): To measure physical/psychological responses pre and
post 30 minutes of music (TX) compared with usual care (UC) in patients
after cardiac surgery. <br/>METHOD(S): In this randomized, 2-group trial
the impact of listening to music was examined in a sample of adults, ages
18-89 years who had undergone cardiac surgery. Cortisol, immunoglobulin A,
vital signs, pain, and anxiety data were collected pre and post study
period. <br/>RESULT(S): There were 120 subjects, 61 in the TX group and 59
in the UC group. There were 84 males and 36 females, with mean age of 62.4
years. There were no differences between TX and UC groups on
preintervention outcomes. Postintervention, the TX group had lower pain
scores (3.8 vs. 4.5, P < .04) and lower heart rate (beats per minute) (78
vs. 81, P < .05) compared with the UC group. <br/>CONCLUSION(S): Listening
to music may be effective in reducing pain, and lowering heart rate,
serving as a safe adjunct for pain management after cardiac
surgery.<br/>Copyright &#xa9; 2025 Wolters Kluwer Health, Inc. All rights
reserved.

<55>
Accession Number
2041538485
Title
To clip or not to clip? A review of precise risk assessment in the
contemporary era of transcatheter edge-to-edge mitral and tricuspid valve
repair.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1693291. Date of Publication: 2025.
Author
Ausbuettel F.; Fichera C.-F.
Institution
(Ausbuettel) Department of Cardiology, University Hospital Marburg,
Marburg, Germany
(Fichera) County Hospital Loerrach, Department of Cardiology, Loerrach,
Germany
Publisher
Frontiers Media SA
Abstract
Transcatheter edge-to-edge mitral and tricuspid valve repair (M-TEER,
T-TEER) have emerged as meaningful treatment modalities among patients at
high surgical risk suffering from valvular heart disease. While previous
research has shown that optimal patient selection is crucial for treatment
outcomes, recent studies have identified a multitude of factors that
independently influence mortality. Although these findings can
significantly support clinical decision-making, the large number of
available studies renders an overview of this topic challenging. In this
review, we provide a comprehensive overview of the currently identified
factors associated with increased mortality after TEER. We also summarize
the current evidence on published risk scores that stratify mortality risk
after M-TEER and T-TEER. We aimed to provide clinical decision-making
support for optimal patient selection and referral to TEER and to identify
remaining gaps in evidence.<br/>Copyright 2025 Ausbuettel and Fichera.

<56>
Accession Number
2042086086
Title
Air bubbles around the heart: a rare case report of pneumohydropericardium
in heart transplantation.
Source
European Heart Journal - Case Reports. 9(2) (no pagination), 2025. Article
Number: ytaf062. Date of Publication: 2025.
Author
Brucato F.; Gentile P.; Musca F.; Casadei F.; Palazzini M.
Institution
(Brucato) Department of Medicine and Surgery, University of
Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1, Milan, Italy
(Gentile, Musca, Casadei, Palazzini) Department of Cardiology, De Gasperis
Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Piazza
dell'Ospedale Maggiore, 3, Milan, Italy
Publisher
Oxford University Press
Abstract
^Background Pneumohydropericardium is a rare but significant
condition characterized by the presence of both air and fluid in the
pericardial space. It is often associated with trauma, invasive
procedures, or thoracic pathologies, and its occurrence following heart
transplantation is particularly unusual. Early recognition is essential to
prevent complications such as cardiac tamponade, although conservative
management can be effective in cases without haemodynamic compromise.
..........................................................................
..........................................................................
......................................... ^{Case summary} We
present the case of a 40-year-old woman with a history of
hypokinetic-dilative cardiomyopathy and heterozygous for TNNT2 gene
mutation (c.547C>T p.Arg183Trp), who underwent orthotopic heart
transplantation. Following the procedure, she developed
pneumohydropericardium, identified by echocardiography as air microbubbles
and fluid in the pericardial space, without associated haemodynamic
instability. The condition was monitored with serial echocardiograms, and
no invasive intervention was required. The air microbubbles resolved after
16 days of echocardiographic follow-up, and the patient was discharged in
stable condition. At follow-up, she showed no recurrence of the
pneumohydropericardium.
..........................................................................
..........................................................................
......................................... Discussion This case highlights
pneumohydropericardium as a rare post-transplant complication that, when
detected early and closely monitored, can be managed conservatively
without severe outcomes. While pneumohydropericardium has been previously
reported in association with other conditions, its post-transplant
manifestation is rare and warrants further awareness. Echocardiographic
surveillance played a key role in guiding management, as invasive
procedures were avoided, and the patient remained haemodynamically stable
throughout. This case underscores the importance of recognizing and
managing pneumohydropericardium in heart transplant patients to ensure
optimal outcomes -<br/>Copyright &#xa9; The Author(s) 2025.

<57>
Accession Number
2042063128
Title
Narrative review on the management of post-thrombotic syndrome:
approaching the emerging technologies.
Source
International Angiology. 44(5) (pp 353-365), 2025. Date of Publication: 01
Oct 2025.
Author
Figueroa A.V.; Cifuentes S.; Tabiei A.; Pizano A.; Rasmussen T.E.;
Labropoulos N.; Ulloa J.H.
Institution
(Figueroa) Division of Vascular and Endovascular Surgery, Department of
Surgery, UT Southwestern Medical Center, Dallas, TX, United States
(Cifuentes, Tabiei, Rasmussen) Division of Vascular and Endovascular
Surgery, Mayo Clinic, Rochester, MN, United States
(Pizano) Department of Surgery, Nassau University Medical Center -
Northwell, East Meadow, NY, United States
(Labropoulos) Division of Vascular Surgery, State University of New York,
Stony Brook, NY, United States
(Ulloa) Universidad de los Andres, Bogota, Colombia
Publisher
Edizioni Minerva Medica
Abstract
Post-thrombotic syndrome (PTS) is a long-term complication of deep vein
thrombosis (DVT) and the most challenging form of chronic venous disease.
Up to 50% of patients who suffer DVT will develop PTS. Clinical
manifestations such as limb pain, edema, skin damage, and ulceration
result from venous hypertension due to reflux, obstruction, or a
combination of both. The current treatment option is conservative
management with limited efficiency. PTS severely affects the quality of
life, and definitive surgical treatment is urgently needed. This article
aims to review the current management paradigm and introduce new
in-development surgical alternatives. A narrative review of the literature
published between 2010 and 2025 was conducted in PubMed, Embase and the
Cochrane Library. Reviewed articles included management guidelines, trial
reports, reviews, and cohort studies regarding the management of
post-thrombotic syndrome and deep valvular insufficiency. The SANRA
Guidelines for narrative reviews were followed. Sixty-seven articles
addressing current and future treatment options for PTS were included.
Over the last five decades, previous unsuccessful attempts to restore deep
valvular function provided the knowledge ground for promising candidates.
Technological improvements within the last decade have taken a novel
implantable bioprosthetic valve, an endovascular neovalve creation device,
and a transcatheter-based venous valve replacement system remarkably close
to being the next-generation armamentarium for treating PTS. The efficacy
of current management alternatives for PTS remains limited. The experience
gained over the last 50 years has propelled the development of novel
prosthetic devices and endovascular systems in response to the unmet need
for an effective PTS treatment. Early-phase results are promising and have
granted the buildout of larger ongoing trials.<br/>Copyright &#xa9; 2025
EDIZIONI MINERVA MEDICA.

<58>
Accession Number
2041555169
Title
Transcatheter Treatment of Bicuspid Aortic Valve Stenosis: From
Observational Studies to Randomized Clinical Trials.
Source
Structural Heart. 9(12) (no pagination), 2025. Article Number: 100754.
Date of Publication: 01 Dec 2025.
Author
Samim D.; Siepe M.; Juni P.; Gupta A.; Jilaihawi H.; Borger M.A.; Makkar
R.R.; Leon M.B.; Windecker S.
Institution
(Samim, Windecker) Department of Cardiology, Bern University Hospital,
Bern, Switzerland
(Samim, Juni) Clinical Trial Service Unit and Epidemiological Studies
Unit, Nuffield Department of Population Health, University of Oxford,
Oxford, United Kingdom
(Siepe) Department of Cardiac Surgery, Bern University Hospital, Bern,
Switzerland
(Gupta, Jilaihawi, Makkar) Smidt Heart Institute, Cedars-Sinai Medical
Center, Los Angeles, CA, United States
(Borger) University Clinic of Cardiac Surgery, Leipzig Heart Center,
Leipzig, Germany
(Leon) Division of Cardiology, Columbia University Irving Medical
Center/NewYork Presbyterian Hospital, New York, NY, United States
(Leon) Cardiovascular Research Foundation, New York, NY, United States
Publisher
Cardiovascular Research Foundation
Abstract
Bicuspid aortic valve (BAV) disease is the most common congenital heart
abnormality, which affects up to 2% of the population and significantly
increases the lifetime risk of aortic stenosis and the need for valve
replacement. While surgical aortic valve replacement (SAVR) remains the
standard of care in low surgical-risk patients, transcatheter aortic valve
implantation (TAVI) is increasingly used as a treatment alternative with
favorable outcomes in well-selected BAV patients. To date, randomized
controlled trials comparing TAVI and SAVR have excluded patients with BAV,
except the UK TAVI and the more recent The NOrdic Aortic Valve
IntervenTION-2 trial. Of note, in The NOrdic Aortic Valve IntervenTION-2
trial, there was a numerical imbalance in the BAV subgroup, with more
events observed in the TAVI group than in the SAVR group for the composite
outcome (all-cause mortality, stroke, and rehospitalization) at 1- and
3-year follow-up, although the risk estimates were imprecise due to the
limited number of events. The upcoming TraNscatheter Aortic Valve
Implantation versus surGical AorTic valvE replacement in patients with
Bicuspid aortic valve stenosis (NAVIGATE Bicuspid) and Bicuspid aortic
valve replacement: EvaLuatIon of transcathetEr VERsus Surgery (BELIEVERS)
trials will directly compare TAVI and SAVR in BAV populations. These
trials are designed to provide robust, adequately powered estimates of the
comparative safety and effectiveness of both interventions over extended
follow-up and are expected to inform future guideline recommendations in
the setting of BAV anatomy. This review summarizes current data on the use
of TAVI in patients with severe BAV stenosis, evaluates anatomical and
procedural complexities, and outlines the design and rationale of upcoming
randomized controlled trials addressing this critical knowledge
gap.<br/>Copyright &#xa9; 2025 The Author(s).

<59>
Accession Number
649403668
Title
In-hospital And Long Term Outcomes Of PULVAB RCT.
Source
Journal of Updates in Cardiovascular Medicine. Conference: 20th
International Congress of Update in Cardiology and Cardiovascular Surgery.
Istanbul Turkey. 12(1) (no pagination), 2024. Date of Publication: 01 Jun
2024.
Author
Revishvili A.; Popov V.; Malyshenko E.; Anishchenko M.; Popova N.; Kozyrin
K.
Institution
(Revishvili, Popov, Malyshenko, Anishchenko, Popova, Kozyrin) A.V.
Vishnevsky National Medical Research Center of Surgery, Moscow, Russian
Federation
Publisher
Heart and Health Foundation of Turkey (HHFT)
Abstract
BACKGROUND. According to current data, the incidence of new onset
postoperative atrial fibrillation (AF) after coronary bypass surgery
(CABG) is 21-30% and worsens both short- and long-term CABG outcomes, that
persuades the necessity to develop prophylaxis approaches. <br/>Aim(s):to
evaluate the results of prophylactic strategies in new onset POAF after
CABG. METHODS. The prospective RCT PROPHYLACTIC PULMONARY VEINS ABLATION
(PULVAB Clinical Trial NCT03857711) includes 175 patients. The inclusion
criteria are the CAD without anamnesis of AF. The exclusion criteria are
urgent surgery, concomitant valvular heart disease, decompensation of
chronic diseases. Patients were randomized into 4 groups: I group -
conventional CABG (n=45), II group - conventional CABG with administration
of amiodarone (n=42), III group - concomitant CABG and RFA PV (n=45) , IV
group - concomitant CABG and RFA PV with administration of amiodarone in
postoperative period (n=42). Primary endpoints are incidence of POAF,
sinus rhythm, freedom from MACCE. Secondary endpoints are operation time,
cross-clamping time, CPB time. Bipolar RFA PV was performed without aortic
cross-clamping using parallel CPB before CABG. The LAA occlusion weren t
performed. There are no differences in clinical, demographic parameters,
comorbidities and EchoCG parameters. RESULTS. Preventive RFA PV did not
increase time of the stages of operation: the operation time (p=0,14), CPB
time (p=0,08), cross-clamping time (p=0,19). There were no incidents of
in-hospital mortality. There weren t any wound complications or bleeding
or perioperative MI or stroke reported. There were 18 (40%) cases of POAF
in I group POAF, 14 (33,3%) cases in II group, 7 (15,5%) cases in III
group, 2 (4,8%) cases in IV group, respectively. No significant difference
was found when comparing the groups I and II (p=0,41), groups II and III
(p=0,23), III IV(p=0,18). Significantly lower rates of POAF relative to
group I was observed in group III (p=0.025) and IV (p=0.003), that can be
caused by high preventive efficiency of both stand-alone RFA PV and the
combination of RFA PV with amiodarone. By the time of discharge sinus
rhythm had 95,5%; 97,6%; 97,6% and 95,5% patients in groups I, II, III IV,
respectively (p=0,21). There was no mortality incidence in 12 months-
follow up. Freedom from MACCE was 91,5%, 94,5%, 98% and 98% in four
groups, respectively. Freedom from AF/AFL/AAT in 12 months was 81,5%,
84,5%, 92,8% and 98% in four groups, respectively. CONCLUSION. Stand-alone
bipolar RFA PV or in combination with amiodarone as a preventive approach
significantly reduces incidence of new onset AF after CABG and don t
increase rates of short- and long-term complications.

<60>
Accession Number
2041620016
Title
Effects of Different Concentrations of Inhaled Oxygen on Lung Collapse and
Oxidative Stress in Patients With One Lung Ventilation, a Single-Center
Prospective, Double-Blinded, Randomized Controlled Trial.
Source
Health Science Reports. 8(12) (no pagination), 2025. Article Number:
e71600. Date of Publication: 01 Dec 2025.
Author
Zhao D.; Wu C.; Zhu H.; Lin J.; Zhang W.; Fang J.
Institution
(Zhao) Department of Anesthesiology, ShenZhen People's Hospital (The
Second Clinical Medical College, Jinan University; The First Affiliated
Hospital, Southern University of Science and Technology), Shenzhen,
Guangdong, China
(Zhao, Wu, Zhang, Fang) Department of Anesthesia, the First Affiliated
Hospital, Sun yat-sen University, Guangzhou, China
(Zhu) Department of thoracic surgery, the First Affiliated Hospital, Sun
yat-sen University, Guangzhou, China
(Lin) Department of Anesthesia, Guangzhou Women and Children's Medical
Center, Guangzhou Medical University, Guangzhou, China
Publisher
John Wiley and Sons Inc
Abstract
Background: During thoracoscopic surgery, the anestheologist assure an
adequate oxygen supply to the body, but at the same time, to improve the
surgical field by completely collapsing the lung on the surgical side.
However, incomplete lung collapse remains problematic. Increasing the
inhaled oxygen concentration might accelerate gas dispersion from the
alveoli, but continuous high oxygen may aggravate oxidative stress. The
selection of inhaled oxygen concentration during OLV is still
controversial. This study intends to explore this issue from the
perspective of collapse effect and the degree of oxidative stress.
<br/>Method(s): This study included patients aged 18-65 undergoing
thoracoscopic lobectomy, divided into two groups: one receiving 70% oxygen
(70% group) and the other 100% oxygen (100% group) during surgery. Lung
collapse was evaluated upon camera entry into the chest cavity, and blood
samples were collected preoperatively, 30 min after OLV, and on the second
postoperative day. <br/>Result(s): Both groups were similar in baseline
characteristics. The 100% oxygen group showed significantly greater
declines in lung volume and elasticity scores at 5 and 10 min
post-thoracic entry compared to the 70% group (p < 0.05). Oxygenation was
significantly lower in the 70% group post-OLV (p < 0.05) during surgery,
and oxidative stress markers were higher in the 100% group during surgery
(p < 0.05). By the second postoperative day, oxidative stress markers
increased in both groups with no significant difference. There was no
significant difference in safety outcomes between the two groups of
patients. <br/>Conclusion(s): High/pure inhaled oxygen may improve the
lung collapse speed and provide a better field of vision for thoracic
surgery. Although pure oxygen ventilation aggravated short-term oxidative
stress, the effect was insignificant on the second postoperative
day.<br/>Copyright &#xa9; 2025 The Author(s). Health Science Reports
published by Wiley Periodicals LLC.

<61>
[Use Link to view the full text]
Accession Number
2041216500
Title
Bispectral Index-Guided Anesthesia for Older Patients Having Non-Cardiac
Surgery: A Randomized Multicenter Trial.
Source
Anesthesiology. Publish Ahead of Print (no pagination), 2025. Date of
Publication: 11 Oct 2025.
Author
Zhou L.; Ding L.; Yang H.; Li C.; Yu Z.; Ma W.; Chen Q.; Zhang Y.; Mao Q.;
Cheng M.; Gong G.; Wang E.; Liu C.; Hao W.; Li H.; Chen C.; Fan Y.; Su Z.;
Cai X.; Zhang X.; Li Z.; Zhang B.; Li Y.; Jiang C.; Yin Q.; Jiao J.;
Sessler D.I.; Li Q.; Liu J.
Institution
(Zhou, Ding, Yang, Li, Ma, Yin, Li, Liu) Department of Anesthesiology,
West China Hospital, Sichuan University, Chengdu, China
(Li) Department of Clinical Research Management, West China Hospital,
Sichuan University, Chengdu, China
(Yu) Department of Bioinformatics and Biostatistics, School of Life
Sciences and Biotechnology and SJTU-Yale Joint Center for Biostatistics,
Shanghai Jiao Tong University, Shanghai, China
(Chen) Department of Anesthesiology, Dazhou Central Hospital, Dazhou,
China
(Zhang) Department of Anesthesiology, Liuzhou Worker's Hospital, The
Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
(Li) Department of Anesthesiology, the Second Clinical Medical College of
Guangzhou University of Chinese Medicine, Guangzhou, China
(Mao) Department of Anesthesiology, Army Medical Center of PLA, Chongqing,
China
(Cheng) Department of Anesthesiology, the First Affiliated Hospital of
Shantou University Medical College, Shantou, China
(Gong) Department of Anesthesiology, General Hospital of Western Theater
Command, Chengdu, China
(Wang) Department of Anesthesiology, the First Affiliated Hospital of Army
Military Medical University, Chongqing, China
(Liu, Chen) Department of Anesthesiology, First Affiliated Hospital with
Nanjing Medical University, Nanjing, China
(Hao) Department of Anesthesiology, First Affiliated Hospital of Hebei
University of Traditional Chinese Medicine, Shijiazhuang, China
(Li) Department of Anesthesiology, Second Affiliated Hospital of Army
Military Medical University, China
(Chen) Department of Anesthesiology, Affiliated Hospital of North Sichuan
Medical College, Nanchong, China
(Fan) Department of Anesthesiology, People's Hospital of Leshan, Leshan,
China
(Su) Department of Anesthesiology, China-Japan Union Hospital of Jilin
University, Changchun, China
(Cai) Department of Anesthesiology, the Fifth Affiliated Hospital of
Xinjiang Medical University, Urumqi, China
(Zhang) Department of Anesthesiology, Ya'an People's Hospital, Ya'an,
China
(Li) Department of Anesthesiology, the Affiliated Yantai Yuhuangding
Hospital of Qingdao University Medical College, Yantai, China
(Zhang) Department of Anesthesiology, the Third Affiliated Hospital of
Xinjiang Medical University, Urumqi, China
(Li) Department of Anesthesiology, Lanzhou University Second Hospital,
Lanzhou, China
(Jiang) Department of Anesthesiology, Chongqing General Hospital,
Chongqing, China
(Jiao) Institute of Translational Medicine, Shanghai Jiao Tong University,
Shanghai, China
(Sessler) Professor and Vice-president for Clinical and Outcomes Research,
Center for Outcomes Research and Department of Anesthesiology, UTHealth,
Houston, TX, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: - Older surgical patients are at risk because of age-related
physiologic decline and comorbidities. Some guidelines recommend
Bispectral Index (BIS) monitoring to optimize anesthetic depth, but robust
evidence supporting improved outcomes is lacking. <br/>Method(s): - We
conducted a randomized, multicenter, double-blind trial across 21
tertiary-care hospitals in China (March 17, 2015 to February 5, 2022).
Patients aged 65 years or older scheduled for elective non-cardiac surgery
(ASA I to IV) were randomized 1:1 to BIS-guided or routine anesthetic
management. In patients assigned to BIS guidance, hypnotic depth was
adjusted to maintain BIS between 40 and 60. Hypnotic depth in patients
assigned to routine-care per clinical judgment with masked BIS monitors.
The primary outcome was 1-year all-cause mortality. Secondary outcomes
included moderate-to-severe complications within 30 days, functional
independence, quality of life, the duration of postoperative critical
care, the duration of postoperative hospitalization, unplanned ICU
admission, and hospital cost. <br/>Result(s): - Among 6982 patients (mean
age 71 [SD 5] years), BIS values averaged 47 (BIS-guided) versus 46
(routine). 1-year mortality was similar in BIS-guided patients [10.2%
(356/3485)] and routinely managed patients [10.0% (351/3497)]: HR 1.02,
95% CI 0.88-1.17; P = 0.812). The incidence of complications within 30
days after surgery were also comparable in each group: 10.4% versus 10.6%
(RR 0.99, 95% CI 0.85-1.16; P = 0.938). No significant differences were
observed in functional independence or quality of life.
<br/>Conclusion(s): - Hypnotic depth, as assessed by BIS, was similar in
patients with or without BIS-guided anesthetic titration.
Anesthesiologists thus apparently titrate hypnotic depth appropriately
even without BIS guidance. Unsurprisingly, outcomes including
postoperative 1-year mortality and 30-day complications were similar in
each group.<br/>Copyright &#xa9; 2025

<62>
Accession Number
2036051226
Title
CARDIOVASCULAR PRECISION: 3D PRINTING & DIGITAL HEALTH SYNERGY.
Source
Atherosclerosis. Conference: The Abstract from ISA 2024 conference. Oman.
399(Supplement 1) (pp 5-6), 2024. Date of Publication: 01 Dec 2024.
Author
Al-Asmar R.
Institution
(Al-Asmar) University of Jordan, Amman, Jordan
Publisher
Elsevier Ireland Ltd
Abstract
Background: The burgeoning field of 3D printing in cardiology
promisestransformative advancements, particularly in cardiovascular
surgery and interventional cardiology, offering precision and personalized
treatment avenues. <br/>Objective(s): This abstract aims to explore the
synergies between 3D printing and digital health in cardiovascular
medicine to create tailored devices, ultimately enhancing patient
outcomes. <br/>Method(s): Utilizing a blend of literature review, case
studies, and expert consultations, we investigate the application of 3D
printing in fourcardinal
areasofcardiovascularhealthcare.Oursystematicreview and expert insights
focus on patient-specific implants, anatomical models, and remote
monitoring devices. We also examine the integration of 3D printing and
digital health platforms in telemedi cine, evaluating teleconsultation
services and patient outcomes. <br/>Result(s): Personalized 3D-printed
implants have markedly improved patient outcomes by ensuring precise fits
and minimizing complica tions. Patient-specific anatomical models aid
surgeons inpreoperative planning, reducing risks and enhancing procedural
success. Customized 3D-printed stents and heart valves tailored to
individual anatomy demonstrate exceptional efficacy in long-term outcomes.
Additionally, 3D printing enriches medical education by providing practice
models for students and trainees. Despite initial costs, personalized 3D
printing proves cost-effective, reducing complications and hospital stays.
<br/>Conclusion(s):Theconvergenceof3Dprintinganddigitalhealthheralds a
newera in cardiovascular medicine, offering tailored solutions that
optimize patient care, surgical outcomes, and medical
education.<br/>Copyright &#xa9; Elsevier Ltd. All rights reserved.

<63>
Accession Number
649403728
Title
The Results Of Simultaneous Cox Maze V Procedure In Patients With
Concomitant Atrial Fibrillation Who Undergo Coronary Artery Bypass
Grafting.
Source
Journal of Updates in Cardiovascular Medicine. Conference: 20th
International Congress of Update in Cardiology and Cardiovascular Surgery.
Istanbul Turkey. 12(1) (no pagination), 2024. Date of Publication: 01 Jun
2024.
Author
Revishvili A.; Popov V.; Malyshenko E.; Anishchenko M.; Popova N.; Kozyrin
K.
Institution
(Revishvili, Popov, Malyshenko, Anishchenko, Popova, Kozyrin) A.V.
Vishnevsky National Medical Research Center of Surgery, Moscow, Russian
Federation
Publisher
Heart and Health Foundation of Turkey (HHFT)
Abstract
BACKGROUND. Simultaneous surgical treatment of various forms of atrial
fibrillation (AF) during coronary artery bypass surgery (CABG) is an
important issue in cardiovascular surgery.We use simultaneous Cox Maze V
procedure for AF treatment in patients who undergo CABG in our center.
<br/>Aim(s): to assess the results of Cox Maze V procedure for AF
treatment in patients who undergo CABG. METHODS. A prospective
single-center trial included 105 patients with CAD and AF. Patients were
randomized into 2 groups - patients with paroxysmal AF (group I, n=53) and
nonparoxysmal AF (group II, n=52). Patients underwent on-pump CABG with
additional Cox Maze V procedure. The Cox Maze V procedure was performed
without aortic cross-clamping using parallel perfusion before CABG.
Primary endpoints included arrhythmia recurrence, sinus rhythm, MACCE and
secondary endpoints included CPR, cross-clamping aorta, surgery,
ventilation time and time of ICU stay, pacemaker implantation. RESULTS.
There were no differences in the types and frequency of complications.
During hospitalization, 2 (3.8%) deaths were documented in group II due to
multiple organ failure. There were no cases of MACCE in both groups. The
combination of AF/AFl was more often observed in group II - 15 (28.8%)
versus 7 (13.3%), p=0.05. The rate of AF recurrence was significantly
higher in group II - 14 (26.9%) versus 6 (11.3%), p=0.049. By the end of
hospitalization, sinus rhythm had 100% and 90.4% patients in groups I and
II, respectively (p=0.02). There were no significant differences in
secondary endpoints. The cumulative freedom from AF/AFL was 100% and 97%
in groups I and II in 1 year of follow up; 96.1% and 91.4% in 2 years of
follow up; 90.9% and 78.7% in 3 years of follow up (Logrank Test, p=0.07).
Cumulative freedom from MACE was 90.2 and 100% in 3 years of follow-up
(Logrank Test, p=0.23). Permanent pacemaker implantation wasn t required
either in short or long-term follow-up. CONCLUSION. The Cox Maze V
procedure for concomitant AF did not didn t significantly affect the
follow up period, which may reflect its sufficient safety. The results of
concomitant Cox Maze V procedure allow us to recommend this strategy for
simultaneous AF treatment in CABG.

<64>
Accession Number
649401107
Title
Outcomes of Ventricular Tachycardia Ablation in Cardiac Laminopathy: An
Updated Systematic Review and Single-Arm Meta-Analysis.
Source
Journal of cardiovascular electrophysiology. (no pagination), 2025. Date
of Publication: 02 Dec 2025.
Author
Castrichini M.; Ferreira Felix I.; Karlinski Vizentin V.; Garmany R.;
Huynh T.; Haq I.U.; Swain W.H.; Siontis K.C.; Killu A.M.; Deshmukh A.J.;
Ackerman M.J.; Giudicessi J.R.
Institution
(Castrichini, Garmany, Haq, Swain, Siontis, Killu, Deshmukh, Ackerman,
Giudicessi) Department of Cardiovascular Medicine (Division of Heart
Rhythm Services), Mayo Clinic, Rochester, MN, United States
(Castrichini, Karlinski Vizentin, Garmany, Huynh, Ackerman, Giudicessi)
Department of Molecular Pharmacology and Experimental Therapeutics
(Windland Smith Rice Sudden Cardiac Death Genomics Laboratory), Mayo
Clinic, Rochester, MN, United States
(Ferreira Felix, Huynh) Department of Internal Medicine, Mayo Clinic,
Rochester, MN, United States
(Garmany) Mayo Clinic Medical Scientist Training Program, Mayo Clinic
Graduate School of Biomedical Sciences, Mayo Clinic Alix School of
Medicine, Rochester, MN, United States
(Ackerman) Department of Pediatric and Adolescent Medicine (Division of
Pediatric Cardiology), Mayo Clinic, Rochester, MN, United States
Abstract
BACKGROUND: Ventricular tachycardia (VT) is a life-threatening arrhythmia
frequently observed in structural heart diseases, including LMNA-related
cardiomyopathy, a genetic disorder associated with high risk of sudden
cardiac death and progressive systolic dysfunction. While catheter
ablation is an established therapeutic option for VT, its efficacy in
cardiac laminopathy remains poorly defined. <br/>OBJECTIVE(S): To
synthesize available evidence on the role and outcomes of VT ablation in
patients with cardiac laminopathy. <br/>METHOD(S): A systematic review and
single-arm meta-analysis was performed in accordance with PRISMA
guidelines. PubMed, Embase, and Cochrane databases were searched for
studies reporting VT ablation outcomes in LMNA-related cardiomyopathy. An
inverse variance random-effects model was applied for meta-analysis of
proportions. <br/>RESULT(S): Seven studies (six cohorts, one abstract)
comprising 62 patients (mean age 53.2 +/- 9.7 years; 85% male; 88% with
implantable cardioverter-defibrillator) were included. An
endocardial/endo-epicardial approach was used in 93% of cases. Acute
procedural success was achieved in 37% (95% CI: 14%-63%; I2 = 27.4%), and
28% required multiple procedures. Over a median follow-up of 26 (9-35)
months, VT recurrence occurred in 91% (95% CI: 76%-100%; I2 = 37.2%).
All-cause mortality was 54% (95% CI: 39%-70%; I2 = 28%), predominantly
from cardiac causes (51%, 95% CI: 25%-76%; I2 = 53%), and 14% (95% CI:
1%-34%; I2 = 42%) underwent heart transplantation. <br/>CONCLUSION(S): In
LMNA-related cardiomyopathy, catheter ablation is associated with high VT
recurrence, limited long-term success, and substantial cardiovascular
mortality and transplantation rates, underscoring the importance of ICD
implantation and the need for alternative strategies, including
variant-specific and molecularly targeted therapies.<br/>Copyright &#xa9;
2025 Wiley Periodicals LLC.

<65>
Accession Number
2042034656
Title
Comparative Outcomes of Right Anterior Minithoracotomy and Ministernotomy
for Aortic Valve Replacement: An Updated Meta-Analysis.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. (no pagination), 2025. Date of Publication: 2025.
Author
Santos K.; Campoverde Farez C.; Zecchin Ferrara V.; Oya K.; Samaniego
M.A.; Chacon Quiros M.; Lopez Barrios V.; Plonek T.
Institution
(Santos, Plonek) Department of Cardiothoracic Surgery, Medisch Spectrum
Twente, Enschede, Netherlands
(Santos) New Vision University School of Medicine, Tbilisi, Georgia
(Campoverde Farez) Faculty of Medical Sciences, Universidad de Cuenca,
Ecuador
(Zecchin Ferrara) University of Padova, Italy
(Oya) National Center for Global Health and Medicine, Tokyo, Japan
(Samaniego) Universidad Autonoma Metropolitana, Ciudad de Mexico, Mexico
(Chacon Quiros) Universidad de Costa Rica, San Jose, Costa Rica
(Lopez Barrios) Centro Cardiovascular SM, San Jose, Costa Rica
Publisher
SAGE Publications Ltd
Abstract
Objective: Right anterior minithoracotomy (RAMT) and ministernotomy (MS)
are established approaches for minimally invasive aortic valve replacement
(MIAVR). There is no consensus about which technique offers better
results. <br/>Method(s): A literature search was conducted in MEDLINE,
Scopus, and Cochrane Library, focusing on studies that compared RAMT and
MS for MIAVR. RevMan 8.13.0 (The Cochrane Collaboration, London, UK) was
used to calculate effect estimates reported as odds ratios (ORs) or mean
differences (MDs) with 95% confidence intervals (CIs). <br/>Result(s): We
included 21 studies with 6,986 patients, of whom 45.8% underwent RAMT.
RAMT was associated with a shorter hospital stay (MD = -0.8 days, 95% CI:
-1.4 to -0.2, P = 0.002) and reduced blood loss (MD = -22.3 mL, 95% CI:
-32.8 to -11.8, P < 0.001), transfusion rates (OR = 0.7, 95% CI: 0.5 to
0.9, P = 0.01), and incidence of acute kidney injury (AKI; OR = 0.7, 95%
CI: 0.5 to 0.9, P = 0.02). However, RAMT was also associated with a
slightly longer cardiopulmonary bypass (CPB) time (MD = 9.0 min, 95% CI:
0.7 to 17.3, P = 0.03, I2 = 97%) and incisional pain score (standardized
MD = 0.5, 95% CI: 0.4 to 0.6, P < 0.001). Mortality, stroke, and other
complications were similar between the 2 techniques. <br/>Conclusion(s):
RAMT offers advantages including shorter hospital stay and reduced blood
loss, transfusion, and AKI rates but at the cost of slightly longer CPB
time and greater incisional pain. These findings underscore the need for
individualized patient selection based on surgical risk, anatomical
considerations, and recovery priorities.<br/>Copyright &#xa9; The
Author(s) 2025

<66>
Accession Number
2041566940
Title
Impact of Concomitant Mitral Regurgitation on Cardiovascular Events and
Mortality After Transcatheter Aortic Valve Replacement: A Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Darouei B.; Shafie D.; Amani-Beni R.; Elyasi Bakhtiari P.; Etemadi M.H.;
Bagherikaram S.; Eshraghi R.; Bahrami A.; Amini-Salehi E.; Hashemi S.M.;
Emami Meybodi M.; Movahed M.R.
Institution
(Darouei, Amani-Beni) Isfahan Cardiovascular Research Center,
Cardiovascular Research Institute, Isfahan University of Medical Sciences,
Isfahan, Iran, Islamic Republic of
(Shafie) Heart Failure Research Center, Cardiovascular Research Institute,
Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Elyasi Bakhtiari, Etemadi, Bagherikaram) Student Research Committee,
Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Eshraghi) Social Determinants of Health Research Center, Isfahan
University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Bahrami) Student Research Committee, Kashan University of Medical
Sciences, Kashan, Iran, Islamic Republic of
(Amini-Salehi) Guilan University of Medical Sciences, Rasht, Iran, Islamic
Republic of
(Hashemi) Cardiovascular Research Center, Hormozgan University of Medical
Sciences, Bandar Abbas, Iran, Islamic Republic of
(Emami Meybodi) Yazd Cardiovascular Research Center, Non-Communicable
Diseases Research Institute, Shahid Sadoughi University of Medical
Sciences, Yazd, Iran, Islamic Republic of
(Movahed) Department of Medicine, University of Arizona College of
Medicine, Tucson, AZ, United States
(Movahed) Department of Medicine, University of Arizona Sarver Heart
Center, Tucson, AZ, United States
Publisher
John Wiley and Sons Inc
Abstract
Mitral regurgitation (MR) is common in patients undergoing transcatheter
aortic valve replacement (TAVR). However, it is unclear how MR severity
affects prognosis. This meta-analysis evaluated the associations among
baseline MR severity, cardiovascular outcomes, and mortality after TAVR.
Eligible studies included adult patients undergoing TAVR with stratified
MR severity (MR >= 2 or MR >= 3) and reported the post-TAVR clinical
outcomes. Sensitivity analyses stratified by follow-up duration,
leave-one-out sensitivity, and meta-regression were also conducted.
Forty-two studies (n = 67,257 patients) were included. MR >= 2 was
associated with increased all-cause mortality during follow-up (> 30 days)
(hazard ratio [HR]: 1.40; 95% confidence interval [CI]: 1.26, 1.55) and
cardiovascular mortality (risk ratio [RR]: 1.80; 95% CI: 1.05, 3.08), but
not with stroke, transient ischemic attack, myocardial infarction (MI), or
heart failure hospitalization. MR >= 3 conferred an even higher risk of
all-cause mortality during follow-up (RR: 1.55; 95% CI: 1.24, 1.94) and
rehospitalization (RR: 1.40; 95% CI: 1.17, 1.67), but not for stroke and
MI. MR improvement occurred in 41% of patients within < 1-year post-TAVR,
declined to 15% at > 1-year post-TAVR. Baseline moderate-to-severe MR (MR
>= 2) predicts all-cause mortality during follow-up and cardiovascular
mortality after TAVR, particularly severe MR (MR >= 3). While no
consistent associations were found with nonfatal outcomes such as stroke,
TIA, MI, or heart failure hospitalization, the prognostic impact of MR
appears to be predominantly mortality-centered.<br/>Copyright &#xa9; 2025
Wiley Periodicals LLC.

<67>
Accession Number
2041426563
Title
Efficacy of multimodal rehabilitation strategies on gastrointestinal
function recovery in postoperative aortic dissection patients: a narrative
review.
Source
Frontiers in Physiology. 16 (no pagination), 2025. Article Number:
1671629. Date of Publication: 2025.
Author
Xiao J.-H.; Wei J.-X.; Bi Z.-T.; Huang L.; Dai Y.-H.; Zhang Y.-S.
Institution
(Xiao, Wei, Bi, Huang, Dai, Zhang) Department of Rehabilitation Medicine,
The First Affiliated Hospital of Guangxi Medical University, Nanning,
China
Publisher
Frontiers Media SA
Abstract
Aortic dissection is associated with significant postoperative
gastrointestinal dysfunction, a common complication that adversely affects
patient prognosis. Recent advancements in multimodal rehabilitation
strategies have shown promise in enhancing postoperative gastrointestinal
recovery, but their impact on gastrointestinal function recovery in
patients after aortic dissection surgery remains unclear. The narrative
review evaluates the efficacy of multimodal rehabilitation strategies on
gastrointestinal function recovery in postoperative aortic dissection
patients. It provides an overview of the associated pathological
mechanisms and fundamental elements of multimodal rehabilitation
strategies, assesses the existing clinical evidence, investigates tailored
applications for specific populations, and identifies barriers and
solutions to implementation. Current evidence indicates that multimodal
rehabilitation strategies positively influence the recovery of
gastrointestinal function in patients following aortic dissection surgery.
Current evidence remains constrained by a scarcity of high-quality,
large-sample randomized controlled trials specific to this population, and
mechanistic understanding continues to rely heavily on extrapolation from
non-cardiac surgery studies. Future efforts should integrate biomarkers,
precision medicine, intelligent monitoring systems, and standardized
protocols to enable large-scale multicenter randomized controlled trials
and advance foundational research.<br/>Copyright &#xa9; 2025 Xiao, Wei,
Bi, Huang, Dai and Zhang.

<68>
Accession Number
2042016637
Title
Evaluation of Analgesic Effectiveness of Continuous Erector Spinae Plane
Block in Patients Undergoing Thoracotomy.
Source
Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi. 26(4) (pp
189-196), 2020. Date of Publication: 2020.
Author
Geyik F.D.; Simsek T.; Erkal K.H.; Yuce Y.; Ozer K.B.; Saracoglu K.T.
Institution
(Geyik, Simsek, Erkal, Yuce, Saracoglu) SBU. Kartal Dr. Lutfi Kirdar
Egitim ve Arastirma Hastanesi, Anesteziyoloji ve Reanimasyon Klinigi,
Istanbul, Turkey
(Ozer) SBU. Kartal Dr. Lutfi Kirdar Egitim ve Arastirma Hastanesi, Gogus
Cerrahisi Klinigi, Istanbul, Turkey
Publisher
Kare Publishing
Abstract
Objective: The erector spinae plane block (ESPB) is performed by injection
of local anesthetic deep into the erector spinae muscle. It is a
relatively simple and safe technique for pain management. It has been
started to be widely used in pain relief. This randomized, controlled
study aimed to report continue comparing the effectiveness of ESPB and
intercostal block applications in thoracic surgery. <br/>Method(s): Forty
patients who were scheduled to undergo elective thoracotomy and
Video-Assisted Thoracic Surgery (VATS) were included in the study.
Patients in first group underwent erector spinae plane block. In the
second group intercostal block(ICB) was applied. Static, and dynamic Pain
scores in the ESPB group were lower than the ICB group in the early
postoperative period. In the postoperative period, the time to the first
analgesic requirement was longer in the ESPB group. <br/>Result(s): The
difference between the groups in terms of time to the first analgesia
requirement was found to be statistically significant (p<0.001). There was
no difference in the number of doses of tramadol hydrochloride and
dexketoprofen used. It was found that the static VAS value was higher in
the ICB group in all time periods except the second hour and this
difference was statistically significant. It was determined that dynamic
VAS values; in all time periods, were higher in the ICB group than the
ESPB group. Dynamic VAS values were found to be statistically
significantly higher in the ICB group from the 3^rd up to the
24^th hour. <br/>Conclusion(s): ESPB performed in thoracic
surgery is very effective for postoperative analgesia plan. Few
complications were also noted.<br/>Copyright &#xa9; The Society of
Thoracic Cardio-Vascular Anaesthesia and Intensive Care. This journal
published by Logos Medical Publishing.

<69>
Accession Number
2042075652
Title
Updates in Radial Access for Neurointervention: Feasibility, Innovations,
and Future Directions.
Source
Seminars in Interventional Radiology. (no pagination), 2025. Date of
Publication: 2025.
Author
Nedelcu S.; Suroop M.; Puri A.S.
Institution
(Nedelcu) Department of Neurology, Brigham and Women's Hospital, Boston,
MA, United States
(Suroop) Northeastern University, Boston, MA, United States
(Puri) University of Massachusetts, Chan Medical School, Worcester, MA,
United States
Publisher
Thieme Medical Publishers, Inc.
Abstract
Radial access has rapidly gained popularity in the neurointervention
world, building on its proven success in cardiovascular procedures. Radial
access is currently used for a variety of neurointervention procedures,
such as diagnostic cerebral angiography, aneurysm embolization, and
mechanical thrombectomy due to a proven strong safety profile,
patient-preferred alternative to traditional femoral access, faster
ambulation, and fewer access-site complications. Additionally, the radial
approach has proven effective for navigating particularly challenging
arches not suitable for the femoral approach, posterior circulation
interventions, and select acute ischemic stroke thrombectomy cases.
Advances in the radial access technique, such as the distal radial access
approach in the anatomical snuffbox, development of specialized access
catheters, long radial sheaths to mitigate spasm, and refined hemostasis
techniques have improved its feasibility, broadened its applicability to
be routinely used in neurointervention procedures, and increased its
utilization in cases with challenging aortic arch anatomy. Meta-analyses
have reported high technical success (around 97%) with low crossover
(approximately 5%) and minimal complications. This review highlights the
latest evidence on radial access in neurointervention, focusing on
technical tips, appropriate patient selection, clinical applications, as
well as complication management.<br/>Copyright &#xa9; 2025. Thieme. All
rights reserved. Thieme Medical Publishers, Inc.

<70>
Accession Number
2036052165
Title
THYROXINE AND HEART TRANSPLANTATION: A META-ANALYSIS OF 65908 PATIENTSP.
Source
Atherosclerosis. Conference: The Abstract from ISA 2024 conference. Oman.
399(Supplement 1) (pp 41-41), 2024. Date of Publication: 01 Dec 2024.
Author
Elkasaby M.H.; Desouki M.T.; AlQurm A.; Elzankaly O.; Elshahat A.; Keshk
M.; Elkoumi O.
Institution
(Elkasaby, Elshahat) Faculty of Medicine, Al-Azhar University, Cairo,
Egypt
(Desouki, Elzankaly) Faculty of Medicine, Alexandria University,
Alexandria, Egypt
(AlQurm) Faculty of Medicine, Jordan University of Science and Technology,
Irbid, Jordan
(Keshk) Faculty of Medicine, Cairo University, Cairo, Egypt
(Elkoumi) Faculty of Medicine, Suez University, Suez, Egypt
(Elkasaby, Desouki, AlQurm, Elzankaly, Elshahat, Keshk, Elkoumi) Medical
Research Group of Egypt (MRGE), Cairo, Egypt
Publisher
Elsevier Ireland Ltd
Abstract
Background: Brain-dead individuals are the primary source of heart donors,
but brain death often leads to hemodynamic instability and cardiac
dysfunction, hindering heart transplantation success. Intravenous
thyroxine administration aims to enhance organ transplantation rates and
optimize recipient outcomes, yet its efficacy remains uncertain. This
systematic review and meta-analysis evaluated the impact of thyroxine on
heart transplantation outcomes. <br/>Method(s):We searched PubMed, Embase,
Scopus,Web of Science, and Cochrane databases up to January 1, 2024.
Included were randomized controlled trials and retrospective studies
comparing thyroxine treatment in brain-dead donors and/or heart recipients
against placebo or no treatment. Primary outcomes included heart and lung
transplantation rates, and primary graft dysfunction (PGD). Secondary
outcomes were the total number of organs transplanted per donor, short-
and long-term recipient mortality, and donor left ventricular ejection
fraction (LVEF). <br/>Result(s): Ten studies encompassing 65,908 patients
were included, with 40,717 (61.7%) in the thyroxine group and 25,191
(38.3%) in the control group. Thyroxine-treated donors had higher odds of
heart transplantation (odds ratio (OR) = 1.99, 95% CI [1.17, 3.37]; P =
0.01). No significant differences were observed in lung transplantation
rates (OR = 1.07, 95% CI [0.94,1.23]), total organs per donor (mean
difference (MD) = 0.29, 95% CI [-0.09, 0.68]), PGD, short-term, or
long-term mortality (OR = 1.47, 95% CI [0.79, 2.76]; OR = 0.95, 95% CI
[0.76, 1.18]; OR = 1.11, 95% CI [1.04, 1.18]). <br/>Conclusion(s):
Thyroxine treatment in brain-dead patients is associated with increased
heart transplantation rates but does not improve PGD or recipient
mortality.<br/>Copyright &#xa9; Elsevier Ltd. All rights reserved.

<71>
Accession Number
649401595
Title
Optimization in long-term survival after multiple arterial grafting in
coronary artery bypass: A systematic review and meta-analysis.
Source
Asian cardiovascular & thoracic annals. (pp 2184923251399733), 2025. Date
of Publication: 03 Dec 2025.
Author
Abdillah A.H.; Sofian A.; Agustian A.H.; Fadhilah A.; Fatharani A.
Institution
(Abdillah, Agustian) Faculty of Medicine, Universitas Sumatera Utara,
Medan, Indonesia
(Sofian) Department of Thoracic and Cardiovascular Surgery, Pertamina
Pusat Hospital, South Jakarta, Indonesia
(Fadhilah) Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
(Fatharani) Faculty of Medicine and Life Sciences, King's College London,
London, United Kingdom
Abstract
IntroductionSurgical revascularization through coronary artery bypass is a
widely accepted approach for treating diseases affecting multiple coronary
vessels. While the standard approach uses a single arterial graft combined
with vein grafts, using numerous arterial grafts may improve long-term
outcomes. Although supported by observational data and guideline
recommendations, the broader adoption of multiple arterial grafting has
been limited due to a lack of definitive randomized trial evidence and
uncertainties in specific patient subgroups.MethodsA systematic review and
meta-analysis were conducted to compare long-term survival in patients
receiving multiple versus single arterial grafts during coronary artery
bypass surgery. Twenty-seven studies (including one randomized trial)
involving more than one million patients were included. The primary
outcome was long-term all-cause mortality. Hazard ratios with 95%
confidence intervals were pooled using a random-effects model. Subgroup
analyses were performed based on age, sex, diabetes status, graft conduit
type, extent of arterial revascularization, and left ventricular function.
Meta-regression examined the impact of patient
characteristics.ResultsMultiple arterial grafting was associated with a
significant reduction in long-term mortality compared to single arterial
grafting. The pooled hazard ratio indicated an approximate 20% relative
reduction in mortality. This survival benefit was consistent across all
evaluated subgroups. Meta-regression did not identify any patient
characteristic that significantly altered the benefit of multiple arterial
grafting. No significant publication bias was detected.ConclusionMultiple
arterial grafting is associated with improved long-term survival in
coronary artery bypass surgery. These findings support the broader
implementation of this strategy in suitable patients while emphasizing the
need for individualized surgical decision-making.

<72>
Accession Number
2041403127
Title
Surgical complications of cardiac implantable electronic devices: a
systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1667583. Date of Publication: 2025.
Author
Suarez-Paul I.; Redondo-Castro B.; Gutierrez Pastor J.M.; Membrive-Jimenez
M.J.; Caballero-Mateos A.; Romero-Bejar J.L.; Canadas-De la Fuente G.A.
Institution
(Suarez-Paul) San Agustin University Hospital, Department of Intensive
Care, Andalusian Health Service, Linares, Spain
(Redondo-Castro) Son Llatzer Hospital, Balearic Islands Health Service,
Palma, Spain
(Gutierrez Pastor, Canadas-De la Fuente) Faculty of Health Sciences,
University of Granada, Granada, Spain
(Membrive-Jimenez) Faculty of Health Sciences of Ceuta, University of
Granada, Ceuta, Spain
(Caballero-Mateos) Department of Gastroenterology, San Cecilio University
Hospital, Andalusian Health Service, Granada, Spain
(Caballero-Mateos) Department of Internal Medicine, Gastroenterology
Section, Santa Ana Hospital, Andalusian Health Service, Granada, Spain
(Romero-Bejar) Department of Statistics and Operations Research,
University of Granada, Granada, Spain
(Romero-Bejar) Instituto de Investigacion Biosanitaria (ibs. GRANADA),
Granada, Spain
(Romero-Bejar) Institute of Mathematics, University of Granada (IMAG),
Granada, Spain
(Canadas-De la Fuente) Brain, Mind and Behaviour Research Center (CIMCYC),
University of Granada, Campus Universitario de Cartuja, Granada, Spain
Publisher
Frontiers Media SA
Abstract
Aim: To identify the most common complications that occur after the
implantation of a permanent pacemaker, and to estimate their prevalence.
<br/>Method(s): systematic review and meta-analysis. <br/>Selection
Criteria: quantitative primary sources, written in English, no age
restriction, published between 1 January 2018 and 1 March 2025.
Information sources: This 30 systematic review is based on a search of the
PubMed scientific database, using descriptors from the MESH thesaurus in
the following search equation: "Pacemaker, artificial AND Surgery AND
Postoperative complications". <br/>Risk of Bias: Studies were assessed
following the Mixed Methods Appraisal Tool (MMAT) guidelines. Results
synthesis: descriptive analysis was used for the systematic review and
random effects meta-analysis were performed. <br/>Result(s): Pacemaker
implantation is a fairly common intervention, but it is not free of
complications. The most frequent are pacemaker pocket infection, contusion
or haematoma at the insertion site, painful shoulder and displacement of
the generator or electrodes. <br/>Conclusion(s): It is important to take
into account the patient's medical history and comorbidities, in order to
match the device and its upkeep to the patient's characteristics, in order
to minimise the risk of complications.<br/>Copyright 2025 Suarez-Paul,
Redondo-Castro, Gutierrez Pastor, Membrive-Jimenez, Caballero-Mateos,
Romero-Bejar and Canadas-De la Fuente.

<73>
Accession Number
2041902754
Title
Myval versus Contemporary Valves in Patients Undergoing Transcatheter
Aortic Valve Implantation: A Systematic Review and Meta-Analysis.
Source
Anatolian Journal of Cardiology. 29(12) (pp 675-686), 2025. Date of
Publication: 01 Dec 2025.
Author
Mansuri Z.; Rajith G.; Taikadan T.; Ashraf H.; Ayesha A.; Cavalcante
L.F.F.
Institution
(Mansuri) Department of Cardiology, Gujarat Cancer Society Medical College
and Research Centre, Ahmedabad, India
(Rajith) All India Institute of Medical Sciences, Guwahati, India
(Taikadan) Calicut Medical College, Government Medical College, Kozhikode,
India
(Ashraf) Rawalpindi Medical University, Rawalpindi, Pakistan
(Ayesha) Shifa College of Medicine, Islamabad, Pakistan
(Cavalcante) Faculdade de Ciencias Medicas da Santa Casa de Sao Paulo-SP,
Brazil
Publisher
Turkish Society of Cardiology
Abstract
Background: Myval is a balloon-expandable valve (BEV) used in
transcatheter aortic valve implantation (TAVI) with distinguished
features. Data comparing Myval with contemporary transcatheter heart
valves (THVs) is limited. The authors performed a meta-analysis of studies
comparing Myval with contemporary THVs (Sapien series and Evolut series).
<br/>Method(s): The authors searched PubMed, EMBASE, and Cochrane
databases. The primary composite endpoint of early safety (freedom from
death and major complications) and other outcomes were extracted as
defined by the Valve Academic Research Consortium 3 (VARC 3). The authors
computed risk ratios (RRs) with 95% CIs using a Mantel-Haenszel method
with a random-effects model with Review Manager (Cochrane Collaboration).
<br/>Result(s): Six studies with 2084 patients were included. Myval had
better early safety at 30 days as per VARC 3 (RR 1.12; 95% CI: 1.02-1.22;
P =.01) and lower need for permanent pacemaker implantation (PPI) (RR
0.62; 95% CI: 0.45-0.86; P =.004). Other outcomes were comparable in both
groups. Vis-a-vis Evolut, Myval had better 30-day device success and lower
rates of moderate or severe paravalvular leak (PVL) in addition to better
early safety and lower need for PPI. Subgroup analyses of Myval with
Sapien showed non-inferiority of Myval. <br/>Conclusion(s): Myval showed
better safety and lower need for PPI and may become a promising
alternative for concurrent THVs.<br/>Copyright @ Author(s) - Available
online at anatoljcardiol.com. Content of this journal is licensed under a
Creative Commons Attribution-NonCommercial 4.0 International License.

<74>
Accession Number
649384346
Title
Amustaline/glutathione pathogen-reduced red cell hemoglobin utilization in
complex cardiac surgery: A post hoc analysis of the phase 3 ReCePI trial.
Source
Transfusion. (no pagination), 2025. Date of Publication: 29 Nov 2025.
Author
Welsby I.J.; Sekela M.E.; Snyder E.L.; Gorham J.D.; McNeil J.S.; Liu K.;
Bentow S.; Gniadek T.; Corash L.; Mufti N.; Benjamin R.J.
Institution
(Welsby) Duke University Medical Center, Durham, NC, United States
(Sekela) Gill Heart Institute, University of Kentucky, Lexington, KY,
United States
(Snyder) Yale University School of Medicine, New Haven, CT, United States
(Gorham, McNeil) University of Virginia Health System, Charlottesville,
VA, United States
(Liu, Bentow, Gniadek, Corash, Mufti, Benjamin) Cerus Corporation,
Concord, CA, United States
Abstract
BACKGROUND: The ReCePI randomized, controlled trial compared
amustaline/glutathione pathogen-reduced (PR) and conventional red blood
cell (RBC) transfusions in cardiac surgery. STUDY DESIGN AND METHODS: We
performed a post-hoc analysis of hemoglobin (Hb) utilization and safety
outcomes. Hb content of study RBCs was measured at manufacture. Subject Hb
levels, estimated blood loss and blood product use were recorded during
and for 7 days post-surgery. Acute kidney injury (AKI) incidence was
graded over 7 days, and adverse events were assessed for 28 days.
<br/>RESULT(S): PR-RBCs contained 5.2% less Hb (mean [SD] Test 58.1 [6.5]
g; Control 61.5 [6.8] g Hb, p < .001) due to manufacturing volume losses.
Four hundred fifty-six PR- and 524 conventional RBCs were transfused to
159 Test and 162 Control subjects, respectively. Mean subject baseline and
post-surgery Hb levels, and blood loss were not different between groups.
Test subjects tended to require fewer total RBCs (3.5 [2.7] Test vs. 4.0
[3.5] Control, p = .08) resulting in 17.6% significantly less mean total
Hb transfused (Test 203.2 g; Control 246.8 g Hb, p = .01). The proportions
of subjects transfused with, and the number of platelet and
cryoprecipitate units transfused were not different. Test subjects
received less plasma (2.3 [1.8] units Test vs. 3.5 [3.8] Control, p =
.03). Overall incidence of adverse events and AKI were not clinically
different. Imbalances in AKI severity (Grade III Test 15/159 [9.4%];
Control 7/162 [4.3%], p = .07) may suggest under-transfusion in the
highest-risk Test subjects. <br/>DISCUSSION(S): Test patients required
less transfused Hb than control subjects to maintain equivalent daily
hemoglobin levels following similar blood loss.<br/>Copyright &#xa9; 2025
The Author(s). Transfusion published by Wiley Periodicals LLC on behalf of
AABB.

<75>
Accession Number
2037374041
Title
N-terminal Pro-brain Natriuretic Peptide as a Prognostic Biomarker for
Cardiac Surgeries: A Systematic Review.
Source
Brazilian Journal of Cardiovascular Surgery. 41(1) (no pagination), 2026.
Article Number: e20240417. Date of Publication: 01 Jan 2026.
Author
Queiroz B.G.S.S.; Arruda A.M.; Villa-Chan L.M.M.S.a.; Costa L.S.S.D.;
Monteiro Junior J.G.M.; Santos A.C.O.
Institution
(Queiroz, Arruda, Monteiro Junior, Santos) Programa de Pos-Graduacao em
Ciencias da Saude, Faculdade de Ciencias Medicas, Universidade de
Pernambuco, Pernambuco, Recife, Brazil
(Villa-Chan, Costa) Faculdade de Ciencias Medicas, Universidade de
Pernambuco, Pernambuco, Recife, Brazil
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: N-terminal pro-brain natriuretic peptide (NT-proBNP) is a
biomarker for heart stress and heart failure, with its production
triggered by the stretching of cardiac fibers. This study investigates if
elevated NT-proBNP levels can independently predict poor outcomes for
patients undergoing heart surgery. <br/>Method(s): A systematic review was
performed in the PubMed, Latin American and Caribbean Health Sciences
Literature (or LILACS), Physiotherapy Evidence Database (PEDro), Web of
Science, and Embase databases, with the following descriptors: "NT-proBNP"
OR "NTproBNP" OR "N-terminal pro-B-type natriuretic peptide" OR
"N-terminal pro brain natriuretic peptide" OR "amino terminal pro brain
natriuretic peptide" AND "Cardiovascular Surgical Procedures" NOT
"Pediatric" OR "children" NOT "cancer" OR "oncology" NOT "animal*".
Articles that evaluated NT-proBNP and adverse outcomes in cardiac surgical
patients were chosen. The levels of evidence and the strength of
recommendation were assessed considering the Grading of Recommendations,
Assessment, Development and Evaluation (or GRADE) system and validity by
the PEDro scale. For systematic review, the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (or PRISMA) criteria and the
Population, Intervention, Comparison, Outcome (or PICO) strategy were
followed. <br/>Result(s): Forty-seven articles were included, of which 17
were related to serious complications, including mortality.
<br/>Conclusion(s): Preoperative NT-proBNP is a prognostic marker for
mortality, length of stay in the postoperative intensive care unit,
postoperative acute kidney injury, postoperative atrial fibrillation,
postoperative low cardiac output, postoperative prolonged mechanical
ventilation time, prolonged hospitalization time, unscheduled hospital
readmission related to heart problems, and postoperative heart
failure.<br/>Copyright &#xa9; 2026, Sociedade Brasileira de Cirurgia
Cardiovascular. All rights reserved.

<76>
Accession Number
649380515
Title
EFFECT OF RBT-1 ON PRECONDITIOING BIOMARKERS AND CARDIAC SURGERY OUTCOMES.
Source
Journal of Hospital Medicine. Conference: Annual Meeting of the Society of
Hospital Medicine, SHM 2024. San Diego, CA United States. 19(Supplement 1)
(pp S29-S30), 2024. Date of Publication: 01 Apr 2024.
Author
Amin A.N.; Lamy A.; Chertow G.M.; Jessen M.E.; Mack C.; Brown C.; Smith
J.; Marzouk M.; Assi R.; Arghami A.; Savage D.H.; Scavo V.; Butler J.;
Zager R.; Wang C.; Snapinn S.; Ruiz S.; Singh B.
Institution
(Amin) University of California, Irvine, United States
(Lamy) Population Health Research Institute, United States
(Chertow) Stanford University, School of Medicine, United States
(Jessen) University of Texas, Southwestern Medical Center, United States
(Mack) Weill Cornell Medicine, United States
(Brown) New Brunswick Heart Centre, Canada
(Smith) Monash University, Australia
(Marzouk) Quebec Heart and Lung Institute, Canada
(Assi) Yale University, School of Medicine, United States
(Arghami) Mayo Clinic, United States
(Savage) Indiana University Health, United States
(Scavo) Lutheran Medical Group, United States
(Butler) Baylor Scott And White Research Institute, United States
(Zager, Ruiz, Singh) Renibus Therapeutics, United States
(Wang) Pharma Data Associates, United States
(Snapinn) Seattle-Quilcene Biostatistics LLC, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Among patients undergoing cardiac surgery on cardiopulmonary
bypass (CPB), post-operative complications are common, occurring in up to
67% of patients, and significantly impact long-term outcomes. We conducted
a Phase 2 clinical trial of RBT-1, a pharmacologic preconditioning drug,
to assess cytoprotective biomarkers and clinical outcomes. Herein, we
report our final results. <br/>Method(s): This randomized, double-blind,
placebo-controlled trial enrolled 152 patients in the US, Canada, and
Australia who were scheduled to undergo coronary artery bypass graft
(CABG) and/or valve surgery on CPB. Eligible patients were randomized to
receive one intravenous (IV) dose of RBT-1 (low or high dose) or placebo
24 to 48 hours before surgery. The primary endpoint was a cytoprotective
preconditioning response, measured by a composite of biomarkers
representing antioxidant, anti-inflammatory, and iron scavenging pathways
(ie, heme oxygenase-1 [HO-1], interleukin-10 [IL-10], and ferritin). Key
secondary/exploratory endpoints included ventilator, intensive care unit
(ICU), and hospital days; readmission rates; incidence of acute kidney
injury (AKI) and major adverse kidney events (MAKE); and adverse events.
<br/>Result(s): Baseline characteristics were as follows: mean age, 65
years; heart failure, 15%; Stage 3 or 4 chronic kidney disease (CKD), 25%;
and combined CABG/valve surgery, 23%. Both low and high doses of RBT-1
significantly increased the biomarker response by >160% (p< 0.0001),
meeting the primary endpoint. RBT-1 yielded a significant reduction in ICU
days (p=0.024), 30-day cardiopulmonary readmission rates (p=0.039), and
hypervolemia (p=0.027), as well as a meaningful reduction in hospital
days, blood transfusion, atrial fibrillation, and MAKE at Day 30 (MAKE30)
(Table 1). RBT-1 was well tolerated with only transient photosensitivity
(20% incidence) as the primary adverse event and more commonly seen in the
high dose group. A post-hoc hierarchical composite (win ratio) of clinical
outcomes (in rankorder of death, AKI requiring dialysis, ICU days, and
30-day cardiopulmonary readmission) achieved a statistically significant
win ratio of 1.74 (p=0.012), suggesting RBT-1 improved clinical outcomes
post-cardiac surgery (Figure 1). <br/>Conclusion(s): RBT-1 is a novel
preconditioning drug used safely in the setting of CABG/valve surgery
requiring CPB. Treatment with RBT-1 resulted in favorable changes in
cytoprotective biomarkers and suggested benefits on multiple clinical
outcomes of relevance. Based on these findings, FDA has granted
Breakthrough Therapy and Fast Track designation to advance clinical
development of RBT-1 to reduce the risk of post-operative complications in
patients undergoing cardiac surgery..

<77>
Accession Number
2037374028
Title
Mid-term Outcomes of Transcatheter Aortic Valve Replacement vs. Surgical
Aortic Valve Replacement in Low-to-Moderate Risk Patients with Severe
Aortic Stenosis: A Systematic Review and Meta-analysis.
Source
Brazilian Journal of Cardiovascular Surgery. 41(1) (no pagination), 2026.
Article Number: e20240250. Date of Publication: 01 Jan 2026.
Author
Pascoal C.A.D.; Faria H.S.; Francisco A.J.; Peres C.A.P.; Tavares L.F.;
Masiero B.B.; Doma M.; Manuel V.
Institution
(Pascoal, Francisco) Department of Medicine, Universidade Agostinho Neto,
Luanda, Angola
(Faria) Escola de Medicina, Universidade Federal de Santa Maria, Rio
Grande do Sul, Santa Maria, Brazil
(Peres) Department of Medicine, Universidade de Pernambuco, Pernambuco,
Recife, Brazil
(Tavares) Department of Medicine, Universidade Federal de Alfenas, Minas
Gerais, Alfenas, Brazil
(Masiero) Department of Medicine, Pontificia Universidade Catolica do Rio
Grande do Sul, Rio Grande do Sul, Porto Alegre, Brazil
(Doma) Alexandria Faculty of Medicine, Alexandria, Egypt
(Manuel) Complexo Hospitalar de Doencas Cardio-Pulmonares Cardeal Dom
Alexandre do Nascimento, Luanda, Angola
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Several clinical trials have demonstrated the
non-inferiority of transcatheter aortic valve replacement compared with
surgical aortic valve replacement in patients with severe aortic stenosis
and low to intermediate surgical risk. However, mid-term results are still
contentious. We performed this meta-analysis to compare the safety and
efficacy of transcatheter vs. surgical aortic valve replacement in the
mid-term in patients with aortic stenosis at low to moderate surgical
risk. <br/>Method(s): We searched Embase, PubMed, and Cochrane databases
for randomized clinical trials that compared transcatheter with surgical
aortic valve replacement in patients with symptomatic severe aortic
stenosis with a follow-up of at least four years. Outcomes of interest
were all-cause mortality and disabling stroke. <br/>Result(s): We included
six randomized clinical trials encompassing 6,444 patients with severe
aortic stenosis, of whom 3,282 (50.9%) underwent transcatheter aortic
valve replacement. There was no difference in all-cause mortality (risk
ratio [RR] 1.08; 95% confidence interval [CI] 0.94-1.25; P = 0.30) and
disabling stroke (RR 0.95; 95% CI 0.75-1.21; P = 0.67) between groups. In
the subgroup analysis, five-year mortality (RR 1.28; 95% CI 1.10-1.49) was
higher in the transcatheter group. The new pacemaker implantation (RR
2.22; 95% CI 1.42-3.45) rate was higher in the transcatheter group.
However, the new atrial fibrillation (RR 0.40; 95% CI 0.31-0.52) rate was
higher in the surgical group. <br/>Conclusion(s): Mid-term mortality and
disabling stroke rates in patients with severe aortic stenosis treated
with either transcatheter or surgical aortic valve replacement were
similar.<br/>Copyright &#xa9; 2026, Sociedade Brasileira de Cirurgia
Cardiovascular. All rights reserved.

<78>
Accession Number
649380516
Title
RBT-1 REDUCES POST-OPERATIVE ANEMIA, BLOOD TRANSFUSION, AND IRON USE.
Source
Journal of Hospital Medicine. Conference: Annual Meeting of the Society of
Hospital Medicine, SHM 2024. San Diego, CA United States. 19(Supplement 1)
(pp S232-S233), 2024. Date of Publication: 01 Apr 2024.
Author
Singh B.; Lobdell K.W.; Arora R.C.; Ruiz S.; Rodriguez J.; O'Connor A.D.;
Lamy A.; Khanna A.K.
Institution
(Singh, Ruiz, Rodriguez, O'Connor) Renibus Therapeutics, United States
(Lobdell) Sanger Heart and Vascular Institute, Atrium Health, United
States
(Arora) Harrington Heart and Vascular Institute, University Hospitals,
United States
(Lamy) Population Health Research Institute, United States
(Khanna) Perioperative Outcomes and Informatics Collaborative (POIC), Wake
Forest University, School of Medicine, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Patients undergoing cardiac surgery are at risk of anemia from
blood loss, inflammation, and red blood cell lysis, necessitating blood
product utilization and increasing the risk of post-operative
complications. RBT-1 (a combination of stannic protoporfin and iron
sucrose) is a novel preconditioning drug administered prior to surgery
that upregulates anti-inflammatory, antioxidant, and iron scavenging
pathways. Activation of these pathways, along with the iron content of
RBT-1, may improve iron levels, iron utilization, and reduce
erythropoietin resistance. A recent phase 2 trial showed that the drug
increased cytoprotective protein levels, and improved clinical outcomes.
Analyses of anemia incidence, transfusion, and iron usage from the study
are presented herein. <br/>Method(s): In this randomized, double-blind,
placebocontrolled trial, 121 patients who were scheduled to undergo
non-emergent coronary artery bypass graft (CABG) and/or valve surgery on
cardiopulmonary bypass (CPB) received one intravenous dose of RBT-1 or
placebo between 24 to 48 hours before surgery. Incidence of post-operative
anemia, need for blood transfusion, and iron supplementation were
recorded. Hemoglobin levels were followed through hospital discharge after
surgery. <br/>Result(s): Baseline characteristics and comorbid conditions
of the study population are summarized in Table 1. A significant relative
risk reduction of 49% in the incidence of post-operative anemia, as
reported by the investigators, was observed in response to RBT-1 compared
with placebo (p=0.0447). A 33% relative risk reduction in the need for
blood transfusion was observed in the RBT-1 group compared with placebo.
Similarly, a 42% relative risk reduction in the need for iron
supplementation was observed in the RBT-1 group compared with placebo.
When comparing all patients who required both blood transfusion and iron,
a statistically significant reduction was observed in the RBT- 1 group
compared with placebo (RBT-1: 0.0% vs Placebo: 12.2%; p=0.0038).
Importantly, hemoglobin levels at discharge in patients who received RBT-1
were comparable to those who received placebo despite lesser rates of
blood transfusion and iron supplementation (RBT-1: 9.8 g/dL vs Placebo:
9.8 g/dL). Anemia analyses are shown in Table 2. <br/>Conclusion(s):
Treatment with the novel preconditioning drug RBT-1 prior to cardiac
surgery may reduce the risk of postoperative anemia and need for blood
transfusion and iron supplementation..

<79>
Accession Number
649386471
Title
Protocol for a randomized controlled trial for comparison of self- and
balloon-expandable valves in patients with Ascending Aortic Dilation
Undergoing Transcatheter Aortic Valve Replacement (AAD-CHOICE).
Source
Trials. (no pagination), 2025. Date of Publication: 28 Nov 2025.
Author
An K.; Zhang F.; Ouyang W.; Li S.; Pan X.
Institution
(An, Zhang, Ouyang, Li, Pan) Department of Structural Heart Disease,
National Center for Cardiovascular Disease, China & Fuwai Hospital,
Chinese Academy of Medical Sciences & Peking Union Medical College, No.
167 North Lishi Rd, Xicheng District, Beijing, China
(An, Zhang, Ouyang, Li, Pan) National Health Commission Key Laboratory of
Cardiovascular Regeneration Medicine, Beijing, China
(An, Zhang, Ouyang, Li, Pan) Key Laboratory of Innovative Cardiovascular
Devices, Chinese Academy of Medical Sciences, Beijing, China
(An, Zhang, Ouyang, Li, Pan) National Clinical Research Center for
Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical
Sciences, Beijing, China
(An, Zhang, Ouyang, Li, Pan) State Key Laboratory of Cardiovscular
Disease, Beijing, China
(Ouyang, Pan) Department of Structural Heart Disease, Fuwai Yunnan
Cardiovascular Hospital, Kunming Medical University, Kunming, China
(Li) Department of Structural Heart Disease, Fuwai Hospital Chinese
Academy of Medical Sciences Shenzhen, Shenzhen, China
Abstract
BACKGROUND: Self-expandable valves (SEVs) and balloon-expandable valves
(BEVs) are the most widely used transcatheter heart valves. In patients
with ascending aortic dilation (AAD) who undergo transcatheter aortic
valve replacement (TAVR), comparison of two type of valves is lacking.
<br/>METHOD(S): The AAD-CHOICE trial is a multi-center, randomized
controlled, open-label study. The trial will randomly assign 100 patients
with AAD (ascending aortic diameter >= 45 mm) who undergo TAVR in 1:1
ratio to either SEV group or BEV group. Participants will be followed for
a minimum of 1 year. The primary end point is device success, 30-day
all-cause mortality and 30-day adverse aortic events. The key secondary
end point is 1-year all-cause mortality, 1-year cardiovascular mortality,
adverse aortic events, major adverse cardiovascular and cerebrovascular
events, and aortic expansion rate >= 3 mm/year. <br/>DISCUSSION(S): The
study will provide evidence regarding the performance of SEVs and BEVs in
patients with AAD who undergo TAVR. TRIAL REGISTRATION: ClinicalTrials.gov
NCT06009588. Registered on August 12, 2023.<br/>Copyright &#xa9; 2025. The
Author(s).

<80>
Accession Number
649369408
Title
Acute postoperative pain management after cardiothoracic surgery: a
bibliometric analysis and future directions.
Source
Journal of cardiothoracic surgery. (no pagination), 2025. Date of
Publication: 27 Nov 2025.
Author
Wang J.; Deng Y.; Chen Q.; Chen F.; Li H.
Institution
(Wang, Deng, Chen, Chen) Department of Anesthesiology, Second Affiliated
Hospital of Army Medical University, Chongqing, China
(Li) Department of Anesthesiology, Second Affiliated Hospital of Army
Medical University, Chongqing, China
Abstract
BACKGROUND: Acute postoperative pain following cardiothoracic surgery
remains a significant clinical challenge with numerous studies on its
management published over the past decades. This study aims to summarize
research progress and identify future research trends in acute
postoperative pain management after cardiothoracic surgery using
retrospective bibliometric analysis. <br/>METHOD(S): Relevant studies on
acute postoperative pain management following cardiothoracic surgery were
retrieved from the Science Citation Index Expanded of the Web of Science
Core Collection database, covering the period from January 1, 2004, to
January 1, 2024. VOSviewer was used to perform and visualize analyses of
total publications, contributing countries, research institutions,
journals, authors, co-citation networks, and keyword co-occurrence.
CiteSpace was employed to visualize burst analyses of co-cited references
and keywords. <br/>RESULT(S): From 2004 to 2024, a total of 740 papers on
acute postoperative pain management in cardiothoracic surgery were
published, authored by 4,054 researchers from 911 organizations across 50
countries. These papers appeared in 196 journals and cited 10,902
references from 2,242 journals. The most high-yield publication year,
countries, institutions, journals, authors were 2021 (n=96), China
(n=173), Cleveland Clinic (n=14), Journal of Cardiothoracic and Vascular
Anesthesia(n=108), and Chauhan, S (n=6), respectively. Regional nerve
blocks were one of the significant research topics in acute postoperative
pain management following cardiothoracic surgery. In recent years, the
keywords with the strongest citation burst were erector spinae plane
block, enhanced recovery, thoracic paravertebral block, nerve block, plane
block, and liposomal bupivacaine. <br/>CONCLUSION(S): This study provides
a bibliometric overview of the development of acute postoperative pain
management in cardiothoracic surgery over the past two decades. Overall,
research in this field has shown a steady increase globally. The future
research hotspots might be erector spinae plane block, enhanced recovery,
thoracic paravertebral block, nerve block, and liposomal
bupivacaine.<br/>Copyright &#xa9; 2025. The Author(s).

<81>
Accession Number
2041413484
Title
Comparative effects of remimazolam and propofol on hemodynamic stability
during sedation for painless gastroscopy: a randomized clinical trial.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 587. Date
of Publication: 01 Dec 2025.
Author
Gong F.; Gui Q.; Lan L.; Zhou G.; Wen Q.; Wei Y.; Li X.; Cao X.
Institution
(Gong, Gui, Lan, Zhou, Wen, Wei, Li, Cao) Department of Anesthesiology,
Dongguan Tungwah Hospital, Dongguan, China
(Gong, Gui, Lan, Zhou, Wen, Wei, Li, Cao) Dongguan Key Laboratory of
Anesthesia and Enhanced Recovery after Surgery, Dongguan, China
Publisher
BioMed Central Ltd
Abstract
Background: Remimazolam, a novel ultra-short-acting benzodiazepine, shows
promise for sedation in endoscopic procedures. However, its cardiovascular
effects during painless gastroscopy remain unclear. This study compared
the effects of remimazolam and propofol on hemodynamic stability in
patients undergoing painless gastroscopy using continuous non-invasive
arterial pressure (CNAP) monitoring. <br/>Method(s): A total of 300
patients scheduled for sedation during upper gastrointestinal endoscopy
were randomly assigned to either the remimazolam group (Group R, n = 150)
or the propofol group (Group P, n = 150). Group R received remimazolam
tosilate (0.2 mg/kg), while Group P received propofol (2 mg/kg). Primary
outcomes were mean arterial pressure (MAP) and cardiac output (CO),
recorded at two time points: the start (T1) and completion (T2) of the
examination. Secondary outcomes included adverse events such as
injection-related pain, hypotension, hypoxemia, respiratory depression,
and bradycardia. <br/>Result(s): At both assessment points, MAP was
significantly higher in Group R than in Group P (82.5 vs. 75.0 mmHg at T1,
p < 0.001; 82.0 vs. 77.0 mmHg at T2, p = 0.002). Additionally, CO was
significantly higher in Group R (5.7 vs. 5.4 L/min, p = 0.017). The
incidence of adverse events was greater in Group P compared to Group R,
including injection pain (25.3% vs. 6.7%), hypotension (24.7% vs. 5.3%),
hypoxia (5.3% vs. 0%), and bradycardia (14.7% vs. 0%). <br/>Conclusion(s):
Both remimazolam and propofol provide effective sedation for painless
gastroscopy. However, remimazolam offers superior hemodynamic stability
and significantly fewer adverse events. Trial registration: The study was
subsequently documented in the Chinese Clinical Trial Registry
(identifier: ChiCTR2300068901; registration date: March 1,
2023).<br/>Copyright &#xa9; The Author(s) 2025.

<82>
Accession Number
2041417464
Title
Rationale and design of REAC-TAVI 2: Single antiplatelet treatment with
ticagrelor vs aspirin after transcatheter aortic valve implantation.
Source
American Heart Journal. 292 (no pagination), 2026. Article Number: 107293.
Date of Publication: 01 Feb 2026.
Author
Hemelrijk K.I.; Jimenez-Diaz V.A.; Vilchez J.P.; Oteo J.F.; Gomez-Blazquez
I.; Sabate M.; Vilalta V.; Jofresa A.B.; Asmarats L.; Amat-Santos I.J.;
Tello-Montoliu A.; de la Torre Hernandez J.M.; Flores X.; Gheorghe L.;
Peral V.; Munoz-Garcia A.J.; Alfonso F.; Tirado-Conte G.; Brugaletta S.;
Veiga G.; Rodriguez-Gabella T.; Regueiro A.; De Lara J.G.; Valle-Fernandez
R.D.; Nodar J.M.R.; Mazuecos J.J.; Pan M.; Baz J.A.; Fernandez J.F.D.;
Guerreiro C.; Jorge E.; Silva M.T.; Marques J.S.; Rodrigues I.; Neves D.;
Braga J.P.; Testa L.; Costa G.; Stefanini G.; Pesarini G.; Sisinni A.;
Capodanno D.; Ribichini F.; Salvadores P.J.; Delewi R.; Angiolillo D.J.;
Garcia-Garcia H.M.; Iniguez A.; Nombela-Franco L.
Institution
(Hemelrijk, Tirado-Conte, Nombela-Franco) Cardiovascular Institute,
Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del
Hospital Clinico San Carlos (IdISSC), Madrid, Spain
(Hemelrijk, Delewi) Heart Center, Amsterdam UMC, University of Amsterdam,
Amsterdam, Netherlands
(Jimenez-Diaz, Baz, Salvadores, Iniguez) Department of Cardiology,
Hospital Alvaro Cunqueiro, University Hospital of Vigo, Vigo, Spain
(Vilchez) Hospital Universitario y Politecnico la Fe de Valencia,
Valencia, Spain
(Oteo) Hospital Universitario Puerta de Hierro-Majadahonda, Spain
(Gomez-Blazquez) Department of Cardiology, Hospital Universitario 12 de
Octubre. Instituto de Investigacion Sanitaria Hospital 12 de Octubre
(imas12), Madrid, Spain
(Sabate, Brugaletta, Regueiro) Department of Cardiology, Cardiovascular
Institute, Hospital Clinic of Barcelona, Institut d'Investigacions
Biomediques August Pi i Sunyer (IDIBAPS), CIBER-CV, Spain
(Vilalta) Department of Interventional Cardiology, Germans Trias i Pujol
University Hospital, Badalona, Spain
(Jofresa) Servicio de Cardiologia, Consorcio Hospital General
Universitario de Valencia, Spain
(Asmarats) Department of Cardiology, Hospital Santa Creu i Sant Pau,
Institut de Recerca Sant Pau (IR Sant Pau), Barcelona, Spain
(Amat-Santos) CIBERCV, Instituto de Ciencias del Corazon (ICICOR),
Hospital Clinico Universitario de Valladolid, Valladolid, Spain
(Tello-Montoliu, De Lara) Servicio de Cardiologia, Hospital Universitario
Virgen de la Arrixaca, Murcia, Spain
(de la Torre Hernandez, Veiga) Hospital Universitario Marques de
Valdecilla, IDIVAL, Santander, Spain
(Flores) Hospital Universitario de A Coruna, Spain
(Gheorghe) Department of Cardiology, Hospital Universitario Puerta del
Mar, Cadiz, Spain
(Peral, Rodriguez-Gabella) Department of Cardiology University Hospital
Son Espases, Health Research Institute of the Balearic Islands (IdISBa),
Balearic Islands, Palma, Spain
(Munoz-Garcia) Hospital Universitario Virgen de la Victoria, Malaga, Spain
(Alfonso) Department of Cardiology. Hospital Universitario de la Princesa.
CIBER-CV. IIS-IP. Universidad Autonoma de Madrid. Madrid, Spain
(Valle-Fernandez) Department of Cardiology. Asturias Central University
Hospital, Oviedo, Spain
(Nodar) Department of Cardiology. Hospital General Universitario de
Alicante, Instituto de Investigacion Sanitaria y Biomedica de Alicante
ISABIAL, CIBER-CV, Alicante, Spain
(Mazuecos) Complejo Hospitalario Universitario Albacete, Albacete, Spain
(Pan) Department of Cardiology. Hospital Universitario Reina Sofia,
IMIBIC, CIVERCV, Cordoba, Spain
(Fernandez) Department of Cardiology. Hospital Universitario Virgen del
Rocio. Sevilla, Spain
(Guerreiro, Braga) Department of Cardiology, Vila Nova de Gaia/Espinho
Hospital Center, Vila Nova de Gaia, Portugal
(Jorge) Department of Cardiology, ULS Coimbra, Portugal/ Faculty of
Medicine, University of Coimbra, Coimbra, Portugal
(Silva) Department of Cardiology, ULS Sao Joao, EPE, RISE-Health, Surgegy
and Physiology Department, Faculty of Medicine, University of Porto,
Porto, Portugal
(Marques) Department of Cardiology, ULS Santa Maria Hospital, Lisbon,
Portugal
(Rodrigues) Cardiology Department, Hospital de Santa Marta, Centro
Hospitalar de Lisboa Central, Lisbon, Portugal
(Neves) Servico de Cardiologia, Hospital Espirito Santo, Evora, Portugal
(Testa, Sisinni) IRCCS Policlinico San Donato, Milan, San Donato Milanese,
Italy
(Costa, Capodanno) Division of Cardiology, Azienda
Ospedaliero-Universitaria "G. Rodolico-San Marco", University of Catania,
Catania, Italy
(Stefanini) Department of Biomedical Sciences, Humanitas University,
Milan, Pieve Emanuele, Italy
(Stefanini) IRCSS Humanitas Research Hospital, Milan, Rozzano, Italy
(Pesarini, Ribichini) Division of Cardiology, Department of Medicine,
Verona University Hospital, Verona, Italy
(Angiolillo) Division of Cardiology, University of Florida College of
Medicine, Jacksonville, FL, United States
(Garcia-Garcia) Department of Interventional Cardiology at MedStar
Washington Hospital Center, Washington, DC, United States
Publisher
Elsevier Inc.
Abstract
Background Patients undergoing transcatheter aortic valve implantation
(TAVI) frequently experience life-threatening ischemic and bleeding
complications. However, management of antithrombotic therapy after TAVI in
patients without oral anticoagulation (OAC), particularly in patients with
high burden for subsequent ischemic events, has limited evidence from
randomized controlled trials. Methods The REAC TAVI2 trial is a
prospective, multicenter, open-label, phase III randomized trial
(NCT05283356). A total of 1206 patients undergoing TAVI with high ischemic
risk (defined as concomitant coronary artery disease, diabetes mellitus or
peripheral vascular disease) will be randomized in a 1:1 ratio to single
antiplatelet therapy with aspirin (100 mg once daily) or low-dose
ticagrelor (60 mg twice daily). The primary endpoint is the incidence of a
net adverse clinical event (NACE) at 1-year after TAVI. NACE is defined as
a composite of all-cause mortality, cerebrovascular events, myocardial
infarction, progressive angina leading to emergency evaluation,
rehospitalization or new coronary angiogram, clinical valve thrombosis,
acute limb ischemia leading to hospitalization, and type 2, 3, or 5
bleeding. The secondary endpoint is the incidence of subclinical valve
thrombosis detected by hypo-attenuated leaflet thickening and reduced
leaflet motion at 3 and 12 months post-TAVI assessed by 4-dimensional
computed tomography. Summary In patients undergoing TAVI without an
indication for OAC, there is a need for antiplatelet therapy that provides
protection against ischemic events without increasing bleeding,
particularly in the subset of patients at heightened risk of ischemic
events. The REAC-TAVI 2 is a randomized multicenter clinical trial
designed to study the effect of single antiplatelet therapy with aspirin
compared to low-dose ticagrelor on a composite outcome of all-cause
mortality, ischemic, and bleeding events after TAVI.<br/>Copyright &#xa9;
2025 Elsevier Inc.

<83>
Accession Number
649385050
Title
Contemporary Outcomes of Lower Extremity Vein Bypass for Chronic
Limb-Threatening Ischemia Based on a Post Hoc Comparison of BEST-CLI and
PREVENT III Multicenter Prospective Randomized Controlled Trials.
Source
Journal of vascular surgery. (no pagination), 2025. Date of Publication:
27 Nov 2025.
Author
Hussain M.A.; Khan A.A.; Menard M.T.; Conte M.S.; Vouyouka A.G.; Doros G.;
Strong M.B.; Kalish J.A.; Chew D.; Gasper W.J.; Tan T.-W.; Darling R.C.;
LaMuraglia G.; Rosenfield K.; Farber A.; Schanzer A.
Institution
(Hussain) Division of Vascular and Endovascular Surgery, Brigham and
Women's Hospital, Harvard Medical School, Boston, MA; Center for Surgery
and Public Health, Brigham and Women's Hospital, Boston, MA
(Khan) Warren Alpert Medical School of Brown University, Providence, RI,
United States
(Menard, Strong) Division of Vascular and Endovascular Surgery, Brigham
and Women's Hospital, Harvard Medical School, Boston, MA, United States
(Conte, Gasper) Division of Vascular & Endovascular Surgery, University of
California, San Francisco, CA, United States
(Vouyouka) Division of Vascular Surgery, Icahn School of Medicine at Mount
Sinai, New York City, NY, United States
(Doros) Department of Biostatistics, Boston University School of Public
Health, Boston, MA, United States
(Kalish, Farber) Division of Vascular & Endovascular Surgery, Department
of Surgery, Boston University Chobanian & Avedisian School of Medicine,
Boston Medical Center, Boston, MA, United States
(Chew) Iowa Heart Center, West Des Moines, IA, United States
(Tan) Department of Vascular Surgery, University of Southern California,
Los Angeles, CA, United States
(Darling) Division of Vascular Surgery, Albany Medical Center Hospital,
Albany, NY, United States
(LaMuraglia, Rosenfield) Division of Vascular & Endovascular Surgery,
Massachusetts General Hospital, Boston, MA, United States
(Schanzer) Division of Vascular Surgery, UMass Chan Medical School,
Boston, MA, United States
Abstract
INTRODUCTION: The BEST-CLI (Best Endovascular versus Best Surgical Therapy
in Patients with Chronic Limb-Threatening Ischemia [CLTI]) trial
demonstrated the superiority of single-segment great saphenous vein bypass
over endovascular treatment for patients with CLTI who were candidates for
both treatment strategies. However, with the rise of endovascular
techniques and the subsequent decline in the number of vein bypass
procedures being performed, concerns have emerged regarding the continued
ability to perform surgical bypass safely and effectively. This study
aimed to evaluate whether outcomes after lower extremity infrainguinal
vein bypass for CLTI have changed over the past two decades by comparing
data from two major randomized controlled trials: BEST-CLI and PREVENT III
(Project or Ex-Vivo vein graft Engineering via Transfection III).
<br/>METHOD(S): This post hoc comparative analysis included patients with
CLTI who underwent lower extremity infrainguinal vein bypass in the
multicenter, prospective BEST-CLI (2014-2019) and PREVENT III (2001-2003)
trials. The primary outcome was a composite of major adverse limb event
(MALE) or death at 1 year. Secondary outcomes included perioperative
(30-day) rates of major adverse cardiovascular (MACE) and limb events.
Multivariable Cox and logistic regression models were used for 1-year and
30-day outcomes, respectively, to compare outcomes between the two
cohorts; confirmatory analyses were conducted using propensity-score
methods. <br/>RESULT(S): In total, 2114 patients underwent infrainguinal
vein bypass for CLTI (710 BEST-CLI and 1404 PREVENT III). Mean (SD) age
was 67.9 (11.0) years; 32.8% were female. Patients in BEST-CLI had higher
utilization of aspirin, statins, and single segment great saphenous vein
conduit. The primary endpoint of 1-year MALE or death was lower in
BEST-CLI (21.0%) compared with PREVENT III (37.8%) (adjusted HR 0.50, 95%
CI,0.40-0.62, p<0.0001) - this observation was consistent across
predefined subgroups and in confirmatory analyses using propensity-score
methods. Major re-interventions (new bypass, surgical revision,
thrombectomy, or endovascular intervention for graft occlusion) at 1 year
were also lower in BEST-CLI (7.2% vs. 18.4%; adjusted HR 0.40, 95% CI
0.28-0.57, p<0.0001), although rates of any re-interventions were similar
(25.8% vs. 29.3%; adjusted HR 0.90, 95% CI 0.72-1.14, p=0.39).
Perioperative major cardiovascular and limb events were significantly
lower in BEST-CLI: MACE (4.1% vs. 7.8%; adjusted OR 0.47, 95% CI
0.28-0.79, p=0.005) and MALE (2.7% vs. 6.3%; adjusted OR 0.44, 95% CI
0.24-0.82, p=0.009). <br/>CONCLUSION(S): Over the past two decades,
outcomes following lower extremity infrainguinal vein bypass for CLTI have
significantly improved. These advances likely reflect a combination of
broad improvements in cardiovascular risk management, surgical techniques,
and postoperative care for CLTI patients.<br/>Copyright &#xa9; 2025.
Published by Elsevier Inc.

<84>
Accession Number
2042006661
Title
Coronary Revascularization in the Era of TAVR: Timing, Strategy, and
Outcomes.
Source
Clinical Medicine Insights: Cardiology. 19 (no pagination), 2025. Date of
Publication: 01 Jan 2025.
Author
Love A.; O'Leary C.; Shahab S.
Institution
(Love, O'Leary, Shahab) The University of Texas Medical Branch, Galveston,
United States
Publisher
SAGE Publications Ltd
Abstract
Background: Coronary artery disease (CAD) is prevalent among patients
undergoing transcatheter aortic valve replacement (TAVR), complicating
clinical decision-making regarding optimal timing of percutaneous coronary
intervention (PCI). Despite widespread clinical experience, there is
ongoing controversy and limited consensus regarding when PCI, before,
during, or after TAVR, offers the best risk-benefit balance.
<br/>Objective(s): To synthesize and critically evaluate the current
evidence on different PCI timing strategies in patients undergoing TAVR
and to identify areas of uncertainty and clinical complexity. Review:
Randomized trials, including ACTIVATION and NOTION-3, have yielded mixed
findings, highlighting a modest reduction in ischemic events with pre-TAVR
PCI but increased procedural bleeding risks. Observational registries
(REVASC-TAVI and the National Readmissions Database) have similarly shown
that pre- and peri-TAVR PCI strategies carry heightened risks of
complications without clear long-term mortality benefits. Recent
meta-analyses reinforce these findings, indicating that no PCI timing
strategy conclusively outperforms others in reducing long-term mortality.
Key considerations such as anatomical complexity, frailty, bleeding risk,
and valve type significantly influence optimal PCI timing.
<br/>Conclusion(s): Current evidence supports a personalized,
patient-centered approach to PCI timing in TAVR candidates, emphasizing
careful consideration of individual anatomical and clinical factors rather
than a standardized timing protocol. Further research exploring advanced
risk stratification, imaging modalities, and long-term clinical outcomes
is essential to refine current guidelines and practice.<br/>Copyright
&#xa9; The Author(s) 2025. This article is distributed under the terms of
the Creative Commons Attribution 4.0 License
(https://creativecommons.org/licenses/by/4.0/) which permits any use,
reproduction and distribution of the work without further permission
provided the original work is attributed as specified on the SAGE and Open
Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).

<85>
[Use Link to view the full text]
Accession Number
2041691199
Title
Multivariable Prediction Models for Atrial Fibrillation after Cardiac
Surgery: A Systematic Review and Critical Appraisal.
Source
Anesthesiology. 143(6) (pp 1643-1655), 2025. Date of Publication: 18 Nov
2025.
Author
Fields K.G.; Milner G.D.M.; Ma J.; Dhiman P.; Redfern O.C.; Karamnov S.;
He J.; Gerry S.; Alhassan H.; Providencia R.; Lip G.Y.H.; Bedford J.P.;
Clifton D.A.; O'Brien B.; Watkinson P.J.; Collins G.S.; Muehlschlegel J.D.
Institution
(Fields) Department of Anesthesiology, Perioperative and Pain Medicine,
Brigham and Women's Hospital, Harvard Medical School, Boston,
Massachusetts, United States
(Milner) Kadoorie Centre for Critical Care Research and Education,
Nuffield Department of Clinical Neurosciences, University of Oxford,
Oxford, United Kingdom
(Ma) Centre for Statistics in Medicine, Nuffield Department of
Orthopedics, Rheumatology and Musculoskeletal Sciences, University of
Oxford, Oxford, United Kingdom
(Dhiman) Centre for Statistics in Medicine, Nuffield Department of
Orthopedics, Rheumatology and Musculoskeletal Sciences, University of
Oxford, Oxford, United Kingdom
(Redfern) Kadoorie Centre for Critical Care Research and Education,
Nuffield Department of Clinical Neurosciences, University of Oxford,
Oxford, United Kingdom
(Karamnov) Department of Anesthesiology, Perioperative and Pain Medicine,
University of Massachusetts, Chan Medical School, Worcester,
Massachusetts, United States
(He) Department of Anesthesiology, Perioperative and Pain Medicine,
Brigham and Women's Hospital, Harvard Medical School, Boston,
Massachusetts, United States
(Gerry) Centre for Statistics in Medicine, Nuffield Department of
Orthopedics, Rheumatology and Musculoskeletal Sciences, University of
Oxford, Oxford, United Kingdom
(Alhassan) Division of Cardiology, Department of Medicine, Beth Israel
Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts,
United States
(Providencia) Institute of Health Informatics Research, University College
London, London, United Kingdom
(Providencia) Department of Cardiac Electrophysiology, Barts Heart Centre,
St. Bartholomew's Hospital, Barts Health National Health Service Trust,
London, United Kingdom
(Lip) Liverpool Centre for Cardiovascular Science at University of
Liverpool, Liverpool John Moores University and Liverpool Heart and Chest
Hospital, Liverpool, United Kingdom
(Lip) Department of Clinical Medicine, Aalborg University, Aalborg,
Denmark
(Bedford) Kadoorie Centre for Critical Care Research and Education,
Nuffield Department of Clinical Neurosciences, University of Oxford,
Oxford, United Kingdom
(Clifton) Institute of Biomedical Engineering, Department of Engineering
Science, University of Oxford, Oxford, United Kingdom
(Clifton) Oxford Suzhou Centre for Advanced Research, University of
Oxford, Suzhou, China
(O'Brien) Department of Cardiac Anesthesiology and Intensive Care
Medicine, Deutsches Herzzentrum der Charite, Charite Universitatsmedizin
Berlin, Berlin, Germany
(O'Brien) Department of Perioperative Medicine, St. Bartholomew's Hospital
and Barts Heart Centre, Barts Health National Health Service Trust,
London, United Kingdom
(O'Brien) Outcomes Research Consortium, UTHealth, Houston, Texas, United
States
(Watkinson) Kadoorie Centre for Critical Care Research and Education,
Nuffield Department of Clinical Neurosciences, University of Oxford,
Oxford, United Kingdom
(Watkinson) Oxford University Hospitals National Health Service Trust,
Oxford, United Kingdom
(Watkinson) National Institute for Health and Care Research Biomedical
Research Centre, Oxford University Hospitals National Health Service
Foundation Trust, Oxford, United Kingdom
(Collins) Centre for Statistics in Medicine, Nuffield Department of
Orthopedics, Rheumatology and Musculoskeletal Sciences, University of
Oxford, Oxford, United Kingdom
(Muehlschlegel) Department of Anesthesiology and Critical Care Medicine,
Johns Hopkins University School of Medicine, Baltimore, Maryland, United
States
Publisher
Lippincott Williams and Wilkins
Abstract
Atrial fibrillation is a common complication of cardiac surgery. Multiple
models exist to estimate the risk of atrial fibrillation after cardiac
surgery (AFACS) and improve targeting of preventative measures, yet none
have been consistently adopted into clinical use. This study performed a
comprehensive systematic review, assessing quality and risk of bias of
studies describing the development or external validation of AFACS
prediction models. Although some models performed well in development and
external validation (median C-statistic for apparent validation alone,
0.71; range, 0.60 to 0.98; external validation, 0.61; range, 0.51 to
0.77), all model analyses were rated at high risk of bias. Common causes
for this were small sample size, data-driven predictor selection, and
inadequate internal validation. Overall, no individual model could be
recommended for clinical use given the methodologic limitations
identified, emphasizing the need for improvements in future AFACS
prediction models to facilitate improved targeting of
prophylaxis.<br/>Copyright &#xa9; 2025

<86>
Accession Number
2041969597
Title
Artificial Intelligence in Pediatric Surgery: From Diagnostics and
Preoperative Planning to Risk Stratification: A Comprehensive Review of
Current Applications.
Source
European Journal of Pediatric Surgery. (no pagination), 2025. Date of
Publication: 2025.
Author
Gnatzy R.; Feng X.; Graefe D.; Deffaa O.J.; Lacher M.
Institution
(Gnatzy, Feng, Deffaa, Lacher) Department of Pediatric Surgery, Leipzig
University, Leipzig, Germany
(Graefe) Department of Pediatric Radiology, Leipzig University, Leipzig,
Germany
Publisher
Georg Thieme Verlag
Abstract
Objective Artificial intelligence (AI) is increasingly explored in
pediatric surgical care, yet its translation into diagnostics and
preoperative planning lags behind adult surgery. Unlike prior reviews,
this study provides a comprehensive synthesis across four domains,
diagnostics, preoperative planning, risk stratification, and surgical
error prevention, highlighting recent advances and unmet challenges.
Methods A narrative review of PubMed/MEDLINE (2020-2025) identified
peer-reviewed studies on AI in pediatric surgery. Eligible articles
addressed one of the four domains and were assessed for methodology,
clinical applicability, and relevance to pediatric surgical patients.
Results Diagnostic imaging is the most advanced field, with deep learning
models for fracture detection and bone age assessment achieving accuracies
up to 95% and near-expert agreement, though external validation is scarce.
Preoperative planning benefits from AI-driven segmentation, 3D
reconstruction, and virtual reality, with reports of altered surgical
strategy in up to 8% of oncology cases, but evidence of outcome benefit is
limited. Risk models for appendicitis and congenital heart surgery often
surpass clinical scores, yet fewer than 10% have undergone external
validation. Tools for error prevention, such as intelligent checklists and
workflow monitoring, remain at the proof-of-concept stage. Across domains,
most studies are retrospective, single-center, and methodologically
heterogeneous. Conclusion AI demonstrates tangible potential to improve
pediatric surgical diagnostics, planning, and safety. However, translation
into clinical practice requires multicenter pediatric datasets,
prospective validation, and transparent, interpretable models. By
consolidating the most recent evidence across four domains, this review
outlines both the opportunities and critical gaps that should be addressed
for safe and effective adoption.<br/>Copyright &#xa9; 2025. Thieme. All
rights reserved.

<87>
Accession Number
2042013334
Title
Dissecting the "Triple Hit" of Perioperative Neurocognitive Disorders
after CABG: A Narrative Review of Microemboli, Hypoperfusion, and
Inflammation.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Zhou Z.; Wan W.; Wei S.
Institution
(Zhou) Cardiovascular Center, Beijing Tongren Hospital, Capital Medical
University, Beijing, China
(Wan) Department of Neurosurgery, Beijing Tiantan Hospital, Capital
Medical University; National Clinical Research Center for Neurological
Diseases; Center for Stroke, Beijing Institute for Brain Disorders,
Beijing Key Laboratory of Translational Medicine for Cerebrovascular
Disease, Beijing, China
(Wei) Department of Neurosurgery, Yangpu District Shidong Hospital of
Shanghai, Shanghai, China
Publisher
W.B. Saunders
Abstract
Perioperative neurocognitive disorders, encompassing a spectrum from
delirium to long-term cognitive decline, remain one of the most
significant and prevalent complications following coronary artery bypass
grafting, profoundly impacting patient recovery and quality of life.
However, perioperative neurocognitive disorders represent only one facet
of a broader spectrum of perioperative neurologic injury (PNI) that also
includes overt stroke and prognostically crucial silent brain infarcts.
The etiology of this injury spectrum is unequivocally multifactorial. This
comprehensive review conceptualizes the intricate pathogenesis of
post-coronary artery bypass grafting neurologic injury through an expanded
"triple-hit" framework. Building on the foundational "double-hit"
hypothesis of embolism and hypoperfusion, this model integrates the
massive systemic inflammatory response as a third, synergistic pillar. We
posit that it is the convergence of these three intraoperative
insults-microembolic events, cerebral hypoperfusion, and
inflammation-acting in a vicious cycle on a patient's preexisting cerebral
vulnerabilities (the "vulnerable brain") that overwhelms cerebral reserve
and precipitates the full spectrum of PNI. This review systematically
deconstructs the pathophysiological mechanisms of each component,
critically appraises clinical evidence for the entire PNI spectrum,
evaluates the influence of evolving surgical and anesthetic techniques,
and explores the pivotal causal link between postoperative delirium and
the trajectory toward long-term dementia. Finally, drawing on
authoritative guidelines, we synthesize the evidence into a holistic,
team-based, and actionable perioperative brain health pathway, providing
practical guidance for the entire perioperative team to preserve the
cognitive function that defines patients' quality of life.<br/>Copyright
&#xa9; 2025 Elsevier Inc.

<88>
Accession Number
2041475623
Title
Evaluating the efficacy of a continuous comprehensive nursing system on
postoperative hemoglobin levels and quality of life in coronary artery
bypass surgery: a randomized controlled trial.
Source
Perioperative Medicine. 14(1) (no pagination), 2025. Article Number: 131.
Date of Publication: 01 Dec 2025.
Author
Liu P.; Xing B.; Wang S.; Liu H.; Wang J.; Zhang M.; Shen H.
Institution
(Liu, Liu) Department of Cardiac Surgery, The First Hospital of Hebei
Medical University, Hebei, Shijiazhuang, China
(Xing) Department of Emergency, The First Hospital of Hebei Medical
University, No.89 Donggang Road, Yuhua District, Hebei, Shijiazhuang,
China
(Wang) Third Department of Cardiovascular Medicine, The First Hospital of
Hebei Medical University, Hebei, Shijiazhuang, China
(Wang) School of Health, The First Hospital of Hebei Medical University,
Hebei, Shijiazhuang, China
(Zhang) Department of Thoracic Surgery, The First Hospital of Hebei
Medical University, Hebei, Shijiazhuang, China
(Shen) Department of Nursing, The First Hospital of Hebei Medical
University, Hebei, Shijiazhuang, China
Publisher
BioMed Central Ltd
Abstract
Objective: This study aimed to investigate the effects of a continuous
comprehensive nursing (CCN) system compared to routine care on
postoperative hemoglobin (Hb) levels and quality of life (QoL) in patients
undergoing coronary artery bypass grafting (CABG). <br/>Method(s): This
randomized controlled trial (RCT) enrolled 120 patients undergoing CABG.
Patients were allocated using computer-generated random numbers (1:1) to
either the intervention group (n = 60), receiving a CCN plan, or the
control group (n = 60), receiving standard postoperative care. The CCN
intervention provided a patient-centered approach encompassing
preoperative education, psychological support, continuous postoperative
monitoring, personalized care plans, rehabilitation guidance, and
structured follow-up extending for three months beyond discharge.
<br/>Result(s): Although baseline differences in BMI and Hb were noted,
both groups were otherwise comparable. While Hb levels initially declined
in both groups, by day 7 post-surgery, the CCN group demonstrated
significantly higher Hb levels compared to the control group (12.28 +/-
0.47 g/L vs. 9.16 +/- 0.41 g/L; P < 0.001). The intervention group also
showed significantly improved red blood cell morphology (lower MCV, P <
0.001; lower RDW, P < 0.001; higher HCT, P < 0.001), changes in IL-2 and
IL-6 levels suggesting an immune response difference (higher IL-2, P <
0.001; lower IL-6, P < 0.001), superior QoL scores across all WHOQOL
domains (psychological, social, environmental, physical; all P < 0.001),
reduced depressive (CES-D, P < 0.001) and anxiety symptoms (SAS, P <
0.001), and significantly higher patient satisfaction (P < 0.001).
<br/>Conclusion(s): Implementing a continuous comprehensive nursing system
after CABG significantly benefits postoperative recovery, leading to
improved hemoglobin levels, favorable red blood cell indices, measurable
changes in immune markers, enhanced quality of life, improved mental
health outcomes, and greater patient satisfaction compared to routine
care. These findings suggest CCN is a promising strategy to optimize
post-CABG patient outcomes.<br/>Copyright &#xa9; The Author(s) 2025.

<89>
Accession Number
2041432715
Title
Role of Cerebral Oximetry in Reducing Postoperative End-Organ Dysfunction
After Major Non-Cardiac Surgery: A Randomised Controlled Trial.
Source
Clinics and Practice. 15(11) (no pagination), 2025. Article Number: 213.
Date of Publication: 01 Nov 2025.
Author
Bieze M.; Foley K.; Beattie W.S.; Carroll J.; Poonawala H.; Ti L.-K.;
Djaiani G.
Institution
(Bieze, Foley, Beattie, Carroll, Poonawala, Djaiani) Department of
Anesthesia & Pain Management, University of Toronto, Toronto General
Hospital, University Health Network, Toronto, ON, Canada
(Ti) Department of Anesthesia, Yong Loo Lin School of Medicine, National
University of Singapore, Singapore, Singapore
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: An increasing number of older individuals require
general anaesthesia for major non-cardiac surgery, with 20% displaying
postoperative complications. Regional cerebral oxygen saturation
(rSO<inf>2</inf>) correlates with the gold standard of mixed venous oxygen
saturation, indicating global perfusion. We hypothesised that
rSO<inf>2</inf>-based anaesthesia reduces organ dysfunction and morbidity
after major non-cardiac surgery. <br/>Method(s): In Singapore and Toronto,
we conducted a prospective, double-blind, randomised controlled trial in
elderly patients undergoing major non-cardiac surgery, after obtaining
research ethics board permission and informed consent. This RCT followed
the CONSORT guidelines. Patients received bilateral cerebral oximetry
sensors, and the control group received standard care. In the intervention
group, an algorithm restored rSO<inf>2</inf> if it dropped 10% below
baseline for >15 s by adjusting cerebral perfusion pressure, inspired
oxygen concentration, end-tidal carbon dioxide, depth of anaesthesia,
haemoglobin, and cardiac index. Postoperative complications and outcomes
were noted. Categorical data were analysed using Chi-square or Fisher's
exact tests and continuous data using a t-test or a Mann-Whitney U test.
The study was powered for 394 patients, but due to the COVID-19 pandemic
and funding constraints, this study was terminated at 101 patients.
<br/>Result(s): Of 101 patients, 49 were randomised to the control and 52
to the intervention group. A total of 31 (63%) patients in the control
group and 30 (58%) in the interventional exhibited bilateral cerebral
desaturation. Time of cumulative cerebral desaturation was longer in the
control group (23 +/- 48 min vs. 9 +/- 15 min, respectively, p = 0.01). A
total of 142 algorithm-based treatments were employed, restoring
rSO<inf>2</inf> in 29 (86%) patients. Both groups displayed equal
postoperative outcomes. <br/>Conclusion(s): In major non-cardiac surgery,
cerebral desaturation is prevalent in over 85% of patients. Although
algorithm-guided therapy restored rSO<inf>2</inf> in the majority of
patients, it did not result in reduced postoperative
morbidity.<br/>Copyright &#xa9; 2025 by the authors.

<90>
Accession Number
2041529063
Title
Impact of Intoxicated Donors on Recipient Survival in Cardiac
Transplantation: A Systematic Review and Meta-Analysis.
Source
Clinical Transplantation. 39(12) (no pagination), 2025. Article Number:
e70404. Date of Publication: 01 Dec 2025.
Author
Souza L.B.D.; Ximenes G.F.; Filho G.F.B.; Marinho J.D.S.F.; Alencar
L.F.T.D.; Feitosa M.P.M.; Vieira J.L.
Institution
(Souza, Ximenes, Filho, Marinho, Alencar, Feitosa) Department of Medicine,
University of Fortaleza, Ceara, Brazil
(Vieira) Hospital De Messejana Dr. Carlos Alberto Studart, Ceara,
Fortaleza, Brazil
(Vieira) Universidade Federal do Ceara, Ceara, Fortaleza, Brazil
Publisher
John Wiley and Sons Inc
Abstract
Background: Heart transplantation remains the main treatment for end-stage
heart failure. The opioid crisis has increased donor availability,
including organs from intoxicated individuals, but the impact on outcomes
is uncertain. <br/>Method(s): Following PRISMA 2020, we searched MEDLINE,
Embase, and Web of Science for studies on adult heart transplant
recipients with donors exposed to substances like cocaine, heroin,
marijuana, tobacco, or opioids. Eligible studies met PICOS criteria, and
meta-analyses used a random-effects model. <br/>Result(s): Twelve
retrospective cohorts were included, totaling 189 935 recipients, 33 393
of whom received organs from intoxicated donors. The most reported
substances were cocaine, alcohol, and tobacco. No significant differences
were found in 5-year survival (HR = 1.05; CI = 0.94-1.17), 10-year
survival (HR = 0.94; CI = 0.88-1.00), or survival with overdose-related
donors (HR = 0.96; CI = 0.84-1.09). Rates of allograft rejection (HR =
0.99; CI = 0.21-0.88) and cardiac allograft vasculopathy (HR = 1.02; CI =
0.95-1.11) were also similar. Subgroup and sensitivity analyses confirmed
result consistency. <br/>Conclusion(s): Organs from intoxicated donors do
not compromise long-term outcomes and may help address donor
shortages.<br/>Copyright &#xa9; 2025 John Wiley & Sons A/S. Published by
John Wiley & Sons Ltd.

<91>
Accession Number
2037374030
Title
Midterm Results of Neocuspidization of the Aortic Valve with Ozaki
Technique in Adults.
Source
Brazilian Journal of Cardiovascular Surgery. 41(1) (no pagination), 2026.
Article Number: e20240126. Date of Publication: 01 Jan 2026.
Author
Seguel S.E.; Reyes M.R.; Gonzalez L.R.; Rubilar P.H.; Sepulveda P.C.;
Barril M.G.; Stockins L.A.
Institution
(Seguel, Reyes, Gonzalez, Stockins) Department of Surgery, Faculty of
Medicine, Universidad de Concepcion, Concepcion, Chile
(Seguel, Reyes, Gonzalez, Stockins) Cardiovascular Center, Guillermo Grant
Benavente Hospital of Concepcion, Concepcion, Chile
(Rubilar, Sepulveda) Department of Medical Education, Faculty of Medicine,
Universidad de Concepcion, Concepcion, Chile
(Barril) Surgery Residency Program, Pontifical Catholic University of
Chile, Santiago, Chile
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
The neocuspidization technique using autologous pericardium (AVNeo) is a
recent alternative for aortic valve replacement in selected patients.
Between 2019 and 2023, we applied it in 56 patients, evaluating surgical
outcomes, survival, reintervention rates, and clinical and
echocardiographic results. We analyzed its advantages, patient selection
criteria, limitations, and management of bicuspid valves. We also assessed
whether it is suitable for all patients and discussed the midterm outcomes
observed. AVNeo may offer a promising option, especially for younger
patients, by preserving native anatomy and avoiding prosthetic materials,
though long-term data and further research are still needed.<br/>Copyright
&#xa9; 2026, Sociedade Brasileira de Cirurgia Cardiovascular. All rights
reserved.

<92>
Accession Number
2040842933
Title
POINTER: study protocol for a phase 2b, randomised, placebo-controlled,
double-blind, parallel group dose-finding clinical study to evaluate the
efficacy of RMC-035 on renal function and safety, in participants at high
risk for kidney injury, following open-chest cardiac surgery.
Source
Trials. 26(1) (no pagination), 2025. Article Number: 449. Date of
Publication: 01 Dec 2025.
Author
Zarbock A.; Strauss C.; Laflamme M.; Myjavec A.; Bohm J.; Burkert J.;
Mazer C.D.; de Varennes B.; Iglesias A.G.; Matschke K.; Larsson T.E.;
Reusch M.
Institution
(Zarbock, Strauss) Department of Anaesthesiology, Intensive Care and Pain
Medicine, University Hospital Munster, Munster, Germany
(Laflamme) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Quebec, Canada
(Myjavec) Department of Cardiac Surgery, Faculty of Medicine, Charles
University, University Hospital in Hradec Kralove, Hradec Kralove, Czechia
(Bohm) Department of Cardiovascular Surgery, Institute Insure, German
Heart Center Munich, Technical University of Munich, Munich, Germany
(Burkert) Fakultni Nemocnice V Motole, Prague, Czechia
(Mazer) St. Michael's Hospital, University of Toronto, Toronto, Canada
(de Varennes) McGill University Health Centre - Royal Victoria Hospital,
Montreal, Canada
(Iglesias) Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
(Matschke) Klinik fur Herzchirurgie, Herzzentrum Dresden
Universitatsklinik, Dresden, Germany
(Larsson, Reusch) Guard Therapeutics International AB, Stockholm, Sweden
Publisher
BioMed Central Ltd
Abstract
Background: Cardiac surgery with cardiopulmonary bypass invariably induces
renal stress and risk of irreversible kidney function loss, with no
approved drug treatments. RMC-035, a recombinant human
alpha-1-microglobulin with potent heme-binding and antioxidant capacity,
has shown promising long-term kidney-protective effects in a phase 2a
trial of patients undergoing cardiac surgery. The primary objective of
this phase 2b dose-optimisation trial is to demonstrate that RMC-035
(pooled dose groups) is superior to placebo in preserving renal function
at 90 days after surgery. <br/>Method(s): This randomised, blinded,
placebo-controlled, multicentre study evaluates the efficacy and safety of
RMC-035 among approximately 161 high-risk patients undergoing cardiac
surgery who are randomised into one of three treatment groups in a 2:2:3
ratio: RMC-035 (30 mg or 60 mg) or placebo. The study drug is administered
via three intravenous infusions, with the first dose given
intraoperatively, followed by additional doses at 6 and 24 h,
respectively. The primary endpoint is the change in estimated glomerular
filtration rate (eGFR) from baseline (pre-surgery) to Day 90. Important
secondary endpoints include the incidence of major adverse kidney events
at Day 90 and short-term outcomes reflecting changes in renal filtration
markers up to Day 7. Safety assessments encompass adverse events, vital
signs, electrocardiograms and routine safety laboratory tests. Additional
evaluations include pharmacokinetics, anti-drug antibodies and
immunological biomarkers. <br/>Discussion(s): This multicentre,
multinational phase 2b trial, will assess the change in eGFR within 90
days of the first dose, providing additional evidence of the long-term
kidney-protective potential of RMC-035 in patients undergoing cardiac
surgery at high risk for kidney injury. Trial outcomes will inform the
preferred dose, dosing regimen, and benefit-risk profile related to
cardiac surgery for a future pivotal phase 3 trial. Trial registration:
The trial was registered June 20, 2024, at Clinicaltrials.gov (NCT06475274
https://clinicaltrials.gov/study/NCT06475274). The trial including the
participating EU countries is also registered with the EUCT number
2024-510658-28 under
https://euclinicaltrials.eu/search-for-clinical-trials/?lang=en&EUCT=2024-
510658-28-00. The first patient was enrolled August 26,
2024.<br/>Copyright &#xa9; The Author(s) 2025.

<93>
Accession Number
2037380727
Title
Perioperative Risk Factors for Permanent Pacemaker Implantation After
Transcatheter Aortic Valve Replacement: A Systematic Review and
Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 26(10) (no pagination), 2025. Article
Number: 39299. Date of Publication: 01 Oct 2025.
Author
Peng X.; Chen N.; Li P.; Zhu F.-H.; Li M.; Zhao X.-H.; Zhang H.-P.
Institution
(Peng, Chen, Zhu, Li, Zhao, Zhang) Department of Cardiology, Beijing
Hospital, National Center of Gerontology, Institute of Geriatric Medicine,
Chinese Academy of Medical Sciences, Beijing, China
(Peng) Arrhythmia Center, Fuwai Hospital, National Center for
Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union
Medical College, Beijing, China
(Li) The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics,
Institute of Geriatric Medicine, Chinese Academy of Medical Sciences,
Beijing Hospital/National Center of Gerontology of National Health
Commission, Beijing, China
Publisher
IMR Press Limited
Abstract
Background: Transcatheter aortic valve replacement (TAVR) has become the
preferred treatment for severe aortic stenosis, particularly in patients
at high surgical risk. Conduction block requiring permanent pacemaker
(PPM) implantation remains a common complica-tion post-TAVR. This
systematic review and meta-analysis aimed to clarify perioperative
(<=30-day) predictors of PPM implantation. <br/>Method(s): A systematic
search was performed using the PubMed, Web of Science, and Embase
databases to gather all relevant studies examining the relationship
between TAVR and pacemaker implantation outcomes within 30 days of the
procedure. Pooled odds ratios (ORs) with 95% confidence intervals (CIs)
were calculated using a random-effects model. <br/>Result(s): A total of
82 studies comprising 124,808 patients were included. The overall
incidence of PPM implantation within 30 days post-TAVR was 17.5%. Key
baseline risk factors included right bundle branch block (RBBB) (OR, 5.48;
95% CI, 4.52-6.64) and first-degree atrioventricular block (AVB) (OR,
2.30; 95% CI, 1.82-2.90). Baseline left bundle branch block (LBBB), mitral
annular calcification, and male sex were not significantly associated with
PPM implantation. A longer membranous septum (MS) length was associated
with a reduced risk (OR, 0.78; 95% CI, 0.66-0.93). Additionally,
procedural risk factors included greater implant depth (OR, 1.20; 95% CI,
1.13-1.28), the use of self-expanding valves (OR, 2.59; 95% CI,
2.06-3.27), and balloon predilation (OR, 1.37; 95% CI, 1.10-1.71). The
cusp overlap technique (COT) significantly reduced PPM risk (OR, 0.45; 95%
CI, 0.35-0.58). Furthermore, a greater difference between MS length and
implantation depth (MSID) was inversely correlated with PPM implantation
risk (OR, 1.36; 95% CI, 1.22-1.50), and post-TAVR new-onset LBBB was a
strong predictor of PPM implantation (OR, 2.26; 95% CI, 1.66-3.07).
<br/>Conclusion(s): This meta-analysis identified key perioperative
predictors of PPM implantation following TAVR. RBBB, first-degree AVB,
increased implant depth, self-expanding valves, and predila-tion all have
been shown to increase PPM risk, whereas COT and lower MSID are protective
factors. The PROSPERO Registration: CRD42023438228, URL:
https://www.crd.york.ac.uk/PROSPERO/view/CRD42023438228.<br/>Copyright
&#xa9; 2025 The Author(s).

<94>
Accession Number
649376429
Title
Efficacy and Safety of Postoperative Autologous Blood Transfusion in
Cardiac Surgery (RESCUE): Rationale, Design, and Study Protocol of a
Multicenter Randomized Controlled Trial.
Source
American heart journal. (pp 107313), 2025. Date of Publication: 27 Nov
2025.
Author
Shan J.; Gao J.; Chen Y.; Ji H.
Institution
(Shan, Gao, Chen) Department of Anesthesiology, Fuwai Hospital, Chinese
Academy of Medical Sciences and Peking Union Medical College, Beijing,
China
(Ji) Department of Anesthesiology, Fuwai Hospital, Chinese Academy of
Medical Sciences and Peking Union Medical College, Beijing 100037, China;
Department of Anesthesiology, Chinese Academy of Medical Sciences Fuwai
Hospital Shenzhen Hospital, Guangdong 518057, China. Electronic address:
13701229553@163.com
Abstract
BACKGROUND: Postoperative bleeding is a major concern in cardiac surgery,
often leading to significant transfusion requirements. Despite this high
transfusion demand, the use of postoperative autologous blood transfusion
(PABT) remains underexplored. METHODS AND RESULTS: This large-scale,
single-blind randomized controlled trial with a 30-day follow-up enrolls
patients undergoing elective on- or off-pump coronary artery bypass
grafting. Patients with shed mediastinal blood volumes over 500 mL within
the first 6 hours postoperatively are randomly assigned 1:1 to either the
PABT group or the standard care group. The PABT group receives
postoperative autotransfusion and additional allogeneic RBC transfusions
if needed, while the standard care group receives allogeneic RBC
transfusions only when clinically necessary, without postoperative
autotransfusion. The primary efficacy endpoint is the postoperative
allogeneic RBC transfusion volume, defined as the cumulative amount
transfused from the day of surgery to discharge. Secondary efficacy
endpoints include postoperative allogeneic RBC and non-RBC transfusion
rates, perioperative hematologic recovery, drainage volume, mechanical
ventilation duration, ICU and hospital length of stay. The primary safety
endpoint is the incidence of a composite of postoperative infections
(pneumonia, bloodstream infections, and surgical site infections).
Secondary safety endpoints include a composite of other postoperative
complications (renal dysfunction, myocardial infarction, stroke, deep vein
thrombosis, and all-cause mortality), individual components of these
composites, and 30-day mortality and morbidity. The estimated sample size
is 1,232 participants. Patient recruitment is planned from January 2026 to
December 2029 and is currently in the preparatory phase. The study is
registered at the Chinese Clinical Trial Registry (ChiCTR2500103269,
https://www.chictr.org.cn/) and was registered on May 27, 2025.
<br/>CONCLUSION(S): The study is designed to identify the efficacy and
safety of PABT after cardiac surgery. We hypothesize that PABT has
superior efficacy and non-inferior safety to the standard
care.<br/>Copyright &#xa9; 2025 The Author(s). Published by Elsevier Inc.
All rights reserved.

<95>
Accession Number
649371701
Title
ROBOTIC-ASSISTED THORACIC SURGERY IN CHILDREN: A SYSTEMATIC REVIEW AND
META-ANALYSIS.
Source
Journal of pediatric surgery. (pp 162840), 2025. Date of Publication: 26
Nov 2025.
Author
Delgado-Miguel C.; Camps J.; Montagut I.G.; Diez R.; Arredondo-Montero J.;
Hernandez-Oliveros F.
Institution
(Delgado-Miguel) Department of Pediatric Surgery, Fundacion Jimenez Diaz
University Hospital, Madrid, Spain; Institute for Health Research IdiPAZ,
La Paz University Hospital, Madrid, Spain
(Camps) Department of Pediatric Surgery, Prisma Health Children's
Hospital, Columbia, SC, United States
(Montagut) Faculty of Medicine. El Bosque University, Bogota, Colombia
(Diez) Department of Pediatric Surgery, Fundacion Jimenez Diaz University
Hospital, Madrid, Spain
(Arredondo-Montero) Department of Pediatric Surgery, Complejo Asistencial
Universitario de Leon, Castilla y Leon, Spain
(Hernandez-Oliveros) Institute for Health Research IdiPAZ, La Paz
University Hospital, Madrid, Spain
Abstract
INTRODUCTION: Robotic-assisted thoracic surgery (RATS) has emerged as an
innovative alternative to conventional video-assisted thoracoscopic
surgery (VATS) in pediatric patients. Although individual case series have
described its feasibility and safety, no systematic synthesis has
previously addressed its role in children. <br/>METHOD(S): We conducted a
systematic review and meta-analysis in accordance with PRISMA guidelines,
registered in PROSPERO (CRD420251091235). A comprehensive search of
PubMed, CINAHL, Web of Science, and EMBASE was performed to identify
studies reporting pediatric RATS. For the quantitative synthesis,
random-effects meta-analyses were applied with restricted maximum
likelihood (REML) estimation, and confidence intervals were adjusted using
either the Knapp-Hartung (HKSJ) or modified Knapp-Hartung (mKH) methods to
account for small-sample uncertainty. <br/>RESULT(S): Thirty-six studies
encompassing 936 patients were included; 638 underwent RATS. Indications
included tracheobronchial procedures, pulmonary resections, diaphragmatic
anomalies, mediastinal tumors, and thymic disorders. Qualitative synthesis
demonstrated high feasibility, versatility, and favorable safety, with a
1.8% conversion rate and complication rates of 5.6%. Quantitative
synthesis included 4 studies comparing pulmonary resections, and revealed
longer operative times for RATS compared to VATS (mean difference 26.4
minutes, 95% CI: 3.26 to 49.47; p=0.04). However, RATS significantly
reduced hospital stay (-0.70 days, 95% CI: -1.22 to -0.17; p=0.02) and
showed a nonsignificant trend toward shorter chest tube duration.
Complication rates did not differ significantly between groups (RR 1.16;
95% CI: 0.83 to 1.63; p=0.39). <br/>CONCLUSION(S): RATS may be considered
a safe and effective minimally invasive technique for selected pediatric
thoracic conditions, offering enhanced precision and versatility. Current
evidence, although limited by the small number of studies, suggests a
potentially beneficial profile for RATS. Larger prospective multicenter
studies are needed to confirm long-term results and optimize patient
selection.<br/>Copyright &#xa9; 2025 Elsevier Inc. All rights reserved.

<96>
Accession Number
2042013065
Title
Sex Differences in Dilated Cardiomyopathy: Evidence Gaps and Future
Directions.
Source
Journal of the American College of Cardiology. (no pagination), 2025.
Date of Publication: 2025.
Author
Stroeks S.L.V.M.; Oko-Osi S.; Arasu A.; Hirst J.E.; Tayal U.P.
Institution
(Stroeks) Department of Cardiology, Maastricht University, Cardiovascular
Research Institute Maastricht, Maastricht, Netherlands
(Stroeks) KU Leuven, Cardiovascular Sciences, Leuven, Belgium
(Stroeks) Department of Clinical Genetics, Maastricht University Medical
Center, Maastricht, Netherlands
(Stroeks) European Reference Network for Rare, Low Prevalence and Complex
Diseases of the Heart (ERN GUARD-Heart), Amsterdam, Netherlands
(Oko-Osi, Arasu, Tayal) National Heart Lung Institute, Imperial College
London, London, United Kingdom
(Oko-Osi, Arasu, Tayal) Royal Brompton & Harefield Hospitals, Guy's and St
Thomas' NHS Foundation Trust, London, United Kingdom
(Hirst) George Institute for Global Health, Imperial College London,
London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Dilated cardiomyopathy (DCM), which affects 1 in 250 people, is a leading
global cause of heart failure and the most common indication for heart
transplantation. Evidence suggests that DCM is more prevalent in men, but
whether this reflects biological differences or underdiagnosis in women
remains uncertain. This review explores the impact of sex on DCM,
examining differences in epidemiology, etiology, clinical presentation,
treatment response, and outcomes. Women often present with less severe
cardiac phenotypes, including lower levels of fibrosis and better left
ventricular function, yet the long-term prognosis of DCM in women is less
clear. Through a systematic review and meta-analysis, we found that male
DCM patients with variants in PLN, DSP, and LMNA had higher arrhythmic
event rates compared with TTNtv and BAG3 carriers. In female patients with
DCM, those with RBM20, DSP, and PLN variants faced the highest arrhythmic
risk, and TTNtv carriers the lowest. PLN and LMNA variants had the highest
heart failure risk in both sexes, whereas BAG3, RBM20, and TTN variants
had lower heart failure rates in female compared with male carriers. These
findings highlight the influence of sex and genotype on clinical outcomes.
Current risk-stratification tools, such as those used for implantable
cardioverter-defibrillators, may undertreat women owing to reliance on
sex-neutral thresholds. We highlight the role of genetic, environmental,
and reproductive factors in shaping these disparities, including the
influence of pregnancy, pregnancy complications, and menopause. This
review identifies key gaps in knowledge and calls for expanded
representation of women in DCM studies and the development of sex-specific
risk models. Addressing these gaps is essential to improving outcomes and
advancing equitable personalized care for all DCM patients.<br/>Copyright
&#xa9; 2025 American College of Cardiology Foundation

<97>
Accession Number
2041978727
Title
Serum biomarkers in cardiac allograft vasculopathy: A systematic review.
Source
Transplantation Reports. 10(4) (no pagination), 2025. Article Number:
100186. Date of Publication: 01 Dec 2025.
Author
Ishaq F.; Fida N.; Thandavarayan R.A.; Casarin S.; Guha A.
Institution
(Ishaq, Fida, Thandavarayan, Guha) Department of Cardiology, Houston
Methodist Hospital, Houston, TX, United States
(Ishaq) Center for Connected Care Innovation & Implementation Research,
Houston Methodist Hospital, Houston, TX, United States
(Casarin) Center for Precision Surgery, Houston Methodist Research
Institute, Houston, TX, United States
(Casarin) LaSIE, UMR 7356 CNRS, La Rochelle Universite, La Rochelle, FR,
United States
(Casarin) Department of Surgery, Houston Methodist Hospital, Houston, TX,
United States
Publisher
Elsevier Inc.
Abstract
Introduction: Cardiac Allograft Vasculopathy (CAV) is a progressive
manifestation of chronic allograft rejection in heart transplant
recipients. While current diagnostic tools involve invasive and
non-invasive imaging of coronary arterial anatomy and blood flow,
circulating biomarkers can lead to earlier detection non-invasively.
<br/>Objective(s): The aim of this systematic review is to synthesize
existing literature of prognostic and diagnostic circulating peripheral
biomarkers of CAV. <br/>Method(s): A thorough literature search was
performed on Pubmed, CINAHL, Scopus and Medline using the terms "cardiac
allograft vasculopathy," "CAV," and "biomarkers." Results: The search
yielded 1648 studies; 109 were included for the final review. Quality of
evidence and risk of bias varied across the studies. <br/>Conclusion(s):
Multiple circulating biomarkers could help diagnose and prognosticate in
the presence of CAV with variable diagnostic accuracy and predictability.
The role of incorporating these biomarkers in traditional coronary imaging
diagnostic paradigm of CAV remains to be studied.<br/>Copyright &#xa9;
2025 The Author(s)

<98>
[Use Link to view the full text]
Accession Number
2041216494
Title
Impact of Preoperative Cardiac Computed Tomography Angiography on Left
Atrial Appendage Closure: A Systematic Review and Meta-Analysis.
Source
Journal of Computer Assisted Tomography. Publish Ahead of Print (no
pagination), 2025. Date of Publication: 11 Oct 2025.
Author
Lin Q.; Duan H.; Li K.; Ma Z.-Y.
Institution
(Lin, Duan, Li, Ma) Department of Radiology, The First Affiliated Hospital
of Kunming Medical University, Kunming, China
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: - Our aim is to evaluate the impact of preoperative cardiac CT
on LAAC. <br/>Method(s): - This research followed the protocols outlined
in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) 2020 checklist, and it adhered to the previously described
established methodologies. A search strategy was designed to utilize
PubMed, EMBASE, Cochrane Library, and Web of Science for studies showing
the effect of preoperative CCTA on LAAC from December 08, 2017, to June
12, 2023. For continuous outcome variables, the weighted mean difference
(WMD) was used to estimate the effect size, whereas the odds ratio (OR)
was used for dichotomous outcomes. We performed meta-regression to explore
the heterogeneity among the included studies. <br/>Result(s): - Eight
cohort studies (including one published only as an abstract) that
evaluated the impact of preoperative CCTA for LAAC were identified and
included in this meta-analysis. Compared with the CCTA negative group,
patients in the CCTA positive group experienced a significantly shorter
LAAC procedure time (WMD: -0.69; 95% CI: -1.11 to -0.28; P=0.00;
I2=95.39%). In contrast, there were no significant differences in
implantation success (OR: 1.04; 95% CI: 0.98-1.11; P=0.18; I2=45.61%),
contrast volume (WMD: -0.07; 95% CI: -0.28 to 0.14; P=0.51; I2=77.38%),
peri-device leak (OR: 0.56; 95% CI: 0.29-1.11; P=0.10; I2=87.33%),
device-related thrombus (OR: 0.70; 95% CI: 0.36-1.35; P=0.29; I2=0%),
pericardial effusion requiring intervention (OR: 1.09; 95% CI: 0.95-1.25;
P=0.21; I2=0%), major adverse events (OR: 0.99; 95% CI: 0.89-1.09; P=0.78;
I2=0%), and all-cause mortality (OR: 0.79; 95% CI: 0.54-1.16; P= 0.23;
I2=0%). <br/>Conclusion(s): - Preoperative CCTA is associated with a
shorter procedure time, but other parameters did not differ significantly
between patients who underwent preoperative CCTA and those who did
not.<br/>Copyright &#xa9; 2025