EPICORE Embase Updates

Total documents retrieved: 144

Results Generated From:
Embase <1980 to 2026 Week 12>
Embase Weekly Updates (updates since 2026-03-13) - (144 records)

<1>
Accession Number
2044062871
Title
Real-world insights into M-TEER: Lessons from the Polish National
Experience.
Source
Kardiologia Polska. 84(2) (pp 157-159), 2026. Date of Publication: 2026.
Author
Scotti A.; Calamita G.; Latib A.
Institution
(Scotti, Calamita, Latib) Interventional Cardiology, Montefiore-Einstein
Center for Heart and Vascular Care, Montefiore Medical Center, Albert
Einstein College of Medicine, Bronx, NY, United States
(Scotti, Latib) Interventional Cardiology, White Plains Hospital, White
Plains, NY, United States
(Scotti) Department of Cardiology, University Hospital of Salamanca,
IBSAL, Salamanca, Spain
Publisher
Via Medica

<2>
Accession Number
650474448
Title
Preoperative audiovisual aid for patients undergoing coronary
revascularization: a randomized clinical trial.
Source
Revista brasileira de enfermagem. 79 (pp e20240321), 2026. Date of
Publication: 2026.
Author
Araujo N.M.; Sarmento S.D.G.; Cabral M.A.L.; Silva S.O.; Silva L.C.M.A.;
Ribeiro K.R.B.; Dantas R.A.N.; Dantas D.V.
Institution
(Araujo, Sarmento, Cabral, Silva, Silva, Ribeiro, Dantas, Dantas)
Universidade Federal do Rio Grande do Norte. Natal, Rio Grande do Norte,
Brazil
Abstract
OBJECTIVES: to evaluate the effect of an audiovisual aid on knowledge
acquisition and anxiety levels during the preoperative period of coronary
revascularization. METHOD(S): we conducted a randomized, double-blind
clinical trial with 44 participants at a large tertiary hospital in
northeastern Brazil. The control group (n = 22) received verbal
instructions alone, while the experimental group (n = 22) received verbal
instructions and an audiovisual intervention. Data were collected using a
knowledge questionnaire and the State-Trait Anxiety Inventory. Statistical
analysis included Student's t-test, the chi-square test, and Fisher's
exact test. RESULT(S): in the experimental group, positive affect
increased and anxiety decreased significantly. Knowledge about the
procedure improved with the audiovisual aid (p < 0.005), and state anxiety
declined more in the experimental group than in the control group (p =
0.001). CONCLUSION(S): educational technologies such as audiovisual
aids enhance preoperative education, reduce anxiety, and increase patient
knowledge.

<3>
Accession Number
2043244528
Title
The Effect of anesthesia depth monitoring on postoperative delirium in
elderly patients: A systematic review and meta-analysis.
Source
Current Problems in Surgery. 76 (no pagination), 2026. Article Number:
101985. Date of Publication: 01 Mar 2026.
Author
Bi Y.; Hu Y.
Institution
(Bi) Department of Anesthesiology, Shanghai Ninth People's Hospital,
Shanghai Jiao Tong University School of Medicine, Shanghai, China
(Hu) Department of Nursing, Shanghai Ninth People's Hospital, Shanghai
Jiao Tong University School of Medicine, Shanghai, China
Publisher
Elsevier Inc.

<4>
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. 40(4) (pp 1205-1213),
2026. Date of Publication: 01 Apr 2026.
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. Design(s): A
prospective, randomized, controlled trial. Setting(s): A tertiary
medical institution. Participant(s): Fifty-eight patients underwent
video-assisted thoracoscopic lung surgery. 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.
 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. 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. Copyright © 2025 Elsevier Inc.

<5>
Accession Number
2043964602
Title
Modern aspects in surgical treatment of atrial fibrillation with
simultaneous mitral valve surgery via minimally invasive approach:
evolution of techniques and analysis of clinical outcomes.
Source
Kardiologiya i Serdechno-Sosudistaya Khirurgiya. 19(1) (pp 84-90), 2026.
Date of Publication: 2026.
Author
Kashapov R.I.; Sharifulin R.M.; Bogachev-Prokofiev A.V.; Pivkin A.N.;
Sapegin A.V.; Zheleznev S.I.; Zalesov A.S.
Institution
(Kashapov, Sharifulin, Bogachev-Prokofiev, Pivkin, Sapegin, Zheleznev,
Zalesov) Meshalkin National Medical Research Center, Novosibirsk, Russian
Federation
Publisher
Media Sphera Publishing Group
Abstract
Objective. To analyze the efficacy and specific features of surgical
treatment of atrial fibrillation (AF) in mitral valve surgery via
minimally invasive approach, as well as to compare the outcomes with those
after conventional sternotomy. Material and methods. A systematic
literature searching was conducted in the following electronic databases
from their inception until June 2025: Ovid MEDLINE, EMBASE, and SCOPUS.
The review examines modern atrial ablation techniques, including cryoand
radiofrequency ablation, as well as left atrial appendage exclusion
methods. Comparative studies evaluating the effectiveness of minimally
invasive versus standard approaches were analyzed. The authors focused on
freedom from AF, complication rates and postoperative mortality. Results.
Minimally invasive techniques demonstrate efficacy comparable to
traditional approaches in AF treatment with freedom from atrial
arrhythmias ranging from 78% to 99% within a year. Advantages of minimally
invasive approach include shorter recovery time, lower complication rates
(6% vs. 13%), and reduced need for pacemaker implantation (4% vs. 18%), as
reported by various authors. Technological advancements in thermal
ablation devices have improved precision and safety of procedures.
Conclusion. Minimally invasive approach is a safe and effective
alternative to conventional sternotomy for surgical treatment of AF
combined with mitral valve repair. Further research should focus on
optimizing techniques, refining patient selection criteria, and evaluating
long-term outcomes. Copyright © R.I. KASHAPOV, R.M. SHARIFULIN,
A.V. BOGACHEV-PROKOFIEV, A.N. PIVKIN, A.V. SAPEGIN, S.I. ZHELEZNEV, A.S.
ZALESOV

<6>
Accession Number
2043742515
Title
Machine learning and Regression-Based models for prediction of
postoperative atrial fibrillation following coronary artery bypass
grafting: A systematic review and meta-analysis.
Source
International Journal of Cardiology: Cardiovascular Risk and Prevention.
29 (no pagination), 2026. Article Number: 200619. Date of Publication: 01
Jun 2026.
Author
Eini P.; serpoush H.; Rezayee M.; Kassulke M.
Institution
(Eini) Cardiovascular Research Center, Rajaie Cardiovascular Institute,
Tehran, Iran, Islamic Republic of
(serpoush) Hamadan University of Medical Sciences, Hamadan, Iran, Islamic
Republic of
(Rezayee, Kassulke) College of Human Medicine, Michigan State University,
East Lansing, MI, United States
Publisher
Elsevier B.V.
Abstract
Background Postoperative atrial fibrillation (POAF) is a common
complication following coronary artery bypass grafting (CABG) and is
associated with adverse clinical outcomes. Traditional risk prediction
models show limited accuracy, prompting increasing interest in machine
learning based approaches. This systematic review and meta analysis aimed
to evaluate the diagnostic performance, methodological quality, and
clinical applicability of machine learning models for predicting POAF
after CABG. Methods A comprehensive literature search identified
observational studies developing or validating machine learning or
advanced statistical models for POAF prediction after CABG. Diagnostic
performance measures were pooled using random effects bivariate models.
Risk of bias and applicability were assessed using PROBAST and PROBAST AI.
Between study heterogeneity, sensitivity analyses, meta regression, and
publication bias were evaluated. Results Twelve studies were included in
the quantitative synthesis. The pooled sensitivity was 0.73 (95% CI
0.64-0.80) and pooled specificity was 0.83 (95% CI 0.73-0.90). The pooled
area under the receiver operating characteristic curve was 0.84 (95% CI
0.80-0.87), indicating moderate discriminative ability. Substantial
heterogeneity was observed (generalized I2 = 87.3%). Most
studies were judged at high risk of bias, primarily due to limitations in
analysis methods and validation strategies, resulting in overall certainty
of evidence rated as moderate to low. Conclusions Machine learning models
demonstrate moderate accuracy for predicting POAF after CABG but are
limited by heterogeneity, methodological shortcomings, and restricted
external validation. Further rigorously designed and prospectively
validated studies are needed to support clinical
implementation. Copyright © 2026 The Authors.

<7>
Accession Number
2043982588
Title
Letter to the Editor "Fractional Flow Reserve in Aortic Stenosis:
Pathophysiological Considerations and Clinical Implications" regarding:
"Fractional Flow Reserve Versus Angiography-Guided Revascularisation in
Patients With Severe Aortic Stenosis: A Systematic Review" by Mridha et
al. Heart Lung Circ. 2025;34:556-565.
Source
Heart Lung and Circulation. 35(3) (pp e39-e40), 2026. Date of Publication:
01 Mar 2026.
Author
Skalidis I.; Laforgia P.; Hovasse T.; Garot P.; Akodad M.
Institution
(Skalidis, Laforgia, Hovasse, Garot, Akodad) Institut Cardiovasculaire
Paris-Sud, Hopital Jacques Cartier, Ramsay-Sante, Massy, France
(Skalidis) Department of Cardiology, HFR - Fribourg Kantonal Hospital and
University, Fribourg, Switzerland
Publisher
Elsevier Ltd

<8>
Accession Number
2043709904
Title
Comparison of Performance Characteristics of Flexible Bronchoscopy- or
Video Laryngoscopy-Assisted Insertion Versus Blind Insertion of
Transesophageal Echocardiography Probe in Adults Undergoing Cardiac
Surgery: A Randomized Controlled Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(4) (pp 1097-1102),
2026. Date of Publication: 01 Apr 2026.
Author
Das D.; Misra S.; Patra T.K.; Das P.K.; Mohanty S.
Institution
(Das, Patra) Department of Anesthesiology (Burn Centre), All India
Institute of Medical Sciences, Bhubaneswar, India
(Misra, Das) Department of Anesthesiology & Critical Care, All India
Institute of Medical Sciences, Bhubaneswar, India
(Mohanty) Department of Cardiothoracic & Vascular Surgery, All India
Institute of Medical Sciences, Bhubaneswar, India
Publisher
W.B. Saunders
Abstract
Objectives: The objective of this study was to compare visually assisted
techniques (flexible bronchoscope and video laryngoscope) versus blind
insertion of the transesophageal echocardiography (TEE) probe. The primary
objective was to evaluate the first-attempt success rate of probe
insertion. Secondary objectives were to evaluate the time required for
probe insertion, the number of attempts required for successful insertion,
hemodynamic perturbation immediately after and at 3 minutes after probe
insertion, operator satisfaction, and the incidence of complications
related to probe insertion. Design(s): A randomized controlled study.
 Setting(s): A single-institution tertiary center.
 Participant(s): One hundred thirty-five adult patients undergoing
elective cardiac surgery. Intervention(s): Patients were randomized
into 3 equal groups of 45 patients each: blind insertion of the TEE probe
(group B), video laryngoscopy-assisted insertion of the TEE probe (group
VL), and flexible bronchoscopy-assisted insertion of the TEE probe (group
FB). Measurements and Main Results: One hundred twenty-four patients
completed the study (group B, n = 42; group VL, n = 41; group FB, n = 41).
The first-attempt success rate was significantly better with visually
assisted techniques: 92.7% in group VL and 95.1% in group FB versus 78.6%
in group B (p = 0.042). Time to probe insertion was significantly longer
in group FB versus both groups VL and B (p = 0.001). The number of
attempts required for successful probe insertion was significantly lower
in the visually assisted groups (p = 0.01). The increases in heart rate
and mean arterial pressure were significantly lower in group FB versus
groups VL and B immediately following probe insertion and at 3 minutes.
However, there was no difference in hemodynamics between groups VL and B.
Operator satisfaction was comparable among the groups. The incidence of
complications such as blood at the tip of the probe was significantly
lower with visually guided techniques (p = 0.005), whereas the incidence
of probe-related injuries was comparable across the groups (p = 0.09).
 Conclusion(s): Flexible bronchoscopy-assisted TEE probe insertion
provides similar performance characteristics to video
laryngoscopy-assisted insertion albeit with less hemodynamic perturbation
and is superior to blind insertion of the TEE probe. Copyright ©
2026

<9>
Accession Number
2043811459
Title
Thoracoscopic right-thoracic repair of esophageal atresia with right
aortic arch: case series and literature review.
Source
Chinese Journal of Pediatric Surgery. 47(2) (pp 143-148), 2026. Date of
Publication: 15 Feb 2026.
Author
Jin Y.; Wu X.; Zhao B.; Zhao L.; Liu W.; Zhang H.; Sun X.; Guo X.; Li W.;
Ren H.
Institution
(Jin, Wu, Zhao, Zhao, Liu, Zhang, Sun, Guo, Li, Ren) Department of
Neonatal Surgery, Shanxi Children's Hospital, Taiyuan, China
Publisher
Chinese Medical Journals Publishing House Co.Ltd
Abstract
Objective To evaluate the feasibility of a thoracoscopic approach via the
right chest for neonatal esophageal atresia (EA) associated with right
aortic arch (RAA), and to summarize outcomes from the literature. Methods
We retrospectively analyzed two male neonates with EA and RAA treated in
the Department of Neonatal Surgery, Shanxi Children's Hospital from
January 2022 to January 2023 (ages 1 and 6 days). One patient had a
preoperative diagnosis of RAA; the diagnosis in the other case was made
intraoperatively. Both patients underwent thoracoscopic right-chest
ligation of the tracheoesophageal fistula (TEF) and primary esophageal
anastomosis. A systematic literature search was performed in Wanfang,
CNKI, VIP, PubMed, and the Cochrane Library using terms including "right
aortic arch", "esophageal atresia", and "thoracoscopy". Relevant studies
were reviewed and summarized. Results Both thoracoscopic procedures were
completed successfully without anastomotic leakage. One infant with an
incomplete vascular ring developed intermittent postoperative respiratory
distress and was lost to follow-up after voluntary discharge. The other
developed an anastomotic stricture that responded to two endoscopic
dilations; at one-year follow-up both growth and development were normal.
Literature review identified 18 English-language reports encompassing 107
patients with RAA and EA, including 20 long-gap EA cases. The reported
prevalence of RAA among EA cohorts ranged from 2.2% to 13.9%. The mean
preoperative detection rate of RAA was 29.0%, and 63.0% of cases had
associated cardiac anomalies. Surgical approaches reported included right
thoracotomy in 89 cases and left thoracotomy in 15; 18 cases required
intraoperative conversion from right to left thoracotomy. 12 patients
underwent delayed repair, and there were 21 deaths across the series (mean
mortality 19.6%). No significant difference in complication rates was
observed between right- and left-sided approaches (P > 0.05). Conclusions
Thoracoscopic repair via a right-thoracic approach is a feasible option
for EA associated with RAA in selected neonates. However, because anatomic
variations (including vascular rings) significantly affect operative
strategy and prognosis, surgical planning should be individualized based
on detailed preoperative imaging and the surgeon's thoracoscopic
expertise. Vascular rings represent a potentially serious comorbidity and
warrant particular attention during diagnosis and perioperative
management. Copyright 2026, Chinese Medical Association

<10>
[Use Link to view the full text]
Accession Number
2032793584
Title
Factors Associated With Coronary Angiography Performed Within 6 Months of
Randomization to the Conservative Strategy in the ISCHEMIA Trial.
Source
Circulation: Cardiovascular Interventions. 17(6) (pp 457-473), 2024. Date
of Publication: 01 Jun 2024.
Author
Spertus J.A.; Broderick S.; Rockhold F.W.; Demchenko E.; Grossman G.B.;
Stone G.W.; Mancini G.B.J.; Hochman J.S.; Boden W.E.; Mavromatis K.; Doan
J.; Linefsky J.; Lee R.; Patel R.; Miller T.; Cho S.Y.; Milbrandt S.;
Shelstad D.; Banerjee S.; Kamath P.; Tejani I.; Reynolds H.R.; Newman
J.D.; Bangalore S.; Phillips L.M.; Saric M.; Abdul-Nour K.; Schley A.;
Golden H.; Stone P.H.; Osseni H.; Wiyarand C.; Douglass P.; Pomeroy H.;
Craft A.; Harvey B.; Jang J.J.; Anaya O.; Yee G.; Goold P.; Weitz S.;
Giovannone S.; Pritchard L.; Arnold S.; Gans R.; O'Keefe J.H.; Kennedy P.;
Shapiro M.D.; Ganesan S.; Schlichting D.; Naher A.; Fein S.A.; Stewart
W.L.; Torosoff M.T.; Salmi K.M.; Lyubarova R.; Mookherjee S.; Drzymalski
K.; McFalls E.O.; Garcia S.A.; Bertog S.C.; Johnson D.K.; Siddiqui R.A.;
Herrmann R.R.; Ishani A.; Hansen R.A.; Khouri M.G.; Arges K.; LeFevre M.;
Tomfohr J.; Goldberg J.L.; Byrne K.A.; Zappernick T.; Goldweit R.; Canada
S.; Kakade M.; Mieses P.; Cohen R.A.; Mirrer B.; Navarro V.; Rantinella
M.; Rodriguez J.; Mancilla O.; Winchester D.E.; Stinson S.; Kronenberg M.;
Weyand T.; Crook S.C.; Heitner J.F.; Ho J.; Khan S.; Mohamed M.; Dauber
I.M.; Soltau M.R.; Rose D.K.; Wimmer R.J.; Siegel K.E.; Derbyshire S.;
Cannan C.; Dixon M.; Leonard G.; Sudarshan S.; Heard C.; Gabriel V.;
Desire S.; Mehta P.K.; McDaniel M.; Rashid F.; Lerakis S.; Asier S.;
Quyyumi A.; Patel K.; Wenger N.K.; Hedgepeth C.M.; Gillis J.; Hurlburt H.;
Manocchia M.; Rosen A.; Moore S.; Congdon E.; Sahul Z.; Brandt G.;
Marchelletta N.; Wippler K.; Leung S.; Reda H.; Ziada K.; Setty S.;
Halverson K.E.; Roraff C.; Thorsen J.; Barua R.S.; Ojajuni A.; Olurinde
O.; Surineni K.; Hage F.; Valaiyapathi B.; Davies J.E.; Leesar M.; Heo J.;
Iskandrian A.; Al Solaiman F.; Dajani K.; Kartje C.M.; El-Hajjar M.;
Mesropian P.D.; Sacco J.; Rawlins M.; McCandless B.; Thomson J.; Orgera
M.; Sidhu M.S.; Rogge M.C.; Arif I.; Bunke J.; Kerr H.; Unterbrink K.;
Fannon J.; Burman C.; Trejo J.F.; Dubin M.F.; Fletcher G.; Lane G.E.;
Neeson L.M.; Parikh P.P.; Pollak P.M.; Shapiro B.P.; Landolfo K.;
Gemignani A.; Beaudry S.; O'Rourke D.; Meadows J.L.; Tirado S.A.; Halliday
J.; Julian P.; Call J.T.; Lane S.M.; Stanford J.L.; Hannan J.; Bojar R.;
Arsenault P.; Kumar D.; Sigel P.; Mukai J.; Martin E.T.; Brooks M.;
Vorobiof G.; Douangvila L.; Gevorgyan R.; Moor-Man A.; Ranjbaran F.; Smith
B.; Ohmart C.; Kinlay S.; Hamburger R.J.; Rocco T.P.; Ly S.; Bhatt D.L.;
Quinn M.C.; Croce K.; Temiyasathit S.; Quin J.A.; Do J.; Anumpa J.; Tobin
D.; Zenati M.; Faxon D.P.; Rayos G.; Langdon J.; Bayer M.W.; Seedhom A.;
O'Malley A.; Sullenberger L.; Orvis E.; Kumkumian G.; Murphy M.; Greenberg
A.; Iraola M.; Sedlis S.P.; Maranan L.C.; Donnino R.M.; Lorin J.;
Tamis-Holland J.E.; Malinay A.; Kornberg R.; Leber R.; Saba S.; Edillo
C.P.; Lee M.W.; Small D.R.; Nona W.; Alexander P.B.; Rehman I.; Badami U.;
Ostrander A.; Wasmiller S.; Marzo K.; Drewes W.; Patel D.; Robbins I.H.;
Levite H.A.; White J.M.; Shetty S.; Hallam A.; Patel M.; Hamroff G.S.;
Spooner B.J.; Hollenweger L.M.; Little R.W.; Little H.; Zimbelman B.D.;
Little T.; Lui C.Y.; Eskelson N.A.; Smith B.R.; Vezina D.P.; Khor L.L.;
Abraham J.D.; Bull D.A.; McKellar S.H.; Booth D.; Taul Y.; Kotter J.;
Rodgers C.; Abdel-Latif A.; Isaacs J.; Bulkley V.; Hu B.; Kaneshiro R.;
Labovitz A.J.; Berlowitz M.; Kirby B.J.; Rogal P.; Tran N.N.; McFarren C.;
Jahrsdorfer C.; Matar F.; Caldeira C.; Maron D.J.; Rodriguez F.; Yunis R.;
Schnittger I.; Patro J.; Fearon W.F.; Deedwania P.; Vega A.; Reddy K.;
Sweeny J.; Bloise-Adames H.; Jimenez S.; Vrestil N.S.; Bhandari R.;
Spizzieri C.; Schade D.; Yost R.; Hochberg C.P.; Beardsley P.; Fine D.;
Salerno W.D.; Tancredi J.; Arakelian P.; Mathus S.; O'Neill D.; Wyman R.;
Burkhardt J.; Hosino S.; Lubyanaya O.A.; Salas J.D.; Zarka A.; Aguirre M.;
Shah A.V.; Dhawan M.; Parra D.; Tran T.; Haldis T.; Fowler-Lehman K.;
Spitzer N.; Riedberger C.; Weick C.; Kohn J.A.; Girotra S.; Drum C.;
Miller-Cox K.; Ollinger A.; Almousalli O.; Capasso-Gulve E.; Loehr A.M.;
Mosley M.; Krishnam M.S.; Heydari S.; Mil-Liken J.C.; Lundeen A.M.; Patel
P.M.; Karanjah E.; Seto A.H.; Marfori W.C.; Harley K.T.; Hernandez-Rangel
E.; Gibson M.A.; Singh P.; Allen B.J.; Coram R.; Webb A.M.; Fridell E.;
Wilson H.; Thomas S.; Kim A.; Schwartz R.G.; Wilmot P.; Chen W.; El
Shahawy M.; Stevens R.; Stafford J.; Black L.; Abernethy W.B.; Hull A.B.;
Lim O.J.; Tucker H.C.; Putnam N.C.; Hall L.L.; Cauthren T.; Tucker T.;
Zurick A.; Horton H.; Orga J.; Meyer T.M.; White J.R.; Morford R.G.;
Baumann C.; Rutkin B.; Seeratan V.; Bokhari S.; Jimenez M.; Sokol S.I.;
Schultz C.; Meisner J.; Russo J.; Hamzeh I.; Misra A.; Huda Z.; Wall M.;
Boan A.; De Rosen V.L.; Alam M.; Turner M.C.; Hinton C.R.; Mulhearn T.J.;
Good A.P.; Archer B.A.; Dionne J.S.; Allardyce C.A.; Sikora L.N.; Czerniak
J.H.; Mull J.A.; Ferguson E.; Laube F.; Shammas N.W.; Shammas G.A.;
Christensen L.; Park H.; Chilton R.; Hecht J.; Nguyen P.K.; Vo D.; Hirsch
J.; Jezior M.; Bindeman J.; Salkind S.; Desimone L.-A.; Gordon P.C.;
Felix-Stern L.; Crain T.; Gomes J.; Gordon C.; Stenberg R.; Mann A.;
McCreary T.; Pedalino R.P.; Cobos S.E.; Dwyer R.R.; Espinosa D.; Quiles
K.J.; Wiesel J.; Juang G.J.; Gopaul C.; Hultberg K.; Huk T.; Hussain A.;
Al-Amoodi M.; Zambrano Y.; Rodriguez S.M.; Milner T.; Wohns D.; Mulder A.;
Van Oosterhout S.; Lader E.W.; Meyer M.; Mumma M.; Clapp N.L.; Barrentine
H.; Dharmarajan L.; Jose J.M.; Manchery J.; McGarvey J.F.X.; McKinney V.;
Schwarz L.; Downes T.R.; Kaczkowski S.M.; Luckasen G.J.; Jaskowiak A.J.;
Klitch J.; Cheong B.; Dees D.; Potluri S.; Vasquez P.; Mastouri R.A.;
Breall J.A.; Hannemann E.L.; Revtyak G.E.; Foltz J.M.; Bazeley J.W.;
DeRosa E.; Jorgenson B.; Riestenberg-Smith J.; Giedd K.; Old W.; Bariciano
R.; Burt F.; Sokhon K.; Waldron J.; Mayon M.; Gopal D.; Valeti U.S.;
Peichel G.A.; Kobashigawa J.; Starks B.; Garcia L.; Thottam M.; Anand A.;
Govindan S.C.; Raj J.; Nair R.G.; Ravindran R.; Rajalekshmi V.S.;
Manjunath C.N.; Nataraj N.; Moorthy N.; Nayak S.; Manjunath S.C.;
Mylarappa M.; Narayanappa S.; Pandit N.; Bajaj S.; Nath R.K.; Yadav V.;
Mishra G.; Dwivedi S.K.; Tewari R.; Narain V.S.; Mishra M.; Chandra S.;
Patel S.; Wander G.S.; Tandon R.; Ralhan S.; Kaur B.; Aslam N.; Gupta S.;
Pharmacy B.; Goyal A.; Bhargava B.; Suvarna C.; Karthikeyan G.;
Ramakrishnan S.; Seth S.; Yadav R.; Singh S.; Roy A.; Parakh N.; Verma
S.K.; Narang R.; Mishra S.; Naik N.; Sharma G.; Choudhary S.K.; Patel C.;
Gulati G.; Sharma S.; Bahl V.K.; Mathew A.; Kurian B.M.; Punnoose E.;
Gadkari M.A.; Karwa S.R.; Gadage S.; Kolhe S.; Pillay T.U.; Satheesh S.;
Vindhya R.J.; Jain P.; Seth A.; Meharwal Z.S.; Mathur A.; Verma A.; Bhatia
M.; Sachdeva A.; Devi T.I.; Jungla N.; Rani K.M.; Menon R.; Reddy M.S.;
Oomman A.; Sidh R.R.; Mao R.; Ramakrishnan T.; Solomon H.; Francis R.;
Priya V.P.; Khan S.P.; Preethi K.; Kumar N.; Grant P.; Hande S.; Sonawane
P.; Kachru R.; Dubey A.; Rawat K.; Kumar A.V.K.; Ganapathi S.; Jayakumar
K.; Vineeth C.P.; Sivadasanpillai H.; Chacko M.; Sasidharan B.; Babu S.;
Kapilamoorthy T.R.; Christopher J.; Reddy S.; Polamuri P.; Rani M.; Kaul
U.; Arambam P.; Singh B.; Senior R.; Fox K.A.A.; Carruthers K.; Elghamaz
A.; Gurunathan S.; Karogiannis N.; Young G.M.; Shah B.N.; Kinsey C.;
Trimlett R.H.J.; Kavalakkat R.; Rubens M.B.; Evans J.; Nicol E.D.; Hassan
I.; Mittal T.K.; Hampson R.; Gamma R.A.; Williams S.; Holland K.; Swan K.;
de Belder M.A.; Atkinson B.; Thambyrajah J.; Nageh T.; Kunhunny S.; Davies
J.R.; Lindsay S.J.; Atkinson C.; Kurian J.; Krannila C.; Jamil H.; Vinod
M.; Raheem O.; Hoye A.; Chaytor L.; Cox L.; Morrow J.; Rowe K.; Donnelly
P.; Kelly S.; Valecka B.; Regan S.; Turnbull D.; Chauhan A.; Fleming C.;
Ghosh A.; Gratrix K.; Preston S.; Barr C.; Cartwright A.; Alfakih K.;
Knighton A.; Byrne J.; Martin K.; Webb I.; Henriksen P.; Flint L.;
Harrison J.; OKane P.; Lake-Man N.; Ljubez A.; de Silva R.; Conway D.S.G.;
Wright J.; Exley D.; Sirker A.A.; Andiapen M.; Richards A.J.; Hoole S.P.;
Wong L.; Witherow F.N.; Munro M.J.; Harbinson M.; McEvoy M.; Walsh S.; Bao
B.; Brown C.; Douglas H.; Luckie M.; Charles T.; Kolakaluri L.; Phillips
H.; Sobolewska J.; Morby L.; Hallett K.; Corbett C.; Winstanley L.;
Jeetley P.; Smit A.; Patel N.; Kotecha T.; Travill C.; Gent S.; Karimullah
I.; Hussain N.; Al-Bustami M.; Braganza D.; Haines F.; Taaffe J.;
Henderson R.; Burton J.; Pointon K.; Colton M.; Naik S.; King R.; Mathew
T.; Brown A.; Docherty A.; Berry C.; McCloy L.; Collison D.; Robb K.;
Roditi G.; Paterson C.; Crawford W.; Kelly J.; McGregor L.; Moriarty A.J.;
Mackin A.; Glover J.D.; Knight J.P.; Pradhan J.; Mikhail G.; Bose T.;
Francis D.P.; Dzavik V.; Proietti A.; Brousseau M.; Corfias M.; Blaise P.;
Harvey L.; Diaz A.; Rheault P.; Barrero M.; Gagne C.-E.; Alarie P.;
Pepin-Dubois Y.; Arcand L.; Costa R.; Roy I.; Sia Y.T.; Montpetit E.;
Lemay C.; Gisbert A.; Gervais P.; Rheault A.; Drouin K.; Phaneuf D.C.;
Bergeron C.; Gosselin G.; Shelley C.; Masson C.; Garg P.; Carr S.; Bone
C.; Chow B.J.W.; Moga E.; Hessian R.C.; Kourzenkova J.; Beanlands R.S.;
Walter O.; Davies R.F.; Bainey K.R.; Hogg N.; Welsh S.; Bagai A.; Wald R.;
Goodman S.; Graham J.J.; Peterson M.; Bello O.; Chow C.-M.; Abramson B.;
Cheema A.N.; Syed I.; Vakani M.T.; Hussain M.; Kushniriuk K.; Cha J.; Otis
J.; Otis R.; Howarth A.G.; Seib M.M.; Rivest S.M.; Sandonato R.; Chow J.;
Starovoytov A.; Uchida N.; Meadows N.; Uxa A.; Asif N.; Tavares S.;
Galiwango P.; Bozek B.; Kassam S.; Shier M.; Mukherjee A.; Larmand L.-A.;
Ricci A.J.; Janmohamed A.; Hart B.; Lam A.; Marucci J.; Tai S.; Mehta S.;
Brons S.; Beck C.; Wong G.; Etherington K.; Arumairajah T.; Udell J.;
Aprile M.; Karlsson S.; Webber S.; Genereux P.; Mercure C.; Hameed A.;
Aedy N.; Daba L.; Farquharson F.; Siddiqui A.; Lopes R.D.; Hueb W.;
Takiuti M.E.; Rezende P.C.; Silva E.E.R.; Hueb A.C.; Smanio P.E.P.;
Caetano L.P.; de Quadros A.S.; Kalil R.A.K.; Deiro A.P.; da Costa Vieira
J.L.; Muller A.M.; Grossmann G.; de Moraes M.A.P.; de Oliveira P.P.;
Ascoli B.M.; Bridi L.; Poletti S.Z.; Savaris S.; Vitola J.V.; Cerci R.J.;
Zier S.S.; Farias F.R.; Veiga V.; Fernandes M.M.; Marin-Neto J.A.; Schmidt
A.; de Oliveira Lima Filho M.; da Cunha D.F.; Oliveira R.M.; Chierice
J.R.A.; Polanczyk C.A.; Rucatti G.G.; Furtado M.V.; Igansi F.; Smidt L.F.;
Haeffner M.P.; Carvalho A.C.; Almeida V.; Pucci G.; de Souza G.S.; Lyra
F.; Alves A.R.; Almeida M.; dos Santos V.; Dracoulakis M.D.A.; Oliveira
N.S.; Lima R.G.S.D.; Figueiredo E.; Azevedo B.E.P.; Caramori P.R.; Santos
M.B.; Germann A.; Gomes V.; Homem R.; Magedanz E.; Tumelero R.; Laimer R.;
Tognon A.; Dall'Orto F.; Mesquita C.T.; Santos R.P.; Colafranseschi A.S.;
Oliveira A.C.; Carvalho L.A.; Palazzo I.C.; Sousa A.S.; da Silva E.E.R.;
de Barros e Silva P.G.M.; Okada M.Y.; de Padua Silva Baptista L.; Batista
A.P.; Rodrigues M.J.; Rabaca A.N.; de Resende M.V.C.; Saraiva J.F.; Trama
L.M.; de Souza Ormundo C.T.; Vicente C.; Costantini C.; Pinheiro C.; Komar
D.; Ruzyllo W.; Demkow M.; Pracon R.; Kepka C.; Teresinska A.; Walesiak
O.; Kryczka K.; Malinowska K.; Henzel J.; Solecki M.; Kaczmarska E.;
Mazurek T.; Maksym J.; Wojtera K.; Fojt A.; Szczerba E.; Drozdz J.;
Czarniak B.; Frach M.; Szymczyk K.; Niedzwiecka I.; Sobczak S.; Ciurus T.;
Jakubowski P.; Misztal-Teodorczyk M.; Teodorczyk D.; Swiderek M.; Fratczak
A.; Wojtala E.; Szkopiak M.; Lebioda P.; Wlodarczyk M.; Plachcinska A.;
Kusmierek J.; Miller M.; Marciniak H.; Wojtczak-Soska K.; Luczak K.;
Tarchalski T.; Cichocka-Radwan A.; Szwed H.; Karwowski J.; Szulczyk G.A.;
Witkowski A.; Kukula K.; Celinska-Spodar M.; Zalewska J.; Gajos G.; Bury
K.; Pruszczyk P.; Labyk A.; Roik M.; Szramowska A.; Zdonczyk O.;
Loboz-Grudzien K.; Jaroch J.; Sokalski L.; Brzezinska B.; Lesiak M.;
Lanocha M.; Reczuch K.W.; Kolodziej A.; Kalarus Z.; Swiatkowski A.; Szulik
M.; Musial W.J.; Marcinkiewicz-Siemion M.; Bockeria O.; Bockeria L.;
Petrosyan K.; Kudzoeva Z.; Trifonova T.; Aripova N.; Chernyavskiy A.M.;
Naryshkin I.A.; Kretov E.I.; Kuleshova A.; Grazhdankin I.O.; Malaev D.;
Bershtein L.L.; Sayganov S.A.; Subbotina I.; Kuzmina-Krutetskaya A.M.;
Gumerova V.; Zbyshevskaya E.V.; Katamadze N.O.; Demchenko E.A.; Nikolaeva
O.B.; Kozlov P.S.; Kozulin V.Y.; Lubinskaya E.I.; Lopez-Sendon J.L.;
Lopez-Sendon J.; Fernandez-Figares V.; Castro A.; Salicio E.R.; Guzman G.;
Galeote G.; Valbuena S.; Peteiro J.; Martinez-Ruiz M.D.; Perez-Fernandez
R.; Blanco-Calvo M.; Cuenca-Castillo J.J.; Alonso-Alvarez E.; Flores-Rios
X.; Garcia-Gonzalez P.; Prada-Delgado O.; Barge-Caballero G.; Juanatey
J.R.G.; Amigo J.S.; Bayarri M.S.; Nunez V.P.; Sanchez R.O.; Alvarez B.C.;
Gil C.P.; Monzonis A.M.; Sionis A.; Martinez A.F.; Perales M.V.; Padro
J.M.; Penaranda A.S.; Picart J.G.; Iglesias A.G.; Marimon X.G.-M.; Llado
G.P.; Costa F.C.; Miro V.; Igual B.; Diez J.L.; Calvillo P.; Ortuno F.M.;
Chavarri M.V.; Giner M.Q.; Montolliu A.T.; Aniorte A.I.R.; Bermudez E.P.;
Caravaca J.M.R.; De La Morena G.; Blancas M.G.; Canavate O.; Guerrero S.;
Riera S.; Luena J.E.C.; Lasala M.; Fernandez-Aviles F.; Lorenzo M.;
Sobrino O.; Vazquez A.; Jiang L.; Chen J.; Dong H.; He P.; Xia C.; Yang
J.; Zhong Q.; Wu Y.; Tian Y.; Li D.; Ma Y.; Yang Y.; Ma X.; Yu Z.; Zhao
Q.; Ji Z.; Li C.; Zhu B.; Yang X.; Chen M.; Chi H.; Zhang J.; Lin W.; Jing
R.; Liu J.; Zeng H.; Zhou Q.; Xu C.; Li Z.; Xiong L.; Fu X.; Gao D.; Jiang
D.; Leng R.; Yuan Q.; Zhang L.; Bai Z.; Li J.; Qi J.; Wang F.; Wang H.;
Yang B.; Yue Z.; Zhang Z.; Wang S.; Dong Y.; Mao J.; Zhang B.; Cheng G.;
Li X.; Yao X.; Zhong N.; Zhou N.; Huang Y.; Zhou P.; Fang X.; Su W.; Zeng
Q.; Kunwu Y.; Peng Y.; Su X.; Wang C.; Zhao Y.; Li Q.; Geng Y.; Wang Y.;
Nie S.-P.; Fan J.-Y.; Feng S.-T.; Wang X.; Yan Y.; Zhang H.-M.; Yu Q.; Chi
L.; Liu F.; Chen H.; Jiang J.; Li H.; Wang J.; Han Y.; Xu L.; Zhang S.;
Liu Z.; Chen G.; Hu R.; Perna G.P.; Pietrucci F.; Marini M.; Gabrielli G.;
Provasoli S.; Di Donato A.; Verna E.; Monti L.; Nardi B.; Di Chiara A.;
Pezzetta F.; Mortara A.; Casali V.; Galvani M.; Attanasio C.; Ottani F.;
Sicuro M.; Leone G.; Pisano F.; Bare C.; Calabro P.; Fimiani F.; Formisano
T.; Tarantini G.; Barioli A.; Cucchini U.; Ramani F.; Andres A.L.; Racca
E.; Rolfo F.; Goletto C.; Briguori C.; De Micco F.; Amati R.; Di Marco S.;
Vergoni W.; Tricoli M.; Russo A.; Villella M.; Fanelli R.; Poh K.-K.; Chai
P.; Lau T.; Loh J.P.; Tay E.L.; Teoh K.; Tan S.-Y.V.; Teo L.L.; Sia W.C.;
Ong C.-C.; Leong A.W.; Wong R.C.; Loh P.-H.; Kofidis T.; Chan W.X.; Chan
K.H.; Foo D.; Yan L.H.; Kong J.L.K.; Er C.M.; Jafary F.-H.H.; Chua T.;
Ismail N.; Kyaw M.T.; Yip D.; Doerr R.; Stumpf J.; Grahl D.; Matschke K.;
Guenther F.; Simonis G.; Bonin K.; Kadalie C.T.; Sechtem U.; Wenzelburger
I.; Ong P.; Gruensfelder S.; Schulze P.C.; Goebel B.; Lenk K.; Nickenig
G.; Sinning J.-M.; Weber M.; Werner N.; Schuchlenz H.; Steinmaurer G.;
Weikl S.; Lang I.M.; Winter M.-P.; Andric T.; Huber K.; Maximilian T.;
Gabriele J.-K.; Claudia W.; Bernhard J.; Florian E.; Keltai M.; Vertes A.;
Sebo J.; Davidovits Z.; Matics L.; Varga A.; Agoston G.; Fontos G.; Dekany
G.; Merkely B.; Bartykowszki A.; Maurovich-Horvat P.; Kerecsen G.; Jakal
A.; Hinic S.; Djokic J.; Zdravkovic M.; Mudrenovic V.; Crnokrak B.;
Beleslin B.D.; Boskovic N.N.; Djordjevic-Dikic A.D.; Petrovic M.T.; Giga
V.L.; Dobric M.R.; Stepanovic J.J.; Markovic Z.Z.; Mladenovic A.S.;
Cemerlic-Adjic N.; Velicki L.; Pupic L.; Davidovic G.; Simovic S.M.; Vucic
R.; Dekleva M.N.; Martinovic M.S.; Stevanovic G.; Stankovic G.; Dobric M.;
Apostolovic S.; Martinovic S.S.; Stanojevic D.; Escobedo J.; de
Jesus-Perez R.; Juarez B.; Baleon-Espinosa R.; Campos-Santaolalla A.S.;
Duran-Cortes E.; Flores-Palacios J.M.; Garcia-Rincon A.; Jimenez-Santos
M.; Penafiel J.V.; Ortega-Ramirez J.A.; Valdespino-Estrada A.; Rosas E.A.;
Brassetti M.F.C.; Anaya D.A.V.; Garcia M.P.; Juarez I.E.C.; Rovalo M.M.;
Rodriguez E.D.M.; Selvanayagam J.B.; Rankin J.; Murphy D.; Lee S.; Joseph
M.X.; Thomas P.; Thambar S.T.; Chaplin M.D.; Boer S.C.; Beltrame J.F.;
Stansborough J.K.; Black M.; Hillis G.S.; Bonner M.M.; Ireland K.F.;
Venn-Edmonds C.; Steg P.-G.; Thobois C.; Thuaire C.; Tachot E.; Dutoiu T.;
Laure C.; Vassaliere C.; Steg P.G.; Abergel H.; Juliard J.-M.; Fuentes A.;
Slama M.S.; Eliahou L.; Mahmoud R.E.; Dubourg O.; Michaud P.; Nicollet E.;
Hadjih S.; Goube P.; Brito P.; Barone-Rochette G.; Furber A.; Cornet C.;
Biere L.; Rautureau J.; Juceviciene A.; Kalibataite-Rutkauskiene I.;
Keinaite L.; Laucevicius A.; Laukyte M.; Celutkiene J.; Mikolaitiene G.;
Smigelskaite A.; Tamasauskiene I.; Urboniene A.; Kedhi E.; Timmer J.;
Bouwhuis I.; Hermanides R.; Nijmeijer L.; Kaplan E.; Riezebos R.K.; Samadi
P.; Schoep J.J.M.; van Dongen E.; Janzen E.M.; Niehe S.R.; Suryapranata
H.; Ahoud S.; van Vugt S.; Ramos R.; Cacela D.; Santana A.; Fiarresga A.;
Sousa L.; Marques H.; Patricio L.; Selas M.; Bernanrdes L.; Silva F.; Rio
P.; Freixo C.; Carvalho R.; Ferreira R.; Silva T.; Rodrigues I.; Modas P.;
Portugal G.; Fragata J.; Pinto F.J.; Cabrita I.Z.; Menezes M.N.; Rocha A.;
Lopes G.C.; Figueiras F.P.; Almeida A.G.; Coelho A.; Silva P.C.; Capinha
M.; Nobre A.; Caetano M.I.; Francisco A.R.; Silva S.; Ferreira N.; Lopes
R.L.; Diaz R.; Guzman L.; Tinnirello V.; Figal J.C.; Mungo M.N.; Mendiz
O.; Cortes C.; Favaloro R.R.; Alvarez C.; Garcia M.; Courtis J.; Godoy V.;
Zeballos G.; Schiavi L.; Actis M.V.; Rubio M.; Scaro G.; Devlin G.P.; Low
L.; Fisher R.; Scales J.; Abercrombie K.; Stewart R.A.H.; Howell L.;
Patten C.; Benatar J.; Kedev S.; Mitevska I.P.; Kostovska E.S.; Pejkov H.;
Held C.; Eggers K.; Frostfelt G.; Bjorklund C.; Johnston N.; Andreasson
M.; Olsowka M.; Essermark M.; Akerblom A.; Soveri I.; Aspberg J.; Persson
L.; Beyar R.; Nikolsky E.; Sharir T.; Harel O.; Elian D.; Kerner A.;
Bentzvi M.; Massalha S.; Helmer L.; Fukuda K.; Ueda I.; Kohsaka S.; Fujita
J.; Yasuda S.; Furukawa A.; Nagai T.; Otsuka F.; Nishimura S.; Nakano S.;
Goetschalckx K.; Robesyn V.; Van de Werf F.; Claes K.; Hung C.-L.; Yang
Y.-H.; Yun C.-H.; Hou C.J.-Y.; Kuo J.-Y.; Yeh H.-I.; Hung T.-C.; Li J.-Y.;
Chien C.-Y.; Tsai C.-T.; Liu C.-C.; Yu F.-C.; Lin Y.-H.; Lan W.-R.; Yen
C.-H.; Tsai J.-P.; Sung K.-T.; Ntsekhe M.; Pandie S.; Philander C.;
Viljoen C.A.; Mtana N.; De Andrade M.; Maggioni A.P.; Moccetti T.; Anesini
A.; Rossi M.G.; Maspoli S.; Mombelli M.; Abdelhamid M.; Talaat A.; Adel
A.; Kamal A.; Mahrous H.; El Kaffas S.; El Fishawy H.; Pop C.; Claudia M.;
Popescu B.A.; Ginghina C.; Rosca M.; Deleanu D.; Beladan C.C.; Iliescu
V.A.; Al-Mallah M.H.; Zahrani S.; Aljzeeri A.; Najm H.; Alghamdi A.; Ramos
W.E.M.; Davila M.A.M.; Kuanprasert S.; Prommintikul A.; Nawarawong W.;
Khwakhong S.; Woragidpoonpol S.; Chaiyasri A.; Tepsuwan T.; Mekara W.;
Taksaudom N.; Kulthawong S.; Rimsukcharoenchai C.; Amaritakomol A.;
Euathrongchit J.; Wannasopha Y.; Yamwong S.; Panpunuan P.; Sritara P.;
Aramcharoen S.; Meemuk K.; White H.D.; Alsweiler C.; Khairuddin A.;
Mokhtar N.S.; Hadi H.A.; Basri N.A.; Yahaya S.A.; Yusnida I.; Hashim H.;
Bugiardini R.
Institution
(Pracon, Ruzyllo) National Institute of Cardiology, Warsaw, Poland
(Spertus) Saint Luke's Mid America Heart Institute, University of
Missouri-Kansas City, Durham, NC, United States
(Broderick, Rockhold) Duke Clinical Research Institute, Durham, NC, United
States
(Bangalore, Newman, Reynolds, Hochman) Cardiovascular Clinical Research
Center, New York University Grossman School of Medicine, Durham, NC,
United States
(Rockhold) Department of Biostatistics and Bioinformatics, Duke University
School of Medicine, Durham, NC, United States
(Demchenko) Almazov National Medical Research Centre, Saint Petersburg,
Russian Federation
(Nageh) Southend University Hospital, United Kingdom
(Grossman) Moinhos de Vento Hospital, Porto Alegre, Brazil
(Grossman) Cardionuclear Clinic, Porto Alegre, Brazil
(Mavromatis) Emory University, Atlanta VA Healthcare System, GA, United
States
(Manjunath) Sri Jayadeva Institute of Cardiovascular Sciences and
Research, Bengaluru, India
(Smanio) Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
(Stone) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Mancini) Center for Cardiovascular Innovation, The University of British
Columbia, Vancouver, Canada
(Boden) VA New England Healthcare System, Boston University School of
Medicine, MA, United States
(Maron) Department of Medicine, Stanford University, CA, United States
(Boden, Mavromatis, Doan) Atlanta VA Medical Center, Decatur, GA, United
States
(Linefsky, Lee, Patel, Miller, Cho) Mayo Clinic, Rochester, MN, United
States
(Milbrandt, Shelstad, Banerjee, Kamath) V.A. North Texas Health Care
System, Dallas, TX, United States
(Tejani) NYU Langone Medical Center-Bellevue Hospital, New York, NY,
United States
(Reynolds, Newman, Bangalore, Donnino, Phillips, Saric, Abdul-Nour,
Schley) Henry Ford Health System, Detroit, MI, United States
(Golden, Stone, Osseni) Brigham & Women's Hospital, Harvard Medical
School, Boston, MA, United States
(Wiyarand, Douglass, Pomeroy, Craft, Harvey, Jang, Anaya) Kaiser
Permanente San Jose, San Jose, CA, United States
(Yee, Goold, Weitz, Giovannone) Cardiology Associates of Schenectady P.C.,
Schenectady, NY, United States
(Pritchard, Arnold, Gans) Saint Luke's Hospital, Kansas City, MO, United
States
(O'Keefe, Kennedy, Shapiro, Ganesan) Oregon Health & Science University,
Portland, OR, United States
(Schlichting, Naher) Albany Medical Center Hospital, Albany, NY, United
States
(Fein, Stewart, Torosoff, Salmi, Lyubarova, Mookherjee, Drzymalski,
McFalls) Minneapolis VAMC, Minneapolis, MN, United States
(Garcia, Bertog, Johnson, Siddiqui, Herrmann, Ishani, Hansen, Khouri,
Arges) Duke University Medical Center, Durham, NC, United States
(LeFevre, Tomfohr, Goldberg, Byrne) Louis Stokes Cleveland Veterans
Affairs Medical Center, Cleveland, OH, United States
(Zappernick, Goldweit, Canada) Englewood Hospital and Medical Center,
Englewood, NJ, United States
(Kakade) NYU-HHC Woodhull Hospital, Brooklyn, NY, United States
(Mieses, Cohen, Mirrer, Navarro, Rantinella, Rodriguez, Mancilla,
Winchester, Stinson) Malcom Randall VAMC, Gainesville, FL, United States
(Kronenberg, Weyand) Vanderbilt University Medical Center, Nashville, TN,
United States
(Rogal, Crook, McFarren, Heitner, Ho) New York -Presbyterian/Brooklyn
Methodist Hospital, Brooklyn, NY, United States
(Khan, Mohamed, Dauber, Soltau) South Denver Cardiology Associates, P.C.,
Littleton, CO, United States
(Rose, Wimmer, Siegel, Derbyshire, Cannan, Dixon) Providence Heart and
Vascular Institute, Portland, OR, United States
(Leonard, Sudarshan, Heard) Wichita Falls Heart Clinic, Wichita Falls, TX,
United States
(Gabriel, Desire, Mehta) Emory University, Atlanta, GA, United States
(McDaniel, Rashid, Lerakis, Asier, Quyyumi, Patel, Wenger, Hedgepeth,
Gillis) Kent Hospital, Warwick, RI, United States
(Hurlburt, Manocchia, Rosen, Moore, Congdon, Sahul, Brandt) Michigan
Heart, PC, Ypsilanti, MI, United States
(Marchelletta, Wippler, Booth, Taul) University of Kentucky, Lexington,
KY, United States
(Leung, Isaacs, Abdel-Latif, Bulkley, Reda, Rodgers, Ziada, Setty,
Halverson) Gundersen Lutheran Medical Center, La Crosse, WI, United States
(Roraff, Thorsen, Barua, Ojajuni) Kansas City VA Medical Center, Kansas
City, MO, United States
(Olurinde, Surineni, Hage, Valaiyapathi) UAB Vascular Biology and
Hypertension Program, Birmingham, AL, United States
(Caldeira, Davies, Leesar, Heo, Iskandrian, Al Solaiman, Singh, Dajani,
Kartje) Loyola University Medical Center, Maywood, IL, United States
(El-Hajjar) Samuel Stratton VA Medical Center of Albany NY, Albany, NY,
United States
(Mesropian, Sacco, Rawlins, McCandless, Thomson, Orgera, Sidhu, Rogge)
Cincinnati VA Medical Center, Cincinnati, OH, United States
(Arif, Bunke, Kerr, Unterbrink, Fannon, Burman, Trejo, Dubin) Mayo Clinic
Florida, Jacksonville, FL, United States
(Fletcher, Lane, Neeson, Parikh, Pollak, Shapiro, Landolfo, Gemignani,
Beaudry) VAMC-White River Junction, White River Junction, VT, United
States
(O'Rourke, Meadows, Tirado) VA Connecticut Healthcare System, West Haven,
CT, United States
(Halliday, Julian, Call, Lane) Winchester Cardiology and Vascular
Medicine, PC, Winchester, VA, United States
(Stanford, Hannan) Saint Vincent Hospital, Worcester Medical Center,
Worcester, MA, United States
(Bojar, Arsenault, Kumar, Sigel, Mukai, Martin, Brooks) Oklahoma Heart
Institute, Tulsa, OK, United States
(Vorobiof, Douangvila) Ronald Reagan UCLA Medical Center, Los Angeles, CA,
United States
(Gevorgyan, Moor-Man, Ranjbaran) University of Washington Medical Center,
Seattle, WA, United States
(Smith, Ohmart, Kinlay) VA Boston Healthcare System, West Roxbury, MA,
United States
(Hamburger, Rocco, Ly, Bhatt, Quinn, Croce, Temiyasathit, Quin, Do,
Anumpa, Tobin, Zenati, Faxon, Rayos, Langdon) Daytona Heart Group, Daytona
Beach, FL, United States
(Bayer, Seedhom, O'Malley) Capital Cardiology Associates, Albany, NY,
United States
(Sullenberger, Orvis, Kumkumian, Murphy) NIH Heart Center, Suburban
Hospital, Bethesda, MD, United States
(Greenberg, Iraola, Sedlis, Maranan) VA New York Harbor Health Care
System, New York, NY, United States
(Donnino, Lorin, Tamis-Holland, Malinay) Mount Sinai Saint Luke's
Hospital, Ridgewood, NJ, United States
(Kornberg, Leber, Saba, Edillo) Providence - Providence Park Hospital,
Southfield, MI, United States
(Lee, Small, Nona, Alexander, Rehman, Badami, Ostrander) Covenant Medical
Center, Inc., Saginaw, MI, United States
(Wasmiller, Marzo, Drewes) NYU Winthrop, Mineola, NY, United States
(Patel, Robbins) AtlantiCare Regional Medical Center, Pomona, NJ, United
States
(Levite, White, Shetty, Hallam, Patel, Hamroff, Spooner) NYP Medical
Medical Group Hudson Valley Cardiology, Cortlandt Manor, NY, United States
(Hollenweger, Little, Little) Houston Heart & Vascular Associates,
Houston, TX, United States
(Zimbelman, Little, Lui, Eskelson) Salt Lake City VA Medical Center, Salt
Lake City, UT, United States
(Smith, Vezina, Khor, Abraham, Bull, McKellar, Booth, Taul) Lexington VA
Medical Center, Lexington, KY, United States
(Kotter, Rodgers, Abdel-Latif, Isaacs, Bulkley, Hu, Kaneshiro) Palo Alto
Medical Foundation Research Institute, Palo Alto, CA, United States
(Labovitz) University of South Florida, Tampa, FL, United States
(Berlowitz, Kirby, Rogal, Tran, McFarren, Jahrsdorfer, Matar, Caldeira,
Maron) Stanford University School of Medicine, Stanford, CA, United States
(Rodriguez, Yunis, Schnittger, Patro, Fearon, Deedwania, Vega) UCSF -
Fresno Community Regional Medical Center, Fresno, CA, United States
(Reddy, Sweeny, Bloise-Adames) Icahn School of Medicine at Mount Sinai,
New York, NY, United States
(Jimenez, Vrestil, Bhandari, Spizzieri, Schade) Holy Spirit Hospital
Cardiovascular Institute, Camp Hill, PA, United States
(Yost, Hochberg, Beardsley) Boston Medical Center, Boston, MA, United
States
(Fine, Salerno, Tancredi) Hackensack University Medical Center, Saddle
Brook, NJ, United States
(Arakelian, Mathus, O'Neill, Wyman, Burkhardt) Torrance Memorial Medical
Center, Torrance, CA, United States
(Hosino, Lubyanaya) Coastal Heart Medical Group, Santa Ana, CA, United
States
(Salas, Zarka, Aguirre, Shah, Dhawan, Parra, Tran, Haldis, Weick) Sanford
Health, Fargo, ND, United States
(Fowler-Lehman, Spitzer, Riedberger, Weick, Kohn) NYU New York Medical
Associates, New York, NY, United States
(Cobos, Quiles, Girotra, Drum) University of Iowa Hospitals and Clinics,
Iowa City, IA, United States
(Miller-Cox, Ollinger, Almousalli, Capasso-Gulve) Advanced Heart Care
Group, Fairview Heights, IL, United States
(Loehr, Mosley, Krishnam, Heydari) University of California Irvine Medical
Center, Orange, CA, United States
(Mil-Liken, Lundeen, Patel, Karanjah, Seto, Marfori, Harley,
Hernandez-Rangel, Gibson, Singh, Allen, Coram, Webb) University of
Louisville, Louisville, KY, United States
(Fridell, Wilson, Thomas, Kim) University of Rochester, Rochester, NY,
United States
(Schwartz, Wilmot, Chen, El Shahawy, Stevens) Cardiovascular Center of
Sarasota, Sarasota, FL, United States
(Stafford, Black) University of Maryland Medical Center, Baltimore, MD,
United States
(Abernethy, Hull) Asheville Cardiology Associates, Asheville, NC, United
States
(Lim, Tucker, Putnam, Hall, Cauthren, Tucker, Zurick, Horton) Saint Thomas
Hospital, Nashville, TN, United States
(Orga, Meyer, White) Stroobants Cardiovascular Center, Lynchburg, VA,
United States
(Morford, Baumann, Rutkin, Seeratan) Northwell Health - Manhasset,
Manhasset, NY, United States
(Bokhari, Jimenez) Columbia University Medical Center, New York, NY,
United States
(Sokol, Schultz) Jacobi Medical Center, Bronx, NY, United States
(Meisner, Russo, Hamzeh) Baylor College of Medicine, Houston, TX, United
States
(Misra, Huda, Wall, Boan, De Rosen, Alam, Turner, Hinton) Cardiovascular
Specialists of Southwest Louisiana, Lake Charles, LA, United States
(Mulhearn, Good, Archer) Ohio Health Grant Medical Center, Columbus, OH,
United States
(Dionne, Allardyce, Sikora, Czerniak, Mull, Ferguson, Laube, Shammas,
Shammas) Midwest Cardiovascular Research Foundation, Davenport, IA, United
States
(Christensen, Park, Chilton, Hecht) Audie Murphy V.A., San Antonio, TX,
United States
(Nguyen, Vo) VA Palo Alto Healthcare System, Palo Alto, CA, United States
(Hirsch, Jezior, Bindeman) Walter Reed National Military Medical Center,
Bethesda, MD, United States
(Salkind, Espinosa) Miriam Hospital, Providence, RI, United States
(Desimone, Gordon, Felix-Stern, Crain, Gomes, Gordon, Stenberg, Mann)
Conemaugh Valley Memorial Hospital, Johnstown, PA, United States
(McCreary, Pedalino, Cobos) NYU-HHC Kings County Hospital Center,
Brooklyn, NY, United States
(Dwyer, Espinosa, Quiles, Wiesel) New York University - Langone
Cardiovascular Associates, Flushing, NY, United States
(Juang, Gopaul) Coney Island Hospital, Brooklyn, NY, United States
(Hultberg, Huk, Hussain, Al-Amoodi, Zambrano) Yuma Regional Medical
Center, Yuma, AZ, United States
(Rodriguez, Milner, Wohns, Mulder) Spectrum Health, Grand Rapids, MI,
United States
(Van Oosterhout, Lader, Meyer) Mid Valley Cardiology, Kingston, NY, United
States
(Mumma, Clapp) Sarasota Memorial Hospital, Sarasota, FL, United States
(Barrentine, Dharmarajan, Jose) NYU-HHC Lincoln Medical and Mental Health
Center, Bronx, NY, United States
(Manchery, McGarvey, McKinney) Doylestown Health Cardiology, Doylestown,
PA, United States
(Schwarz, Downes, Kaczkowski) Medical Center of the Rockies, Loveland, CO,
United States
(Luckasen, Jaskowiak, Klitch, Cheong, Dees) Baylor St. Luke's Medical
Center, Houston, TX, United States
(Potluri, Vasquez) Baylor Research Institute, Legacy Heart Center, Plano,
TX, United States
(Mastouri) Indiana University, Krannert Institute of Cardiology,
Indianapolis, IN, United States
(Breall, Hannemann, Revtyak, Foltz, Bazeley, Li, DeRosa) HealthEast Saint
Joseph's Hospital, St. Paul, MN, United States
(Jorgenson, Riestenberg-Smith, Giedd) Beth Israel Medical Center, New
York, NY, United States
(Old, Bariciano) Cardiovascular Associates, Ltd., Chesapeake, VA, United
States
(Burt) Saint Luke's Hospital and Health Network, Bethlehem, PA, United
States
(Sokhon, Waldron) Medicus Alliance Clinical Research Org., Inc., Sugar
land, TX, United States
(Mayon, Gopal) The Heart Hospital Baylor, Plano, TX, United States
(Valeti, Peichel) University of Minnesota, Minneapolis, MN, United States
(Kobashigawa, Starks) Cedars Sinai Medical Center, Beverly Hills, CA,
United States
(Garcia, Thottam, Bhargava, Anand) Government Medical College, Calicut,
India
(Govindan, Raj, Nair, Ravindran, Rajalekshmi, Manjunath, Nataraj) Sri
Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru,
India
(Moorthy, Nayak, Manjunath, Mylarappa, Narayanappa, Pandit, Bajaj) Dr Ram
Manohar Lohia Hospital, New Delhi, India
(Nath, Yadav, Mishra, Dwivedi, Tewari) King George's Medical University,
Department of Cardiology, Lucknow, India
(Narain, Mishra, Chandra, Patel, Singh, Wander) Hero DMC Heart Institute,
Dayanand Medical College and Hospital, Ludhiana, India
(Tandon, Ralhan, Kaur, Aslam, Gupta, Pharmacy, Goyal, Bhargava, Suvarna)
All India Institute of Medical Sciences, New Delhi, India
(Karthikeyan, Ramakrishnan, Seth, Yadav, Singh, Roy, Parakh, Verma,
Narang, Mishra, Naik, Sharma, Choudhary, Patel, Gulati, Sharma, Bahl,
Mathew, Kurian) MOSC Medical College Hospital, Kolenchery, India
(Punnoose, Gadkari, Karwa) KEM Hospital Pune, Pune, India
(Gadage, Kolhe, Pillay, Satheesh, Vindhya) Jawaharlal Institute of
Postgraduate Medical Education & Research (JIPMER), Pondicherry, India
(Jain) Fortis Escort Heart Institute, New Delhi, India
(Seth, Meharwal, Mathur, Verma, Kaul, Bhatia, Sachdeva, Devi, Jungla,
Christopher, Rani) Gurunanak CARE Hospital, Hyderabad, India
(Menon, Reddy, Kumar, Preethi, Oomman, Sidh) Apollo Research and
Innovation, Chennai, India
(Mao, Ramakrishnan, Solomon, Francis, Naik, Priya) Apollo Research &
Innovations, Hyderabad, India
(Khan, Christopher, Preethi) CARE Nampally, Hyderabad, India
(Kumar, Grant, Hande) Ruby Hall Clinic, Grant Medical Foundation, Pune,
India
(Sonawane, Kachru, Dubey) Fortis Healthcare Fl.t Lt. Rajan Dhall Hospital,
New Delhi, India
(Rawat, Kumar) Sree Chitra Tirunal Institute for Medical Sciences and
Technology, Trivandrum, India
(Ganapathi, Jayakumar, Vineeth, Sivadasanpillai, Chacko, Sasidharan, Babu,
Kapilamoorthy, Christopher, Reddy) CARE Hospital, Hyderabad, India
(Polamuri, Rani, Kaul, Arambam) Batra Hospital and Medical Research Centre
(BHMRC), New Delhi, India
(Singh, Senior, Fox, Young, Carruthers) Northwick Park Hospital Harrow,
Royal Brompton Hospital London, Harrow, United Kingdom
(Elghamaz, Gurunathan, Karogiannis, Young, Shah, Kinsey, Trimlett,
Kavalakkat, Rubens, Evans, Nicol, Hassan, Mittal, Hampson, Gamma,
Williams) Broomfield Hospital, Chelmsford, United Kingdom
(Holland, Swan, de Belder, Atkinson) The James Cook University Hospital,
Middlesbrough, Middlesbrough, United Kingdom
(Thambyrajah, Nageh, Kunhunny) Southend University Hospital, Westcliffe on
Sea, United Kingdom
(Davies, Lindsay, Atkinson) Bradford Royal Infirmary, Bradford, United
Kingdom
(Kurian, Krannila, Jamil, Vinod, Raheem, Hoye, Chaytor) The University of
Hull, Castle Hill Hospital, Cottingham, United Kingdom
(Cox, Morrow, Rowe, Donnelly, Kelly) South Eastern Health and Social Care,
Belfast, United Kingdom
(Valecka, Regan, Turnbull, Chauhan, Fleming) Blackpool Teaching Hospitals,
Blackpool, United Kingdom
(Ghosh, Gratrix, Preston, Barr, Cartwright) Russells Hall Hospital,
Dudley, United Kingdom
(Alfakih, Knighton) King's College NHS Foundation Hospital, London, United
Kingdom
(Byrne, Martin, Webb, Henriksen, Flint) Royal Infirmary of Edinburgh,
Edinburgh, United Kingdom
(Harrison, OKane, Lake-Man) Royal Bournemouth Hospital, Bourneouth, United
Kingdom
(Ljubez, de Silva) Bedford Hospital NHS Trust, Bedford, United Kingdom
(Conway, Wright) Pinderfields Hospital, Wakefield, United Kingdom
(Exley, Sirker, Andiapen) University College London Hospitals NHS
Foundation Trust, London, United Kingdom
(Richards) BartsHealth NHS Trust, United Kingdom
(Hoole, Wong) Papworth Hospital, Cambridge, United Kingdom
(Witherow, Munro) Dorset County Hospital, Dorchester, United Kingdom
(Johnston, Bao) Belfast Trust, Belfast, United Kingdom
(Harbinson, Bao, McEvoy, Walsh, Bao, Brown, Douglas, Luckie, Charles)
Central Manchester University Hospital, Manchester, United Kingdom
(Kolakaluri, Phillips, Sobolewska, Morby) The Pennine Acute Hospitals NHS
Trust, Oldham, United Kingdom
(Hallett, Corbett, Winstanley, Jeetley, Smit) Royal Free London NHS
Foundation Trust, London, United Kingdom
(Patel, Kotecha, Travill, Gent) Luton and Dunstable University Hospital
NHS FT, Luton, United Kingdom
(Karimullah, Hussain, Al-Bustami, Braganza, Haines) Peterborough City
Hospital, Peterborough, United Kingdom
(Taaffe, Henderson, Burton) Nottingham University Hospitals, Nottingham,
United Kingdom
(Pointon, Colton, Naik, King, Mathew, Brown) University of Glasgow,
Clydebank, United Kingdom
(Docherty, Berry, McCloy, Collison, Robb, Roditi, Paterson, Crawford,
Kelly, McGregor, Moriarty, Mackin) Cardiovascular Research Unit, Craigavon
Area Hospital, Craigavon, United Kingdom
(Glover, Knight) Hampshire Hospitals NHS Foundation Trust, Basingstoke,
United Kingdom
(Pradhan, Mikhail, Bose) Imperial College Healthcare NHS Trust, London,
United Kingdom
(Francis, Dzavik, Goodman, Gosselin, Proietti) Montreal Heart Institute,
Montreal, QC, Canada
(Brousseau, Corfias, Blaise, Harvey, Diaz) Centre Hospitalier de Regional
Trois-Rivieres, Trois-Rivieres, QC, Canada
(Rheault, Barrero, Gagne, Alarie, Pepin-Dubois, Arcand, Costa, Roy, Sia,
Montpetit, Lemay, Gisbert, Gervais, Rheault, Drouin) CISSSL - Hopital
Pierre-Le Gardeur, Terrebonne, QC, Canada
(Phaneuf, Bergeron, Gosselin, Shelley, Masson, Garg, Carr) London Health
Sciences Centre, London, ON, Canada
(Bone, Chow, Moga) University of Ottawa Heart Institute, Ottawa, ON,
Canada
(Hessian, Kourzenkova, Beanlands, Walter, Davies, Bainey, Hogg) University
of Alberta, Edmonton, AB, Canada
(Welsh, Cheema) St. Michael's Hospital, Toronto, ON, Canada
(Bagai, Wald, Goodman, Kushniriuk, Graham, Hussain, Peterson, Bello, Chow,
Abramson, Cheema, Syed) Dixie Medical Group, Mississauga, ON, Canada
(Vakani, Hussain, Kushniriuk, Cha, Otis) Dr James Cha, Oshawa, ON, Canada
(Otis, Howarth, Seib) University of Calgary, Calgary, AB, Canada
(Rivest, Sandonato, Wong, Chow) Vancouver General Hospital, Vancouver, BC,
Canada
(Starovoytov, Uchida, Meadows, Uxa, Asif) University Health Network,
Toronto, ON, Canada
(Tavares, Galiwango, Bozek) Scarborough Cardiology Research, Scarborough,
ON, Canada
(Kassam, Shier, Mukherjee, Larmand, Ricci, Janmohamed, Hart, Lam, Marucci)
West Lincoln Memorial Hospital East Grimsby, ON, Canada
(Tai, Mehta, Brons) Hamilton General Hospital, Hamilton, ON, Canada
(Beck, Wong, Etherington, Arumairajah, Udell, Aprile) Women's College
Hospital, Toronto, ON, Canada
(Karlsson, Webber, Genereux, Mercure) Centre Integre Universitaire de
Sante et de Services Sociaux du Montreal, Montreal, QC, Canada
(Hameed, Aedy) Saint Catharines General Hospital, Catharines, ON, Canada
(Daba, Farquharson) Northwest GTA Cardiovascular and Heart Rhythm Program,
Vaughan, ON, Canada
(Siddiqui, Carvalho, Lopes, Hueb, Takiuti) Heart Institute (InCor),
University of Sao Paulo, Sao Paulo, Brazil
(Rezende, Silva, Hueb, Smanio, Caetano) Instituto Dante Pazzanese de
Cardiologia, Sao Paulo, Brazil
(de Quadros) Instituto de Cardiologia de Porto Alegre, Porto Alegre,
Brazil
(Kalil, Deiro, da Costa Vieira, Muller, Grossmann, de Moraes, de Oliveira,
Ascoli, Bridi, Poletti, Savaris, Vitola) Quanta Diagnostico & Terapia,
Curitiba, Brazil
(Cerci, Zier, Farias, Veiga, Fernandes, Marin-Neto) Hospital das Clinicas
da Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo,
Ribeirao Preto, Brazil
(Schmidt, de Oliveira Lima Filho, da Cunha, Oliveira, Chierice, Polanczyk,
Rucatti) Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
(Furtado, Igansi, Smidt, Haeffner, Carvalho, Almeida) Unifesp - Hospital
Sao Paulo, Sao Paulo, Brazil
(Pucci, de Souza, Lyra, Alves, Almeida) Fundacao Bahiana de Cardilogia,
Salvador, Brazil
(dos Santos, Dracoulakis, Oliveira) Hospital da Bahia, Salvador, Brazil
(Lima, Figueiredo, Azevedo) Hospital Lifecenter, Belo Horizonte, Brazil
(Caramori, Santos) Hospital Sao Lucas da Pontificia Universidade Catolica
do Rio Grande do Sol, Porto Alegre, Brazil
(Germann, Gomes, Homem, Magedanz, Tumelero, Laimer) Hospital Sao Vicente
de Paulo Fundo, Brazil
(Tognon, Dall'Orto) Hospital Maternidade e Pronto Socorro Santa Lucia,
Pocos de Caldas, Brazil
(Mesquita, Santos) Hospital Pro-Cardiaco Botafogo, Brazil
(Colafranseschi, Oliveira, Carvalho, Palazzo, Sousa, da Silva) Hospital
TotalCor, Sao Paulo, Brazil
(de Barros e Silva, Okada, de Padua Silva Baptista, Batista, Rodrigues,
Rabaca, de Resende, Saraiva, Trama) Hospital Celso Pierro, Sao Paulo,
Brazil
(Silva, de Souza Ormundo, Vicente, Costantini, Pinheiro, Pracon) Hospital
Cardiologico Costantini, Curitiba, Brazil
(Komar, Ruzyllo, Szwed, Demkow, Pracon) Coronary and Structural Heart
Diseases Department, Institute of Cardiology, Warsaw, Poland
(Kepka, Teresinska, Walesiak, Kryczka, Malinowska, Henzel, Solecki,
Kaczmarska, Mazurek, Maksym) Medical University of Warsaw, Warszawa,
Poland
(Wojtera, Fojt, Szczerba, Drozdz) Cardiology Clinic, Medical University in
Lodz, Lodz, Poland
(Czarniak, Frach, Szymczyk, Niedzwiecka, Sobczak, Ciurus, Jakubowski,
Misztal-Teodorczyk, Teodorczyk, Swiderek, Fratczak, Wojtala, Szkopiak,
Lebioda, Wlodarczyk, Plachcinska, Kusmierek, Miller, Marciniak,
Wojtczak-Soska, Luczak, Tarchalski, Cichocka-Radwan, Szwed, Karwowski)
National Institute of Cardiology, Warsaw, Warsaw, Poland
(Szulczyk, Witkowski) Department of Interventional Cardiology & Angiology,
Institute of Cardiology, Warsaw, Poland
(Kukula, Celinska-Spodar, Zalewska, Gajos) Department of Coronary Disease,
John Paul II Hospital, Jagiellonian University Medical College, Krakow,
Poland
(Bury, Pruszczyk, Labyk) Department of Internal Medicine and Cardiology,
Infant Jesus Teaching Hospital, Medical University of Warsaw, Warszawa,
Poland
(Roik, Szramowska, Zdonczyk, Loboz-Grudzien, Jaroch) T.Marciniak Hospital,
Wroclaw, Poland
(Sokalski, Brzezinska, Lesiak) Szpital Kliniczny Przemienienia Panskiego,
Poznan, Poland
(Lanocha, Reczuch, Kolodziej) Military Hospital, Medical University,
Wroclaw, Poland
(Kalarus) Medical University of Silesia, School of Medicine, The Division
of Dentistry, Department of Cardiology, Congenital Heart Diseases and
Electrotherapy, Silesian Center for Heart Diseases, Zabrze, Poland
(Swiatkowski, Szulik, Musial, Marcinkiewicz-Siemion) University Hospital
in Bialystok, Bialystok, Poland
(Bockeria, Bockeria) National Medical Research Center for Cardiovascuar
Surgery, Moscow, Russian Federation
(Petrosyan, Kudzoeva, Trifonova, Aripova, Chernyavskiy, Naryshkin)
E.Meshalkin National Medical Research Center, The Ministry of Health of
the Russian Federation, Novosibirsk, Russian Federation
(Kretov, Kuleshova, Grazhdankin, Malaev, Bershtein) North-Western State
Medical University, Saint Petersburg, Russian Federation
(Sayganov, Subbotina, Kuzmina-Krutetskaya, Gumerova, Zbyshevskaya,
Katamadze, Demchenko, Nikolaeva) Federal Almazov North-West Medical
Research Centre, Saint Petersburg, Russian Federation
(Kozlov, Kozulin, Lubinskaya, Lopez-Sendon, Castro, Lopez-Sendon,
Fernandez-Figares) Hospital La Paz. IdiPaz, Madrid, Spain
(Castro, Salicio, Guzman, Galeote, Valbuena, Peteiro) Complexo
Hospitalario Universitario A Coruna (CHUAC) Sergas, Department of
Cardiology, INIBIC A Coruna. CIBER-CV., Universidad de A Coruna, A Coruna,
Spain
(Martinez-Ruiz, Perez-Fernandez, Blanco-Calvo, Cuenca-Castillo,
Alonso-Alvarez, Flores-Rios, Garcia-Gonzalez, Prada-Delgado,
Barge-Caballero, Juanatey, Amigo) Hospital Clinico Universitario de
Santiago, Santiago de Compostela, Spain
(Bayarri, Nunez, Sanchez, Alvarez, Gil, Monzonis, Sionis, Martinez)
Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
(Perales, Padro, Penaranda, Picart, Iglesias, Marimon, Llado, Costa, Miro,
Igual) Hospital Universitario y Politecnico La Fe, Valencia, Spain
(Diez, Calvillo, Ortuno) HUVA, Hospital Clinico Universitario Virgen De La
Arrixaca, Murcia, Spain
(Chavarri, Giner, Montolliu, Aniorte, Bermudez, Caravaca, De La Morena,
Blancas, Canavate) Hospital De Bellvitge, Barcelona, Spain
(Guerrero, Riera, Luena, Luena) Hospital Universitario Miguel Servet,
Zaragoza, Spain
(Lasala, Fernandez-Aviles, Lorenzo) Hospital General Universitario
Gregorio Maranon, Madrid, Spain
(Sobrino, Vazquez, Jiang, Chen, Dong) Guangdong General Hospital,
Guangzhou, China
(He, Xia, Yang, Zhong, Wu, Tian) Chinese Academy of Medical Sciences,
Fuwai Hospital, Beijing, China
(Li) First Affiliated Hospital of Xinjiang Medical University, Urumqi,
China
(Ma, Li, Yang, Ma, Yu, Zhao, Ji, Li) Tangshan Gongren Hospital, Tangshan,
China
(Zhang, Zhao, Zhu, Yang, Chen) Beijing Chao-yang Hospital, Capital Medical
University, Beijing, China
(Chi, Wang, Zhang, Lin, Jing) TEDA International Cardiovascular Hospital,
Tianjing, China
(Liu, Zeng, Zhou) Tongji Medical College, Wuhan, China
(Xu, Li, Li, Xiong, Fu, Gao) The First Affiliated Hospital of Zhengzhou
University, Zhengzhou, China
(Jiang, Leng, Wang, Yuan, Zhang, Yang, Bai) Shanxi Cardiovascular
Hospital, Taiyuan, China
(Li, Qi, Wang, Wang, Yang, Yue, Zhang, Wang, Dong) Qingdao Fuwai Hospital,
Qingdao, China
(Mao, Zhang, Cheng, Li) Shanxi Provincial People's Hospital, Xian, China
(Yao, Zhong, Zhou, Zhao, Huang) The Second Affiliated Hospital of
Zhengzhou University, Zhengzhou, China
(Zhou, Fang, Su) Liangxiang Hospital, Beijing, Fangshan District, Beijing,
China
(Zeng, Kunwu) Wuhan Union Hospital, Tongji Medical College, Huazhong
Science and Tech University, Wuhan, China
(Peng, Su, Su, Wang) Wuhan Asia Heart Hospital, Wuhan, China
(Zhao, Li, Geng) Affiliated Hospital of Jining Medical University, Jining,
China
(Wang, Nie, Fan) Beijing Anzhen Hospital, Beijing, China
(Feng, Wang, Yan, Zhang, Yu, Chi) Affiliated Zhongshan Hospital of Dalian
University, Dalian, China
(Liu, Wang, Chen) The Second Affiliated Hospital Zhejiang University
School of Medicine, Hangzhou, China
(Jiang, Li, Wang, Han) Peking Union Medical College Hospital, Beijing,
China
(Xu, Zhang, Liu, Liu, Chen, Hu, Maggioni, Perna, Pietrucci) Cardiology and
CCU - Ospedali Riuniti Ancona, Ancona, Italy
(Marini, Gabrielli, Provasoli, Di Donato) Ospedale di Circolo e Fondazione
Macchi, Varese, Italy
(Verna, Monti) Humanitas Research Hospital, Rozzano (MI), Rozzano, Italy
(Nardi, Di Chiara, Pezzetta) Azienda Servizi Sanitaria n.3 Alto
Friuli-Collinare-Medio Friuli, Tolmezzo, Italy
(Mortara, Casali) Policlinico di Monza, Monza, MB, Monza, Italy
(Galvani, Attanasio) Ospedale "G.B. Morgagni - L. Pierantoni" Forli (AUSL
della Romagna), Forli, Italy
(Ottani, Sicuro, Leone) Ospedale Regionale Umberto Parini, Aosta, Italy
(Pisano, Bare, Calabro, Fimiani) AORN Dei Colli "V. Monaldi" UOC
Cardiologia Universita della Campania "L.Vanvitelli", Napoli, Italy
(Formisano, Tarantini, Barioli) University of Padua- Cardiology Clinic,
Padua, Italy
(Cucchini, Ramani, Andres, Racca, Rolfo) Azienda Ospedaliera S. Croce e
Carle, Cuneo, Italy
(Goletto, Briguori, De Micco) Clinica Mediterranea, Naples, Italy
(Amati, Di Marco) UO Cardiologia Ospedale SS Cosma e Damiano, Pescia,
Italy
(Vergoni, Tricoli, Russo, Villella) IRCCS "Casa Sollievo della
Sofferenza", San Giovanni Rotondo, Italy
(Fanelli, White, Alsweiler, Poh) National University Heart Center
Singapore, Singapore, Singapore
(Chai, Lau, Loh, Tay, Teoh, Tan, Teo, Sia, Ong, Leong, Wong, Loh, Kofidis,
Chan, Chan, Foo, Yan) Tan Tock Seng Hospital, Singapore, Singapore
(Kong, Er, Jafary, Chua, Ismail) National Heart Centre Singapore,
Singapore, Singapore
(Kyaw, Yip, Doerr) Praxisklinik Herz und Gefaesse, Dresden, Germany
(Stumpf, Grahl, Matschke, Guenther, Simonis, Bonin, Kadalie, Sechtem,
Wenzelburger) Robert-Bosch-Krankenhaus, Stuttgart, Germany
(Ong, Gruensfelder, Schulze) University Hospital Jena, Jena, Germany
(Goebel, Lenk, Nickenig, Sinning) Universitatsklinikum Bonn, Bonn, Germany
(Weber, Werner, Lang, Huber, Schuchlenz, Steinmaurer) LKH Graz West, Graz,
Austria
(Weikl, Lang, Winter) Medical University of Vienna, Department of
Cardiology, Vienna, Austria
(Andric) Wilhelminen Hospital Vienna, Vienna, Austria
(Huber, Maximilian, Gabriele, Claudia, Bernhard, Florian, Keltai, Vertes,
Sebo) Eszszk- Szent Istvan Hospital, Budapest, Hungary
(Davidovits, Matics, Varga, Agoston) University of Szeged, Szeged, Hungary
(Fontos, Dekany) George Gottsegen National Institute of Cardiology,
Budapest, Hungary
(Merkely, Bartykowszki) Heart and Vascular Center, Semmelweis University,
Budapest, Hungary
(Maurovich-Horvat, Kerecsen, Jakal) Military Hospital, Budapest, Budapest,
Hungary
(Hinic, Djokic) University Hospital Center Bezanijska Kosa, Belgrade,
Serbia
(Zdravkovic, Mudrenovic, Crnokrak, Beleslin) Faculty of Medicine,
University of Belgrade, Cardiology Clinic, Clinical Center of Serbia,
Belgrade, Serbia
(Boskovic, Djordjevic-Dikic, Petrovic, Giga, Dobric, Stepanovic, Markovic,
Mladenovic, Cemerlic-Adjic, Velicki) Institute of Cardiovascular Diseases
Vojvodina, Sremska Kamenica, Serbia
(Pupic, Davidovic, Simovic) Clinical Center Kragujevac, Kragujevac, Serbia
(Vucic, Dekleva, Martinovic) University Clinical Hospital Zvezdara,
Belgrade, Serbia
(Stevanovic, Stankovic, Dobric) Clinical Center of Serbia, Belgrade,
Serbia
(Apostolovic, Martinovic) Clinic for Cardiovascular Diseases, Clinical
Center Nis, Nis, Serbia
(Stanojevic, Escobedo, de Jesus-Perez, Juarez) Instituto Mexicano del
Seguro Social, Mexico
(Baleon-Espinosa, Campos-Santaolalla, Duran-Cortes, Flores-Palacios,
Garcia-Rincon, Jimenez-Santos, Penafiel, Ortega-Ramirez,
Valdespino-Estrada, Rosas, Brassetti, Selvanayagam) Instituto Nacional de
Cardiologia "Ignacio Chavez", Mexico City, Mexico
(Anaya, Garcia, Juarez, Rovalo, Rodriguez, Selvanayagam, Rankin, Murphy,
Lee) Flinders Medical Centre, Adelaide, Australia
(Joseph, Thomas, Thambar, Chaplin) John Hunter Hospital, New Lambton
Heights, Australia
(Boer, Beltrame, Stansborough) The Queen Elizabeth Hospital, Woodville
South, Australia
(Black, Hillis, Bonner) Royal Perth Hospital, Perth, Australia
(Ireland, Venn-Edmonds, Steg, Abergel, Juliard, Thobois) C.H. Louis
Pasteur, Chartres, France
(Thuaire, Tachot, Dutoiu, Laure, Vassaliere, Steg, Abergel) Bichat
Hospital, Paris, France
(Juliard, Fuentes, Slama, Eliahou) Antoine-Beclere Hospital, Clamart,
France
(Mahmoud, Dubourg) Ambroise Pare Hospital, Boulogne, France
(Michaud, Nicollet, Hadjih) Centre Hospitalier Sud Francilien,
Corbeil-Essonnes, France
(Goube, Brito, Barone-Rochette, Barone-Rochette) Grenoble University
Hospital, Grenoble, France
(Furber, Cornet) Centre Hospitalier Universitaire d'Angers, Angers, France
(Biere, Rautureau, Juceviciene) Vilnius University Hospital Santariskes
Clinic, Vilnius, Lithuania
(Kalibataite-Rutkauskiene, Keinaite, Laucevicius, Laukyte, Celutkiene,
Mikolaitiene, Smigelskaite, Tamasauskiene, Urboniene, Kedhi) Isala
Klinieken, Zwolle, Netherlands
(Timmer, Bouwhuis, Hermanides, Nijmeijer, Kaplan, Riezebos) Cardio
Research Hartcentrum OLVG, Amsterdam, Netherlands
(Samadi, Schoep, van Dongen, Janzen, Niehe, Suryapranata, Ahoud)
Radboudumc, Nijmegen, Netherlands
(van Vugt, Ramos) Hospital de Santa Marta, Lisbon, Portugal
(Cacela, Santana, Fiarresga, Sousa, Marques, Patricio, Selas, Bernanrdes,
Silva, Rio, Freixo, Carvalho, Ferreira, Silva, Rodrigues, Modas, Portugal,
Fragata, Pinto, Cabrita) Santa Maria University Hospital, Cardiology
Department, CHLN, Lisbon, Portugal
(Menezes, Rocha, Lopes, Figueiras, Almeida, Coelho, Silva, Capinha, Nobre,
Caetano, Francisco, Silva, Ferreira) Centro Hospitalar de Vila Nova de
Gaia/Espinho, EPE, Vila Nova de Gaia, Portugal
(Lopes, Diaz, Guzman, Tinnirello) Instituto Medico DAMIC, Cordoba,
Argentina
(Figal, Mungo) Fundacion Favaloro, Ciudad Autonoma de Buenos Aires,
Argentina
(Mendiz, Cortes, Favaloro, Alvarez, Garcia) Hospital Italiano Regional del
Sur Bahia Blanca, Bahia Blanca, Argentina
(Courtis, Godoy) Clinica Romagosa and Clinica De La Familia, Cordoba,
Spain
(Zeballos, Schiavi, Actis) Clinica Del Prado, Cordoba, Spain
(Rubio) Clinica Privada Velez Sarsfield, Cordoba, Spain
(Scaro, Devlin, Low) Waikato Hospital, Hamilton, New Zealand
(Fisher, Scales, Abercrombie, Stewart) Auckland City Hospital, Auckland,
New Zealand
(Howell, Patten, Benatar, Kedev, Held) University Clinic of Cardiology,
Skopje, North Macedonia
(Mitevska, Kostovska, Pejkov, Held) Uppsala University, Uppsala, Sweden
(Eggers, Frostfelt, Bjorklund, Johnston, Andreasson, Olsowka, Essermark,
Akerblom, Soveri, Aspberg, Persson, Sharir) Karolinska Institutet,
Danderyd Hospital, Stockholm, Sweden
(Beyar, Nikolsky, Sharir, Harel) Assuta Medical Centers, Tel-Aviv, Israel
(Elian, Kerner, Bentzvi) Rambam Medical Center, Haifa, Israel
(Massalha, Helmer, Kohsaka, Fukuda, Ueda) Keio University, Shinjuku-ku,
Japan
(Kohsaka, Fujita, Yasuda, Furukawa) National Cerebral and Cardiovascular
Center, Kanae Hirase, RN, -4, Suita-shi, Japan
(Nagai, Otsuka, Nishimura, Nakano) Saitama Medical University, Hidaka,
Japan
(Van de Werf, Goetschalckx, Robesyn) University Hospital Leuven, Leuven,
Belgium
(Van de Werf, Claes, Hung, Yang) Mackay Memorial Hospital, Taipei City,
Taiwan (Republic of China)
(Yun, Hou, Kuo, Yeh, Hung, Li, Chien, Tsai, Liu, Yu, Lin, Lan, Yen, Tsai,
Sung, Ntsekhe) Groote Schuur Hospital, University of Cape Town, Cape Town,
South Africa
(Pandie, Philander, Viljoen, Mtana, De Andrade, Maggioni, Moccetti,
Anesini) Cardiocentro, Lugano, Switzerland
(Rossi, Maspoli, Mombelli, Abdelhamid, Talaat) Cairo University, Cairo,
Egypt
(Adel, Kamal, Mahrous, El Kaffas, El Fishawy, Pop) Emergency County
Hospital Baia Mare, Bucharest, Romania
(Claudia, Popescu) Emergency Institute of Cardiovascular Diseases ''Prof.
Dr. C. C. Iliescu'', Bucharest, Romania
(Ginghina, Rosca, Deleanu, Beladan, Iliescu, Al-Mallah, Zahrani) King
AbdulAziz Cardiac Center, Central Province, Saudi Arabia
(Aljzeeri, Najm, Alghamdi, Ramos) Instituto Neuro Cardiovascular De Las
Americas, Mirafloes, Peru
(Davila, Kuanprasert) Maharaj Nakorn Chiang Mai Hospital, Chiang Mai,
Thailand
(Prommintikul, Nawarawong, Khwakhong, Woragidpoonpol, Chaiyasri, Tepsuwan,
Mekara, Taksaudom, Kulthawong, Rimsukcharoenchai, Amaritakomol,
Euathrongchit, Wannasopha, Yamwong, Panpunuan) Ramathibodi Hospital,
Bangkok, Thailand
(Sritara, Aramcharoen, Meemuk, White, Alsweiler, Khairuddin, Mokhtar)
Institut Jantung Negara, Kuala Lumpur, Malaysia
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: ISCHEMIA (International Study of Comparative Health
Effectiveness With Medical and Invasive Approaches) did not find an
overall reduction in cardiovascular events with an initial invasive versus
conservative management strategy in chronic coronary disease; however,
there were conservative strategy participants who underwent invasive
coronary angiography early postrandomization (within 6 months).
Identifying factors associated with angiography in conservative strategy
participants will inform clinical decision-making in patients with chronic
coronary disease. METHOD(S): Factors independently associated with
angiography performed within 6 months of randomization were identified
using Fine and Gray proportional subdistribution hazard models, including
demographics, region of randomization, medical history, risk factor
control, symptoms, ischemia severity, coronary anatomy based on
protocol-mandated coronary computed tomography angiography, and medication
use. RESULT(S): Among 2591 conservative strategy participants,
angiography within 6 months of randomization occurred in 8.7% (4.7% for a
suspected primary end point event, 1.6% for persistent symptoms, and 2.6%
due to protocol nonadherence) and was associated with the following
baseline characteristics: enrollment in Europe versus Asia (hazard ratio
[HR], 1.81 [95% CI, 1.14-2.86]), daily and weekly versus no angina (HR,
5.97 [95% CI, 2.78-12.86] and 2.63 [95% CI, 1.51-4.58], respectively),
poor to fair versus good to excellent health status (HR, 2.02 [95% CI,
1.23-3.32]) assessed with Seattle Angina Questionnaire, and new/more
frequent angina prerandomization (HR, 1.80 [95% CI, 1.34-2.40]). Baseline
low-density lipoprotein cholesterol <70 mg/dL was associated with a lower
risk of angiography (HR, 0.65 [95% CI, 0.46-0.91) but not baseline
ischemia severity nor the presence of multivessel or proximal left
anterior descending artery stenosis >70% on coronary computed tomography
angiography. CONCLUSION(S): Among ISCHEMIA participants randomized to
the conservative strategy, angiography within 6 months of randomization
was performed in <10% of patients. It was associated with frequent or
increasing baseline angina and poor quality of life but not with objective
markers of disease severity. Well-controlled baseline low-density
lipoprotein cholesterol was associated with a reduced likelihood of
angiography. These findings point to the importance of a comprehensive
assessment of symptoms and a review of guideline-directed medical therapy
goals when deciding the initial treatment strategy for chronic coronary
disease. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique
identifier: NCT01471522. GRAPHIC ABSTRACT: A graphic abstract is available
for this article. Copyright © 2024 American Heart Association,
Inc.

<11>
Accession Number
2042960950
Title
Efficacy of Ropivacaine Infiltration by Presternal Multi-orifice Catheter
for Post-Sternotomy Pain Relief in Adult Patients Undergoing Cardiac
Surgery-A Prospective, Randomized, Control Study.
Source
Annals of Cardiac Anaesthesia. 29(1) (pp 104-109), 2026. Date of
Publication: 01 Jan 2026.
Author
Swetha L.S.N.; Prakash M.; Hasija S.; Gayatri B.S.; Chauhan S.; Jha P.K.
Institution
(Swetha, Prakash, Hasija, Chauhan) Department of Cardiac Anesthesia and
Critical Care, All India Institute of Medical Sciences, New Delhi, India
(Gayatri, Jha) Department of Cardiothoracic and Vascular Surgery, All
India Institute of Medical Sciences, New Delhi, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Post-sternotomy pain management remains a key concern
in adult cardiac surgery. This study evaluated the efficacy and safety of
ropivacaine infiltration via a presternal multi-orifice catheter for
postoperative analgesia. Design(s): A prospective randomized
controlled trial. Setting(s): A single tertiary care center.
 Material(s) and Method(s): A total of 175 adult patients undergoing
cardiac surgery via median sternotomy were randomized into three groups:
Group A (n = 58): Received 0.375% ropivacaine as continuous infusion at 5
mL/hour, Group B (n = 58): Received 5 mL of 0.375% ropivacaine as
intermittent boluses every 8 hours, and Group C (n = 59): Received
conventional intravenous tramadol. Pain was assessed using the visual
analogue scale (VAS) for 48 hours post-extubation. Intravenous tramadol
was used as rescue analgesia if VAS>=3. Result(s): Group B reported
significantly lower VAS scores and rescue tramadol requirements (56 +/- 35
mg) compared to Group A (155 +/- 32 mg) and Group C (135 +/- 45 mg). No
significant differences were observed among the groups regarding
hemodynamic parameters, catheter-related infections, time to extubation,
or intensive care unit (ICU) stay. Conclusion(s): Presternal
infiltration of 0.375% ropivacaine is safe and effective for
post-sternotomy analgesia. The intermittent bolus technique provides
superior pain relief and reduces opioid consumption compared to continuous
infusion and standard intravenous analgesia. Copyright © 2026
Annals of Cardiac Anaesthesia.

<12>
Accession Number
2043751361
Title
Comparison of a TrachoSpray Device and Manual Lidocaine Spray on
Hemodynamic Stability and Postoperative Sore Throat in Patients Undergoing
Double-Lumen Tube Intubation: A Randomized Controlled Trial.
Source
Journal of Investigative Surgery. 39(1) (no pagination), 2026. Article
Number: 2586017. Date of Publication: 2026.
Author
Tumer M.; Geyik F.D.; Buz M.; Taskin K.; Sogut M.S.; Cevik B.; Demirhan R.
Institution
(Tumer) Department of Anesthesiology and Reanimation, VKV Amerikan
Hospital, Istanbul, Turkey
(Geyik, Taskin, Cevik) Department of Anesthesiology and Reanimation,
Health Sciences University Kartal Dr. Lutfi Kirdar High Specialization
Training and Research Hospital, Istanbul, Turkey
(Buz, Demirhan) Department of Thoracic Surgery, Health Sciences University
Kartal Dr. Lutfi Kirdar High Specialization Training and Research
Hospital, Istanbul, Turkey
(Sogut) Department of Anesthesiology and Reanimation, Koc University,
Faculty of Medicine, Istanbul, Turkey
Publisher
Taylor and Francis Ltd.
Abstract
Background: Postoperative sore throat (POST) is an distressing
complication following endotracheal intubation, particularly with
double-lumen tube (DLT) intubation. Study evaluated the effects of two
local anesthetic techniques on hemodynamic responses and POST in
DLT-intubated patients. Method(s): A randomized controlled study was
conducted with 60 patients scheduled for elective thoracic surgery.
Participants were randomized into three groups: TrachoSpray group (2 mL of
10% lidocaine), Manual spray group (10% lidocaine) and, Control group
(0.9% saline). Hemodynamic parameters, including systolic blood pressure
(SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP),
were monitored preoperatively, intraoperatively, and postoperatively. POST
was assessed using a visual analog scale at 2, 6, 12, and 24 h
post-extubation. Result(s): Both lidocaine groups demonstrated
significant reductions in SBP, DBP, and MAP at key time points compared to
control group. Post-extubation, MAP was significantly higher in
TrachoSpray group than lidocaine group (p = 0.04). No statistically
significant differences in POST scores were observed between groups.
 Conclusion(s): TrachoSpray device and manual lidocaine spray improved
hemodynamic stability in DLT-intubated patients; however, neither method
resulted in a significant reduction in POST scores. Further research is
needed to confirm these hemodynamic benefits and to explore potential
effects on long-term outcomes. Copyright © 2026 The Author(s).
Published with license by Taylor & Francis Group, LLC.

<13>
Accession Number
2030840705
Title
Electronic Glycemic Management System Improved Glycemic Control and
Reduced Complications in Patients With Diabetes Undergoing Coronary Artery
Bypass Surgery: A Randomized Controlled Trial.
Source
Journal of Diabetes Science and Technology. 20(2) (pp 308-316), 2026. Date
of Publication: 01 Mar 2026.
Author
Camara de Souza A.B.; Toyoshima M.T.K.; Cukier P.; Lottenberg S.A.; Bolta
P.M.P.; Lima E.G.; Serrano Junior C.V.; Nery M.
Institution
(Camara de Souza, Cukier, Lottenberg, Nery) Department of Endocrinology
and Metabolism, Hospital das Clinicas da Faculdade de Medicina da
Universidade de Sao Paulo, Sao Paulo, Brazil
(Toyoshima) Instituto do Cancer do Estado de Sao Paulo Octavio Frias de
Oliveira, Hospital das Clinicas da Faculdade de Medicina da Universidade
de Sao Paulo, Sao Paulo, Brazil
(Bolta, Lima, Serrano Junior) Instituto do Coracao, Hospital das Clinicas
da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
Publisher
SAGE Publications Inc.
Abstract
Background: In-hospital hyperglycemia poses significant risks for patients
with diabetes mellitus undergoing coronary artery bypass graft (CABG)
surgery. Electronic glycemic management systems (eGMSs) like InsulinAPP
offer promise in standardizing and improving glycemic control (GC) in
these settings. This study evaluated the efficacy of the InsulinAPP
protocol in optimizing GC and reducing adverse outcomes post-CABG.
 Method(s): This prospective, randomized, open-label study was
conducted with 100 adult type 2 diabetes mellitus (T2DM) patients
post-CABG surgery, who were randomized into two groups: conventional care
(gCONV) and eGMS protocol (gAPP). The gAPP used InsulinAPP for insulin
therapy management, whereas the gCONV received standard clinical care. The
primary outcome was a composite of hospital-acquired infections, renal
function deterioration, and symptomatic atrial arrhythmia. Secondary
outcomes included GC, hypoglycemia incidence, hospital stay length, and
costs. Result(s): The gAPP achieved lower mean glucose levels (167.2
+/- 42.5 mg/dL vs 188.7 +/- 54.4 mg/dL; P = .040) and fewer patients-day
with BG above 180 mg/dL (51.3% vs 74.8%, P = .011). The gAPP received an
insulin regimen that included more prandial bolus and correction insulin
(either bolus-correction or basal-bolus regimens) than the gCONV (90.3% vs
16.7%). The primary composite outcome occurred in 16% of gAPP patients
compared with 58% in gCONV (P < .010). Hypoglycemia incidence was lower in
the gAPP (4% vs 16%, P = .046). The gAPP protocol also resulted in shorter
hospital stays and reduced costs. Conclusion(s): The InsulinAPP
protocol effectively optimizes GC and reduces adverse outcomes in T2DM
patients' post-CABG surgery, offering a cost-effective solution for
inpatient diabetes management. Copyright © 2024 Diabetes
Technology Society

<14>
Accession Number
634851185
Title
A prospective randomized comparison of manta and proglide in terms of
vascular complications in tavi.
Source
Thoracic and Cardiovascular Surgeon. Conference: 50th Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery, DGTHG 2021.
Online. 69(SUPPL 1) (no pagination), 2021. Date of Publication: 19 Feb
2021.
Author
Kofler M.; Unbehaun A.; Klein C.; Ivleva A.; Meyer A.; Buz S.; Sundermann
S.H.; Falk V.; Kempfert J.
Institution
(Kofler, Unbehaun, Klein, Ivleva, Meyer, Buz, Sundermann, Falk, Kempfert)
BerlinGermany
Publisher
Georg Thieme Verlag
Abstract
Vascular and bleeding complications following transcatheter aortic valve
implantation (TAVI) are known toincrease morbidity and mortality. We aimed
to compare the rate of vascular and bleeding complications between a
novelplug-based vascular closure device (PB-VCD) and a wide available
suture-based vascular closure device (SB-VCD) inpatients undergoing TAVI
in a prospective randomized study. Method(s): From September 2019 to
April 2020, a total of 145 patients with severe aortic stenosis scheduled
for isolatedtransfemoral TAVI were prospectively included.
Block-randomization using varying block sizes was performed to
randomizepatients either to PB-VCD ( n = 73, 50.3%) or to SB-VCD ( n = 72,
49.7%) in a 1:1 ratio. The primary endpoint of the studywas any vascular
complication (major and minor combined) defined in accordance to the Valve
Academic ResearchConsortium - II (VARC-II) criteria. Secondary endpoints
were rates of VARC-II bleeding complications. Result(s): The rate of
any vascular complication according to VARC-II occurred in 21.9% ( n = 16)
and 26.4% ( n = 19) ofpatients treated with PB-VCD and SB-VCD respectively
( p = 0.664). Details regarding individual vascular and bleedingVARC-II
endpoints are listed in the attached table. Conclusion(s): PB-VCD and
SB-VCD show comparable results in all assessed rates of vascular and
bleeding complicationsdefined in accordance to VARC-II criteria. Presented
results should be interpreted under the light of the relatively lowsample
size of the study.

<15>
Accession Number
634850985
Title
Singe-center experience: Minimally invasive aortic valve replacement.
Source
Thoracic and Cardiovascular Surgeon. Conference: 50th Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery, DGTHG 2021.
Online. 69(SUPPL 1) (no pagination), 2021. Date of Publication: 19 Feb
2021.
Author
Mehdiani A.; Smiris K.; Sipahi F.; Boeken U.; Akhyari P.; Lichtenberg A.
Institution
(Mehdiani, Smiris, Sipahi, Boeken, Akhyari, Lichtenberg) DusseldorfGermany
Publisher
Georg Thieme Verlag
Abstract
Further development of minimally invasive techniques for isolated aortic
valve replacement (MIS-AVR) ismandatory in cardiac surgery, especially
under the aspect of the current successful development of interventional
methods.To maintain MIS-AVR case numbers and to establish it more widely,
the feasibility and safety of alternative access strategiesmust be
continuously demonstrated. Method(s): Between 2015 and 2019, isolated
AVR was performed in 215 patients in our department using a
rapiddeployment prosthesis, involving right anterolateral thoracotomy
(RALT) or J -shaped partial upper sternotomy (JS). In RALTgroup
cardiopulmonary bypass (CPB) was established via femoral approach, mainly
using percutaneous closure systems,while in the JS group central
cannulation was used. Thus calcification of femoral vessels was a
contraindication for RALT,those patients where threated via JS. All
patients received preoperative CT-scans for surgical planning.
Perioperative dataand 30-day mortality were retroperspectively analyzed.
 Result(s): There were 99 (46%) patients in RALT and 116 (54%)
patients in JS group. Patients in RALT compared with JSwere mostly women
(63 vs. 48%, p < 0.05), but did not show any difference regarding
EuroSCORE II or age. Analysis ofintraoperative data revealed a by trend
prolonged duration pf operation, CPB and cross clamp time in group RALT
versus JS( p = n.s.) while postoperative data such as ICU and hospital
stay were comparable between the 2 groups. We observed anincidence of
pacemaker implantation with 10 and 12%, however without significance. No
patient suffered from woundinfection, and patients in group JS were
expectably free of any vessel complication whereas one patient in group
RALTsuffered from bleeding due to a technical failure of the femoral
closing system. Conversion to full sternotomy was observedin 2 patients
(2%) in RALT and no patient in JS group. Paravalvular leakage could be
detected in 4% (RALT) and 6% (JS)patients ( p = n.s.). Two patients died
during hospital stay in group RALT (2 vs. 0%, p = n.s.)
 Conclusion(s): Aortic valve replacement via right anterolateral
thoracotomy or partial upper sternotomy seems to be a validand
reproducible technique for AVR patients. The definitive evidence should be
obtained in controlled clinical trials. Theoptimal selection for
successful access strategy is extremely important and should be performed
individually for eachpatient. A CT scan is essential for careful
preoperative planning.

<16>
Accession Number
631112501
Title
Ten year survival after coronary artery bypass grafting versus
percutaneous coronary intervention: The syntax extended survival
(SYNTAXES) study.
Source
Thoracic and Cardiovascular Surgeon. Conference: 49th Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery. Wiesbaden
Germany. 68(Supplement 1) (no pagination), 2020. Date of Publication: 13
Feb 2020.
Author
Noack T.; Thuijs D.; Kappetein P.; Serruys P.; Mohr F.W.; Morice M.C.;
Mack M.; Holmes D.; Davierwala P.; Head S.
Institution
(Noack, Mohr, Davierwala) LeipzigGermany
(Thuijs, Kappetein, Head) RotterdamNetherlands
(Serruys) LondonUnited Kingdom
(Morice) ParisFrance
(Mack) DallasUnited States
(Holmes) RochesterUnited States
Publisher
Georg Thieme Verlag
Abstract
Objectives: Ten-year survival outcomes from contemporaneous randomized
trials comparing percutaneous coronary intervention (PCI) with drug
eluting stents and coronary artery bypass grafting (CABG) in patients with
de novo three vessel (3VD) or left main coronary artery disease (LMCAD)
have not been reported. Method(s): The randomized synergy between PCI
with TAXUS and cardiac surgery (SYNTAX) trial reported comparable survival
rates between PCI with paclitaxel-eluting stents and CABG at 5 years.
Therefore, the SYNTAX extended survival study (SYNTAXES) aims to determine
10-year survival in the SYNTAX randomized patients (n = 1,800; CABG = 897,
PCI = 903). Follow-up was performed in accordance with local law and
regulations of each of the currently 76-participating institutions.
Cumulative time-to-death is estimated by Kaplan-Meier analysis and
compared with log-rank tests. Hazard ratios (HR) with 95% confidence
intervals (CI), of CABG versus PCI, are established by Cox's proportional
hazard models. Prespecified subgroup analyses of CABG versus PCI are
performed in cohorts of patients with three vessel disease, left main
disease, in patients with and without medically treated diabetes and
according to SYNTAX scores. Result(s): From March, 2005, to April,
2007, 1,800 patients were randomly assigned to the PCI (n = 903) or CABG
(n = 897) group. Vital status information at 10 years was complete for 841
(93%) patients in the PCI group and 848 (95%) patients in the CABG group.
At 10 years, 244 (27%) patients had died after PCI and 211 (24%) after
CABG (HR = 1.17 [95% CI: 0.97-1.41], p = 0.092). Among patients with
three-vessel disease, 151 (28%) of 546 had died after PCI versus 113 (21%)
of 549 after CABG (HR = 1.41 [95% CI: 1.10-1.80]), and among patients with
left main coronary artery disease, 93 (26%) of 357 had died after PCI
versus 98 (28%) of 348 after CABG (0.90 [0.68-1.20], p for interaction =
0.019). There was no treatment-by-subgroup interaction with diabetes (p
for interaction = 0.66) and no linear trend across SYNTAX score tertiles
(p = 0.30). Conclusion(s): At 10 years, no significant difference
existed in all-cause death between PCI using first-generation
paclitaxeleluting stents and CABG. However, CABG provided a significant
survival benefit in patients with three-vessel disease, but not in
patients with left main coronary artery disease.

<17>
Accession Number
628084501
Title
Partial upper sternotomy versus full sternotomy for mitral valve surgery:
A propensity score matched analysis.
Source
Thoracic and Cardiovascular Surgeon. Conference: 48th Annual Meeting
German Society for Thoracic, Cardiac, and Vascular Surgery. Wiesbaden
Germany. 67(Supplement 1) (no pagination), 2019. Date of Publication: 28
Jan 2019.
Author
Oezpeker C.U.; Barbieri F.; Bonaros N.; Grimm M.; Hoefer D.; Mueller L.
Institution
(Oezpeker, Barbieri, Bonaros, Grimm, Hoefer, Mueller) Department of
Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria
Publisher
Georg Thieme Verlag
Abstract
Objectives: Minimally invasive mitral valve surgery (MIMVS) through
anterolateral minithoracotomy (MT) has become the standard therapy for
isolated mitral valve disease in experienced centers. Multiple valve
disease or other anatomical and certain clinical conditions, however, make
this access not suitable for some patients and conventional full
sternotomy (FS) is the mostly preferred alternative approach. For those
patients, partial upper sternotomy (PS) can be used as a less invasive
access. Although FS has been widely investigated, there are not enough
insights to the PS approach for mitral valve surgery (MVS). Therefore, we
compared the data of both accesses. Method(s): This retrospective
analysis includes data on 1,639 patients who underwent either isolated or
combined primary MVS at our department from May 2011 to August 2017. Out
of these, 663 patients were operated via MT access and were excluded from
this analysis. Further 528 patients were excluded mainly due to
concomitant coronary artery bypass (CABG) surgery but also because of
re-do cases, concomitant aortic surgery or urgent/salvage MVS. Finally, 99
patients who had been judged suitable for PS had either isolated MVS (n =
47, 47.5%) or multivalve surgery (n = 52, 52.5%). In addition, 349
patients with FS for primary MVS were included in our study. To reduce the
possibility of selection bias a 1:1 propensity score match making was
performed which resulted in 98 pairs. For analysis of postoperative
survival Kaplan-Meier curves were calculated. Result(s): During a
median follow-up time of 1,491 days (478-2,186; PS 1,103 [331-1,806 days],
FS 2,180 days [8413,054]) all-cause mortality was 15.90% (70 of 439
patients). In the propensity score paired model, PS showed statistically
significant superior survival compared with FS at 30 days (p = 0.044,
hazard ratio [HR] 7.525, 95% confidence interval [CI] 1.06-53.56).
Furthermore, 90 and 365 days survival after surgery showed a similar
trend, but without reaching statistical significance (p = 0.096, HR 3.898,
95% CI 0.79-19.34; p = 0.077, HR 2.774, 95% CI 0.89-8.61). As secondary
end points, number of second pump runs and hospital length of stay were
significantly less (p = 0.016, p < 0.001) in PS patients.
 Conclusion(s): The less invasive PS approach for MVS seems to have
short- and long-term survival benefits. In patients who are not candidates
for MT PS seems a favorable approach although prospective
randomized-controlled trials are necessary for confirmation.

<18>
Accession Number
631112422
Title
Long-term durability and valve integrity of aortic valve bioprostheses:
Single-center experience with patients under 50 years of age.
Source
Thoracic and Cardiovascular Surgeon. Conference: 49th Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery. Wiesbaden
Germany. 68(Supplement 1) (no pagination), 2020. Date of Publication: 13
Feb 2020.
Author
Polat E.; Muller C.; Sinani L.; Neumann-Schniedewind P.; Peterss S.;
Juchem G.; Pichlmaier M.; Hagl C.
Institution
(Polat, Muller, Sinani, Neumann-Schniedewind, Peterss, Juchem, Pichlmaier,
Hagl) MunichGermany
Publisher
Georg Thieme Verlag
Abstract
Objectives: There is no consensus for the lower age limit of bioprosthesis
in aortic position for surgical aortic valve replacement (SAVR) and
current available long-term data is insufficient. The objective of this
retrospective analysis is to add clinical echocardiographic evidence and
provide decision guidance for the choice of an age-appropriate prosthesis
in patients younger than 50 years. Method(s): From January 2000 to
December 2017, a total of 3,519 patients underwent isolated SAVR with a
biological prosthesis at our institution. A total of 120 patients younger
than 50 years at the time of surgery were identified, of whom 95 patients
contributed follow-up data. Data were retrospectively analyzed, including
clinical and echocardiographic assessment. Mean follow-up was 8 +/- 4.4
years with a maximum of 19 years and a total of 677 valve years.
 Result(s): Mean age at the time of surgery was 41 +/- 8.6 years.
Eighty-three percent of patients were male. There was no perioperative
mortality. Mean diameter of implanted bioprostheses was 25 +/- 2.1 mm. Six
patients died during follow-up (6.3%). Structural valve deterioration
(SVD) occurred in 22 patients (23.2%), followed by redo surgical aortic
valve replacement with a bioprosthesis in 11 patients, mechanical
prosthesis in 8 patients, and transcatheter valve-in-valve implantations
in 3 patients, respectively. Other major adverse cardiac events including
endocarditis and thromboembolic events were seen in 16.3% of patients.
 Conclusion(s): In the present cohort of patients < 50 years of age,
new-generation bioprostheses provide satisfying results for bleeding and
thromboembolic events, hemodynamic performance, and SVD. The inherent need
for repeat valve intervention in young adults remains the major drawback
for bioprostheses. Further large-number studies and randomized long-term
outcome in younger cohorts are mandatory to substantiate whether this
practice is justified.

<19>
Accession Number
635343240
Title
Empagliflozin reduces the total burden of cardiovascular events including
recurrent events in the EMPA-REG OUTCOME trial.
Source
Diabetologie und Stoffwechsel. Conference: Diabetes Kongress 2021 - 55.
Jahrestagung der DDG. Online. 16(SUPPL 1) (pp S51), 2021. Date of
Publication: 06 May 2021.
Author
Autoren Fitchett D.; Inzucchi S.E.; Zinman B.; Wanner C.; Anker S.D.;
Pocock S.; Kaspers S.; George J.T.; Johansen O.E.; Jamal W.; Hantel S.;
Lund S.S.
Institution
(Autoren Fitchett) Institut University of Toronto, St Michael's Hospital,
Division of Cardiology, Toronto, ON, Canada
(Inzucchi) Yale University School of Medicine, Section of Endocrinology,
New Haven, CT, United States
(Zinman) University of Toronto, Mount Sinai Hospital, Lunenfeld-Tanenbaum
Research Institute, Toronto, ON, Canada
(Wanner) Wurzburg University Clinic, Department of Internal Medicine I,
Wurzburg, Germany
(Anker) Charite-Universitatsmedizin Berlin, Department of Cardiology
(CVK), Berlin, Germany
(Pocock) London School of Hygiene and Tropical Medicine, Department of
Medical Statistics, London, United Kingdom
(Kaspers, George, Jamal, Lund) Boehringer Ingelheim International GmbH,
CardioMetabolism and Respiratory, Ingelheim, Germany
(Johansen) Boehringer Ingelheim Norway KS, Medicine, Asker, Norway
(Hantel) Boehringer Ingelheim Pharma GmbH and Co. KG, Department
Biostatistics and Data Sciences, Biberach an der Ris, Germany
Publisher
Georg Thieme Verlag
Abstract
Introduction In EMPA-REG OUTCOME, empagliflozin (EMPA) reduced the risk of
major adverse cardiovascular (CV) events (MACE), CV mortality and
hospitalization for heart failure (HHF) in analyses of first events in
patients with type 2 diabetes (T2D) and atherosclerotic CV disease
(ASCVD). We assessed the effect of EMPA on the total burden of CV events.
Methods Patients were randomized to EMPA 10 mg, EMPA 25 mg, or placebo. We
assessed the effects of EMPA pooled vs placebo on any (first plus
recurrent) adjudicated CV event (composite of myocardial infarction (MI),
stroke, coronary revascularization (CR), hospitalization for unstable
angina, transient ischemic attack, HHF, and CV death) using a negative
binomial model. Results Among 7,020 treated patients (mean [SD] age 63 [9]
years), there were 2,142 total adjudicated CV events, most frequently CR
(585), MI (421), and HHF (321). EMPA reduced the risk of total adjudicated
CV events by 24% vs placebo (event rate ratio (95% CI): 0.76 (0.67, 0.87),
p < 0.0001). Risk reductions were driven predominantly by reductions in
HHF (0.58 (0.42, 0.81), p=0.0012), MI (0.79 (0.620, 0.998), p=0.0486), and
CV death (0.62 (0.50, 0.78), p < 0.0001). The estimated number of total CV
events prevented with EMPA was 414.4, and the number of patients needed to
treat over 3 years to prevent one event was 10.2 (6.6, 22.7). Conclusions
EMPA produced a sizeable risk reduction in the total burden of any
adjudicated CV outcome, including HHF, MI and CV death, in patients with
T2D and ASCVD.

<20>
Accession Number
2041770098
Title
Evaluating Surgical Approaches in Early NSCLC: A Meta-Analysis of
Robot-Assisted and Video-Assisted Techniques.
Source
Annals of Surgical Oncology. 33(3) (pp 2123-2136), 2026. Date of
Publication: 01 Mar 2026.
Author
Khan W.; Ali T.; Bilal M.; Ahmad W.; Ali S.A.; Hashim A.; Khan A.Z.; Kumar
A.; Abdullah M.; Khan S.; Ahmed A.; Jawad M.
Institution
(Khan, Abdullah, Jawad) Dow Medical College, Dow University of Health
Sciences, Karachi, Pakistan
(Ali) Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi,
Pakistan
(Bilal) Peshawar Medical College, Peshawar, Pakistan
(Ahmad) King Edward Medical University, Lahore, Pakistan
(Ali) Bahria Medical College, Karachi, Pakistan
(Hashim, Khan) Al-Aleem Medical College, Lahore, Pakistan
(Kumar, Ahmed) Ziauddin Medical College, Ziauddin University, Karachi,
Pakistan
(Khan) Nishtar Medical College, Multan, Pakistan
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Lung cancer, especially non-small cell lung cancer (NSCLC), is
a leading cause of cancer death. Surgical resection is the primary
treatment for early-stage NSCLC. Video-assisted thoracoscopic surgery
(VATS) and robot-assisted thoracic surgery (RATS) are minimally invasive
options, with RATS offering better precision at higher costs. This
meta-analysis compared the perioperative outcomes of both techniques in
NSCLC. Method(s): A systematic search in PubMed, Web of Science, NLM,
CNKI, and Wanfang was conducted for RCTs published between 31 July 2021
and 31 December 2024. Primary outcomes included operation time, blood
loss, lymph node dissection, conversion to thoracotomy, chest drainage
time, and hospital stay. Statistical analyses were performed using RevMan
5.3, with heterogeneity assessed using the I2 statistic. A p
value lower than 0.05 was considered significant. Result(s): Three
RCTs were analyzed. Blood loss showed no significant difference between
VATs and RATs (mean difference [MD], -33.00; 95% CI, -85.51 to 22.89; p =
0.07). Conversion to thoracotomy was comparable (MD, 0.69; 95% CI, 0.37 to
1.28; p = 0.24). Hospital stay did not differ significantly (MD, 0.13; 95%
CI, -0.58 to 0.84; p = 0.74). Operation time remained similar (MD, -4.63;
95% CI, -10.93 to 1.67; p = 0.15). The VATS procedure enabled
significantly greater lymph node dissection (MD, 1.83; 95% CI, 0.16 to
3.49; p = 0.03). Chest drainage duration showed no difference (MD, 0.00;
95% CI, -0.27 to 0.27; p = 1.00). Conclusion(s): In NSCLC, RATS and
VATS yield comparable outcomes, with RATS potentially reducing blood loss
and VATS allowing more lymph node dissection. Further high-quality RCTs
are needed to clarify the optimal approach for NSCLC. Copyright ©
Society of Surgical Oncology 2025.

<21>
Accession Number
2043456490
Title
Left Atrial Appendage Occlusion Versus NOACs in patients With Atrial
Fibrillation: Rationale and Design of the CATALYST Trial.
Source
American Heart Journal. 296 (no pagination), 2026. Article Number: 107367.
Date of Publication: 01 Jun 2026.
Author
Reddy V.Y.; Hylek E.; Camm A.J.; Halperin J.L.; Diener H.-C.; Thaler D.;
Schmidt B.; Hara H.; Huisman M.V.; Price M.J.; Lakkireddy D.; Gage R.;
Zhao H.; Jensen T.P.; Quintana M.; Windecker S.
Institution
(Reddy, Halperin) Mount Sinai Fuster Heart Hospital, Icahn School of
Medicine at Mount Sinai, New York, NY, United States
(Hylek) Boston University School of Medicine, Boston, MA, United States
(Camm) City St. George's University of London, London, United Kingdom
(Diener) University Duisburg-Essen, Essen, Germany
(Thaler) Tufts Medical Center, Boston, MA, United States
(Schmidt) Cardioangiologisches Centrum Bethanien, Frankfurt, Germany
(Hara) Toho University Ohashi Medical Center, Tokyo, Japan
(Huisman) Leiden University Medical Center, Leiden, Netherlands
(Price) Scripps Clinic, La Jolla, CA, United States
(Lakkireddy) Kansas City Heart Rhythm Institute and Research Foundation,
Overland Park, KS, United States
(Gage, Zhao) Abbott, St. Paul, MN, United States
(Jensen, Quintana) Berry Consultants, Austin, TX, United States
(Windecker) Department of Cardiology, Bern University Hospital, University
of Bern, Bern, Switzerland
Publisher
Elsevier Inc.
Abstract
Introduction Both percutaneous left atrial appendage occlusion (LAAO) and
nonvitamin K antagonist oral anticoagulants (NOACs) are noninferior to
warfarin for stroke prevention in high-risk patients with atrial
fibrillation (AF). However, there is limited data comparing LAAO with
NOACs. The CATALYST trial compares a dual-seal LAAO device (AmplatzerTM
AmuletTM) to NOACs in AF patients indicated for thromboprophylaxis. Method
CATALYST is a prospective, multicenter, randomized controlled, open-label
trial with an adaptive statistical design. Up to 2,650 AF patients with
CHA<inf>2</inf>DS<inf>2</inf>-VASc score >=2 (men) or >=3 (women) will be
randomly assigned to LAAO or NOAC at 123 global sites. Patients randomized
to NOACs take the appropriate labeled dose with compliance monitored at
each visit, while LAAO patients receive dual antiplatelet therapy followed
by aspirin monotherapy for >=12 months postimplant. Patients are followed
through 5 years, with postimplant cardiac imaging at 3- and 12-months.
There are three co-primary endpoints: (1) ischemic stroke, systemic
embolism, or cardiovascular death through 2 years, tested for
noninferiority; (2) major or clinically relevant nonmajor bleeding through
2 years, tested for superiority; and (3) ischemic stroke or systemic
embolism through 3 years, tested for noninferiority. The following
secondary endpoints will be tested if the primary endpoints are met: (1)
all-bleeding, tested for noninferiority; (2) followed by testing for
superiority; (3) disabling or fatal strokes, tested for superiority; all
through 2 years. Conclusions CATALYST is evaluating the safety and
effectiveness of a dual seal LAAO device compared to NOACs in patients
with AF at increased risk of stroke. Clinical Trial Registration URL
https://clinicaltrials.gov ; Unique Identifier NCT04226547. Copyright
© 2026 The Authors.

<22>
Accession Number
2042494002
Title
A pilot trial of long-distance shipped, extended- and cold-stored
platelets in 100% plasma for cardiothoracic surgical bleeding.
Source
Transfusion. 66(3) (pp 555-567), 2026. Date of Publication: 01 Mar 2026.
Author
Stolla M.; Bailey S.L.; Chauhan A.; Byrne D.A.; Ting L.; Klotz P.; Pulido
J.N.; Lehr E.J.; Youssef S.; Lawrence J.; Limanek A.; Alcorn K.; Ryan P.;
Stout D.M.
Institution
(Stolla, Bailey, Chauhan, Byrne, Klotz) Bloodworks Northwest Research
Institute, Seattle, WA, United States
(Stolla, Alcorn) Bloodworks Northwest, Medical Services Division, Seattle,
WA, United States
(Stolla) Department of Medicine, Division of Hematology and Oncology,
University of Washington, Seattle, WA, United States
(Stolla) Department of Laboratory Medicine and Pathology, University of
Washington, Seattle, WA, United States
(Stolla) Clinical Research Division, Fred Hutch Cancer Institute, Seattle,
WA, United States
(Ting, Lawrence, Limanek) Stasys Medical Corporation, Seattle, WA, United
States
(Pulido, Stout) Department of Critical Care, Division of Cardiac
Anesthesiology, US Anesthesia Partners, Swedish Medical Center, Cherry
Hill Campus, Seattle, WA, United States
(Lehr, Youssef, Ryan) Swedish Medical Center, Swedish Cardiac Surgery,
Seattle, WA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: In this pilot trial, we tested the feasibility of conducting a
randomized controlled trial in cardiac surgery patients using extended-,
100% plasma-, cold-stored, and long-distance-shipped platelets (CSPs).
Study Design and Methods: We conducted a single center, controlled,
double-blind pilot study in adult patients undergoing elective redo or
complex cardiothoracic surgery. Patients were allocated in a week-based
block randomization scheme to receive either room temperature-stored
platelets (RTPs) or CSPs shipped from a Texas-based blood center and
stored between 10 and 14 days. The primary outcome was defined as the
feasibility of recruitment and accrual. Several other secondary endpoints
were assessed. All platelet units were screened for aggregates using RTP
release criteria. Result(s): In a post-hoc "as treated" analysis, 15
patients received RTPs, and 9 received CSPs (including 3 who received
both). We found that most CSPs (58%) were not usable for transfusion due
to the presence of aggregates. This resulted in an excess of subjects
receiving RTPs; consequently, the final nine transfused participants were
allocated to receive CSPs without randomization. We accrued 0.7 evaluable
subjects/month of active enrollment, which was below our desired primary
outcome feasibility target of >=1.2. One death within 28 days occurred in
the RTP transfusion group, while none occurred in the CSPs group. In vitro
testing yielded contradictory results. Conclusion(s): Due to slow
recruitment and the abundance of aggregates in CSPs, this pilot trial does
not support the feasibility of the study protocol. Copyright ©
2026 AABB.

<23>
Accession Number
2039969338
Title
Prognostic impact of guideline-directed medical therapy after functionally
complete revascularisation in patients with obstructive coronary artery
diseases.
Source
Heart. 112(5) (pp 270-277), 2026. Date of Publication: 01 Mar 2026.
Author
Geng Y.; Guan C.; Jiang Y.; Yang W.; Yu B.; Fu G.; Pu J.; Qu X.; Zhang Q.;
Zhao Y.; Yu L.; Huang Y.; Tu S.; Qiao S.; Song L.
Institution
(Geng, Guan, Jiang, Yang, Huang, Qiao, Song) Department of Cardiology,
National Clinical Research Center for Cardiovascular Diseases, Fuwai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences, Peking Union Medical College, Beijing, China
(Yu) Department of Cardiology, The Second Affiliated Hospital of Harbin
Medical University, Heilongjiang, Harbin, China
(Fu) Department of Cardiology, Sir Run Run Shaw Hospital, Zhejiang
University School of Medicine, Zhejiang Province, Hangzhou, China
(Pu) Department of Cardiology, Renji Hospital, Shanghai Jiao Tong
University School of Medicine, Shanghai, China
(Qu) Department of Cardiology, Huadong Hospital Affiliated to Fudan
University, Shanghai, China
(Zhang) Department of Cardiology, Shanghai East Hospital, Tongji
University School of Medicine, Shanghai, China
(Zhao) Medical Research and Biometrics Center, National Clinical Research
Center for Cardiovascular Diseases, Fuwai Hospital, National Center for
Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking
Union Medical College, Beijing, China
(Yu) Department of Cardiology, Renmin Hosp. of Wuhan, Univ. Cardiac
Autonomic Nervous System Research Center of Wuhan University,
Cardiovascular Research Institute, Wuhan University Hubei Key Laboratory
of Cardiology, Hubei Province, Wuhan, China
(Tu) Biomedical Instrument Institute, School of Biomedical Engineering,
Shanghai Jiao Tong University, Shanghai, China
Publisher
BMJ Publishing Group
Abstract
Objective Functional complete revascularisation (FCR) has been proven to
be associated with superior prognosis following percutaneous coronary
intervention. Whether guideline-directed medical therapy (GDMT) still
impacts clinical outcomes in patients who have achieved FCR requires
further evaluation. Methods The study population was drawn from patients
who achieved FCR in the FAVOR III China trial, defined as a quantitative
flow ratio (QFR)-based residual functional Synergy between percutaneous
coronary intervention with taxus and cardiac Surgery score of 0, measured
only in vessels with QFR<=0.80. GDMT was defined as the combination of
single or dual antiplatelet therapy, a beta-blocker and a statin, with or
without an ACE inhibitor or angiotensin receptor blocker, according to
contemporary guideline recommendations. Patients were categorised into the
GDMT group (compliance with all 4 agents) or non-GDMT group (compliance
with 0-3 agents). The primary endpoint was major adverse cardiac and
cerebrovascular events (MACCE) at 3 years, a composite of death,
myocardial infarction, stroke and ischaemia-driven revascularisation.
Results Among 3221 (85.2%) patients who achieved FCR, a total of 1964
(61.2%), 1919 (59.9%), 1545 (48.4%), 1483 (46.6%) and 1084 (35.3%)
patients adhered to GDMT at 1 month, 6 months, 1 year, 2 years and 3
years, respectively. The MACCE occurred in 313 (10.2%) patients through 3
years. The rate of MACCE was similar between GDMT and non-GDMT groups
within the first year, but significantly lower in the GDMT group from the
second year (adjusted HR: 0.66, 95% CI: 0.51 to 0.85; p<0.01) and
sustained until the third year (adjusted HR: 0.65, 95% CI: 0.50 to 0.85;
p<0.01), compared with the non-GDMT group. Conclusions In patients who
achieved FCR, the benefit of good adherence to GDMT remained significant,
starting from the second year and continuing up to 3 years. Trial
registration number NCT03656848. Copyright © 2026 BMJ Publishing
Group. All rights reserved.

<24>
Accession Number
2043602571
Title
Echocardiographic Results of Transcatheter Versus Surgical Aortic Valve
Replacement in Women With Severe Aortic Stenosis: The RHEIA Trial.
Source
Journal of the American Heart Association. 15(1) (no pagination), 2025.
Article Number: e047196. Date of Publication: 30 Dec 2025.
Author
Silva I.; Alperi A.; Hecht S.; Zanuttini A.; Theron A.; Giuliani C.;
Camacho B.; Dahou A.; Mares J.; Bax J.; Bonaros N.; Windecker S.;
Messika-Zeitoun D.; Wesselink W.; Rakova R.; Bramlage P.; Tchetche D.;
Eltchaninoff H.; Pibarot P.
Institution
(Silva, Alperi, Rakova) Department of Cardiology, Hospital Universitario
Central de Asturias, Instituto de Investigacion Sanitaria del Principado
de Asturias, Oviedo, Spain
(Silva, Alperi, Hecht, Zanuttini, Theron, Giuliani, Rakova, Pibarot)
Quebec Heart & Lung Institute, Laval University, Quebec City, QC, Canada
(Theron) Department of Cardiology, Assistance Publique, Hopitaux de
Marseille, Marseille, France
(Camacho) Interventional Cardiology, Hospital Arnau de Vilanova, Lerida,
Spain
(Dahou) Division of Cardiovascular Imaging, St. Francis Hospital and Heart
Center, Catholic Health, New York, NY, United States
(Dahou) Division of Cardiology, Massachusetts General Hospital/Harvard
Medical School, Boston, MA, United States
(Mares) Department of Data Science, Institute for Clinical and
Experimental Medicine, Prague, Czechia
(Bax) Department of Cardiology, Leiden University Medical Center, Leiden,
Netherlands
(Bonaros) Department of Cardiac Surgery, Medical University of Innsbruck,
Innsbruck, Austria
(Windecker) Department of Cardiology, Inselspital University Hospital of
Bern, University of Bern, Bern, Switzerland
(Messika-Zeitoun) Division of Cardiology, University of Ottawa Heart
Institute, Ottawa, ON, Canada
(Wesselink) Edwards Lifesciences Prague, Prague, Czechia
(Bramlage) Institute for Pharmacology and Preventive Medicine Cloppenburg,
Cloppenburg, Germany
(Tchetche) Clinique Pasteur, Toulouse, France
(Eltchaninoff) Department of Cardiology, Univ Rouen Normandie, INSERM
U1096, CHU Rouen, Rouen, France
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: In the RHEIA (Randomized Research in Women All Comers With
Aortic Stenosis) trial, the incidence of the primary end point of death,
stroke, or rehospitalization at 1 year was lower with transcatheter aortic
valve implantation (TAVI) than with surgical aortic valve replacement. The
objective of this substudy was to compare echocardiographic findings in
women with severe aortic stenosis following surgical aortic valve
replacement or TAVI. METHOD(S): At 48 European centers, 443 women
underwent randomization 1:1, and 420 were treated as randomized.
Echocardiograms were available in 356 patients and were analyzed by a core
laboratory. RESULT(S): Rates of or greater moderate paravalvular
regurgitation was low (<1%) and similar between groups. At 30 days, TAVI
was associated with higher mean transprosthetic gradient and smaller
aortic valve area, but the rate of severe patient-prosthesis mismatch (3.0
versus 2.6%; P=1) was low and not different between groups. Valve
hemodynamics were stable at 1 year. The rate of residual left ventricular
hypertrophy (45.3 versus 28.6%; P=0.004) at 1 year was significantly
higher with TAVI, whereas the rate of right ventricular systolic
dysfunction (14.5 versus 40.7%; P<0.001) and evolution of cardiac damage
stage (improved in 21.8 versus 18.1%; worsened in 16.8 versus 47.0%;
P=0.001) were better with TAVI. CONCLUSION(S): Among women with
severe aortic stenosis, both TAVI and surgical aortic valve replacement
achieve excellent valve hemodynamic results with low and similar rates of
moderate or greater paravalvular regurgitation or severe
patient-prosthesis mismatch. Surgical aortic valve replacement was
associated with lower gradients and more pronounced regression of left ven
tricular hypertrophy, whereas TAVI was associated with better right
ventricular systolic function and evolution of cardiac damage
stage. Copyright © 2025 The Author(s). Published on behalf of the
American Heart Association, Inc., by Wiley.

<25>
Accession Number
2043467344
Title
Efficacy and safety of a Venus A valve among Chinese patients undergoing
transcatheter aortic valve replacement: a systematic review and single-arm
meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article
Number: 1725106. Date of Publication: 2026.
Author
Sun Z.; Shan D.; Wang J.; Jiang B.; Chen T.; Zhang Y.; Han T.; Wang W.;
Guo J.; Liu C.
Institution
(Sun, Shan, Wang, Jiang, Chen, Zhang, Han, Guo, Liu) Senior Department of
Cardiology, The Sixth Medical Center of PLA General Hospital, Beijing,
China
(Wang) Department of Cardiology, The First Medical Center of PLA General
Hospital, Beijing, China
Publisher
Frontiers Media SA
Abstract
Background: The Venus A valve is a first-generation self-expanding valve
used in China for transcatheter aortic valve replacement (TAVR). However,
data on its efficacy and safety remain limited. The present study assessed
the efficacy and safety of the Venus A valve in Chinese patients
undergoing TAVR. Method(s): A single-arm meta-analysis was performed,
and relevant studies were systematically retrieved from PubMed, Embase,
Web of Science, the Cochrane Library, ClinicalTrials.gov, and Google
Scholar from inception until 1 June 2022. Domestic libraries were not
searched due to data overlap. All study types evaluating the Venus A valve
were considered for inclusion, except case reports or reviews. Non-English
language studies or those without corresponding data were excluded. The
Newcastle-Ottawa scale (NOS) was used to evaluate the included
retrospective studies, and the methodological index for non-randomized
studies (MINORS) was used to assess the included non-randomized study
(single-arm study). The random-effects model was used to calculate the
combined proportion and 95% confidence interval (CI) when I2
was >50%; otherwise, a fixed-effect model was used. Publication bias was
assessed using the Egger test, with P < 0.05 indicating potential bias.
 Result(s): This meta-analysis included 15 studies involving 1,144
Chinese patients who underwent TAVR with a Venus A valve. The
device/procedure success rate was 90%. The mean transvalvular gradient
decreased from 58.52 to 10.85 mmHg, and the peak jet velocity decreased
from 4.86 s to 2.23 m/s. At the 30-day follow-up evaluation, the all-cause
mortality rate was 3%. The requirement for a second valve accounted for
12% of cases. Major vascular complications were uncommon, as were major
bleeding, stroke, acute kidney injuries, and new-onset atrial
fibrillation. At the 1-year follow-up evaluation, the all-cause mortality
rate was 7%. The incidence of new permanent pacemaker implantation in
patients with bicuspid aortic valves was 16%, and the all-cause mortality
rate was 8% at the 30-day follow-up evaluation. Conclusion(s):
Despite its relatively high requirement for a second valve, the Venus A
valve is feasible for Chinese patients undergoing TAVR. Its effectiveness
and safety were demonstrated by a high device/procedure success rate,
immediate hemodynamic improvement, and low incidence of
complications. Copyright 2026 Sun, Shan, Wang, Jiang, Chen, Zhang,
Han, Wang, Guo and Liu.

<26>
Accession Number
2043840954
Title
Association of frailty with dementia and the impact of frailty on
antihypertensive treatment protection against dementia in older
hypertensive adults.
Source
Age and Ageing. 55(2) (no pagination), 2026. Article Number: afag037. Date
of Publication: 01 Feb 2026.
Author
Chen L.; You S.; Ee N.; Rockwood K.; Ward D.D.; Hubbard R.E.; Woodward M.;
Fitzgerald O.; Wang R.; Gao Y.; Williamson J.D.; Anderson C.S.; Harris K.;
Chen X.; Peters R.
Institution
(Chen, You, Ee, Woodward, Wang, Gao, Anderson, Harris, Chen, Peters) The
George Institute for Global Health, University of New South Wales, Faculty
of Medicine, Sydney, NSW, Australia
(You) Department of Neurology, Clinical Research Center of Neurological
Disease, Second Affiliated Hospital of Soochow University, Jiangsu,
Suzhou, China
(Rockwood) Division of Neurology, Department of Medicine, Dalhousie
University, Halifax, NS, Canada
(Rockwood) Division of Geriatric Medicine, Department of Medicine,
Dalhousie University, Halifax, NS, Canada
(Rockwood) Frailty and Elder Care Network, Halifax, NS, Canada
(Ward, Hubbard) Australian Frailty Network, Centre for Health Services
Research, Faculty of Health and Behavioural Sciences, The University of
Queensland, Brisbane, QLD, Australia
(Ward, Hubbard) Princess Alexandra Hospital, Woolloongabba, QLD, Australia
(Woodward) The George Institute for Global Health, Imperial College London
School of Public Health, London, United Kingdom
(Fitzgerald) National Perinatal Epidemiology and Statistics Unit,
University of New South Wales, Sydney, NSW, Australia
(Wang) Department of Epidemiology, Suzhou Medical College of Soochow,
University School of Public Health, Jiangsu, Suzhou, China
(Williamson) Section of Gerontology and Geriatric Medicine, Wake Forest
University, Department of Internal Medicine, Winston-Salem, NC, United
States
(Anderson) Institute of Science and Technology for Brain-inspired
Intelligence, Fudan University, Shanghai, China
(Anderson) The George Institute for Global Health, The George Institute
for Global Health China, Beijing, China
(Anderson) Neurology Department, Royal Prince Alfred Hospital, Camperdown,
NSW, Australia
Publisher
Oxford University Press
Abstract
Background The relationship between frailty and dementia risk in
hypertensive patients remains unclear, as does the impact of frailty on
the effectiveness of antihypertensive treatment in preventing dementia.
Methods Using data from the Systolic Hypertension in the Elderly Program
trial, a baseline frailty index (FI) including 55 health deficits was
constructed. Multinomial regression models were used to examine the
association between frailty and dementia, as well as to examine whether
the impact of antihypertensive treatment on the risk of dementia was
modified by baseline FI. Results A total of 4692 participants (mean age:
72.1 years, 56.8% female) were included with a median (inter-quartile
interval) FI of 0.127 (0.091-0.173). During a median follow-up of 4.4
years, 81 dementia cases occurred. Each SD (0.061) increase in FI was
associated with a 33% higher risk of dementia [odds ratio (OR): 1.33, 95%
confidence interval (CI): 1.08-1.64], after adjusting for age, sex, race,
education and treatment group. This association differed between the
active treatment group (OR: 1.57; 95% CI: 1.16-2.11) and the placebo group
(OR: 1.17; 95% CI: 0.87-1.56), with a P for interaction=.049.
Correspondingly, in the lowest FI quarter, antihypertensive treatment
reduced dementia risk (OR: 0.19, 95% CI: 0.04-0.94), an effect not
observed in higher FI quarters (interaction P=.058). Conclusion In
patients with isolated systolic hypertension, frailty may serve as a risk
factor for dementia, and elevated levels of frailty may attenuate the
effectiveness of antihypertensive treatment in reducing dementia
risk. Copyright © The Author(s) 2026. Published by Oxford
University Press on behalf of the British Geriatrics Society.

<27>
Accession Number
637495706
Title
Cardiac Patient Education Goes Digital: From Paper-Based Methods and
3D-Printed Modelsto Virtual Reality.
Source
Thoracic and Cardiovascular Surgeon. Conference: 51st Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery, DGTHG 2022.
Online. 70(SUPPL 1) (no pagination), 2022. Date of Publication: 03 Feb
2022.
Author
Grab M.; Hundertmark F.; Grefen L.; Konig F.; Fairchild M.; Hagl C.;
Thierfelder N.
Institution
(Grab, Hundertmark, Grefen, Konig, Hagl, Thierfelder) Ludwig-Maximilian
University of Munich, Manchen, Germany
(Fairchild) Vr-on GmbH, Manchen, Germany
Publisher
Georg Thieme Verlag
Abstract
Background: Cardiac surgery represents one of the most intrusive surgical
procedures in a patient's life. Due to theseverity, many patients suffer
from postoperative mental health issues. Therefore, the aim of this study
was to employdigital models during the pre-surgical education, focusing on
their impact on patient's anxiety. Method(s): To create standardized
digital models for CABG, SAVR and TAA procedures anonymized patient
CT-datasets werecollected retrospectively. These digital models were
surface modified in a 3D-modeling software and subsequently insertedinto a
multi-user virtual reality (VR) platform or 3D printed. Presurgical
patient education was conducted with patientsadmitted to our cardiac
surgery department. Patients were randomly divided into three groups for
different patienteducation methods based on conventional paper sheets,
3D-printed models, and VR models. Presurgical consultation withthe paper
sheet was treated as a control. Education quality and impact on patient
anxiety was determined by aquestionnaire combining customized questions
with the standardized State-Trait Anxiety Inventory. A cardiac
surgeonconducted pre-surgical consultation and questionnaires were filled
out before and after. Result(s): Three representative VR scenes were
created for some of the most common procedures in cardiac surgery.
Patientand physician, using two cordless VR headsets were able to freely
move around the education model inside a medical-styleVR room. The
physician was able to cycle through different steps of the procedure,
while highlighting and scaling importantstructures. Forty patients were
included in classic paper sheet, 3D-printed model and VR-model education
groups,respectively. Questionnaires revealed an increase in procedural
understanding for all three groups, with the 3D-printedmodel and VR model
groups additionally showing an increase in anatomical and spatial
awareness. Anxiety levels decreasedfor patients educated with all
education methods. Patients educated with 3D-printed and VR models
expressed higherconfidence in the procedure and surgical team. Ten
patients in the VR-model group experienced nausea or struggled withthe VR
controls and were excluded from the study. Conclusion(s): It was
possible to create a VR-based patient education platform for the most
common cardiac surgicalprocedures. The patients overall satisfaction with
the 3D-models be it physical or digital, was very high making
anintegration into everyday clinical practice feasible.

<28>
Accession Number
2043397732
Title
Risk factors for neurological complications in adult ECMO patients: a
systematic review and meta-analysis.
Source
Frontiers in Medicine. 12 (no pagination), 2026. Article Number: 1726621.
Date of Publication: 2026.
Author
Dong M.; Gu P.; Cai L.; Zhu Y.; Sheng L.; Liang J.; Zhao S.; Zeng F.
Institution
(Dong, Gu, Cai, Zhu, Sheng, Liang, Zhao, Zeng) Department of Nursing, The
Second Affiliated Hospital of Zhejiang University School of Medicine,
Hangzhou, China
Publisher
Frontiers Media SA
Abstract
Objective: Aiming to systematically review risk factors for neurological
complications in adults receiving ECMO support. Method(s): A
comprehensive computerized search was conducted in Chinese and English
databases for studies examining risk factors of neurological complications
in adult ECMO patients, supplemented by manual and reference tracking,
with the search period extending up to April 2025. Meta-analysis and
sensitivity analyses were performed using Stata 18.0 software. 29 studies
involving 62,656 patients were included. The meta-analysis results showed
that female sex, pre-ECMO cardiac arrest, renal replacement therapy, and
cardiac insufficiency were influencing factors of composite neurological
complications in adult ECMO patients. Female sex and ECMO duration were
risk factors of stroke. Female sex, pre-ECMO lactate, pre-ECMO pH,
platelet count, low platelets, APTT, and vasoactive drug use were risk
factors of intracranial hemorrhage. The pooled results for female sex in
the stroke group was not robust. Significant publication bias was observed
for composite neurological complications outcomes, whereas no significant
publication bias was detected for stroke or intracranial hemorrhage.
 Conclusion(s): Given the diverse etiologies underlying neurological
injury in adult ECMO recipients, protocolized neurological monitoring and
prompt intervention for detected abnormalities are strongly recommended.
Systematic review registration: PROSPERO (CRD420251069285). Copyright
© 2026 Dong, Gu, Cai, Zhu, Sheng, Liang, Zhao and Zeng.

<29>
[Use Link to view the full text]
Accession Number
2040321205
Title
Health Status Outcomes With Percutaneous Coronary Intervention and
Coronary Artery Bypass Grafting in ISCHEMIA.
Source
Circulation. 152(12) (pp 846-858), 2025. Date of Publication: 23 Sep 2025.
Author
Huded C.P.; Spertus J.A.; Jones P.G.; O'Brien S.M.; Mark D.B.; Bangalore
S.; Stone G.W.; Williams D.O.; White H.D.; Boden W.E.; Reynolds H.R.;
Hochman J.S.; Maron D.J.; Mavromatis M.; Mavromatis K.; Linefsky J.;
Miller T.; Banerjee S.; Newman J.D.; Donnino R.M.; Saric M.; Abdul-Nour
K.; Stone P.H.; Jang J.J.; Yee G.; Weitz S.; Arnold S.; O'Keefe J.H.;
Shapiro M.D.; Fein S.A.; Torosoff M.T.; Lyubarova R.; Mookherjee S.;
Drzymalski K.; McFalls E.O.; Garcia S.A.; Bertog S.C.; Siddiqui R.A.;
Ishani A.; Hansen R.A.; Georges Khouri M.; Goldberg J.L.; Goldweit R.;
Cohen R.A.; Mirrer B.; Navarro V.; Winchester D.E.; Kronenberg M.;
McFarren C.; Heitner J.F.; Dauber I.M.; Cannan C.; Sudarshan S.; Mehta
P.K.; McDaniel M.; Lerakis S.; Quyyumi A.; Wenger N.K.; Hedgepeth C.M.;
Hurlburt H.; Rosen A.; Sahul Z.; Leung S.; Reda H.; Ziada K.; Setty S.;
Barua R.S.; Hage F.; Davies J.E.; Leesar M.; Heo J.; Iskandrian A.; Al
Solaiman F.; Dajani K.; El-Hajjar M.; Der Mesropian P.; Sacco J.;
McCandless B.; Orgera M.; Sidhu M.S.; Arif I.; Kerr H.; Trejo (Gutierrez)
J.F.; Fletcher G.; Lane G.E.; Neeson L.M.; Parikh P.P.; Pollak P.M.;
Shapiro B.P.; Landolfo K.; Gemignani A.; O'Rourke D.; Meadows J.L.; Call
J.T.; Hannan J.; Bojar R.; Kumar D.; Mukai J.; Martin E.T.; Vorobiof G.;
Moorman A.; Kinlay S.; Hamburger R.J.; Rocco T.P.; Bhatt D.L.; Croce K.;
Quin J.A.; Anumpa J.; Zenati M.; Faxon D.P.; Rayos G.; Seedhom A.;
Sullenberger L.; Kumkumian G.; Sedlis S.P.; Lorin L.; Lorin J.;
Tamis-Holland J.E.; Kornberg R.; Leber R.; Saba S.; Lee M.W.; Small D.R.;
Nona W.; Alexander P.B.; Rehman I.; Badami U.; Marzo K.; Robbins I.H.;
Levite H.A.; Shetty S.; Patel M.; Hamroff G.S.; Little R.W.; Zimbelman
B.D.; Lui C.Y.; Smith B.R.; Vezina D.P.; Khor L.L.; Abraham J.D.; Bull
D.A.; McKellar S.H.; Booth D.; Kotter J.; Abdel-Latif A.; Hu B.; Labovitz
A.J.; Berlowitz M.; Rogal P.; Matar F.; Caldeira C.; Rodriguez F.;
Schnittger I.; Fearon W.F.; Deedwania P.; Reddy K.; Sweeny J.; Spizzieri
C.; Hochberg C.P.; Salerno W.D.; Wyman R.; Zarka A.; Shah A.V.; Haldis T.;
Kohn J.A.; Girotra S.; Almousalli O.; Krishnam M.S.; Milliken J.C.; Patel
P.M.; Seto A.H.; Harley K.T.; Gibson M.A.; Allen B.J.; Coram R.; Thomas
S.; Schwartz R.G.; Chen W.; El Shahawy M.; Stafford J.; Abernethy W.B.;
Zurick A.; Meyer T.M.; Morford R.G.; Rutkin B.; Bokhari S.; Sokol S.I.;
Meisner J.; Hamzeh I.; Misra A.; Wall M.; De Rosen V.L.; Alam M.; Turner
M.C.; Mulhearn T.J.; Good A.P.; Shammas N.W.; Chilton R.; Nguyen P.K.;
Jezior M.; Gordon P.C.; Crain T.; Stenberg R.; Pedalino R.P.; Wiesel J.;
Juang G.J.; Al-Amoodi M.; Wohns D.; Lader E.W.; Mumma M.; Dharmarajan L.;
McGarvey J.F.X.; Downes T.R.; Luckasen G.J.; Cheong B.; Potluri S.;
Mastouri R.A.; Breall J.A.; Revtyak G.E.; Bazeley J.W.; Giedd K.; Old W.;
Burt F.; Sokhon K.; Gopal D.; Valeti U.S.; Kobashigawa J.; Chakanalil
Govindan S.; Gopalan Nair R.; Nanjappa Manjunath C.; Moorthy N.;
Cholenahally Manjunath S.; Narayanappa S.; Pandit N.; Kumar Nath R.;
Dwivedi S.K.; Narain V.S.; Chandra S.; Wander G.S.; Tandon R.; Ralhan S.;
Aslam N.; Karthikeyan G.; Ramakrishnan S.; Seth S.; Yadav R.; Roy A.;
Parakh N.; Kumar Verma S.; Narang R.; Mishra S.; Naik N.; Sharma G.; Kumar
Choudhary S.; Patel C.; Gulati G.; Sharma S.; Bahl V.K.; Mathew A.;
Punnoose E.; Gadage S.; Umesh Pillay T.; Satheesh S.; Mathur A.;
Christopher J.; Menon R.; Kumar N.; Oomman A.; Mao R.; Solomon H.; Parveen
Khan S.; Grant P.; Kachru R.; Ajit Kumar V.K.; Ganapathi S.; Jayakumar K.;
Sivadasanpillai H.; Sasidharan B.; Kapilamoorthy T.R.; Polamuri P.; Kaul
U.; Fox K.A.A.; Carruthers K.; Elghamaz A.; Gurunathan S.; Karogiannis N.;
Shah B.N.; Trimlett R.H.J.; Rubens M.B.; Nicol E.D.; Mittal T.K.; Hampson
R.; Andreas Gamma R.; de Belder M.A.; Thambyrajah J.; Nageh T.; Davies
J.R.; Lindsay S.J.; Kurian J.; Jamil H.; Raheem O.; Hoye A.; Donnelly P.;
Valecka B.; Chauhan A.; Barr C.; Alfakih K.; Byrne J.; Webb I.; Henriksen
P.; OKane P.; de Silva R.; Conway D.S.G.; Sirker A.A.; Hoole S.P.;
Witherow F.N.; Harbinson M.; Walsh S.; Douglas H.; Luckie M.; Sobolewska
J.; Jeetley P.; Patel N.; Kotecha T.; Travill C.; Karimullah I.;
Al-Bustami M.; Braganza D.; Henderson R.; Pointon K.; Naik S.; Mathew T.;
Berry C.; Collison D.; Roditi G.; Moriarty A.J.; Glover J.D.; Pradhan J.;
Ghada M.; Francis D.P.; Dzavik V.; Diaz A.; Rheault P.; Barrero M.; Gagne
C.; Pepin-Dubois Y.; Costa R.; Tung Sia Y.; Lemay C.; Gisbert A.; Gervais
P.; Rheault A.; Carl Phaneuf D.; Gosselin G.; Garg P.; Hessian R.C.;
Beanlands R.S.; Davies R.F.; Cheema A.N.; Bagai A.; Wald R.; Goodman S.;
Graham J.J.; Peterson M.; Chow C.-M.; Abramson B.; Nazir Cheema A.; Tariq
Vakani M.; Cha J.; Howarth A.G.; Uxa A.; Galiwango P.; Kassam S.;
Mukherjee A.; Joseph Ricci A.; Lam A.; Mehta S.; Udell J.; Genereux P.;
Hameed A.; Daba L.; Hueb W.; Cury Rezende P.; Ciappina Hueb A.; Smanio
P.E.P.; Schaan de Quadros A.; Kalil R.A.K.; Vieira J.L.D.C.; Grossmann G.;
Piccaro de Oliveira P.; Bridi L.; Savaris S.; Vitola J.V.; Cerci R.J.;
Farias F.R.; Fernandes M.M.; Antonio Marin-Neto J.; Schmidt A.; Lima Filho
M.D.O.; Mendes Oliveira R.; Chierice J.R.A.; Polanczyk C.A.; Furtado M.V.;
Smidt L.F.; Carlos Carvalho A.; Pucci G.; Lyra F.; Junior A.R.A.;
Dracoulakis M.D.A.; Lima R.G.S.D.; Figueiredo E.; Ricardo Caramori P.;
Tumelero R.; Dall'Orto F.; Mesquita C.T.; Colafranseschi A.S.; Oliveira
A.C.; Carvalho L.A.; Palazzo I.C.; Sousa A.S.; Ribeiro da Silva E.E.; de
Barros e Silva P.G.M.; Baptista L.D.P.S.; Rodrigues M.J.; de Resende
M.V.C.; Francisco Saraiva J.; Costantini C.; Ruzyllo W.; Demkow M.; Pracon
R.; Kepka C.; Teresinska A.; Kryczka K.; Henzel J.; Solecki M.; Kaczmarska
E.; Mazurek T.; Drozdz J.; Czarniak B.; Frach (formerly Stasiak) M.;
Szymczyk K.; Niedzwiecka I.; Sobczak S.; Ciurus T.; Jakubowski P.;
Misztal-Teodorczyk M.; Teodorczyk D.; Fratczak A.; Szkopiak M.; Lebioda
P.; Wlodarczyk M.; Plachcinska A.; Kusmierek J.; Miller M.; Marciniak H.;
Wojtczak-Soska K.; Luczak K.; Tarchalski T.; Cichocka-Radwan A.; Anna
Szulczyk G.; Witkowski A.; Kukula K.; Celinska-Spodar M.; Zalewska J.;
Gajos G.; Bury K.; Pruszczyk P.; Roik M.; Loboz-Grudzien K.; Sokalski L.;
Brzezinska B.; Lesiak M.; Lanocha M.; Reczuch K.W.; Kalarus Z.;
Swiatkowski A.; Szulik M.; Musial W.J.; Bockeria L.; Petrosyan K.;
Trifonova T.; Chernyavskiy A.M.; Kretov E.I.; Grazhdankin I.O.; Bershtein
L.L.; Sayganov S.A.; Kuzmina-Krutetskaya A.M.; Zbyshevskaya E.V.;
Katamadze N.O.; Demchenko E.A.; Kozlov P.S.; Kozulin V.Y.; Lubinskaya
E.I.; Lopez-Sendon J.; Castro A.; Refoyo Salicio E.; Guzman G.; Galeote
G.; Valbuena S.; Peteiro J.; Dolores Martinez-Ruiz M.; Perez-Fernandez R.;
Cuenca-Castillo J.J.; Flores-Rios X.; Prada-Delgado O.; Barge-Caballero
G.; Gonzalez Juanatey J.R.; Souto Bayarri M.; Pubull Nunez V.; Ocaranza
Sanchez R.; Cid Alvarez B.; Pena Gil C.; Martinez Monzonis A.; Sionis A.;
Vila Perales M.; Maria Padro J.; Serra Penaranda A.; Garcia Picart J.;
Ginel Iglesias A.; Garcia-Moll Marimon X.; Pons Llado G.; Carreras Costa
F.; Miro V.; Diez J.L.; Calvillo P.; Marin Ortuno F.; Valdes Chavarri M.;
Tello Montolliu A.; Pinar Bermudez E.; De La Morena G.; Gracida Blancas
M.; Luena J.E.C.; Fernandez-Aviles F.; Chen J.; Wu Y.; Ma Y.; Yang Y.; Ji
Z.; Yang X.; Lin W.; Zeng H.; Fu X.; Wang S.; Cheng G.; Fang X.; Zeng Q.;
Li Q.; Nie S.-P.; Yu Q.; Wang J.; Zhang S.; Liu Z.; Maggioni A.P.; Piero
Perna G.; Marini M.; Gabrielli G.; Provasoli S.; Verna E.; Monti L.; Nardi
B.; Di Chiara A.; Mortara A.; Galvani M.; Ottani F.; Sicuro M.; Calabro
P.; Formisano T.; Tarantini G.; Cucchini U.; Luigi Andres A.; Racca E.;
Briguori C.; Amati R.; Vergoni W.; Russo A.; Fanelli R.; Poh K.-K.; Chai
P.; Lau T.; Loh J.P.; Tay E.L.; Teoh K.; Teo L.L.; Ong C.-C.; Wong R.C.;
Loh P.-H.; Kofidis T.; Xian Chan W.; Hui Chan K.; Foo D.; Kong J.L.K.; Min
Er C.; Haider Jafary F.; Chua T.; Stumpf J.; Matschke K.; Simonis G.;
Kadalie C.T.; Sechtem U.; Christian Schulze P.; Goebel B.; Lenk K.;
Nickenig G.; Schuchlenz H.; Weikl S.; Marthe Lang I.; Huber K.;
Jakl-Kotauschek G.; Keltai M.; Vertes A.; Varga A.; Fontos G.; Merkely B.;
Kerecsen G.; Hinic S.; Zdravkovic M.; Mudrenovic V.; Crnokrak B.; Beleslin
B.D.; Boskovic N.N.; Petrovic M.T.; Dobric M.R.; Markovic Z.Z.; Mladenovic
A.S.; Cemerlic-Adjic N.; Davidovic G.; Vucic R.; Nikola Dekleva M.;
Stankovic G.; Apostolovic S.; Escobedo J.; Baleon-Espinosa R.;
Campos-Santaolalla A.S.; Duran-Cortes E.; Flores-Palacios J.M.;
Garcia-Rincon A.; Jimenez-Santos M.; Penafiel J.V.; Ortega-Ramirez J.A.;
Valdespino-Estrada A.; Alexanderson Rosas E.; Murphy D.; Selvanayagam
J.B.; Joseph M.X.; Thambar S.T.; Rankin (past) J.; Beltrame J.F.; Hillis
G.S.; Thuaire C.; Dutoiu T.; Juliard J.-M.; Slama M.S.; El Mahmoud R.;
Nicollet E.; Goube P.; Barone-Rochette G.; Furber A.; Biere L.;
Laucevicius A.; Kedhi E.; Timmer J.; Hermanides R.; Kaplan E.; Riezebos
R.K.; Samadi P.; van Dongen E.; Niehe S.R.; Suryapranata H.; van Vugt S.;
Cacela D.; Santana A.; Fiarresga A.; Sousa L.; Marques H.; Patricio L.;
Bernanrdes L.; Rio P.; Carvalho R.; Ferreira R.; Rodrigues I.; Modas P.;
Portugal G.; Fragata J.; Pinto F.J.; Nobre Menezes M.; Cantinho Lopes G.;
Gomes Almeida A.; Canas Silva P.; Nobre A.; Francisco A.R.; Ferreira N.;
Lopes R.L.; Diaz R.; Guzman L.; Cesar Figal J.; Mendiz O.; Cortes C.; Rene
Favaloro R.; Alvarez C.; Courtis J.; Zeballos G.; Schiavi L.; Rubio M.;
Alsweiler C.; Patrick Devlin G.; Fisher R.; Stewart R.A.H.; Benatar J.;
Kedev S.; Peovska Mitevska I.; Srbinovska Kostovska E.; Pejkov H.; Held
C.; Eggers K.; Frostfelt G.; Johnston N.; Olsowka M.; Akerblom A.; Soveri
I.; Aspberg J.; Beyar R.; Nikolsky E.; Sharir T.; Elian D.; Kerner A.;
Massalha S.; Fukuda K.; Kohsaka S.; Yasuda S.; Nishimura S.; Van de Werf
F.; Claes K.; Hung C.-L.; Yun C.-H.; Jia-Yin Hou C.; Kuo J.-Y.; Yeh H.-I.;
Hung T.-C.; Li J.-Y.; Chien C.-Y.; Tsai C.-T.; Liu C.-C.; Yu F.-C.; Lin
Y.-H.; Lan W.-R.; Yen C.-H.; Tsai J.-P.; Sung K.-T.; Ntsekhe M.; Pandie
S.; Viljoen C.A.; De Andrade M.; Moccetti T.; Grazia Rossi M.; Abdelhamid
M.; Adel A.; Kamal A.; Mahrous H.; El Kaffas S.; El Fishawy H.; Pop C.;
Claudia M.; Popescu B.A.; Ginghina C.; Deleanu D.; Iliescu V.A.; Al-Mallah
M.H.; Aljzeeri A.; Najm H.; Alghamdi A.; Ramos W.E.M.; Kuanprasert S.;
Prommintikul A.; Nawarawong W.; Woragidpoonpol S.; Tepsuwan T.; Taksaudom
N.; Rimsukcharoenchai C.; Euathrongchit J.; Wannasopha Y.; Yamwong S.;
Sritara P.; Aramcharoen S.; Meemuk K.; Khairuddin A.; Abd Hadi H.; Azmi
Yahaya S.; Doan J.; Lee R.; Patel R.; Yang Cho S.; Milbrandt S.; Shelstad
D.; Kamath P.; Tejani I.; Quiles K.J.; Schley A.; Golden H.; Osseni H.;
Wiyarand C.; Douglass P.; Pomeroy H.; Craft A.; Harvey B.; Anaya O.; Goold
P.; Giovannone S.; Pritchard L.; Gans R.; Kennedy P.; Ganesan S.;
Schlichting D.; Naher A.; Stewart W.L.; Salmi K.M.; Johnson D.K.; Herrmann
R.R.; Arges K.; LeFevre M.; Tomfohr J.; Ann Byrne K.; Zappernick T.;
Canada S.; Kakade M.; Mieses P.; Cobos S.E.; Dwyer R.R.; Espinosa D.;
Rantinella R.; Rantinella M.; Rodriguez J.; Mancilla O.; Stinson S.;
Weyand T.; Crook S.C.; Ho J.; Khan S.; Mohamed M.; Soltau M.R.; Rose D.K.;
Wimmer R.J.; Siegel K.E.; Derbyshire S.; Dixon M.; Leonard G.; Heard C.;
Gabriel V.; Desire S.; Rashid F.; Asier S.; Patel K.; Gillis J.; Manocchia
M.; Moore S.; Congdon E.; Brandt G.; Marchelletta N.; Wippler K.;
Halverson K.E.; Roraff C.; Thorsen J.; Ojajuni A.; Olurinde O.; Surineni
K.; Valaiyapathi B.; Kartje C.M.; Rawlins M.; Thomson J.; Colleen Rogge
M.; Bunke J.; Unterbrink K.; Fannon J.; Burman C.; Dubin M.F.; Beaudry S.;
Tirado S.A.; Halliday J.; Julian P.; Lane S.M.; Stanford J.L.; Arsenault
P.; Sigel P.; Brooks M.; Douangvila L.; Gevorgyan R.; Ranjbaran F.; Smith
B.; Ohmart C.; Ly S.; Quinn M.C.; Temiyasathit S.; Do J.; Tobin D.;
Langdon J.; Werner Bayer M.; O'Malley A.; Orvis E.; Murphy M.; Greenberg
A.; Iraola M.; Maranan L.C.; Malinay A.; Edillo C.P.; Ostrander A.;
Wasmiller S.; Drewes W.; Patel D.; White J.M.; Hallam A.; Spooner B.J.;
Hollenweger L.M.; Little H.; Little T.; Eskelson N.A.; Taul Y.; Rodgers
C.; Isaacs J.; Bulkley V.; Kaneshiro R.; Kirby B.J.; Tran N.N.;
Jahrsdorfer C.; Yunis R.; Patro J.; Vega A.; Bloise-Adames H.; Jimenez S.;
Saint Vrestil N.; Bhandari R.; Schade D.; Yost R.; Beardsley P.; Fine D.;
Tancredi J.; Arakelian P.; Mathus S.; O'Neill D.; Burkhardt J.; Hosino S.;
Lubyanaya O.A.; Salas J.D.; Aguirre M.; Dhawan M.; Parra D.; Tran T.;
Fowler-Lehman K.; Spitzer N.; Riedberger C.; Weick C.; Weick W.; Drum C.;
Miller-Cox K.; Ollinger A.; Capasso-Gulve E.; Melanie Loehr A.; Mosley M.;
Heydari S.; Lundeen A.M.; Karanjah E.; Marfori W.C.; Hernandez-Rangel E.;
Singh P.; Marie Webb A.; Fridell E.; Wilson H.; Kim A.; Wilmot P.; Stevens
R.; Black L.; Hull A.B.; Lim O.J.; Tucker H.C.; Putnam N.C.; Hall L.L.;
Cauthren T.; Tucker T.; Horton H.; Orga J.; White J.R.; Baumann C.;
Seeratan V.; Jimenez M.; Schultz C.; Russo J.; Huda Z.; Boan A.; Hinton
C.R.; Archer B.A.; Dionne J.S.; Allardyce C.A.; Sikora L.N.; Czerniak
J.H.; Mull J.A.; Ferguson E.; Laube F.; Shammas G.A.; Christensen L.; Park
H.; Hecht J.; Vo D.; Hirsch J.; Bindeman J.; Salkind S.; Desimone L.-A.;
Felix-Stern L.; Gomes J.; Gordon C.; Mann A.; McCreary T.; Gopaul G.;
Gopaul C.; Hultberg K.; Huk T.; Hussain A.; Zambrano Y.; Medina Rodriguez
S.; Milner T.; Mulder A.; Van Oosterhout S.; Meyer M.; Clapp N.L.;
Barrentine H.; Jose J.M.; Manchery J.; McKinney V.; Schwarz L.; Kaczkowski
S.M.; Jaskowiak A.J.; Klitch J.; Dees D.; Vasquez P.; Hannemann E.L.; Mae
Foltz J.; DeRosa E.; Jorgenson B.; Riestenberg-Smith J.; Bariciano R.;
Waldron J.; Mayon M.; Ann Peichel G.; Starks B.; Garcia L.; Thottam M.;
Anand A.; Raj J.; Ravindran R.; Rajalekshmi V.S.; Nataraj N.; Bajaj S.;
Yadav V.; Mishra G.; Tewari R.; Mishra M.; Patel S.; Singh S.; Kaur B.;
Gupta S.; Suvarna C.; Mannekkattukudy Kurian B.; Rupesh Karwa S.; Kolhe
S.; Vindhya R.J.; Jain P.; Seth A.; Singh Meharwal Z.; Verma A.; Bhatia
M.; Sachdeva A.; Indira Devi T.; Jungla N.; Manjula Rani K.; Sowjanya
Reddy M.; Sidh R.R.; Priya V.; Preethi K.; Hande S.; Dubey A.; Rawat K.;
Vineeth C.P.; Chacko M.; Babu S.; Reddy S.; Rani M.; Arambam P.; Singh B.;
Young G.M.; Kinsey C.; Kavalakkat R.; Evans J.; Hassan I.; Williams S.;
Holland K.; Swan K.; Atkinson B.; Kunhunny S.; Atkinson C.; Krannila C.;
Vinod M.; Chaytor L.; Cox L.; Morrow J.; Rowe K.; Kelly S.; Regan S.;
Turnbull D.; Fleming C.; Ghosh A.; Gratrix K.; Preston S.; Cartwright A.;
Knightonc A.; Martin K.; Flint L.; Harrison J.; Lakeman N.; Ljubez A.;
Wright J.; Exley D.; Andiapen M.; Richards A.J.; Wong L.; Munro M.J.;
McEvoy M.; Brown C.; Charles T.; Kolakaluri L.; Phillips H.; Morby L.;
Hallett K.; Corbett C.; Winstanley L.; Smit A.; Gent S.; Hussain N.;
Haines F.; Taaffe J.; Burton J.; Colton M.; King R.; Brown A.; Docherty
A.; McCloy L.; Robb K.; Paterson C.; Crawford W.; Kelly J.; McGregor L.;
Mackin A.; Knight J.P.; Bose T.; Proietti A.; Brousseau M.; Corfias M.;
Blaise P.; Harvey L.; Alarie P.; Arcand L.; Roy I.; Montpetit E.; Drouin
K.; Bergeron C.; Shelley C.; Masson C.; Carr S.; Bone C.; Moga E.;
Kourzenkova J.; Walter O.; Hogg N.; Welsh S.; Hussain M.; Bello O.; Syed
I.; Kushniriuk K.; Otis J.; Otis R.; Seib M.M.; Rivest S.M.; Sandonato R.;
Chow J.; Starovoytov A.; Uchida N.; Meadows N.; Asif N.; Tavares S.; Bozek
B.; Shier M.; Larmand L.-A.; Janmohamed A.; Hart B.; Marucci J.; Tai S.;
Brons S.; Beck C.; Wong G.; Etherington K.; Arumairajah T.; Aprile M.;
Karlsson S.; Webber S.; Mercure C.; Aedy N.; Farquharson F.; Siddiqui A.;
Emy Takiuti M.; Pizzol Caetano L.; Peixoto Deiro A.; Manica Muller A.; de
Moraes M.A.P.; Maria Ascoli B.; Zottis Poletti S.; Zier S.S.; Veiga V.;
Franca da Cunha D.; Rucatti G.G.; Igansi F.; Haeffner M.P.; Almeida V.;
Sanchez de Souza G.; Almeida M.; dos Santos V.; Oliveira N.S.; Azevedo
B.E.P.; Bizzaro Santos M.; Germann A.; Gomes V.; Homem R.; Magedanz E.;
Laimer R.; Tognon A.; Santos R.P.; Yumi Okada M.; Paula Batista A.;
Nogueira Rabaca A.; Miranda Trama L.; Silva T.; Ormundo C.T.D.S.; Vicente
C.; Pinheiro C.; Komar D.; Walesiak O.; Malinowska K.; Maksym J.; Wojtera
K.; Fojt A.; Szczerba E.; Swiderek M.; Wojtala E.; Karwowski J.; Labyk A.;
Szramowska A.; Zdonczyk O.; Jaroch J.; Kolodziej A.; Marcinkiewicz-Siemion
M.; Bockeria O.; Kudzoeva Z.; Aripova N.; Naryshkin I.A.; Kuleshova A.;
Malaev D.; Subbotina I.; Gumerova V.; Nikolaeva O.B.; Fernandez-Figares
V.; Blanco-Calvo M.; Alonso-Alvarez E.; Garcia-Gonzalez P.; Seijas Amigo
J.; Fernandez Martinez A.; Igual B.; Quintana Giner M.; Romero Aniorte
A.I.; Rivera Caravaca J.M.; Canavate O.; Guerrero S.; Riera S.; Lasala M.;
Lorenzo M.; Sobrino O.; Vazquez A.; Dong H.; He P.; Xia C.; Yang J.; Zhong
Q.; Tian Y.; Li D.; Ma X.; Yu Z.; Zhao Q.; Li C.; Zhu B.; Chen M.; Chi H.;
Jing R.; Zhou Q.; Xu C.; Li Z.; Xiong L.; Gao D.; Jiang D.; Leng R.; Yuan
Q.; Bai Z.; Qi J.; Wang F.; Wang H.; Yang B.; Yue Z.; Zhang Z.; Dong Y.;
Mao J.; Zhang B.; Li X.; Yao X.; Zhong N.; Zhou N.; Huang Y.; Zhou P.; Su
W.; Kunwu Y.; Peng Y.; Su X.; Wang C.; Zhao Y.; Geng Y.; Wang Y.; Fan
J.-Y.; Feng S.-T.; Wang X.; Yan Y.; Zhang H.-M.; Chi L.; Liu F.; Chen H.;
Jiang J.; Li H.; Han Y.; Xu L.; Chen G.; Hu R.; Pietrucci F.; Di Donato
A.; Pezzetta F.; Casali V.; Attanasio C.; Leone G.; Pisano F.; Bare C.;
Fimiani F.; Barioli A.; Ramani F.; Rolfo F.; Goletto C.; De Micco F.; Di
Marco S.; Tricoli M.; Villella M.; Tan S.-Y.V.; Sia W.C.; Leong A.W.; Hai
Yan L.; Ismail N.; Tun Kyaw M.; Yip D.; Grahl D.; Guenther F.; Bonin K.;
Wenzelburger I.; Gruensfelder S.; Sinning J.-M.; Weber M.; Werner N.;
Steinmaurer G.; Winter M.-P.; Tijana A.; Tscharre M.; Wegmayrc C.; Jager
B.; Egger F.; Sebo J.; Davidovits Z.; Matics L.; Agoston G.; Dekany G.;
Bartykowszki A.; Jakal A.; Djokic J.; Djordjevic-Dikic A.D.; Giga V.L.;
Stepanovic J.J.; Velicki L.; Pupic L.; Simovic S.M.; Stevo Martinovic M.;
Stevanovic G.; Dobric M.; Salinger Martinovic S.; Stanojevic D.; de
Jesus-Perez R.; Brassetti M.F.C.; Anaya D.A.V.; Perez Garcia M.; Juarez
I.E.C.; Madero Rovalo M.; Lee S.; Thomas P.; Chaplin M.D.; Stansborough
J.K.; Black M.; Bonner M.M.; Ireland K.F.; Venn-Edmonds C.; Thobois C.;
Tachot E.; Laure C.; Vassaliere C.; Abergel H.; Fuentes A.; Eliahou L.;
Dubourg O.; Michaud P.; Hadjih S.; Brito P.; Cornet C.; Rautureau J.;
Juceviciene A.; Kalibataite-Rutkauskiene I.; Keinaite L.; Laukyte M.;
Mikolaitiene G.; Smigelskaite A.; Tamasauskiene I.; Urboniene A.; Bouwhuis
I.; Nijmeijer L.; Schoep J.J.M.; Janzen E.M.; Ahoud S.; Selas M.; Silva
F.; Freixo C.; Zimbarra Cabrita I.; Rocha A.; Patuleia Figueiras F.;
Coelho A.; Capinha M.; Ines Caetano M.; Silva S.; Tinnirello V.; Nicolas
Mungo M.; Garcia M.; Godoy V.; Victoria Actis M.; Scaro G.; Low L.; Scales
J.; Abercrombie K.; Howell L.; Patten C.; Bjorklund C.; Andreasson M.;
Essermark M.; Persson L.; Harel O.; Bentzvi M.; Helmer L.; Ueda I.; Fujita
J.; Furukawa A.; Hirase K.; Nagai T.; Otsuka F.; Nakano S.; Robesyn V.;
Yang Y.-H.; Mtana N.; Anesini A.; Maspoli S.; Mombelli M.; Talaat A.;
Rosca M.; Beladan C.C.; Zahrani S.; Davila M.A.M.; Khwakhong S.; Chaiyasri
A.; Mekara W.; Kulthawong S.; Amaritakomol A.; Panpunuan P.; Syamira
Mokhtar N.; Asiah Basri N.; Yusnida I.; Hashim H.; Berger J.; Harrington
R.; Jiang L.; Lopes R.D.; Bairey Merz C.N.; Weintraub W.; Rodriguez
E.D.M.; Maurovich-Horvat P.; Sonawane P.; Francis R.; Ramakrishnan T.;
Nayak S.; Boer S.C.; Rosenberg Y.; Hamm C.; Helm M.; Peterson E.;
Ballantyne C.; Calfas K.; Ann Champagne M.; Fleg J.; McCullough P.A.;
Menasche P.; Davidson M.; Fremes S.; Guyton R.; Mack M.; Mohr F.; Rao A.;
Sabik J.; Shapira O.; Taggart D.; Tatoulis J.; Blankenship J.; Brener S.;
Buller C.; Colombo A.; de Bruyne B.; Kereiakes D.; Lefevre T.; Moses J.;
Mahaffey K.; Cruz-Flores S.; Danchin N.; Feen E.; Garcia M.J.; Hauptman
P.; Laddu A.A.; Passamani E.; Pina I.L.; Simoons M.; Skali H.; Thygesen
K.; Waters D.; Endsley P.; Esposito G.; Kanters J.; Pownall J.; Stournaras
D.; Friedrich M.; Hachamovitch R.; Oliver D.; Harrell F.; Blume J.; Lee
K.; Kullo I.; McManus B.; Newby K.; Cohen D.; Bugiardini R.; Mattina D.;
Ali Z.; Mathew R.; Friedman L.; Anderson J.; Berg J.; DeMets D.; Gibson
C.M.; Lamas G.; Deming N.; Himmelfarb J.; Ouyang P.; Woodard P.; Nwosu S.;
Kirby R.; Jeffries N.; Denaro J.E.; Boumakis S.; Chan K.; Cobb G.;
Contreras A.; Cukali D.; Ferket S.; Gabriel A.; Hansen A.; Roberts A.;
Chang M.; Islam S.; Wayser G.; Yakubov S.; Yee M.; Callison C.; Hogan I.;
Qelaj A.; Pirro C.; Van Loo K.; Wisniewski B.; Gilsenan M.; Lang B.;
Mohamed S.; Esquenazi-Karonika S.; Mathews P.D.; Naumova A.; Lyo J.;
Setang V.; Xavier M.; Anstrom K.; Baloch K.; Blount J.; Cowper P.;
Davidson-Ray L.; Drew L.; Harding T.; Knight J.D.; Minshall Liu D.; O'Neal
B.; Redick T.; Nugent K.; Wang G.J.; Goyal A.; Hetrick H.; Hayes S.W.;
Friedman J.D.; Gerlach R.J.; Hyun M.; Miranda-Peats R.; Slomka P.; Thomson
L.; Pierre Mongeon F.; Michael S.; Hung J.; Zeng X.; Eckstein J.; Guruge
B.; Streif M.; Alfonso M.A.; Corral M.P.; Garcia J.J.; Horst J.; Jankovic
I.; Konigstein M.; Lustre M.B.; Peralta Y.; Sanchez R.; Arsanjani R.;
Elmore K.; Gomez M.; Hindoyan N.; Nakanishi R.; Srichai-Parsia M.B.; Yeoh
E.; Youn T.; Bianchini F.; Ceseri M.; Lorimer A.; Magnoni M.; Orso F.;
Sarti L.; Mazza Barbosa L.; Bello Duarte T.; Colaiacovo Soares T.; de
Aveiro Morata J.; Carvalho P.; Maffei N.D.C.; Egydio F.; Kawakami A.;
Oliveira J.; Restelli Piloto E.; Pozzibon J.; Camara D.; Mowafy N.;
Spindler C.; Dai H.; Feng F.; Li J.; Li L.; Liu J.; Xie Q.; Zhang H.;
Zhang J.; Zhang L.; Zhang N.; Zhong H.; Escobar C.; Eugenia Martin M.;
Pascual A.; Moraga P.; Hernandez V.; Posada M.; Fernandez S.; Villanueva
J.L.N.; Selgas R.; Luyten A.; Garcevic N.; Stojkovic J.; Ahmed A.; Bhatt
R.; Chadha N.; Kumar V.; Lubna S.; Naik P.; Pandey S.; Ramasamy K.; Saleem
M.; Sharma P.; Siddaram H.
Institution
(Huded, Spertus, Jones) Saint Luke's Mid America Heart Institute, Kansas
City, MO, United States
(Huded, Spertus, Jones) University of Missouri-Kansas City's Healthcare
Institute for Innovations in Quality, United States
(O'Brien, Mark) Duke Clinical Research Institute, Durham, NC, United
States
(Bangalore, Reynolds, Hochman) Department of Medicine, New York University
Grossman School of Medicine, NY, United States
(Stone) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Williams) Brigham and Women's Hospital, Boston, MA, United States
(White) Health New Zealand-Whatu Ora-Te Toka Tumai, Green Lane
Cardiovascular Service, Auckland City Hospital, New Zealand
(Boden) VA New England Healthcare System, Boston, MA, United States
(Boden) Boston University School of Medicine, MA, United States
(Maron) Department of Medicine, Stanford University, CA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: - In ISCHEMIA (International Study of Comparative Health
Effectiveness With Medical and Invasive Approaches), an invasive strategy
demonstrated better health status outcomes than a conservative strategy in
patients with chronic coronary disease (CCD). Some previous studies have
shown greater health status benefits with coronary artery bypass grafting
(CABG) than percutaneous coronary intervention (PCI). Whether the health
status benefits of invasive management in ISCHEMIA were driven primarily
by participants treated with CABG is unknown. METHOD(S): - The aim of
this analysis was to describe the health status outcomes of participants
treated with a conservative strategy (n=2232) compared with invasively
managed participants treated with PCI (n=1198) or CABG (n=340) in
ISCHEMIA. The Seattle Angina Questionnaire-7 summary score (SAQ-SS) and
angina frequency score (SAQ-AF) were the primary outcomes, with higher
scores indicating better health status. Proportional odds models comparing
1- and 3-year outcomes were fit, adjusting for demographic, clinical, and
angiographic characteristics. RESULT(S): - SAQ-SS in the
conservative, PCI, and CABG groups increased by 9.9+/-18.1, 15.7+/-19.3,
and 16.1+/-19.1 points at 1 year and 11.5+/-20.2, 16.5+/-21.8, and
15.0+/-19.4 points at 3 years, respectively. Freedom from angina in the
conservative, PCI, and CABG groups was noted in 61.4%, 73.3%, and 82.4% at
1 year and 70.4%, 76.1%, 81.4% at 3 years, respectively. In risk-adjusted
analyses, PCI and CABG were each associated with a higher SAQ-SS and
SAQ-AF at 1 and 3 years compared with conservative management. SAQ-AF was
higher with CABG than PCI at 1 year (odds ratio, 1.54 [95% CI, 1.03,
2.31]), but no differences between CABG and PCI were observed in SAQ-SS
(odds ratio, 1.11 [95% CI, 0.78, 1.57]) or SAQ-AF (odds ratio, 0.94 [95%
CI, 0.58, 1.54]) at 3 years. CONCLUSION(S): - In ISCHEMIA, both PCI
and CABG were associated with better 3-year health status than
conservative management. Better angina relief with CABG than PCI was seen
at 1, but not 3, years. REGISTRATION: - URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT01471522. Copyright © 2025 American Heart Association, Inc.

<30>
Accession Number
2034072517
Title
Comparison of different venous access ways for right heart
catheterization-a meta-analysis.
Source
Hellenic Journal of Cardiology. 87 (pp 121-132), 2026. Date of
Publication: 01 Jan 2026.
Author
Genske F.; Rawish E.; Macherey-Meyer S.; Buchel C.; Dejanovikj M.; Jurczyk
D.; Schulten-Baumer J.; Marquetand C.; Stiermaier T.; Eitel I.; Rosenkranz
S.; Frerker C.; Schmidt T.
Institution
(Genske, Rawish, Buchel, Dejanovikj, Jurczyk, Schulten-Baumer, Marquetand,
Stiermaier, Eitel, Frerker, Schmidt) University Hospital
Schleswig-Holstein, Medical Clinic II, University Heart Center Lubeck,
Lubeck, Germany
(Genske, Rawish, Jurczyk, Stiermaier, Eitel, Frerker, Schmidt) DZHK
(German Centre for Cardiovascular Research), partner site
Hamburg/Kiel/Lubeck, Lubeck, Germany
(Macherey-Meyer, Rosenkranz) University of Cologne, Faculty of Medicine
and University Hospital Cologne, Clinic III for Internal Medicine,
Cologne, Germany
Publisher
Hellenic Cardiological Society
Abstract
Objectives: Right heart catheterization (RHC) is a common diagnostic tool
and of special importance in the diagnosis of pulmonary hypertension (PH).
Until today, there have been no clear instructions or guidelines on which
venous access to prefer. This meta-analysis assessed whether the choice of
the venous access site for elective RHC has an impact on procedural or
clinical outcomes. Method(s): A structured literature search was
performed. Single-arm reports and controlled trials reporting event data
were eligible. The primary endpoint was a composite of access-related and
overall complications. Result(s): Nineteen studies, including 6509
RHC procedures, were eligible. The results were analyzed in two groups.
The first group compared central venous access (CVA; n = 2072) with
peripheral venous access (PVA; n = 2680) and included only multi-arm
studies (n = 12, C/P comparison). In the second group, all studies (n =
19, threeway comparison) were assessed to compare the three individual
access ways. The overall complication rate was low at 1.0% (n = 68). The
primary endpoint in the C/P comparison occurred significantly less for PVA
than for CVA (0.1% vs. 1.2%; p = 0.004). In the threeway comparison, PVA
had a significantly lower complication rate than femoral access (0.3% vs.
1.1%; p = 0.04). Jugular access had the numerically highest complication
rate (2.0%), but the difference was not significant compared to peripheral
(0.3%; p = 0.29) or femoral access (1.1%; p = 0.32). Conclusion(s):
This meta-analysis showed that PVA for RHC has a significantly lower
complication rate than CVA. There was a low level of certainty and high
heterogeneity. This pooled data analysis indicated PVA as the primary
venous access for RHC. Copyright © 2024 Hellenic Society of
Cardiology. Publishing services by Elsevier B.V. This is an open access
article under the CC BY-NC-ND license.
http://creativecommons.org/licenses/by-nc-nd/4.0/

<31>
Accession Number
2043091751
Title
Cognitive Outcomes in Randomized Controlled Trials of Coronary Artery
Bypass Graft Surgery From 2005 to 2025: A Systematic Review.
Source
Journal of the American Heart Association. 15(2) (no pagination), 2026.
Article Number: e041946. Date of Publication: 14 Jan 2026.
Author
Srivatsa S.; Sujanthan S.; Paleczny S.; Ripsman D.A.; de Rivera S.N.;
Dimagli A.; Taghdiri F.; Cheng P.-S.; Lou W.; Farkouh M.E.; Fremes S.E.;
Gaudino M.F.; Rabin J.; Razzouk L.; Owen A.M.; Creber R.M.; Swartz R.H.
Institution
(Srivatsa) Department of Medicine, University of North Carolina School of
Medicine, Chapel Hill, NC, United States
(Srivatsa, Rabin, Swartz) Department of Medicine (Neurology), Hurvitz
Brain Sciences Program, Sunnybrook HSC, Institute of Medical Sciences,
University of Toronto, Toronto, ON, Canada
(Paleczny) Department of Neuroscience, Schulich School of Medicine and
Dentistry, Western University, London, ON, Canada
(Ripsman) Department of Medicine (Neurology), University of British
Columbia, Vancouver, BC, Canada
(de Rivera, Creber) Columbia University School of Nursing, Columbia
University Irving Medical Center, New York, NY, United States
(Dimagli) Department of Surgery, Columbia University Irving Medical
Center, New York, NY, United States
(Taghdiri) Division of Neurology, Department of medicine, University of
Toronto, Toronto, ON, Canada
(Cheng) Biostatistics Division, Dalla Lana School of Public Health,
University of Toronto, Toronto, ON, Canada
(Lou) Dalla Lana School of Public Health, University of Toronto, Toronto,
ON, Canada
(Farkouh) Academic Affairs, Cedars-Sinai Health System, Los Angeles, CA,
United States
(Sujanthan, Fremes) Division of Cardiac Surgery, Schulich Heart Centre,
Sunnybrook HSC, Department of Surgery, Institute of Medical Sciences,
Institute of Health Policy Management and Evaluation, University of
Toronto, Toronto, ON, Canada
(Gaudino) Department of Cardio-thoracic Surgery, Cornell Medicine, New
York, NY, United States
(Rabin) Harquail Centre for Neuromodulation, Sunnybrook Research
Institute, Toronto, ON, Canada
(Razzouk) Department of Interventional Cardiology, Leon H. Charney
Division of Cardiology, New York University Grossman School of Medicine,
New York, NY, United States
(Owen) Department of Physiology and Pharmacology and Department of
Psychology, Western University, London, ON, Canada
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Cognitive decline after coronary artery bypass graft (CABG) is
common and affects morbidity, mortality, and quality of life. We
systematically reviewed randomized CABG trial control arms to characterize
cognitive assessments, testing frequency, attrition, and ability to detect
perioperative change. METHOD(S): We searched MEDLINE, Embase,
Cochrane Library, and PsycINFO for randomized controlled trials of CABG
surgery that included at least one arm of patients solely undergoing CABG
and that reported at least one objective cognitive assessment, from
January 2005 to February 2025. Trials with mixed cardiac surgery or only
subjective measures were excluded. We summarized task frequency, cognitive
domains, and attrition. For tasks assessed preoperatively and
postoperatively in >=3 trials, we reported control group means and SDs.
Risk of bias was assessed using the Cochrane Risk of Bias tool among 6
bias domains. This study was supported by NIH-R01NS123639. RESULT(S):
Of 3494 screened studies, 2284 were CABG trials, and only 71 (3.1%)
reported cognitive evaluation. These involved 15 925 patients (79% men;
mean age, 64.2 years; median follow-up, 90 days) and used 145 unique
cognitive tasks, with the Trail Making Test Part B (40 of 71; 56.3%) and
Part A (38 of 71; 53.5%) being the most frequently administered. Among 7
tasks with sufficient data, none detected preoperative to postoperative
changes. Attrition rates averaged 18.9%, with a broad range of 0 to 62%.
 CONCLUSION(S): Cognitive assessment is uncommon in CABG trials, and
commonly used tests rarely detect change. Heterogeneity precluded
meta-analysis, and high attrition raises concerns about selection and
survivorship bias. To evaluate cognitive impact after CABG, trials need
standardized, sensitive assessment strategies resilient to attrition and
feasible for broad deployment. Copyright © 2026 The Author(s).
Published on behalf of the American Heart Association, Inc., by Wiley.
This is an open access article under the terms of the Creative Commons
Attribution-NonCommercial-NoDerivs License, which permits use and
distribution in any medium, provided the original work is properly cited,
the use is non-commercial and no modifications or adaptations are made.

<32>
Accession Number
634851161
Title
The impact of standardized eras (Enhanced Recovery After Surgery) protocol
in patients undergoing minimally invasive heart valve surgery.
Source
Thoracic and Cardiovascular Surgeon. Conference: 50th Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery, DGTHG 2021.
Online. 69(SUPPL 1) (no pagination), 2021. Date of Publication: 19 Feb
2021.
Author
Gebauer A.; Reichenspurner H.; Girdauskas E.
Institution
(Gebauer, Reichenspurner, Girdauskas) HamburgGermany
Publisher
Georg Thieme Verlag
Abstract
ERAS (enhanced recovery after surgery) protocol is a pre-, intra-, and
postoperative, multimodal strategyaiming to reduce postoperative
complications and hospital length of stay (LOS) in a cost-effective way.
Core elements areimmediate extubation after surgery in the OR, early
physical therapy under adjusted pain therapy and early hospitaldischarge
with direct transfer to rehab. At our center, ERAS-protocol started in
February 2018 in selected patientsundergoing minimally invasive heart
valve surgery. The data collected in this retrospective cohort analysis
providesinformation about potential medical and economic benefits of ERAS
protocol in minimally invasive heart valve surgery. Method(s):
Non-randomized, retrospective cohort analysis. Pre-, intra-, and
postoperative data of a total of 210 patientsundergoing minimally invasive
heart valve surgery. A total of 101 patients received treatment following
ERAS protocol and109 patients received routine care. The data contains
information about pre-existing health condition, individual patientrisk,
measures of physical activity, type, and duration of surgery,
convalescence, measures of pre-and postoperative echoand rehabilitation.
Primary end-points were postoperative complications and hospital LOS,
broken down into total LOS, ICULOS, and postoperative LOS. Result(s):
Patients were predominantly men (77% in ERAS vs. 75% in control group)
with low EuroSCORE II (0.836 vs.0.808) and without differences in disease
characteristics. In the ERAS group 47% of the patients had right
lateralminithoracotomy (vs. 56% in the control group) and 54% had partial
upper sternotomy (44% in control group). No intra-orperioperative
complications were associated with ERAS-protocol. In-hospital mortality
was 0% in both groups. There wereno significant difference in the
appearance of nosocomial infections (13% in ERAS versus 16% in control
group, p = 0.48)and rehospitalization (17% readmissions from rehab in
ERAS-group versus 9% in control group, p = 0.38). A significantdecrease in
hospital LOS (6.1 +/- 2.6 vs. 7.7 +/- 3.7 days, p = 0.005) as well as
intensive care LOS (1.5 +/- 1.1 vs. 2.1 +/- 1.9days, p = 0.019) in the
ERAS cohort was shown. Conclusion(s): Our ERAS protocol is safe and
leads to quicker hospital discharge without compromising patient safety
inpatients undergoing minimally invasive heart valve surgery. Findings of
this analysis shall prepare the setup of theINCREASE study, a randomized
clinical trial, which is expected to provide high-quality data about the
execution of ERASprotocol in the treatment of heart valve pathologies and
their potential transfer into standard-of-care treatment.

<33>
Accession Number
634850854
Title
Packing of the chest as last resort to control bleeding in thoracic
surgery.
Source
Thoracic and Cardiovascular Surgeon. Conference: 50th Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery, DGTHG 2021.
Online. 69(SUPPL 1) (no pagination), 2021. Date of Publication: 19 Feb
2021.
Author
Sandhaus T.; Seiz E.; Steinert M.; Doenst T.
Institution
(Sandhaus, Seiz, Doenst) JenaGermany
(Steinert) LeipzigGermany
Publisher
Georg Thieme Verlag
Abstract
Severe pleural empyema, thoracic trauma, anticoagulation therapy and liver
cirrhosis are associated with ahigh risk of uncontrolled bleeding in
thoracic operations. Packing is an established treatment in patients with
the sameproblems at the liver. Removal of the abdominal bandages requires
a second operation. In thoracic surgery, this procedureis not established
in routine practice. In general, these conditions are associated with
extremely high mortality. There areno established evidence-based treatment
algorithms or randomized clinical trials. Thus far, only a few small
reports exist inthe literature. We analyzed the outcome of our packing
strategy in thoracic surgical patients. Method(s): We retrospectively
analyzed all 64 patients treated with a packing strategy over a period of
4 years. Patientdemographics, operations, clinical course and mortality
were evaluated. Result(s): The majority of the patients were male
81.3%, (female 18.7%) and mean age was 59.5 +/- 15.5. Indications for
theprocedure were stage III empyema (59%), hemothorax (36%), and
pneumothorax 6%. 28 patients (43.8%) had anoncological underlying disease,
34 (53.1) had significant anticoagulation therapy and 7 (10.9%) clotting
disorders. Duringthe operations, an average of 3.3 +/- 1.5 abdominal
bandages was left in the hemithorax (right 62.5%, left 37.5%). De-Packing
was performed in average 56 hours later. Median length of postoperative
hospitalization was 14.8 +/- 14.3 days andhospital mortality was 39.1%.
Anticoagulation therapy and the need of a second packing (12%) were
identified assignificant risk factors. Conclusion(s): Patients with
severe thoracic bleeding who cannot be conventionally controlled carry a
high risk. A packingstrategy seems to be an option in these last resort
situations. Although it was associated with a high mortality, 61% of
thepatients survived in our collective.

<34>
Accession Number
631112574
Title
Remote ischemic preconditioning in elective cardiac surgery: Long-term
overall survival benefit in a single-center randomized double-blinded
controlled trial.
Source
Thoracic and Cardiovascular Surgeon. Conference: 49th Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery. Wiesbaden
Germany. 68(Supplement 1) (no pagination), 2020. Date of Publication: 13
Feb 2020.
Author
Thielmann M.; Vaghiri S.; Dirkmann D.; Neuhauser M.; Peters J.; Heusch G.;
Jakob H.; Ruhparwar A.; Kamler M.; Kleinbongard P.
Institution
(Thielmann, Vaghiri, Dirkmann, Neuhauser, Peters, Heusch, Jakob,
Ruhparwar, Kamler, Kleinbongard) EssenGermany
Publisher
Georg Thieme Verlag
Abstract
Objectives: Remote ischemic preconditioning (RIPC) by repeated brief
cycles of limb ischemia/reperfusion can reduce myocardial injury and
improve patients' prognosis following cardiac surgery in proof-of-concept
and smaller randomized controlled trials (RCT), while two recent large
Phase III RCTs were neutral for troponin release and outcome after 90 days
and 1 year. Method(s): Between April 2008 and August 2018, a total of
1,204 patients scheduled for elective cardiac surgery with the use of
isoflurane anesthesia, cardiopulmonary bypass, and crystalloid
cardioplegic arrest were allocated to receive either RIPC (n = 607; three
cycles of 5-min transient left upper arm ischemia with 5-min reperfusion
after induction of anesthesia) or served as controls (n = 597).
 Result(s): Patient characteristics and intraoperative data did not
differ between the two groups. The primary short-term endpoint was
myocardial injury following surgery as reflected by the perioperative
cardiac troponin (cTn) serum concentration over 72 hours and its area
under the curve (AUC). The mean troponin AUC profiles in the RIPC group
were lower (geometric mean [confidence interval, CI]: 137.97 [122.26;
155.71] for controls vs. 131.60 [116.55; 148.60] for RIPC group; ratio
[CI] 0.95 [0.80; 1.13], but did not reach statistical significance,
neither in the intention-to-treat (ITT; p = 0.589) nor in the per-protocol
(PP) analysis (p = 0.482). The primary long-term endpoint was all-cause
mortality, and the secondary endpoint was the rate of major adverse
cardiac and cerebrovascular events (MACCE). In the ITT analysis, there
were 111 deaths in the control group and 85 in the RIPC group (p = 0.031),
but 80 deaths in the control group versus 71 in the RIPC group in the PP
analysis (p = 0.252) over a total follow-up of 4.0 +/- 2.5 years. The
Kaplan-Meier overall survival in the ITT analysis was superior with RIPC
(p = 0.024), but did not reach statistical significance in the PP analysis
(p = 0.234), whereas MACCE rate was superior with RIPC in the ITT (p =
0.040) as well as in the PP analysis (p = 0.045). Conclusion(s): Our
extended RCT confirms that RIPC provides no significant difference in
perioperative cardiac troponin AUC profiles, but demonstrates a continued
robust prognostic benefit with superior survival and MACCE rate in
patients undergoing elective cardiac surgery with isoflurane anesthesia,
cardiopulmonary bypass, and crystalloid cardioplegic arrest.

<35>
Accession Number
628084776
Title
Up to 7-year follow-up of bicuspid aortic valves (BAV) undergoing TAVI
versus surgical aortic valve replacement (SAVR).
Source
Thoracic and Cardiovascular Surgeon. Conference: 48th Annual Meeting
German Society for Thoracic, Cardiac, and Vascular Surgery. Wiesbaden
Germany. 67(Supplement 1) (no pagination), 2019. Date of Publication: 28
Jan 2019.
Author
Josic T.; Koehne J.; Liebetrau C.; Schonburg M.; Kim K.W.; Doss M.
Institution
(Josic, Koehne, Schonburg, Doss) Kerckhoff-Klinik, Cardiac Surgery, Bad
Nauheim, Germany
(Liebetrau, Kim) Kerckhoff-Klinik, Cardiology, Bad Nauheim, Germany
Publisher
Georg Thieme Verlag
Abstract
Objectives: Recently many groups have reported their results with TAVI in
bicuspid aortic valves and have pointed out technical challenges in this
patient population. The aim of this study was to compare clinical outcomes
of bicuspid aortic valves; in TAVI vs. surgical aortic valve replacement
in an up to 7-year follow-up. Method(s): Between January 2011 and
December 2014, a total of 2,506 patients with aortic stenosis underwent
aortic valve replacement in our institution. 1,515 patients had a surgical
aortic valve replacement and 991 patients had a TAVI procedure. In this
cohort of patients, there were 104 bicuspid aortic valves (BAV) identified
(SAVR = 52 vs. TAVI = 52). The diagnosis of BAV was made preoperatively by
CT scan, echocardiography, or intraoperatively. Clinical endpoints were
procedural and postoperative complications. Mean follow-up was 5 +/- 2.82
years. Result(s): Postoperative complications with the need for a
secondary intervention were higher in the TAVI group 36.53% (n = 19) vs.
19.23% (n = 10) (vascular complications, pacemaker and conversion/
re-sternotomy). Significantly more patients in the TAVI group had a stroke
postoperatively; 25% (n = 13) vs. 7, 69% (n = 4); p = 0.011. Residual
aortic regurgitation > grade II was significantly higher in the TAVI group
(21.2 vs. 0%). Thirty-day mortality was lower in the SAVR group, 1.92% (n
= 1) vs. 7.69% (n = 4), also the 5-year follow-up was lower in the SAVR
group, 5.7% (n=3), then in the TAVI group, 46.30% (n = 24).
 Conclusion(s): Treatment of BAV with TAVI bears significant
procedural challenges. It may be an alternative treatment option for
high-risk patients with BAV. In our study TAVI had significantly higher
rates of mortality and procedural complications. Since the cohort was
small, a randomized trial would lead to more conclusive results.

<36>
Accession Number
631112418
Title
Randomized controlled trial: Use of hydrocolloid silver-containing wound
dressing after sternotomy to reduce wound complications after cardiac
surgery.
Source
Thoracic and Cardiovascular Surgeon. Conference: 49th Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery. Wiesbaden
Germany. 68(Supplement 1) (no pagination), 2020. Date of Publication: 13
Feb 2020.
Author
Dohle K.; Chaban R.; Oberhoffer M.; Dohle D.S.; Vahl C.F.
Institution
(Dohle, Chaban, Oberhoffer, Dohle, Vahl) MainzGermany
Publisher
Georg Thieme Verlag
Abstract
Objectives: Surgical site infections (SSIs) are a serious complication
after cardiac surgery. New wound dressing techniques could reduce the
incidence of SSIs. This prospective randomized industry-independent
clinical trial investigates the influence of a hydrocolloid
silver-containing wound dressing (AQUACEL Ag Surgical, HD) on the
incidence of SSIs compared to the standard procedure. Method(s): A
total of 423 elective CABG patients operated between January 2018 and July
2019 were randomized into conventional and HD wound management groups.
According to our study protocol, 73 randomized patients were excluded
(ventilation > 48 hours, n = 29; rethoracotomy, n = 10; HD not received, n
= 10; no IMA, n = 8; no OP, n = 6; mortality, n = 5; immunosuppression
drugs, n = 3; no CABG, n = 2). 350 patients (mean age 68 +/- 9.4, 80%
male) were randomized into control (n = 173) and study group (n = 177) and
treated according to the study protocol. The HD was applied
intraoperatively and remained five days. In the control group regular
wound dressing was applied intraoperatively and changed the first time
after 48 hours. After the fifth postoperative day, wounds in both groups
remained without further dressings. Wounds were monitored daily until the
7th and on the 30th postoperative days. SSIs were classified into three
categories (superficial, deep, and organ SSI) according to severity and
need for treatment. Result(s): No differences in demographics,
cardiovascular risk factors, intraoperative process and postoperative care
were found between both groups. The total SSI rate was 9.14% with 14
patients (8.1%) in the control and 18 patients (10.2%) in the study group
(p = 0.5). The extent of SSIs in control and study group according to
superficial (2.3 vs. 3.4%), deep (4.1 vs. 5.1%), and organ SSI (1.7 vs.
1.7%) showed no significant differences (p = 0.895). Twenty-five patients
required surgical wound revision (6.4 vs. 7.9%; p = 0.573) 23.8 +/- 12.9
days after primary surgery. Sixteen patients required VAC therapy and
secondary closure (4.6 vs. 4.5%; p = 0.52). Conclusion(s): No
difference was found in the incidence or extent of wound healing disorder.
The type of dressing therefore does not seem to have any influence on
wound healing. Known patient-specific and intraoperative factors seem to
play a significantly greater role in the development of wound healing
disorders and should therefore be consistently considered.

<37>
Accession Number
631112511
Title
Complete versus incomplete revascularization and influence of
postoperative antiplatelet therapy in coronary artery bypass grafting:
Results from the ticab study.
Source
Thoracic and Cardiovascular Surgeon. Conference: 49th Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery. Wiesbaden
Germany. 68(Supplement 1) (no pagination), 2020. Date of Publication: 13
Feb 2020.
Author
Schafer A.; Conradi L.; Schneeberger Y.; Sill B.; Reichenspurner H.;
Kastrati A.; Von Scheidt M.; Schunkert H.
Institution
(Schafer, Conradi, Schneeberger, Sill, Reichenspurner) HamburgGermany
(Kastrati, Von Scheidt, Schunkert) MunichGermany
Publisher
Georg Thieme Verlag
Abstract
Objectives: The recently published results of the TiCAB trial showed no
significant differences of outcomes, regarding major cardiovascular events
or bleeding, in patients receiving aspirin or ticagrelor adjunctive to
coronary artery bypass grafting (CABG). We herein aimed to analyze
subgroups of patients who received complete (CR) or incomplete
revascularization (ICR) during CABG and determine possible impact of the
different antiplatelet therapies. Method(s): In this randomized
controlled trial (RCT), 1,859 patients were enrolled between April 2013
and April 2017 and randomly assigned to aspirin or ticagrelor therapy
adjunctive to CABG. Of these, 1,550 patients (83.4%; 14.9% female, age
60-75 years: 60.8%) received CR and 309 patients (16.6%; 15.9% female, age
60-75: 57.9%) received ICR. Outcomes were evaluated based on the primary
outcomes of cardiovascular death, myocardial infarction (MI), repeat
revascularization, PTCA, and stroke 12 months after CABG. Result(s):
Baseline parameters revealed significant differences regarding clinical
presentation (stable angina pectoris [AP]: CR 68.9 vs. ICR 71.2%, instable
AP: 14.1 vs. 7.8%, NSTEMI: 17.0 vs. 21.0%, p = 0.005), lesion
characteristics (chronic total occlusion [CTO]: CR 91.3 vs. ICR 96.8%, p =
0.001), operative technique (off-pump coronary artery bypass grafting
[OPCAB]: CR 3.0 vs. ICR 6.1%, p = 0.005) and number of utilized grafts
(venous grafts: CR 1.02/patient vs. ICR 0.86/patient, p = 0.01; total
number of grafts: 2.69/patient vs. 2.49/patient, p = 0.0002). Patients
with ICR presented with significantly higher rates of PTCA (CR: 3.3% vs.
ICR: 6.3%, p = 0.02) and repeat revascularization (CR: 3.9% vs. ICR: 7.3%,
0.01) up to 12 months after the index procedure. No significant
differences were found regarding stroke, MI, cardiovascular death, or
BARC-adjudicated clinical endpoints. Also, no differences were found
between subgroups receiving aspirin or ticagrelor. Conclusion(s): In
this large RCT, patients who received ICR for coronary vessel disease were
significantly more frequently exposed to repeat revascularization or PTCA
up to 12 months following the index procedure. Patients who were
incompletely revascularized presented more stable at the time of admission
and received less grafts, highly likely due to the presence of
significantly more CTO of coronary arteries and were significantly more
often provided with OPCAB. Although mortality presented no differences
between groups, our results suggest that patients benefit from CR with
regards to prevention of re-revascularization. Therefore, concept of CR
should be taken into consideration even if CTO or challenging operative
circumstances are present.

<38>
Accession Number
631112567
Title
Negative pressure therapy after median sternotomy on closed incision: A
randomized controlled study.
Source
Thoracic and Cardiovascular Surgeon. Conference: 49th Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery. Wiesbaden
Germany. 68(Supplement 1) (no pagination), 2020. Date of Publication: 13
Feb 2020.
Author
Darwisch A.; Fajfrova Z.
Institution
(Darwisch, Fajfrova) DresdenGermany
Publisher
Georg Thieme Verlag
Abstract
Objectives: Surgical site infections (SSIs) are serious complications
after cardiothoracic surgery and contribute significantly to postoperative
morbidity, mortality, and healthcare costs. Negative pressure wound
therapy (NPWT), in this case PICO dressing, is a concept introduced
initially to assist in the treatment of chronic open wounds. Recently,
there has been growing interest in using the technique on closed incisions
after surgery to prevent potentially severe surgical site infections and
other wound complications, but has not yet been rigorously tested in a
randomized controlled trial. The purpose of this study was to evaluate
NPWT as a prevention and therapy of superficial infection. Method(s):
In this single-center, superiority designed prospective randomized
controlled trial, patients after cardiac surgery performed via median
sternotomy (n = 528) were after stratification according to the marker
body mass index (BMI >=35 yes/no) randomized to receive either a
disposable PICO dressing (PD) (Smith & Nephew, the Netherlands) (n =
56/193) or a standard dry dressing (SDD) (n = 66/213) over the incision
immediately at the conclusion of surgery. We have examined the development
of infection depending on the type of dressing. The primary end point was
SSIs within 30 days. Result(s): The study showed no significant
difference in the number of infections after operation in patients with
BMI >=35 (p = 0.622). In patients with BMI <35, there was no significant
difference in the number of infections after operation (PD/SDD 20.8%/16%;
p = 0.2926), but there was significant difference in the progress of the
infection. In the PD group, 57.7% of infections remained superficial and
42.3% emerged a deep infection. Compared with SDD group, 32.5% of
infections remained superficial and 67.5% emerged a deep infection (p =
0.0432). Conclusion(s): These results suggest that the use of PD
compared with SDD did not improve the rate of SSIs in 30 days, but PD
treatment reduced the rate of deep type of SSIs; so, there is a shift
toward more superficial and thus less feared and also less costly SSIs. It
should be a standard to use the PD in patients with BMI <35 suffering from
superficial infection in the surgical wound after median sternotomy.

<39>
Accession Number
627605928
Title
Fibrinogen concentrate vs. cryoprecipitate for acquired hypofibrinogenemia
in cardiac surgery-The fibres study.
Source
Hamostaseologie. Conference: 63rd Annual Meeting of the Society of
Thrombosis and Haemostasis Research. Berlin Germany. 39(Supplement 1) (no
pagination), 2019. Date of Publication: 13 Feb 2019.
Author
Karkouti K.
Institution
(Karkouti) Toronto General Hospital, Toronto, Canada
Publisher
Georg Thieme Verlag
Abstract
Scientific Research Question: Cardiopulmonary bypass (CPB) is associated
with coagulopathy and excessive bleeding. This often requires the
transfusion of large volumes of allogeneic blood products and is linked to
an increased risk of adverse outcomes. A primary cause of coagulopathy is
acquired hypofibrinogenemia; when fibrinogen levels drop below 1.5-2 mg/L,
fibrinogen supplementation is required to maintain hemostasis. The
FIBrinogen REplenishment in Surgery (FIBERS) study aims to compare the
standard intervention, cryoprecipitate, with a new highly purified, double
virus-inactivated human fibrinogen concentrate. Methodology: The FIBERS
study (NCT03037424) is a pragmatic, multicenter, active-control,
randomized, single-blinded, non-inferiority phase 3 trial in adult
patients undergoing cardiac surgery with CPB. The study will enroll
patients with clinically significant bleeding associated with acquired
hypofibrinogenemia. Patients for whom fibrinogen supplementation is
ordered within 24 hours of surgery will be randomized to receive
fibrinogen concentrate (4 g) or cryoprecipitate (10 units; dose equivalent
to 4 g fibrinogen concentrate). All randomized patients will receive
fibrinogen supplementation as clinically indicated. Owing to the emergency
nature of the clinical setting, patient consent at the point of
randomization will be waived, with written informed consent obtained
within 24-48 hours thereafter. The primary outcome is total allogeneic
blood products (red blood cells, plasma, platelets) administered within
the first 24 hours of surgery. Secondary outcomes include blood product
use within 7 days, incidence of major bleeding within 24 hours, fibrinogen
levels, and adverse events (AEs) and serious AEs within 28 days. Enrolment
of 1,200 patients will provide >90% power to demonstrate non-inferiority,
assuming a 20% non-inferiority margin, >550 patients per group, and an
approximate 10% drop-out rate. One pre-planned interim analysis will be
conducted after data are available for 600 evaluable patients with the
option to stop early for futility or overwhelming efficacy. The pragmatic
design and treatment algorithm align with standard practice, aiding
adherence and generalizability. Finding(s): To date, 600 patients
have been treated across 11 sites. An IDMEAC review of safety has been
performed every 100 patients enrolled, with the recommendation to continue
as planned each time. An interim analysis of the study is expected to
complete in 2018 with final data available late 2019. Conclusion(s):
FIBERS is the largest randomized study to date of fibrinogen concentrate
versus cryoprecipitate in adult cardiac surgical patients, an
under-studied yet high-risk population. Non-inferiority of the new
fibrinogen concentrate would support its use for patients developing
acquired hypofibrinogenemia during cardiac surgery. Results from the
FIBERS study are likely to improve care for cardiac surgical patients
experiencing significant bleeding.

<40>
Accession Number
628084705
Title
Preoperative intracranial hemorrhage affecting surgical decision making in
endocarditis patients: a literature review and a single-centre
retrospective study.
Source
Thoracic and Cardiovascular Surgeon. Conference: 48th Annual Meeting
German Society for Thoracic, Cardiac, and Vascular Surgery. Wiesbaden
Germany. 67(Supplement 1) (no pagination), 2019. Date of Publication: 28
Jan 2019.
Author
Musleh R.; Diab M.; Guenther A.; Faerber G.; Lehmann T.; Tasar R.; Franz
M.; Witte W.O.; Doenst T.
Institution
(Musleh, Diab, Faerber, Tasar, Doenst) Department of Cardiothoracic
Surgery, Friedrich-Schiller-University Jena, Jena, Germany
(Guenther, Witte) Department of Neurology, Friedrich-Schiller-University
Jena, Jena, Germany
(Lehmann) Center of Clinical Studies, Friedrich-Schiller-University Jena,
Jena, Germany
(Franz) Department of Internal Medicine I, Friedrich-Schiller-University
Jena, Jena, Germany
Publisher
Georg Thieme Verlag
Abstract
Objectives: Cardiac surgery in infectious endocarditis (IE) patients with
preoperative intracranial hemorrhage (Pre-ICH) is considered a highly
debatable issue, and guidelines are still not well defined. Recent studies
suggest that the incidence of neurological exacerbations has decreased in
recent years. In this study, we aimed to investigate the effect of cardiac
surgery on clinical outcomes of IE patients accompanied by Pre-ICH.
 Method(s): Through using PubMed, EMBASE, and Cochrane databases, a
systematic review of the recent publications (1995-August 2018) was
conducted. Twenty-six articles were retrieved, but due to the lack of
controlled studies, only seven articles provided the best evidence to
answer our clinical question and thus were included. We also
retrospectively analyzed data from our own patients who were operated for
left-sided endocarditis between January 2007 and May 2018. A total of 525
patients were identified, but only 287 patients with preoperative brain
imaging were included in further analysis. Result(s): Literature
review illustrated a total of 133 cases of IE patients with Pre-ICH who
underwent cardiac surgery. A total of 112 patients (84.2%) reported no
postoperative neurological deterioration regardless of the timing of the
surgery; 12 patients (9.1%) had postoperative events (10 with new strokes
as cerebral infarcts or ICH; 2 with ectopic asymptomatic hemorrhages).
However, none of the observed events led to death. Nine patients (6.7%)
died, and one article confirmed the cause of mortality in four of nine
deaths as cardiac or multiorgan failure (MOF). As for our own
retrospective study, we identified a total of 34 patients with Pre-ICH who
were assigned to cardiac surgery. There was no significant difference in
hospital mortality between patients with Pre-ICH and without Pre-ICH (29.4
vs. 28.9%; p = 1.0). The rate of postoperative bleeding was higher in
patients with pre-ICH compared with those without pre-ICH, but the
difference was not statistically significant (17.5 vs. 7.5%; p = 0.095).
Out of six patients who presented with postoperative bleeding, three
showed resorption of the ICH on follow-up brain imaging.
 Conclusion(s): Recent studies report a low rate of neurological
deterioration and good survival in operated IE patients with Pre-ICH. The
results of our patient data and the literature review suggest that the
perception of preoperative ICH may be worse than it actually is. These
findings may facilitate decision making in endocarditis patients with
intracranial hemorrhage.

<41>
Accession Number
631112627
Title
Simulation of TAVI in patient-specific testing inserts at physiologic flow
conditions.
Source
Thoracic and Cardiovascular Surgeon. Conference: 49th Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery. Wiesbaden
Germany. 68(Supplement 1) (no pagination), 2020. Date of Publication: 13
Feb 2020.
Author
Konig F.; Kramer A.; Grab M.; Mehilli J.; Hagl C.; Thierfelder N.
Institution
(Konig, Mehilli, Hagl, Thierfelder) MunichGermany
(Kramer, Grab) Garching bei MunchenGermany
Publisher
Georg Thieme Verlag
Abstract
Objectives: Transcatheter aortic valve implantation (TAVI) evolved to be
the standard treatment in high-risk patients with aortic stenosis. The
prosthesis landing zone, characterized by the anatomy of the aortic root
and the calcifications of the aortic valve, is associated to the
prevalence of complications during TAVI. This study aims to develop a
process that allows the simulation of TAVI in patient-specific anatomies.
 Method(s): A total of 100 computed tomography (CT) datasets of
patients who underwent a TAVI in our clinic have been randomly selected,
rendered anonymous and were digitally analyzed (3-Mensio) as follows.
Classifications of the total aortic root calcium as well as calcium
distribution on the aortic leaflets were conducted. Findings were
correlated to the occurrence of complications (e.g., paravalvular leaks
and atrioventricular blocks). Based on these results, specific anatomies
were selected for 3D printing. 3D models of the aortic valve and the
aortic valve calcium were generated based on the CT data. A commercial
polymer printer was used to produce flexible aortic roots. These were used
for in vitro simulations of TAVI procedures in a newly developed pulsatile
flow system under physiologic conditions. Result(s): The evaluation
of the CT datasets allowed a classification of the patients based on
calcification volume and distribution. We were further able to create
anatomical models of a representative of each group based on the patients'
CT data. These models were successfully printed and inserted into our
testing device to simulate the TAVI procedure under physiologic flow and
pressure conditions. We were finally able to correlate the simulation data
to the original outcome. Conclusion(s): In this study, we
successfully analyzed and correlated CT scans to TAVI-related
complications. Based on these results a set of 3D-printed aortic roots
were manufactured for in vitro testing. TAVI prosthesis evaluation under
pulsatile flow conditions was possible and enabled good insights in
patho-mechanical causes of TAVI-related complications. The similar
behavior of our simulation compared to the actual outcome of the procedure
validates our process. The potential of this process, including simulation
of patient-specific TAVI in complex cases with different implants, will
have to be proven with additional experiments.

<42>
Accession Number
631112518
Title
External stenting of saphenous vein grafts in coronary artery bypass
grafting: Two-year angiographic and intravascular ultrasound follow-up
from a single-center randomized cohort.
Source
Thoracic and Cardiovascular Surgeon. Conference: 49th Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery. Wiesbaden
Germany. 68(Supplement 1) (no pagination), 2020. Date of Publication: 13
Feb 2020.
Author
Paraforos A.; Donovan J.; Donovan D.; Kraiker P.; Friedrich I.
Institution
(Paraforos, Donovan, Donovan, Kraiker, Friedrich) TrierGermany
Publisher
Georg Thieme Verlag
Abstract
Objectives: Degeneration of saphenous vein grafts (SVG) continues to be an
Achilles' heel of bypass surgery. High wall tension and in the arterial
circulation coupled with high and turbulent flow profiles trigger
pathological remodeling of the bypass vessel and intimal hyperplasia which
leads to SVG failure. External stenting was shown to reduce intimal
hyperplasia, improve lumen uniformity SVG flow pattern 1 year after CABG.
Our objective was to evaluate the effect of external stenting on SVG
disease 2 years after CABG. Method(s): Thirty-five patients were
enrolled in our center as part of the VEST III multicenter randomized
trial (n = 184). In addition to an internal mammary artery graft, each
patient received one external stent to a single SVG, randomized to either
the right or left coronary territories, while one or more non-stented SVG
served as control(s). Graft patency was confirmed at 6 months using CT
angiography. At 2 years, angiography and intravascular ultrasound (IVUS)
were performed to assess graft patency, Fitzgibbon classification for
lumen irregularities and intimal hyperplasia (area + thickness). All
angiographic and IVUS analysis were performed by independent core-lab
(Mount Sinai, New York). Result(s): Clinical follow-up for MACCE was
completed for 33 patients (94%) and angiographic follow up was completed
for 26 patients (76%). Two patients died during 24-month follow-up, 5
patients refused control angiography, and 2 patients were contraindicated
due to impaired kidney function. At 2 years, event-free survival was 85.8%
with 2.8% of patients having perioperative MI and 2.8% target vessel
re-revascularizations. Patency rates at 6 months were 100, 100, and 97% in
the LIMA-LAD grafts, externally stented SVG, and nonstented SVG,
respectively. At 2 years, all SVGs were patent. 88, 12, and 0% of stented
SVG were classified as Fitzgibbon I, II, and III, respectively, compared
to 73, 19, and 8% of SVG. Intimal hyperplasia area was 2.53 mm2
in the stented SVG and 3.18 mm2 in nonstented SVG (p < 0.01).
Intimal thickness was reduced by 24% (p < 0.001) in the stented SVG.
 Conclusion(s): External stenting of vein grafts is safe and effective
in mitigating SVG disease progression 2 years after CABG by significantly
reducing intimal hyperplasia and improving perfect patency rates
(Fitzgibbon I). Further studies will show whether clinical endpoints are
improved by reducing graft degeneration.

<43>
Accession Number
2043499697
Title
Patient-Controlled Analgesia in ICU: A Scoping Review.
Source
Journal of Personalized Medicine. 16(2) (no pagination), 2026. Article
Number: 109. Date of Publication: 01 Feb 2026.
Author
Califano A.; Caldonazzo R.; Gotti M.; Sabbatini G.; Galimberti A.; Angelo
P.; Formenti P.
Institution
(Califano, Caldonazzo) School of Medicine and Surgery, University of
Milano-Bicocca, Milano, Italy
(Gotti, Sabbatini, Galimberti, Angelo, Formenti) SC Anestesia,
Rianimazione e Terapia Intensiva, ASST Nord Milano, Ospedale Bassini,
Cinisello Balsamo, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Patient-Controlled Analgesia (PCA) is a
well-established strategy for managing postoperative pain, but its use in
the Intensive Care Unit (ICU) remains poorly defined, poorly standardized,
and fragmented. The aim of this scoping review is to map the extent,
nature, and characteristics of the available evidence on the use of PCA in
ICU patients, identifying key areas of uncertainty and knowledge gaps that
require further study. Method(s): Scoping review reported according
to the PRISMA-ScR guidelines. Result(s): 12 relevant studies were
identified. Available evidence suggests that PCA can provide pain control
comparable to traditional techniques in post-cardiac surgery patients in
the ICU, while data on its use in non-surgical patients are limited. The
studies reported good feasibility and a generally favorable safety
profile, with a low incidence of significant respiratory events thanks to
intensive monitoring. Methodological variability prevents direct
comparisons between studies. Conclusion(s): PCA supports personalized
pain management based on patient-specific clinical conditions and
response. However, more standardized studies are needed to define its
role. Copyright © 2026 by the authors.

<44>
Accession Number
2043788101
Title
CT coronary angiography guided treatment versus routine invasive coronary
angiography in patients with non-ST elevation myocardial infarction: a
systematic review and meta-analysis.
Source
Open Heart. 13(1) (no pagination), 2026. Article Number: e003919. Date of
Publication: 12 Feb 2026.
Author
Lee R.H.K.; Kam M.H.M.; Chatchalermwit P.; Weston C.; Oon G.R.; Moosa B.;
Gray A.J.; Kelham M.; Jones D.A.; Wang K.-L.; Henriksen P.A.
Institution
(Lee, Kam, Chatchalermwit, Weston, Oon, Moosa) The University of Edinburgh
Medical School, Edinburgh, United Kingdom
(Gray) Emergency Department, Royal Infirmary of Edinburgh, Edinburgh,
United Kingdom
(Gray) Saint Bartholomew's Hospital Barts Heart Centre, London, United
Kingdom
(Kelham, Jones) Centre for Cardiovascular Medicine and Devices, Queen Mary
University of London, William Harvey Research Institute, London, United
Kingdom
(Kelham, Jones, Wang) British Heart Foundation, University of Edinburgh,
Edinburgh, United Kingdom
(Henriksen) Edinburgh Heart Centre, Royal Infirmary of Edinburgh,
Edinburgh, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Background Non-ST-segment-elevation myocardial infarction (NSTEMI)
accounts for the majority of acute coronary syndrome presentations.
Invasive coronary angiography (ICA) is recommended but challenging to
deliver within guideline-recommended timeframes and unnecessary in
patients without obstructive disease. CT coronary angiography (CTCA)
offers a non-invasive alternative for lower-risk patients that may reduce
procedural-related complications and optimise resource use by avoiding
unnecessary ICA. Methods We conducted a systematic review and
meta-analysis following Cochrane standards. Four databases were searched
from January 2005 to March 2025. Eligible studies included adult patients
with NSTEMI undergoing CTCA to guide management, with comparators of
standard care (ICA-first strategies). Primary outcomes were ICA
utilisation, composite cardiovascular events (myocardial infarction,
cardiovascular and all-cause death) and diagnostic accuracy of CTCA versus
ICA. Results From 12 058 records, eight studies met inclusion criteria;
three randomised controlled trial (RCT) studies and five observational
cohorts; total n=2700. Across two RCTs, a CTCA-first strategy did not
significantly reduce ICA use (pooled relative risk (RR)=0.82 (0.55-1.22)).
Evidence for composite clinical outcomes was heterogeneous: The Rapid
Assessment of Potential Ischaemic Heart Disease with CTCA trial reported
no difference in death or MI, whereas the trial, Computed Tomography
Cardiac Angiography Before Invasive Coronary Angiography in Patients with
Previous Bypass Surgery, observed reduced events at 1 year (RR=0.63
(0.43-0.94)). Pooled diagnostic accuracy for >50% stenosis from
observational studies demonstrated high sensitivity (96.3%) and moderate
specificity (79.6%), with high heterogeneity. Length of stay and patient
satisfaction were similar or improved with CTCA-first strategies, though
cost-effectiveness data were limited. Overall evidence quality ranged from
moderate (RCTs) to low (observational studies). Conclusions CTCA
demonstrates excellent diagnostic accuracy and may reduce complications
while maintaining clinical outcomes in patients with NSTEMI. Current
evidence does not show consistent reductions in ICA use or major adverse
events. Larger trials are needed to clarify its role in NSTEMI management
pathways. Copyright © Author(s) (or their employer(s)) 2026.

<45>
Accession Number
2043421353
Title
Effect of levosimendan treatment in cardiac surgery: a network
meta-analysis of randomized controlled trials.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2026. Article
Number: 1673410. Date of Publication: 2026.
Author
Zhu B.; Zhao W.; Li Y.
Institution
(Zhu, Zhao, Li) Department of Pediatrics, West China Second University
Hospital, Sichuan University, Sichuan, Chengdu, China
Publisher
Frontiers Media SA
Abstract
Background: The prophylactic administration of levosimendan in patients
undergoing cardiac surgery remains clinically contentious, particularly
regarding its efficacy and safety in improving key postoperative outcomes,
such as cardiac function, renal protection, and mortality in high-risk
surgical populations. Existing randomized controlled trials (RCTs) are
heterogeneous in sample size, timing, and dosing of levosimendan and
comparator inotropes and have yielded neutral or conflicting results for
these endpoints. Moreover, prior meta-analyses have predominantly used
pairwise comparisons and have not systematically compared levosimendan
with all major inotropic alternatives (e.g., dobutamine, milrinone, and
standard therapy) across multiple clinically relevant outcomes. As a
result, the relative benefits and harms of levosimendan vs. other
perioperative inotropic strategies in cardiac surgery remain unclear. To
evaluate the potential benefits and risks of perioperative levosimendan
therapy, we conducted a systematic network meta-analysis of available
evidence. Method(s): A comprehensive literature search was conducted
in PubMed, Embase, the Cochrane Library, and other databases for RCTs
evaluating perioperative levosimendan vs. placebo or alternative inotropic
therapies, published up to 31 December 2024. Primary outcomes included
cardiac index, central venous pressure (CVP), mean arterial pressure
(MAP), intensive care unit (ICU) length of stay, and creatinine levels.
The frequentist surface under the cumulative ranking curve (SUCRA) was
calculated for each outcome to rank competing interventions.
 Result(s): A total of 29 RCTs encompassing 4,509 patients were
included. Levosimendan was associated with higher postoperative CI
[standardized mean difference (SMD) 1.16, 95% CI 0.04-2.29] compared with
placebo and lower postoperative MAP (SMD -0.93, 95% CI -1.62 to -0.23)
compared with dobutamine. Milrinone had lower CVP compared with dobutamine
(SMD -0.66, 95% CI -1.22 to -0.10) and placebo (SMD -0.46, 95% CI -0.83 to
-0.09), and levosimendan (SMD 0.40, 95% CI 0.05-0.75) had higher CVP
compared with milrinone. Both levosimendan (SMD -0.68, 95% CI -1.13 to
-0.24) and milrinone (SMD -0.71, 95% CI -1.25 to -0.17) significantly
shortened ICU stays compared with dobutamine. No significant differences
in creatinine levels were identified across interventions in the network
meta-analysis. Conclusion(s): Levosimendan improved postoperative
hemodynamic parameters, showing a higher cardiac index than placebo and
shorter ICU stays than dobutamine, but it did not provide significant
renal protection as assessed by creatinine levels. Systematic Review
Registration: https://www.crd.york.ac.uk/PROSPERO/recorddashboard,
identifier CRD42024612151. Copyright 2026 Zhu, Zhao and Li.

<46>
Accession Number
2037685802
Title
Is Papillotrema (Cryptococcus) laurentii an Emerging Concern? A Literature
Review and Case Series from a Tertiary Hospital.
Source
Mediterranean Journal of Infection, Microbes and Antimicrobials. 14(1) (no
pagination), 2025. Article Number: 24316.8. Date of Publication: 01 Jan
2025.
Author
Deniz M.T.; Arslan S.
Institution
(Deniz) Kocaeli University Faculty of Medicine, Department of Infectious
Diseases and Clinical Microbiology, Kocaeli, Turkey
(Arslan) Mus Bulanik State Hospital, Clinic of Infectious Diseases and
Clinical Microbiology, Mus, Turkey
Publisher
Galenos Publishing House
Abstract
Introduction: Cryptococcosis is a significant opportunistic fungal
infection, particularly affecting immunocompromised individuals.
Papillotrema laurentii has been increasingly reported in recent years,
especially in immunosuppressed patients. This study aims to provide
guidance on the diagnosis and treatment of P. laurentii-related infections
or colonization, along with a review of the existing literature.
 Material(s) and Method(s): Patients with P. laurentii isolated in any
culture sample between 2017 and 2022 were included in this study. A
literature search was conducted using the electronic databases Scopus, Web
of Science, MEDLINE (PubMed), and Google Scholar. Result(s): Over the
past 5 years, P. laurentii was identified in culture samples from nine
patients in our hospital. A literature review revealed 35 publications
reporting a total of 40 cases of P. laurentii infection between 1998 and
2022. The most common risk factors included the use of broad-spectrum
antibiotics and the presence of invasive devices or catheters.
 Conclusion(s): Although P. laurentii is considered a rare pathogen,
it can cause infections of various organ systems. Therefore, clinicians
should be aware that this uncommon fungal species may act as an infectious
agent, particularly in patients receiving broad-spectrum antibiotics or
steroid therapy. Copyright © 2025 The Author. Published by
Galenos Publishing House on behalf of Infectious Diseases and Clinical
Microbiology Specialty Society of Turkey.

<47>
Accession Number
2043436092
Title
STrategies for antithrombotic tRreatment following transcatheter
edge-to-edge repair in patients with severe mitral regurgitation:
Rationale and design of STAR-TEER trial.
Source
American Heart Journal. 296 (no pagination), 2026. Article Number: 107362.
Date of Publication: 01 Jun 2026.
Author
Liu Z.; Li Z.; Yan X.; Wang C.; Zhou N.; Zhang F.; Ouyang W.; Zhao G.; Ma
J.; Wang S.; Pan X.
Institution
(Wang, Liu, Li, Yan, Wang, Zhou, Zhang, Ouyang, Zhao, Ma, Wang, Pan)
Department of Structural Heart Disease, National Center for Cardiovascular
Disease, China and Fuwai Hospital Chinese Academy of Medical Sciences and
Peking Union Medical College, Beijing, China
(Wang, Liu, Li, Yan, Wang, Zhou, Zhang, Ouyang, Zhao, Ma, Wang, Pan) State
Key Laboratory of Cardiovascular Disease, Beijing, China
(Wang, Liu, Li, Yan, Wang, Zhou, Zhang, Ouyang, Zhao, Ma, Wang, Pan) Key
Laboratory of Innovative Cardiovascular Devices, Chinese Academy of
Medical Sciences, Beijing, China
(Wang, Liu, Li, Yan, Wang, Zhou, Zhang, Ouyang, Zhao, Ma, Wang, Pan)
National Clinical Research Center for Cardiovascular Diseases, Fuwai
Hospital Chinese Academy of Medical Sciences, Beijing, China
(Pan) Department of Structural Heart Disease, Fuwai Yunnan Cardiovascular
Hospital, Yunnan, Kunming, China
Publisher
Elsevier Inc.
Abstract
Background Transcatheter edge-to-edge repair (TEER) has emerged as an
important therapy for severe mitral regurgitation. Current guidelines lack
evidence-based recommendations for optimal postprocedural antithrombotic
strategies, leading to heterogeneous clinical practices. And there are no
randomized controlled trials (RCTs) available to compare different
antithrombotic strategies following TEER. Methods STAR-TEER trial is an
investigator-initiated, multicenter, randomized, parallel controlled,
open-label trial, aiming to assess the safety and efficacy of de-escalated
antithrombotic strategies with monotherapy in post-TEER patients with or
without indications for oral anticoagulation (OAC) respectively. This
trial plans to enroll 1,912 patients stratified into 2 cohorts: patients
in Cohort A (requiring long-term OAC, n = 880) will be randomized 1:1 to
rivaroxaban monotherapy or rivaroxaban plus clopidogrel, and patients in
Cohort B (no OAC indication, n = 1,032) will be randomized 1:1 to aspirin
monotherapy or aspirin plus clopidogrel. The primary outcome is all
bleeding complications within 12 months post-TEER. The 2 key secondary
outcomes are nonprocedure-related bleeding within 12 months post-TEER (key
secondary outcome 1) and a composite of ischemic events including
all-cause mortality, stroke, systemic embolism, and myocardial infarction
within 12 months post-TEER (key secondary outcome 2). A hierarchical
hypothesis testing will be performed, with the primary outcome and key
secondary outcome 1 tested for superiority, followed by the key secondary
outcome 2 tested for noninferiority. Conclusion The STAR-TEER trial is the
first large randomized controlled trial (RCT) to stratify patients based
on OAC indication and compare different antithrombotic strategies
following TEER in these 2 distinct cohorts. Trial Registration URL:
https://www.clinicaltrials.gov . Unique identifier: NCT06901466 (Cohort
A), NCT07007143 (Cohort B). Copyright © 2026 The Authors.

<48>
Accession Number
637495812
Title
Risk Factors for Acute Kidney Injury Requiring Renal Replacement Therapy
after Orthotopic Heart Transplantation in Patients with Preserved Renal
Function.
Source
Thoracic and Cardiovascular Surgeon. Conference: 51st Annual Meeting of
the German Society for Thoracic and Cardiovascular Surgery, DGTHG 2022.
Online. 70(SUPPL 1) (no pagination), 2022. Date of Publication: 03 Feb
2022.
Author
Mpembele R.; Roth S.; Stroda A.; Buse G.L.; Westenfeld R.; Tudorache I.;
Aubin H.; Akhyari P.; Lichtenberg A.; Huhn R.; Boeken U.
Institution
(Mpembele, Roth, Stroda, Buse, Westenfeld, Tudorache, Aubin, Akhyari,
Lichtenberg, Huhn, Boeken) University Hospital Duesseldorf, Dasseldorf,
Germany
Publisher
Georg Thieme Verlag
Abstract
Background:Acute kidney injury (AKI) requiring renal replacement therapy
(RRT) is a serious complication after orthotopic heart transplantation
(HTX),In patients with preexisting impaired renal function, postoperative
AKI is not surprising,However, even in patients with preserved renal
function, AKI requiring RRT is frequent,Therefore, this study aimed to
identify risk factors associated with postoperative AKI requiring RRT
after HTX in this sub-cohort,Method:This retrospective cohort study
included patients >=18 years who underwent HTX at the University Hospital
Duesseldorf, Germany, from 2010 to 2021,Preserved renal function was
defined as preoperative creatinine-based glomerular filtration rate >=60
mL/min,The association between all available patient-A nd
procedure-related factors with postoperative AKI requiring RRT within 72
hours after HTX was assessed in univariate logistic regression
models,Based on systematic literature research, most suitable significant
variables were included into multivariate logistic regression,Results:A
total of 206 patients were screened for this study,Thirteen patients had
hemodialysis prior to HTX and 86 patients had baseline GFR<60 mL/min,Based
on the inclusion and exclusion criteria, 107 patients remained for
statistical analysis (mean age: 52+/-12 years, 78.5% male, 45.8% AKI
requiring RRT),After univariate analysis, use of extracorporeal membrane
oxygenation, postoperative infection, levosimendan therapy, duration of
norepinephrine (NE) therapy, and maximum daily increase in tacrolimus
plasma levels were included into multivariate analysis,Duration of NE
therapy and maximum daily increase in tacrolimus plasma levels remained as
independent significant risk factors (NE: OR 1.01, 95% CI:
1.00-1.02,p=0.005; increase in tacrolimus plasma level: OR 1.18, 95% CI:
1.01-1.37,p=0.036),In addition, there was a nonsignificant trend for
VA-ECMO due to primary graft dysfunction after HTX (OR: 4.54, 95% CI:
0.96-21.43;p=0.056),Conclusion:This retrospective cohort study identified
prolonged NE therapy and maximum daily increase in tacrolimus plasma
levels as risk factors for AKI requiring RRT in HTX patients with
preserved renal function,These results are clinically relevant and new
therapeutic approaches for HTX patients are urgently needed,In this
context, the role of calcineurin inhibitor free induction therapy or
extended release tacrolimus should be investigated.

<49>
Accession Number
2043457224
Title
Simulation in robotic-assisted thoracic surgery: a systematic review.
Source
Journal of Robotic Surgery. 20(1) (no pagination), 2026. Article Number:
296. Date of Publication: 01 Dec 2026.
Author
Walji H.D.; de Rosenzweig P.G.-D.S.; Jesani H.; Martin-Ucar A.;
Hernandez-Arenas L.
Institution
(Walji, de Rosenzweig, Jesani, Martin-Ucar, Hernandez-Arenas) Department
of Cardio-Thoracic Surgery, University Hospitals Coventry and
Warwickshire, Clifford Bridge Road, Coventry, United Kingdom
Publisher
Springer Nature
Abstract
Method: A literature search was conducted across three databases using
terms: robot* AND simulat* AND thora* OR chest* from January 2010 to
December 2025. Themes regarding development of a robotic surgical program
were identified. The papers were critically appraised and scored using the
MMERSQI tool. Result(s): Out of 455 articles, 24 full-text articles
were reviewed, and ten included in the final review. Three themes emerged:
competency assessment, skills development, and MDT education. Studies
indicated minimally invasive surgery skills can predict robotic skill
acquisition. There is conflicting evidence on whether simulation sets a
benchmark for competency or enhances surgical skills. Translation of
improvements from simulation to clinical practice remains unclear.
Simulation was also highlighted as a method to ensure team members develop
together and offer organisations learning opportunities.
 Conclusion(s): Recommendations on incorporating simulation into a
RATS program include: prioritize surgeons experienced in minimally
invasive techniques for early introduction to RATS via simulation; avoid
using simulation benchmarking as the sole marker of competence; use
virtual simulation-based learning for familiarity with robotic systems but
do not accept it as surgical experience for certification; and emphasize
MDT simulation for improved teamwork and organizational
learning. Copyright © The Author(s), under exclusive licence to
Springer-Verlag London Ltd., part of Springer Nature 2026.

<50>
Accession Number
650153225
Title
Direct oral anticoagulants versus vitamin K antagonists for postoperative
atrial fibrillation after cardiac surgery: a systematic review and
meta-analysis of randomized controlled trials.
Source
BMC cardiovascular disorders. 26(1) (no pagination), 2026. Date of
Publication: 04 Feb 2026.
Author
Ahmed O.A.O.; Abbas M.; Ahmed A.A.O.; Ibrahim M.A.A.; Abakar M.E.M.; Yasir
E.; Edris M.E.E.; Ahmed R.A.O.; Babkir M.; Abdulaziz M.A.M.; Sota H.A.;
Gilbert C.; Eissa A.A.
Institution
(Ahmed, Abdulaziz) Faculty of Medicine, University of Khartoum, Khartoum,
Sudan
(Abbas, Yasir, Edris, Ahmed, Ahmed) Faculty of Medicine, National Ribat
University, Khartoum, Sudan
(Ahmed) Faculty of Medicine, National Ribat University, Khartoum, Sudan
(Ibrahim, Abakar, Babkir) Faculty of Medicine, Sudan International
University, Khartoum, Sudan
(Sota, Gilbert) St. Georges University, St. Georges, Grenada
(Eissa) Ain Shams University, Cairo, Egypt

<51>
Accession Number
637470837
Title
Acquired von Willebrand's syndrome in congenital heart disease.
Source
Thoracic and Cardiovascular Surgeon. Conference: 54th Annual Meeting of
the German Society for Pediatric Cardiology, DGPK 2022. Online. 70(SUPPL
2) (no pagination), 2022. Date of Publication: 12 Feb 2022.
Author
Icheva V.; Ebert J.; Budde U.; Wiegand G.; Schober S.; Engel J.; Kumpf M.;
Jaschonek K.; Neunhoeffer F.; Michel J.; Schlensak C.; Hofbeck M.; Magunia
H.
Institution
(Icheva, Schober) Universtiy Childrens' Hospital Tubingen, Tubingen,
Germany
(Ebert) Faculty of Medicine, Eberhard Karls University, Tubingen, Germany
(Budde) cMEDILYS Coagulation Lab mbH, Hamburg, Germany
(Wiegand, Kumpf) Department of Pediatric Cardiology, University of
Tuebingen, Tuebingen, Germany
(Engel, Michel) Department of Pediatric Cardiology, University Childrens'
Hospital Tubingen, Tuebingen, Germany
(Jaschonek) Department of Medical Oncology and Pneumology (Internal
Medicine VIII), University Hospital Tubingen, Tuebingen, Germany
(Neunhoeffer) Abteilung fur Kinderkardiologie, Pulmologie,Intensivmedizin,
Tubingen, Germany
(Schlensak) Hoppe-Seyler-Strase 3, Tabingen, Germany
(Hofbeck) Hoppe-Seyler-Str. 1, Tubingen, Germany
(Magunia) Department of Anesthesiology and Intensive Care Medicine,
Tubingen, Germany
Publisher
Georg Thieme Verlag
Abstract
Background: The aVWS (acquired von Willebrand's syndrome) has been
reported in association with congenital heart diseases (CHD) causing high
shear. Its incidence and impact on intraoperative bleeding have not been
systematically evaluated by now. This was also due to the lack of methods
for rapid testing under intraoperative conditions. Method(s): This
prospective observational single-center pilot trial searched for
appropriate diagnostic tools and predictors of aVWS in neonates and
infants with CHD undergoing cardiac surgery. The study aimed to clarify to
which extent aVWS contributes to intraoperative hemorrhage.
 Result(s): A total of 65 infants, categorized into four groups
according to the type of surgery, could be included in the study.
Intraoperative high molecular weight multimers (HMWM) ratio was inversely
correlated with duration of cardiopulmonary bypass (r = -0.55) and aortic
cross clamp time (r = -0.49) but showed weaker correlations with surrogate
bleeding parameters such as quantity of supplemented platelets (r =
-0.28), fibrinogen (r = -0.34), and fresh frozen plasma (r = -0.35). The
GP1bM/VWF:Ag ratio provided meaningful predictability of aVWS (AUC = 0.81)
with good correlation to HMWM ratio (r = 0.64). The aVWS positive patients
in the neonatal group had longer chest closure times compared with aVWS
negative patients (146 [118-174] vs. 95 [74-115] min, p = 0,016).
 Conclusion(s): CPB triggers aVWS in pediatric cardiac surgery. The
aVWS is not a major cause of bleeding after cardiac surgery, but its
correction might be beneficial in selected cases. The GP1bM/VWF:Ag ratio
is feasible for rapid aVWS diagnostics and should be implemented in the
routine hemostatic workup of complex CHD surgery. A cut-off value of 0.85
is proposed as a basis for further prospective randomized trials
evaluating the effect of von Willebrand's factor supplementation on
intraoperative bleeding.

<52>
Accession Number
644447461
Title
Association between lipoprotein levels and outcomes after coronary artery
bypass grafting surgery: a systematic review and meta-analysis.
Source
Minerva cardiology and angiology. 74(1) (pp 128-134), 2026. Date of
Publication: 01 Feb 2026.
Author
Cancelli G.; Harik L.; Ibrahim M.; Hameed I.; Rossi C.; Caldonazo T.;
Dell'aquila M.; Soletti G.J.; An K.R.; Leith J.; Demetres M.; Dimagli A.;
Gaudino M.F.
Institution
(Cancelli, Harik, Rossi, Caldonazo, Dell'aquila, Soletti, An, Leith,
Dimagli) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New
York, NY, USA
(Ibrahim) Department of General Surgery, Maimonides Medical Center,
Brooklyn, NY, United States
(Hameed) Department of Cardiothoracic Surgery, Yale University School of
Medicine, New Haven, CT, United States
(Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information
Center, Weill Cornell Medicine, New York, NY, USA
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, USA - mfg9004@med.cornell.edu
Abstract
INTRODUCTION: Lipoprotein(a) (Lp[a]) is a variant of low-density
lipoprotein (LDL) and has been associated with increased risk of vascular
inflammation and thrombosis. Coronary artery bypass grafting (CABG) has
been associated with local inflammation of the myocardium. It is
plausible, therefore, that patients with elevated baseline Lp(a) may be
prone to unfavorable clinical outcomes following CABG. We evaluate
differences in outcomes between CABG patients with high and low serum
Lp(a) in this meta-analysis. EVIDENCE ACQUISITION: A comprehensive
literature search was performed to identify studies reporting outcomes in
CABG patients stratified by preoperative Lp(a) level. When possible, the
outcomes were pooled in a meta-analysis. We assessed post-operative
mortality, major cardiovascular events, stroke occurrence and saphenous
graft occlusion. EVIDENCE SYNTHESIS: Eight studies involving 8681 patients
were included. Articles used varying cut-offs for high versus low Lp(a),
and outcomes varied. In the three studies evaluating mortality, two showed
no statistically significant difference between groups while one reported
increased mortality associated with high Lp(a) level. Both studies
investigating major adverse cardiovascular events reported higher risk in
patients with high Lp(a). A study-level meta-analysis of four studies
reporting saphenous vein graft occlusion incidence after CABG was
performed. High (>=30 mg/dL) preoperative Lp(a) was not associated with an
increased risk of graft occlusion compared with low (<30 mg/dL)
preoperative Lp(a) (OR=1.88, 95% CI: 0.66-5.36; P=0.15).
 CONCLUSION(S): Studies evaluating the impact of Lp(a) on outcomes in
CABG patients are few, with heterogenous cut-offs and outcomes. In the
limited published studies, Lp(a) level was not associated with graft
occlusion.

<53>
Accession Number
648091967
Title
Optimal 6-hour window for salvaged mediastinal blood retransfusion after
cardiovascular surgery: an in vitro quality and safety analysis.
Source
Blood transfusion = Trasfusione del sangue. 24(2) (pp 129-138), 2026. Date
of Publication: 01 Mar 2026.
Author
Shan J.; Gao J.; Chen Y.; Ji H.
Institution
(Shan, Gao, Chen, Ji) Department of Anesthesiology, Fuwai Hospital,
Chinese Academy of Medical Sciences and Peking Union Medical College,
Beijing, China
(Ji) Department of Anesthesiology, Chinese Academy of Medical Sciences
Fuwai Hospital Shenzhen Hospital, Guangdong, China
Abstract
BACKGROUND: Postoperative hemorrhage is a significant complication of
cardiovascular surgery. Although autologous cell salvage is safe and
effective for preserving patients' blood, its use in the postoperative
context remains underexplored. We, therefore, evaluated the quality and
safety of mediastinal blood collected for different periods at room
temperature after cardiac surgery. MATERIALS AND METHODS: In this
preclinical, in vitro investigation, 60 patients who lost >=500 mL
mediastinal blood within 6 hours after cardiovascular surgery were
randomized into three groups (6H, 8H, 12H) according to the time the shed
mediastinal blood was processed. The quality of the salvaged blood was
evaluated through measurements of hematocrit, pH, electrolyte and lactate
levels, 2,3-diphosphoglycerate (2,3-DPG) and adenosine triphosphate (ATP)
content, and red blood cell (RBC) deformability and morphology. The safety
evaluations included hemolysis, contamination, and levels of inflammatory
cytokines. RESULT(S): With regard to quality, the median [IQR] values
for the 6H group were hematocrit 56.3 [46.5-59.0] %, pH 7.34 [7.31-7.40]),
potassium 1.10 [0.91-1.25] mmol/L, lactate 0.45 [0.20-0.90] mmol/L,
2,3-DPG 12.00 [9.24-13.32] mumol/gHb), ATP 5.59 [5.27-5.93] mumol/gHb and
deformability 0.88 [0.77-0.93]. The values were similar across the three
groups, except for pH, which decreased over collection period. RBC
morphology transitioned from biconcave in the 6H and 8H groups to spiny
forms in the 12H group. Hemolysis and inflammatory cytokine levels were
low in all groups. Only the 6H group achieved total microbial sterility,
with 0% bacterial contamination, compared to 10% (No.=2) in the 8H group
and 5% (No.=1) in the 12H group. DISCUSSION(S): Our study establishes
a 6-hour window as the optimal period for ensuring microbial sterility and
preserving the quality and safety of salvaged mediastinal blood
postoperatively. Although blood quality remained stable for up to 12
hours, the heightened risk of contamination beyond 6 hours necessitates
rigorous microbiological monitoring.

<54>
Accession Number
648546522
Title
Effect of vitamin D on postoperative atrial fibrillation in patients
undergoing coronary artery bypass grafting: a systematic review and
meta-analysis.
Source
Minerva cardiology and angiology. 74(1) (pp 75-82), 2026. Date of
Publication: 01 Feb 2026.
Author
Nisa F.; Nauman H.M.; Lal P.K.; Assad A.A.; Arain M.; Ali R.; Saleem H.M.;
Shafiq F.; Farooq A.U.; Zeb M.A.; Ijaz H.; Laeeq F.; Ibrahim M.; Arshad
M.S.
Institution
(Nisa) Department of Medicine, Fatima Jinnah Medical University, Lahore,
Pakistan
(Nauman) Department of Medicine, Shaikh Khalifa Bin Zayed Al-Nahyan
Medical and Dental College, Lahore, Pakistan
(Lal) Department of Medicine, Dow International Medical College, Dow
University of Health Sciences, Karachi, Pakistan
(Assad, Saleem) Department of Medicine, Allama Iqbal Medical College,
Lahore, Pakistan
(Arain, Arshad) Department of Medicine, Dow University of Health Sciences,
Karachi, Pakistan
(Ali) Department of Medicine, People University of Medical and Health
Sciences SBA, Nawabshah, Pakistan
(Shafiq) Department of Medicine, Karachi Medical and Dental College,
Karachi, Pakistan
(Farooq, Ijaz) Department of Medicine, King Edward Medical University,
Lahore, Pakistan
(Zeb) Department of Medicine, Swat Medical College, Khyber Pakhtunkhwa,
Pakistan
(Laeeq) Department of Medicine, Shalamar Medical and Dental College,
Lahore, Pakistan
(Ibrahim) Department of Medicine, Ziauddin University, Karachi, Pakistan
Abstract
INTRODUCTION: The aim of this paper was to determine whether vitamin D
supplementation reduces the incidence of postoperative atrial fibrillation
(POAF) in patients undergoing coronary artery bypass grafting (CABG).
EVIDENCE ACQUISITION: PubMed and Cochrane Central Register of Controlled
Trials were systematically searched from inception through May 2023 for
randomized controlled trials (RCTs) assessing the effectiveness of Vitamin
D in preventing atrial fibrillation among postoperative patients after
CABG. EVIDENCE SYNTHESIS: The primary outcome extracted was the incidence
of atrial fibrillation after Vitamin D in CABG patients. Secondary outcome
included the length of hospital stay. Data were pooled using a
random-effect model. A total of 4 RCTs, involving 694 patients, were
included in the final analysis. The results showed that Vitamin D
supplementation significantly reduced the incidence of POAF in CABG
patients (RR: 0.55; 95% CI: 0.40 to 0.76; P=0.0003; I2=1%). However,
administration of Vitamin D did not lead to significant reduction in the
length of hospital stay (WMD: -0.14; 95% CI: -0.82 to 0.53; P=0.68;
I2=34%). CONCLUSION(S): Our updated pooled analysis concludes that
vitamin D reduces the incidence of POAF in CABG patients. Future
large-scale studies should focus on more diverse patient populations and
explore a broader range of outcomes to better understand the full impact
of Vitamin D supplementation in this context.

<55>
Accession Number
2024278697
Title
Hydroxocobalamin for Vasodilatory Hypotension in Shock: A Systematic
Review With Meta-Analysis for Comparison to Methylene Blue.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 37(9) (pp 1757-1772),
2023. Date of Publication: 01 Sep 2023.
Author
Brokmeier H.M.; Seelhammer T.G.; Nei S.D.; Gerberi D.J.; Mara K.C.;
Wittwer E.D.; Wieruszewski P.M.
Institution
(Brokmeier, Nei, Wieruszewski) Department of Pharmacy, Mayo Clinic,
Rochester, MN
(Seelhammer, Wittwer, Wieruszewski) Department of Anesthesiology, Mayo
Clinic, Rochester, MN
(Gerberi) Mayo Medical Libraries, Mayo Clinic, Rochester, MN
(Mara) Department of Quantitative Health Sciences, Division of Clinical
Trials and Biostatistics, Mayo Clinic, Rochester, MN
Publisher
W.B. Saunders
Abstract
Hydroxocobalamin inhibits nitric oxide-mediated vasodilation, and has been
used in settings of refractory shock. However, its effectiveness and role
in treating hypotension remain unclear. The authors systematically
searched Ovid Medline, Embase, EBM Reviews, Scopus, and Web of Science
Core Collection for clinical studies reporting on adult persons who
received hydroxocobalamin for vasodilatory shock. A meta-analysis was
performed with random-effects models comparing the hemodynamic effects of
hydroxocobalamin to methylene blue. The Risk of Bias in Nonrandomized
Studies of Interventions tool was used to assess the risk of bias. A total
of 24 studies were identified and comprised mainly of case reports (n =
12), case series (n = 9), and 3 cohort studies. Hydroxocobalamin was
applied mainly for cardiac surgery vasoplegia, but also was reported in
the settings of liver transplantation, septic shock, drug-induced
hypotension, and noncardiac postoperative vasoplegia. In the pooled
analysis, hydroxocobalamin was associated with a higher mean arterial
pressure (MAP) at 1 hour than methylene blue (mean difference 7.80, 95% CI
2.63-12.98). There were no significant differences in change in MAP (mean
difference -4.57, 95% CI -16.05 to 6.91) or vasopressor dosage (mean
difference -0.03, 95% CI -0.12 to 0.06) at 1 hour compared to baseline
between hydroxocobalamin and methylene blue. Mortality was also similar
(odds ratio 0.92, 95% CI 0.42-2.03). The evidence supporting the use of
hydroxocobalamin for shock is limited to anecdotal reports and a few
cohort studies. Hydroxocobalamin appears to positively affect hemodynamics
in shock, albeit similar to methylene blue. Copyright © 2023
Elsevier Inc.

<56>
Accession Number
2044019324
Title
Effectiveness and safety of antifibrinolytic agents in off-pump coronary
artery bypass grafting: a systematic review and meta-analysis.
Source
Brazilian Journal of Anesthesiology (English Edition). 76(2) (no
pagination), 2026. Article Number: 844731. Date of Publication: 01 Mar
2026.
Author
Marchesani J.L.W.C.; Leite e Silva M.H.; Thomaz M.S.; Wolff D.B.; Almeida
E.C.L.; Costa M.D.S.S.
Institution
(Marchesani, Leite e Silva, Thomaz, Wolff, Almeida) Faculdade de Medicina
da Universidade Federal de Minas Gerais, MG, Belo Horizonte, Brazil
(Costa) Faculdade de Medicina da Universidade Federal de Minas Gerais,
Department of Surgery, MG, Belo Horizonte, Brazil
Publisher
Elsevier Editora Ltda
Abstract
Background: Coronary Artery Bypass Grafting (CABG) is the most widely used
cardiac intervention and can be accomplished without an extracorporeal
circulation off-pump. The benefits of antifibrinolytics in off-pump CABG
have yet to be demonstrated. Method(s): Randomized Controlled Trials
(RCTs) and observational studies comparing the use of antifibrinolytic
agents (tranexamic acid, aprotinin, and epsilon-aminocaproic) versus
controls in patients undergoing off-pump CABG were searched in the PubMed,
Embase, and Cochrane databases. Outcomes included thromboembolic events,
in-hospital mortality, overall mortality, bleeding, Intensive Care Unit
(ICU) length of stay, and blood product transfusions. Meta-analyses were
conducted using the Inverse Variance method under a random-effects model,
with p < 0.05 considered statistically significant. Result(s): Of the
23,149 patients in 20 RCTs and seven observational studies, 51% received
antifibrinolytic agents (tranexamic acid or aprotinin). Observational and
randomized designs were analyzed separately in primary subgroup analyses.
Significant reduction was found for overall mortality (RR = 0.72; [95% CI
0.54-0.95]) in the RCT subgroup. Red-blood-cell transfusion requirements
were reduced (RR = 0.65; [95% CI 0.53, 0.78]) as well as Platelets (RR =
0.59; [95% CI 0.41, 0.84]) and fresh-frozen-plasma (RR = 0.39; [95% CI
0.36, 0.42]) transfusion requirement. The RCT subgroup showed a reduction
in thromboembolic events (RR = 0.55; [95% CI 0.39, 0.79]).
 Conclusion(s): In off-pump CABG, antifibrinolytics reduced the need
for blood transfusion while reducing thromboembolic events and overall
mortality in RCT subgroups, while pooled analyses combining RCTs and
observational studies did not demonstrate significant reductions. Prospero
Link:
https://www.crd.york.ac.uk/PROSPERO/view/CRD42024545640 Copyright
© 2026 Sociedade Brasileira de Anestesiologia

<57>
Accession Number
2042381898
Title
Inclusion of Retracted Studies in a Systematic Review and Meta-Analysis of
Prophylactic Dexmedetomidine and Postoperative Junctional Ectopic
Tachycardia in Pediatric Cardiac Surgery Patients.
Source
Paediatric Anaesthesia. 36(4) (pp 458-460), 2026. Date of Publication: 01
Apr 2026.
Author
Feinstein M.M.; Levy R.J.; Ing C.
Institution
(Feinstein, Levy, Ing) Department of Anesthesiology, Columbia University
Vagelos College of Physicians and Surgeons, New York, NY, United States
(Ing) Department of Epidemiology, Mailman School of Public Health, New
York, NY, United States
Publisher
John Wiley and Sons Inc

<58>
Accession Number
2043762986
Title
Factor XI inhibitors versus direct oral anticoagulants for the prevention
of thromboembolic events and safety in patients with atrial fibrillation:
A systematic review and meta-analysis of randomized controlled trials.
Source
Heart and Lung. 78 (no pagination), 2026. Article Number: 102739. Date of
Publication: 01 Jul 2026.
Author
de Alcantara J.P.T.L.; Gotz G.W.X.D.R.; Amaral P.E.O.; Cecchetti G.;
Marques G.L.
Institution
(de Alcantara, Gotz, Amaral) School of Medicine, Pontifical Catholic
University of Parana, Brazil
(Cecchetti) Department of Hematology, Clinical Hospital of the Federal
University of Parana, Brazil
(Marques) Department of Cardiology and Internal Medicine, Clinical
Hospital of the Federal University of Parana, Brazil
Publisher
Elsevier Inc.
Abstract
Background: While DOACs - Direct Oral Anticoagulants are the current
standard for stroke prevention, nearly 30-50% of eligible patients remain
untreated or undertreated due to perceived or actual bleeding risk.
Therefore, evaluating agents that potentially uncouple antithrombotic
efficacy from hemostasis is a clinical priority. Factor XI/XIa (FXI/XIa)
inhibitors are proposed to reduce bleeding while maintaining
antithrombotic efficacy. Objective(s): We aimed to compare the
efficacy and safety of FXI/XIa inhibitors versus DOACs in patients with
AF. Method(s): We conducted a systematic review and meta-analysis of
randomized controlled trials (RCTs) comparing FXI/XIa inhibitors with
DOACs in adults with AF. Databases including MEDLINE, Embase, and Scopus
were searched until February 28, 2025. The study protocol was
prospectively registered in PROSPERO (CRD420251045353). The primary
outcome was ISTH major bleeding. Secondary outcomes included ischemic
stroke, clinically relevant non-major (CRNM) bleeding, and all-cause
mortality. Random-effects models were used to pool odds ratios (ORs) and
95% confidence intervals (CIs). Heterogeneity was assessed using I2.
 Result(s): Four RCTs (OCEANIC-AF, AZALEA-TIMI 71, PACIFIC-AF, and
LIBREXIA-AF [design protocol]) involving 16,852 patients were included in
the qualitative synthesis, with data from three trials contributing to
quantitative meta-analyses. Compared to DOACs, FXI/XIa inhibitors were
associated with a significant reduction in ISTH major bleeding (0.40% vs.
1.32%; OR 0.30, 95% CI 0.20-0.43; P < 0.001; I2=0%) and CRNM bleeding
(1.53% vs. 3.94%; OR 0.38, 95% CI 0.30-0.47; P < 0.001; I2=0%). However,
FXI/XIa inhibitors were associated with a significantly increased risk of
ischemic stroke (1.12% vs. 0.35%; OR 3.20, 95% CI 1.85-5.55; P = 0.004;
I2=0%). A modest but statistically significant reduction in all-cause
mortality was observed (1.37% vs. 1.68%; OR 0.81, 95% CI 0.69-0.95; P =
0.021; I2=0%). Conclusion(s): In patients with atrial fibrillation,
Factor XI/XIa inhibitors significantly reduce major and clinically
relevant non-major bleeding compared to DOACs but are associated with an
increased risk of ischemic stroke. While a modest reduction in all-cause
mortality was noted, the unfavorable efficacy profile for stroke
prevention raises concerns about the net clinical benefit of the currently
evaluated FXI/XIa inhibitors in this population. Further data from ongoing
large-scale trials are needed to define their ultimate clinical
role. Copyright © 2026

<59>
Accession Number
2043665789
Title
Left ventricular systolic recovery after TAVI in severe aortic stenosis: A
systematic review and meta-analysis.
Source
International Journal of Cardiology: Cardiovascular Risk and Prevention.
29 (no pagination), 2026. Article Number: 200610. Date of Publication: 01
Jun 2026.
Author
Hasabo E.A.; Elgadi A.; Ahmed A.S.; Alfadul E.S.A.; Hemmeda L.; Elnaiem
W.; Qasba R.K.; Elzomor H.; Sawabi R.; Baqal O.; Ruck A.; Saleh N.;
Soliman O.
Institution
(Hasabo, Soliman) Royal College of Surgeons in Ireland (RCSI) University
of Medicine and Health Sciences, Dublin, Ireland
(Hasabo, Sawabi, Soliman) Cardiovascular Research Institute Dublin, and
Department of Cardiology, Mater Private Network, Dublin, Ireland
(Elgadi, Ahmed, Alfadul, Hemmeda, Elnaiem) Faculty of Medicine, University
of Khartoum, Khartoum, Sudan
(Qasba) Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
(Qasba) Green Life Medical College and Hospital, Dhaka, Bangladesh
(Elzomor) Department of Cardiology, University of Galway, Galway, Ireland
(Baqal) Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ,
United States
(Ruck, Saleh) Department of Cardiology, Karolinska University Hospital,
Stockholm, Sweden
(Soliman) Euro Heart Foundation, Netherlands
Publisher
Elsevier B.V.
Abstract
Background Severe aortic stenosis (AS) imposes chronic pressure overload
on the left ventricle (LV), leading to adverse remodeling and systolic
dysfunction. While transcatheter aortic valve implantation (TAVI) can
reverse this process, the overall prevalence and predictors of LV
functional recovery are not fully understood. This study aims to assess
the left ventricular ejection fraction (LVEF) recovery following TAVI.
Methods A meta-analysis was conducted in accordance with PRISMA
guidelines. The PubMed, Scopus, Web of Science, and Cochrane databases
were searched from inception through November 2024 for studies reporting
on LVEF improvement after TAVI in patients with severe AS. The primary
outcome was LVEF improvement, defined as an absolute increase of >=10%
from baseline. A random-effects model was employed for all pooled analyses
to account for inter-study heterogeneity. Results Eighteen studies
encompassing 4782 patients met the inclusion criteria. In the subgroup of
patients with reduced LVEF, 14 studies with a total of 3182 patients
reported a LV systolic recovery of 49% (95% CI: 40-57; I2 = 97%). The
recovery was observed across all follow-up periods, from immediately
post-procedure to one-year. A meta-regression has identified that baseline
LVEF is a predictor of LV systolic recovery (beta = -0.042 (95% CI:
[-0.075, -0.008], p = 0.018, I2 = 93.31%). Conclusions TAVI is associated
with substantial LV systolic recovery in nearly half of all patients with
pre-existing systolic dysfunction. These findings underscore the
prognostic importance of myocardial recovery in this high-risk patient
population and can inform clinical decision-making and patient
counseling. Copyright © 2026. Published by Elsevier B.V.

<60>
Accession Number
2043091456
Title
Associations of Perfluoroalkyl and Polyfluoroalkyl Substances With
Cardiovascular Disease Incidence in Adults With Prediabetes: Findings From
the Diabetes Prevention Program.
Source
Journal of the American Heart Association. 15(1) (no pagination), 2025.
Article Number: e046298. Date of Publication: 18 Dec 2025.
Author
Lin P.-I.D.; Cardenas A.; Temprosa M.; Botelho J.C.; Calafat A.M.; Gold
D.R.; Oken E.; Fleisch A.F.
Institution
(Lin, Oken) Division of Chronic Disease Research Across the Lifecourse,
Department of Population Medicine, Harvard Medical School and Harvard
Pilgrim Health Care Institute, Boston, MA, United States
(Cardenas) Department of Epidemiology and Population Health, Stanford
University, Stanford, CA, United States
(Temprosa) Department of Biostatistics and Bioinformatics and
Biostatistics Center, Milken Institute School of Public Health, the George
Washington University, Washington, DC, United States
(Botelho, Calafat) Division of Laboratory Sciences, National Center for
Environmental Health, Centers for Disease Control and Prevention, Atlanta,
GA, United States
(Gold) Department of Environmental Health, Harvard T.H. Chan School of
Public Health, Boston, MA, United States
(Gold) Channing Division of Network Medicine, Brigham and Women's
Hospital, Harvard Medical School, Boston, MA, United States
(Oken) Department of Nutrition, Harvard T.H. Chan School of Public Health,
Boston, MA, United States
(Fleisch) Center for Interdisciplinary Population & Health Research,
MaineHealth Institute for Research, Westbrook, ME, United States
(Fleisch) Pediatric Endocrinology and Diabetes, Maine Medical Center,
Portland, ME, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are
persistent, widespread environmental contaminants linked to
cardiometabolic outcomes including obesity, hyperlipidemia, and diabetes.
We examined whether baseline plasma PFAS concentrations are associated
with incident cardiovascular disease (CVD) in adults with prediabetes,
leveraging data from DPPOS (Diabetes Prevention Program Outcomes Study).
 METHOD(S): Among 1382 participants, we quantified baseline plasma
concentrations of 6 PFAS. We used Cox proportional hazards models to
estimate the risks of developing CVD outcomes during a median of 21 years
of follow-up for each PFAS and used quantile g-computation to evaluate the
joint effect of all 6 PFAS. Effect modification by age, sex, menopausal
status, diet, and physical activity was explored. RESULT(S): The
incidence of major adverse cardiovascular events was 9.6%; 3.9% had
CVD-related death. Each increase in interquartile range (1.1 ng/mL) in
2-(N-methyl-perfluorooctane sulfonamido) acetate was associated with a 16%
higher risk of major adverse cardiovascular events (95% CI, 1-33%) and a
24% higher risk of CVD death (95% CI, 2-52%). Higher concentrations of
perfluorohexane sulfonate, perfluorooctane sulfonate,
2-(N-ethyl-perfluorooctane sulfonamido) acetate, and perfluorooctanoate
were associated with greater risk of CVD outcomes, including nonfatal
myocardial infarction, hospitalized congestive heart failure, and
cardiovascular death. However, PFAS mixture was not associated with CVD.
Age, sex, treatment arm, physical activity, and diet did not modify the
associations of individual PFAS. CONCLUSION(S): In adults with
prediabetes, higher plasma concentrations of select PFAS, but not their
mixture, were prospectively associated with increased CVD risk. These
findings underscore PFAS as a potential environmental risk factor for CVD
in high-risk populations. REGISTRATION: URL: https://clinicaltrials.gov/;
Unique identifiers: NCT00004992 and NCT00038727. Copyright © 2025
The Author(s). Published on behalf of the American Heart Association,
Inc., by Wiley. This is an open access article under the terms of the
Creative Commons Attribution-NonCommercial-NoDerivs License, which permits
use and distribution in any medium, provided the original work is properly
cited, the use is non-commercial and no modifications or adaptations are
made.

<61>
Accession Number
2038177480
Title
SAPIEN 3 versus Myval transcatheter heart valves for transcatheter aortic
valve implantation (COMPARE-TAVI 1): a multicentre, randomised,
non-inferiority trial.
Source
The Lancet. 405(10487) (pp 1362-1372), 2025. Date of Publication: 19 Apr
2025.
Author
Terkelsen C.J.; Freeman P.; Dahl J.S.; Thim T.; Norgaard B.L.; Mogensen
N.S.B.; Tang M.; Eftekhari A.; Povlsen J.A.; Poulsen S.H.; Pedersen L.;
Hjort J.; Ellert J.; Christiansen E.H.; Sorensen H.T.; Nissen H.
Institution
(Terkelsen, Thim, Norgaard, Povlsen, Poulsen, Christiansen) Department of
Cardiology, Aarhus University Hospital, Aarhus, Denmark
(Hjort) Department of Clinical Medicine, Aarhus University Hospital,
Aarhus, Denmark
(Tang) Department of Cardiothoracic and Vascular Surgery, Aarhus
University Hospital, Aarhus, Denmark
(Freeman, Eftekhari) Department of Cardiology, Aalborg University
Hospital, Aalborg, Denmark
(Dahl, Mogensen, Ellert, Nissen) Department of Cardiology, Odense
University Hospital, Odense, Denmark
(Pedersen, Sorensen) Department of Clinical Epidemiology, Aarhus
University Hospital and Aarhus University, Aarhus, Denmark
Publisher
Elsevier B.V.
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is a
guideline-directed treatment for severe aortic stenosis and degenerated
aortic bioprostheses. When new transcatheter heart valve (THV) platforms
for TAVI are launched, they should be compared with best-in-practice
contemporary THVs for their short-term and long-term performance. The
COMPARE-TAVI 1 trial was designed to provide a head-to-head comparison of
the SAPIEN 3 or SAPIEN 3 Ultra THVs and the Myval or Myval Octacor THVs.
 Method(s): This multicentre, all-comers, randomised, non-inferiority
trial was done at three university hospitals in Denmark. Eligible patients
were aged 18 years or older, scheduled for transfemoral TAVI, and eligible
for treatment with SAPIEN 3 THVs or Myval THVs. Patients were randomly
assigned (1:1) to treatment with SAPIEN 3 (29 mm diameter) or SAPIEN 3
Ultra (20 mm, 23 mm, or 26 mm diameter) THVs or Myval or Myval Octacor
THVs (20-32 mm diameter). The TAVI procedure was performed according to
local practice and under local anaesthesia unless leaflet laceration was
performed. The primary endpoint was a composite of death, stroke, moderate
or severe aortic regurgitation, or moderate or severe haemodynamic THV
deterioration at 1 year according to Third Valve Academic Research
Consortium criteria. All patients assigned to THV treatment were included
in the intention-to-treat analysis, and all patients who were treated as
randomly assigned were included in the per-protocol analysis. With an
expected event rate of 13%, the prespecified non-inferiority margin was
5.3%. This trial is registered with ClinicalTrials.gov, NCT04443023, and
is closed to accrual. Finding(s): Between June 15, 2020, and Nov 3,
2023, 1031 patients were enrolled. Enrolment was paused twice because of
patent-related legal proceedings. Of 1031 patients, 517 patients were
randomly assigned to SAPIEN 3 THVs and 514 to Myval THVs. The median
patient age was 81.6 years (IQR 77.6-85.0), and 415 (40%) of 1031 patients
were female and 616 (60%) were male. The primary endpoint occurred in 67
(13%) of 517 patients randomly assigned to SAPIEN 3 THVs versus 71 (14%)
of 514 patients randomly assigned to Myval THVs (risk difference -0.9%
[one-sided upper 95% CI 4.4%]; p<inf>non-inferiority</inf>=0.019).
 Interpretation(s): Myval THVs were non-inferior to SAPIEN 3 THVs in
terms of a 1-year composite endpoint of death, stroke, moderate or severe
aortic regurgitation, or moderate or severe haemodynamic THV
deterioration. Funding(s): Meril Life Sciences, Vingmed Denmark, the
Danish Heart Foundation, and the Central Denmark Region. Copyright
© 2025 Elsevier Ltd

<62>
Accession Number
2042910521
Title
Pressure Monitoring-Augmented Long-Axis In-Plane Versus Long-Axis In-Plane
Alone for Ultrasound-Guided Radial Artery Catheterization in Elderly
Patients Undergoing Coronary Artery Bypass Grafting: A Randomized
Prospective Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(4) (pp 1074-1080),
2026. Date of Publication: 01 Apr 2026.
Author
Lu Y.; Yuan Z.; He W.; Song X.; Teng S.
Institution
(Lu, Yuan, He, Song, Teng) Department of Anesthesiology, First Hospital of
Jilin University, Changchun, China
Publisher
W.B. Saunders
Abstract
Objectives: Radial artery catheterization is challenging in patients with
poor vascular conditions, particularly those with severe atherosclerotic
changes. The long-axis in-plane ultrasound technique provides full
visualization and reduces the risk of posterior vessel wall injury;
however, its precision is compromised by slice-thickness artifacts
inherent to ultrasound beam physics. The authors hypothesized that
combining pressure monitoring with ultrasound-guided long-axis in-plane
catheterization would improve first-attempt success by mitigating
ultrasound beam-thickness artifacts. Design(s): Single-center
prospective randomized controlled study. Setting(s): Tertiary
academic cardiac hospital. Participant(s): One hundred eight elderly
patients scheduled for coronary artery bypass grafting were enrolled, with
54 patients allocated to each study group. Nine junior anesthesiologists
performed the procedures after standardized training.
 Intervention(s): Patients were randomly assigned to 2 groups:
pressure monitoring combined with ultrasound-guided long-axis in-plane
catheterization (intervention group) and long-axis in-plane
ultrasound-guided catheterization alone (control group). Measurements
and Main Results: The primary outcome was the first-attempt success rate;
secondary outcomes included procedural time, overall success rate, number
of attempts, and complication rate. The intervention group showed a higher
first-attempt success rate (74.07% [40 of 54] v 53.70% [29 of 54];
difference, 20.37% [95% confidence interval, 4.2%-36.5%], p = 0.028) and a
shorter median procedural time (48.15 seconds [interquartile range,
40.95-116.73 seconds] v 62.05 seconds [interquartile range, 46.08-165.68
seconds]; p = 0.024). Fewer attempts were needed in the intervention group
(p = 0.039). No significant differences were observed in overall success
rate (90.74% [49 of 54] v 81.48% [44 of 54], p = 0.164) or hematoma rate
(5.56% [3 of 54] v 9.26% [5 of 54], p = 0.462), and arterial thrombosis
did not occur in either group. Conclusion(s): Pressure monitoring
combined with ultrasound-guided long-axis in-plane catheterization is an
improved technique. In this study, it helped junior operators achieve
higher success rates of radial artery catheterization in elderly patients
undergoing coronary artery bypass grafting compared with the conventional
long-axis in-plane technique. Copyright © 2025 Elsevier Inc.

<63>
Accession Number
2040999773
Title
Neoaortic outcomes after the arterial switch operation: A systematic
review and meta-analysis.
Source
Archives of Cardiovascular Diseases. 119(3) (pp 233-243), 2026. Date of
Publication: 01 Mar 2026.
Author
Negm S.; Mahmoud A.B.; Desnous B.; Elatafy E.E.; Fouilloux V.; Gran C.;
Mace L.; Lenoir M.
Institution
(Negm, Desnous, Fouilloux, Gran, Mace, Lenoir) Department of
Cardio-Thoracic Surgery, Hopital de la Timone Enfants et Adultes, AP-HM,
Aix-Marseille University, Marseille, France
(Negm, Mahmoud, Elatafy) Department of Cardio-Thoracic Surgery, Faculty of
Medicine, Tanta University, Tanta, Egypt
Publisher
Elsevier Masson s.r.l.
Abstract
Background The arterial switch operation has become the treatment of
choice for neonates with transposition of great arteries. Aim This
systematic review and meta-analysis aimed to summarize the current
evidence regarding neoaortic root dilatation and aortic valve
insufficiency as long-term outcomes after the arterial switch operation,
and to identify associated risk factors. Methods A systematic search of
PubMed, EMBASE and Cochrane databases was conducted for human studies
published in English or French until May 2024. Results Out of 1480
identified records, 80 studies were included in the final analysis. The
total incidence of moderate-to-severe aortic insufficiency was 588 out of
20,338 patients (2.89%). The total number of neoaortic reinterventions was
306 in 11,291 patients (2.71%). The total number of neoaortic
reinterventions for aortic insufficiency was 78 in 4757 patients (1.63%).
Distensibility of both the aortic root and the ascending aorta in patients
after the arterial switch operation was significantly lower than in the
normal population. Several factors were significantly associated with an
increased risk of moderate-to-severe aortic insufficiency: ventricular
septal defect (P < 0.001); pulmonary artery banding (P = 0.007);
aortopulmonary mismatch (P < 0.001); and neoaortic root dilatation (P <
0.001). Coronary anomalies showed a borderline association (P = 0.055),
and the trapdoor technique was significant in one study (P = 0.0005).
Distensibility of both the aortic root and the ascending aorta was found
to be significantly reduced in patients after the arterial switch
operation compared with healthy controls, reflecting increased vascular
stiffness. Conclusions Significant neoaortic valve insufficiency and
reintervention remain relatively rare after the arterial switch operation.
However, measurable risk factors-including ventricular septal defect,
pulmonary artery banding, aortopulmonary mismatch and coronary
anomalies-are associated with an increased long-term risk of valve
dysfunction or surgical reintervention. Copyright © 2025 The
Authors.

<64>
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. 40(3) (pp 1024-1036),
2026. Date of Publication: 01 Mar 2026.
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. 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. 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. 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. Copyright © 2025 Elsevier Inc.

<65>
Accession Number
2043674988
Title
A Comparative Study Between Intravenous Dexmedetomidine Versus Nebulized
Dexmedetomidine in Attenuating Laryngoscopy and Intubation Induced
Sympathetic Response and Hemodynamic Changes in Coronary Artery Disease
Patients Posted for Elective CABG Procedure.
Source
International Journal of Current Pharmaceutical Review and Research. 18(2)
(pp 231-240), 2026. Date of Publication: 2026.
Author
Elumalai B.; Mohanasundaram J.; Kavitha A.J.
Institution
(Elumalai, Mohanasundaram) Institute of Anaesthesiology, Madras Medical
College, Tamil Nadu, India
(Kavitha) Department of Anaesthesiology, Vels Medical College, Tamil Nadu,
India
Publisher
Dr. Yashwant Research Labs Pvt. Ltd.
Abstract
Background: Laryngoscopy and intubation trigger sympathetic surges that
increase heart rate (HR) and blood pressure (BP), posing significant risks
for patients with coronary artery disease (CAD). Dexmedetomidine, a
sympatholytic alpha-2 agonist, may mitigate these stress responses.
 Aim(s): To compare the effectiveness and safety of intravenous (IV)
versus nebulized dexmedetomidine in attenuating hemodynamic stress
responses during laryngoscopy and intubation in CAD patients undergoing
elective coronary artery bypass grafting (CABG). Material(s) and
Method(s): Seventy-eight elective CABG patients were randomized into two
groups (n=39 each). Group A received nebulized dexmedetomidine (1
microg/kg) over 10 minutes, while Group B received IV dexmedetomidine (1
microg/kg) over 10 minutes. HR, systolic BP, diastolic BP, and mean
arterial pressure (MAP) were monitored at baseline and peri- intubation.
 Result(s): Both routes effectively blunted the pressor response to
laryngoscopy. However, the IV group experienced a more precipitous decline
in MAP and a significantly higher incidence of bradycardia and
hypotension. Nebulized administration maintained superior cardiovascular
stability and was associated with a lower incidence of postoperative sore
throat. Post-operative recovery times were comparable between groups.
 Conclusion(s): While both routes attenuate hemodynamic responses
during laryngoscopy and intubation in CAD patients, nebulized
dexmedetomidine is a clinically advantageous, non- invasive alternative
for high-risk CAD patients. Its superior safety profile-specifically the
reduced risk of cardiovascular instability-makes it a viable and
attractive option for perioperative management. Copyright ©
(2026), (Dr. Yashwant Research Labs Pvt. Ltd.). All rights reserved.

<66>
Accession Number
2043416638
Title
Hypoalbuminaemia contributes to postoperative pulmonary complications and
mortality: a systematic review and meta-analysis.
Source
BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 142. Date
of Publication: 01 Dec 2026.
Author
Wang X.; Tang H.; Zheng M.; Xu F.
Institution
(Wang, Tang, Zheng, Xu) Department of Critical Care Medicine, The First
Affiliated Hospital of Chongqing Medical University, Yuzhong, China
Publisher
BioMed Central Ltd
Abstract
Objective: This review aimed to assess whether hypoalbuminaemia can
predict postoperative pulmonary complications (PPCs) and mortality in
patients receiving general anaesthesia for surgery. Method(s):
PubMed, Web of Science, EMBASE, and the Cochrane Library were searched for
relevant articles published up to 18 July 2024. Three authors
independently reviewed the studies and assessed the quality of related
articles via the Newcastle-Ottawa Scale. The data were recorded, and a
meta-analysis was performed using Review Manager version 5.4.1.
 Result(s): A total of 40 studies with 477,701 patients were included
in the meta-analysis. Adjusted data were pooled to calculate the odds
ratio (OR). A sensitivity test was conducted. A meta-analysis of 18
studies demonstrated that hypoalbuminaemia was a significant predictor of
PPCs and mortality after general anaesthesia (OR: 2.88, 95% CI 2.50 to
3.32, P < 0.01, I2 = 90%). The 40 studies were divided into 4
groups based on surgical site: the orthopaedic surgery group (OR: 4.03,
95% CI 3.49 to 4.64, P < 0.01, I2 = 43%), the thoracic surgery
group (OR: 1.82, 95% CI 1.46 to 2.26, P < 0.01, I2 = 23%), the
abdominal surgery group (OR: 2.48, 95% CI 1.81 to 3.40, P < 0.01,
I2 = 95%) and the other surgery group (OR: 2.34, 95% CI 1.66 to
3.29, P < 0.01, I2 = 87%). In addition, patients with
hypoalbuminaemia had increased mortality (OR: 4.31, 95% CI 4.124.51, P,
I2 = 68%). Conclusion(s): Preoperative hypoalbuminaemia is
significantly associated with postoperative pulmonary complications and
has different correlation coefficients in different types of surgeries.
Trial registration: This systematic review and meta-analysis was
registered at the International Prospective Register of Systematic Reviews
(Number CRD42024540493). Copyright © The Author(s) 2025.

<67>
Accession Number
2043091419
Title
Paradoxical Normal-Flow Aortic Stenosis Despite Reduced Left Ventricular
Ejection Fraction: Insights From the Randomized COMPARE-TAVI 1 Trial.
Source
Journal of the American Heart Association. 15(1) (no pagination), 2025.
Article Number: e045521. Date of Publication: 17 Dec 2025.
Author
Ravn E.J.; Christiansen U.; Nissen H.; Povlsen J.A.; Frederiksen C.A.;
Poulsen S.H.; Clavel M.-A.; Carter-Storch R.; Fur C.B.; Thim T.; Freeman
P.; Uttenthal F.; Christiansen E.H.; Terkelsen C.J.; Dahl J.S.
Institution
(Ravn, Nissen, Clavel, Carter-Storch, Dahl) Department of Cardiology,
Odense University Hospital, Odense, Denmark
(Povlsen, Frederiksen, Poulsen, Fur, Thim, Christiansen, Terkelsen)
Department of Cardiology, Denmark
(Poulsen, Terkelsen) Department of Clinical Medicine, Aarhus University
Hospital, Aarhus, Denmark
(Christiansen, Poulsen, Freeman, Uttenthal, Terkelsen) Department of
Cardiology, Aalborg University Hospital, Aalborg, Denmark
(Dahl) Department of Clinical Research, University of Southern Denmark,
Odense, Denmark
(Dahl) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN,
United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: The hemodynamic profile and remodeling patterns of paradoxical
low-flow, low-gradient aortic stenosis are well understood. However, some
patients with severe aortic stenosis exhibit eccentric remodeling with
enlarged left ventricular cavities, enabling a normal flow, low ejection
fraction (NF-LEF) phenotype. We assessed the prevalence, hemodynamic
characteristics, and post-transcatheter aortic valve implantation outcomes
of NF-LEF. METHOD(S): In this substudy of the COMPARE-TAVI 1 trial,
979 patients undergoing transfemoral transcatheter aortic valve
implantation were stratified by left ventricular ejection fraction (LVEF)
(< or >=50%) and stroke volume index (< or >=35mL/m2) into 4
groups: normal flow, normal LVEF, NF-LEF, low flow, normal ejection
fraction, and low flow, low ejection fraction. RESULT(S): NF-LEF was
observed in 10.7% of patients. Reduced LVEF was associated with previous
myocardial infarction, pacemakers, New York Heart Association class >2,
atrial fibrillation, moderate or worse mitral regurgitation, and larger
left ventricular cavities (P<0.001) with eccentric hypertrophy (P=0.004).
Compared with low-flow, low-ejection fraction, patients with NF-LEF more
frequently had moderate or worse aortic regurgitation (P=0.007), whereas
low flow, low ejection fraction showed poorer diastolic indices,
suggesting diastolic dysfunction with high left ventricular filling
pressures. Patients with low flow, normal ejection fraction were the most
symptomatic and showed less improvement in 6-minute walk distance at 1
year compared with normal flow, normal ejection fraction. During
follow-up, both low-flow groups demonstrated significant increases in
stroke volume index (P<0.001), whereas LVEF also improved among patients
with reduced LVEF (P<0.001). CONCLUSION(S): NF-LEF is a prevalent
aortic stenosis phenotype characterized by preserved flow despite reduced
LVEF, likely driven by eccentric remodeling with moderate or worse aortic
regurgitation and more favorable diastolic properties, with similar
survival and time-to-event outcomes across phenotypes after transcatheter
aortic valve implantation at long-term followup. Despite higher
comorbidity burdens, patients with NF-LEF showed functional and clinical
improvements comparable with normal flow, normal ejection fraction,
indicating a severe aortic stenosis phenotype. Copyright © 2025
The Author(s). Published on behalf of the American Heart Association,
Inc., by Wiley. This is an open access article under the terms of the
Creative Commons Attribution-NonCommercial-NoDerivs License, which permits
use and distribution in any medium, provided the original work is properly
cited, the use is non-commercial and no modifications or adaptations are
made. JAHA is available at: www.ahajournals.org/journal/jaha

<68>
Accession Number
2043799870
Title
The Predictive Value of Machine Learning for Postoperative Delirium in
Cardiac Surgery: Systematic Review and Meta-Analysis.
Source
Journal of Medical Internet Research. 28 (no pagination), 2026. Article
Number: e72304. Date of Publication: 2026.
Author
Guo Y.; Xu H.; Wang A.; Zhang M.; Zhang S.; Xie P.
Institution
(Guo, Wang, Zhang, Zhang) Department of Anesthesiology, Norinco General
Hospital, Xi'an, China
(Xu) Department of Operating Room, Norinco General Hospital, Xi'an, China
(Xie) Department of Hepatobiliary and Vascular Surgery, Norinco General
Hospital, Xi'an, China
Publisher
JMIR Publications Inc.
Abstract
Background: Postoperative delirium (POD) following cardiac surgery is a
severe complication, and early identification of delirium risk remains a
challenge in clinical practice. While machine learning (ML) has garnered
increasing attention in health care applications, effective early
prediction tools remain limited in current clinical practice. Recent
investigations have explored the effectiveness of ML-based methods for
identifying the risk of POD in patients undergoing cardiac surgery.
However, more evidence is required to validate the feasibility of these
methods. Objective(s): This study aims to ascertain the performance
of ML in identifying the risk of POD following cardiac surgery, providing
evidence for the development or updating of future ML-based assessment
tools. Method(s): A comprehensive literature search was conducted
across 4 databases-PubMed, the Cochrane Library, Embase, and Web of
Science-through August 30, 2024, to identify studies investigating
individual POD risk prediction using ML approaches and nomograms. The risk
of bias of the models in the included studies was assessed leveraging the
Prediction Model Bias Risk Assessment Tool. Subgroup analyses were
performed based on datasets, validation methods, study types, risk of
bias, and model types. Result(s): The analysis incorporated 28
original studies comprising 80,143 patients undergoing cardiac surgery, of
whom 6326 developed POD. Meta-analysis revealed that, in validation
datasets, the c-index, sensitivity, and specificity for delirium
prediction reached 0.805 (95% CI 0.759-0.852), 0.72 (95% CI 0.65-0.79),
and 0.78 (95% CI 0.71-0.83), respectively. Logistic regression was the
primary modeling method. In validation datasets, the c-index, sensitivity,
and specificity reached 0.773 (95% CI 0.724-0.823), 0.73 (95% CI
0.64-0.80), and 0.70 (95% CI 0.65-0.74), respectively. Conclusion(s):
ML-based prediction tools for POD following cardiac surgery demonstrate
promising performance. However, the limited number of studies and
validation approaches necessitate cautious interpretation of these
findings. Future multicenter studies are warranted to develop more robust
ML-based prediction tools, enabling precise risk stratification and
targeted preventive interventions for POD. Copyright © Yi Guo,
Hong Xu, Ankui Wang, Mingming Zhang, Shuai Zhang, Peng Xie.

<69>
Accession Number
2043683917
Title
Preventive effect of liraglutide on postoperative delirium in elderly
patients undergoing cardiac surgery: protocol for a single-centre,
randomised, double-blind, placebo-controlled trial.
Source
BMJ Open. 16(2) (no pagination), 2026. Article Number: e110759. Date of
Publication: 15 Feb 2026.
Author
Bai S.; Wei M.; Wu Y.; Zhu X.; Wang Z.; Wang Y.; Zhu C.; Guan Y.; Wang D.;
Liu W.
Institution
(Bai, Wang, Wang, Zhu, Guan, Wang, Liu) Department of Cardio-Thoracic
Surgery, Nanjing Drum Tower Hospital, Nanjing University Medical School,
Nanjing, China
(Wei, Wu) Department of Cardio-Thoracic Surgery, Drum Tower Clinical
College, Nanjing University of Chinese Medicine, Nanjing, China
(Zhu) Department of Anesthesiology, Nanjing University Medical School,
Nanjing Drum Tower Hospital, Nanjing, China
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative delirium (POD) is a common and serious
complication after cardiac surgery, particularly in elderly patients, and
is associated with adverse short- and long-term outcomes. Effective
preventive strategies remain limited. Liraglutide, a glucagon-like
peptide-1 receptor agonist, has demonstrated potential neuroprotective,
anti-inflammatory and metabolic benefits, which may reduce the incidence
of POD. Methods and analysis This is a single-centre, randomised,
double-blind, placebo-controlled trial in elderly patients undergoing
elective cardiac surgery. Participants will be randomised in a 1:1 ratio
to receive liraglutide or placebo from the day before surgery until
postoperative day 3. A total of 260 patients are planned to be enrolled in
this study. The primary endpoint is the incidence of POD within 7days,
assessed using the Confusion Assessment Method (CAM) or CAM-intensive care
unit. Secondary outcomes include delirium severity, neurocognitive and
psychological function, cardiac function, clinical outcomes, major adverse
cardiovascular events within 1 year and perioperative biomarker changes.
Exploratory outcomes include functional MRI in selected subgroups and
additional biomarker analyses. Ethics and dissemination The protocol has
been approved by the Medical Ethics Committee of Nanjing Drum Tower
Hospital. Written informed consent will be obtained from all participants.
Findings will be disseminated in peer-reviewed journals and academic
conferences. Copyright © Author(s) (or their employer(s)) 2026.
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ Group.

<70>
Accession Number
2042216845
Title
Sex-Based Differences in Outcomes of Surgical Aortic Valve Replacement: A
Meta-Analysis with Reconstructed Time-to-Event Data.
Source
CJC Open. 8(3) (pp 344-355), 2026. Date of Publication: 01 Mar 2026.
Author
Consoli L.N.; Majeed M.W.; Cetinel E.; Lajczak P.; Koziakas I.G.;
Caldonazo T.
Institution
(Consoli) Federal University of Bahia, Salvador, Brazil
(Majeed) Government Medical College Srinagar, Srinagar, India
(Cetinel) San Raffaele University, Milan, Italy
(Lajczak) Medical University of Silesia, Katowice, Poland
(Koziakas) Cardiac Surgery Department, Onassis Hospital, Athens, Greece
(Caldonazo) Department of Cardiothoracic Surgery, Jena University
Hospital, Friedrich Schiller University of Jena, Jena, Germany
(Caldonazo) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, New York, United States
Publisher
Elsevier Inc.
Abstract
Background: Results in the literature are mixed on how patient sex impacts
the outcomes of surgical aortic valve replacement (SAVR), with a high risk
of confounding bias due to different risk profiles at presentation. We
aimed to assess short- and long-term outcomes of SAVR in male and female
patients. Method(s): We searched PubMed, Embase, and the Cochrane
Library for eligible confounder-adjusted studies, including those that
used propensity-score-matching, multivariable regressions, and inverse
probability of treatment weighting. Meta-analysis was performed for
short-term (early mortality and procedural complications) and long-term
(late mortality, reoperation, and adverse events) endpoints. We compared
endpoints, using risk ratio (RR) for short-term endpoints and hazards
ratio (HR) for long-term endpoints. We calculated 95% confidence intervals
(CIs) for all outcomes. A meta-analysis of Kaplan-Meier-derived individual
patient data was done for long-term mortality. Result(s): We included
13 studies (n = 159,415). In the short-term, female patients had a higher
mortality rate (RR 1.25 [95% CI 1.19, 1.32], P < 0.001), more operative
deaths (RR 1.33 [95% CI 1.01, 1.75], P = 0.04), and required more blood
product use (RR 1.36 [95% CI 1.14, 1.63], P < 0.001). Male patients had
more transient ischemic attacks (RR 0.74 [95% CI 0.56, 0.99], P = 0.04)
and acute kidney injury (RR 0.73 [95% CI 0.7, 0.77], P < 0.001). At
long-term follow-up, male patients had a higher mortality rate (HR 0.93
[95% CI 0.88, 0.98], P = 0.001), and more reoperations; no significant
differences were seen in the rates of late stroke or bleeding.
 Conclusion(s): This meta-analysis found that, compared to male
patients, female patients had higher early mortality but lower late
mortality following SAVR. Copyright © 2025 The Authors

<71>
Accession Number
2042607891
Title
Atrial Fibrillation Recurrence After Left Atrial Appendage Occlusion in
Patients Undergoing Ablation: The OPTION Trial Sub analysis.
Source
JACC: Clinical Electrophysiology. 12(2) (pp 294-303), 2026. Date of
Publication: 01 Feb 2026.
Author
Younis A.; Nair D.G.; Di Biase L.; Tilz R.; Saliba W.; Kanj M.; Tabaja C.;
Woods C.; Lellouche N.; Defaye P.; Willems S.; Boersma L.V.A.; Doshi R.N.;
Healey J.S.; Jaber W.A.; Mansour M.; Natale A.; Phillips K.; Tondo C.; Roy
K.; Christen T.; Sutton B.S.; Reddy V.Y.; Wazni O.M.
Institution
(Younis, Saliba, Kanj, Tabaja, Wazni) Department of Cardiovascular
Medicine, Cardiac Electrophysiology, Cleveland Clinic, Cleveland, OH,
United States
(Nair) St Bernards Medical Center and Arrhythmia Research Group,
Jonesboro, AR, United States
(Di Biase) Cardiac Arrhythmia Center, Montefiore Einstein Center for Heart
and Vascular Care, New York, NY, United States
(Tilz) Department of Rhythmology, University Heart Center, University
Hospital Schleswig-Holstein, Lubeck, Germany
(Woods) Division of Cardiology, California Pacific Medical Center, San
Francisco, CA, United States
(Lellouche) Department of Cardiology, Henri Mondor Teaching Hospital,
Creteil, France
(Defaye) Centre Hospitalier Regional Universitaire Albert Michallon,
Grenoble, France
(Willems) Heart Center Bad Neustadt, Rhoen-Clinic Campus Bad Neustadt, Bad
Neustadt an der Saale, Germany
(Boersma) Cardiology Department, St Antonius Hospital, Nieuwegein,
Netherlands
(Doshi) HonorHealth Research Institute, Scottsdale, AZ, United States
(Healey) McMaster University, Hamilton, ON, Canada
(Jaber) Department of Cardiovascular Medicine, Cardiac Imaging, Cleveland
Clinic, Cleveland, OH, United States
(Mansour) Cardiology Department, Massachusetts General Hospital, Boston,
MA, United States
(Natale) Cardiac Arrhythmia Institute, Austin, TX, United States
(Natale) Department of Biomedicine and Prevention, Division of Cardiology,
University of Tor Vergata, Rome, Italy
(Phillips) The Brisbane AF Clinic, Greenslopes Private Hospital,
Greenslopes, Brisbane, Australia
(Tondo) Centro Cardiologico Monzino, Milan, Italy
(Roy, Christen, Sutton) Boston Scientific Corporation, Marlborough, MA,
United States
(Reddy) Helmsley Electrophysiology Center, Mount Sinai Fuster Heart
Hospital, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: It remains unclear whether concomitant or subsequent left
atrial appendage closure (LAAC) may affect atrial fibrillation (AF)
ablation outcomes. Objective(s): This study sought to evaluate the
impact of LAAC on AF recurrence and its role in clinical outcomes.
 Method(s): A subanalysis was conducted on 1,600 patients from the
randomized OPTION (Comparison of Anticoagulation With Left Atrial
Appendage Closure After AF Ablation) trial. Patients were stratified into
2 groups: anticoagulation (no device) and LAAC. The primary endpoint was
AF recurrence, and the secondary endpoint was stroke or systemic embolism
occurring after 12 months of follow-up. Patients were categorized based on
AF recurrence (yes/no) at 12 months. Arrhythmia recurrence was assessed
using device interrogations in patients with cardiac implantable
electronic devices and 12-lead electrocardiograms in those without
devices. Result(s): Of the total cohort, 803 patients (50%) underwent
LAAC (41% concomitant, 59% sequential), and 797 patients (50%) were in the
control group (no device). Baseline characteristics were balanced across
both treatment arms. At 36-month follow-up, AF recurrence rates did not
differ significantly between the groups (LAAC: 49.2% vs no LAAC: 45.5%; P
= 0.08). No difference was found between sequential and concomitant LAAC
(43.6% vs 43.9%, respectively; P = 0.83). Stroke and systemic embolism
rates were low and comparable between patients with and without AF
recurrence (no AF: 1.00%, AF recurrence: 1.30%; P = 0.57).
 Conclusion(s): Among patients undergoing AF ablation, LAAC
(concomitant or sequential) does not affect AF ablation outcomes. The
stroke/systemic embolism rate was low in all groups. Nevertheless, the
trial highlights that stroke and systemic embolism remain significant
risks, even in patients without AF recurrence, and should not be
overlooked. Copyright © 2026 The Authors

<72>
Accession Number
2041244082
Title
Interventions to prevent postoperative neurocognitive complications: an
umbrella review of meta-analyses of randomised controlled trials.
Source
Anaesthesia. 81(4) (pp 532-540), 2026. Date of Publication: 01 Apr 2026.
Author
D'Amico F.; Turi S.; Manazza M.; Lo Bianco G.; Monti G.; Zangrillo A.;
Landoni G.; Beretta L.
Institution
(D'Amico, Turi, Manazza, Lo Bianco, Monti, Zangrillo, Landoni, Beretta)
Department of Anaesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Monti, Zangrillo, Landoni, Beretta) Vita-Salute San Raffaele University,
Milan, Italy
Publisher
John Wiley and Sons Inc
Abstract
Introduction: The certainty of the effectiveness of interventions to
manage postoperative neurocognitive complications remains unclear. The
objective of this umbrella review was to synthesise and evaluate the
evidence for interventions aimed at reducing the incidence of
peri-operative neurocognitive complications. Method(s): We searched
relevant databases from inception to 23 August 2025. We included
systematic reviews and meta-analyses of randomised trials evaluating
pharmacological and non-pharmacological interventions for the prevention
of postoperative neurocognitive complications in adult surgical
populations. Certainty of evidence for each intervention was assessed
using the GRADE framework. Methodological quality was appraised using
AMSTAR and the Ioannidis classification. Result(s): A total of 114
systematic reviews and meta-analyses, with data from 250,777 patients,
were included. Dexmedetomidine, cerebral monitoring, acupuncture, sleep
interventions, steroids, antipsychotics, peripheral nerve blocks,
esketamine and remimazolam were associated with reductions in
postoperative neurocognitive complications. Subgroup analyses indicated
that these interventions also showed potential benefits across
non-cardiac, orthopaedic and cardiac surgery. However, the overall
certainty of evidence for all these interventions was predominantly very
low. Discussion(s): A number of peri-operative interventions are
associated with a reduction in postoperative neurocognitive complications
but the certainty of evidence supporting these interventions to prevent is
very low. High-quality research is needed to advance the evidence base and
inform future clinical practice. Copyright © 2025 The Author(s).
Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of
Anaesthetists.

<73>
Accession Number
650221744
Title
Effects of combined Triflow, deep breathing and coughing exercises on
postoperative pulmonary function after mitral valve replacement: a
randomized controlled trial.
Source
BMC surgery. 26(1) (no pagination), 2026. Date of Publication: 10 Feb
2026.
Author
Akinci N.; Eren E.
Institution
(Akinci) Department of Nursing, Faculty of Health Sciences, Fenerbahce
University, Istanbul, Turkey
(Eren) Department of Nursing, Faculty of Health Sciences, Istanbul Medipol
University, Istanbul, Turkey
Abstract
BACKGROUND: Postoperative pulmonary complications remain a major cause of
morbidity after cardiac valve surgery. Although incentive spirometry
(Triflow) is routinely used in postoperative care, evidence regarding the
additional benefits of combining Triflow with deep breathing and coughing
exercises remains limited. This study aimed to evaluate the effects of
combined Triflow, deep breathing, and coughing exercises on postoperative
pulmonary function in adult patients undergoing mitral valve replacement.
 METHOD(S): This randomized controlled, single-blind trial was
conducted between May and August 2025 in a private hospital in Istanbul. A
total of 60 adult patients undergoing mitral valve replacement were
randomly allocated to an experimental group (n = 30) or a control group (n
= 30) using simple randomization. The experimental group performed Triflow
combined with deep breathing and coughing exercises, while the control
group performed Triflow alone. RESULT(S): Postoperative SpO2 levels
were significantly higher in the experimental group at T1 (p = 0.009; 95%
CI: 0.46-3.14), T2 (p < 0.001; 95% CI: 1.57-3.43), and T3 (p < 0.001; 95%
CI: 2.72-4.54). The FEV1/FVC ratio increased significantly in the
experimental group compared with the control group at discharge (p <
0.001; 95% CI: 4.46-6.41). Respiratory rate was significantly higher in
the experimental group at T1 (p < 0.001; 95% CI: 1.68-4.45), T2 (p <
0.001; 95% CI: 3.34-6.26), and T3 (p < 0.001; 95% CI: 5.23-8.37).
Hematocrit levels were significantly lower in the experimental group at T1
(p = 0.039; 95% CI: -8.32 to - 0.24), T2 (p = 0.007; 95% CI: -8.29 to -
1.40), and T3 (p = 0.034; 95% CI: -6.54 to - 0.28). Pain scores were
significantly lower in the experimental group at T1 (p < 0.001; 95% CI:
-2.82 to - 1.71) and T2 (p < 0.001; 95% CI: -1.98 to - 1.08). Time to
first mobilization was significantly shorter in the experimental group (p
< 0.001; 95% CI: -2.94 to - 1.26). No postoperative pulmonary
complications were observed in either group. CONCLUSION(S): The
combined application of Triflow, deep breathing, and coughing exercises
was associated with significant improvements in postoperative pulmonary
function, oxygen saturation, pain reduction, and earlier mobilization
compared with Triflow alone in patients undergoing mitral valve
replacement. These findings suggest that a structured, combined
respiratory exercise protocol may provide additional clinical benefits in
the early postoperative period. TRIAL REGISTRATION: ClinicalTrials.gov
Identifier NCT06997224 (First registered on 15 May 2025). Copyright
© 2026. The Author(s).

<74>
Accession Number
2043093532
Title
Climate change and the immune system.
Source
Expert Review of Clinical Immunology. 22(1) (pp 61-77), 2026. Date of
Publication: 2026.
Author
Rijkers G.T.; Timraliyeva Z.; Mackie E.; Lupusoara M.
Institution
(Rijkers, Timraliyeva, Mackie, Lupusoara) Department of Health, Cognition,
and Behavior, University College Roosevelt, Middelburg, Netherlands
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Climate change and global warming have major consequences
for human health, including effects on the immune system. Areas covered:
The impact of global warming on vector transmitted infectious diseases,
such as West Nile Virus and dengue. Changes in pollen grain composition
and pollen season duration, along with increased frequencies of dust
storms, have detrimental impacts on asthmatic and allergic patients. The
direct and indirect effects of climate change on autoimmune and
cardiovascular diseases are also discussed. Literature on climate and the
immune system was retrieved from PubMed and Google Scholar up to 21 July
2025. Expert opinion: Climate change will lead to the spread of tropical
infectious diseases toward moderate climate regions. Recommended
vaccination schedules should be adapted to include these diseases. The
changing climate has also extended pollen season and increased both the
frequency and severity of dust storms, which impacts asthmatic patients.
There are indications that next to extreme heath, pollen exposure
contributes to acute cardiac events and complications after cardiovascular
surgery. More insight into the underlying mechanisms of the negative
effects of climate changes on the immune system could allow to take the
appropriate measures and interventions to mitigate climate-associated
immune-mediated diseases. Copyright © 2026 The Author(s).
Published by Informa UK Limited, trading as Taylor & Francis Group.

<75>
Accession Number
2043396505
Title
Rhomboid intercostal block versus erector spinae plane block for
perioperative analgesia in patients undergoing reduction mammoplasty: a
prospective randomized study.
Source
BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 138. Date
of Publication: 01 Dec 2026.
Author
Abd Ellatif S.E.; Wahdan R.A.; Ibrahim E.S.; Galal Eldin A.M.
Institution
(Abd Ellatif, Wahdan, Wahdan, Galal Eldin) Department of Anesthesia,
Intensive Care, and Pain Management, Faculty of Medicine, Zagazig
University, Al- qwmiah, Zagazig, Egypt
(Ibrahim) Department of Plastic and Reconstructive Surgery, Faculty of
Medicine, Zagazig University, Zagazig, Egypt
Publisher
BioMed Central Ltd
Abstract
Background: Erector spinae plane block (ESP) is inevitably effective in
posterior thoracic surgeries, but its efficacy and safety in anterior
thoracic surgeries-particularly bilateral surgeries-remain in dispute.
This study aimed to evaluate the analgesic efficacy of rhomboid
intercostal block (RIB) and ESP after reduction mammoplasty.
 Method(s): This prospective randomized controlled study was conducted
on 72 patients scheduled for reduction mammoplasty. Patients were randomly
assigned to three groups. Group C received general anesthesia, and groups
ESP and RIB received ESP and RIB blocks, and general anesthesia. The
primary outcome was the first rescue analgesic time. Postoperative pain
score, 24 h nalbuphine consumption, and dermatomal level were the
secondary outcomes. Result(s): Compared with those in the ESP and
control groups, the first rescue analgesic time and 24 h nalbuphine
consumption were significantly longer and lower, respectively, in the RIB
group. Furthermore, the RIB group had the lowest significant pain scores
within the first 6 h postoperatively. Significant sensory blocking of the
anterior hemithorax from T2-T9 was accomplished by the RIB, while more
dermatomal blockade of the posterior hemithorax from T2-T9 was provided by
the ESP. Conclusion(s): RIB is more effective than ESP in managing
pain after reduction mammoplasty. It prolongs the duration of analgesia,
reduces postoperative nalbuphine consumption and is associated with a
lower incidence of complications; hence, RIB can be utilized as a
promising alternative in anterior thoracic wall surgeries such as
reduction mammoplasty. Trial registration: This clinical trial was
approved by Zagazig University's Institutional Review Board (IRB) (ZU-IRB#
11408/January15, 2024) and ClinicalTrials.gov (NCT06225895, registration
date January 26, 2024), with the first research participant enrolled on
February 1, 2024. Copyright © The Author(s) 2026.

<76>
Accession Number
2041803736
Title
Peri-operative risk of non-cardiac surgery in patients with aortic
stenosis: a systematic review and meta-analysis.
Source
Anaesthesia. 81(4) (pp 570-579), 2026. Date of Publication: 01 Apr 2026.
Author
Place A.; Rodrigues T.S.; Naimo P.S.; Lee M.G.Y.; Batchelor R.J.; Weinberg
L.; Miles L.F.; Lefkovits J.; Koshy A.N.
Institution
(Place, Naimo, Lee, Batchelor, Lefkovits, Koshy) Department of Cardiology,
The Royal Melbourne Hospital, Melbourne, VIC, Australia
(Rodrigues, Naimo, Lee, Koshy) Department of Medicine, Melbourne Medical
School, The University of Melbourne, Melbourne, VIC, Australia
(Rodrigues, Weinberg, Miles, Koshy) Department of Cardiology, Austin
Health, Melbourne, VIC, Australia
(Weinberg, Miles) Department of Anaesthesia, Austin Health, Melbourne,
VIC, Australia
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Aortic stenosis is a risk factor for adverse outcomes
following non-cardiac surgery; however, existing data regarding
peri-operative morbidity and mortality in this patient cohort remain
conflicted. This systematic review and meta-analysis aimed to quantify the
peri-operative risks in patients with aortic stenosis undergoing
non-cardiac surgery. Method(s): Following the development of our
search strategy, we searched databases for relevant studies. The primary
endpoint was all-cause in-hospital or 30-day mortality associated with
aortic stenosis in patients undergoing non-cardiac surgery. Secondary
endpoints included: myocardial infarction; heart failure; stroke;
delirium; venous thromboembolism; and acute kidney injury. Result(s):
Nineteen studies involving 100,486 patients were included. The estimated
all-cause mortality was 3.8% (95%CI 3.7-3.9%) for patients with any degree
of aortic stenosis and 9.6% (95%CI 7.7-12.1%) for those with severe aortic
stenosis. A meta-analysis of 14 comparative studies involving 2,885,254
patients revealed significantly increased mortality in patients with
aortic stenosis compared with those without aortic stenosis (relative risk
1.58, 95%CI 1.18-2.12, p < 0.001). Aortic stenosis was also associated
with an elevated risk of postoperative myocardial infarction (relative
risk 1.79, 95%CI 1.2-2.67, p < 0.001) and heart failure (relative risk
2.06, 95%CI 1.19-3.59, p < 0.001). Discussion(s): Aortic stenosis in
patients undergoing non-cardiac surgery is associated with a three-fold
relative increase in the risk of mortality. These results highlight the
need for further delineation of which surgical procedures are associated
with the greatest risk of poor peri-operative outcomes to guide heightened
surveillance protocols, optimised peri-operative management and thresholds
for pre-operative intervention. Copyright © 2025 Association of
Anaesthetists.

<77>
Accession Number
2041424582
Title
Development and application of quality assurance methods for interventions
in randomised controlled trials of surgical oncology: the ROMIO study (a
comparison of minimally invasive and open oesophagectomy).
Source
British Journal of Cancer. 134(3) (pp 404-413), 2026. Date of Publication:
08 Feb 2026.
Author
Blazeby J.M.; Barham C.P.; Hornby S.; Robb W.B.; Wong N.A.C.S.; Porter
H.C.; Hossain T.; Powell A.; Jones R.; Wadley M.; Koshy R.; Hollowood
A.D.; Peckham-Cooper A.; Guner A.; Bowrey D.; Byrne J.; Underwood T.;
Berrisford R.; Wilkerson P.; Dwerryhouse S.; Higgs S.; Boddy A.; Brierley
R.; Gaunt D.M.; Metcalfe C.; Shirkey B.; King A.; Blencowe N.S.; Hanna G.;
Farooq N.; Welch N.; Parsons S.; Akhtar K.; Chaparala R.; Shetty V.;
Turner P.; Exon D.; Williams R.; Ubhi S.; Paisley A.; Deans C.; Skipworth
R.; Couper G.; Noble F.; Kelly J.; Ariyarathenam A.; Sanders G.; Wheatley
T.; Humphreys L.; Daniel Titcomb; Streets C.; Alkhaffaf B.; Krysztopik R.;
Pursnani K.; Melhado R.; Catton J.; Vohra R.; Lamb P.; Jepson M.;
Culliford L.; Donovan J.; Avery K.; Elliott J.; Hollingworth W.; Rogers
C.; Howes B.
Institution
(Blazeby, King, Blencowe, Avery, Howes) NIHR Bristol Biomedical Research
Centre, Bristol, United Kingdom
(Porter, Brierley, Gaunt, Metcalfe, Shirkey, Culliford, Rogers) Bristol
Trials Centre, Population Health Sciences, Bristol Medical School,
University of Bristol, Bristol, United Kingdom
(Bowrey, Boddy, Exon, Williams, Ubhi) University Hospitals Leicester,
Leicester Royal Infirmary, Leicester, United Kingdom
(Hornby, Wadley, Dwerryhouse, Higgs) Three Counties Oesophago-Gastric
Unit, Gloucestershire Royal Hospital, Gloucester, United Kingdom
(Blazeby, Barham, Hollowood, Wilkerson, Daniel Titcomb, Streets,
Krysztopik) Division of Surgery, University Hospitals Bristol and Weston
NHS Foundation Trust, Bristol, United Kingdom
(Berrisford, Ariyarathenam, Sanders, Wheatley, Humphreys) University
Hospitals Plymouth NHS Trust, Plymouth, United Kingdom
(Byrne, Underwood, Noble, Kelly) University Hospitals Southampton NHS
Foundation Trust, Southampton, United Kingdom
(Guner) Division of Upper GI Surgery, Karadeniz Technical University
College of Medicine, Trabzon, Turkey
(Hossain, Peckham-Cooper) St James' University Hospital, Leeds, United
Kingdom
(Koshy) Royal Victoria Infirmary, Newcastle-upon-Tyne, United Kingdom
(Jones) South Tees NHS Trust, Middlesbrough, United Kingdom
(Powell) Cardiff and Vale University Health Board, Cardiff, United Kingdom
(Wong) Department of Cellular Pathology, North Bristol NHS Trust, Bristol,
United Kingdom
(Robb) Minimally Invasive Upper GI Surgery Group, Beaumont Hospital,
Dublin, Ireland
(Hollingworth) Department of Health Economics and Health Policy,
University of Bristol, Bristol, United Kingdom
(Elliott) Patient and Public Contributor, Bristol, United Kingdom
(Jepson, Donovan) Population Health Sciences, Bristol Medical School,
University of Bristol, Bristol, United Kingdom
(Paisley, Deans, Skipworth, Couper, Lamb) Department of General Surgery,
Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
(Welch, Parsons, Catton, Vohra) Trent Oesophago-gastric Unit, Nottingham
University Hospitals NHS Trust, Nottingham, United Kingdom
(Farooq, Akhtar, Chaparala, Alkhaffaf, Melhado) Greater Manchester
Oesophagogastric Surgery Unit, Northern Care Alliance, Salford, United
Kingdom
(Shetty, Turner, Pursnani) Department of Upper GI Surgery, Royal
Lancashire Hospitals NHS Foundation Trust, Preston, United Kingdom
(Hanna) Division of Surgery, Imperial College London, London, United
Kingdom
Publisher
Springer Nature
Abstract
Introduction: Results of RCTs are criticised because the quality assurance
(QA) of surgical interventions is not considered. This is particularly
true in cancer trials, because higher standards of surgery may confer more
favourable outcomes. Although methods for surgical QA exist, it is unclear
how to operationalise and report them in the context of pragmatic cancer
trials. We describe the development and application of QA processes to an
RCT comparing laparoscopically assisted (LAO) and open oesophagectomy (OO)
in patients with localised oesophageal cancer. Method(s): Three QA
measures were developed in Phase 1 and tested for feasibility in Phase 2:
(i) centre/surgeon entry criteria, (ii) agreement of key components of
LAO/OO, and (iii)monitoring adherence to intervention protocols using CRFs
and intra-operative photographs. Result(s): All centres met entry
criteria and 30/31 Phase 2 surgeons submitted two videos. Although photos
were received for 88.8% of procedures, only 44(14.9%) were complete.
Adherence to key intervention components (abdominal/thoracic nodal
clearance, hiatal dissection) was consistently reported as better in CRFs
than that observed in the intra-operative photographs. Conclusion(s):
Embedding QA measures into pragmatic surgical cancer RCTs is feasible, and
provides important data about the quality of interventions. Methods to
streamline data collection and analyses are needed prior to widespread
use. Copyright © The Author(s) 2025.

<78>
Accession Number
636681128
Title
Scientific Publishing Differences between Sexes in Cardiology, Cardiac,
and General Surgery.
Source
Thoracic and Cardiovascular Surgeon. 70(2) (pp 143-151), 2022. Date of
Publication: 10 Mar 2022.
Author
Farber G.; Alscher L.; Heyne E.; Doenst T.; Schwarzer M.
Institution
(Farber, Alscher, Heyne, Doenst, Schwarzer) Department of Cardiothoracic
Surgery, Jena University Hospital, Thuringen, Jena, Germany
Publisher
Georg Thieme Verlag
Abstract
Background Research and scientific publications are important for the
advancement of science but also for the individual career development.
While women have become the majority of students in medicine we do not
know about female presence and scientific activity in cardiac surgery. We
thus aimed to compare scientific output of women and men in German
University departments of cardiac surgery with cardiology departments
focusing on the same organ and surgical departments not addressing the
heart (general surgery) of 34 universities in Germany. Methods Personnel
working at University departments was identified on the institutions
internet homepage in 2014. Publications in 2011 to 2013 on PubMed were
identified. Author and manuscript characteristics were determined. Results
A lower proportion of women were working in cardiac surgery (25%) compared
with cardiology (35%) and general (32%) surgery independent of executive
function or academic degree. Scientifically active women published fewer
manuscripts per capita than men both, in total and as first author.
Additionally, the mean and the cumulated journal impact factor of the
journals chosen was lower for women compared with men in cardiology but
not in cardiac and general surgery. Conclusion We conclude that the
differences in scientific activity between women and men are more
pronounced in cardiology compared with general and cardiac surgery,
indicating that a higher proportion of women in a field does not result in
reduced differences between sexes. The low number of women together with
the lower number of manuscripts in cardiac surgery may render the
appointment of women as directors challenging. Copyright © 2022
American Society of Civil Engineers (ASCE). All rights reserved.

<79>
Accession Number
637286141
Title
Bibliometric Analysis of 50 Most Cited Articles Comparing Lobectomy with
Sublobar Resection.
Source
Thoracic and Cardiovascular Surgeon. 71(4) (pp 307-316), 2021. Date of
Publication: 23 May 2023.
Author
Tekneci A.K.; Ozgur G.K.; Akcam T.I.; Cagirici U.
Institution
(Tekneci, Ozgur, Akcam, Cagirici) Department of Thoracic Surgery, Ege
University, School of Medicine, Izmir, Turkey
Publisher
Georg Thieme Verlag
Abstract
Background Recent years have seen an increase in the number of studies of
the sublobar resection approach in non-small cell lung cancer (NSCLC)
surgery. The purpose of this bibliometric analysis is to assess the
significance and impact of articles comparing sublobar resection and
lobectomy in NSCLC surgery. Material and Methods The Web of Science
database was searched to identify studies comparing sublobar resection and
lobectomy in NSCLC surgery published between 2005 and 2020 (accessed:
September 11, 2020). The 50 most cited articles were analyzed by years,
countries, authors, authors' affiliations, journals, journals' addresses,
and impact factors. Results The bibliometric analysis revealed that the
most cited article had 443 citations, while the total number of citations
of all articles was 2,820. The mean number of citations, in turn, was 56.4
+/- 75.62 (1-443) times. The highest number of publications over the past
15 years was in 2016, with eight articles. The Annals of Thoracic Surgery
(n = 10; 20%) had the highest number of publications on the list. The
articles included in the present study were mostly (n = 35, 70%) published
in U.S. journals. While multiple subject matters and analyses were
presented by many studies, survival was the topic of greatest interest,
with 37 (74%) studies. Conclusion This study revealed that interest in
studies comparing sublobar resection with lobectomy has increased in
recent years. It also presents both quantitative and qualitative analyses
of the most cited articles in the literature on this topic. Therefore, it
can serve as a guide for researchers. Copyright © 2021 Georg
Thieme Verlag. All rights reserved.

<80>
Accession Number
2034564057
Title
Ultrasound-guided arterial catheterization with acoustic shadowing
technique: A randomized controlled trial.
Source
Journal of Vascular Access. 27(2) (pp 456-466), 2026. Date of Publication:
01 Mar 2026.
Author
Geng H.; Liu W.; Lyu R.; Bai Y.; Liu R.; Wang J.
Institution
(Geng, Liu, Lyu, Bai, Liu, Wang) Department of Anesthesiology and
Perioperative Medicine, Hebei Cangzhou Hospital of Integrated Traditional
Chinese Medicine and Western Medicine, Hebei, China
Publisher
SAGE Publications Ltd
Abstract
Background: Ultrasound-guided dynamic needle tip positioning (DNTP) and
acoustic shadowing technologies demonstrate superior efficacy to palpation
in improving radial artery catheterization success rates. This study aimed
to evaluate the benefits of combining DNTP with acoustic shadowing
technology for patients undergoing radial artery catheterization.
 Method(s): In this randomized controlled study conducted at a single
center, 152 patients requiring radial artery catheterization during
anesthesia were enrolled. Participants were randomly assigned to either
the ultrasound-guided acoustic shadowing combined with dynamic needle tip
positioning (AS-DNTP) group or the DNTP group (1:1). All procedures were
performed by experienced operators. The primary outcome was the number of
needle tip retractions and directional corrections, while the secondary
outcomes included the first-pass success rate, total number of attempts,
ultrasound localization time, overall operating time, length of the
intra-arterial catheter, needle tip position score, and overall
complications. Result(s): The AS-DNTP group demonstrated fewer total
needle tip retractions and directional corrections (2.22 +/- 1.06 vs 2.84
+/- 1.18, p = 0.001), and a higher first-pass success rate (96.10%, 74/77
cases) compared to the DNTP group (86.67%, 65/75 cases), with an absolute
difference of 9.44% (95% confidence interval (CI): 0.31%-19.28%; p =
0.038). Additionally, the AS-DNTP group had a lower overall number of
attempts (1.04 +/- 0.195 vs 1.13 +/- 0.342, p = 0.038) and a shorter
ultrasound localization time (6.78 +/- 2.28 s vs 7.57 +/- 2.55 s, p =
0.045). Conclusion(s): AS-DNTP technology holds the potential to
reduce the need for needle tip retractions and directional corrections
during radial artery catheterization while increasing the first-pass
success rate and decreasing the ultrasound localization
time. Copyright © The Author(s) 2025

<81>
Accession Number
2043677766
Title
Mortality after urgent versus elective transcatheter aortic valve
replacement: a systematic review and meta-analysis using reconstructed
individual patient data from Kaplan-Meier curves.
Source
BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number:
187. Date of Publication: 01 Dec 2026.
Author
Babaei M.; Fallahtafti P.; Mohammadi N.S.H.; Azarboo A.; Habibzadeh A.;
Azizpour A.; Rashedi S.; Mattumpuram J.; Mohsen A.; Hosseini Z.; Soleimani
H.; Kolte D.
Institution
(Babaei) Vascular Disease and Thrombosis Research Center, Rajaie
Cardiovascular Institute, Tehran, Iran, Islamic Republic of
(Babaei, Hosseini) Cardiovascular Intervention Research Center, Rajaie
Cardiovascular Institute, Tehran, Iran, Islamic Republic of
(Fallahtafti, Mohammadi, Azarboo) Tehran Heart Center, Cardiovascular
Diseases Research Institute, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Habibzadeh, Azizpour) School of Medicine, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Rashedi) Thrombosis Research Group, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Rashedi) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, Harvard Medical School, Boston, United States
(Mattumpuram) Division of Cardiology, University of Louisville School of
Medicine, Louisville, KY, United States
(Mohsen) Division of Cardiology, Loma Linda University Medical Center,
Loma Linda, CA, United States
(Soleimani) Department of Cardiology, Imam Khomeini Hospital Complex,
Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Kolte) Cardiology Division, Massachusetts General Hospital and Harvard
Medical School, Boston, MA, United States
Publisher
BioMed Central Ltd
Abstract
Background: Urgent transcatheter aortic valve replacement (TAVR),
performed during unplanned hospitalizations, is linked to worse outcomes
compared with elective TAVR. However, temporal trends in mortality remains
poorly understood. This study aimed to compare survival after urgent
versus elective TAVR using a reconstructed individual patient data (IPD)
meta-analysis. Method(s): PubMed, Embase, and Scopus were searched
through August 2025. Studies reporting Kaplan-Meier (KM) survival curves
for urgent versus elective TAVR were included. Survival data were
digitally extracted from published KM curves, and IPD were reconstructed
algorithmically using a two-stage approach. Kaplan-Meier curves and Cox
frailty models estimated survival and hazard ratios (HRs). Landmark
analysis at one-year post-procedure and restricted mean survival time
(RMST) were also employed to compare survival. Result(s): Eleven
studies including 77,108 patients were identified. Kaplan-Meier curves
were available for 76,108 patients (urgent: 5,683; elective: 71,425) and
used for reconstructed IPD analysis. Urgent TAVR was associated with
higher early mortality (HR 1.83, 95% CI: 1.73-1.93; p < 0.001), with
convergence beyond one year (HR 1.01, 95% CI: 0.84-1.22; p = 0.83). RMST
analysis demonstrated a 6.5-month overall survival advantage in favor of
elective TAVR (p = 0.001). Conclusion(s): Urgent TAVR is associated
with significantly increased early mortality compared with elective TAVR.
These findings highlight the prognostic implications of procedural timing
and support early referral for elective intervention in patients with
severe AS. Copyright © The Author(s) 2026.

<82>
Accession Number
2019427222
Title
Infarct Size and Long-Term Clinical Outcomes of Prasugrel versus
Clopidogrel in Patients with Acute Coronary Syndrome Undergoing Coronary
Artery Stenting: A Prospective Randomized Study.
Source
International Journal of Angiology. 32(1) (pp 56-65), 2023. Date of
Publication: 30 Jan 2023.
Author
Yabe T.; Noike R.; Okubo R.; Amano H.; Ikeda T.
Institution
(Yabe, Noike, Okubo, Amano, Ikeda) Department of Cardiovascular Medicine,
Toho University Faculty of Medicine, Tokyo, Japan
Publisher
Thieme Medical Publishers, Inc.
Abstract
The antiplatelet drug prasugrel inhibits platelet aggregation early after
oral administration. This study examined whether prasugrel is effective in
inhibiting infarct size and can reduce the incidence of major adverse
cardiovascular events (MACE) in patients with acute coronary syndrome
(ACS). This study was a single-center, prospective, randomized pilot
study. Among 80 ACS patients treated at our institution between August
2014 and September 2015, 76 ACS patients who underwent stenting and
achieved thrombolysis in myocardial infarction flow grade 3 were assigned
to receive aspirin plus prasugrel (prasugrel group; n = 37) or aspirin
plus clopidogrel (clopidogrel group; n = 39). The primary endpoint was
survival free of MACE. The secondary endpoint was the evaluation of
infarct size defined as the area under the curve (AUC) of troponin I,
calculated using the linear trapezoidal method. During follow-up (mean,
1262.4 +/- 599.6 days), 14 patients showed MACE. No significant
differences in CYP2C19 genotype were seen between groups. AUC of troponin
I up to 72 hours after intervention tended to be smaller in the prasugrel
group (1,927.1 +/- 2,189.3 ng/mL) than in the clopidogrel group (3,186.0
+/- 3,760.1 ng/mL, p = 0.08). Cumulative incidence of MACE was
significantly higher in the clopidogrel group (log-rank test; p = 0.02).
Compared with clopidogrel, prasugrel was associated with reduced infarct
size and lower frequency of long-term outcomes among ACS patients
undergoing stenting. Copyright © 2021. Thieme. All rights
reserved.

<83>
Accession Number
2043351864
Title
Renal Protection at a Metabolic Cost: A Systematic Review and
Meta-Analysis of Perioperative Use of Sodium-Glucose Cotransporter 2
Inhibitors.
Source
Endocrinology, Diabetes and Metabolism. 9(2) (no pagination), 2026.
Article Number: e70180. Date of Publication: 01 Mar 2026.
Author
Balbaa E.; Gadelmawla A.F.; Ibrahim A.; Manasrah A.; Elbataa A.; Shubietah
A.; Elgendy M.S.; Sobhy A.; Mansour A.; Awashra A.; Elguindy N.N.;
Bazzazeh M.; Ben-Selma A.
Institution
(Balbaa, Ibrahim, Bazzazeh) Faculty of Medicine, Alexandria University,
Alexandria, Egypt
(Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia, Egypt
(Gadelmawla) Medical Research Group of Egypt, Negida Academy, Arlington,
MA, United States
(Manasrah, Ben-Selma) Department of Internal Medicine, United Health
Services-Wilson Medical Center, Johnson city, NY, United States
(Elbataa, Mansour) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Shubietah) Department of Medicine, Advocate Illinois Masonic Medical
Center, Chicago, IL, United States
(Elgendy) Faculty of Medicine, Tanta University, Tanta, Egypt
(Sobhy) Faculty of Medicine, Kafr Elshiekh University, Kafr el-Sheikh,
Egypt
(Awashra) Department of Medicine, An Najah National University, Nablus,
Palestine
(Elguindy) Faculty of Medicine, Ainshams University, Cairo, Egypt
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Concerns about diabetic ketoacidosis (DKA) and euglycemic
ketoacidosis (eKA) are balanced against possible organ-protective benefits
in the debated perioperative management of sodium-glucose cotransporter-2
(SGLT2) inhibitors. This meta-analysis compared the perioperative clinical
and laboratory outcomes associated with perioperative exposure to SGLT2i.
 Method(s): Through July 31, 2025, we searched PubMed, Web of Science,
Scopus, and CENTRAL for observational studies and randomised controlled
trials comparing the outcomes of preoperative use of SGLT2 inhibitors with
non-use in patients undergoing cardiac or non-cardiac surgery. We pooled
data using a random-effects model and investigated heterogeneity using
leave-one-out sensitivity analyses. PROSPERO-ID: CRD420251155809.
 Result(s): There were 10 studies comprising 246,242 patients. Due to
considerable heterogeneity, the primary pooled analysis revealed no
significant association between SGLT2 inhibitor use and either eKA (OR
4.86; p = 0.11) or DKA (OR 2.21; p = 0.11). However, a significant
increase in the risk of eKA (OR 1.11; p < 0.001) and DKA (OR 5.33; p <
0.001) was observed using leave-one-out sensitivity analysis to identify
outliers. On the other hand, the usage of SGLT2 inhibitors was associated
with a statistically significant decrease in both mortality (OR 0.73; p =
0.006) and acute renal injury (OR 0.68; p < 0.0001). The SGLT2 inhibitor
group had significantly lower perioperative pH, base excess, and blood
glucose levels. Conclusion(s): The use of perioperative SGLT2
inhibitors poses a clinical paradox between significant renoprotection and
survival advantages and a latent risk of ketoacidosis concealed by
considerable heterogeneity. While metabolic monitoring is essential,
current surgeries requiring more prolonged withholding may need to weigh
metabolic risk against the drug's significant benefit in reducing acute
kidney injury and mortality. Copyright © 2026 The Author(s).
Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.

<84>
Accession Number
636036098
Title
Thoracic Paravertebral Block Ameliorates Postoperative Delirium in
Geriatric Patients.
Source
Thoracic and Cardiovascular Surgeon. 70(5) (pp 439-444), 2022. Date of
Publication: 10 Aug 2022.
Author
Heng L.; Wang M.; Li L.; Zhu S.
Institution
(Heng, Zhu) Department of Anesthesia, Xuzhou Cancer Hospital, Jiangsu
Province, Xuzhou City, China
(Wang) Department of Anesthesia, Xuzhou Maternity and Child Health Care
Hospital, Jiangsu Province, Xuzhou City, China
(Wang) Department of Anesthesia, The People's Hospital of Jiawang District
of Xuzhou, Jiangsu Province, Xuzhou City, China
(Li) Intensive Care Unit, Xuzhou No. 1 People's Hospital, College Road,
Jiangsu Province, Xuzhou City, China
Publisher
Georg Thieme Verlag
Abstract
Objectives ?Thoracic surgery often causes postoperative delirium (POD) in
geriatric patients. This study aimed to explore the effect of
ultrasound-guided continuous thoracic paravertebral block (UG-TPVB) on POD
in geriatric patients undergoing pulmonary resection. Methods ?Total 128
patients who underwent pulmonary resection were randomly allocated to
either the conventional patient-controlled analgesia (PCA) group or the
UG-TPVB group (n = 64 per group). The consumption of opioid agents
(propofol and remifentanil), postoperative hospital stay, postoperative
pulmonary atelectasis, postoperative nausea/vomiting, and postoperative
itchiness were recorded. The diagnosis of delirium was dependent on the
Nursing Delirium Screening Scale. The postoperative pain was assessed by
visual analogue scale (VAS) score. The serum levels of interleukin
(IL)-1beta, IL-6, and tumor necrosis factor-alpha were used to evaluate
the postoperative neuroinflammation. Results ?The consumption of propofol
and remifentanil, postoperative hospital stay, postoperative pulmonary
atelectasis, postoperative nausea/vomiting, and postoperative itchiness in
the UG-TPVB group were lower than that in the PCA group. Compared with the
PCA group, the prevalence of POD was decreased in the UG-TPVB group. In
addition, use of UG-TPVB not only reduced postoperative pain (VAS score)
but also decreased postoperative neuroinflammation compared with PCA in
geriatric patients undergoing pulmonary resection. Conclusions ?This study
determined the benefits of UG-TPVB over PCA, providing an effectiveness
approach to alleviate POD in geriatric patients undergoing pulmonary
resection. Copyright © 2022 Georg Thieme Verlag. All rights
reserved.

<85>
Accession Number
2019560527
Title
Tranexamic Acid and Its Potential Anti-Inflammatory Effect: A Systematic
Review.
Source
Seminars in Thrombosis and Hemostasis. 48(5) (pp 568-595), 2022. Date of
Publication: 26 Jul 2022.
Author
Okholm S.H.; Krog J.; Hvas A.-M.
Institution
(Okholm, Hvas) Department of Clinical Medicine, Health, Aarhus University,
Vennelyst Boulevard 4, Aarhus C, Denmark
(Krog) Department of Anesthesiology and Intensive Care, Aarhus University
Hospital, Aarhus C, Denmark
(Hvas) Department of Clinical Biochemistry, Aarhus University Hospital,
Aarhus C, Denmark
Publisher
Thieme Medical Publishers, Inc.
Abstract
Tranexamic acid (TXA) is an antifibrinolytic drug primarily used for
reducing blood loss in patients with major bleedings. Animal and cell
studies have shown that TXA might modulate the inflammatory response by
either enhancing or inhibiting cytokine levels. Furthermore, recent human
studies have found altered inflammatory biomarkers in patients receiving
TXA when compared with patients who did not receive TXA. In this
systematic review we investigated the effect of TXA on inflammatory
biomarkers in different patient groups. A systematic literature search was
conducted on the databases PubMed and Embase to identify all original
articles that investigated inflammatory biomarkers in patients receiving
TXA and compared them to a relevant control group. The review was
performed according to the PRISMA guidelines, and the literature search
was performed on November 29, 2021. Thirty-three studies were included,
among which 14 studies compared patients receiving TXA with patients
getting no medication, another 14 studies investigated different dosing
regimens of TXA, and finally five studies examined the administration form
of TXA. The present review suggests that TXA has an anti-inflammatory
effect in patients undergoing orthopaedic surgery illustrated by decreased
levels of C-reactive protein and interleukin-6 in patients receiving TXA
compared with patients receiving no or lower doses of TXA. However, the
anti-inflammatory effect was not found in patients undergoing cardiac
surgery, pediatric craniosynostosis patients, or in rheumatoid arthritis
patients. The inflammatory response was not affected by administration
form of TXA (oral, intravenous, or topical). In conclusion, an
anti-inflammatory effect of TXA was consistently found among orthopaedic
patients only. Copyright © 2022. Thieme. All rights reserved.

<86>
Accession Number
2043644182
Title
Efficacy and safety of Yingxin pill for stable angina pectoris with heart
blood stasis obstruction syndrome: a randomized, single-blind,
positive-controlled trial.
Source
Frontiers in Pharmacology. 17 (no pagination), 2026. Article Number:
1730842. Date of Publication: 2026.
Author
Niu C.; Lai H.; Wang C.; Wu Z.; Zhang P.; Wei L.; Sun W.; Dong J.; Ma L.;
Shi Y.; Zhang L.
Institution
(Niu, Lai, Wang, Wu, Zhang, Wei, Sun, Dong, Ma, Zhang) Department of
Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine,
Beijing, China
(Zhang) Department of Integrated Traditional Chinese and Western Medicine,
Hohhot Maternal and Child Health Hospital, Hohhot, China
(Shi) Department of Cardiology, The Seventh Medical Center of Chinese PLA
General Hospital, Beijing, China
Publisher
Frontiers Media SA
Abstract
Objective: To evaluate the clinical efficacy and safety of Yingxin Pill
(YXP) in patients with stable angina pectoris (SAP) and heart blood stasis
obstruction syndrome. Method(s): Sixty patients were randomly
assigned to either the experimental group (YXP plus conventional Western
medicine) or the control group (Shexiang Baoxin Pill [SBP] plus
conventional Western medicine), with 30 patients in each group. Treatment
lasted for 4 weeks. Outcomes included the Seattle Angina Questionnaire
(SAQ), a Traditional Chinese Medicine (TCM) efficacy scale, blood lipid
profiles, and inflammatory markers. The effective rate and incidence of
adverse events were also compared. Result(s): After treatment, both
groups showed significant improvements in SAQ scores, TCM efficacy scale
scores, lipid profiles, and inflammatory markers compared to baseline (P <
0.05). There were no significant differences between the two groups in
these outcomes, nor in the total effective rate or incidence of adverse
events (P > 0.05). Conclusion(s): The addition of YXP to conventional
therapy can improve symptoms, reduce blood lipid and inflammation levels,
and is safe for patients with SAP and heart blood stasis obstruction
syndrome. Clinical Trial Registration: https://itmctr.ccebtcm.org.cn/,
identifier ITMCTR2025000274. Copyright © 2026 Niu, Lai, Wang, Wu,
Zhang, Wei, Sun, Dong, Ma, Shi and Zhang.

<87>
Accession Number
2020772087
Title
Effect of Ascorbic Acid on Cardiac Surgery-Associated Acute Kidney Injury
Incidence.
Source
Thoracic and Cardiovascular Surgeon. 70(7) (pp 566-574), 2022. Date of
Publication: 12 Oct 2022.
Author
Djordjevic A.; Susak S.; Kotnik P.; Gorenjak M.; Knez Z.; Antonic M.
Institution
(Djordjevic, Antonic) Department of Cardiac Surgery, University Medical
Centre Maribor, Maribor, Slovenia
(Susak) Department of Cardiovascular Surgery, Institute of Cardiovascular
Diseases of Vojvodina, Sremska Kamenica, Vojvodina, Serbia
(Kotnik, Gorenjak, Knez) Faculty of Medicine, University of Maribor,
Maribor, Slovenia
Publisher
Georg Thieme Verlag
Abstract
Objectives a Acute kidney injury (AKI) is associated with higher
perioperative mortality and morbidity. Oxidative stress has been proposed
as a cause of postoperative AKI. Ascorbic acid (AA) supplementation was
suggested as a novel and promising antioxidant. The aim of this study was
to evaluate the capability of AA to reduce the incidence of postoperative
AKI in cardiac surgery patients. Methods a A prospective randomized trial
was conducted in patients scheduled for on-pump cardiac surgery. Subjects
in the AA group received 2 g of AA intravenously during the induction of
anesthesia, 2 g before aortic cross-clamp removal and 1 g every 8 hours
for five postoperative days (the JERICA protocol). Postoperatively, the
patients were monitored for AKI and other complications. Malondialdehyde
levels were monitored in a subpopulation of 100 patients to evaluate the
effect of AA on oxidative stress level. Results a The AA and control group
consisted of 163 and 169 patients, respectively. The groups were well
matched for baseline demographics and had similar intraoperative
characteristics. The incidence of AKI in the AA and control group was 20.9
and 28.4%, respectively (p = 0.127). The estimated glomerular filtration
rate did not differ between the study groups in the entire postoperative
period. There was a trend toward higher malondialdehyde values with
statistical significance on postoperative day 1 and lower in-hospital
mortality in the AA group (0.6 vs. 4.1%, p = 0.067). Conclusion a Our
results do not support the effectiveness of AA supplementation in reducing
the incidence of postoperative AKI in on-pump cardiac surgery patients.
Clinical Registration Number a This study was registered with the ISRCTN
Registry under the trial registration number ISRCTN98572043. Copyright
© 2022 Georg Thieme Verlag. All rights reserved.

<88>
Accession Number
650151181
Title
Cerebral oximetry-guided anaesthesia and postoperative delirium in elderly
patients undergoing off-pump coronary artery bypass grafting: a randomized
controlled trial.
Source
BMC geriatrics. 26(1) (no pagination), 2026. Date of Publication: 03 Feb
2026.
Author
Tian L.; Wang H.; Jia Y.; Guo J.; Shan J.; Zhou H.; Zhao W.; Yuan S.
Institution
(Tian, Wang, Jia, Guo, Shan) Department of Anesthesiology, Fuwai Hospital,
National Center for Cardiovascular Diseases, National Clinical Research
Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences
and Peking Union Medical College, 167 Beilishi Road, Xicheng District,
Beijing, China
(Zhou) Department of Intensive Care Unit, National Center for
Cardiovascular Diseases, National Clinical Research Center for
Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical
Sciences and Peking Union Medical College, Beijing, China
(Zhao) Department of Cardiovascular Surgery, Fuwai Hospital, National
Center for Cardiovascular Diseases, National Clinical Research Center for
Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking
Union Medical College, Beijing, China
(Yuan) Department of Anesthesiology, Fuwai Hospital, National Center for
Cardiovascular Diseases, National Clinical Research Center for
Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking
Union Medical College, 167 Beilishi Road, Xicheng District, Beijing, China

<89>
Accession Number
637507990
Title
Veno-Arterial Partial Pressure of Carbon Dioxide Difference as a Metric of
Systemic Oxygen Delivery: Insights from a Correlative Meta-Analysis.
Source
Journal of Pediatric Intensive Care. 13(4) (pp 372-378), 2022. Date of
Publication: 22 Nov 2024.
Author
Loomba R.S.; Farias J.S.; Savorgnan F.; Acosta S.; Flores S.; Villarreal
E.G.
Institution
(Loomba) Division of Cardiology, Advocate Children's Hospital, Chicago,
IL, United States
(Loomba) Department of Pediatrics, Chicago Medical School/Rosalind
Franklin University of Medicine and Science, Chicago, IL, United States
(Farias, Villarreal) Section of Critical Care Medicine and Cardiology,
Texas Children's Hospital, Houston, TX, United States
(Savorgnan, Acosta, Flores) Department of Pediatrics, Baylor College of
Medicine, Houston, TX, United States
(Savorgnan, Acosta, Flores) Tecnologico de Monterrey, School of Medicine
and Health Sciences, Nuevo Leon, Monterrey, Mexico
Publisher
Georg Thieme Verlag
Abstract
The assessment of cardiac output and adequacy of systemic oxygen delivery
in children after cardiac surgery require the use of an aggregate of
hemodynamic monitors and blood tests. There are previously published data
regarding the utility of the veno-arterial partial pressure of carbon
dioxide difference (AVDco2) to help with this. This study pooled data on
the correlation of AVDco2 with other metrics of cardiac output and
systemic oxygen delivery such as arteriovenous oxygen saturation
difference, venous saturation, and serum lactate. A systematic review of
the literature was done to identify studies analyzing the correlation of
AVDco2 with other hemodynamic and laboratory values. Data were extracted,
and correlation coefficients were pooled for each specific comparison to
create a point estimate for the overall correlation. A total of four
studies with 350 patients and 809 paired blood gases were pooled. Adequate
data were available to assess the correlation of AVDco2 with arteriovenous
oxygen saturation difference, venous saturation, and serum lactate. There
was a significant, moderate correlation with arteriovenous oxygen
saturation difference and venous saturation. A significant, weak
correlation with serum lactate was found. The AVDco2 has significant,
moderate correlations with other metrics of the adequacy of systemic
oxygen delivery such as arteriovenous oxygen saturation difference and
venous saturation. There was a significant but only weak correlation with
serum lactate. AVDco2 may be complementary to assess the adequacy of
cardiac output and systemic oxygen delivery. Copyright © 2022.
Thieme. All rights reserved.

<90>
Accession Number
635866431
Title
Effect of Remote Ischemic Conditioning on Bleeding Complications in
Surgery: A Systematic Review and Meta-Analysis.
Source
Seminars in Thrombosis and Hemostasis. 48(2) (pp 229-239), 2022. Date of
Publication: 28 Feb 2022.
Author
Krag A.E.; Hvas C.L.; Kiil B.J.; Hvas A.-M.
Institution
(Krag, Hvas) Thrombosis and Hemostasis Research Unit, Department of
Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
(Krag, Hvas) Department of Clinical Medicine, Aarhus University, Aarhus,
Denmark
(Krag, Kiil) Department of Plastic and Breast Surgery, Aarhus University
Hospital, Denmark
(Hvas) Department of Anesthesiology and Intensive Care, Aarhus University
Hospital, Denmark
Publisher
Thieme Medical Publishers, Inc.
Abstract
Remote ischemic conditioning (RIC) is administered with an inflatable
tourniquet by inducing brief, alternating cycles of limb ischemia and
reperfusion. RIC possibly impacts the hemostatic system, and the
intervention has been tested as protective therapy against
ischemia-reperfusion injury and thrombotic complications in cardiac
surgery and other surgical procedures. In the present systematic review,
we aimed to investigate the effect of RIC on intraoperative and
postoperative bleeding complications in meta-analyses of randomized
controlled trials including adult patients undergoing surgery. A
systematic search was performed on November 7, 2020 in PubMed, Embase, and
the Cochrane Central Register of Controlled Trials. Randomized controlled
trials comparing RIC versus no RIC in adult patients undergoing surgery
that reported bleeding outcomes in English publications were included.
Effect estimates with 95% confidence intervals were calculated using the
random-effects model for intraoperative and postoperative bleeding
outcomes. Thirty-two randomized controlled trials with 3,804 patients were
eligible for inclusion. RIC did not affect intraoperative bleeding volume
(nine trials; 392 RIC patients, 399 controls) with the effect
estimate-0.95 [-9.90; 7.99] mL (p = 0.83). RIC significantly reduced
postoperative drainage volume (seven trials; 367 RIC patients, 365
controls) with mean difference-83.6 [-134.9;-32.4] mL (p = 0.001). The
risk of re-operation for bleeding was reduced in the RIC group (16 trials;
838 RIC patients, 839 controls), albeit not significantly, with the
relative risk 0.65 [0.39; 1.09] (p = 0.10). In conclusion, RIC reduced
postoperative bleeding measured by postoperative drainage volume in this
meta-analysis of adult patients undergoing surgery. Copyright ©
2021 Thieme. All rights reserved. Thieme Medical Publishers, Inc.

<91>
Accession Number
637212779
Title
Comparison the Effect of Etomidate vsThiopentone on Left Ventricular
Strain and Strain Rate at the Time of Anesthesia Induction in Patients
Undergoing Elective Coronary Artery Bypass Surgery: A Randomized Double
Blind Controlled Trial.
Source
Journal of Cardiac Critical Care. 5(3) (pp 201-207), 2021. Article Number:
2190005. Date of Publication: 02 Feb 2022.
Author
Singh U.; Choudhury M.; Choudhury A.; Hote M.P.; Kapoor P.M.
Institution
(Singh) Department of Cardiac Surgical Intensive Care, All India Institute
of Medical Sciences, New Delhi, India
(Choudhury, Choudhury, Kapoor) Department of Cardiac Anaesthesia and
Critical Care, All India Institute of Medical Sciences, New Delhi, India
(Hote) Department of Cardiothoracic and Vascular Surgery, All India
Institute of Medical Sciences, New Delhi, India
Publisher
Thieme Medical and Scientific Publishers Pvt Ltd
Abstract
Myocardial strain imaging with speckle tracking echocardiography (STE) is
getting popularity because it does not depends on insonation angle and has
shown good correlation with intraoperative and postoperative ventricular
function in patients with coronary artery disease. The impact of
thiopentone and etomidate induction on myocardial function was studied and
compared on sixty patients undergoing elective coronary artery bypass
grafting. Three loops for each views (apical 4 chamber, apical 2 chamber,
and apical long axis) were acquired at base line (T0) and 1 minute (T1)
after induction for offline analysis. In Group T, significant increase in
HR from the base line values (67.8 +/- 13.8 vs 79.2 +/- 15.6, p = 0.001)
occurred post induction, where as in Group E it remain near to the base
line (71.7 +/- 8.3 vs 70.1+/- 8.9, p = 0.345). A reduction in mean
arterial pressure (MAP) was noted in both the groups after the injection
of the allocated drug. There was no significant difference in the index of
contractility (ICON) (T0 vs T1: 48.7 +/- 10.6 vs 47.0 +/- 11.7, p = 0.120)
in Group E where as in Group T there was a reduction in the ICON value (T0
vs T1: 45.0 +/- 10.7 vs 41.0 +/- 8.4, p = 0.005). A similar picture was
also noted in systemic vascular resistance index. A significant decrease
in cardiac index (CI) was seen in Group E (T0 vs T1: 2.7 +/- 0.4 vs 2.5
+/- 0.4, p = 0.027), however it remain near to the base line in Group T.
There occurred no changes in stroke index (SI) in Group E (T0 vs T1: 38.7
+/- 6 vs 37.0+/- 5.3, p = 0.134), where as a significant decrease was
noted after injection of thiopental (T0 vs T1: 38.0 +/- 6.2 vs 36.1+/-
4.9, p = 0.049). A significant decline in cardiac performance index (CPI)
was also recorded in Group E (T0 vs T1: 0.57 +/- 0.15 vs 0.52 +/- 0.12, p
= 0.032), and not in Group T. There was decrease in left ventricular
ejection fraction (LVEF) after the injection of both the drugs (Group E,
T0 vs T1: 57 +/- 3.7 vs 54+/- 3.7, p= 0.001; and Group T, T0 vs T1: 57 +/-
3.7 vs 54+/- 3.7, p = 0.001). In Group E, global longitudinal peak
systolic strain (GLPSS) showed no change after the injection of the drug
(T0 vs T1: -13.2 +/- 2.2 vs -13.1+/- 2.3, p = 0.631). However, a
significant decrease in GLPSS (T0 vs T1: -13.5 +/- 1.5 vs - 10 +/- 1.8, p
= 0.001) after injection of thiopental. Longitudinal peak systolic strain
rate (LPSSR) was significantly decreased in all echocardiographic views
after the injection of respective drugs. However, the decrease in LPSSR
was significantly less in Group E in comparison to Group T. To conclude,
STE provides accurate and reliable real time quantitative regional and
global LV assessment. Use of thiopentone for anesthesia induction is
associated with more profound impairment of LV function in comparison to
etomidate as assessed by a decreased longitudinal peak systolic strain
rate and global longitudinal peak systolic strain. Further studies are
warranted to understand the exact clinical impact, which may influence the
choice of intravenous induction agent based upon preoperative patient
characteristics. Copyright © 2021 Thieme India. All rights
reserved.

<92>
Accession Number
2043938443
Title
Interdisciplinary and Cross-Sectoral Perioperative Care Model in Cardiac
Surgery: ERAS Implementation in the Setting of Minimally Invasive Heart
Valve Surgery (INCREASE)-Results of a Randomized Controlled Trial.
Source
European Journal of Cardio-thoracic Surgery. 68(2) (no pagination), 2026.
Article Number: ezag061. Date of Publication: 01 Feb 2026.
Author
Petersen J.; Stock S.; Brettschneider C.; Dolata L.; Dumps C.; Lowe B.;
Nijman E.; Ozga A.-K.; Reichenspurner H.; Schmid M.E.; Schulte-Uentrop L.;
Vettorazzi E.; Zapf A.; Zastrow I.; Klotz S.G.R.; Girdauskas E.
Institution
(Petersen, Reichenspurner, Girdauskas) Department of Cardiovascular
Surgery, University Heart and Vascular Center, University Medical Center
Hamburg-Eppendorf, Hamburg, Germany
(Petersen, Reichenspurner, Girdauskas) DZHK, German Centre for
Cardiovascular Research, partner site North, Hamburg, Germany
(Stock, Schmid, Girdauskas) Department of Cardiothoracic Surgery,
University Hospital Augsburg, Augsburg, Germany
(Brettschneider) Department of Health Economics and Health Services
Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Dolata, Zastrow) Department of Patient and Care Management, University
Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Dumps) Faculty of Medicine, University of Augsburg, Anesthesiology and
Operative Intensive Care, Augsburg, Germany
(Lowe) Department of Psychosomatic Medicine and Psychotherapy, University
Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Nijman) Department of Physiotherapy and Occupational Therapy, University
Hospital Augsburg, Augsburg, Germany
(Ozga, Vettorazzi, Zapf) Institute of Medical Biometry and Epidemiology,
University Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Schulte-Uentrop) Department of Anesthesiology, Center of Anesthesiology
and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf,
Hamburg, Germany
(Klotz) Department of Physiotherapy, University Medical Center
Hamburg-Eppendorf, Hamburg, Germany
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Objectives: Enhanced recovery after surgery (ERAS) protocols are
patient-centred, interprofessional perioperative care models aimed at
reducing hospital stays, complications, healthcare costs, and improving
patient satisfaction. Evidence for ERAS in cardiac surgery is scarce;
therefore, we aimed to assess its efficacy and safety in minimally
invasive heart valve surgery (MIHS). Method(s): Interdisciplinary
Perioperative Care in Minimally Invasive Heart Valve Surgery (INCREASE) is
a randomized-controlled trial that compares ERAS with standard care in
MIHS. The intervention group (IG) received ERAS-based treatment; the
control group (CG) standard care. Co-primary end-points were in-hospital
stay for cardiovascular reasons within 1 year postoperatively (superiority
hypothesis) and physical performance (6-minute walk test [6MWT]) at
discharge (non-inferiority hypothesis). Superiority hypothesis was tested
primarily in surgically treated patients (modified intention to treat
population), while non-inferiority hypothesis was tested in per protocol
population. Results In total, 201 patients scheduled for MIHS were
randomized (IG: 101; CG: 100). Total weighted in-hospital stay within 1
year was non-significantly shorter in the IG (adjusted mean difference
-2.7 days, 95% confidence interval (CI) (-6.3, 0.9), 1-sided P =.07).
Sensitivity analyses favoured the IG (adjusted ratio 0.71, 95% CI, 0.6,
0.85). For 6MWT, adjusted mean difference was -14%, 95% CI (-43%, 15%)
exceeding the non-inferiority margin of -15% (1-sided P =.48). Without
baseline adjustment, 6MWT values revealed a mean difference between groups
of -1%, 95% CI (-10%, 8%), reaching non-inferiority of the IG. Safety
outcomes were comparable with the exception of an unexpected higher rate
of post-operative atrial fibrillation in patients randomized to ERAS.
 Conclusion(s): ERAS is feasible and safe in MIHS. The trial did not
demonstrate a reduction in length of hospital stay during the first
postoperative year in the population studied. Exploratory analyses suggest
that further evaluation of ERAS concepts is justified. Copyright
© The Author(s) 2026. Published by Oxford University Press on behalf
of the European Association for Cardio-Thoracic Surgery.

<93>
Accession Number
2043662716
Title
Left atrial appendage closure versus direct oral anticoagulants after
pulmonary vein isolation for atrial fibrillation: protocol for a
multicentre, prospective, randomised, non-inferiority trial (PROMOTE
study).
Source
BMJ Open. 16(2) (no pagination), 2026. Article Number: e103632. Date of
Publication: 16 Feb 2026.
Author
Jiang L.; Hao Z.; Chu H.; Wang X.; Ning Z.; Zhang J.; Yang B.; Xu Y.; Fang
R.; Kong L.; Zhang X.; He Q.; Zhang Z.; Zhang T.; Du C.; Wu Y.; Zhao D.;
Huang H.; Ma W.; Liang Z.; Pan X.; Wang C.; Miao Y.; Shen L.; He B.
Institution
(Shen) University of Pittsburgh Medical Center Health System, Pittsburgh,
PA, United States
(Jiang, Yang, Wu, He) Department of Cardiology, Shanghai East Hospital,
Tongji University School of Medicine, Shanghai, China
(Hao, Liang, Pan, Wang, Miao, Shen) Department of Cardiology, Shanghai
Chest Hospital, Shanghai Jiao Tong University School of Medicine,
Shanghai, China
(Chu, Fang) Department of Cardiovascular Medicine, The First Affiliated
Hospital of Ningbo University, Ningbo University, Zhejiang, Ningbo, China
(Wang, Kong) Department of Cardiology, Renji Hospital, Shanghai Jiaotong
University, School of Medicine, Shanghai, China
(Ning, Zhang) Department of Cardiology, Shanghai Pudong New District
Zhoupu Hospital, Pudong, Shanghai, China
(Zhang, He, Zhang, Zhang) Department of Cardiology, Shanghai Jiao Tong
University School of Medicine, Affiliated Ninth People's Hospital,
Shanghai, China
(Xu, Zhao) Department of Cardiology, Shanghai Tenth People's Hospital,
Shanghai Jiaotong University School of Medicine, Shanghai, China
(Du) Department of Geriatrics, The Ninth People's Hospital, Affiliated of
Shanghai Jiaotong University, Shanghai, China
(Huang) School of Public Health, Shanghai Jiao Tong University School of
Medicine, Shanghai Jiao Tong University, Shanghai, China
(Ma) Clinical Research Unit, Shanghai Chest Hospital, Shanghai Jiao Tong
University School of Medicine, Shanghai, China
Publisher
BMJ Publishing Group
Abstract
Introduction Atrial fibrillation (AF), with a prevalence of 1-2%, is the
most common cardiac arrhythmia. AF is associated with a fivefold increased
risk of cardioembolic events; approximately 20% of all strokes are caused
by AF. Pulmonary vein isolation (PVI) has become the first-line treatment
for AF. However, PVI cannot eliminate the residual stroke risk. Current
guidelines recommend that anticoagulation be continued in this specific
group of patients, regardless of the presence or absence of AF. In this
large AF population post-PVI, who are considered to be in an earlier stage
of AF, it is unknown whether left atrial appendage closure (LAAC) offers
an alternative to direct oral anticoagulant (DOAC) therapy. Methods and
analysis The trial will be a prospective, randomised, multicentre
non-inferiority study comparing two treatment strategies in AF patients
after atrial ablation. Patients will be randomly assigned to either
percutaneous LAAC (group A) or DOAC treatment (group B) in a 1:1 ratio;
both sequential and concomitant planned ablation with or without LAAC are
accepted. Randomisation will be conducted using web-based randomisation
software. A total of 1012 participants (506 patients per group) will be
enrolled. The primary effectiveness measure will be the occurrence of any
of the specified events within 24 months after randomisation:
stroke/transient ischaemic attack/systemic thromboembolism, cerebral
haemorrhage, other major haemorrhages (Bleeding Academic Research
Consortium >=2), cardiovascular mortality and all-cause mortality. Ethics
and dissemination The study was approved by the Ethical Review Board of
Shanghai Chest Hospital, China (KS(Y)20287). Written informed consent will
be obtained from all participants. The trial will follow the Declaration
of Helsinki and Good Clinical Practice. Confidentiality will be maintained
with anonymised, securely stored data. Findings will be disseminated
through peer-reviewed publications and conferences. Copyright ©
Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ Group.

<94>
Accession Number
637379347
Title
Serum Lactate and Mortality during Pediatric Admissions: Is 2 Really the
Magic Number?.
Source
Journal of Pediatric Intensive Care. 11(2) (pp 83-90), 2022. Date of
Publication: 20 Jun 2022.
Author
Loomba R.S.; Farias J.S.; Villarreal E.G.; Flores S.
Institution
(Loomba) Division Of Pediatric Cardiac Critical Care, Advocate Children's
Hospital, Oak Lawn, IL, United States
(Loomba) Department Of Pediatrics, Chicago Medical School, Rosalind
Franklin University Of Medicine And Science, Chicago, IL, United States
(Farias, Villarreal) Tecnologico De Monterrey, School Of Medicine And
Health Sciences, Nuevo Leon, Monterrey, Mexico
(Flores) Section Of Critical Care Medicine And Cardiology, Texas
Children's Hospital, Houston, TX, United States
(Flores) Department Of Pediatrics, Baylor College Of Medicine, Houston,
TX, United States
Publisher
Georg Thieme Verlag
Abstract
The primary objective of this study was to determine if serum lactate
level at the time of hospital admission can predict mortality in pediatric
patients. A systematic review was conducted to identify studies that
assessed the utility of serum lactate at the time of admission to predict
mortality in pediatric patients. The areas under the curve from the
receiver operator curve analyses were utilized to determine the pooled
area under the curve. Additionally, standardized mean difference was
compared between those who survived to discharge and those who did not. A
total of 12 studies with 2,099 patients were included. Out of these, 357
(17%) experienced mortality. The pooled area under the curve for all
patients was 0.74 (0.67-0.80, p < 0.01). The pooled analyses for all
admissions were higher in those who experienced mortality (6.5 vs. 3.3
mmol/L) with a standardized mean difference of 2.60 (1.74-3.51, p < 0.01).
The pooled area under the curve for cardiac surgery patients was 0.63
(0.53-0.72, p < 0.01). The levels for cardiac surgery patients were higher
in those who experienced mortality (5.5 vs. 4.1 mmol/L) with a
standardized mean difference of 1.80 (0.05-3.56, p = 0.04). Serum lactate
at the time of admission can be valuable in identifying pediatric patients
at greater risk for inpatient mortality. This remained the case when only
cardiac surgery patients were included. Copyright © 2020. Thieme.
All rights reserved.

<95>
Accession Number
2043375593
Title
Incidence and risk factors of hypoxemia after general anesthesia in
children undergoing non-cardiac surgery: a systematic review and
meta-analysis.
Source
Pediatric Surgery International. 42(1) (no pagination), 2026. Article
Number: 105. Date of Publication: 01 Dec 2026.
Author
Zhang D.; Yu X.; Cui Y.
Institution
(Zhang, Cui) Department of Anesthesiology, School of Medicine, Chengdu
Women's and Children's Central Hospital, University of Electronic Science
and Technology of China, Sichuan, Chengdu, China
(Yu) Department of Clinical Laboratory, School of Medicine, Chengdu
Women's and Children's Central Hospital, University of Electronic Science
and Technology of China, Sichuan, Chengdu, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Postoperative hypoxemia is a critical complication in
pediatric (<= 18 years) patients undergoing non-cardiac surgeries with
endotracheal intubation, which will potentially lead to poorer outcomes.
Despite its clinical significance, systematic approaches to ascertain
prevalence and risk factors are lacking. Thus, our study aims to conduct a
systematic review and meta-analysis to assess the prevalence of
postoperative hypoxemia in pediatric patients following endotracheal
intubation for non-cardiac procedures and to identify associated risk
factors. Method(s): A comprehensive search of PubMed, Ovid, Embase,
Web of Science, and Cochrane Library was conducted from inception to
November 30, 2024, using terms related to children, postoperative, and
hypoxemia. Observational and interventional studies reporting
postoperative hypoxemia in pediatric patients undergoing non-cardiac
surgeries with endotracheal intubation were included. Two reviewers
independently extracted data. Random-effects meta-analysis estimated
pooled prevalence. Subgroup analyses examined age, publication year, and
geographic region. Meta-regression examined surgical types. The primary
outcome was the overall incidence of postoperative hypoxemia. The
secondary outcomes were the risk factors related to postoperative
hypoxemia. Result(s): A total of 37 studies involving 14,597 patients
were identified. The pooled prevalence of postoperative hypoxemia was
10.1% (95% CI: 0.066-0.142). Infants (< 1 year) had a higher prevalence
than older children (17.5% vs. 7.4%; p = 0.025). Studies published before
2010 reported higher rates (15.4-20.6%) than post-2010 studies (5.5-6.7%).
No significant variations were observed across World Health Organization
regions, World Bank income classifications or surgical types.
 Conclusion(s): This study provides a global estimation of
postoperative hypoxemia prevalence in pediatric patients undergoing
non-cardiac surgeries with endotracheal intubation. Standardizing the
definition of hypoxemia in future research is crucial to enhance
comparability and clinical relevance. Trial registration: The review
protocol was registered in advance with PROSPERO (ID CRD42025631572), date
of registration: Dec 26 2024. Copyright © The Author(s), under
exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature
2026.

<96>
Accession Number
636226120
Title
Cardiovascular Mortality after Venous Thromboembolism: A Meta-Analysis of
Prospective Cohort Studies.
Source
Seminars in Thrombosis and Hemostasis. 48(4) (pp 481-489), 2022. Date of
Publication: 30 Jun 2022.
Author
Noumegni S.R.; Grangereau T.; Demir A.; Bressollette L.; Couturaud F.;
Hoffmann C.
Institution
(Noumegni, Grangereau, Bressollette, Hoffmann) Department of Vascular
Medicine, Brest Teaching Hospital, Brest University, EA 3878 GETBO, Brest,
France
(Noumegni, Bressollette, Couturaud, Hoffmann) EA3878 (GETBO), Western
Brittany Thrombosis Study Group, Brest University, Brest, France
(Grangereau) Department of Cardiovascular Medicine, Guingamp Hospital,
Guingamp, France
(Demir) Department of Vascular Medicine, Bordeaux Teaching Hospital,
Bordeaux, France
(Couturaud) Department of Internal Medicine and Pneumology, Brest Teaching
Hospital, Brest, France
Publisher
Thieme Medical Publishers, Inc.
Abstract
Many studies from current literature show that cardiovascular diseases in
patients with venous thromboembolism (VTE) are more frequent than in the
general population without VTE. However, data summarizing the impact of
cardiovascular diseases on mortality of patients with VTE are lacking. In
this systematic review and meta-analysis, we aimed to determine the
frequency and incidence rate of cardiovascular death in patients with VTE.
MEDLINE and EMBASE were searched from January 1, 2000 to February 28,
2021. Eligible studies were observational prospective cohort studies
including patients with VTE and reporting all causes of death.
Cardiovascular death was defined as deaths that result from new or
recurrent pulmonary embolism, death due to acute myocardial infarction,
sudden cardiac death or heart failure, death due to stroke, death due to
cardiovascular procedures or hemorrhage, death due to ruptured aortic
aneurysm or aortic dissection and death due to other cardiovascular
causes. Random-effect models meta-analysis served to determine all pooled
effect size of interest with their 95% confidence interval (CI). Thirteen
observational studies enrolling 22,251 patients were identified and
included. The mean/median age varied between 49 and 75 years. The
proportion of men ranged from 38.3 to 53.2%. The overall pooled frequency
of cardiovascular death in patients with VTE was 3.9% (95% CI: 2.5-5.6%),
while the overall pooled frequency of all-cause mortality was 12.0% (95%
CI: 9.1-15.4%). The pooled proportion of cardiovascular death among all
causes of deaths in patients with VTE was 35.2% (95% CI: 22.2-49.3%). The
pooled incidence rate of cardiovascular death was 1.92 per 100
patient-years (95% CI: 0-4.1). The frequency of cardiovascular death in
patients with VTE was significantly higher than in patients without VTE
(risk ratio: 3.85, 95% CI: 2.75-5.39). Based on this updated meta-analysis
from 13 prospective cohort studies, cardiovascular death in patients with
VTE is more frequent than in the general population without
VTE. Copyright © 2022 Thieme Medical Publishers, Inc.. All rights
reserved.

<97>
Accession Number
635317125
Title
Anti-Xa Monitoring of Low-Molecular-Weight Heparin during Pregnancy: A
Systematic Review.
Source
Seminars in Thrombosis and Hemostasis. 47(7) (pp 824-842), 2021. Date of
Publication: 04 Oct 2021.
Author
Kjaergaard A.B.; Fuglsang J.; Hvas A.-M.
Institution
(Kjaergaard, Hvas) Department of Clinical Biochemistry, Palle Juul-Jensens
Boulevard 99, Aarhus N, Denmark
(Fuglsang) Department of Obstetrics and Gynecology, Aarhus University
Hospital, Aarhus, Denmark
(Fuglsang, Hvas) Department of Clinical Medicine, Aarhus University,
Aarhus, Denmark
Publisher
Thieme Medical Publishers, Inc.
Abstract
Low-molecular-weight heparin (LMWH) is commonly used for preventing or
treating venous thromboembolic disease (VTE) during pregnancy. The
physiological changes in maternal metabolism have led to discussions on
optimal LMWH dosing strategy and possible need for monitoring. The aim of
this systematic review is to summarize and discuss whether LMWH dose
adjustment according to anti-Xa provides superior effectiveness and safety
compared with weight adjusted or fixed dosed LMWH in pregnant women. A
systematic literature search was performed in PubMed, Embase, and Scopus
on September 26, 2020. The study is reported according to Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
guidelines. Effectiveness was defined as episodes of thrombosis and safety
as bleeding episodes. In total, 33 studies were included: 4 randomized
controlled studies and 29 cohort studies. Prophylactic dosing strategies
employing weight dosed, fixed dosed, or anti-Xa adjusted LMWH dosing
performed equal in effectiveness and safety. In pregnant women with VTE or
high thromboembolic risk, therapeutic weight-adjusted LMWH and weight plus
anti-Xa-adjusted LMWH provided equal results in terms of effectiveness and
safety. Pregnant women with mechanical heart valves (MHVs) received
therapeutic anti-Xa-adjusted LMWH with four out of seven studies
presenting mean peak anti-Xa within target ranges. Still, pregnant women
with MHV experienced both thrombosis and bleeding with anti-Xa in target.
Based on the results of this systematic review, current evidence does not
support the need for anti-Xa monitoring when using LMWH as
thromboprophylaxis or treatment during pregnancy. Nonetheless, the need
for anti-Xa monitoring in pregnant women with MHV may need further
scrutiny. Copyright © 2021 Georg Thieme Verlag. All rights
reserved.

<98>
Accession Number
2043559150
Title
Improved patient selection for renal artery stenting: a game-changer.
Source
European Heart Journal. 47(6) (pp 770-772), 2026. Date of Publication: 07
Feb 2026.
Author
White C.J.
Institution
(White) Department of Cardiology, John Ochsner Heart and Vascular
Institute, Ochsner Clinical School, University of Queensland, Australia
(White) Ochsner Health, New Orleans, LA, United States
Publisher
Oxford University Press

<99>
Accession Number
635935221
Title
Percutaneous Coronary Intervention with Stenting versus Coronary Artery
Bypass Grafting in Stable Coronary Artery Disease.
Source
International Journal of Angiology. 30(3) (pp 221-227), 2021. Date of
Publication: 10 Nov 2021.
Author
Glenn I.C.; Iacona G.M.; Mangi A.A.
Institution
(Glenn) Department of Thoracic and Cardiovascular Surgery, Heart,
Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH, United
States
(Iacona, Mangi) Medstar Health Cardiac Surgery, Heart and Vascular
Institute, Medstar Washington Hospital Center, 110 Irving Street
Northwest, Washington, DC, United States
Publisher
Thieme Medical Publishers, Inc.
Abstract
The debate over coronary artery bypass grafting (CABG) or percutaneous
coronary intervention (PCI) with stent placement for the treatment of
stable multivessel coronary artery disease (CAD) continues in spite of
numerous studies investigating the issue. This paper reviews the most
recent randomized control trials (RCT) and meta-analyses of pooled RCT
data to help address this issue. General trends demonstrated that CABG was
superior in all-cause mortality and fulfilling the need for repeat
revascularization. These advantages tended to be more pronounced in
multivessel CAD and diabetes, and less so in left main CAD. PCI showed a
consistently lower rate of cerebrovascular events. CABG continues to offer
significant advantages over PCI, even as drug-eluting stent technology
continues to evolve. The ideal endpoint for comparing PCI and CABG remains
to be determined. Furthermore, additional research is required to further
refine patient selection criteria for each intervention. Copyright
© 2021. International College of Angiology. All rights reserved.

<100>
Accession Number
2043851585
Title
Impact of Transcatheter Mitral and Tricuspid Valve Repair on Hepatic
Function and Outcomes in Patients with Cirrhosis or Advanced Liver
Disease-A Personalized Approach.
Source
Journal of Clinical Medicine. 15(5) (no pagination), 2026. Article Number:
1883. Date of Publication: 01 Mar 2026.
Author
Becic T.; Jukic I.; Prizmic P.S.; Matulic I.; Dogas H.; Radic M.; Radic
J.; Vukovic J.; Fabijanic D.
Institution
(Becic, Fabijanic) Department of Cardiovascular Diseases, University
Hospital of Split, Split, Croatia
(Jukic, Vukovic) Department of Internal Medicine, Division of
Gastroenterology, University Hospital of Split, Split, Croatia
(Jukic) Faculty of Health Sciences, University of Split, Split, Croatia
(Prizmic, Radic) Department of Internal Medicine, Division of
Rheumatology, Allergology and Clinical Immunology, University Hospital of
Split, Split, Croatia
(Matulic) Private Clinic Matulic, Osjecka Ulica 24a, Split, Croatia
(Dogas) Department of Neurology, University Hospital of Split, Split,
Croatia
(Radic, Radic, Vukovic) Department of Internal Medicine, School of
Medicine, University of Split, Split, Croatia
(Radic) Department of Internal Medicine, Division of Nephrology, Dialysis
and Arterial Hypertension, University Hospital of Split, Split, Croatia
(Fabijanic) Department of Clinical Propedeutics, School of Medicine,
University of Split, Split, Croatia
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Transcatheter edge-to-edge repair (TEER) has emerged as an
established treatment option for patients with severe mitral (MR) and
tricuspid regurgitation (TR) who are at high surgical risk. Patients
referred for TEER frequently present with advanced comorbidities,
including cirrhosis or chronic liver disease (CLD). Hepatic dysfunction,
driven by chronic venous congestion and impaired cardiac output,
represents a key yet underrecognized determinant of prognosis in this
population. The impact of TEER on hepatic function and outcomes in
patients with advanced liver disease remains incompletely defined.
 Method(s): This systematic review was conducted in accordance with
PRISMA 2020 guidelines and registered in PROSPERO. A comprehensive
literature search of PubMed, Scopus, Web of Science, and the Cochrane
Library was performed up to 16 January 2026, without language
restrictions. Studies evaluating mitral or tricuspid TEER in adult
patients with cirrhosis, chronic or advanced liver disease, congestive
hepatopathy, or cardiohepatic syndrome were included. Hepatic function was
assessed using biochemical markers, clinical diagnoses, or composite
scores such as Model for End-Stage Liver Disease (MELD) score and Model
for End-Stage Liver Disease Excluding INR (MELD-XI). A qualitative
synthesis was performed due to heterogeneity in study design and outcome
reporting. Result(s): Twelve studies were included, comprising
prospective and retrospective cohorts, registry-based analyses,
mechanistic studies, and one illustrative case report. Six studies
evaluated mitral TEER (M-TEER) and six tricuspid (T-TEER). Across both
valve interventions, impaired baseline hepatic function was consistently
associated with increased mortality and adverse clinical outcomes. MELD
and MELD-XI scores emerged as robust prognostic markers following both
M-TEER and T-TEER. Successful reduction in valvular regurgitation was
associated with stabilization or improvement of hepatic parameters in
selected patients, particularly after T-TEER. However, advanced
cardiohepatic syndrome and limited hepatic reserve were linked to poor
outcomes despite procedural success. Conclusion(s): Hepatic
dysfunction is a powerful determinant of prognosis in patients undergoing
M-TEER and T-TEER. While TEER may improve hepatic congestion and
liver-related parameters in selected patients, outcomes are highly
dependent on baseline hepatic reserve and global hemodynamic status. A
personalized approach integrating hepatic assessment into patient
selection and risk stratification is essential to optimize outcomes in
this complex and growing population. Copyright © 2026 by the
authors.

<101>
Accession Number
2043865261
Title
Risk factors for acute kidney injury following transcatheter aortic valve
replacement: a systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article
Number: 1684953. Date of Publication: 2026.
Author
Jiang N.; Liu X.; Huang J.; Jiang Y.; Li D.
Institution
(Jiang, Huang, Jiang, Li) Department of Cardiology, The First People's
Hospital of Zigong, Sichuan, Zigong, China
(Liu) Department of Oncology, The Second People's Hospital of Yibin,
Sichuan, Yibin, China
Publisher
Frontiers Media SA
Abstract
Objective: To delineate risk factors for acute kidney injury (AKI) after
transcatheter aortic valve replacement (TAVR) via a systematic review and
meta-analysis. Method(s): PubMed, Embase, the Cochrane Library, and
Web of Science were searched through February 2025 for case-control
studies reporting post-TAVR AKI. Two reviewers independently performed
study selection, data extraction, and bias assessment. Pooled analyses
were conducted with Stata 15.0. Result(s): Thirty-four studies
(10,353 patients) met the inclusion criteria; 2,250 patients (21.7%)
developed AKI. Univariable meta-analysis implicated multiple comorbid,
hemodynamic, and procedural factors [e.g., hypertension, diabetes,
coronary and peripheral vascular disease, porcelain aorta, prior PCI,
atrial fibrillation, chronic kidney disease (CKD), advanced NYHA class,
left ventricular ejection fraction (LVEF) <40%, anemia, diuretic use,
transapical/transaortic access, general anesthesia, rapid pacing, bleeding
or vascular complications, transfusion, and peri-procedural myocardial
infarction or stroke; all p < 0.05). Multivariable pooling isolated eight
independent predictors: hypertension (OR 2.87), coronary artery disease
(1.46), peripheral vascular disease (1.71), prior stroke (1.61), CKD
(3.27), elevated serum creatinine (2.80), higher STS score (1.06 per
point), and transapical access (3.45). Publication bias was not detected.
 Conclusion(s): Post-TAVR AKI is chiefly driven by cardiovascular
comorbidity and renal impairment, with hypertension, coronary and
peripheral vascular disease, prior stroke, CKD, elevated creatinine, high
STS score, and transapical access displaying the strongest, independent
associations. Awareness of these factors may facilitate peri-procedural
risk stratification and targeted renal-protective
strategies. Copyright 2026 Jiang, Liu, Huang, Jiang and Li.

<102>
Accession Number
2043855469
Title
The Exercise aNd hEArt Transplant (ENEA) Trial: A Randomized Controlled
Trial of Cardiac Rehabilitation After Heart Transplantation.
Source
Journal of Clinical Medicine. 15(5) (no pagination), 2026. Article Number:
1832. Date of Publication: 01 Mar 2026.
Author
Pedersini P.; Villaschi A.; Toccafondi A.; Antolini L.; Grati P.; Cusmano
I.; Mapelli L.; Gonella M.; Di Lauro S.; Gonella R.; Masciocco G.;
Garascia A.; Morici N.
Institution
(Pedersini, Villaschi, Toccafondi, Antolini, Grati, Cusmano, Mapelli,
Gonella, Di Lauro, Gonella, Morici) IRCCS Fondazione Don Carlo Gnocchi,
Milan, Italy
(Pedersini) Department of Clinical and Experimental Sciences, University
of Brescia, Brescia, Italy
(Villaschi) Department of Biomedical Sciences, Humanitas University, Pieve
Emanuele, Milan, Italy
(Masciocco, Garascia) De Gasperis Cardio Center, ASST Grande Ospedale
Metropolitano Niguarda, Milan, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Heart transplantation (HTx) remains the gold-standard therapy
for patients with end-stage heart failure. Cardiac rehabilitation (CR) is
a multidisciplinary intervention that improves cardiovascular prognosis
and quality of life. The aim of this randomized controlled trial was to
evaluate the impact of cardiac telerehabilitation on cardiovascular events
after HTx. Method(s): Forty patients who had undergone HTx were
recruited at a single Italian institution and randomly allocated 1:1 to an
experimental group (on-site CR followed by 12 weeks of telerehabilitation)
or a control group (on-site CR followed by standard homecare and an
exercise program). The primary outcome was a 6-month composite of major
cardiovascular events, including acute allograft rejection, heart failure
hospitalization, coronary allograft vasculopathy, stroke, and all-cause
mortality. Secondary outcomes included return to work within 6 months,
physical and functional activity levels and treatment adherence.
 Result(s): Forty patients were equally allocated to control and
experimental groups, with well-balanced baseline demographic, clinical,
and functional characteristics. At 6 months, the primary composite
endpoint occurred in 35% of patients in both groups, with no significant
between-group differences. Return to work was observed in 72.2% of the
controls and 64.3% of intervention patients. Physical activity levels were
comparable between groups, with most patients classified as sufficiently
active. Adherence to the cardiac telerehabilitation program was complete
in only 50% of the patients. Conclusion(s): In this randomized trial
on HTx patients, a hybrid telerehabilitation program was as safe as
standard care regarding major cardiovascular events at 6 months. The low
adherence observed suggests that future digital interventions must focus
on enhancing patient engagement. Copyright © 2026 by the authors.

<103>
Accession Number
2037800457
Title
Vitamin C in cardiac surgery: a narrative review.
Source
Acta Anaesthesiologica Belgica. 76(Supplement 1) (pp 103-115), 2025. Date
of Publication: 01 Dec 2025.
Author
Lelong Q.; Maseri A.; Coulie R.; Dincq A.S.
Institution
(Lelong, Maseri, Coulie, Dincq) Universite catholique de Louvain, CHU UCL
Namur, Anesthesiology Department, Yvoir, Belgium
Publisher
BeSARPP
Abstract
Cardiothoracic surgery, particularly when involving extracorporeal
circulation, is associated with a systemic inflammatory response and
oxidative stress resulting from the ischemia-reperfusion phenomenon. This
phenomenon leads to the release of free radicals, causing cellular damage,
activation of pro-inflammatory signaling pathways, and depletion of
endogenous antioxidants. These processes contribute to various
perioperative complications, including postoperative atrial fibrillation,
pulmonary complications and endothelial dysfunction. Due to its
antioxidant properties, vitamin C has been proposed to exert a protective
effect against these adverse responses and to potentially enhance
postoperative recovery. This narrative review aims to evaluate the role of
vitamin C in cardiothoracic surgery and to examine its potential benefits
with regard postoperative atrial fibrillation, fatigue, etomidate-induced
adrenergic inhibition, cardiac allograft vasculopathy, postoperative
pulmonary complications, endothelial function, vasoplegia, acute renal
failure, biochemical markers and erythrocytes integrity. The only outcomes
with consistent evidence of benefit from vitamin C supplementation were a
reduction in the incidence of postoperative atrial fibrillation, an
improvement in endothelial function and a reduction in oxidative stress.
Further large-scale, multicenter randomized controlled trials are
warranted to establish the optimal dosage, timing of administration and
specific patient populations that may derive the greatest benefit from
vitamin C administration. Copyright © 2025, BeSARPP. All rights
reserved.

<104>
Accession Number
2043840292
Title
Conduction system pacing vs right ventricular pacing after TAVR: A
systematic review and meta-analysis.
Source
Heart Rhythm O2. (no pagination), 2026. Date of Publication: 2026.
Author
Deaconu A.; Alexandru Bistriceanu M.I.; Deaconu S.; Makdah O.; Ursu C.G.;
Calin I.; Moldovan H.; Vatasescu R.G.
Institution
(Deaconu, Alexandru Bistriceanu, Makdah, Ursu, Moldovan, Vatasescu)
Faculty of Medicine, Carol Davila University of Medicine and Pharmacy,
Bucharest, Romania
(Deaconu, Moldovan, Vatasescu) Department of Cardio-Thoracic Pathology,
Faculty of Medicine, Carol Davila University of Medicine and Pharmacy,
Bucharest, Romania
(Deaconu, Moldovan, Vatasescu) Emergency Clinical Hospital, Bucharest,
Romania
(Deaconu, Calin) Monza Ares Hospital, Bucharest, Romania
Publisher
Elsevier B.V.
Abstract
Background Conduction system pacing (CSP), including His bundle pacing and
left bundle branch pacing, has emerged as a physiological alternative to
right ventricular pacing (RVP) for patients developing conduction
disturbances after transcatheter aortic valve replacement. Objective We
performed a systematic review and meta-analysis to compare CSP with RVP.
Methods PubMed, Embase, and Cochrane databases were searched according to
the Preferred Reporting Items for Systematic Reviews and Meta-Analyses
guidelines. A random-effects model was used for all outcomes, and
heterogeneity was assessed using I2 statistics. The protocol
was registered in PROSPERO (CRD420251125169). Results 8 studies, including
784 patients, were analyzed. At 15-month follow-up, all-cause mortality
did not differ significantly between CSP (left bundle branch pacing in
74%) and RVP (odds ratio 0.76; 95% confidence interval [CI] 0.51-1.14; P =
.15; I2 = 0%). CSP was associated with a shorter paced QRS
duration after implant (mean difference -34.6 ms; 95% CI -40.2 to -29.1; P
< .001) and higher left ventricular ejection fraction (mean difference
+5.4%; 95% CI 3.5-7.3; P = .003) at 15-month follow-up. Heart failure
hospitalization at 15 months was associated with a reduction in CSP (odds
ratio 0.44; 95% CI 0.27-0.72; P = .006), whereas cardiovascular mortality,
sensing, impedance, and lead dislodgement were similar between pacing
strategies. Conclusion These findings suggest that CSP provides more
physiological ventricular activation and may improve functional outcomes
after transcatheter aortic valve replacement without affecting overall
survival. Further randomized studies are warranted to confirm these
observations. Copyright © 2026 Heart Rhythm Society.

<105>
[Use Link to view the full text]
Accession Number
650536663
Title
Evaluating the benefits of high-dose statin preloading in ST-segment
elevation myocardial infarction management: insights from a systematic
review and meta-analysis.
Source
Coronary artery disease. (no pagination), 2026. Date of Publication: 09
Mar 2026.
Author
Resende B.; Mata E.; Carlos T.; Portugues J.; Ribeiro S.; Gameiro J.;
Lourenco A.; Goncalves L.
Institution
(Resende, Carlos, Gameiro, Goncalves) Cardiology Department, Unidade Local
de Saude de Coimbra, Coimbra, Portugal
(Mata, Portugues, Ribeiro, Lourenco) Cardiology Department, Unidade Local
de Saude Alto Ave, Guimaraes
(Goncalves) Faculdade de Medicina da Universidade de Coimbra
(Goncalves) Coimbra Institute for Clinical and Biomedical Research (iCBR),
Coimbra, Portugal
Abstract
INTRODUCTION: ST-segment elevation myocardial infarction (STEMI) is a
life-threatening condition needing urgent reperfusion, with better
outcomes linked to optimal myocardial perfusion. Statins may reduce
ischemia-reperfusion injury through pleiotropic effects. While the 2019
European Society of Cardiology (ESC) Dislipidemia Guidelines recommended
high-intensity statins before percutaneous coronary intervention (PCI),
this was not included in the 2023 ESC or 2025 ACC/AHA/ACEP/NAEMSP/SCAI ACS
Guidelines. OBJECTIVE(S): To evaluate the effect of high-dose statin
loading before primary PCI in improving coronary reperfusion and clinical
outcomes in STEMI patients through a systematic review and meta-analysis
of randomized controlled trials (RCTs). METHOD(S): On June 2025,
CENTRAL, EMBASE, and PubMed were searched for RCTs comparing high-dose
statin preloading with placebo or no statin in STEMI patients undergoing
primary PCI. The primary outcome was post-PCI thrombolysis in myocardial
infarction (TIMI) flow grade 3. Secondary outcomes included all-cause
mortality and greater than or equal to 50% ST-segment resolution. Data
were pooled using random-effects models, reporting odds ratios (OR) with
95% confidence intervals (CIs). RESULT(S): Nine RCTs with 1862
patients were included. High-dose statin preloading significantly
increased the likelihood of achieving post-PCI TIMI flow grade 3 (OR:
1.52, 95% CI: 1.06-2.20). It was also associated with a reduction in
all-cause mortality (OR: 0.59, 95% CI: 0.36-0.98). No significant
difference was observed in greater than or equal to 50% ST-segment
resolution (OR: 1.04, 95% CI: 0.71-1.50). CONCLUSION(S): High-dose
statin loading before primary PCI in STEMI patients seems to be associated
with improved coronary reperfusion and reduced all-cause mortality. These
findings offer timely and clinically relevant insight, reminding the
cardiovascular community of the potential value of this
therapeutic. Copyright © 2026 Wolters Kluwer Health, Inc. All
rights reserved.

<106>
Accession Number
2044149799
Title
Impact of resection vs respect techniques on left ventricular function
after mitral valve repair: a systematic review and meta-analysis.
Source
Heart, Vessels and Transplantation. 9(4) (no pagination), 2025. Date of
Publication: 01 Dec 2025.
Author
Christiany C.; Nababan V.J.; Satria D.
Institution
(Christiany, Nababan) Department of Thoracic, Cardiac, and Vascular
Surgery, BP Batam Hospital, Riau Island, Batam, Indonesia
(Satria) Department of Thoracic, Cardiac, and Vascular Surgery, Syiah
Kuala University, Aceh, Banda Aceh, Indonesia
Publisher
Bishkek: Center for Scientific Research and Development of Education
Abstract
Objective: Mitral valve disease, ranging from degenerative to infective
origin, is one of the most prevalent left heart diseases globally and
affects a large number of individuals. Conventionally, surgical repair has
grown to become the treatment of choice, with two main techniques being
resection and respect. Current literature has yet to address which
technique is superior to the other, particularly in regard to left
ventricular (LV) function. Method(s): We performed a systematic
review and meta-analysis on three databases with a primary outcome of LV
function alongside its' parameters, and a secondary outcome of repair
durability, mitral valve gradient, and mortality rates. Meta-analysis was
performed using random effects, and results were displayed in forest
plots. Risk of bias was conducted using the Newcastle-Ottawa Scale.
 Result(s): Six retrospective studies were included, evaluating a
total of 3376 patients. Pooled results showed that LV function were
preserved equally in both groups, showing no statistically significant
differences. The respect group had slightly lower mortality rates in
comparison to the resect group, and the repair success rate showed a
slight superiority in the respect group. Significant heterogeneity was
observed on left atrial diameter (LAD) measurement, indicating
variability. The overall differences in LV function coming from both
techniques appear intangible. Plenty of consideration must be made beyond
LV function in determining which repair technique should be performed on a
patient. Conclusion(s): This study demonstrated that both the resect
and respect techniques were found to be equally excellent in preserving
left ventricular function after mitral valve repair. Copyright
©2025 Heart, Vessels and Transplantation. This is an open access
article CC-BY-NC-ND 4.0 license (http://hvt-journal.com/pages/aims-scope)

<107>
Accession Number
2037792676
Title
The use of jet ventilation in today's anesthesia: a narrative review.
Source
Acta Anaesthesiologica Belgica. 76(suppl 1) (pp 63-75), 2025. Date of
Publication: 01 Dec 2025.
Author
Henrard G.; Beck F.; Kirsch M.
Institution
(Henrard, Beck, Kirsch) Departement of Anesthesia and Intensive Care
Medicine, Liege University Hospital Center, Liege, Belgium
Publisher
BeSARPP
Abstract
Objective: This narrative review seeks to examine the fundamental
mechanisms, optimal settings, current applications, and emerging
indications of jet ventilation. This review is focused on jet ventilation
in interventional procedures both within and outside the operating
theatre, through a critical analysis of existing literature.
 Background(s): Jet ventilation is primarily utilized in
otolaryngology (ENT) surgical procedures, particularly those involving the
larynx or trachea. It allows for an unobstructed operating field by
eliminating the need of a conventional endotracheal tube. Because of the
minimal thoracic expansion it generates, jet ventilation is now used in
other fields such as interventional radiology and electrophysiology.
Despite its benefits, this technique carries risks such as barotrauma,
hypoventilation, hypercapnia, and catheter misplacement. Expertise and a
thorough understanding of its principles are therefore essential for its
use. Method(s): A literature search was conducted in October 2024
using the PubMed Database. Additional search es were carried out in Google
Scholar. Main keywords were combine using the Boolean equations. This
narrative study does not aim to be as methodologically comprehensive as a
systematic review. The selection of articles is influenced by clinical
relevance. However, it offers a critical overview of current practices and
future prospects for jet ventilation. This article respect the Scale for
the quality Assessment of Narrative Review Articles (SANRA).
 Result(s): Fifty-five publications from 1956 to 2024 were selected
for the review. Only three of these articles were published before the
year 2000. A thematic analysis was used to structure the results. The use
of high-frequency jet ventilation is validated in ear, nose and throat
(ENT) surgery, interventional pulmonology, and has its place in emergency
situations. It can be used in both adults and children. More recently, its
use in interventional radiology, electrophysiology, and lithotripsy has
been studied and appears to show certain advantages. The complications
related to the use of jet ventilation are generally associated with a lack
of experience from the teams. Conclusion(s): Jet ventilation is a
critical modality in certain clinical settings, particularly within
anesthesia for upper airway procedures, laryngeal surgery, bronchoscopy,
or when surgical access necessitates an unobstructed operating field. The
principal benefits of jet ventilation include preserving excellent
operative visibility, minimizing thoracic movement, and frequently
ensuring adequate oxygenation despite low tidal volumes. This technique
necessitates specialized expertise and diligent monitoring due to its
limitations, such as the risk of barotrauma or CO2 accumulation. Further
research, including comprehensive comparative studies, is necessary to
more precisely delineate its indications, contraindications, and long-term
effects, particularly in emerging fields such as interventional radiology,
electrophysiology, and lithotripsy. Copyright © 2025, BeSARPP.
All rights reserved.

<108>
Accession Number
2043851604
Title
Thrombotic Versus Bleeding Risk After Transcatheter Aortic Valve
Implantation.
Source
Journal of Clinical Medicine. 15(5) (no pagination), 2026. Article Number:
1767. Date of Publication: 01 Mar 2026.
Author
Fotoula K.S.; Ibrahem A.; Harfoush A.; Hussain H.; Ezeldin A.; Khan H.;
Gorog D.A.; Farag M.
Institution
(Fotoula, Ibrahem, Harfoush) Cardiology Department, North Bristol NHS
Trust, Bristol, United Kingdom
(Ibrahem, Gorog, Farag) School of Life and Medical Sciences, University of
Hertfordshire, Hatfield, United Kingdom
(Harfoush) The Faculty of Health, Medicine, and Society, University of
Chester, Chester, United Kingdom
(Hussain) Cardiology Department, Grange University Hospital, Cwmbran,
United Kingdom
(Ezeldin) Queens Elizabeth Hospital, Newcastle Upon Tyne, Gateshead,
United Kingdom
(Khan, Farag) Cardiothoracic Department, Freeman Hospital, Newcastle Upon
Tyne, United Kingdom
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is increasingly
used across all risk groups, meaning more patients are living long-term
with transcatheter bioprosthetic valves. These patients are often
multimorbid and vulnerable to both thrombotic and bleeding complications.
Optimal antithrombotic therapy remains uncertain due to differences in
trial design, patient demographics, and procedural practices.
 Method(s): We undertook a narrative review that included randomised
controlled trials, observational studies, biomarker research, and
guideline recommendations on post-TAVI antithrombotic therapy. We
evaluated the available evidence for antiplatelet and anticoagulant
strategies after TAVI, predictors of bleeding and thrombotic
complications, to identify emerging approaches using biomarkers for
personalised risk stratification. Result(s): Thrombotic events after
TAVI are predominantly early and procedural in origin, while new-onset
atrial fibrillation (AF) leads to substantial late risk. Subclinical
leaflet thrombosis is frequent, but its clinical significance remains
uncertain, as anticoagulation reduces CT-detected leaflet abnormalities
without improving clinical outcomes. Early bleeding within the first 30
days remains a principal contributor to mortality, influenced by frailty,
vascular access, comorbidity, and intensity of antithrombotic therapy.
Randomised evidence consistently supports a minimalist, indication-driven
regimen: single antiplatelet therapy for patients without an
oral-anticoagulation (OAC) indication, and OAC monotherapy for those with
AF. Routine OAC use in unselected patients carries no advantage and
exposes them to harm. Biomarkers and machine-learning models show promise
for future individualised risk assessment. Conclusion(s):
Antithrombotic strategies post-TAVI should prioritise minimising bleeding
while maintaining adequate thromboembolic protection. Single antiplatelet
therapy for patients without an indication for OAC and OAC alone for those
with AF offer the best balance of safety and efficacy. Ongoing trials may
clarify the role of imaging-guided therapy and biomarker-based risk
stratification and refine antithrombotic strategies. Copyright ©
2026 by the authors.

<109>
Accession Number
2043855456
Title
Rupture of Caseous Calcification of the Mitral Annulus: Pathophysiology,
Diagnosis and Treatment.
Source
Diagnostics. 16(5) (no pagination), 2026. Article Number: 778. Date of
Publication: 01 Mar 2026.
Author
Ruggio A.; Belmusto A.; Locorotondo G.; Ruscio E.; Graziani F.; Lombardo
A.; Lanza G.A.; Burzotta F.
Institution
(Ruggio, Belmusto, Locorotondo, Ruscio, Graziani, Lombardo, Lanza,
Burzotta) Department of Cardiovascular Sciences, Fondazione Policlinico
Universitario A.Gemelli, IRCCS, Rome, Italy
(Lombardo, Lanza, Burzotta) Department of Cardiovascular Sciences-CUORE,
Catholic University of the Sacred Heart, Rome, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Caseous calcification of the mitral annulus (CCMA) is a liquefactive
necrosis of mitral annular calcification (MAC). CCMA is rare and usually
asymptomatic, has a benign course, and, when incidentally found, can be
misdiagnosed as a thrombus, abscess, cardiac tumor or vegetation. Although
rarely, CCMA may complicate with rupture, which can lead to
ventricular-atrial fistulization, pseudoaneurysm, severe mitral
regurgitation (with possible heart failure and atrial fibrillation) and
systemic embolism of caseous material (with cerebral ischemic events). A
significant increase in CCMA dimensions and an infectious involvement of
liquefactive necrosis make CCMA prone to rupture. To date, only case
reports and some case series have been published on CCMA, without focusing
on the pathophysiological mechanisms responsible for rupture, nor
recommendations for prevention and management. However, despite general
concerns about surgical treatment of CCMA because of high perioperative
risks, most published cases actually underwent successful cardiac surgery.
In the present review, we conducted a systematic review of the studies
published in the medical literature up to March 2025, reporting cases of
CCMA and its complications, as identified through the PubMed database. We
analyzed clinical and biological risk factors for CCMA rupture and its
diagnostic criteria, focusing on imaging features differentiating mitral
annular calcification from uncomplicated CCMA and ruptured CCMA. To this
regard, we focused on the key role of multimodality imaging in the
achievement of the correct diagnosis. Finally, we propose a management
strategy for CCMA, with the aim to fill a gap in this field in the current
literature. Copyright © 2026 by the authors.

<110>
Accession Number
650534188
Title
EA5181: Phase 3 Trial of Concurrent and Consolidative Durvalumab vs
Consolidation Durva Alone for Unresectable Stage 3 NSCLC.
Source
Journal of Thoracic Oncology. Conference: 2025 World Conference on Lung
Cancer. Barcelona Spain. 20(10 Supplement 1) (pp S4-S5), 2025. Date of
Publication: 01 Oct 2025.
Author
Varlotto J.M.; Xie Y.; Pennell N.; Oettel K.; Lovly C.M.; Anagnostou V.;
Srkalovic G.; Mackler N.J.; Faller B.A.; Dyk P.T.; Chowdhary A.A.; Videtic
G.M.M.; Chen Y.; Thieme P.O.; Jabbour S.K.; Haigentz M.; Almquist D.;
Nurkic S.R.; Onitilo A.A.; Lammers P.E.; Ogbeide O.; Iheagwara U.K.;
Weksberg D.C.; Ross H.J.; Harkenrider M.M.; Masters G.A.; Borghaei H.;
Brahmer J.; Ramalingam S.S.
Institution
(Varlotto) Marshall University, Huntington, WV, United States
(Xie) Dana Farber Cancer Institute, ECOG-ACRIN Biostatistics Center,
Boston, MA, United States
(Pennell) Cleveland Clinic, Case Comprehensive Cancer Center, Cleveland,
OH, United States
(Oettel) Gundersen Lutheran Medical Center, La Crosse, WI, United States
(Lovly) Vanderbilt University, Ingram Cancer Center, Nashville, TN, United
States
(Anagnostou, Brahmer) Johns Hopkins University, Sidney Kimmel Cancer
Center, Baltimore, MD, United States
(Srkalovic) University of Michigan Health - Sparrow Lansing, Lansing, MI,
United States
(Mackler) Trinity Health Saint Joseph Mercy Hosp Ann Arbor, Ann Arbor, MI,
United States
(Faller) Heartland Cancer Research NCORP, St. Louis, MO, United States
(Dyk) Missouri Baptist Medical Center, Saint Louis, MO, United States
(Chowdhary, Videtic) Cleveland Clinic, Cleveland, OH, United States
(Chen) Cancer Research Consortium of West Michigan NCORP, Grand Rapids,
MI, United States
(Thieme) Corewell Health Reed City Hospital, Reed City, MI, United States
(Jabbour, Haigentz) Rutgers Cancer Institute of New Jersey, New Brunswick,
NJ, United States
(Almquist) Sanford NCORP of the North Central Plains, Fargo, ND, United
States
(Nurkic) Sanford Roger Maris Cancer Center, Fargo, ND, United States
(Onitilo) Wisconsin NCORP, Weston, WI, United States
(Lammers, Ogbeide) Baptist Memorial Health Care/Mid South MU NCORP,
Memphis, TN, United States
(Iheagwara) UPMC Hillman Cancer Center, Pittsburgh, PA, United States
(Weksberg) UPMC Hillman Cancer Center, Harrisburg, PA, United States
(Ross) Rush University Medical Center, Chicago, IL, United States
(Harkenrider) Loyola University Medical Center, Maywood, IL, United States
(Masters) Christiana Care-Union Hospital, Newark, NJ, United States
(Borghaei) Fox Chase Cancer Center, Philadelphia, PA, United States
(Ramalingam) Emory University, Winship Cancer Institute, Atlanta, GA,
United States
Publisher
Elsevier Inc.
Abstract
Introduction: Consolidation durvalumab improves survival for patients
(pts) with unresectable stage 3 nonsmall cell lung cancer (NSCLC) after
definitive concurrent chemoradiotherapy (CRT). However, the optimal timing
of initiation of immune checkpoint inhibition is unknown. EA5181 tested
the hypothesis that starting durvalumab concurrent with CRT and continuing
as consolidation would improve overall survival compared to consolidation
durvalumab alone. Method(s): 662 pts with previously untreated,
unresectable stage III A C (N = 635) NSCLC or with mediastinal node
recurrence after prior surgery (N = 27) and ECOG performance status (ECOG
PS) 0-1 were randomized to either concurrent durvalumab with chemotherapy
(weekly carboplatin/paclitaxel, cisplatin/pemetrexed x 2 cycles or
cisplatin/etoposide x 2 cycles) and 60Gy radiotherapy (Arm A), or to CRT
alone (Arm B). Patients in both arms who completed CRT and did not
progress, had treatment-related toxicity < grade 1 within 45 days of CRT
and did not develop pneumonitis were assigned to one year (12 cycles) of
durvalumab (Arm C). Stratification factors include age, sex, stage, and
chemotherapy regimen. The primary endpoint was OS in the
intention-to-treat population, with secondary endpoints of
progression-free survival (PFS), objective response rate (ORR), patterns
of failure (local vs. distant), and toxicity. The stratified log-rank test
was used to compare OS and PFS, while stratified Cox propor tional hazards
models were applied to assess the treatment effect. Two-sided Fisher's
exact tests were used to compare ORR and recurrence patterns between the
two arms. Result(s): 335 and 327 pts were randomly assigned to arms A
and B with median follow -up of 29.9 months (95% CI: 28.4 - 33.1). 277 pts
in arms A (82.7%) and B (84.7%) started Arm C. The most common
chemotherapy partner was carboplatin/paclitaxel (553/646=85.6%). Median
age was 67.1 with 60.6% men, 88.4% White, 8.3% Black and 94.9%
Non-Hispanic. The proportions receiving all treatment cycles in step 1 in
Arms A and B were 93.7% and 94.0% respectively. The median OS for Arms A
and B was 41.5 vs. 39.4 months, p = 0.83, HR = 1.03 (95% CI: 0.80 - 1.32).
Disease progression was reported in 152 (45.4%) Arm A /C pts and 144
(44.0%) Arm B /C pts, and median PFS was 15.5 vs. 16.8 months,
respectively, p = 0.65, HR = 1.05 (95% CI: 0.86- 1.29). Multivariable
analysis noted that OS and PFS were significantly associated with ECOG PS.
Prior thoracic surgery was significantly associated with a better PFS.
Adenocarcinoma histology and DLCO > 80% were associated with significantly
better OS. In step 1, the overall response rates (CR and PR) were 51.3%
(Arm A) and 47.1% (Arm B), p = 0.28. There were no significant differences
in grade 3-5 or grade 2-5 cardiac/pulmonary events per arm in steps 1 and
2. Local recurrences were 55.9% and 49.6% in Arms A and B, respectively, p
= 0.34. Radiation in-field recurrences were noted in 28.6% (Arm A) and
28.4% (Arm B). Conclusion(s): Concurrent and consolidation durvalumab
with CRT in unresectable Stage III NSCLC did not improve OS compared to
consolidation durvalumab alone. There were also no differences in ORR,
PFS, failure patterns nor toxicity between arms.

<111>
Accession Number
2043864036
Title
PERSISTENT ORAL INFECTIONS MAY INCREASE THE RISK OF INFECTIOUS
COMPLICATIONS IN ORGAN TRANSPLANT RECIPIENTS.
Source
Journal of Evidence-Based Dental Practice. 26(2) (no pagination), 2026.
Article Number: 102232. Date of Publication: 01 Jun 2026.
Author
Zanjir M.; Azarpazhooh A.
Publisher
Elsevier Inc.
Abstract
Article Title and Bibliographic Information Olsson J, Hunfjord S, Braun O,
Haggman-Henrikson B, Ljunggren A. Impact of Oral Infection on Organ
Transplantation: A Systematic Review. J Evid Based Dent Pract. 2024
Dec;24(4):102035. doi: 10.1016/j.jebdp.2024.102035 . Epub 2024 Sep 5.
PMID: 39631966. Source of Funding No grants were received from funding
agencies in the public, commercial, or not-for-profit sectors. Type of
Study/Design Systematic review Copyright © 2026. Published by
Elsevier Inc.

<112>
Accession Number
650528334
Title
Shexiang Baoxin pill in patients with stable coronary artery disease and
reduced eGFR: Subgroup analysis of phase IV randomized trial.
Source
Phytomedicine : international journal of phytotherapy and
phytopharmacology. 154 (pp 157946), 2026. Date of Publication: 09 Feb
2026.
Author
Zhou J.; Chen Y.; Shi H.; Jin Y.; Li X.; Wu J.; Pan C.; Qian J.; Wu Y.;
Wang X.; Wang Y.; Lu F.; Ge J.
Institution
(Zhou, Ge) Department of Cardiology, Zhongshan Hospital, Fudan University,
Shanghai, China
(Chen) Shanghai Innovative Engineering Technology Research Center for
Traditional Chinese Medicine Solid Preparations, Shanghai, China
(Shi) Department of Cardiology, Huashan Hospital, Fudan University,
Shanghai, China
(Jin) Department of Cardiology, Fourth Affiliated Hospital of China
Medical University, Shenyang, China
(Li) Department of Cardiology, Jiangsu Province Hospital, Nanjing, China
(Wu) Department of Cardiology, Affiliated Hospital of Jiangxi University
of Chinese Medicine, Nanchang, China
(Pan) Department of Cardiology, First Affiliated Hospital of Guangxi
University of Chinese Medicine, Nanning, China
(Qian) Department of Cardiology, Maanshan General Hospital of Ranger-duree
Healthcare, China
(Wu) Department of Cardiology, Dongfang Hospital, Beijing University of
Chinese Medicine, Beijing, China
(Wang) Department of Cardiology, Shuguang Hospital, Shanghai University of
Traditional Chinese Medicine, Shanghai, China
(Wang) Department of Cardiology, Xiamen Cardiovascular Hospital, Xiamen
University, Xiamen, China
(Lu) Department of Cardiology, Affiliated Hospital of Shandong University
of Traditional Chinese Medicine, Jinan, China
Abstract
BACKGROUND: Shexiang Baoxin pill (MUSKARDIA) is a well-known traditional
Chinese medicine that has demonstrated protective effects in coronary
artery disease (CAD). PURPOSE: To evaluate MUSKARDIA in patients with
stable CAD and reduced estimated glomerular filtration rate (eGFR). STUDY
DESIGN: This was a subgroup analysis of the multicenter, double-blind,
placebo-controlled phase IV randomized clinical trial (MUST,
ChiCTR-TRC-12,003,513). The MUST trial randomly assigned patients with
stable CAD to MUSKARDIA or placebo group in a 1:1 ratio. The primary
composite efficacy endpoint was the incidence of major adverse
cardiovascular events. The secondary composite efficacy endpoint included
all-cause mortality, non-fatal MI, non-fatal stroke, hospitalization for
unstable angina or heart failure, and coronary revascularization.
 METHOD(S): This subgroup analysis included patients with reduced
baseline eGFR (< 90 ml/min/1.73m2). RESULT(S): Among the 1354
participants with reduced baseline eGFR, there were numerical advantages
with MUSKARDIA in improving the primary (hazard ratio=0.713; 95% CI:
0.379-1.342; p = 0.292) and secondary (hazard ratio=0.840; 95% CI:
0.608-1.161; p = 0.290) composite efficacy endpoints. Multivariable
adjustment confirmed these benefits. The primary composite efficacy
endpoint showed a trend toward a protective effect of MUSKARDIA after 12
months. MUSKARDIA significantly improved the secondary composite efficacy
endpoint after 14 months. The profiles of adverse events were comparable
between groups. There were no clinically meaningful differences in liver
and kidney function indicators. CONCLUSION(S): Long-term MUSKARDIA
shows a protective trend against cardiovascular events in patients with
stable CAD and reduced eGFR, and may be a consideration for clinical
management. Copyright © 2026. Published by Elsevier GmbH.

<113>
Accession Number
2043868344
Title
Fibrinolysis vs urgent surgery in obstructive prosthetic valve thrombosis:
updated evidence from a systematic review and meta-analysis.
Source
Journal of Thrombosis and Haemostasis. (no pagination), 2026. Date of
Publication: 2026.
Author
Resende B.; Mata E.; Castro M.; Pinto A.M.; Ribeiro S.; Gameiro J.;
Lourenco A.; Ferraz-Costa G.; Goncalves L.
Institution
(Resende, Gameiro, Ferraz-Costa, Goncalves) Department of Cardiology,
Coimbra Local Health Unit, Coimbra, Portugal
(Mata, Castro, Pinto, Ribeiro, Lourenco) Department of Cardiology, Alto
Ave Local Health Unit, Guimaraes, Portugal
(Ferraz-Costa, Goncalves) Faculty of Medicine, University of Coimbra,
Coimbra, Portugal
(Goncalves) Coimbra Institute for Clinical and Biomedical Research (iCBR),
Coimbra, Portugal
Publisher
Elsevier B.V.
Abstract
Background Obstructive prosthetic valve thrombosis (PVT) is a
life-threatening complication. The first-line therapy remains uncertain.
While surgery has historically been preferred, advances in low-dose,
slow-infusion fibrinolysis protocols have improved outcomes. Objectives To
evaluate the efficacy and safety of fibrinolytic therapy versus urgent
valve surgery in PVT. Methods Following a systematic search of 5
databases, a meta-analysis compared fibrinolysis with urgent valve surgery
for obstructive PVT. The primary outcomes were in-hospital all-cause
mortality and complete restoration of valve function. Secondary outcomes
included stroke, systemic embolism, major bleeding, recurrent PVT, and
all-cause mortality during follow-up. Data were pooled as risk ratio (RR)
using random-effects models, with sensitivity and meta-regression
analyses. Results Across 12 observational studies and 1 randomized
controlled trial, 1300 patients (fibrinolysis/surgery: 714/586) were
included. No significant difference was observed in in-hospital mortality
(RR: 0.59 [0.27-1.30]; I 2=57.1%). However, fibrinolysis was
associated with lower complete restoration of valve function (RR: 0.82
[0.70-0.96]; I 2=71.6%) and higher risks of stroke (RR: 3.19
[1.30-7.85]; I 2=0%), systemic embolism (RR: 3.88 [1.44-10.4];
I 2=0%), and recurrent PVT (RR: 2.44 [1.18-5.05]; I
2=58.3%). No differences were found in major bleeding or
all-cause mortality during follow-up. Sensitivity analyses restricted to
alteplase-based regimens favored fibrinolysis, showing lower in-hospital
mortality (RR: 0.12 [0.05-0.29]; I 2=0%), consistent with
meta-regression findings, and efficacy comparable to surgery. Conclusion
Our study suggests that surgery offers higher immediate success with fewer
embolic or recurrent events. However, contemporary alteplase protocols may
be associated with improved safety outcomes relative to surgery, with no
apparent loss of efficacy. Given the low certainty of available evidence,
treatment should be individualized according to patient risk profile, and
institutional resources. Copyright © 2026 International Society
on Thrombosis and Haemostasis.

<114>
Accession Number
650508623
Title
Physiology-guided complete revascularization in older patients with
myocardial infarction and complex non-culprit lesion: A fire trial
subanalysis.
Source
Giornale Italiano di Cardiologia. Conference: 46. Congresso Nazionale
della Societa Italiana di Cardiologia Interventistica - GISE. Milan Italy.
26(10 Supplement 1) (pp e1), 2025. Date of Publication: 01 Oct 2025.
Author
Sarti A.; Erriquez A.; Dal Passo B.; Casella G.; Guiducci V.; Moreno R.;
Escaned J.; Marchini F.; Cocco M.; Verardi F.M.; Clo S.; Caglioni S.;
Farina J.; Barbato E.; Campo G.; Biscaglia S.
Institution
(Sarti, Erriquez, Dal Passo, Campo, Biscaglia) Cardiology Unit, Azienda
Ospedaliero Universitaria di Ferrara, Ferrara, Italy
(Casella) Cardiology Unit, Ospedale Maggiore, Bologna, Italy
(Guiducci) Cardiology Unit, Azienda USL-IRCCS Reggio Emilia, Reggio
Emilia, Italy
(Moreno) Hospital Universitario la Paz, Madrid, Spain
(Escaned) Hospital Clinico San Carlos, Madrid, Spain
(Marchini, Cocco, Verardi, Clo, Caglioni, Farina) Azienda Ospedaliero
Universitaria di Ferrara, Ferrara, Italy
(Barbato) Sapienza University of Rome, Roma, Italy
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
The Functional Assessment in Elderly MI Patients With Multivessel Disease
(FIRE) randomized clinical trial showed that physiology-guided complete
revascularization was superior as compared to culprit-only strategy in
older (>=75 years) with multivessel disease patients admitted to hospital
for myocardial infarction (MI). Older MI patients tend to have more
complex coronary artery disease (CAD) as compared to younger ones.
Accordingly, it would be interesting to understand if the benefit of
physiology-guided complete revascularization was consistent across simple
and complex CAD. The aim of the present analysis is to investigate if the
benefit of physiology-guided complete revascularization vs a culprit only
strategy was consistent in patients with complex non-culprit lesion (NCL).
Methods This was a sub-Analysis of the Functional Assessment in Elderly MI
Patients With Multivessel Disease (FIRE) randomized clinical trial data.
FIRE was an investigator-initiated, open-label, multicenter trial.
Patients 75 years or older with MI and multivessel disease were enrolled
at 34 European centers from July 2019 through October 2021. Patients were
randomized to receive either physiology-guided complete or culprit-only
revascularization. For the scope of the present analysis, patients were
divided into patients having at least one NCL meeting CHIP criteria vs
others. CHIP criteria of interest were: Angiographic heavy calcification,
true bifurcation lesions involving side-branches >2.5mm, in-stent
restenosis, long-lesions (estimated stent length > 28mm), being left main
disease and chronic total occlusion exclusion criteria. The primary
endpoint was the 3-year occurrence of all-cause mortality, stroke,
reinfarction or ischemia-driven revascularization. Secondary endpoints
were the singular components of the primary endpoint. Results Among 1445
patients, 641 (44%) patients had at least one NCL meeting CHIP criteria.
At univariate analysis patients with complex NCL were at higher risk for
the primary end point (hazard ratio [HR], 1.29; 95% Cl, 1.05-1.58; p =
0.013), cardiovascular death or MI (HR, 1.41; 95% CI, 1.07-1.85; p =
0.013), MI or ischemia-driven coronary revascularization at 3 years [(HR,
2.37; 95% CI, 1.47-3.82; p < 0.001), (HR, 2.26; 95% CI, 1.45-3.51; p <
0.001) respectively]. After adjustment for potential confounding factors,
patients with at least one complex NCL remained at higher risk of MI and
ischemia-driven coronary revascularization at 3 years. No signal of
interaction was noted between revascularization strategy and presence of
at least one complex NCL for the primary endpoint. On the contrary, we
observed significant interaction between randomization arm and complex NCL
in terms of secondary endpoint MI and ischemia-driven revascularization.
Physiology-guided complete revascularization as compared with culprit-only
strategy reduced the risk of MI at 3 years significantly only in patient
with complex NCL (p for interaction 0.021). Physiology-guided complete
revascularization as compared with culprit-only strategy reduced the risk
of ischemia-driven coronary revascularization at 3 years significantly in
patient with complex NCL (p for interaction 0.0002). Conclusions Complex
coronary anatomy status is frequent among older patients with Ml,
significantly increasing the likelihood of adverse events. Physiology
guided complete revascularization emerges as an effective strategy, in
comparison with culprit-only revascularization, for mitigating adverse
events in patients having NCL meeting CHIP criteria, in particular
reducing MI and ischemia-driven coronary revascularization.

<115>
Accession Number
650509725
Title
Metformin Protects Against Atrial Fibrillation in Racehorses.
Source
European Pharmaceutical Journal. Conference: 10th Annual Meeting of the
European Section of the International Academy of Cardiovascular Sciences,
IACS-ES. Bratislava Slovakia. 71(Supplement 1) (pp 93), 2024. Date of
Publication: 01 Dec 2024.
Author
Haugaard S.L.; Schneider M.; Kjeldsen S.T.; Sattler S.M.; Bastrup J.A.;
Carstensen H.; Iversen C.H.; Altintas A.; Jepps T.A.; Herum K.M.; Saljic
A.; Jespersen T.; Nissen S.D.; Buhl R.
Institution
(Haugaard, Schneider, Kjeldsen, Carstensen, Iversen, Nissen, Buhl)
University of Copenhagen, Department of Veterinary Clinical Sciences,
Taastrup, Denmark
(Sattler, Saljic, Jespersen, Nissen) University of Copenhagen, Faculty of
Health and Medical Sciences, Cardiac Physiology Laboratory, Department of
Biomedical Sciences, Copenhagen, Denmark
(Bastrup, Jepps) University of Copenhagen, Faculty of Health and Medical
Sciences, Physiology of Circulation, Kidney and Lung, Department of
Biomedical Sciences, Copenhagen, Denmark
(Altintas) Novo Nordisk Foundation Center for Basic Metabolic Research,
Faculty of Health and Medical Sciences, University of Copenhagen,
Copenhagen, Denmark
(Herum) Novo Nordisk A/S, Research and Early Development, Novo Nordisk
Park, Denmark
Publisher
Sciendo
Abstract
Atrial fibrillation (AF) is a common arrhythmia in both horses and humans,
sustained by electrical, structural, and metabolic changes that compromise
treatment efficacy. This study investigates the molecular and
electrophysiological remodelling associated with chronic AF and evaluates
the potential of metformin, an indirect activator of AMP-activated protein
kinase (AMPK), in mitigating these pathological changes. Twenty retired
racehorses underwent AF induction via two weeks of right atrial
tachypacing and were randomized to receive either metformin (n = 10) or
placebo (n = 10). Four additional sham-operated controls were maintained
in sinus rhythm. Baseline effective refractory periods (ERPs) were
measured, and right atrial (RA) biopsies were collected. After four
months, bi-atrial epicardial mapping was performed for AF complexity
analysis, and ERPs were measured again. Terminal biopsies were collected
from both atria. We employed data-independent acquisition mass
spectrometry and RNA-sequencing on atrial biopsies to compare expression
profiles between groups. The metformin-treated horses required
significantly longer tachypacing to achieve self-sustained AF compared to
controls. After four months of AF, metformin-treated horses had longer RA
ERPs and AF cycle length (AFCL) but demonstrated fewer RA re-entries.
Integrative transcriptomic and proteomic analyses revealed right
atrial-specific alterations in ion channel gene expression, along with
changes in metabolic pathways and the extracellular matrix proteome in
metformin-treated horses. These molecular changes were associated with
increased activation of AMPKa2. Metformin delayed early AF stabilization
and reduced right atrial AF complexity after 4 months of chronic AF in a
horse model. These findings highlight the potential of metformin as a
cost-effective, upstream therapy for AF prevention.

<116>
Accession Number
650508831
Title
Omega laa occluder for tiny left atrial appendages: A european multicenter
case series.
Source
Giornale Italiano di Cardiologia. Conference: 46. Congresso Nazionale
della Societa Italiana di Cardiologia Interventistica - GISE. Milan Italy.
26(10 Supplement 1) (pp e31), 2025. Date of Publication: 01 Oct 2025.
Author
Tumminello G.; Barbieri L.; Mallardi G.P.F.; Pellegrini D.; Sacchetta D.;
Guarracini S.; Piccaluga E.; Fassini G.; Cereda A.; Colombo F.; Gobbi C.;
Mircoli L.; Ruscica M.; Carugo S.
Institution
(Tumminello, Barbieri, Mallardi, Colombo, Gobbi, Mircoli, Carugo)
Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca'
Granda Ospedale Maggiore Policlinico, Milano, Italy
(Pellegrini) Cardiology Division, IRCCS Ospedale Galeazzi Sant'Ambrogio,
Milano, Italy
(Sacchetta) Department of Cardiology, ASL 03 Abruzzo, Pescara, Italy
(Guarracini) Department of Cardiology, "pierangeli" Hospital, Pescara,
Italy
(Piccaluga) Cardiology I, 'A.De Gasperis' Department, Niguarda Ca' Granda
Hospital, Milano, Italy
(Fassini) Dept. of Clinical Electrophysiology and Cardiac Pacing Heart
Rhythm Center at Monzino Cardiac Center, IRCCS, Milano, Italy
(Cereda) ASST Santi Paolo e Carlo, Milano, Italy
(Ruscica) Department of Pharmacological and Biomolecular Sciences "rodolfo
Paoletti, Universita Degli Studi di Milano, Milano, Italy
(Carugo) Department of Clinical Sciences and Community Health, Universita
Degli Studi di Milano, Milano, Italy
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Introduction: Left atrial appendage (LAA) occlusion is an interventional
technique used to prevent ischemic strokes in patients with atrial
fibrillation and a contraindication for oral anticoagulation. Current left
atrial appendage occlusion devices do not fit all anatomical variations of
the left atrial appendage. The Omega left atrial appendage occluder is a
highly conformable device, which can occlude LAAs with a minimum landing
zone diameter as small as 10.5 mm. Our registry aimed to determine if very
small LAAs, with a landing zone <10.5 mm, which is below the recommended
size for most LAA occluders, including Omega, can be safely closed.
 Method(s): This multicentre retrospective registry involved 10
patients from seven European centres between May 2023 and July 2024. All
patients had atrial fibrillation with an indication for left atrial
appendage occlusion and a minimum LAA diameter less than 10.5 mm. The
primary endpoint was to assess the safety and efficacy of the procedure,
while secondary endpoints included complete left atrial appendage closure,
absence of embolization, and incidence of stroke during follow-up.
 Result(s): The Omega device was successfully implanted, without
complications, and achieved complete left atrial appendage closure without
significant peri-device leak in all patients. No events occurred within 7
days post implant. Similarly, at an average follow-up of 130 +/- 69 days,
there were no device embolization, thrombosis, thromboembolic events,
major bleedings or deaths. Conclusion(s): The registry suggest that
Omega left atrial appendage occluder may be safely and effectively
utilized in patients with very small left atrial appendages, offering a
viable alternative for stroke prevention in atrial fibrillation; further
prospective, randomized, controlled studies are needed to confirm and
support these data.

<117>
Accession Number
2043822397
Title
Arterial Branching Patterns Supplying the Left Upper Lobe of the Lung and
Their Incidence: A Systematic Review.
Source
Journal of Clinical Medicine. 15(5) (no pagination), 2026. Article Number:
1724. Date of Publication: 01 Mar 2026.
Author
Dworski K.J.; Tulski M.; Wozniak S.; Anders M.; Kuo C.-A.; Tabola R.
Institution
(Dworski, Tulski, Wozniak, Anders, Kuo) Department of Anatomy, Wroclaw
Medical University, Tytusa Chalubinskiego 6a, Wroclaw, Poland
(Dworski, Tabola) Department of Thoracic Surgery, Wroclaw Medical
University, Grabiszynska 105, Wroclaw, Poland
(Tulski) Urology Center Student Scientific Club, Wroclaw Medical
University, Wroclaw, Poland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Objective: The arterial anatomy of the left upper lobe exhibits the
greatest variability in branching patterns among all pulmonary lobes. This
lobe is commonly described as having four segments: the fused
apicoposterior segment (S1+2), the anterior segment (S3), and the lingular
segments (S4 and S5). Each segment may contain subsegments with distinct
vascular supplies. Although several studies have examined patterns and
diversity of branching, a comprehensive assessment of the incidence of
these variations has not yet been performed. Method(s): This
systematic review was conducted in accordance with a protocol registered
in PROSPERO (CRD42024546839). The search was performed between December
2023 and February 2024. A systematic search of databases was carried out
to identify publications describing arterial branching patterns supplying
the left upper lobe of the lung in adults. Furthermore, we collected and
analyzed data on the relationship between the different origins of the
lingular arteries and the corresponding bronchial and venous patterns. The
AUQA tool was used to perform bias assessment. Data extraction included
study characteristics, participant demographics (listed in AUQA), and
anatomical variables based on the Yamashita classification of LUL arterial
patterns and the number of branches supplying the left upper lobe.
 Result(s): In total, 15 publications were included (3313 cases).
Lobar vasculature was firstly categorized more broadly, analyzing the
number of branches from the left pulmonary artery, which supplies the left
upper lobe, most commonly four branches. Then, analysis based on the
Yamashita classification was performed, and Type A (A3, A(1+2) a+b, A(1+2)
c) was established as the most common variant. Conclusion(s): The
left upper lobe is most commonly supplied by four different arterial
branches, followed by three and five. Differences in arterial branching
patterns between Asian and Western populations may represent an important
distinguishing factor. According to Yamashita's classification, Type A
(A3, A1+2a+b, A1+2c) is the most frequently observed pattern. Further
attention should be directed to the relationship between the presence of a
common trunk and the origin of the lingular arteries. Detailed knowledge
of this anatomy remains fundamental for segmental thoracic
surgery. Copyright © 2026 by the authors.

<118>
Accession Number
650514633
Title
Assessing preoperative bleeding risk using INR/APTT: a systematic review.
Source
Journal of thrombosis and haemostasis : JTH. (no pagination), 2026. Date
of Publication: 04 Mar 2026.
Author
Rahhal H.; Sampat R.; Tse B.; Liontos L.; Hicks L.K.; Tang G.H.; Sholzberg
M.
Institution
(Rahhal) Departamento de Clinica Medica, Instituto Central, Hospital das
Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao
Paulo, SP, Brazil; Faculdade de Medicina, Universidade de Sao Caetano do
Sul, Sao Paulo, SP, Brazil
(Sampat, Tang) Hematology-Oncology Clinical Research Group, St. Michael's
Hospital, Toronto, ON, Canada
(Tse) Hematology-Oncology Clinical Research Group, St. Michael's Hospital,
Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology,
University of Toronto, Toronto, ON, Canada
(Liontos) Department of Laboratory Medicine and Molecular Diagnostics,
Sunnybrook Health Sciences Centre, Toronto, ON, Canada
(Hicks) Department of Medicine, St. Michael's Hospital, Li Ka Shing
Knowledge Institute, Toronto, ON, Canada
(Sholzberg) Department of Laboratory Medicine and Pathobiology, University
of Toronto, Toronto, ON, Canada; Department of Medicine, St. Michael's
Hospital, Li Ka Shing Knowledge Institute, Toronto, ON, Canada
Abstract
BACKGROUND: The prothrombin time (PT) and activated partial thromboplastin
time (APTT) are often considered "routine" tests in the assessment of
perioperative bleeding risk. Physicians continue to order these tests and
major medical societies guidelines exhibit significant heterogeneity
regarding the utility of coagulation tests as a general screening tool,
despite many advocating for a risk-stratified approach over routine
testing. OBJECTIVE(S): To assess for association between preoperative
coagulation tests and bleeding events around elective surgery.
 METHOD(S): We conducted a systematic review of the literature. Three
electronic databases were consulted MEDLINE, EMBASE, and EBM Reviews.
Randomized trials and observational studies that assessed the predictive
accuracy of pre-procedural PT and APTT test results for perioperative
bleeding were deemed eligible for inclusion. Outcomes included any
bleeding events in the postoperative period. RESULT(S): One hundred
studies were included in our qualitative synthesis: otolaryngology (n=15),
minor surgeries and procedures (n=15), neurosurgery (n=17), orthopedic
surgeries (n=6), cardiac surgeries (n=16), liver transplantation or
hepatectomy (n=20), general surgery and other types of major surgery
(n=11). Qualitative synthesis demonstrated a weak or inconsistent
association between PT or APTT and bleeding events. Associations were more
frequently reported in studies involving patients with cirrhosis and/or
neoplastic disease of the liver undergoing liver resection,
transplantation or major abdominal cancer debulking surgery.
 CONCLUSION(S): Our findings confirm that coagulation testing results
are not consistently associated with bleeding in minor surgeries and
nearly all major elective surgeries. However, PT results might be
associated with bleeding outcomes in patients with advanced liver disease
undergoing major abdominal surgeries. Copyright © 2026
International Society on Thrombosis and Haemostasis. Published by Elsevier
Inc. All rights reserved.

<119>
Accession Number
2043813869
Title
Wedge Resection for Early-Stage Non-Small Cell Lung Cancer: Are We There
Yet?.
Source
Annals of Thoracic Surgery. (no pagination), 2026. Date of Publication:
2026.
Author
Baiu I.; Altorki N.K.; Kneuertz P.J.
Institution
(Baiu, Kneuertz) Division of Thoracic Surgery, Department of Surgery, The
Ohio State University Wexner Medical Center, Columbus, OH, United States
(Altorki) Department of Cardiothoracic Surgery, Weill Cornell
Medicine/NewYork-Presbyterian Hospital, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
The optimal extent of resection for early-stage non-small cell lung cancer
(NSCLC) remains one of the most debated questions in thoracic surgery.
Although lobectomy has traditionally represented the standard of care,
contemporary randomized trials have redefined the role of sublobar
resection. For appropriately selected patients with small, peripherally
located tumors, segmentectomy has shown oncologic equivalence to
lobectomy, whereas the evidence supporting wedge resection remains less
definitive. This review synthesizes the available evidence comparing wedge
resection and segmentectomy, contextualized against lobectomy as the
historical benchmark. A comprehensive literature review was performed,
focusing on studies published over the last 30 years reporting outcomes of
anatomic and non-anatomic, lobar and sublobar lung resections in patients
with stage I NSCLC. Wedge resection offers a less-invasive option for
early-stage NSCLC, with potential benefits in pulmonary preservation and
perioperative safety. However, current evidence remains mixed, and
although wedge resection may be appropriate in carefully selected
standard-risk patients, its routine use awaits further high-level
validation. Careful patient selection, attention to margins, appropriate
lymph node evaluation, and consideration of tumor biology are critical in
determining patients for whom a wedge resection can be oncologically
adequate. Copyright © 2026 The Authors.

<120>
Accession Number
650515144
Title
Impact of advanced cardiac damage in severe aortic stenosis on short-term
and mid-term mortality and rehospitalisation after transcatheter aortic
valve implantation: a systematic review and meta-analysis.
Source
Heart (British Cardiac Society). (no pagination), 2026. Date of
Publication: 06 Mar 2026.
Author
Baay M.; Hosseini Z.; Zadgari E.; Moayerifar M.; Taghavi S.; Sammak
Salekdeh M.; Amouzadeh Lichahi M.; Jafari M.; Agajani A.; Firouzi A.; Abdi
S.; Khalilipur E.; Alemzadeh Ansari M.J.; Elahifar A.; Safavi Rad A.;
Gholipour M.; Ghasemzadeh G.
Institution
(Baay, Hosseini, Firouzi, Abdi, Alemzadeh Ansari, Elahifar, Safavi Rad)
Cardiovascular Intervention Research Center, Rajaie Cardiovascular
Institute, Tehran, Iran, Islamic Republic of
(Zadgari) Medicine, Guilan University of Medical Sciences, Rasht, Iran,
Islamic Republic of
(Moayerifar, Gholipour, Ghasemzadeh) Department of Cardiology, Healthy
Heart Research Center, Heshmat Hospital, School of Medicine, Guilan
University of Medical Sciences, Rasht, Iran, Islamic Republic of
(Moayerifar) Department of Cardiovascular Surgery, Imam Khomeini Hospital
Complex, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Taghavi, Khalilipur) Rajaie Cardiovascular Medical and Research Center,
Tehran, Iran, Islamic Republic of
(Sammak Salekdeh, Amouzadeh Lichahi, Jafari, Agajani) Student Research
Committee, School of Medicine, Guilan University of Medical Sciences,
Anzali International Campus, Rasht, Iran, Islamic Republic of
(Gholipour) Cardiovascular Intervention Research Center, Rajaie
Cardiovascular Institute, Tehran, Iran, Islamic Republic of
Abstract
BACKGROUND: Severe aortic stenosis (AS) is commonly associated with
advanced cardiac damage, including right ventricular dysfunction (RVD),
pulmonary hypertension (PH) and tricuspid regurgitation (TR), which may
worsen prognosis after transcatheter aortic valve implantation (TAVI).
This systematic review and meta-analysis aimed to assess the effect of
these conditions on short-term and mid-term mortality and
rehospitalisation following TAVI. METHOD(S): We conducted a
systematic search of PubMed, Scopus and Web of Science for studies
published up to June 2025. Eligible studies included adults with AS
undergoing TAVI and reported outcomes at 1 month, 6 months or 12 months
stratified by the presence of RVD, PH or TR. Studies had to report either
HRs, risk ratios (RRs) or sufficient raw event data for mortality or
rehospitalisation. Data were synthesised using a random-effects
meta-analysis. Subgroup analyses were conducted by cardiac damage severity
according to the Genereux staging system and stratified by valve type and
diagnostic modality. Risk of bias in included studies was assessed using
the Joanna Briggs Institute's checklist for cohort studies.
Meta-regression was performed to explore sources of between-study
heterogeneity. RESULT(S): A total of 34 studies including 26 076
patients met inclusion criteria. Twelve-month HRs for all-cause mortality
increased with advancing cardiac damage: borderline stage HR 1.61
(1.22-2.12), stage 3 HR 2.06 (1.63-2.60) and stage 4 HR 2.77 (2.11-3.64).
RRs followed a similar trend. Cardiovascular mortality was highest in
stage 4 (HR 3.13 (1.20-8.17); RR 2.63 (1.54-4.47)). Rehospitalisation data
were limited but suggested elevated risk in stage 3 (RR 1.33 (1.12-1.58)).
Meta-regression indicated that age, sex and comorbidities contributed to
between-study heterogeneity, particularly in stage 3 analyses.
 CONCLUSION(S): Extravalvular cardiac damage, especially RVD (stage
4), is strongly associated with increased short-term and mid-term
mortality and rehospitalisation after TAVI. Even borderline-stage patients
face elevated risk, underscoring the continuous nature of AS-related
cardiac injury. Incorporating cardiac damage staging into preprocedural
assessment can enhance risk stratification and guide management to improve
patient outcomes. PROSPERO REGISTRATION NUMBER:
CRD420250638838. Copyright © Author(s) (or their employer(s))
2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights
and permissions. Published by BMJ Group.

<121>
Accession Number
2043808882
Title
Research Trends in Pain Management After Thoracoscopic Surgery
(2015-2024): A Bibliometric Analysis.
Source
Pain Research and Management. 2026(1) (no pagination), 2026. Article
Number: 2700117. Date of Publication: 2026.
Author
Jiang D.; Liu F.; Liu Z.; Peng J.; Liu Y.; Weng Y.; Wang R.; Zhong Q.
Institution
(Jiang, Peng, Liu, Wang) Department of Anesthesiology, Chengdu Jinniu
District People's Hospital, Sichuan, Chengdu, China
(Jiang, Liu) Graduate School, Chengdu Medical College, Sichuan, Chengdu,
China
(Liu, Liu, Weng, Zhong) Department of Anesthesiology, The People's
Hospital of Jianyang/The Affiliated Jianyang Hospital of Chengdu Medical
College, Sichuan, Jianyang, China
(Liu, Zhong) Department of Anesthesiology, The Affiliated Hospital of
Southwest Medical University, Sichuan, Luzhou, China
Publisher
John Wiley and Sons Ltd
Abstract
Background: Thoracoscopic surgery, a representative minimally invasive
approach in thoracic surgery, is increasingly employed. However,
postoperative pain remains a significant barrier to recovery and quality
of life. We aimed to quantitatively analyze research on postoperative pain
following thoracoscopic surgery over the past decade; to identify the
current research landscape, research hotspots, and future trends; and to
provide a reference for future studies. Method(s): Publications on
postoperative pain following thoracoscopic surgery from 2015 to 2024 were
retrieved from the Web of Science database. CiteSpace, VOSviewer, and
Bibliometrix were used to analyze publication trends, journals, authors,
institutions, countries, regions, and keywords. Result(s): The number
of publications increased steadily between 2015 and 2024. China and the
United States were the leading contributors, forming a global
collaboration network with Europe. Major contributing institutions
included Tongji Medical College, Guangzhou Medical University, and the
Cleveland Clinic. Leading authors included Jianxing He, Hengrui Liang, and
Ali Alagoz. Research areas spanned thoracic surgery, pain medicine, and
anesthesiology. Frequently cited keywords were "pain," "rapid recovery,"
"analgesia," "pain management," "paravertebral nerve block," and "erector
spinae plane block." Key research themes included multimodal analgesia,
chronic pain, and quality of life. Conclusion(s): Research on
postoperative pain after thoracoscopic surgery has evolved from clinical
observation to multimodal analgesia, making advancements toward precision
medicine and long-term outcomes. Current research hotspots include
optimizing analgesic strategies, understanding pain mechanisms, refining
surgical techniques, and promoting rapid recovery. Promising areas include
regional analgesia techniques, liposomal bupivacaine, chronic pain
prevention, opioid-sparing strategies, and spontaneous ventilation
anesthesia. Copyright © 2026 Dezhou Jiang et al. Pain Research
and Management published by John Wiley & Sons Ltd.

<122>
Accession Number
2043832898
Title
Cardiac Surgery in Cancer Patients: Clinical Dilemmas and Decision-Making
Challenges.
Source
Cancers. 18(5) (no pagination), 2026. Article Number: 748. Date of
Publication: 01 Mar 2026.
Author
Keramida K.; Tsekoura D.; Roubelakis A.; Michalopoulou H.; Androutsopoulou
V.
Institution
(Keramida) General Anticancer Oncological Hospital, Agios Savvas, Athens,
Greece
(Tsekoura) 2nd Department of Surgery, Aretaieio University Hospital,
National and Kapodistrian University of Athens, Athens, Greece
(Roubelakis) 3rd Department of Cardiac Surgery, Athens Medical Center,
Athens, Greece
(Michalopoulou) Department of Cardiology, Laiko General Hospital of
Athens, Athens, Greece
(Androutsopoulou) Department of Cardiothoracic Surgery, University
Hospital of Larissa, Larissa, Greece
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Improvements in cancer detection and treatment have led to a
growing population of cancer survivors who subsequently develop
cardiovascular (CV) disease requiring cardiac surgery. Method(s):
This narrative review synthesizes contemporary evidence from observational
studies, registries, meta-analyses, and international guidelines
addressing cardiac surgery in patients with active or prior cancer.
 Result(s): Cancer patients undergoing cardiac surgery face heightened
risks related to hypercoagulability, bleeding, immunosuppression, frailty,
and prior exposure to chemotherapy or radiotherapy. Conventional surgical
risk scores inadequately capture cancer-specific factors such as tumor
biology, prognosis, treatment trajectory, and frailty, often
underestimating operative risk. Timing of surgery must balance CV urgency
against oncologic priorities, with urgent cardiac conditions necessitating
prompt intervention irrespective of cancer status, while stable disease
allows individualized sequencing. Transcatheter and minimally invasive
approaches increasingly play a key role, particularly in patients with
limited life expectancy, hostile thoracic anatomy, or high surgical risk.
Outcomes are heterogeneous and largely driven by cancer stage and
prognosis rather than cardiac pathology alone. Conclusion(s): Cardiac
surgery can be lifesaving and restore eligibility for definitive oncologic
therapy in carefully selected patients, particularly those with
early-stage or potentially curable malignancies. In advanced cancer, the
benefits of invasive intervention must be weighed against perioperative
burden, quality of life impact, and overall prognosis. Multidisciplinary,
patient-centered decision-making within specialized cardio-oncology teams
is essential. Future priorities include the development of cancer-specific
risk prediction models, prospective surgical registries, and greater
integration of quality-of-life outcomes into clinical
decision-making. Copyright © 2026 by the authors.

<123>
Accession Number
2043768350
Title
Effect of age on restrictive and liberal transfusion outcomes in patients
with anemia and myocardial infarction.
Source
American Heart Journal. 297 (no pagination), 2026. Article Number: 107381.
Date of Publication: 01 Jul 2026.
Author
Goldsweig A.M.; Ballantyne C.M.; White H.D.; Abbott J.D.; Fergusson D.A.;
Herbert B.M.; Goodman S.G.; Carson J.L.; Brooks M.M.
Institution
(Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center
and Division of Cardiovascular Medicine, University of
Massachusetts-Baystate, Springfield, MA, United States
(Goldsweig) Division of Cardiovascular Medicine, University of Nebraska
Medical Center, Omaha, NE, United States
(Ballantyne, Herbert, Brooks) Department of Epidemiology, University of
Pittsburgh, Pittsburgh, PA, United States
(White) Green Lane Clinical Coordinating Centre, Auckland, New Zealand
(Abbott) Division of Cardiology, Warren Alpert Medical School, Brown
University, Providence, RI, United States
(Fergusson) Ottawa Hospital Research Institute, Ottawa, ON, Canada
(Goodman) St. Michael's Hospital, University Health Toronto, Toronto, ON,
Canada
(Goodman) Peter Munk Cardiac Centre, University Health Network, Toronto,
ON, Canada
(Goodman) University of Toronto, Toronto, ON, Canada
(Goodman) Canadian VIGOUR Centre, University of Alberta, Edmonton, AB,
Canada
(Carson) Division of General Internal Medicine, Rutgers Robert Wood
Johnson Medical School, New Brunswick, NJ, United States
Publisher
Elsevier Inc.
Abstract
For patients with anemia and myocardial infarction (MI), the randomized,
3,504-patient MINT trial found that a liberal transfusion threshold (10
g/dL) may be preferable to a restrictive threshold (8 g/dL) in terms of
death or MI. The relative effects of liberal versus restrictive
transfusion in younger and older patients are unknown. The present
prespecified MINT substudy found no significant interaction between age
and transfusion strategy for death or MI, heart failure, revascularization
procedures, cardiac death, pulmonary embolism or deep vein thrombosis,
bacteremia or pneumonia, and death at 30 and 180 days. A liberal
transfusion approach appears to be safe and may be the preferred
transfusion strategy in anemic patients with MI, regardless of age. MINT
Trial, ClinicalTrials.gov Number NCT02981407, https://www.minttrial.org/
. Copyright © 2026 Elsevier Inc.

<124>
Accession Number
650499392
Title
Postoperative Sleep Interventions and Cardiac Surgery: A Systematic Review
and Meta-Analysis.
Source
ANZ journal of surgery. (no pagination), 2026. Date of Publication: 05
Mar 2026.
Author
Lombardo A.; Tsimiklis J.; Zaka A.; Leslie A.; Stretton B.; Kovoor J.;
Kovoor P.; Bacchi S.; Gupta A.
Institution
(Lombardo) Princess Alexandra Hospital, Brisbane, Australia
(Tsimiklis, Stretton, Kovoor, Bacchi, Gupta) University of Adelaide,
Adelaide, Australia
(Zaka) Gold Coast University Hospital, Southport, Australia
(Leslie) Johns Hopkins University, Baltimore, MD, United States
(Kovoor, Bacchi) Royal Adelaide Hospital, Adelaide, Australia
(Kovoor) Westmead Hospital ,Westmead, Australia
(Gupta) Royal North Shore, Sydney, Australia
Abstract
INTRODUCTION: Sleep disturbance is a common issue affecting nearly 78% of
cardiothoracic postoperative patients. There are no systematic reviews of
randomised controlled trials (RCTs) that evaluate the impact of sleep
interventions within this population. This study aims to evaluate the
sleeping patterns in post-operative cardiac surgery patients and identify
if sleep interventions improve sleep quality. The primary outcomes were
subjective and objective measures of sleep using the Pittsburgh Sleep
Quality Index (PSQI) in addition to the duration of intensive care unit
(ICU) and hospital admission. METHOD(S): Searches on PubMed, Medline,
Embase, Scopus and Cochrane were undertaken from database inception to 24
February 2023. Only RCTs that recorded a sleep intervention in addition to
standardised sleep scoring measures in adult cardiac surgical patients
were included. RESULT(S): A total of 26 studies were included (n =
2323). Total PSQI score had a statistically significant standardised mean
difference (SMD) between intervention and control groups for improved
scores as indicated by the SMD of -0.73 (95% CI; -0.93; -0.52, p = 0.04).
The duration of ICU admission had a SMD of -0.23 (95% CI; -0.50 to 0.03, p
= 0.19) and was not statistically significant. Similarly, the duration of
hospital admission had a SMD of -1.10 (95% CI; -2.56 to 0.37, p = < 0.01)
and was not statistically significant. CONCLUSION(S): Whilst sleep
interventions did not have a statistically significant effect on the
duration of ICU or hospital admission, they did show a significant
improvement in sleep quality as reported through the PSQI total
score. Copyright © 2026 The Author(s). ANZ Journal of Surgery
published by John Wiley & Sons Australia, Ltd on behalf of Royal
Australasian College of Surgeons.

<125>
Accession Number
2044108424
Title
Integrating Artificial Intelligence Into Digital Health-Optimized
Therapeutics for the Remote Cardiac Rehabilitation.
Source
Clinical Medicine Insights: Cardiology. 20 (no pagination), 2026. Date of
Publication: 01 Jan 2026.
Author
Wan X.; Ge L.; Tian J.; Ding G.; Gao B.; Geng H.; Ge C.; Song X.
Institution
(Wan, Tian, Ding, Gao, Geng, Ge, Song) Department of Cardiology, Beijing
Anzhen Hospital, Capital Medical University, Beijing Institute of Heart,
Lung and Blood Vessel Disease, Beijing, China
(Ge) Department of Philosophy, East China Normal University, Shanghai,
China
Publisher
SAGE Publications Ltd
Abstract
Cardiovascular diseases (CVDs), which have high morbidity and mortality,
have become one of the world's largest public health concerns. Although
primary hospitalization can partially relieve symptoms, many patients
continue to have poor prognoses and lowered quality of life after
discharge. Cardiac rehabilitation (CR) is an important recommendation for
patients undergoing cardiac surgery, as well as those who suffer from
severe cardiovascular events or chronic cardiac disease. However,
standard, center-based CR options tend to be ineffective and hard to
access, leading to low compliance. The development of digital health
technologies (DHTs), especially wearables-which can be combined with
mobile applications-has enabled home-based CR, that is, remote CR. This
model has substantially enhanced CR efficiency and patient adherence. With
advancements in artificial intelligence (AI), including machine learning
(ML) algorithms and deep learning, large-scale data from wearables and
other DHTs can be effectively retrieved and interpreted. Further
incorporation of AI into DHTs may provide real-time fitness
telemonitoring, accurate risk recognition and prediction, individualized
exercise recommendations, and improved patient adherence. In this review,
we succinctly highlight several applications of both AI and wearables in
remote CR, and evaluate their collective roles in patient CR execution
from several perspectives. We hope our review will help advance further
integration of AI and DHT into home-based CR, and plan to direct future
research toward refining the use of AI in new-era digital
CR. Copyright © The Author(s) 2026. This article is distributed
under the terms of the Creative Commons Attribution-NonCommercial 4.0
License (https://creativecommons.org/licenses/by-nc/4.0/) which permits
non-commercial use, reproduction and distribution of the work without
further permission provided the original work is attributed as specified
on the SAGE and Open Access pages
(https://us.sagepub.com/en-us/nam/open-access-at-sage).

<126>
Accession Number
2044099698
Title
Implementation and Results of Intraoperative Methadone in Pediatric
Cardiac Surgery: Early Experiences and Outcomes.
Source
World Journal for Pediatric and Congenital Heart Surgery. (no
pagination), 2026. Date of Publication: 2026.
Author
Gallagher B.; Ghandi D.; Whitley M.; Walker J.
Institution
(Gallagher, Whitley) Department of Anesthesiology and Perioperative
Medicine, Division of Pediatric Anesthesia, Penn State Milton S. Hershey
Medical Center, Hershey, PA, United States
(Ghandi) Penn State College of Medicine, Hershey, PA, United States
(Walker) Department of Anesthesiology and Perioperative Medicine, Division
of Cardiac Anesthesia, Penn State Milton S. Hershey Medical Center,
Hershey, PA, United States
Publisher
SAGE Publications Inc.
Abstract
Postoperative pain continues to be an intense area of research in
pediatric cardiac surgery, and there is a scarcity of information
regarding the use of methadone in this population. We performed a single
center retrospective descriptive cohort analysis of all pediatric cardiac
surgery patients who received intraoperative methadone between January 1,
2020 and December 21, 2024. In total 111 congenital cardiac surgeries were
completed in patients aged 0-18 years during the study period, of which 45
(41%) received intraoperative methadone. In the cohort receiving
methadone, there were 29 male patients (64%), with an average age of 10.3
(SD+/-5.3) year. The average dose of methadone was 0.16mg/kg
(SD+/-0.05mg/kg). With respect to post-operative analgesia, average pain
scores at 6, 12, and 24 hours of 1.8 (SD+/-2.3), 1.95 (SD+/-2.7), and 1.44
(SD+/-2.2), respectively. The median 24-hour opioid requirement was 0.59
Morphine Milligram Equivalents(MME)/kg (IQR 0.25-0.96). In total, 32 of
our 45 patients (71%) were able to be extubated in the operating room with
no reintubations or need for rescue non-invasive positive pressure
ventilation (NIPPV). Our study demonstrates that even a modest dose of
intraoperative methadone in pediatric cardiac surgery can be safe and
effective for intra and postoperative analgesia. Additional randomized
controlled trials are necessary to further evaluate its
effectiveness. Copyright © The Author(s) 2026. This article is
distributed under the terms of the Creative Commons
Attribution-NonCommercial 4.0 License
(https://creativecommons.org/licenses/by-nc/4.0/) which permits
non-commercial 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).

<127>
Accession Number
650496832
Title
Reported Causes of Device Embolization Following Transcatheter Aortic
Valve Replacement: A Systematic Review and Meta-Analysis.
Source
The Permanente journal. (pp 1-12), 2026. Date of Publication: 06 Mar
2026.
Author
Echefu G.C.; Adabale O.; Isa T.S.; Bond A.; Nayyar M.; Ibebuogu U.N.
Institution
(Echefu, Isa, Bond, Nayyar) Department of Cardiovascular Medicine,
University of Tennessee Health Sciences Center, College of Medicine,
Memphis, TN, United States
(Adabale, Ibebuogu) Department of Cardiovascular Medicine, University of
Colorado, Health, Parkview Medical Center, Pueblo, CO, United States
Abstract
In the last 2 decades, transcatheter aortic valve replacement (TAVR) has
become widely adopted for the treatment of aortic valve stenosis, and
prosthetic valve embolization (PVE) is one of the rarely reported, but
often catastrophic, complications of this procedure. The authors performed
an updated systematic review of contemporary studies to determine the
prevalence of post-TAVR PVE and its associated risk factors. A systematic
search was conducted in multiple databases for all relevant published
studies from 2014 to August 2024. Studies reporting on embolization were
included. Data extracted encompassed participants' characteristics, study
characteristics, and clinical outcomes. Pooled event rates were calculated
using the random effects method. In the final analysis, 34 studies
reported 501 cases of device embolization, of which 50% were male with a
mean age of 80.7 +/- 3.16 years while the other 50% were female. The rate
of PVE was 1.4%. About 80% of the embolization occurred in the
intraprocedural period, with 61% of the embolized valves requiring
surgical treatment. The prevalence of embolization across included studies
was 1.4%, with most embolization occurring during the procedure. The
chance of mortality is significantly heightened at about 18% to 20% at 30
days and ~30% at 1 year in some series, compared with much lower baseline
rates for uncomplicated TAVR. Prosthetic valve embolization complicates
TAVR procedures, increasing procedural complexity, with over 50% of
instances resulting in conversion to surgical intervention. Given that
this complication is rare (~1%), the overall risk is low in the general
TAVR population, but for the individual, it is serious and warrants
aggressive management.

<128>
Accession Number
2043753648
Title
Fosaprepitant versus Ondansetron for Preventing Postoperative Nausea and
Vomiting After Video-Assisted Thoracoscopic Lung Resection: A Randomized
Controlled Clinical Trial.
Source
Drug Design, Development and Therapy. 20 (no pagination), 2026. Article
Number: 584402. Date of Publication: 2026.
Author
Qi X.; Zhang J.; Sun J.; Wang X.; Chang T.; Yi W.; Zhang Y.; Zhang P.
Institution
(Qi, Zhang, Sun, Yi, Zhang, Zhang) Department of Anesthesiology, Qilu
Hospital of Shandong University, Shandong University, Shandong, Jinan,
China
(Wang) Department of Anesthesiology, The First Affiliated Hospital of
Shandong First Medical University, Shandong, Jinan, China
(Wang) Shandong Institute of Anesthesia and Respiratory Critical Care
Medicine, The First Affiliated Hospital of Shandong First Medical
University, Shandong, Jinan, China
(Wang) Shandong Provincial Clinical Research Center for Anesthesiology,
the First Affiliated Hospital of Shandong First Medical University,
Shandong, Jinan, China
(Chang) Department of Clinical Epidemiology, Qilu Hospital of Shandong
University, Shandong University, Shandong, Jinan, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: Postoperative nausea and vomiting (PONV) is a frequent
complication after video-assisted thoracoscopic lung resection,
particularly in patients at moderate to high risk, and substantially
hinders recovery. Fosaprepitant, a neurokinin-1 (NK-1) receptor
antagonist, is approved for PONV prevention; however, its efficacy in
video-assisted thoracoscopic lung resection remains uncertain. This
randomized trial evaluated the efficacy of fosaprepitant versus
ondansetron in preventing PONV in high-risk patients undergoing
video-assisted thoracoscopic lung resection. Patients and Methods: In
this prospective, double-blind, randomized controlled clinical trial, 233
adults aged 18-70 years undergoing elective video-assisted thoracoscopic
lung resection with an Apfel score >= 2 were randomized 1:1 to receive
intravenous fosaprepitant 150 mg or ondansetron 8 mg, each combined with
dexamethasone 5 mg. The primary outcome was the incidence of PONV at 24
hours postoperatively. Secondary outcomes included the incidence and
severity of PONV at 6, 12, and 48 hours postoperatively, the use of rescue
antiemetics, adverse events, and recovery outcomes. Result(s): The
24-hour incidence of PONV was 31.0% [36] in the fosaprepitant group and
41.0% [48] in the ondansetron group (OR, 0.76; 95% CI, 0.53 to 1.07;
P=0.112). Fosaprepitant significantly reduced PONV at 48 hours (10.3% [12]
vs 20.5% [24]; OR, 0.51; 95% CI, 0.27 to 0.96; P=0.032), as well as
vomiting at 24 hours (8.6% [10] vs 21.4% [25]; OR, 0.40; 95% CI, 0.20 to
0.80; P=0.006) and 48 hours (0% [0] vs 5.1% [6]; OR, 0.07; 95% CI, 0.00 to
1.32; P=0.040). Conclusion(s): Fosaprepitant was superior to
ondansetron in preventing early postoperative vomiting and delayed-phase
PONV, and it represents an effective antiemetic strategy for high-risk
thoracic surgical patients. Trial Number and Registry Url: Registration
number, NCT05881486; https://clinicaltrials.gov. Copyright © 2026
Qi et al.

<129>
Accession Number
650474507
Title
Real-Time Heart Team for Revascularization in Complex Coronary Artery
Disease: The EHEART Randomized Trial.
Source
Journal of the American College of Cardiology. (no pagination), 2026.
Date of Publication: 25 Feb 2026.
Author
Lin S.; Su X.; Ma H.; Dou K.; Song L.; Zhao H.; Qian J.; Liu S.; Xu F.;
Wang X.; Yang Y.; Su P.; Jin Z.; Wang Y.; Zheng Z.
Institution
(Lin, Zheng) National Clinical Research Center for Cardiovascular
Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital,
National Center for Cardiovascular Diseases, Chinese Academy of Medical
Sciences and Peking Union Medical College, Beijing, China; Department of
Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular
Diseases, Chinese Academy of Medical Sciences and Peking Union Medical
College, Beijing, China
(Su) National Clinical Research Center for Cardiovascular Diseases, State
Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center
for Cardiovascular Diseases, Chinese Academy of Medical Sciences and
Peking Union Medical College, Beijing, China
(Ma) Chinese Academy of Medical Sciences and Peking Union Medical College,
Beijing, China
(Dou, Song, Zhao, Qian) Department of Cardiology, Fuwai Hospital, National
Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences
and Peking Union Medical College, Beijing, China
(Liu, Xu, Wang, Yang) Department of Cardiovascular Surgery, Fuwai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences and Peking Union Medical College, Beijing, China
(Su) Department of Cardiac Surgery, Beijing Chao-Yang Hospital, Capital
Medical University, Beijing, China
(Jin) Department of Cardiology and Macrovascular Disease, Beijing Tiantan
Hospital, Capital Medical University, Beijing, China
(Wang) Medical Research and Biometrics Center, Fuwai Hospital, National
Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences
and Peking Union Medical College, Beijing, China
Abstract
BACKGROUND: The routine implementation of heart teams for patients with
complex coronary artery disease (CAD) is challenging due to the
insufficient multidisciplinary specialist resources for face-to-face
discussion. A real-time heart team during the angiography, based on an
online meeting, offers the potential to efficiently integrate resources.
 OBJECTIVE(S): In this study, we sought to evaluate the implementation
value and safety of a "real-time heart team" decision making approach.
 METHOD(S): This noninferiority randomized controlled trial enrolled
patients with de novo left main or 3-vessel CAD at 3 cardiac centers.
Patients were randomly assigned to the conventional heart team group
(discussed by a face-to-face meeting after the angiography) or the
real-time heart team group (discussed by an online meeting during the
angiography). Implementation value outcomes included care efficiency
(waiting time for treatment, recatheterization, specialist workload, and
economic outcomes) and process evaluation metrics (discussion adequacy,
surgeon participation, and shared decision making). The safety outcomes
were a composite of 1-year major adverse cardiovascular and
cerebrovascular events (MACCE) (including all-cause mortality, myocardial
infarction, stroke, unplanned revascularization, and readmission due to
reangina) and revascularization decision making. RESULT(S): Overall,
490 complex CAD patients were included, with 245 patients in each group.
Waiting time for final therapy (median: 2 days [Q1-Q3: 0-7 days] vs 5 days
[Q1-Q3: 2-10 days]; P < 0.001), recatheterization rate (12.5% vs 98.9%; P
< 0.001), specialist high workload rate (5.3% vs 29.0%; P < 0.001), and
percutaneous coronary intervention (PCI) hospitalization cost (percentage
of decrease: 18.0%; P < 0.001) were significantly reduced in the real-time
group. More discussion time spent (4.0 +/- 1.8 min vs 3.4 +/- 1.6 min),
better specialist satisfaction (based on NASA Task Load Index scale), more
chief surgeon participation (26.5% vs 18.8%), but less multidisciplinary
synchronous shared decision making (2.0% vs 11.5%) were found in the
real-time group. The real-time heart team group was noninferior to the
conventional group in 1-year MACCE (8.2% vs 10.6%; risk difference:
-2.45%; 95% CI: -7.61%-2.71%; P for noninferiority < 0.001). The
proportions of PCI, coronary artery bypass grafting, and medical therapy
were similar between the 2 groups (P = 0.892). CONCLUSION(S):
Compared with the conventional heart team, the real-time heart team
significantly improved care efficiency and process evaluation metrics,
with similar clinical outcomes and decision making. However, insufficient
shared decision making and intercenter generalizability should be
optimized before widespread implementation of this approach. (Feasibility
and Effectiveness of a Real-Time Heart Team Approach in Complex CAD
[EHEART; NCT05514210]). Copyright © 2026 American College of
Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

<130>
Accession Number
2043741684
Title
Incidence and Predictors of Pacemaker Implantation Post-Transcatheter
Aortic Valve Replacement in Patients with Pre-existing Right Bundle-Branch
Block.
Source
Canadian Journal of Cardiology. (no pagination), 2026. Date of
Publication: 2026.
Author
Prabhu R.; Rao K.; Ciofani J.L.; Litkouhi P.N.; Baer A.; Hansen P.; Bhindi
R.
Institution
(Prabhu, Rao, Ciofani, Litkouhi, Hansen, Bhindi) Department of Cardiology,
Royal North Shore Hospital, Sydney, Australia
(Rao, Ciofani, Litkouhi, Hansen, Bhindi) School of Medicine, University of
Sydney, Australia
(Ciofani) Department of Epidemiology and Biostatistics, School of Public
Health, Imperial College London, London, United Kingdom
(Baer) Department of Cardiology, North Shore Private Hospital, Sydney,
Australia
Publisher
Elsevier Inc.
Abstract
Background Pre-existing right bundle branch block (RBBB) is the leading
predictor of permanent pacemaker implantation (PPI) following
transcatheter aortic valve implantation (TAVI). The applicability of
conventional PPI predictors in this high-risk subgroup remains unclear.
This review evaluates PPI incidence and associated predictors in TAVI
patients with pre-existing RBBB. Methods A systematic review of PubMed,
Scopus, Embase, and Web of Science identified studies reporting PPI
incidence and predictors in RBBB patients undergoing TAVI. Studies not
addressing RBBB-specific factors were excluded. Pooled PPI incidence was
calculated, and a qualitative narrative synthesis of predictors was
performed. Results Of 2269 identified references, 22 studies with 429,342
patients met the inclusion criteria. Within the RBBB cohort, the mean age
was 81.6 +/- 7.4 years, with 64.2% being male, and 23.7% having atrial
fibrillation. Balloon-expandable valves were used in 69.8% of cases, and
the transfemoral approach in 88.6%. The pooled PPI incidence was 37%
across 17 studies. Substantial interstudy heterogeneity necessitated
further analysis among 13 studies reporting consistent 30-day follow-up,
which yielded 39% incidence. PPI predictors in the RBBB cohort encompassed
demographic, anatomic, electrophysiological, and procedural domains.
Conclusions Patients with baseline RBBB have significantly higher
post-TAVI PPI rates. Identifying RBBB specific predictors could facilitate
individualized procedural planning and risk stratification. This review
reinforces how both traditional (eg, implantation depth) and
nontraditional (eg, female sex, myocardial fibrosis, calcium volume, and
distribution) factors have an amplified role in predicting PPI risk,
emphasizing the need for further research in this subgroup to improve risk
stratification and reduce PPI incidence. Copyright © 2026 .

<131>
Accession Number
2043723432
Title
Rapid deployment valves: current position on the market and future
directions.
Source
Expert Review of Medical Devices. (no pagination), 2026. Date of
Publication: 2026.
Author
Szecel D.; Van den Bosch M.; Meuris B.
Institution
(Szecel, Van den Bosch, Meuris) Department of Cardiovascular Sciences,
Katholieke Universiteit Leuven, Leuven, Belgium
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: With an estimated prevalence of nine million people
worldwide, calcific aortic valve stenosis is the most common valvular
heart disease in North America and Western Europe. Although transcatheter
procedures have expanded considerably over the past decade, surgical
aortic valve replacement (SAVR) remains a reliable and trusted therapeutic
option. Sutureless (SU) and rapid deployment valves (RDVs) are
bioprostheses specifically designed for implantation during SAVR using few
or no sutures. These bioprostheses offer well-recognized advantages,
including ease of implantation and shorter operative times, although
higher rates of permanent pacemaker implantation have been reported. Their
use is also well documented in the context of minimally invasive surgery.
Areas covered: This article presents a narrative overview of the current
evidence on the benefits, limitations, and typical clinical indications of
SU/RDV prostheses. Recent developments and potential future applications
are also discussed. Expert opinion: In the context of a rapidly evolving
treatment paradigm for aortic valve stenosis, SU and RDV bioprostheses
have demonstrated their value as reliable devices for surgical valve
replacement. Continued clinical research will be essential to better
delineate which patients may benefit most as part of an individualized,
lifetime valve-management strategy. Copyright © 2026 Informa UK
Limited, trading as Taylor & Francis Group.

<132>
[Use Link to view the full text]
Accession Number
2043433761
Title
Effects of Serratus Anterior Plane Block on Early Recovery from
Thoracoscopic Lung Resection: A Randomized, Blinded, Placebo-controlled
Trial.
Source
Journal of the American College of Surgeons. 141(6) (pp 1065-1074), 2024.
Date of Publication: 01 Dec 2024.
Author
Jackson J.C.; Tan K.S.; Pedoto A.; Park B.J.; Rusch V.W.; Jones D.R.;
Zhang H.; Desiderio D.; Fischer G.W.; Amar D.
Institution
(Jackson) Department of Anesthesiology and Critical Care Medicine,
Memorial Sloan Kettering Cancer Center, New York, New York; Department of
Anesthesiology, Weill Cornell Medical College, New York, New York, United
States
(Tan) Department of Anesthesiology and Critical Care Medicine, Memorial
Sloan Kettering Cancer Center, New York, New York, United States
(Pedoto) Department of Anesthesiology and Critical Care Medicine, Memorial
Sloan Kettering Cancer Center, New York, New York; Department of
Anesthesiology, Weill Cornell Medical College, New York, New York, United
States
(Park) Thoracic Service, Department of Surgery, Memorial Sloan Kettering
Cancer Center, New York, New York; Department of Surgery, Weill Cornell
Medical College, New York, New York, United States
(Rusch) Thoracic Service, Department of Surgery, Memorial Sloan Kettering
Cancer Center, New York, New York; Department of Surgery, Weill Cornell
Medical College, New York, New York, United States
(Jones) Thoracic Service, Department of Surgery, Memorial Sloan Kettering
Cancer Center, New York, New York; Department of Surgery, Weill Cornell
Medical College, New York, New York, United States
(Zhang) Department of Anesthesiology and Critical Care Medicine, Memorial
Sloan Kettering Cancer Center, New York, New York, United States
(Desiderio) Department of Anesthesiology and Critical Care Medicine,
Memorial Sloan Kettering Cancer Center, New York, New York; Department of
Anesthesiology, Weill Cornell Medical College, New York, New York, United
States
(Fischer) Department of Anesthesiology and Critical Care Medicine,
Memorial Sloan Kettering Cancer Center, New York, New York; Department of
Anesthesiology, Weill Cornell Medical College, New York, New York, United
States
(Amar) Department of Anesthesiology and Critical Care Medicine, Memorial
Sloan Kettering Cancer Center, New York, New York; Department of
Anesthesiology, Weill Cornell Medical College, New York, New York, United
States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: - The efficacy of serratus anterior plane block for treatment
of pain after minimally invasive thoracic surgery remains unclear. This
trial assesses the impact of serratus anterior plane block on
postoperative opioid consumption and on measures of early recovery after
thoracoscopic lung resection. Method(s): - Patients undergoing
minimally invasive anatomic lung resection at a single center were
randomized to undergo serratus anterior plane block with 40 ml injectate
containing bupivacaine 0.25%, clonidine 100 mug, and dexamethasone 4 mg
(serratus anterior plane block group) or sham block with 40 ml normal
saline (placebo group) at the conclusion of surgery. The primary outcome
was cumulative intravenous morphine equivalents during the first 24 h
postoperatively. Secondary outcomes were intravenous morphine equivalents,
pain scores at rest and with cough, inspiratory volume on incentive
spirometry, incidence of nausea or vomiting during the first 48 h
postoperatively, Quality of Recovery-15 score on postoperative day 7, and
length of stay. Result(s): - Using the protocol-specified
intention-to-treat analysis, the median (interquartile range) intravenous
morphine equivalents was 10.6 (5.0 to 27.1) mg in serratus anterior plane
block patients (n = 46) versus 18.8 (9.9 to 29.6) mg in placebo patients
(n = 46; 32% reduction; ratio, 0.68 [95% CI, 0.44 to 1.06]; P = 0.085). Of
the secondary outcomes, only the composite pain with cough scores differed
significantly in the serratus anterior plane block group by a coefficient
of -0.41 (95% CI, -0.81 to -0.01; P = 0.044). A sensitivity as-treated
analysis reported median (interquartile range) intravenous morphine
equivalents of 10.0 (5.0 to 27.2) mg in serratus anterior plane block
patients (n = 44) versus 19.9 (10.4 to 29.0) mg in placebo patients (n =
48; 36% reduction; ratio, 0.64 [95% CI, 0.41 to 1.00]; P = 0.048).
 Conclusion(s): - The protocol-specified intention-to-treat analysis
demonstrated that serratus anterior plane block did not result in a
significant reduction in opioid consumption when added to a multimodal
analgesic regimen after thoracoscopic anatomic lung resection. The
sensitivity as-treated analysis showed a significant and modest clinical
reduction in the primary outcome that warrants further
investigation. Copyright © 2024 American Society of
Anesthesiologists. All Rights Reserved

<133>
Accession Number
2044072162
Title
Comparative evaluation of clonidine and metoprolol for perioperative
hemodynamic stability, blood loss control, and postoperative recovery in
patients undergoing elective surgery: a prospective randomized controlled
study.
Source
Anaesthesia, Pain and Intensive Care. 30(2) (pp 189-199), 2026. Date of
Publication: 01 Feb 2026.
Author
Sereen B.V.A.; Natarajan S.; Arunkumar B.; Shanmugasundaram S.; Choudhary
A.K.; Periasamy P.
Institution
(Sereen, Shanmugasundaram) Dept. of Anesthesiology, VMMC & H, VMRF-DU,
Salem, India
(Natarajan) Dept. of Anesthesiology, PSG IMS & R, Coimbatore, India
(Arunkumar) VMMC & H, VMRF-DU, Salem, India
(Choudhary, Periasamy) Govt. Erode Medical College, Tamil Nadu, Erode,
India
Publisher
Faculty of Anaesthesia, Pain and Intensive Care, AFMS
Abstract
Background & objective: Maintaining hemodynamic stability and minimizing
blood loss are critical goals in perioperative care. Clonidine, an
alpha2-adrenergic agonist, and metoprolol, a selective beta1-blocker, are
frequently used to modulate cardiovascular responses during surgery.
However, their comparative efficacy in reducing intraoperative blood loss
and supporting postoperative recovery remains a subject of clinical
interest. This study compared the efficacy of the both to facilitate the
choice. Methodology: This prospective, randomized controlled trial
included 60 ASA I-II patients aged 18-60 years undergoing elective surgery
under general anesthesia. Participants were randomized to receive either
oral clonidine (0.15 mg, Group-C, n = 30) or metoprolol (50 mg, Group-M, n
= 30) two hours before surgery. Intraoperative hemodynamic parameters,
estimated blood loss, surgical field quality, and postoperative outcomes
including pain score, nausea incidence, recovery time, and hospital stay
were recorded and statistically analyzed. Result(s): Both groups
maintained stable intraoperative heart rate, blood pressure, and oxygen
saturation (P > 0.05). Clonidine significantly reduced intraoperative
blood loss compared to metoprolol (137 +/- 14.71 mL vs. 151 +/- 9.94 mL, P
= 0.0002) and achieved better surgical field visibility (Good field: 70%
vs. 56.7%, P = 0.041). Postoperative outcomes, including pain scores,
recovery time, and hospital stay, were comparable across groups (P >
0.05). Conclusion(s): Clonidine and metoprolol are both effective for
intraoperative hemodynamic control and safe postoperative recovery.
However, clonidine demonstrates a distinct advantage in minimizing blood
loss and improving surgical field quality. These findings support its
preferential use in procedures where blood conservation is crucial. Larger
multicentric studies are recommended to guide patient-specific drug
selection in perioperative management. Copyright © 2026, Faculty
of Anaesthesia, Pain and Intensive Care, AFMS. All rights reserved.

<134>
Accession Number
2044101127
Title
Impact of Tactile Stimulation on Sternal Pain in Post-Coronary Artery
Bypass Graft Patients at PIC Hospital, Lahore, Pakistan; A
Quasi-Experimental Trial.
Source
Medical Forum Monthly. 37(2) (pp 56-60), 2026. Date of Publication: 04 Mar
2026.
Author
Naureen; Salam A.; Kausar S.; Latif W.; Sharif M.
Institution
(Naureen, Kausar, Sharif) Institute of Nursing, University of Health
Sciences Lahore, Lahore, Pakistan
(Salam) Department of Physiology, University of Health Sciences Lahore,
Lahore, Pakistan
(Latif) University of Health Sciences Lahore, Lahore, Pakistan
Publisher
Medical Academic Foundation
Abstract
Objective: To evaluate the effectiveness of tactile stimulation in
reducing sternal pain among post coronary artery bypass graft patients.
 Study Design: A quasi-experimental study Place and Duration of Study:
This study was conducted at the Punjab Institute of Cardiology, Lahore, in
collaboration with the University of Health Sciences, Lahore from April
2024 till September 2024. Method(s): A total of 36 post coronary
artery bypass graft patients aged 40 to 60 years were enrolled and
allocated into an intervention group (n = 18) and a comparison group (n =
18). Result(s): Baseline demographic and clinical characteristics
were comparable between groups. The intervention group demonstrated a
significant reduction in sternal pain over three postoperative days, with
mean pain scores decreasing from 7.9 +/- 0.8 at baseline to 1.6 +/- 0.5 by
day 3 (p < 0.001). In contrast, pain scores in the comparison group
remained persistently high with no clinically meaningful change. Between
group differences in post intervention pain scores were statistically
significant across all assessment points. Conclusion(s): Tactile
stimulation is an effective, safe, and low-cost adjunctive intervention
for reducing postoperative sternal pain in patients following coronary
artery bypass grafting and may enhance postoperative recovery when
integrated into routine nursing care. Copyright © 2026, Medical
Academic Foundation. All rights reserved.

<135>
Accession Number
2043741549
Title
Anticoagulation for Pregnant Individuals With Mechanical Heart Valves: A
Methodologic Review of Systematic Reviews.
Source
Canadian Journal of Cardiology. (no pagination), 2026. Date of
Publication: 2026.
Author
Ashraf R.; Clarfield L.; Sayfi S.; Keepanasseril A.; Bhatia K.; Shehata
N.; Shah P.S.; Hwang M.; Giannarakos A.; Brignardello-Petersen R.; Beyene
J.; D'Souza R.
Institution
(Ashraf, Sayfi, D'Souza) Department of Obstetrics and Gynaecology,
McMaster University, Hamilton, ON, Canada
(Ashraf, Sayfi, Brignardello-Petersen, Beyene, D'Souza) Department of
Health Research Methods, Evidence and Impact, McMaster University,
Hamilton, ON, Canada
(Ashraf, Clarfield, D'Souza) Department of Obstetrics and Gynaecology,
University of Toronto, Toronto, ON, Canada
(Keepanasseril) Department of Obstetrics and Gynaecology, Jawaharlal
Institute of Postgraduate Medical Education & Research, Dhanvantri Nagar,
Pondicherry, India
(Bhatia) Department of Anaesthesiology, St. Mary's Hospital, University of
Manchester, Manchester, United Kingdom
(Shehata) Department of Medicine, Mount Sinai Hospital, Toronto, ON,
Canada
(Shehata) Department of Laboratory Medicine and Pathobiology, Mount Sinai
Hospital, Toronto, ON, Canada
(Shah) Department of Pediatrics, Mount Sinai Hospital, University of
Toronto, Toronto, ON, Canada
(Hwang, Giannarakos) Library & Knowledge Services, Trillium Health
Partners, Mississauga, ON, Canada
Publisher
Elsevier Inc.
Abstract
In this study we aimed to describe methodologic variations in systematic
reviews (SRs) that estimated clinical outcomes with different
anticoagulant strategies for pregnant individuals with mechanical heart
valves (MHVs), and present the most reliable risk estimates. We identified
eligible SRs through a search involving 8 databases and critically
appraised: 1) study quality using A MeaSurement Tool to Assess systematic
Reviews (AMSTAR 2); 2) search strategies using Peer Review of Electronic
Search Strategies (PRESS) guidelines and operationalized criteria of SR
searches; and 3) meta-analytic approaches using a self-designed checklist.
We determined most reliable estimates for clinical outcomes using an
algorithm considering AMSTAR 2 scores, quality of search strategy, and
recency of publication. Of the 12 eligible SRs, most (9 of 12) were of
critically low quality based on AMSTAR 2. Of the 4 SRs that published
search strategies, 3 were of low quality based on PRESS guidelines.
Meta-analytic approaches varied widely. The most reliable risk estimates
with vitamin K antagonists were 0.9% (95% confidence interval [CI]
0.1%-1.6%) for maternal mortality, 2.7% (1.4%-4.0%) for thromboembolism,
35.5% (19.8%-51.2%) for fetal loss, and 2.0% (0.3%-3.7%) for congenital
anomalies. These risks with sequential therapy were 2.0% (0.8%-3.1%), 5.8%
(3.8%-7.7%), 20.1% (14.4%-25.7%), and 1.4% (0.3%-2.5%), and with
low-molecular-weight heparin they were 2.9% (0.2%-5.7%), 8.7%
(3.9%-13.4%), 8.0% (2.0%-13.9%), and 0.0% (0.0), respectively. SRs on
anticoagulation for pregnant individuals with MHVs demonstrated
considerable heterogeneity in terms of study quality, search strategies,
and meta-analytical approaches. The risk estimates provided could inform
shared decision-making and clinical practice guidelines. Copyright
© 2026 The Authors.

<136>
Accession Number
2043754705
Title
Analgesic efficacy and safety of lidocaine administered by intravenous
route vs erector spinae plane blocks following open heart surgery: An
open-label, randomized clinical trial.
Source
Journal of Clinical Anesthesia. 111 (no pagination), 2026. Article Number:
112166. Date of Publication: 01 Apr 2026.
Author
Selvamani B.J.; Sharma A.; Farhat B.; Sahin L.; Seering M.S.; Parra M.;
Swaran Singh T.S.; Sibenaller Z.A.; Singhal A.K.; Bashir M.A.; Sondekoppam
R.V.
Institution
(Selvamani, Parra) Department of Anesthesia, Mayo Clinic, Rochester, MN,
United States
(Sharma, Seering, Swaran Singh, Sibenaller) Department of Anesthesia,
University of Iowa, Iowa City, IA, United States
(Singhal, Bashir) Department of Cardiothoracic Surgery, University of
Iowa, Iowa City, IA, United States
(Farhat) Department of Anesthesia, University of Mississippi Medical
Center, Jackson, MS, United States
(Sahin) Department of Anesthesia, Washington University School of
Medicine, St. Louis, MO, United States
(Sondekoppam) Department of Anesthesia, Perioperative and Pain Medicine,
Stanford University, Palo Alto, United States
Publisher
Elsevier Inc.
Abstract
Introduction The erector spinae plane (ESP) block is a widely used
regional analgesic technique for truncal analgesia. This randomized,
open-label trial compared intravenous (IV) lidocaine to lidocaine
administered via bilateral continuous ESP blocks for analgesic efficacy in
the context of open heart surgery. Methods Seventy patients (18-80 years)
undergoing primary single procedure elective cardiac surgery via midline
sternotomy were randomized to receive lidocaine infusion via IV or
continuous bilateral ESP block routes. The primary outcomes were
cumulative opioid consumption in the first 48 h postoperatively (Oral
Morphine milligram equivalents- OME) and pain scores at 48 h (Numeric
Rating Scale NRS). Secondary outcomes included additional timepoints for
pain and opioid consumption measures within the first 48 postoperative
hours and plasma lidocaine levels at various timepoints within 24 h of
initiating therapy. Results Sixty patients were analyzed after various
exclusions. Both groups achieved acceptable analgesia, but the ESP group
was not found to be superior to IV lidocaine in reducing opioid
consumption in the first 48 hours (MD = -12.43 [95% CI, -43.7 to 18.8], p
= 0.375) or pain scores at 48 h (MD 0.05 [95% CI, -1.7 to 1.8], p =
0.878). No significant differences were found in secondary outcomes.
Plasma arterial lidocaine levels exceeded 5 mug/mL in 4 patients in the IV
group and 2 in the ESP group at 24 h. Conclusions ESP blocks utilizing
lidocaine did not demonstrate superior postoperative analgesia compared to
intravenous lidocaine in patients undergoing elective primary cardiac
surgery via midline sternotomy. Safety concerns regarding systemic
lidocaine accumulation from both administration routes warrant further
evaluation. Copyright © 2026 Elsevier Inc.

<137>
Accession Number
2043751613
Title
Risk factors for acute kidney injury after coronary artery bypass graft
surgery: a systematic review and meta-analysis.
Source
Frontiers in Medicine. 13 (no pagination), 2026. Article Number: 1722801.
Date of Publication: 2026.
Author
Chu H.; Li S.; Cao L.; Xu G.; Yang L.; Ma C.
Institution
(Chu, Xu) College of Traditional Chinese Medicine, Changchun University of
Chinese Medicine, Jilin, Changchun, China
(Li, Yang, Ma) Department of Geriatrics, Affiliated Hospital of Changchun
University of Traditional Chinese Medicine, Jilin, Changchun, China
(Cao) College of Integrated Traditional Chinese and Western Medicine,
Changchun University of Chinese Medicine, Jilin, Changchun, China
Publisher
Frontiers Media SA
Abstract
Background: Acute kidney injury (AKI) is one of the common and severe
complications following coronary artery bypass graft (CABG) surgery,
significantly increasing patient mortality, complication rates, and length
of hospital stay. Although numerous studies have explored risk factors for
postoperative AKI after CABG, results remain inconsistent. This systematic
review and meta-analysis aim to synthesize existing evidence to identify
the primary risk factors for AKI following CABG. Method(s):
Systematically searched PubMed, Embase, Web of Science, and Cochrane
Library databases from their inception to 20 September 2025. Observational
studies reporting risk factors for postoperative AKI following CABG were
included. Two researchers independently performed literature screening,
data extraction, and quality assessment. Random-effects models were used
to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs).
The I2 statistic was employed for heterogeneity analysis, and
funnel plots and Egger's test were used to assess publication bias.
 Result(s): A total of 17 research papers involving 33,809 patients
were included. The results of the meta-analysis suggest that older age [OR
= 1.05, 95% CI (1.03, 1.08)], prolonged cardiopulmonary bypass [OR = 1.14,
95% CI (1.06, 1.22)], diabetes [OR = 1.29, 95% CI (1.15, 1.45)],
intra-aortic balloon pump [OR = 3.19, 95% CI (1.74, 5.85)], transfusion of
red blood cells [OR = 1.73, 95% CI (1.25, 2.38)] may be associated with
the occurrence of AKI after CABG. Conclusion(s): Meta-analysis
results indicate that older age, prolonged cardiopulmonary bypass
duration, diabetes, intra-aortic balloon pump use, and red blood cell
transfusion are all significant risk factors for AKI following CABG. Among
these, prolonged cardiopulmonary bypass duration and intra-aortic balloon
pump use exert a particularly pronounced effect on AKI occurrence.
Systematic review registration: [https://www.crd.york.ac.uk/prospero/],
identifier [CRD420251144655]. Copyright © 2026 Chu, Li, Cao, Xu,
Yang and Ma.

<138>
Accession Number
650475222
Title
Valve-sparing root replacement versus Bentall procedure with bioprosthetic
valves in patients with aortic insufficiency: a meta-analysis.
Source
General thoracic and cardiovascular surgery. (no pagination), 2026. Date
of Publication: 05 Mar 2026.
Author
Yokoyama Y.; Shimoda T.M.; Kuno T.; Sa M.P.; Miyamoto Y.; Takagi H.;
Fukuhara S.; Kaneko T.
Institution
(Yokoyama) Division of Cardiothoracic Surgery, Emory University School of
Medicine, 100 Woodruff Circle, Atlanta, GA, United States
(Shimoda) Department of Cardiovascular Surgery, University of Tsukuba,
Tsukuba, Japan
(Kuno) Cardiology Division, Massachusetts General Hospital, Harvard
Medical School, Boston, MA, United States
(Sa) Department of Cardiac Surgery, Massachusets General Hospital, Harvard
Medical School, Boston, MA, United States
(Miyamoto) Department of Real-world Evidence, Graduate School of Medicine,
University of Tokyo, Tokyo, Japan
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Fukuhara) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, MI, United States
(Kaneko) Division of Cardiothoracic Surgery, Washington University in St.
Louis, St. Louis, MO, United States

<139>
Accession Number
2043827440
Title
Early Experience of Managing the Patient Pathway in the Neoadjuvant Era:
Surgical Outcomes from a Single Centre District General Hospital.
Source
Lung Cancer. Conference: 24th Annual British Thoracic Oncology Group
Conference 2026. EICC Edinburgh, Edinburgh United Kingdom. 212(Supplement
1) (no pagination), 2026. Article Number: 108993. Date of Publication: 01
Feb 2026.
Author
Palmer J.; Kar A.; Das T.; Athey V.
Institution
(Palmer, Das) Sheffield Teaching Hospitals, Sheffield, United Kingdom
(Kar) Department of Cardiothoracic Surgery, Sheffield Teaching Hospitals
NHS Foundation Trust, Sheffield, United Kingdom
(Kar) School of Medicine and Population Health, University of Sheffield,
Sheffield, United Kingdom
(Athey) Rotherham Hospital, Rotherham, United Kingdom
Publisher
Elsevier Ireland Ltd
Abstract
Introduction The establishment of neoadjuvant and peri-operative
chemo-immunotherapy (chemo-IO) as part of multi-modality treatment has
transformed local treatment pathways for lung cancer. We sought to share
our approach in adapting to this within a regional MDT. Methods
Retrospective analysis of all consecutive patients discussed within
regional lung cancer MDT (October 2023 - November 2025) who were referred
for neo-adjuvant chemo-IO was performed (n = 10). All patients are
reviewed by a respiratory physician to discuss MDT outcome in the presence
of dedicated lung CNS and support worker. In view of the complexity of
information relayed, subsequently, patients are routinely brought back to
'one-stop' sequential outpatient surgery and oncology review, so that
treatment planning can be optimised, again with CNS support, prior to
pulmonary rehabilitation and smoking cessation referral. Results 10
patients started curative treatment (median age = 68; 60% Male). 1 patient
is currently undergoing chemo-IO. 8 patients underwent thoracic surgery,
with 60% undergoing open surgery; all patients had R0 resection. Notably
87.5% of patients had partial response on repeat CT before resection (1
patient had near complete response). On pathological staging, 5 patients
had complete, 2 major and 1 partial response following surgery; only 1
patient developed recurrence at 14 months and the only complication after
surgery was a stroke in a single patient which has now resolved.
Unfortunately, 1 patient developed grade 3 toxicity after treatment
precipitating immunotherapy induced myocarditis, hepatitis and colitis,
leading to sepsis and inpatient admission which was non-survivable.
Conclusions This early experience from a single centre regional centre
highlights that 10% of patients undergoing neo-adjuvant chemo-IO do not go
on to have surgery, as per randomised control trials. Careful counselling
of patients is required with a multi-disciplinary approach that minimises
unnecessary delays in the patient pathway, while at the same time gives
patients time to consider options. Disclosure No significant
relationship. Copyright © 2026 Elsevier B.V.

<140>
Accession Number
650474749
Title
Surgical Aortic Valve Replacement: Early Rehospitalizations and Their
Implication for Trial Endpoints.
Source
Journal of the American College of Cardiology. (no pagination), 2026.
Date of Publication: 19 Feb 2026.
Author
Dietze Z.; Marin-Cuartas M.; Milojevic M.; Myers P.O.; Falk V.; Borger
M.A.
Institution
(Dietze, Marin-Cuartas, Borger) University Department of Cardiac Surgery,
Leipzig Heart Center, Leipzig, Germany
(Milojevic) Department of Cardiac Surgery and Cardiovascular Research,
Dedinje Cardiovascular Institute, Belgrade, Serbia; Department of Cardiac
Surgery, University Hospital Zurich, Zurich, Switzerland
(Myers) Department of Cardiac Surgery, University Hospital Zurich, Zurich,
Switzerland
(Falk) Department of Cardiothoracic and Vascular Surgery, Deutsches
Herzzentrum der Charite, Berlin, Germany; German Center for Cardiovascular
Research (DZHK), Berlin, Germany; ETH Zurich, Department of Health
Sciences and Technology, Zurich, Switzerland

<141>
Accession Number
650475267
Title
Outcomes for congenitally corrected transposition of great arteries using
various surgical techniques: a systematic review and network
meta-analysis.
Source
Annals of the Royal College of Surgeons of England. (no pagination),
2026. Date of Publication: 05 Mar 2026.
Author
Hasan S.U.; Usmani S.; Ahmed S.H.; Pervez A.; Kamalia M.A.; Shah A.D.;
Zubair M.M.
Institution
(Hasan, Pervez) Nottingham University Hospitals NHS Trust, United Kingdom
(Usmani) Dow University of Health Sciences, Karachi, Pakistan
(Ahmed) Geisinger Health System, Danville, United States
(Kamalia) Medical College of Wisconsin, Milwaukee, United States
(Shah) University of Minnesota, Minneapolis, United States
(Zubair) Children's Mercy, Kansas City, United States
Abstract
INTRODUCTION: Congenitally corrected transposition of the great arteries
(ccTGA) is a rare disorder. Here, we evaluated the effectiveness of
physiological, anatomical and Fontan repair techniques for ccTGA.
 METHOD(S): A systematic database search in PubMed, Embase and
Cochrane Central Register of Controlled Trials was conducted from
inception to 5 June 2023. Random-effects network meta-analysis was
performed, comparing mortality, postoperative arrhythmias, reintervention
after definitive surgery and transplant-free survival in patients
undergoing physiological, anatomical and Fontan repair. FINDINGS: A total
of 1,209 patients were included from nine studies. Fontan repair was
associated with a higher rate of transplant-free survival (absolute risk
[AR] 0.999 (+/-0.0101), 95% confidence interval [CI]) and reintervention
after definitive surgery (AR 0.098 (+/-0.067), 95% CI), whereas the
difference for mortality and postoperative arrhythmias did not reach
statistical significance. CONCLUSION(S): Fontan repair is
significantly better than anatomical or physiological repair in terms of
transplant-free survival and also had a better rank probability for
overall survival and reintervention after definitive surgery.

<142>
Accession Number
2043704729
Title
The efficacy and safety of cerebral embolic protection devices in patients
undergoing transcatheter aortic valve replacement: a systematic review and
meta-analysis with trial sequential analysis of randomized controlled
trials.
Source
Expert Review of Cardiovascular Therapy. (no pagination), 2026. Date of
Publication: 2026.
Author
Elazab A.; Hageen A.W.; Elbataa A.; Labeeb E.E.; Najah Q.; Elbahloul M.A.;
Elnady M.I.; Abdelsatar S.M.; Mansour A.; Elkasaby M.H.; Odat R.M.;
Rhabneh L.; Nassar M.; Turkmani M.; Hakim D.
Institution
(Elazab) Faculty of Medicine, South Valley University, Qena, Egypt
(Hageen) Faculty of Medicine, Tanta University, Tanta, Egypt
(Elbataa, Mansour, Labeeb, Mansour, Elkasaby) Faculty of Medicine,
Al-Azhar University, Cairo, Egypt
(Najah) Faculty of Medicine, Elmergib University, Alkhums, Libyan Arab
Jamahiriya
(Elbahloul, Elnady) Faculty of Medicine, Kafr El Sheik University, Kafr El
Sheikh, Egypt
(Abdelsatar) Faculty of Nursing, Beni-Suef National University, Beni-Suef,
Egypt
(Odat) Faculty of Medicine, Jordan University of Science and Technology,
Irbid, Jordan
(Rhabneh) Department of Internal Medicine, HMH Ocean University Medical
Center, Brick, NJ, United States
(Nassar) Division of Endocrinology and Diabetes, Larner College of
Medicine, University of Vermont, Burlington, VT, United States
(Turkmani) Faculty of Medicine, Michigan State University, East Lansing,
MI, United States
(Turkmani) Department of Pulmonary and Critical Care, University of
Toledo, Toledo, OH, United States
(Hakim) Brigham & Women's Hospital/Harvard Medical School, Boston, MA,
United States
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Transcatheter aortic valve replacement (TAVR) is an
established treatment for severe aortic stenosis but carries a risk of
stroke and cerebral embolism. Cerebral embolic protection devices (CEPD),
including filter-based and deflection-based systems (Sentinel and
TriGUARD), aim to reduce embolic complications; however, their clinical
benefit remains uncertain. This study evaluated the efficacy and safety of
CEPD during TAVR using trial sequential analysis (TSA) and the Grading of
Recommendations, Assessment, Development, and Evaluation (GRADE)
framework. Method(s): Randomized controlled trials (RCTs) comparing
TAVR with and without CEPD were identified through four electronic
databases from inception to April 2025. Primary outcomes were all-cause
mortality, major adverse cardiovascular and cerebrovascular events
(MACCE), stroke, and disabling stroke. Pooled risk ratios (RR) with 95%
confidence intervals (CI) were calculated. TSA was conducted with a 5%
type I error and 80% power. Result(s): Nine RCTs including 11,876
patients were analyzed. CEPD use showed no significant reduction in
mortality, MACCE, stroke, or disabling stroke. Secondary and subgroup
analyses yielded consistent findings. TSA demonstrated that the accrued
evidence was insufficient to confirm a clinical benefit.
 Conclusion(s): Current evidence does not support the routine use of
CEPD during TAVR, given the lack of significant benefit in key clinical
outcomes. Registration: The protocol of this study was registered at
Prospero CRD420251036308. Copyright © 2026 The Author(s).
Published by Informa UK Limited, trading as Taylor & Francis Group.

<143>
Accession Number
2044048964
Title
Tuning in To Recovery.
Source
Mayo Clinic Proceedings. 101(3) (pp 471-485), 2026. Date of Publication:
01 Mar 2026.
Author
Trinchet L.P.; Chen K.Y.; Lopez-Ruiz A.A.; Millstine D.M.; Misra L.
Institution
(Trinchet, Lopez-Ruiz) Mayo Clinic Alix School of Medicine, Mayo Clinic,
Scottsdale, AZ, United States
(Millstine) Division of Women's Health Internal Medicine, Department of
Medicine, Mayo Clinic, Scottsdale, AZ, United States
(Chen, Misra) Department of Anesthesiology and Perioperative Medicine,
Mayo Clinic, Scottsdale, AZ, United States
Publisher
Elsevier Ltd
Abstract
Cardiothoracic surgery can be a physically and emotionally challenging
experience for patients, often involving significant pain, anxiety, and a
reliance on opioid-based analgesia. As health care moves toward more
holistic and patient-centered approaches, there is growing interest in
complementary therapies like music. Music interventions represent a safe,
noninvasive, and cost-effective strategy to support recovery in
cardiothoracic surgery patients. This review explores how music
interventions can support recovery in patients undergoing cardiothoracic
procedures, focusing on pain reduction, anxiety alleviation, and
physiological responses. A search of PubMed, CINAHL, and PsychInfo
identified 19 studies, primarily randomized controlled trials,
investigating music interventions during the perioperative period in adult
cardiothoracic surgery patients. Across the studies reviewed, music
interventions significantly reduced postoperative pain and anxiety
compared with control groups. Several trials also reported reductions in
analgesic use, heart rate, and blood pressure, although findings on
physiological measures were mixed. Although further research is still
warranted to optimize implementation and assess long-term benefits, the
current evidence suggests that music can positively impact surgical
recovery. Incorporating music into multimodal recovery protocols may
improve patient experiences and reduce reliance on pharmacological
interventions. Copyright © 2025 Mayo Foundation for Medical
Education and Research. Published by Elsevier Inc. All rights are
reserved, including those for text and data mining, AI training, and
similar technologies.

<144>
Accession Number
2043947040
Title
Physiology or Angiography-Guided Coronary Artery Bypass Grafting: A
Meta-Analysis.
Source
Arquivos Brasileiros de Cardiologia. 117(6) (no pagination), 2021. Date of
Publication: 2021.
Author
Martins J.; Afreixo V.; Santos L.; Fernandes L.; Briosa A.
Institution
(Martins, Santos, Briosa) Baixo Vouga Hospital Centre, Aveiro, Portugal
(Afreixo) CIDMA, IBIMED, Department of Mathematics, University of Aveiro,
Aveiro, Portugal
(Fernandes) Centre for Health Economics, University of York, York, United
Kingdom
Publisher
Sociedade Brasileira de Cardiologia
Abstract
Background: While invasive coronary angiography is considered the gold
standard for the diagnosis of coronary artery disease (CAD) involving the
epicardial coronary vessels, coronary physiology-guided revascularization
represents a contemporary gold-standard practice for the invasive
management of patients with intermediate CAD. Nevertheless, the long-term
results of assessing the severity of stenosis through physiology compared
to the angiogram as the guide to bypass surgery - coronary artery bypass
grafting (CABG) are still uncertain. This meta-analysis aims to assess the
clinical outcomes of a physiology guided CABG compared to the
angiography-guided CABG. Objective(s): We sought to determine if
outcomes differ between a physiology guided CABG compared to an
angiography-guided CABG. Method(s): We searched Medline, EMBASE, and
the Cochrane Library. The last date for this search was June 2020, and all
of the previous studies were included. We conducted a pooled risk-ratio
meta-analysis for four main outcomes: all-cause death, myocardial
infarction (MI), target vessel revascularization (TVR) and major adverse
cardiovascular events (MACE). P-value <0.05 was considered as
statistically significant. Heterogeneity was assessed with Cochran's Q
test and quantified by the I2 index. Result(s): We
identified five studies that included a total of 1,114 patients. A pooled
meta-analysis showed no significant difference between a physiology guided
strategy and an angiography-guided strategy in MI (risk ratio [RR] = 0.72;
95%CI, 0.39-1.33; I2 = 0%; p = 0.65), TVR (RR = 1.25; 95%CI = 0.73-2.13;
I2 = 0%; p = 0.52), or MACE (RR = 0.81; 95%CI = 0.62-1.07; I2 = 0%; p =
1). The physiology guided strategy has 0.63 times the risk of all-cause
death compared to the angiography-guided strategy (RR = 0.63; 95%CI =
0.42-0.96; I2 = 0%; p = 0.55). Conclusion(s): This meta-analysis
demonstrated a reduction in all-cause death when a physiology guided CABG
strategy was used. Nevertheless, the short follow-up period, small sample
size of the included studies and the non-discrimination of the causes of
death can largely justify these conclusions. Studies with an extended
follow-up period of observation are required to draw more robust and
definitive conclusions. Copyright © 2021 Sociedade Brasileira de
Cardiologia. All rights reserved.

EPICORE Embase Updates

Saturday, March 21, 2026

EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

Followers

Blog Archive

About Me