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<1>
Accession Number
2037428651
Title
Early Versus Bail-Out Left Ventricular Unloading During Venoarterial
Extracorporeal Membrane Oxygenation: A Systematic Review And
Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(4) (pp 1015-1025),
2025. Date of Publication: 01 Apr 2025.
Author
Picado-Loaiza S.; Ayala R.; Ferreira R.O.M.; Zeledon F.; Almeidinha L.;
Clemente M.; Bittar de Pontes V.; Lee E.C.
Institution
(Picado-Loaiza, Zeledon) Cardiovascular Surgery Department, Caja
Costarricense del Seguro Social, San Jose, Costa Rica
(Ayala) Cardiovascular Surgery Department, Robert Bosch Hospital,
Stuttgart, Germany
(Ferreira) Federal University of Santa Catarina, Florianopolis, Brazil
(Almeidinha) Rochester General Hospital, Rochester, NY, United States
(Clemente) Petropolis School of Medicine, Petropolis, Brazil
(Bittar de Pontes) University Centre of Associated Colleges of Education,
Sao Joao da Boa Vista, Sao Paulo, Brazil
(Lee) Sands Constellation Heart Institute, Rochester, NY, United States
Publisher
W.B. Saunders
Abstract
Left ventricular (LV) unloading has demonstrated favorable outcomes in
patients undergoing venoarterial extracorporeal membrane oxygenation
(VA-ECMO). However, the optimal timing for LV unloading during VA-ECMO
remains controversial. PubMed, Embase, and Cochrane were searched for
studies comparing early versus bail-out LV unloading in patients
undergoing VA-ECMO. We computed mean differences (MD) for continuous
outcomes and risk ratios (RR) for binary outcomes, with 95% confidence
intervals (95%CIs). Heterogeneity was assessed using I2 statistics.
Statistical analyses were performed using R version 4.2.3. Six studies
comprising 1,556 participants were included in the meta-analysis, of whom
936 (60%) were referred to early LV unloading. There were no significant
differences between groups in weaning from VA-ECMO (MD 1.07; 95% CI 0.86 -
1.33; p = 0.55; I2 = 26%), in-hospital mortality (RR 0.95; 95% CI 0.86 -
1.05; p = 0.28; I2 = 0%), 30-day mortality (RR 0.75; 95% CI 0.52 - 1.10; p
= 0.14; I2 = 64%), or duration of VA-ECMO (MD 0.37; 95% CI -1.57 - 2.32; p
= 0.71; I2 = 20%). Sepsis (RR 0.84; 95% CI 0.63 - 1.11; p = 0.22; I2 =
0%), stroke (RR 0.90; 95% CI 0.52 - 1.56; p = 0.70; I2 = 48%), and bridge
to heart transplantation or left ventricular assist device (RR 1.20; 95%
CI 0.90 - 1.62; p = 0.22; I2 = 0%) also did not differ significantly
between the groups. In patients undergoing VA-ECMO, early LV unloading was
not associated with improved efficacy and safety outcomes when compared to
the bail-out strategy for LV unloading. Copyright © 2025 Elsevier
Inc.

<2>
Accession Number
2037118155
Title
The Renal Effect of 20% Human Albumin Solution Fluid Bolus Therapy in
Patients After Cardiac Surgery. A Secondary Analysis of the HAS FLAIR II
Randomized Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(4) (pp 967-974),
2025. Date of Publication: 01 Apr 2025.
Author
Wigmore G.J.; Deane A.M.; Presneill J.J.; Serpa Neto A.; Eastwood G.;
Maiden M.J.; Bihari S.; Baker R.A.; Bennetts J.S.; Ghanpur R.; Anstey
J.R.; Raman J.; Bellomo R.
Institution
(Wigmore, Deane, Presneill, Serpa Neto, Maiden, Bellomo) Department of
Critical Care, Melbourne Medical School, University of Melbourne,
Parkville, VIC, Australia
(Wigmore) Department of Anaesthesia and Pain Medicine, Western Health,
Melbourne, VIC, Australia
(Deane, Presneill, Maiden, Anstey, Bellomo) Department of Intensive Care,
Royal Melbourne Hospital, Melbourne, VIC, Australia
(Presneill, Serpa Neto, Bellomo) Australian and New Zealand Intensive Care
Research Centre (ANZIC-RC), School of Public Health and Preventive
Medicine, Monash University, Melbourne, VIC, Australia
(Serpa Neto, Eastwood, Raman, Bellomo) Department of Intensive Care,
Austin Hospital, Melbourne, VIC, Australia
(Serpa Neto) Department of Critical Care Medicine, Hospital Israelita
Albert Einstein, Sao Paulo, Brazil
(Maiden) Intensive Care Unit, Barwon Health, Geelong, VIC, Australia
(Bihari) College of Medicine and Public Health, Flinders University,
Bedford Park, SA, Australia
(Bihari) Department of ICCU, Flinders Medical Centre, Bedford Park, SA,
Australia
(Baker, Bennetts) Cardiothoracic Quality and Outcomes, Flinders Medical
Centre and College of Medicine and Public Health Flinders University, SA,
Australia
(Ghanpur) Department of Intensive Care, Warringal Private Hospital,
Melbourne, Australia
(Raman) University of Melbourne, Parkville, VIC, Australia
(Raman) St Vincent's Hospital, Melbourne, VIC, Australia
(Raman) Department of Cardiothoracic Surgery, Townsville University
Hospital, Townsville, QLD, Australia
(Bellomo) Data Analytics Research and Evaluation Centre, Austin Hospital,
Melbourne, VIC, Australia
Publisher
W.B. Saunders
Abstract
Objective: To compare the effects of fluid bolus therapy (FBT) with 20%
albumin to crystalloid FBT on the incidence of cardiac surgery-associated
acute kidney injury (CSA-AKI) and its severity and duration.
 Design(s): Secondary analysis of the multicenter, parallel-group,
open-label, randomized HAS FLAIR-II trial. Setting(s): Six intensive
care units. Participant(s): Patients who required
clinician-determined FBT after cardiac surgery requiring cardiopulmonary
bypass. Intervention(s): Patients were randomized to receive FBT with
20% albumin (up to 400 mL/day) or crystalloid fluid for all FBTs in the
intensive care unit. Measurements and Main Results: A total of 452
patients were included in the modified intention-to-treat population (224
in the 20% albumin group and 228 in the crystalloid group). AKI occurred
in 54 (24%) patients in the 20% albumin group and 50 (22%) in the
crystalloid group (odds ratio: 1.13, 95% confidence interval [CI]: 0.73 to
1.76). However, in patients who developed stages 2 and 3 AKI, those
allocated to 20% albumin had a significantly lower median time-weighted
average (TWA) creatinine: 144 micromol/L (interquartile range [IQR]: 109
to 162) versus 254 micromol/L (IQR: 182 to 294) than the crystalloid group
(difference -105 micromol/L, [95% CI -170 to -41], p = 0.003) and a lower
peak serum creatinine (-110 micromol/L [-189 to -32], p = 0.01). The
reduced TWA creatinine in the 20% albumin group was seen in patients with
both a low (p = 0.04) and normal preoperative serum albumin concentration
(p < 0.001). Conclusion(s): FBT with 20% albumin compared with
crystalloid-based regimen did not reduce the occurrence of AKI in patients
after cardiac surgery. However, it reduced the severity and duration of
stages 2 and 3 AKI. Copyright © 2025 The Authors

<3>
Accession Number
2037130822
Title
Entrapment of Pulmonary Artery Catheters in Cardiac Surgery: A Structured
Literature Review and Analysis of Published Case Reports.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(4) (pp 916-924),
2025. Date of Publication: 01 Apr 2025.
Author
Kumar N.; Toda C.; Couture E.J.; Vlahakes G.J.; Fitzsimons M.G.
Institution
(Kumar, Fitzsimons) Department of Anesthesia, Critical Care, and Pain
Medicine, Massachusetts General Hospital, Harvard Medical School, Boston,
MA, United States
(Toda) Department of Anesthesia, TidalHealth Peninsula Regional,
Salisbury, MD, United States
(Couture) Department of Anesthesiology & Division of Intensive Care
Medicine, Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Quebec, QC, Canada
(Vlahakes) Cardiac Surgery Division, Department of Surgery, Massachusetts
General Hospital, Harvard Medical School, Boston, MA, United States
Publisher
W.B. Saunders
Abstract
Objectives: This systematic review aims to tabulate and analyze the
published literature regarding pulmonary artery catheter (PAC) entrapment
during cardiac surgery. Design(s): Systematic review.
 Setting(s): Case reports and series. Participant(s): Adults
undergoing cardiac surgery. Intervention(s): None. Measurements
and Main Results: 223 distinct incidents of PAC entrapment were published
across 77 case reports and 3 retrospective studies. The reported incidence
of an entrapped PAC was 137/200,831 (0.068%, 95% confidence interval:
0.067%, 0.069%). Reported PAC entrapment was most seen in the setting of
mitral valve surgery and was not discovered until the postoperative period
in 77% of cases. Inadvertent fixation to cardiac structures was the most
common mechanism of PAC entrapment. A total of 75% of patients with an
entrapped PAC required an immediate redo sternotomy for PAC retrieval.
After PAC retrieval, these patients still had longer hospital length of
stay compared with the Society of Thoracic Surgeons Adult Cardiac Surgery
Database averages. Conclusion(s): Although PAC entrapment during
cardiac surgery is rare, an entrapped PAC increases patient morbidity,
delays recovery, and increases hospital length of stay. Surgeons and
anesthesiologists are encouraged to be attentive to PAC entrapment before
chest closure. Copyright © 2025 Elsevier Inc.

<4>
Accession Number
2037330280
Title
Impella versus Non-Impella for Nonemergent High-Risk Percutaneous Coronary
Intervention.
Source
American Journal of Cardiology. 242 (pp 88-92), 2025. Date of Publication:
01 May 2025.
Author
Reddy P.; Merdler I.; Zhang C.; Cellamare M.; Ben-Dor I.; Bernardo N.;
Hashim H.; Satler L.; Rogers T.; Waksman R.
Institution
(Reddy, Merdler, Zhang, Cellamare, Ben-Dor, Bernardo, Hashim, Satler,
Rogers, Waksman) Section of Interventional Cardiology, MedStar Washington
Hospital Center, Washington, DC, United States
(Rogers) Cardiovascular Branch, Division of Intramural Research, National
Heart, Lung and Blood Institute, National Institutes of Health, Bethesda,
MD, United States
Publisher
Elsevier Inc.
Abstract
The benefit of mechanical circulatory support (MCS) with Impella (Abiomed,
Inc, Danvers, MA) for patients undergoing nonemergent, high-risk
percutaneous coronary intervention (HR-PCI) is unclear and currently the
subject of a large randomized clinical trial (RCT), PROTECT IV. While
contemporary registry data from PROTECT III demonstrated improvement of
outcomes with Impella when compared with historical data (PROTECT II),
there is lack of direct comparison to the HR-PCI cohort that did not
receive Impella support. We retrospectively identified patients from our
institution meeting PROTECT III inclusion criteria (left ventricular
ejection fraction [LVEF] <35% with unprotected left main or last remaining
vessel or LVEF <30% undergoing multivessel PCI), and compared this group
(NonIMP) to the published outcomes data from the PROTECT III registry
(IMP). Baseline differences were balanced using inverse propensity
weighting (IPW). The co-primary outcome was major adverse cardiac events
(MACE) in-hospital and at 90 days. Secondary outcomes included in-hospital
post-PCI complications. We identified 284 high-risk patients who did not
receive Impella support; 200 patients had 90-day event ascertainment and
were included in IPW analysis, with 504 patients in the IMP group. After
calibration, few residual differences remained; patients in the NonIMP
group were older (73.4 vs. 69.3, p <0.001) with higher prevalence of
coronary artery bypass grafting (65.0% vs. 13.7%, p <0.001). Unprotected
left main intervention was performed in 43% of patients in both groups.
The primary outcome was not different in-hospital (3.0% vs. 4.8%, p =
0.403), but lower in the NonIMP group at 90 days (7.5% vs. 13.8%, p =
0.033). Peri-procedural vascular complications, bleeding, and transfusion
rates were not different between groups. However, acute kidney injury
occurred more frequently in the NonIMP group (10.5% vs. 5.4%, p = 0.023).
Under identical HR-PCI inclusion criteria for Impella use in PROTECT III,
an institutional non-Impella supported HR-PCI cohort demonstrated similar
MACE in-hospital but lower MACE at 90 days. There was no signal for
peri-procedural harm with Impella use. These results do not support
routine usage of Impella for HR-PCI patients. Careful patient selection is
critical until a large RCT demonstrates benefits in a broad HR-PCI
population. Copyright © 2025

<5>
Accession Number
2033540217
Title
Novel Predictors of Major Adverse Cardiovascular Events in Renal
Transplant Patients: A Systematic Review and Meta-Analysis.
Source
Nephrology. 30(3) (no pagination), 2025. Article Number: e70015. Date of
Publication: 01 Mar 2025.
Author
Patel K.; Danaila V.; Khanna S.; Thakur A.; Bhat A.; Tarafdar S.
Institution
(Patel, Khanna, Bhat) Department of Cardiology, Blacktown Hospital,
Sydney, Australia
(Danaila) Department of Cardiology, Westmead Hospital, Sydney, Australia
(Thakur) Department of Medicine, Royal Prince Alfred Hospital, Sydney,
Australia
(Tarafdar) Department of Nephrology, Blacktown Hospital, Sydney, Australia
Publisher
John Wiley and Sons Inc
Abstract
Adult patients with a prior renal transplantation are at increased risk of
accelerated cardiovascular disease. This study aims to identify key
clinical and biochemical predictors of major adverse cardiovascular events
(MACEs) in this population. Understanding these predictors may improve
risk stratification and enhance long-term outcomes for kidney transplant
recipients. A systematic literature search of medical databases was
performed using PRISMA principles to identify all relevant studies
assessing clinical and biochemical parameters in adult patients with a
prior renal transplantation (2000-2024; English only; PROSPERO
registration CRD42024596207). Data for a range of clinical and biochemical
parameters were individually extracted, and those with low heterogeneity
were then meta-analysed using a random-effects model for overall effect
size and assessed through standardised mean difference (SMD) and odds
ratios (ORs). The primary outcomes assessed were fatal or non-fatal
cardiovascular events occurring after renal transplantation during
hospitalisation and up to 10 years post discharge. Of 506 screened
studies, 17 peer-reviewed articles met inclusion criteria and included a
total of 181,938 renal transplant patients. The key novel predictors of
MACE included pre-transplant haemodialysis (OR 2.562, 95% CI =
1.585-4.139, p < 0.001) and delayed graft function (OR 2.113, 95% CI =
1.397-3.198, p < 0.001). Importantly, transplant from a living donor (OR
0.463, 95% CI = 0.393-0.546, p < 0.001) was a protective factor.
Traditional cardiovascular risk factor profiles were all predictors of
MACE events (p < 0.05). This study identified several traditional and
novel predictors of cardiovascular events in patients with pre-existing
renal transplantation. Early recognition of these high-risk clinical
predictors should prompt more aggressive monitoring and
treatment. Copyright © 2025 Asian Pacific Society of Nephrology.

<6>
Accession Number
2038060634
Title
The clinical impact of prophylactic concomitant left atrial appendage
occlusion during cardiac surgery: A systematic review and meta-analysis.
Source
American Heart Journal Plus: Cardiology Research and Practice. 53 (no
pagination), 2025. Article Number: 100534. Date of Publication: 01 May
2025.
Author
Zhao C.; Girdauskas E.; Schoones J.W.; Klautz R.J.M.; Palmen M.; Tomsic A.
Institution
(Zhao, Klautz, Palmen, Tomsic) Department of Cardiothoracic Surgery,
Leiden University Medical Centre, Leiden, Netherlands
(Girdauskas, Tomsic) Department of Cardiothoracic Surgery, Augsburg
University Medical Centre, Augsburg, Germany
(Schoones) Directorate of Research Policy, Leiden University Medical
Centre, Leiden, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Recently, concomitant left atrial appendage occlusion (LAAO)
has emerged as prophylactic treatment option for preventing thromboembolic
events in patients undergoing cardiac surgery with no known history of
atrial fibrillation. The efficacy of prophylactic LAAO remains unknown.
 Method(s): PubMed, Embase, Web of Science, Emcare, and the Cochrane
Library were searched for studies on prophylactic LAAO in patients
undergoing cardiac surgery. The primary endpoints were postoperative
thromboembolic complications and postoperative atrial fibrillation (POAF).
 Result(s): Three randomized trials and seven retrospective
observational studies were included: in total, 7369 patients received
either prophylactic LAAO (n = 3823) or no prophylactic LAAO (n = 3546)
during their index cardiac surgery. Prophylactic LAAO reduced the risk of
early thromboembolic events by 58 % (risk ratio: 0.42; 95 % confidence
interval: 0.25 to 0.73; p = 0.002; I2 = 0 %) with an estimated
absolute risk reduction of 0.8 %. On the other hand, a higher risk, albeit
statistically not significant, of POAF was seen with LAAO (risk ratio:
1.15; 95 % confidence interval: 1.00 to 1.32; p = 0.051; I2 =
64 %). Prophylactic LAAO also reduced the risk of all-time thromboembolic
complications by 52 % (hazards ratio: 0.48; 95 % CI: 0.29 to 0.80; p =
0.005; I2 = 41 %). Conclusion(s): Prophylactic LAAO was
associated with a reduction in early and all-time thromboembolic events
but demonstrated a potential relation to a higher risk of
POAF. Copyright © 2025

<7>
Accession Number
2037394663
Title
The risk of donor-acquired allergy in solid-organ transplant recipients: A
systematic review.
Source
Annals of Allergy, Asthma and Immunology. 134(4) (pp 474-483.e7), 2025.
Date of Publication: 01 Apr 2025.
Author
Lee E.Y.; Sohng K.; Singer L.G.; Tarlo S.M.; Phillips E.J.
Institution
(Lee, Sohng, Tarlo) Division of Clinical Immunology and Allergy,
Department of Medicine, University of Toronto, Toronto, ON, Canada
(Lee, Singer) Ajmera Transplant Centre, Toronto General Hospital, Toronto,
ON, Canada
(Singer, Tarlo) Division of Respirology, Department of Medicine,
University of Toronto, ON, Canada
(Singer, Tarlo) Division of Respirology, University Health Network,
Toronto, ON, Canada
(Phillips) Center for Drug Safety and Immunology, Vanderbilt University
Medical Centre, Nashville, TN, United States
(Phillips) Institute for Immunology and Infectious Diseases, Murdoch
University, Murdoch, WA, Australia
Publisher
American College of Allergy, Asthma and Immunology
Abstract
Background: Donor-acquired allergy (DAA) occurs when donors transfer their
allergies to recipients through solid-organ transplant (SOT). However, the
risk of DAA in recipients of organs from allergic donors has not been
systematically characterized. Objective(s): To synthesize the
available evidence on the risk of DAA in SOT recipients. Method(s):
We searched Embase and MEDLINE databases for original and peer-reviewed
articles related to transplant allergy since database inception to
February 11, 2024. Two reviewers independently screened records, extracted
data, and assessed risk of bias. Result(s): The review included 24
studies with 747 SOT recipients and their 135 allergic donors in the
category of food, drug, or venom. Only 40 recipients (5.4%) underwent
allergy testing to donor allergens, and 23 of them had the testing done
before an exposure to donor allergens. Among the 30 recipients (4.0%) who
were diagnosed with having DAA based on a clinical reaction or positive
allergy testing result, 19 (2.5%) had anaphylaxis to donor allergens. Only
the type of SOT (lung or liver) was associated with an increased risk of
DAA (odds ratio 88.0, 95% CI 22.5-481.3), with no association found for
other organs. Conclusion(s): Despite the uncommon occurrence,
recipients of organs from allergic donors could be at risk of severe
allergic reactions to donor allergens. Although infrequently performed,
allergy testing to donor allergens can effectively assess the risk of
developing DAA. These findings highlight the risk of DAA and underscore
the importance of proactive allergy assessment to prevent unnecessary
anaphylaxis in this vulnerable population. Copyright © 2025 The
Authors

<8>
Accession Number
2037780968
Title
A Comparative Study of Preoperative Oral Pregabalin and Oral Clonidine in
Attenuation of Hemodynamic Stress Responses During Laryngoscopy and
Intubation.
Source
European Journal of Cardiovascular Medicine. 15(3) (pp 152-157), 2025.
Date of Publication: 01 Mar 2025.
Author
Thengumgal R.G.; Kanaki L.; Thayil P.
Institution
(Thengumgal, Kanaki, Thayil) SreeMookambika Institute of Medical
Institute, Kulashekarum, Tamilnadu, Nagercoil, India
Publisher
Healthcare Bulletin
Abstract
Background: Direct laryngoscopy and tracheal intubation can result in
severe effects such as tachycardia, hypertension, cardiac ischaemia, and
cerebral haemorrhage.Clonidine is an alpha-2 adrenergic receptor agonist
that exerts a central sympatholytic action. Clonidine premedication
mitigates the haemodynamic stress reactions associated with direct
laryngoscopy and tracheal intubation. Pregabalin, a gabapentinoid, seems
to exert an inhibitory effect on neuronal excitability. Aim(s): The
purpose of this study was to compare the effect of oral pregabalin 150 mg
& oral clonidine 0.2 mg given 90 minutes before surgery, on haemodynamic
stress response resulting from laryngoscopy and endotracheal intubation.
 Material(s) and Method(s):The present study was a
prospectiveobservational randomizedcomparativestudy performed conducted
for a period of one year in a tertiary care centre. The study comprised 60
patients classified as ASA I and II, scheduled for diverse elective
operations under general anaesthesia. The participants were randomised
into two groups, A and B, each consisting of 30 patients: the Pregabalin
group (Group A) and the Clonidine group (Group B). Group A received
premedication with 150 mg of capsaicin pregabalin, whereas Group B was
administered 0.2 mg of clonidine. Subsequently, the haemodynamic
parameters including heart rate(HR), systolic blood pressure(SBP),
diastolic blood pressure(DBP) and mean arterial pressure(MAP) were
compared between the two groups during induction, laryngoscopy, and
intubation.Result wasanalysed using SPSS 20.0 version and the association
was tested using t test. A p value less than 0.05 was considered
statistically significant. Result(s): Administration of oral
clonidine 0.2 mg 90 minutes before to surgery mitigated sympathetic
stimulation and catecholamine responses during laryngoscopy and tracheal
intubation. Our investigation revealed that the increase in HR, SBP, DBP,
and MAP after laryngoscopy and endotracheal intubation was considerably
lower in the Clonidine group compared to the Pregabalin group. The
Clonidine group exhibited superior haemodynamic stability throughout
surgery compared to the pregabalin group. Conclusion(s): When
compared to oral pregabalin, oral clonidine substantially reduces the
sympathetic responses that occur during laryngoscopy and endotracheal
intubation, while simultaneously preserving the stability of the
cardiovascular system during surgery. Copyright © 2025 Healthcare
Bulletin. All rights reserved.

<9>
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Accession Number
2037974164
Title
Liver Fibrosis and Cardiovascular Events.
Source
Southern Medical Journal. 118(1) (pp 19-25), 2025. Date of Publication: 01
Jan 2025.
Author
Nso N.; Bookani K.R.; Trimingham M.; Orji R.; Njei B.; Balasubramanian
S.S.; Pursnani A.
Institution
(Nso, Bookani, Balasubramanian, Pursnani) Department of Medicine, Division
of Cardiovascular Disease, University of Chicago, Northshore Program,
Evanston, IL, United States
(Trimingham) American University of Antigua, College of Medicine, St
Johns, Antigua and Barbuda
(Orji) Department of Internal Medicine, Chicago Medical School, Rosalind
Franklin University of Medicine and Science, North Chicago, IL, United
States
(Njei) Yale School of Medicine, Yale University, New Haven, CT, United
States
Publisher
Lippincott Williams and Wilkins
Abstract
Objectives Liver fibrosis represents a common sequela of nonalcoholic
fatty liver disease (NAFLD) and other chronic liver diseases. Noninvasive
liver fibrosis scores (LFSs) aim to evaluate the severity of liver
fibrosis. Whether LFSs can predict the risk of future cardiovascular
events (CVEs) remains unclear. This systematic review aimed to clarify the
association between liver fibrosis and CVEs by studying the value of LFSs,
namely the Fibrosis-4 (FIB-4) Index for Liver Fibrosis score and the NAFLD
Fibrosis Score (NFS), for predicting CVEs. Methods PubMed, Scopus, Web of
Science, and Cochrane Library were searched for relevant prospective
studies. Retrieved articles were screened to confirm their eligibility for
the systematic review. We evaluated the quality of the included studies
using the National Institutes of Health tool. Results Twelve studies of
high to fair quality were included in this systematic review. Of note,
10/12 studies reported an independent association between high LFSs and
the risk of CVEs, cardiovascular mortality, and all-cause mortality (all P
< 0.05). In addition, an advanced histological grade of liver fibrosis
(grade 3 or 4) was suggestive of CVE occurrence. NAFLD also appeared to be
associated with a higher risk of CVEs at any severity of fibrosis (all P <
0.05). Conclusions The findings of this review suggest that liver fibrosis
in patients with NAFLD is an independent predictor of future adverse CVEs,
cardiovascular mortality, and all-cause mortality. Noninvasive and
easy-to-perform LFSs, including FIB-4 score and the NFS, appear useful in
predicting such events in patients with a spectrum of cardiovascular
diseases and the general population without known cardiovascular
disease. Copyright © Lippincott Williams & Wilkins.

<10>
Accession Number
2033978307
Title
Exercise-Based Cardiac Rehabilitation for Patients After Heart Valve
Surgery: A Systematic Review and Re-Evaluation With Evidence Mapping
Study.
Source
Clinical Cardiology. 48(3) (no pagination), 2025. Article Number: e70117.
Date of Publication: 01 Mar 2025.
Author
Zhang R.; Zhu C.; Chen S.; Tian F.; Chen Y.
Institution
(Zhang, Chen) Xiamen Cardiovascular Hospital, Xiamen University, Xiamen,
China
(Zhang, Zhu, Chen, Tian, Chen) School of Nursing, Fujian University of
Traditional Chinese Medicine, Fuzhou, China
Publisher
John Wiley and Sons Inc
Abstract
Objective: This systematic review and evidence mapping study aims to
assess the effects of exercise-based cardiac rehabilitation on clinical
outcomes in patients after heart valve surgery. By consolidating and
visualizing existing evidence, the study seeks to identify gaps in
knowledge, evaluate the quality and breadth of current research, and
provide guidance for clinical practice and future research. The evidence
mapping will highlight under-researched areas and inform healthcare
providers on effective strategies to enhance postoperative recovery.
 Method(s): A comprehensive search was performed across multiple
databases, including PubMed, Embase, Cochrane CENTRAL, Web of Science,
CNKI, and Wanfang, up to May 2024. Two reviewers independently screened
the articles, extracted relevant data, and assessed study quality. Study
characteristics and outcomes were visualized using bubble plots.
 Result(s): Ten systematic reviews/meta-analyses met the inclusion
criteria. Based on AMSTAR-2, two were rated "high quality," two "low
quality," and six "very low quality." Using the GRADE system, of the 48
pieces of evidence across 10 outcomes, 1 was "high quality," 8 "moderate,"
19 "low," and 20 "very low.". Conclusion(s): Current evidence
indicates that exercise-based cardiac rehabilitation can enhance physical
capacity, left ventricular ejection fraction, peak oxygen uptake, and
daily living activities in heart valve surgery patients. However, more
large-scale, high-quality studies are needed to verify its effects on
all-cause mortality, quality of life, adverse events, return to work, and
emotional health. Copyright © 2025 The Author(s). Clinical
Cardiology published by Wiley Periodicals, LLC.

<11>
Accession Number
2037661692
Title
Intraoperative assessment of myocardial perfusion using near-infrared
fluorescence and indocyanine green: A literature review.
Source
JTCVS Techniques. 30 (pp 81-93), 2025. Date of Publication: 01 Apr 2025.
Author
Peul R.C.; Kharbanda R.K.; Koning S.; Kruiswijk M.W.; Tange F.P.; van den
Hoven P.; Vahrmeijer A.L.; Klautz R.J.M.; Hamming J.F.; Hjortnaes J.; van
der Vorst J.R.
Institution
(Peul, Koning, Kruiswijk, Tange, van den Hoven, Vahrmeijer, Hamming, van
der Vorst) Department of Surgery, Leiden University Medical Center,
Leiden, Netherlands
(Kharbanda, Klautz, Hjortnaes) Department of Cardiothoracic Surgery,
Leiden University Medical Center, Leiden, Netherlands
(Klautz) Department of Cardiothoracic Surgery, Amsterdam University
Medical Center, Amsterdam-Zuidoost, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Coronary artery bypass grafting (CABG) is among the most
commonly performed major surgical procedures worldwide. While flow
measurements help assess graft patency during surgery, there are limited
tools available for surgeons to objectively evaluate myocardial perfusion
after graft placement. Near-infrared fluorescence (NIRF) imaging shows
promise in this area, offering real-time visualization of flow and
perfusion without the need for radiation or nephrotoxic contrast agents.
This review summarizes current knowledge of and developments in myocardial
perfusion assessment via NIRF imaging, emphasizing the potential benefits
of adding quantification to enhance this technique. Method(s): PubMed
was searched for articles describing the use of NIRF imaging for
myocardial perfusion assessment. Articles were subsequently analyzed based
on study objectives, subjects, and quantification capabilities.
Limitations, future directions, and comparisons with other techniques were
examined to recognize patterns and describe the chronological developments
in NIRF imaging for myocardial perfusion assessment. Result(s):
Twenty-eight articles were included, 11 of which explored quantification.
Only 5 of these articles included patients. Aims and techniques varied
significantly among studies. Compared to the abundance of qualitative
assessments, quantified NIRF imaging in patients remains limited.
 Conclusion(s): This literature review highlights that NIRF imaging
has been broadly researched qualitatively, showing promise for guiding
CABG surgery through visualization of graft flow. However, the critical
step of incorporating quantification to accurately assess myocardial
perfusion remains insufficiently explored. To optimize decision making
during CABG surgery, future studies must focus on intraoperative
application of quantified NIRF imaging in cardiovascular
patients. Copyright © 2025 The Author(s)

<12>
Accession Number
2033743893
Title
Dual-task training and cognitive performance in individuals with coronary
artery disease and/or heart failure: a systematic review.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1462385. Date of Publication: 2025.
Author
Cezareti T.; Souza W.M.M.D.; Deslandes A.C.; Guimaraes T.C.F.; Kasal
D.A.B.; Rodrigues Junior L.F.; Mediano M.F.F.
Institution
(Cezareti, Guimaraes, Kasal, Rodrigues Junior, Mediano) Department of
Research and Education, National Institute of Cardiology, Rio de Janeiro,
Brazil
(Souza) Center for Cardiology and Exercise, Aloysio de Castro State
Institute of Cardiology, Rio de Janeiro, Brazil
(Deslandes) Institute of Psychiatry, Federal University of Rio de Janeiro,
Rio de Janeiro, Brazil
(Rodrigues Junior) Department of Physiological Sciences, Biomedical
Institute, Federal University of the State of Rio de Janeiro, Rio de
Janeiro, Brazil
(Mediano) Evandro Chagas National Institute of Infectious Diseases,
Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
Publisher
Frontiers Media SA
Abstract
Introduction: Dual-task training (DTT) emerged as a promising intervention
strategy to improve cognition in individuals with cardiovascular diseases
(CVDs). The aim of this study is to describe the literature on the
relationship between motor-cognitive DTT and cognitive performance (CP) in
individuals with coronary artery disease (CAD) and/or heart failure (HF).
 Method(s): This systematic review includes intervention and
observational studies that assessed motor-cognitive DTT on CP in
individuals with CAD and/or HF. Searches were performed in the
MEDLINE/Pubmed, Scielo, Lilacs, PEDro, and EMBASE databases.
Methodological quality was assessed using the PEDro and ROBII scales for
intervention studies and the Newcastle-Ottawa Scale for observational
studies. The certainty of evidence was assessed using Grading of
Recommendations, Assessment, Development and Evaluation (GRADE) approach.
 Result(s): A total of 2,098 articles were retrieved, and 21 articles
were selected for full reading. Among these, 16 were excluded according to
pre-specified exclusion criteria, resulting in five studies conducted
between 2018 and 2022, conducted in three countries (United States,
Portugal, and Russia). The studies included 228 individuals, comprising
one study with HF participants, one including women with CAD, two
including individuals that underwent myocardial revascularization, and one
with patients with CAD enrolled in a phase 2 of cardiac rehabilitation
program. Each study used different combinations of motor and cognitive
tasks, conducted sequentially (n = 2 studies) or simultaneously (n = 3
studies), with one study using virtual training. The overall certainty of
evidence for CP was low according to GRADE approach. Reduction in
postoperative cognitive dysfunction after myocardial revascularization was
observed in two studies. Moreover, the results indicate that DTT may have
a positive impact on memory, selective attention, and conflict resolution
capacity. Conclusion(s): The studies reviewed indicate
motor-cognitive DTT as a potential approach to improve CP in individuals
with CAD and/or HF. Systematic Review Registration:
www.crd.york.ac.uk/prospero/display_record.php?ID=CRD4202341516,
identifier (CRD 4202341516). Copyright 2025 Cezareti, Souza,
Deslandes, Guimaraes, Kasal, Rodrigues Junior and Mediano.

<13>
Accession Number
2033078550
Title
Off-pump versus on-pump coronary artery bypass grafting in patients with
chronic obstructive pulmonary disease: a systematic review and
meta-analysis.
Source
General Thoracic and Cardiovascular Surgery. 73(4) (pp 201-208), 2025.
Article Number: e14388. Date of Publication: 01 Apr 2025.
Author
Cappellaro A.P.; de Almeida L.F.C.; Pinto M.L.; Martins M.A.B.; Sousa
A.G.E.; Gadelha J.G.; Vieira A.C.P.; Rocha L.F.R.; Thet M.S.
Institution
(Cappellaro) Centro Universitario Mauricio de Nassau de Barreiras,
Barreiras, Brazil
(de Almeida, Rocha) Department of Surgery, Federal Fluminense University,
Niteroi, Brazil
(Pinto) Universidade Federal de Ciencias da Saude de Porto Alegre, Porto
Alegre, Brazil
(Martins) Universidade Federal de Ouro Preto, Ouro Preto, Brazil
(Sousa) Centro Universitario de Anapolis, Anapolis, Brazil
(Gadelha) Afya Faculdade de Ciencias Medicas da Paraiba, Joao Pessoa,
Brazil
(Vieira) Universidade Santo Amaro, Sao Paulo, Brazil
(Thet) Department of Surgery & Cancer, Imperial College London, South
Kensington, United Kingdom
Publisher
Springer
Abstract
Introduction: Off-pump coronary artery bypass graft surgery (OPCAB) has
been suggested as superior to on-pump coronary artery bypass graft surgery
(ONCAB) in certain high-risk subgroups, but its benefit in patients with
chronic obstructive pulmonary disease (COPD) remains controversial. This
meta-analysis aimed to evaluate OPCAB versus ONCAB outcomes in COPD
patients. Method(s): We followed PRISMA guidelines and searched
PubMed, Embase, and the Cochrane Library in August 2024 for studies
comparing OPCAB and ONCAB in COPD patients. Statistical analysis was
conducted using Review Manager 5.4.1 and Rstudio with a fixed or random
effects model. Result(s): Six studies with a total of 1,687 patients
were included, of which 1,062 (62.95%) underwent OPCAB. The mean patient
age was 63.6 years. OPCAB did not significantly affect all-cause mortality
compared to ONCAB (OR 1.14; 95% CI 0.65-1.99). There were no significant
differences in reintubation (OR 0.81; 95% CI 0.53-1.23), prolonged
ventilation (OR 0.54; 95% CI 0.24-1.22), post-operative atrial
fibrillation (OR 0.90; 95% CI 0.70-1.15), or ARDS (OR 0.43; 95% CI
0.14-1.33). However, ventilation time was significantly shorter in the
OPCAB group (MD - 5.30 h; 95% CI - 7.22 to - 3.38). Conclusion(s):
OPCAB is associated with reduced ventilation time in COPD patients though
it shows no significant difference in all-cause mortality or other
post-operative complications compared to ONCAB. Copyright © The
Author(s) 2025.

<14>
Accession Number
2033891951
Title
Longer-term and landmark analysis of transcatheter vs. surgical
aortic-valve implantation in severe aortic stenosis: a meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1479200. Date of Publication: 2025.
Author
Wang Y.; Zhang X.; Xu W.
Institution
(Wang, Zhang, Xu) Department of Cardiology, Nanjing Drum Tower Hospital,
The Affiliated Hospital of Nanjing University Medical School, Nanjing,
China
(Zhang) Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower
Hospital, The Affiliated Hospital of Nanjing University Medical School,
Nanjing, China
Publisher
Frontiers Media SA
Abstract
Background: Previous reports of longer-term outcomes of transcatheter
aortic valve implantation (TAVI) focus on higher risk patients and suggest
potential temporal changes. Aim(s): To evaluate the longer-term and
temporal performances of TAVI compared to surgical aortic valve
replacement (SAVR). Method(s): Randomized controlled trials reporting
outcomes with at least 1-year follow-up. The primary outcome was the
composite of all-cause death or disabling stroke. Result(s): We
included 8 trials with 8,749 patients. TAVI was associated with a higher
risk of longer-term (5-year) primary outcome compared to SAVR among
higher-risk [odds ratio (OR), 1.25; 95% CI, 1.07-1.47] but not lower-risk
participants [1.0 (0.77-1.29)]. However, a significant temporal
interaction was detected in both risk profiles. TAVI with
balloon-expandable valves was associated with a higher risk of longer-term
primary outcome compared to SAVR [1.38 (1.2-1.6)], whereas no statistical
difference was found with self-expanding valves [1.03 (0.89-1.19)]. There
was a significant interaction between the two valve systems, and a
temporal interaction was detected in both systems. Overall landmark
analysis revealed a lower risk in TAVI within the initial 30 days [0.76
(0.6, 0.96)], comparable between 30 days to 2 years [1.04 (0.85, 1.28)],
and higher beyond 2 years [1.36 (1.15-1.61)]. Analysis for all-cause death
generated largely similar results. Conclusion(s): TAVI was associated
with a higher longer-term risk of primary outcome compared to SAVR in
higher-risk patients and with balloon-expandable valves. However, a
characteristic temporal interaction was documented in all subgroups.
Future studies are warranted to test these findings. Copyright 2025
Wang, Zhang, Zhang and Xu.

<15>
Accession Number
2033952195
Title
Investigating the results of transcatheter aortic valve implantation
(TAVI) in non-diabetic and diabetic patients: a systematic review and
meta-analysis.
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
205. Date of Publication: 01 Dec 2025.
Author
Soleimani A.; Maghsoodi M.; Bahrani S.; Amerizadeh A.; Teimouri-Jervekani
Z.
Institution
(Soleimani, Amerizadeh, Teimouri-Jervekani) Cardiac Rehabilitation
Research Center, Isfahan Cardiovascular Research Institute, Isfahan
University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Maghsoodi, Bahrani) Hypertension Research Center, Cardiovascular Research
Institute, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic
Republic of
Publisher
BioMed Central Ltd
Abstract
Background: Transcatheter aortic valve implantation (TAVI) has emerged as
an effective treatment option for patients with severe aortic stenosis,
particularly in those who are not suitable candidates for open-heart
surgery. While diabetes is known to be associated with a higher risk of
cardiovascular diseases, the impact of diabetes on the outcomes of TAVI
remains controversial. Method(s): A systematic literature search was
conducted across major databases, including PubMed, Web of Science (WOS),
and Google Scholar, for studies published in English over the past 20
years, up until July 2024. Result(s): A total of 10 observational
studies were analyzed, revealing that diabetic patients were generally
younger than non-diabetic patients. The 30-day mortality rate was lower in
non-diabetics (0.03 [0.02-0.04]) compared to diabetics (0.04 [0.03-0.05]).
However, the hazard ratio for death beyond 30 days in diabetics was 2.05
(95% CI: 0.91-4.60, p = 0.08), and at one year, it was 1.04 (95% CI:
0.78-1.39, p = 0.77), with neither result reaching statistical
significance. Meta-regression analysis showed that non-insulin-treated
diabetes was significantly associated with an increased risk of acute
kidney injury (AKI) compared to non-diabetics, with a log odds ratio
(LogOR) of 0.3393 (p = 0.035) in one analysis and 0.3166 (p = 0.028) in
another, confirming a statistically significant increase in AKI risk.
 Conclusion(s): This review highlights that while diabetes slightly
increases short-term mortality after TAVI, long-term survival remains
comparable to non-diabetic patients. However, non-insulin-treated diabetes
significantly raises the risk of acute kidney injury (AKI), emphasizing
the need for enhanced renal protection and perioperative management.
Clinical trial number: Not applicable. Copyright © The Author(s)
2025.

<16>
Accession Number
2037167260
Title
Pharmacological preventions and treatments for pericardial complications
after open heart surgeries.
Source
Heart. 111(8) (pp 353-361), 2025. Date of Publication: 01 Apr 2025.
Author
Malektojari A.; Tahmasebipour R.; Fadaeihosein M.; Ghazizadeh S.; Ardali
F.; Haghighat B.; Keshavarz F.; Azari Y.Y.; Javdan F.; Shahsavari E.; Ersi
M.H.; Abbaszadeh S.; Al-Jafar R.; Dehghan A.; Pitre T.
Institution
(Malektojari, Ghazizadeh, Ardali, Shahsavari) Evidence Based Medicine
Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran,
Islamic Republic of
(Malektojari, Tahmasebipour, Ghazizadeh, Azari, Abbaszadeh) Cardiovascular
Research Center, Hormozgan University of Medical Sciences, Bandar Abbas,
Iran, Islamic Republic of
(Tahmasebipour, Fadaeihosein, Haghighat, Keshavarz, Azari, Javdan, Ersi)
Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar
Abbas, Iran, Islamic Republic of
(Al-Jafar, Dehghan) Department of Epidemiology and Biostatistics, School
of Public Health, Imperial College London, London, United Kingdom
(Al-Jafar) Data Services Sector, Lean Business Services, Riyadh, Saudi
Arabia
(Dehghan) MRC-PHE Centre for Environment and Health, School of Public
Health, Imperial College London, London, United Kingdom
(Pitre) Division of Respirology, Department of Medicine, University of
Toronto, Toronto, ON, Canada
Publisher
BMJ Publishing Group
Abstract
Background Pericardial complications following cardiac surgery are common
and debilitating, significantly impacting patients' survival. We performed
this network meta-analysis to identify the most effective and safest
preventions and treatments for pericardial complications following cardiac
surgery. Methods We systematically searched PubMed/MEDLINE, EMBASE and
Cochrane CENTRAL from inception to 22 January 2024. Pairs of reviewers
screened eligible studies. They included randomised controlled trials that
enrolled adults undergoing major cardiac surgeries and reported
postpericardiotomy syndrome, pericardial effusion and pericarditis as
primary or secondary outcomes. We summarised the effects of interventions
using relative risks and corresponding 95% CIs. We performed a frequentist
random-effects network meta-analysis using the restricted maximum
likelihood estimator. Results We included 39 trials that enrolled a total
of 6419 participants. Our network meta-analysis demonstrates colchicine
reduces the risk of postpericardiotomy syndrome (RR 0.53, 95% CI 0.38 to
0.73). Beta-blockers probably prevent atrial fibrillation with a large
magnitude of effect (RR 0.4, 95% CI 0.20 to 0.81) and may prevent
postoperative pericarditis (RR 0.66, 95% CI 0.45 to 0.97) compared with
control. Fish oil (RR 0.28, 95% CI 0.09 to 0.90), non-steroidal
anti-inflammatory drugs (RR 0.37, 95% CI 0.23 to 0.59) and colchicine (RR
0.37, 95% CI 0.23 to 0.59) may reduce the risk of postoperative atrial
fibrillation. We found no evidence of a difference in the risk of pleural
effusion, all-cause mortality, serious adverse events or postoperative ICU
stay. Conclusions The results of our study highly recommend colchicine use
to reduce the risk of the postpericardiotomy syndrome and beta-blocker use
to reduce postoperative atrial fibrillation. Additionally, our study
suggests that further research is needed to investigate other
interventions and to evaluate newly proposed interventions in large,
high-quality trials, as the current evidence for some interventions is
relatively weak. Copyright © Author(s) (or their employer(s))
2025.

<17>
Accession Number
2034785389
Title
Safety implications of mask use: A systematic review and evidence map.
Source
BMJ Evidence-Based Medicine. 30(2) (pp 91-103), 2025. Date of Publication:
01 Apr 2025.
Author
Farah W.; Abusalih M.F.; Hasan B.; Lees E.H.; Fleti F.; Elkhatib W.Y.;
Johnson B.D.; Toups G.; Wolf M.; Murad M.H.
Institution
(Farah, Abusalih, Hasan, Fleti, Murad) Evidence-Based Practice Center,
Mayo Clinic, Rochester, MN, United States
(Farah) Division of Pulmonary and Critical Care Medicine, Mayo Clinic,
Rochester, MN, United States
(Abusalih, Hasan, Lees, Fleti, Elkhatib, Toups, Wolf, Murad) Division of
Public Health Infectious Diseases and Occupational Medicine, Mayo Clinic,
Rochester, MN, United States
(Johnson) Division of Preventive Cardiology, Mayo Clinic, Rochester, MN,
United States
Publisher
BMJ Publishing Group
Abstract
Background Widespread use of respiratory protection masks has become a
critical component of public health response. Objectives This systematic
review synthesises the evidence on the acute physiological, cognitive and
psychological impacts associated with different types of masks and
provides an evidence map of research gaps. Methods A comprehensive search
from 2000 to 2023 was conducted across multiple databases (MEDLINE,
EMBASE, Cochrane databases, Scopus and PubMed). An umbrella systematic
overview was conducted for physiological outcomes using existing
systematic reviews. We conducted de novo systematic reviews for cognitive
and psychological outcomes. Pairs of independent reviewers determined
eligibility, extracted data and assessed risk of bias. Certainty at an
outcome level was appraised using the Grading of Recommendations
Assessment, Development and Evaluation approach. Results The search
resulted in 13 370 potential citations, leading to the inclusion of nine
systematic reviews for physiological outcomes (87 primary studies) and 10
primary studies for cognitive and psychological outcomes (3815
participants), with the majority of participants being healthy adults.
Studies evaluating physiological outcomes demonstrated that various types
of masks have little to no significant difference in heart rate (surgical
mask (mean difference (MD): 0.96 (-1.01 to 2.93)), N95 mask (MD: 1.63
(-2.79 to 6.05)) and cloth mask (MD: -0.94 (-6.39 to 4.52))) or
respiratory rate during rest or exercise (surgical mask (MD: -1.35 (-3.00
to 0.29)), N95 mask (MD: 0.10 (-3.10 to 3.29)) and cloth mask (MD: -2.57
(-6.44 to 1.29)) (low certainty for most outcomes)). Mask use may be
associated with very small changes in minute ventilation (surgical mask
(MD: -13.9 (-20.30 to -7.53)) and N95 mask (MD: -16.3 (-28.7 to -3.9))),
tidal volume (surgical mask (MD: -0.14 (-0.23 to -0.05)) and N95 mask (MD:
-0.10 (-0.33 to 0.13))), oxygen saturation (surgical mask (MD: -0.59%
(-0.87 to -0.30)), N95 mask (MD: -0.35% (-0.75 to 0.05)) and cloth mask
(MD: -0.50% (-1.23; 0.24))), carbon dioxide partial pressure (surgical
mask (standardised MD (SMD): 1.17 (0.70 to 1.64)) and N95 mask (SMD: 0.43
(0.08 to 0.79))) and exercise performance (surgical mask (SMD: -0.12
(-0.39 to 0.15)), N95 mask (SMD: -0.42 (-0.76 to -0.08)) and cloth mask
(SMD: -0.26 (-0.54 to 0.02)) (low certainty for most outcomes)). Studies
evaluating cognitive outcomes showed mixed results. Some studies reported
reduced mental workload, and others showed no significant effect or
decreased performance. The impact on attention, errors and reaction time
was variable. These studies were small and at moderate to high risk of
bias. Evidence was insufficient to estimate the effect of mask use on
psychological outcomes (claustrophobia, depression and anxiety) as these
studies were small, non-longitudinal and at high risk of bias. Conclusion
This evidence map provides a comprehensive insight into the multifaceted
impact of respiratory protection mask use, and highlights the limited
certainty in the available body of evidence. This evidence map supports
the development of future research agenda. Copyright © Author(s)
(or their employer(s)) 2025.

<18>
Accession Number
2033703131
Title
Robotic Congenital Cardiac Surgery Practice Worldwide: A Systematic
Review.
Source
Journal of Cardiac Surgery. 2025(1) (no pagination), 2025. Article Number:
4692522. Date of Publication: 2025.
Author
Lee M.E.; Amabile A.; Hameed I.; Antonios J.; Awad A.K.; Brackett A.;
Krane M.; Gruber P.J.; Geirsson A.
Institution
(Lee, Amabile, Hameed, Antonios, Awad, Gruber, Geirsson) Division of
Cardiac Surgery, Department of Surgery, Yale School of Medicine, New
Haven, CT, United States
(Brackett) Harvey Cushing/John Hay Whitney Medical Library Division, Yale
School of Medicine, New Haven, CT, United States
(Krane) Department of Cardiovascular Surgery, Institute Insure, German
Heart Center Munich, Technical University of Munich, Munich, Germany
Publisher
John Wiley and Sons Inc
Abstract
Background: With the increasing adoption of robotic technology in adult
cardiac surgery patients, improved surgeon experience and wider
utilization have been reported. However, interpreting trends in robotic
congenital surgery is more challenging. By performing a systematic review,
the authors aim to evaluate the current literature on robotic congenital
operations. Method(s): The protocol was registered with PROSPERO. The
inclusion and exclusion criteria were established based on the population,
intervention, comparison, and outcome (PICO) framework. A comprehensive
literature search was conducted from January 1998 to December 2021.
Studies involving patients undergoing congenital cardiac surgery
operations performed with robotic assistance were included. Two
independent reviewers screened titles/abstracts and then full text of
eligible studies. A third reviewer resolved any discrepancies. The
Newcastle-Ottawa Scale was applied to quantify quality assessment for
nonrandomized observational studies. Result(s): A total of
one-hundred twenty-eight publications underwent full-text review, and 66
studies were included. Overwhelmingly, the majority are from single
institutions and observational and retrospective studies. The population
was mostly adults with only 10.6% (7/66) studies solely reporting
pediatric patients. About 50% of the studies were case reports (28/66).
Selective reporting of outcomes varied widely across studies. Cumulative
mortality rates were 0.3%. The highest incidence of morbidities included
pleural effusion (12.3%), reoperation for bleeding (10.7%), atrial
fibrillation (10.7%), heart block (9.5%), and peripheral
cannulation-related complications (8.6%). The overall quality of the
studies was unsatisfactory, with the majority of studies receiving a score
of 3 out of 9. Conclusion(s): Most publications were case reports or
small case series performed in adults and restricted to a few
international institutions. To address these clinical challenges,
technological improvements and advanced training will be mandatory before
wider application to children and complex congenital diagnoses.
Unfortunately, the overall quality of studies is poor, with inconsistent
outcomes reporting. Improved and standardized reporting will be necessary
before an appropriate evaluation of robotics in the treatment of
congenital heart disease is feasible. Copyright © 2025 Madonna E.
Lee et al. Journal of Cardiac Surgery published by John Wiley & Sons Ltd.

<19>
Accession Number
2036791908
Title
The Prognostic Relevance of a New Bundle Branch Block After Transcatheter
Aortic Valve Implantation: A Systematic Review and Meta-Analysis.
Source
Structural Heart. 9(3) (no pagination), 2025. Article Number: 100392. Date
of Publication: 01 Mar 2025.
Author
Rao K.; Ahmed M.; Brieger D.; Baer A.; Hansen P.; Bhindi R.
Institution
(Rao, Brieger, Hansen, Bhindi) Royal North Shore Hospital, Sydney,
Australia
(Rao, Baer, Hansen, Bhindi) North Shore Private Hospital, Sydney,
Australia
(Rao, Ahmed, Bhindi) University of Sydney, Australia
Publisher
Cardiovascular Research Foundation
Abstract
Background: Interference with the cardiac conduction system is common
after transcatheter aortic valve implantation (TAVI), manifesting as
atrioventricular block, or more commonly, new-onset persistent left bundle
branch block (NOP-LBBB). Bundle branch block results in ventricular
dyssynchrony and reduced cardiac output and may be associated with a
poorer prognosis. This systematic review and meta-analysis evaluates the
prognostic impact of a left or right bundle branch block after TAVI.
 Method(s): A systematic review was performed of the following online
databases: PubMed, Medline, Scopus, and Web of Science, including English
language studies from 2014 to 2024. Two separate searches for conducted
for NOP-LBBB and new-onset persistent right bundle branch block
(NOP-RBBB). The Newcastle-Ottawa Scale was used to evaluate risk of bias.
 Result(s): Twenty-three studies totaling 18875 patients were included
for NOP-LBBB, whilst 5 studies with a total of 3525 patients were included
for NOP-RBBB. NOP-LBBB was associated with higher all-cause mortality at 1
year (risk ratio [RR] 1.41 [95% CI 1.12-1.78], I2 = 49%, p <
0.01), cardiovascular mortality (RR 1.34 [95% CI 1.02-1.75], I2
= 60%, p = 0.02), heart failure-related rehospitalization (RR 1.56 [95% CI
1.31-1.84], I2 = 47%, p < 0.01), and permanent pacemaker
implantation at 1 year (RR 3.05 [95% CI 2.39-3.89], I2 = 14%, p
< 0.01). NOP-RBBB was not associated with higher all-cause mortality at 1
year (RR 1.74 [95% CI 0.88-3.46], I2 = 93%, p = 0.11), however
increased the risk of pacemaker implantation at 1 year (RR 4.68 [95% CI
3.60-6.08], I2 = 67%, p < 0.01). Conclusion(s): NOP-LBBB
is associated with higher mortality and heart failure rehospitalization
after TAVI, whilst both NOP-LBBB and NOP-RBBB increase the risk of
permanent pacemaker implantation at 1 year after TAVI. Copyright
© 2024 The Authors

<20>
Accession Number
2033532360
Title
Systematic Review of Methods for Individual Prediction of Postoperative
Pain.
Source
Pain Research and Management. 2025(1) (no pagination), 2025. Article
Number: 1331412. Date of Publication: 2025.
Author
Mogianos K.; Akeson J.; Persson A.K.M.
Institution
(Mogianos, Persson) Department of Anesthesiology and Intensive Care
Medicine, Halland's Hospital Halmstad, Halmstad, Sweden
(Mogianos, Akeson, Persson) Department of Clinical Sciences Malmo, Lund
University, Malmo, Sweden
(Akeson) Department of Anesthesiology and Intensive Care Medicine, Skane
University Hospital, Malmo, Sweden
Publisher
John Wiley and Sons Ltd
Abstract
Background: Acute postoperative pain is a common problem in clinical
practice and merits attention considering its potential long-term adverse
effects. This systematic review covers current knowledge on methods for
individual prediction of postoperative pain. Method(s): A systematic
literature search was conducted using the PubMed, EMBASE, and CINAHL
databases for original studies with adult patients published in English
between 2016 and 2022. Inclusion required assessment of risk factors
preoperatively and assessment of postoperative pain. No reviews,
meta-analyses, or study protocols were included, nor studies with outcomes
other than pain or where risk factor analysis was not performed
preoperatively. A two peer-reviewed system was utilized using the
screening and data collection tool Covidence, with a focus on new tools
for preoperative pain prediction. The results were only analyzed
qualitatively. Result(s): The search yielded 1950 abstracts to be
screened. In total, 208 articles were subjected to full-text review, and
107 articles were included in the data synthesis of this review. The
evaluated scientific methods were grouped and analyzed separately.
Psychometric questionnaires and methods for quantitative sensory testing
are still being studied. New methods proposed include the evaluation of
pain induced by tourniquet inflation, venous cannulation, or pin-prick
stimulation, the analgesia/nociception index, electroencephalographic
recording, and other new equipment developed for this purpose.
 Conclusion(s): Various screening methods have been proposed to
identify patients prone to postoperative pain. The focus has shifted from
procedure-specific to individualized strategies to improve early
management of pain. However, many traditional predictive methods still
have a questionable role in clinical practice. Trial Registration:
ClinicalTrials.gov identifier: CRD42022298479. Copyright © 2025
Krister Mogianos et al. Pain Research and Management published by John
Wiley & Sons Ltd.

<21>
Accession Number
2037118457
Title
Combined Short-Long Axis Versus Medial Oblique Axis for Internal Jugular
Vein Cannulation: A Prospective Single-Blinded Randomized Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(4) (pp 910-915),
2025. Date of Publication: 01 Apr 2025.
Author
Afifi S.; Soltan S.A.; Farag A.M.G.
Institution
(Afifi) Department of Anesthesia, Faculty of Medicine, Ain Shams
University, Cairo, Egypt
(Afifi, Soltan) Specialized Anesthesia Department, King Abdullah Medical
City in Holy Capital KAMC-HC, Makkah, Saudi Arabia
(Soltan) Department of Anesthesia, Faculty of Medicine, Al Azhar
University, Cairo, Egypt
(Farag) Department of Cardiac Anesthesia, King Abdullah Medical City in
Holy Capital KAMC-HC, Makkah, Saudi Arabia
Publisher
W.B. Saunders
Abstract
Objective(s): Previous literature suggested the advantage of combined
short-long axis (CSLA) technique to avoid posterior wall puncture during
internal jugular vein (IJV) cannulation. The purpose of this study is to
define the best ultrasound-guided IJV cannulation technique regarding the
success rate in the first trial of insertion, time to successful central
line placement, number of attempts, procedural complications, and operator
satisfaction. Design(s): Single-blinded, prospective randomized
clinical trial. Setting(s): Elective cardiac surgeries in a tertiary
care center. Participant(s): One hundred seventy-eight elective
cardiac surgery patients older than 18 years accepted to participate in
the study and signed the informed consent. Intervention(s): Patients
were randomized into two equal groups: medial oblique axis and CSLA.
During the technique, vein dimensions, patient characteristics, technique
duration, posterior wall puncture, number of attempts, complications, and
operator satisfaction were documented. Measurements and Main Results:
Apart from body weight, there were no significant differences in baseline
characteristics between both groups. Compared to the CSLA, the medial
oblique approach showed significantly higher first-trial success rate
(92.1% v 75.0%, p = 0.002), less time for successful insertion (mean +/-
SD, 60.9 +/- 54.9 seconds v 110.7 +/- 101.6 seconds, p < 0.001),
accomplishment with fewer attempts (mean +/- SD, 1.09 +/- 0.28 v 1.44 +/-
0.81, p < 0.001), and higher operator satisfaction (mean +/- SD, 4.45 +/-
0.92 v 3.46 +/- 1.32, p < 0.001). No significant difference in
complications, including posterior wall puncture (p = 0.469), was noted
between both groups. Conclusion(s): This study demonstrated the
medial oblique axis approach was superior to the CSLA approach regarding
first-trial success rate, time to successful line placement, number of
attempts, and operator satisfaction when used during elective cannulation
of the IJV. However, regarding the incidence of complications, there was
no advantage of one approach over the other. Further research is needed to
confirm these results among specific groups of operators, with awake
patients and in emergent situations. Copyright © 2025 Elsevier
Inc.

<22>
Accession Number
2037231242
Title
The Effect of 30% or More Volume Reduction Achieved by Surgical
Ventricular Reconstruction for Ischemic Cardiomyopathy: A Systematic
Review.
Source
Structural Heart. 9(3) (no pagination), 2025. Article Number: 100390. Date
of Publication: 01 Mar 2025.
Author
Osmani H.; Hoefsmit P.C.; Hegeman R.R.M.J.J.; Burchell G.L.; Kluin J.;
Klein P.; Zandbergen R.
Institution
(Osmani, Hoefsmit, Hegeman, Kluin, Klein, Zandbergen) Department of
Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam,
Netherlands
(Burchell) Medical Library, Vrije Universiteit Amsterdam, Amsterdam,
Netherlands
Publisher
Cardiovascular Research Foundation
Abstract
Background: Ischemic cardiomyopathy, commonly attributable to coronary
artery disease, leads to ventricular remodeling. Surgical ventricular
reconstruction (SVR) aims to reverse this by restoring cardiac morphology.
This review evaluates SVR's influence on ventricular volume reduction,
comparing <30% to >30% reduction effects on left ventricular ejection
fraction (LVEF) and patient outcomes. Method(s): A systematic search
following Preferred Reporting Items for Systematic Reviews and
Meta-Analysis guidelines was performed in PubMed, Embase, Web of Science,
and the Cochrane Collaboration. Data extracted included left ventricular
end systolic volume, LVEF, New York Heart Association classification,
mitral regurgitation grade, and mortality rates. Result(s): Of the 37
articles included, 29 reported a mean volume reduction of >30%, while 8
reported a reduction <30%. A total of 4975 participants were included
across all studies. Mean volume reduction was 43% in group 1 (>30%) and
28% in group 2 (<30%). The mean relative increase in LVEF for group 1 was
38%, which was larger compared to group 2 with 30%. Additionally, mean
reduction in New York Heart Association class was 1.5 in group 1 and 1.2
in group 2. There was no difference in mitral regurgitation grade
reduction between the 2 groups. Postoperative mortality within 30 days was
5.8% in group 1 vs. 5.2% in group 2. Conclusion(s): Both volume
reduction groups showed improved LVEF and outcomes post-SVR, indicating
the efficacy of SVR. The majority of studies achieved a volume reduction
exceeding 30%, surpassing the 19% reported in the Surgical Treatment for
Ischemic Heart Failure trial. Further meta-analysis can determine optimal
volume reduction for enhanced cardiac function and outcomes. Copyright
© 2024 The Authors

<23>
Accession Number
2035949665
Title
Multicenter Experience of Percutaneous Left Atrial Appendage Occlusion in
Current Indications and Different Anesthetic Approaches.
Source
Acta Cardiologica Sinica. 41(2) (pp 251-260), 2025. Date of Publication:
01 Mar 2025.
Author
Lin S.-I.; Chen C.-Y.; Chen W.-T.; Wang C.-H.; Hua C.-P.; Lin P.-L.; Chiou
W.-R.; Wang K.; Tsai C.-T.; Lee Y.-H.
Institution
(Lin, Chen, Hua, Tsai, Lee) Cardiovascular Center, MacKay Memorial
Hospital, Taipei, Taiwan (Republic of China)
(Lin, Chen, Wang, Chiou, Tsai, Lee) Department of Medicine, MacKay Medical
College, New Taipei City, Taiwan (Republic of China)
(Lin) Department of Nursing, MacKay Junior College of Medicine, Nursing,
and Management, Taipei, Taiwan (Republic of China)
(Chen) Division of Cardiovascular Medicine, Taipei Medical University
Hospital, Taipei, Taiwan (Republic of China)
(Chen) Department of Internal Medicine, School of Medicine, Taipei Medical
University, Taipei, Taiwan (Republic of China)
(Wang) Department of Anesthesiology, MacKay Memorial Hospital, Taipei,
Taiwan (Republic of China)
(Lin) Department of Cardiology, Hsinchu MacKay Memorial Hospital, Hsinchu,
Taiwan (Republic of China)
(Chiou, Wang) Division of Cardiology, Department of Internal Medicine,
Taitung MacKay Memorial Hospital, Taitung, Taiwan (Republic of China)
(Tsai) Department of Cosmetic Applications and Management, MacKay Junior
College of Medicine, Nursing, and Management, Taipei, Taiwan (Republic of
China)
(Lee) Department of Artificial Intelligence and Medical Application,
MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
(Republic of China)
Publisher
Republic of China Society of Cardiology
Abstract
Background: Stroke remains a concern in patients with atrial fibrillation
despite the efficacy of oral anticoagulants. Left atrial appendage closure
has emerged as a treatment option for patients with suboptimal
pharmacological therapy. Objective(s): This retrospective multicenter
study aimed to evaluate the feasibility, safety, and outcomes of left
atrial appendage occlusion procedures for two different indications.
Short-term outcomes between two different methods of general anesthesia
during the procedures were also compared. Method(s): The study
included patients who underwent appendage closure between September 2017
and June 2021. Two indications for the procedures, anticoagulant
intolerance, and anticoagulant inadequacy were recorded. One-year outcomes
were analyzed between groups. Short-term outcomes were compared between
the intravenous general anesthesia with high-flow nasal cannula oxygen
therapy and intubated general anesthesia groups. Result(s): A total
of 75 consecutive patients were enrolled: 19 patients in the anticoagulant
inadequacy group and 56 in the anticoagulant intolerance group. Appendage
occlusion was effective in reducing stroke risk in atrial fibrillation
patients with suboptimal pharmacological therapy. There were no
significant differences in outcomes between the two indication groups.
Appendage closure under high-flow nasal cannula oxygen therapy was found
to be feasible and safe, with comparable results to intubated general
anesthesia. Conclusion(s): Appendage occlusion is effective and safe
for Taiwan National Health Insurance-approved indications, with no
difference between indication groups during 1-year of follow-up. Appendage
occlusion under high-flow nasal cannula oxygen therapy is feasible and
comparable to intubated general anesthesia. Larger randomized studies with
longer follow-up are needed to confirm these findings. Copyright
© 2025, Republic of China Society of Cardiology. All rights reserved.

<24>
Accession Number
2037928102
Title
A Systematic Review and Analysis of Brucella Endocarditis Cases.
Source
Anatolian Journal of Cardiology. 29(3) (pp 111-117), 2025. Date of
Publication: 2025.
Author
Basaran S.; Simsek-Yavuz S.; Saricaoglu M.E.; Aydin M.; Aygun G.; Azap A.;
Azap O.; Benli A.; Demirturk N.; Ergonul O.; Kocagul-Celikbas A.; Kuscu
F.; Ozger S.; Kutlu S.S.; Turker N.; Turkoglu-Yilmaz E.
Institution
(Basaran, Simsek-Yavuz, Benli) Department of Infectious Diseases and
Clinical Microbiology, Istanbul University, Istanbul Faculty of Medicine,
Istanbul, Turkey
(Saricaoglu, Azap) Department of Infectious Diseases and Clinical
Microbiology, Faculty of Medicine, Ankara University, Ankara, Turkey
(Aydin) Department of Infectious Diseases and Clinical Microbiology,
Umraniye Training and Research Hospital, Istanbul, Turkey
(Aygun) Department of Infectious Diseases and Clinical Microbiology,
Cerrahpasa Faculty of Medicine, Istanbul University Cerrahpasa, Istanbul,
Turkey
(Azap) Department of Infectious Diseases and Clinical Microbiology,
Faculty of Medicine, Baskent University, Ankara, Turkey
(Demirturk) Department of Infectious Diseases and Clinical Microbiology,
Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey
(Ergonul) Department of Infectious Diseases and Clinical Microbiology,
Faculty of Medicine, Koc University, Istanbul, Turkey
(Kocagul-Celikbas) Department of Infectious Diseases and Clinical
Microbiology, Faculty of Medicine, Hitit University, Corum, Turkey
(Kuscu) Department of Infectious Diseases and Clinical Microbiology,
Faculty of Medicine, Cukurova University, Adana, Turkey
(Ozger) Department of Infectious Diseases and Clinical Microbiology,
Faculty of Medicine, Gazi University, Ankara, Turkey
(Kutlu) Department of Infectious Diseases and Clinical Microbiology,
Faculty of Medicine, Pamukkale University, Denizli, Turkey
(Turker) Department of Infectious Diseases and Clinical Microbiology,
Izmir Ataturk Training and Research Hospital, Izmir, Turkey
(Turkoglu-Yilmaz) Department of Infectious Diseases and Clinical
Microbiology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
Publisher
Turkish Society of Cardiology
Abstract
Endocarditis is the most common cause of death from brucellosis. The
information used to guide the management of cases with Brucella
endocarditis has relied on case reports/ series. Risk factors related to
death and other adverse outcomes in patients with Brucella endocarditis
were identified by an individual-patient data analysis of all reported
Brucella endocarditis cases in the literature. The keywords "Bruce" and
"endocard" were used to search articles published until July 2022 on
PubMed and ULAKBIM databases. Case reports/series containing patients with
endocarditis caused by Brucella spp., aged >=17 years, and with data on
antimicrobial or surgical treatment were included in the study.
Epidemiological, clinical, laboratory, and treatment characteristics and
outcomes of 273 cases from 86 eligible articles were recorded. It was
found that male gender, a Wright serum tube agglutination (STA) titer of
>=1/1280 on admission, development of heart failure due to endocarditis
were independent risk factors that increase mortality, while the usage of
aminoglycoside and cardiac surgical intervention for endocarditis were
factors reducing mortality. Including streptomycin or gentamicin in the
treatment regimen may benefit patients with Brucella endocarditis. Valve
surgery could be life-saving in patients with Brucella endocarditis. An
STA titer of >=1/1280, which probably reflects long-term and advanced
disease, may be used as a marker for increased mortality. However,
additional and more reliable studies are needed to define the most
appropriate management approach in diagnosing and treating cases with
Brucella endocarditis due to the low quality of the current
evidence. Copyright@Author(s)

<25>
Accession Number
2033488305
Title
High-dose inhaled NO for the prevention of nosocomial pneumonia after
cardiac surgery under cardiopulmonary bypass: A proof-of-concept
prospective randomised study.
Source
Pulmonology. 31(1) (no pagination), 2025. Article Number: 2471706. Date of
Publication: 2025.
Author
Kalashnikova T.P.; Kamenshchikov N.O.; Arsenyeva Y.A.; Podoksenov Y.K.;
Kravchenko I.V.; Kozulin M.S.; Tyo M.A.; Churilina E.A.; Kim E.B.; Svirko
Y.S.; Kozlov B.N.; Boshchenko A.A.
Institution
(Kalashnikova, Kamenshchikov, Arsenyeva, Podoksenov, Kravchenko, Kozulin,
Tyo, Churilina, Kim, Svirko, Kozlov, Boshchenko) Cardiology Research
Institute, Tomsk National Research Medical Center, Russian Academy of
Sciences, Tomsk, Russian Federation
Publisher
Taylor and Francis Ltd.
Abstract
Objective: This study aimed to assess the safety and potential efficacy of
high-dose inhaled nitric oxide therapy for the prevention of postoperative
pneumonia in cardiac surgery patients Methods: A prospective randomised
controlled pilot study included 74 patients with moderate risk of
postoperative pneumonia after elective cardiac surgery under
cardiopulmonary bypass. Patients were randomised into two groups. The main
group (NO-group) (n = 37) received inhaled nitric oxide at a dose of 200
ppm for 30 minutes 2 times a day for 5 days or until pneumonia developed.
The control group received conventional postoperative care (n = 37). The
primary endpoint was the incidence of postoperative pneumonia during
in-hospital stay. Result(s): Preventive nitric oxide inhalations were
associated with a reduced incidence of postoperative nosocomial pneumonia
(2 (5.4%) cases in the main group (NO-group) vs. 9 (24.3%) cases in the
control group, p = 0.046; OR = 0.178, 95% CI = 0.036-0.89)). There was no
decrease in either peak expiratory flow, or peak inspiratory flow in
comparison with the preoperative values in the NO-group. Inhaled nitric
oxide therapy is safe. It did not lead to an increase in the incidence of
acute kidney injury. Conclusion(s): High-dose inhaled nitric oxide
therapy is safe and effective for the prevention of postoperative
nosocomial pneumonia in cardiac surgery. Copyright © 2025 The
Author(s). Published by Informa UK Limited, trading as Taylor & Francis
Group.

<26>
Accession Number
2033501313
Title
Oral vs. Outpatient Parenteral Antimicrobial Treatment for Infective
Endocarditis: Study Protocol for the Spanish OraPAT-IE GAMES Trial.
Source
Infectious Diseases and Therapy. 14(3) (pp 643-655), 2025. Article Number:
100213. Date of Publication: 01 Mar 2025.
Author
Alonso-Socas M.M.; Lopez-Lirola A.; Goikoetxea-Agirre A.J.; Ribas M.A.;
Navarro D.; Sala C.; Ambrosioni J.; Olivares P.; Lopez-Cortes L.E.;
Morales I.; Mendez I.; de Cueto M.; Calvo-Jambrina R.; Barquero J.M.;
Araji O.; Almendro-Delia M.; Brase A.; Calvo-Fernandez A.; Tauron M.;
Recasens L.; Sorli L.; Suarez M.; Silverio A.; Sanchez F.; Ribas N.;
Serrat R.; Molina L.; Mestres A.; Mas A.; Ginel A.J.; Horcajada-Gallego
J.P.; Ble M.; Lopez-Montesinos I.; Salavert-Lleti M.; Garcia-Bustos V.;
Fernandez-Navarro J.A.; Calabuig-Munoz E.; Montero-Alonso M.;
Tasias-Pitarch M.; Domingo-Valero D.; Arnau-Vives M.A.; Blanes-Hernandez
R.; Vives-Borras M.; Vidal-Bonet L.; Ruiz de Gopegui-Bordes E.;
Ribas-Blanco M.A.; Zarauza J.; Teira R.; Ruiz-Alonso N.; Parra J.A.;
Pajaron M.; Gutierrez-Diez J.; Gutierrez-Cuadra M.; Gutierrez-Fernandez
L.; Gonzalez-Rico C.; Garrido R.; Garcia I.; Fernandez-Sampedro M.;
Farinas-Alvarez C.; Farinas M.C.; Cobo-Belaustegui M.; Arnaiz de las
Revillas F.; Arminanzas-Castillo C.; Amado-Fernandez C.; Aguero-Balbin J.;
Martin-Blanco N.; Oteo J.A.; Garcia-Alvarez L.; Corral-Armas E.; Blanco
J.R.; Azcona-Gutierrez J.M.; Azcarate P.; Alonso L.J.; Saura D.;
Roura-Piloto A.; Perez-Andreu J.; Ortin A.; Oliva M.J.; Moral-Escudero E.;
Martinez-Toldos M.C.; de Gea J.H.; de la Morena Valenzuela G.; Blazquez
A.; Hernandez-Torres A.; Vazquez E.G.; Canovas S.; Albert L.;
Rivera-Martinez M.A.; Lopez-Contreras J.; Leta-Petracca R.; Grillo S.;
Ginel-Iglesias A.; Barros-Membrilla A.; Camprecios M.; Gasch O.; Monsalvez
V.; Gomila A.; Calzado S.; Diaz E.; Lozano L.; Capilla S.; Guillamon L.;
Guillaumet E.; Castaldo F.; Araujo G.; Dietl B.; Ibars S.; Xercavins M.;
Boix-Palop L.; Badia C.; Rosillo S.; Romero M.; Rial-Baston V.; Ramirez
U.; Moreno M.; Loeches B.; Antorrena I.; Ruiz S.; Rodriguez-Roda-Stuart
J.; del Rio A.; Oliva E.; Navas E.; Martin-Davila P.; Moya J.L.; Hermida
J.M.; Centella T.; Sanchez-Rodriguez I.; Gracia-Sanchez L.; Blasco A.;
Sbraga F.; Ruiz-Majoral A.; Alegre O.; Sanchez-Salado J.C.; Berbel D.;
Ardanuy C.; Grau I.; Carratala J.; Escrihuela-Vidal F.;
Gonzalez-de-la-Aleja P.; Pinargote-Celorio H.; Reus S.; Plazas J.; Merino
E.; Llamas P.; Climent V.; Carrasco R.; Goyeneche M.; Bidegain M.; Sanchez
S.; Zabalo-Arrieta M.; Villanueva-Benito I.; Vicente-Anza D.;
Unamuno-Ugartemendia I.; Solla-Ruiz I.; Sebastian-Alda R.; Sanchez-Haza
E.; Saez-Berbejillo A.; Reviejo K.; Rengel-Jimenez A.;
Perez-Moreiras-Lopez J.I.; Kortajarena-Urkola X.; Iribarren J.A.;
Granda-Bauza A.; Goyeneche del Rio M.; Goenaga M.A.; Fuentes A.;
Eizaguirre-Yarza A.; Echeverria T.; del Bosque-Martin C.;
Bustinduy-Odriozola M.J.; Berritu-Boronat E.; Azkune-Galparsoro H.; Camino
X.; Alvarez-Rodriguez I.; Voces R.; Vitoria Y.; Rodriguez R.; Rodrigo D.;
Nieto J.; Montejo M.; Lopez-Soria L.; Irurzun-Zuazabal J.; Iruretagoyena
J.R.; Ibarrola-Hierro M.; Goikoetxea A.J.; Euba-Ugarte G.; Del Alamo
Martinez de Lagos M.; Guio-Carrion L.; Crespo A.; Campana-Lazaro M.; Boado
M.V.; Blanco R.; Blanco-Vidal M.J.; Bereciartua E.; de la Villa S.;
Verde-Moreno E.; Vazquez P.; Valerio M.; Segado A.; Sanchez-Perez E.;
Rodriguez-Abella H.; Rincon C.; Pinto A.; Pinilla B.; Pedraz A.; Olmedo
M.; Monzon D.; Munoz P.; Melero R.; Martinez-Selles M.; Marin M.; Machado
M.; Hualde A.M.; Kestler-Hernandez M.; Gonzalez-Ramallo V.;
Gonzalez-Moraga F.J.; Mansilla A.G.; Garcia-Leoni M.E.; Gargallo E.;
Fortuny-Ribas R.; Estevez A.; Delgado-Montero A.; Cuerpo-Caballero G.;
Calatayud J.; Bouza E.; Bermejo J.; Alvarez-Uria A.; Alonso J.C.; Adan I.;
Rodriguez-Moreno F.; Prada-Arrondo P.; Perez-Ramirez A.; Lorenzo de la
Pena L.; Lacalzada J.; Gonzalez Gonzalez J.; Garcia-Rosado D.;
Fernandez-Sarabia J.; Delgado-Melian T.; Castro B.; Alonso M.D.M.;
Poyato-Borrego M.; Sanchez-Dominguez E.; Ortiz-Carrellan A.; Marin G.;
Luque-Marquez R.; Lopez-Haldon J.; Lepe J.A.; Gutierrez-Carretero E.;
Navarro-Amuedo D.; de Alarcon A.; Vila J.; Tuset M.; Vidal B.; Urra X.;
Tolosana J.M.; Tellez A.; Soy D.; Sitges M.; Sanchis L.; Sandoval E.;
Rovira I.; Roque M.; Roca C.; Regueiro A.; Ramirez J.; Quintana E.; Pomar
J.L.; Perissinotti A.; Pericas J.M.; Pereda D.; Pare C.; Ortiz J.; Ninot
S.; Nicolas D.; Moreno A.; Miro J.M.; Marco F.; Lopez T.; Llopis-Perez J.;
Hernandez-Meneses M.; Garcia-Pares D.; Garcia de la Maria C.; Fuster D.;
Fita G.; Fernandez-Pittol M.; Espasa M.; Falces C.; de Diego O.; Cuervo
G.; Canas M.A.; Castella M.; Cartana R.; Brunet M.; Azqueta M.; Ascaso M.;
Alcocer J.; Almela M.; Andrea R.
Institution
(Cuervo, Hernandez-Meneses, Moreno, Sala, Ambrosioni, Miro) Infectious
Diseases Department, Hospital Clinic-IDIBAPS, University of Barcelona,
Villarroel 170, Barcelona, Spain
(Nicolas) Internal Medicine-Home Hospitalization Unit, Hospital
Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
(Vidal) Cardiology Department, Hospital Clinic-IDIBAPS, University of
Barcelona, Barcelona, Spain
(Fernandez-Pittol) Microbiology Department, Hospital Clinic-IDIBAPS,
University of Barcelona, Barcelona, Spain
(Cuervo, de Alarcon, Martin-Davila, Lopez-Montesinos, Lopez-Cortes,
Ambrosioni, Miro) CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
(de Alarcon, Luque-Marquez, Navarro) Clinical Unit of Infectious Diseases,
Microbiology and Parasitology (UCEIMP), Institute of Biomedicine of
Seville (IBiS), Virgen del Rocio University Hospital/CSIC/University of
Seville, Seville, Spain
(Alonso-Socas, Lopez-Lirola) Hospital Universitario de Canarias, Tenerife,
Spain
(Gonzalez-Ramallo) Hospital General Universitario Gregorio Maranon,
Madrid, Spain
(Goikoetxea-Agirre) Hospital Universitario de Cruces, Bilbao, Spain
(Goenaga) Hospital Universitario Donosti, Instituto Investigacion
Biogipuzkoa, San Sebastian, Spain
(Merino) Unit of Infectious Diseases, Alicante General University Hospital
- Alicante Institute of Health and Biomedical Research (ISABIAL),
Alicante, Spain
(Merino) Clinical Medicine Department, Miguel Hernandez University, Elche,
Spain
(Escrihuela-Vidal) Hospital Universitario de Bellvitge, Barcelona, Spain
(Martin-Davila) Hospital Universitario Ramon y Cajal, Instituto Ramon y
Cajal de Investigacion Sanitaria (IRYCIS), Madrid, Spain
(Loeches) Hospital Universitario La Paz, Madrid, Spain
(Boix-Palop) Hospital Mutua de Terrassa, Terrassa, Spain
(Gasch) Servei de Malalties Infeccioses, Hospital Universitari Parc Tauli,
Institut d'Investigacio i Innovacio Parc Tauli (I3PT-CERCA), Universitat
Autonoma de Barcelona, Sabadell, Spain
(Camprecios) Hospital de la Santa Creu y Sant Pau, Barcelona, Spain
(Hernandez-Torres) Hospital Virgen de la Arrixaca, Murcia, Spain
(Garcia-Alvarez) Hospital San Pedro-CIBIR, Logrono, Spain
(Pajaron) Hospital Marques de Valdecilla, Santander, Spain
(Ribas) Hospital Son Espases, Palma, Spain
(Blanes-Hernandez) Hospital de La Fe, Valencia, Spain
(Lopez-Montesinos) Hospital del Mar, Barcelona, Spain
(Lopez-Cortes) Unidad Clinica de Enfermedades Infecciosas y Microbiologia,
Hospital Universitario Virgen Macarena, Seville, Spain
(Lopez-Cortes) Departamentos de Medicina y Microbiologia, Facultad de
Medicina, Universidad de Sevilla, Seville, Spain
(Lopez-Cortes) Instituto de Biomedicina de Sevilla (IBiS)/CSIC, Seville,
Spain
Publisher
Adis
Abstract
Introduction: The POET trial demonstrated that moving from intravenous to
oral antibiotics in stable patients with left-sided infective endocarditis
(IE) was noninferior to fully parenteral treatment. However, it did not
compare outpatient strategies. Method(s): The OraPAT-IE GAMES trial
is a noninferiority, multicenter, randomized, open-label study aimed to
compare partial oral versus outpatient parenteral antibiotic therapy
(OPAT) for consolidation of antibiotic treatment in left-sided IE. A total
of 342 stable patients with IE caused by selected micro-organisms will
eventually be included. After a minimum of 10 days of parenteral
treatment, stable patients are randomized to oral therapy or OPAT. The
primary end-point is a composite of all-cause mortality, unplanned cardiac
surgery, relapse of positive blood cultures and/or unplanned hospital
admission. Patients are followed-up for 6 months after completing
antibiotic therapy. Planned Outcome: This trial seeks to demonstrate the
equivalent efficacy of the two outpatient strategies currently available
for stable patients with IE in the consolidation phase of antibiotic
treatment. Conclusion(s): In a global context of limited healthcare
resources and a sustained increase in elderly and frail patients, it is of
great importance to demonstrate the effectiveness and safety of outpatient
management strategies that could reduce the duration of conventional
hospitalizations with their potential complications and inherent costs.
Trial Registration: EudraCT: 2020-001024-34. ClinicalTrials.gov
identifier: NCT05398679. Copyright © The Author(s) 2025.

<27>
Accession Number
2027253652
Title
Medical graphics to improve patient understanding and anxiety in elderly
and cognitively impaired patients scheduled for transcatheter aortic valve
implantation (TAVI).
Source
Clinical Research in Cardiology. 114(3) (pp 302-312), 2025. Article
Number: e015975. Date of Publication: 01 Mar 2025.
Author
Brand A.; Hornig C.; Crayen C.; Hamann A.; Martineck S.; Leistner D.M.;
Dreger H.; Sundermann S.; Unbehaun A.; Sherif M.; Haghikia A.; Bischoff
S.; Lueg J.; Kuhnle Y.; Paul O.; Squier S.; Stangl K.; Falk V.; Landmesser
U.; Stangl V.
Institution
(Brand, Hornig, Dreger, Bischoff, Lueg, Stangl, Stangl) Department of
Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum
der Charite, Campus Charite Mitte, Berlin, Germany
(Brand, Leistner, Haghikia, Landmesser) Department of Cardiology,
Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite,
Campus Benjamin Franklin, Berlin, Germany
(Brand, Leistner, Dreger, Sundermann, Haghikia, Falk, Landmesser, Stangl)
DZHK (German Centre for Cardiovascular Research), partner Site Berlin,
Berlin, Germany
(Crayen) Department of Education and Psychology, Freie Universitat Berlin,
Habelschwerdter Allee 45, Berlin, Germany
(Hamann) Mintwissen-Science Communication Agency and Publishing House,
Paulusstr. 11, Dusseldorf, Germany
(Martineck) Kollwitzstrase 52, Berlin, Germany
(Sundermann, Unbehaun, Falk) Department of Cardiothoracic and Vascular
Surgery, Deutsches Herzzentrum der Charite, Berlin, Germany
(Sherif, Kuhnle, Paul) Department of Cardiology, Angiology and Intensive
Care Medicine, Deutsches Herzzentrum der Charite, Campus Virchow Klinikum,
Berlin, Germany
(Squier) English and Women's, Gender and Sexuality Studies, The
Pennsylvania State University, University Park, PA, United States
(Leistner) Department of Cardiology, Angiology and Intensive Care
Medicine, Goethe University Hospital, Universitares Herz- und
Gefasszentrum Frankfurt, Frankfurt am Main, Frankfurt, Germany
(Leistner) DZHK (German Centre for Cardiovascular Research), partner site
Rhein-Main, Munich, Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Anxiety and limited patient comprehension may pose significant
barriers when informing elderly patients about complex procedures such as
transcatheter aortic valve implantation (TAVI). Objective(s): We
aimed to evaluate the utility of medical graphics to improve the patient
informed consent (IC) before TAVI. Method(s): In this prospective,
randomized dual center study, 301 patients were assigned to a patient
brochure containing medical graphics (Comic group, n = 153) or sham
information (Control group, n = 148) on top of usual IC. Primary outcomes
were patient understanding of central IC-related aspects and
periprocedural anxiety assessed by the validated Spielberger State Trait
Anxiety Inventory (STAI), both analyzed by cognitive status according to
the Montreal Cognitive Assessment (MoCA). Result(s): Patient
understanding was significantly higher in the Comic group [mean number of
correct answers 12.8 (SD 1.2) vs. 11.3 (1.8); mean difference 1.5 (95% CI
1.2-1.8); p < 0.001]. This effect was more pronounced in the presence of
cognitive dysfunction (MoCA < 26) [12.6 (1.2) in the Comic vs. 10.9 (1.6)
in the Control group; mean difference 1.8 (1.4-2.2), p < 0.001]. Mean STAI
score declined by 5.7 (95% CI 5.1-6.3; p < 0.001) in the Comic and 0.8
points (0.2-1.4; p = 0.015) in the Control group. Finally, mean STAI score
decreased in the Comic group by 4.7 (3.8-5.6) in cognitively impaired
patients and by 6.6 (95% CI 5.8 to 7.5) in patients with normal cognitive
function (p < 0.001 each). Conclusion(s): Our results prove
beneficial effects for using medical graphics to inform elderly patients
about TAVI by improving patient understanding and reducing periprocedural
anxiety (DRKS00021661; 23/Oct/2020). Copyright © The Author(s)
2023.

<28>
Accession Number
2037965012
Title
Effect of intraoperative intravenous remimazolam on the postoperative
quality of recovery after noncardiac surgery: A meta-analysis of
randomized controlled trials.
Source
PLoS ONE. 20(3 MARCH) (no pagination), 2025. Article Number: e0319044.
Date of Publication: 01 Mar 2025.
Author
Liu H.; Zhou M.; Chen X.; Esmaeili E.; Sun M.; Wu Z.
Institution
(Liu, Chen, Esmaeili, Sun, Wu) Department of Anesthesiology, Union
Hospital, Tongji Medical College, Huazhong University of Science and
Technology, Wuhan, China
(Liu, Chen, Esmaeili, Sun, Wu) Institute of Anesthesia and Critical Care
Medicine, Union Hospital, Tongji Medical College, Huazhong University of
Science and Technology, Wuhan, China
(Liu, Chen, Esmaeili, Sun, Wu) Key Laboratory of Anesthesiology and
Resuscitation, Huazhong University of Science and Technology, Ministry of
Education, China
(Zhou) Operation room, Xinzhou district people's hospital, Wuhan, China
Publisher
Public Library of Science
Abstract
Objectives The postoperative quality of recovery holds significant
economic and prognostic implications. Numerous studies have investigated
the postoperative quality of recovery following surgery. However, the
impact of intraoperative intravenous remimazolam on postoperative recovery
has yielded conflicting results. Methods In this qualitative review of
randomized controlled clinical trials assessing the use of intraoperative
remimazolam, we present the effects of intravenous remimazolam on
postoperative recovery quality in noncardiac surgery patients. We
conducted a comprehensive search of PubMed, MEDLINE, Web of Science and
Cochrane Library for randomized controlled trials published up to
September 23, 2024, without any language restrictions, to investigate the
impact of intraoperative intravenous remimazolam on the quality of
postoperative recovery following noncardiac surgery. The primary outcome
measure was the quality of postoperative recovery assessed using global
QoR-40 scores or QoR-15 scores. Secondary outcomes included five
dimensions of quality of postoperative recovery: physical comfort,
emotional state, physical independence, psychological support, and pain.
As well as time to extubation, VAS score, PACU stay, and days in hospital.
We analyzed the pooled data using a random-effects model. Results This
meta-analysis included 18 studies published between 2022 and 2024
involving 1720 patients. The quality of postoperative recovery was
assessed using the QoR-15 or QoR-40 questionnaires. The pooled results
showed no significant difference in QoR scores between the two groups on
the first postoperative day (SMD = 0.12; 95% CI -0.13-0.36; I2
= 78%; p = 0.35). Furthermore, differences in QoR dimensions, PACU
duration, extubation time, and length of hospital stay were not observed.
Conclusion Our analysis showed that the quality of recovery after general
anaesthesia in the remimazolam group was similar to that of conventional
sedation. Therefore, remimazolam may be used as a potential anaesthetic
agent as an alternative to conventional sedation for non-cardiac surgical
anaesthesia. Copyright © 2025 Liu et al. This is an open access
article distributed under the terms of the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in
any medium, provided the original author and source are credited.

<29>
Accession Number
2033674390
Title
Efficacy of the Renal-guard system in the prevention of contrast-induced
nephropathy following cardiac interventions among patients with chronic
kidney disease.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1438076. Date of Publication: 2025.
Author
Yasmin F.; Mashkoor Y.; Najeeb H.; Shaikh A.A.; Nusrat B.; Moeed A.;
Asghar M.S.; Alraies C.
Institution
(Yasmin, Mashkoor, Najeeb, Nusrat, Moeed) Dow University of Health
Sciences, Karachi, Pakistan
(Shaikh) Ziauddin University, Karachi, Pakistan
(Asghar) AdventHealth, Sebring, FL, United States
(Alraies) Cardiovascular Institute, Detroit Medical Center, Detroit, MI,
United States
Publisher
Frontiers Media SA
Abstract
Background: Contrast-induced nephropathy (CIN), also called as contrast
associated-acute kidney injury (CA-AKI) is a common complication following
cardiac procedures. KDIGO guidelines define CIN as a >=25% increase in
serum creatinine or an absolute increase of at least 0.5 mg/dl 48-72 h
post-contrast administration. The single most effective measure in
preventing CIN is peri-procedural intravascular hydration typically from
12 h before to 24 h after contrast media exposure but has limitations.
Recently, the RenalGuard (RG) system has emerged as a new tool,
demonstrating safer and more efficient hydration and reducing the
incidence of AKI caused by CIN. Aim(s): We conducted this
meta-analysis on the effectiveness of the RG system in preventing CIN in
patients undergoing cardiac interventions. Method(s): A comprehensive
literature search of PubMed (MEDLINE), Science Direct, and Embase was
conducted from its inception until February 2024 for randomized controlled
trials (RCTs) including patients aged >18 years undergoing cardiac
procedures with underlying chronic kidney disease (CKD), estimated
glomerular filtration rate (eGFR) 20-60 ml/min/1.73 m2 and left
ventricular ejection fraction (LVEF) >50%. The outcomes of interest were
risk of CIN, risk of renal replacement therapy (RRT), in-hospital
mortality and 30-day mortality, major adverse cardiovascular events
(MACE), changes in serum creatinine (sCr) levels, and incidence of
pulmonary edema. A random-effects meta-analysis was performed using Review
Manager (RevMan) [Computer Program] Version 5.4 Cochrane Collaboration.
 Result(s): A total of 9 RCTs including 3,215 patients with CKD
undergoing cardiac procedures on volume expansion strategies were included
with 1,802 patients on the RG system and 1,413 patients using alternate
volume expansion techniques. Pooled analysis of 9 RCTs reported a
significantly lower risk of CIN in patients using the RG system vs.
control [OR 0.51 (0.35, 0.74), P = 0.0004; I2 = 55%]. There was
no significant difference in the risks of RRT, in-hospital mortality,
30-day MACE, pulmonary edema, or change in sCr levels. Conclusion(s):
This meta-analysis indicates the beneficial utilization of the RG system
in populations with moderate-to-high risk and underlying CKD undergoing
cardiac interventions in preventing CIN. However, it did not demonstrate a
notable impact on mortality, RRT, MACE, pulmonary edema, and sCr levels
when compared to the control group. Copyright 2025 Yasmin, Mashkoor,
Najeeb, Shaikh, Nusrat, Moeed, Asghar and Alraies.

<30>
Accession Number
2030110122
Title
Conventional versus minimally invasive extra-corporeal circulation in
patients undergoing cardiac surgery: A randomized controlled trial
(COMICS).
Source
Perfusion (United Kingdom). 40(3) (pp 730-741), 2025. Date of Publication:
01 Apr 2025.
Author
Angelini G.D.; Reeves B.C.; Culliford L.A.; Maishman R.; Rogers C.A.;
Anastasiadis K.; Antonitsis P.; Argiriadou H.; Carrel T.; Keller D.;
Liebold A.; Ashkaniani F.; El-Essawi A.; Breitenbach I.; Lloyd C.; Bennett
M.; Cale A.; Gunaydin S.; Gunertem E.; Oueida F.; Yassin I.M.; Serrick C.;
Murkin J.M.; Rao V.; Moscarelli M.; Condello I.; Punjabi P.; Rajakaruna
C.; Deliopoulos A.; Bone D.; Lansdown W.; Moorjani N.; Dennis S.
Institution
(Angelini, Reeves, Culliford, Maishman, Rogers) Bristol Medical School,
University of Bristol, Bristol, United Kingdom
(Anastasiadis, Antonitsis, Argiriadou) Aristotle University of
Thessaloniki School of Medicine, Thessaloniki, Greece
(Carrel, Keller) University Hospital Bern, Bern, Switzerland
(Liebold, Ashkaniani) Universitatsklinikum Ulm, Ulm, Germany
(El-Essawi) Universitatsmedizin Gottingen, Gottingen, Germany
(Breitenbach) Klinikum Braunschweig, Braunschweig, Germany
(Lloyd, Bennett) University Hospitals Plymouth NHS Trust, Plymouth, United
Kingdom
(Cale) Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
(Gunaydin, Gunertem) Numune Training and Research Hospital in Ankara,
Ankara, Turkey
(Oueida, Yassin) Saud Al-Babtain Cardiac Centre, Dammam, Saudi Arabia
(Serrick, Rao) University Health Network, Toronto, ON, Canada
(Murkin) University of Western Ontario, London, ON, Canada
(Moscarelli, Condello) Anthea Hospital Bari, Italy
(Punjabi) Imperial College Healthcare, London, United Kingdom
(Rajakaruna, Bone, Lansdown) University Hospitals Bristol NHS Foundation
Trust, Bristol, United Kingdom
(Deliopoulos) AHEPA University Hospital, Thessaloniki, Greece
(Moorjani, Dennis) Royal Papworth Hospital, Cambridge, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Introduction: The trial hypothesized that minimally invasive
extra-corporeal circulation (MiECC) reduces the risk of serious adverse
events (SAEs) after cardiac surgery operations requiring extra-corporeal
circulation without circulatory arrest. Method(s): This is a
multicentre, international randomized controlled trial across fourteen
cardiac surgery centres including patients aged >=18 and <85 years
undergoing elective or urgent isolated coronary artery bypass grafting
(CABG), isolated aortic valve replacement (AVR) surgery, or CABG + AVR
surgery. Participants were randomized to MiECC or conventional
extra-corporeal circulation (CECC), stratified by centre and operation.
The primary outcome was a composite of 12 post-operative SAEs up to 30
days after surgery, the risk of which MiECC was hypothesized to reduce.
Secondary outcomes comprised: other SAEs; all-cause mortality; transfusion
of blood products; time to discharge from intensive care and hospital;
health-related quality-of-life. Analyses were performed on a modified
intention-to-treat basis. Result(s): The trial terminated early due
to the COVID-19 pandemic; 1071 participants (896 isolated CABG, 97
isolated AVR, 69 CABG + AVR) with median age 66 years and median EuroSCORE
II 1.24 were randomized (535 to MiECC, 536 to CECC). Twenty-six
participants withdrew after randomization, 22 before and four after
intervention. Fifty of 517 (9.7%) randomized to MiECC and 69/522 (13.2%)
randomized to CECC group experienced the primary outcome (risk ratio =
0.732, 95% confidence interval (95% CI) = 0.556 to 0.962, p = 0.025). The
risk of any SAE not contributing to the primary outcome was similarly
reduced (risk ratio = 0.791, 95% CI 0.530 to 1.179, p = 0.250).
 Conclusion(s): MiECC reduces the relative risk of primary outcome
events by about 25%. The risk of other SAEs was similarly reduced. Because
the trial terminated early without achieving the target sample size, these
potential benefits of MiECC are uncertain. Copyright © The
Author(s) 2024.

<31>
Accession Number
2029814887
Title
Extracorporeal life support after surgical repair for acute type a aortic
dissection: A systematic review and meta-analysis.
Source
Perfusion (United Kingdom). 40(3) (pp 631-639), 2025. Date of Publication:
01 Apr 2025.
Author
Sa M.P.; Jacquemyn X.; Hess N.; Brown J.A.; Caldonazo T.; Kirov H.; Doenst
T.; Serna-Gallegos D.; Kaczorowski D.; Sultan I.
Institution
(Sa, Hess, Brown, Serna-Gallegos, Kaczorowski, Sultan) Department of
Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, United
States
(Sa, Hess, Brown, Serna-Gallegos, Kaczorowski, Sultan) UPMC Heart and
Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh,
PA, United States
(Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Caldonazo, Kirov, Doenst) Department of Cardiothoracic Surgery, Jena
University Hospital, Jena, Germany
Publisher
SAGE Publications Ltd
Abstract
Background: The use of extracorporeal life support (ECLS) in patients
after surgical repair for acute type A aortic dissection (ATAAD) has not
been well documented. Method(s): We performed a systematic review and
meta-analysis to assess the outcomes of ECLS after surgery for ATAAD with
data published by October 2023 in compliance with the Preferred Reporting
Items for Systematic Reviews and Meta-analyses (PRISMA) and the
Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting
guidelines. The protocol was registered in PROSPERO (CRD42023479955).
 Result(s): Twelve observational studies met our eligibility criteria,
including 280 patients. Mean age was 55.0 years and women represented
25.3% of the overall population. Although the mean preoperative left
ventricle ejection fraction was 59.8%, 60.8% of patients developed left
ventricle failure and 34.0% developed biventricular failure. Coronary
involvement and malperfusion were found in 37.1% and 25.6%, respectively.
Concomitant coronary bypass surgery was performed in 38.5% of patients.
Regarding ECLS, retrograde flow (femoral) was present in 39.9% and central
cannulation was present in 35.4%. In-hospital mortality was 62.8% and
pooled estimate of successful weaning was 50.8%. Neurological
complications, bleeding and renal failure were found in 25.9%, 38.7%, and
65.5%, respectively. Conclusion(s): ECLS after surgical repair for
ATAAD remains associated with high rates of in-hospital death and
complications, but it still represents a chance of survival in critical
situations. ECLS remains a salvage attempt and surgeons should not try to
avoid ECLS at all costs after repairing an ATAAD case. Copyright
© The Author(s) 2024.

<32>
Accession Number
2030599688
Title
Natural history of initially asymptomatic severe aortic stenosis: a
one-stage meta-analysis.
Source
Clinical Research in Cardiology. 114(3) (pp 350-367), 2025. Date of
Publication: 01 Mar 2025.
Author
Tan J.T.A.; He G.S.; Chia J.L.L.; Tan G.Q.X.; Teo Y.N.; Teo Y.H.; Syn
N.L.; Chai P.; Wong R.C.C.; Yeo T.-C.; Kong W.K.F.; Poh K.-K.; Sia C.-H.
Institution
(Tan, He, Chia, Tan, Teo, Syn, Chai, Wong, Yeo, Kong, Poh, Sia) Department
of Medicine, Yong Loo Lin School of Medicine, National University of
Singapore, Singapore, Singapore
(Teo) Department of Medicine, National University Hospital, Singapore,
Singapore
(Chai, Wong, Yeo, Kong, Poh, Sia) Department of Cardiology, National
University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block
Level 9, Singapore, Singapore
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Current guidelines on the management strategy for patients
with asymptomatic severe aortic stenosis (AS) remain unclear. This
uncertainty stems from the lack of data regarding the natural history of
these patients. To address this gap, we performed a systematic review and
meta-analysis examining the natural history of asymptomatic severe AS
patients receiving conservative treatment. Method(s): The PubMed,
Cochrane, and Embase databases were searched from inception to 24 January
2024 using the keywords "asymptomatic" AND "aortic" AND "stenosis". We
included studies examining patients with asymptomatic severe AS. In
interventional trials, only data from conservatively managed arms were
collected. A one-stage meta-analysis was conducted using individual
patient data reconstructed from published Kaplan-Meier curves. Sensitivity
analysis was performed for major adverse cardiovascular outcomes in
patients who remained asymptomatic throughout follow-up. Result(s): A
total of 46 studies were included (n = 9545). The median time to the
development of symptoms was 1.11 years (95% CI 0.90-1.53). 49.36%
(40.85-58.59) of patients who were asymptomatic had suffered a major
adverse cardiovascular event by 5 years. The median event-free time for
heart failure hospitalization (HFH) was 5.50 years (95% CI 5.14-5.91) with
36.34% (95% CI 33.34-39.41) of patients experiencing an HFH by year 5. By
5 years, 79.81% (95% CI 69.26-88.58) of patients developed symptoms
(angina, dyspnoea, syncope and others) and 12.36% (95% CI 10.01-15.22) of
patients died of cardiovascular causes. For all-cause mortality, the
median survival time was 9.15 years (95% CI 8.50-9.96) with 39.43% (CI
33.41-36.40) of patients dying by 5 years. The median time to AVR was 4.77
years (95% CI 4.39-5.17), with 52.64% (95% CI 49.85-55.48) of patients
requiring an AVR by 5 years. Conclusion(s): Our results reveal poor
cardiovascular outcomes for patients with asymptomatic severe AS on
conservative treatment. A significant proportion eventually requires an
AVR. Further research is needed to determine if early intervention with
AVR is more effective than conservative treatment. Copyright ©
Springer-Verlag GmbH Germany, part of Springer Nature 2024.

<33>
Accession Number
2028213805
Title
Outcomes after TAVI in patients with atrial fibrillation and a history of
recent PCI: Results from the ENVISAGE-TAVI AF trial.
Source
Clinical Research in Cardiology. 114(3) (pp 313-322), 2025. Date of
Publication: 01 Mar 2025.
Author
Moreno R.; Souza J.; Smolnik R.; Nombela-Franco L.; Van Mieghem N.M.;
Hengstenberg C.; Valgimigli M.; Jin J.; Ohlmann P.; Dangas G.; Unverdorben
M.; Mollmann H.
Institution
(Moreno) Interventional Cardiology, University Hospital La Paz, Paseo La
Castellana, Madrid, Spain
(Souza, Smolnik) Daiichi Sankyo, Inc., Munich, Germany
(Nombela-Franco) Interventional Cardiology, Hospital Clinico San Carlos,
Madrid, Spain
(Van Mieghem) Department of Cardiology, Erasmus University Medical Centre,
Thoraxcenter, Rotterdam, Netherlands
(Hengstenberg) Department of Internal Medicine II, Division of Cardiology,
Vienna General Hospital, Medical University, Vienna, Austria
(Valgimigli) Division of Cardiology, Cardiocentro Ticino Institute, Ente
Ospedaliero Cantonale, Universita Della Svizzera Italiana (USI) and
University of Berne, Berne, Switzerland
(Jin, Unverdorben) Daiichi Sankyo, Inc, Basking Ridge, NJ, United States
(Ohlmann) Division of Cardiovascular Medicine, University Hospital of
Strasbourg, Strasbourg, France
(Dangas) Mount Sinai Hospital, Zena and Michael A. Wiener Cardiovascular
Institute, New York, NY, United States
(Dangas) School of Medicine, National and Kapodistrian University of
Athens, Athens, Greece
(Mollmann) Department of Internal Medicine, St. Johannes Hospital,
Dortmund, Germany
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Patients with atrial fibrillation (AF) and a recent (<= 90
days) percutaneous coronary intervention (PCI) undergoing transcatheter
aortic valve implantation (TAVI) are at high bleeding risk due to the
addition of oral antiplatelet (OAP) agents on top of oral anticoagulants.
Data on outcomes of these patients are needed to optimize antithrombotic
treatment. Method(s): This analysis compared annualized clinical
event rates in patients with and without a recent PCI enrolled in
ENVISAGE-TAVI AF, a prospective, randomized, open-label,
adjudicator-masked trial comparing edoxaban and vitamin K antagonists in
AF patients after TAVI. The primary efficacy and safety outcomes were net
adverse clinical events (NACE) and major bleeding. Result(s):
Overall, 132 (94.3%) patients with a recent PCI (n = 140) received OAP
after TAVI, compared with 692 (55.9%) patients without a recent PCI (n =
1237). Among patients with a recent PCI on OAP agents, use of dual
antiplatelet therapy decreased to 5.5%, and use of single antiplatelet
therapy (SAPT) increased to 78.0% over 3 months post-randomization.
Conversely, use of SAPT predominated at all time points in patients
without a recent PCI history. There were no significant differences in the
incidence of NACE or other outcomes assessed, except for major bleeding
events, which were more frequent in patients with vs without a recent PCI
history (hazard ratio [95% confidence interval]: 2.17 [1.27, 3.73]; P =
0.005). Conclusion(s): Patients with AF undergoing TAVI with a recent
PCI have a similar risk of ischemic events and mortality, but an increased
risk of major bleeding compared with patients without a recent
PCI. Copyright © The Author(s) 2024.

<34>
Accession Number
2037427144
Title
Characterization of ischemic etiology in heart failure with reduced
ejection fraction randomized clinical trials: A systematic review and
meta-analysis.
Source
European Journal of Internal Medicine. 134 (pp 51-58), 2025. Date of
Publication: 01 Apr 2025.
Author
Canepa M.; Anastasia G.; Ameri P.; Vergallo R.; O'Connor C.M.; Sinagra G.;
Porto I.
Institution
(Canepa, Anastasia, Ameri, Vergallo, Porto) Cardiovascular Unit,
Department of Internal Medicine, University of Genova, Italy
(Canepa, Ameri, Vergallo, Porto) Cardiovascular Unit, IRCCS Ospedale
Policlinico San Martino, Genoa, Italy
(O'Connor) Inova Heart and Vascular Institute, Falls Church, VA, United
States
(O'Connor) Division of Cardiology, Duke University Medical Center, Durham,
NC, United States
(Sinagra) Cardiovascular Department, Azienda Sanitaria Universitaria
Giuliano-Isontina (ASUGI), University of Trieste, Trieste, Italy
Publisher
Elsevier B.V.
Abstract
Aims: We investigated how ischemic etiology has been assigned in heart
failure with a reduced ejection fraction (HFrEF) randomized controlled
trials (RCTs). Methods and Results: We performed a systematic review
and meta-analysis of definitions, rates of ischemic etiology and of each
ischemic definition component: i) coronary artery disease (CAD), ii)
myocardial infarction (MI), iii) coronary revascularization, and iv)
prior/current angina. A total of 145 HFrEF RCTs were selected, of which
133 (91.7 %) enrolling both ischemic and non-ischemic patients (629
patients/study on average, median age 64.8 years and ejection fraction
28.2 %). The majority of these RCTs (84.2 %) lacked of clear ischemic
etiology definition. Rate of ischemic etiology was 57.8 % (122 RCTs,
169,855 patients), of CAD 53.8 % (25 RCTs, 18,756 patients), of prior MI
46.7 % (57 RCTs, 80,582 patients), of prior revascularization 39.9 % (32
RCTs, 30,730 patients), and of prior/current angina 25.5 % (22 RCTs,
25,572 patients). In studies presenting both variables, prior MI showed
the strongest correlations with assigned ischemic etiology (beta = 0.84, p
< 0.0001, 49 RCTs), followed by prior/current angina (beta = 0.84, p <
0.0001, 20 RCTs), prior revascularization (beta = 0.30, p = 0.006, 28
RCTs), whereas CAD had no significant correlation (beta = 0.29, p = 0.162,
from 17 RCTs). Rate of prior MI decreased over time (1986-2007: 51.4 +/-
11.6 %; 2008-2016: 48.2 +/- 8.8 %; 2017-2023: 41.4 +/- 16.6 %; p = 0.057),
whereas the one of prior revascularization increased (28.3 +/- 11.2 %;
40.7 +/- 19.6 %; 49.3 +/- 19.4 %; p = 0.048). Conclusion(s): An
accurate definition of ischemic etiology is mostly lacking in HFrEF RCTs,
and primarily assigned based on investigators clinical judgment, sometimes
in the presence of a prior MI, although the rate of this component showed
a decline over time. Copyright © 2025 The Authors

<35>
Accession Number
2033968918
Title
Efficacy and Safety of Thoracic Epidural vs. Paravertebral Block for
Analgesia in Thoracotomy: A Systematic Review of Randomized Controlled
Trials.
Source
Current Pain and Headache Reports. 29(1) (no pagination), 2025. Article
Number: 69. Date of Publication: 01 Dec 2025.
Author
Eaves G.K.; Ware E.E.; Touchet D.R.; Hamilton W.K.; Netterville S.S.;
Stevens J.R.; Ahmadzadeh S.; Shekoohi S.; Kaye A.D.
Institution
(Eaves, Ware, Touchet, Hamilton, Netterville, Stevens) School of Medicine,
Louisiana State University Health Sciences Center at Shreveport,
Shreveport, LA, United States
(Ahmadzadeh, Shekoohi, Kaye) Department of Anesthesiology, Louisiana State
University Health Sciences Center Shreveport, Shreveport, LA, United
States
(Kaye) Departments of Pharmacology, Toxicology, and Neurosciences,
Louisiana State University Health Sciences Center Shreveport, Shreveport,
LA, United States
Publisher
Springer
Abstract
Purpose of Review: This systematic review aimed to compare the efficacy
and safety of thoracic epidural block (TEB) and thoracic paravertebral
block (TPB) for managing postoperative pain following thoracotomy for
pulmonary procedures. Recent Findings: A comprehensive search of PubMed,
Embase, Web of Science, and Google Scholar identified randomized
controlled trials (RCTs) published prior to April 10, 2024. Studies were
eligible if they compared TEB and TPB in adult patients undergoing
thoracotomy for pulmonary procedures and reported outcomes on
postoperative pain, opioid consumption, hemodynamic parameters, or
complications. Two reviewers independently screened studies, extracted
data, and assessed quality using the Cochrane Risk of Bias tool. The
review adhered to PRISMA guidelines. From 1,114 records screened, 7 RCTs
comprising 429 patients met the inclusion criteria. TEB demonstrated
superior pain relief in the immediate postoperative period, particularly
when continuous infusions with opioids were utilized. TPB, however,
provided greater hemodynamic stability, with significantly lower rates of
hypotension and more stable mean arterial pressure and heart rate during
the first 24 h. Beyond 24 h, both techniques offered comparable pain
relief and opioid consumption. While the incidence of nausea, vomiting,
and urinary retention was similar between groups, TPB was associated with
fewer respiratory complications. Summary: Both TEB and TPB are
effective for postoperative pain management following thoracotomy, each
with distinct advantages. TEB provides optimal early pain control, making
it suitable for patients with significant early postoperative pain. TPB,
with its superior hemodynamic profile, is better suited for patients at
risk of hypotension or cardiovascular instability. Tailoring analgesic
strategies to patient-specific needs can optimize outcomes. Future
large-scale RCTs are necessary to confirm these findings across broader
thoracic surgical populations. Registration and Protocol: This review was
registered with PROSPERO prior to initiation (Registration Number:
CRD42024578768). Copyright © The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature
2025.

<36>
Accession Number
2037272949
Title
Treatment of Pleural Mesothelioma: ASCO Guideline Update.
Source
Journal of Clinical Oncology. 43(8) (pp 1006-1038), 2025. Date of
Publication: 10 Mar 2025.
Author
Kindler H.L.; Ismaila N.; Bazhenova L.; Chu Q.; Churpek J.E.; Dagogo-Jack
I.; Bryan D.S.; Drazer M.W.; Forde P.; Husain A.N.; Sauter J.L.; Rusch V.;
Bradbury P.A.; Cho B.C.J.; De Perrot M.; Ghafoor A.; Graham D.L.; Khorshid
O.; Lebensohn A.; White J.; Hassan R.
Institution
(Kindler, Bryan, Drazer, Husain) University of Chicago Medicine, Chicago,
IL, United States
(Ismaila) American Society of Clinical Oncology, Alexandria, VA, United
States
(Bazhenova) University of California, Moores Cancer Center, San Diego, CA,
United States
(Chu) Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada
(Churpek) University of Wisconsin-Madison, Carbone Cancer Center, Madison,
WI, United States
(Dagogo-Jack) Massachusetts General Hospital, Cancer Center, Boston, MA,
United States
(Forde) Johns Hopkins University, Baltimore, MD, United States
(Sauter, Rusch) Memorial Sloan Kettering Cancer Center, New York, NY,
United States
(Bradbury, Cho) Princess Margaret Cancer Centre, Toronto, ON, Canada
(De Perrot) Toronto General Hospital, Toronto, ON, Canada
(Ghafoor, Lebensohn, Hassan) Center for Cancer Research, National Cancer
Institute, Bethesda, MD, United States
(Graham) Levine Cancer Institute, Charlotte, NC, United States
(Khorshid) National Cancer Institute, Cairo University, Cairo, Egypt
(White) Mesothelioma Foundation, Washington, DC, United States
Publisher
Lippincott Williams and Wilkins
Abstract
ASCO Guidelines provide recommendations with comprehensive review and
analyses of the relevant literature for each recommendation, following the
guideline development process as outlined in the ASCO Guidelines
Methodology Manual. ASCO Guidelines follow the ASCO Conflict of Interest
Policy for Clinical Practice Guidelines.Clinical Practice Guidelines and
other guidance ("Guidance") provided by ASCO is not a comprehensive or
definitive guide to treatment options. It is intended for voluntary use by
clinicians and should be used in conjunction with independent professional
judgment. Guidance may not be applicable to all patients, interventions,
diseases or stages of diseases. Guidance is based on review and analysis
of relevant literature and is not intended as a statement of the standard
of care. ASCO does not endorse third-party drugs, devices, services, or
therapies and assumes no responsibility for any harm arising from or
related to the use of this information. See complete disclaimer in
Appendix 1 and 2 (online only) for more.PURPOSETo provide evidence-based
recommendations to practicing physicians and others on the management of
pleural mesothelioma (PM).METHODSASCO convened an Expert Panel of medical
oncology, thoracic surgery, radiation oncology, pathology, cancer
genetics, and advocacy experts to conduct an updated literature search,
which included systematic reviews, meta-analyses, randomized controlled
trials, and prospective and retrospective comparative observational
studies published from 2016 through 2024. Outcomes of interest included
survival, disease-free or recurrence-free survival, and quality of life.
Expert Panel members used available evidence and informal consensus to
develop evidence-based guideline recommendations.RESULTSThe literature
search identified 110 additional relevant studies to inform the evidence
base for this guideline.RECOMMENDATIONSEvidence-based recommendations were
developed for surgical cytoreduction, immunotherapy, chemotherapy,
pathology, and germline testing in patients with PM.Additional information
is available at www.asco.org/thoracic-cancer-guidelines. Copyright
© American Society of Clinical Oncology.

<37>
Accession Number
2031682517
Title
Pulmonary and Cardiac Smoking-Related History Improves Abstinence Rates in
an Urban, Socioeconomically Disadvantaged Patient Population.
Source
Journal of General Internal Medicine. 40(4) (pp 749-755), 2025. Article
Number: 100349. Date of Publication: 01 Mar 2025.
Author
Khera Z.; Illenberger N.; Sherman S.E.
Institution
(Khera, Illenberger, Sherman) NYU Grossman School of Medicine, New York,
NY, United States
(Illenberger, Sherman) Department of Population Health, Seventeenth Floor,
NYU Langone Health, New York, NY, United States
(Sherman) Department of Medicine, NYU Langone Health, New York, NY, United
States
(Sherman) VA New York Harbor Healthcare System, New York, NY, United
States
Publisher
Springer
Abstract
Background: Tobacco use continues to take the lives of many, and targeted
interventions can counter this health burden. One possible target
population is patients who have had a smoking-related diagnosis, as they
may have a greater drive to quit. Objective(s): To assess whether
patients with previous cardiac or pulmonary conditions directly
attributable to smoking have greater rates of abstinence post-discharge
from hospitalization in the CHART-NY trial. Design(s): CHART-NY was a
randomized comparative effectiveness trial comparing a more intensive
versus a less intensive smoking cessation intervention after hospital
discharge. We divided the 1618 CHART-NY participants into a
smoking-related history group of 597 and a nonsmoking-related history
group of 1021 based on cardiac or pulmonary conditions in a retrospective
chart review. We conducted chi-squared analyses on baseline
characteristics. Using follow-up survey data, we conducted chi-squared
analyses on abstinence outcomes and made logistic regression models for
the predictive value of smoking-related conditions on abstinence.
 Participant(s): A total of 1059 and 1084 participants in CHART-NY who
completed both 2- and 6-month follow-up surveys respectively. Main
Measures: Self-reported 30-day abstinence at 2- and 6-month follow-up and
survey data for baseline characteristics. Key Results: Those abstinent at
6-month follow-up were more likely to have a smoking-attributable history
(OR = 1.40, 95% CI 1.09-1.81). When stratified based on intervention, only
the intensive counseling group was significant (OR = 1.53, 95% CI
1.08-2.17). The regression model using a smoking-related comorbidity score
was significant at 6 months (OR = 1.29, p = 0.03), and the multivariate
logistic regression model analyzing each smoking-related condition
separately demonstrated significance for myocardial infarction at 6 months
(OR = 1.66, p = 0.03). Conclusion(s): People who smoke who have
experienced smoking-related conditions may be more likely to benefit from
smoking cessation interventions, especially intensive telephone-based
counseling. Multiple conditions had an additive effect in predicting
long-term abstinence after intervention, and myocardial infarction had the
greatest predictive value. Copyright © The Author(s), under
exclusive licence to Society of General Internal Medicine 2024.

<38>
Accession Number
2035951140
Title
Analgesic Efficacy of Thoracoscopic Direct-View Versus Ultrasound-Guided
Thoracic Paravertebral Block in Multi-Port Video-Assisted Thoracoscopic
Lung Surgery: A Randomized Controlled Non-Inferiority Study.
Source
Drug Design, Development and Therapy. 19 (pp 1825-1838), 2025. Date of
Publication: 2025.
Author
Tong Y.; Wu J.; Wu X.; Mo Y.; Wang F.
Institution
(Tong, Mo) Department of Anesthesiology, the First Affiliated Hospital of
Wenzhou Medical University, Wenzhou, China
(Wu, Wang) Department of Anesthesiology, Lishui People's Hospital, Lishui
Hospital of Wenzhou Medical University, Lishui, China
(Wu) Department of Thoracic Surgery, Lishui People's Hospital, Lishui
Hospital of Wenzhou Medical University, Lishui, China
(Wang) Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision
and Brain Health), Wenzhou Medical University, Wenzhou, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: This study compares the analgesic effects of the Thoracoscopic
Direct-view Thoracic Paravertebral Nerve Block (DTPVB) with those of the
Ultrasound-guided Thoracic Paravertebral Nerve Block (UTPVB), providing a
clinical reference. Patients and Methods: Sixty-eight patients
undergoing three-port video-assisted thoracic surgery (VATS) with general
anesthesia were randomly assigned to either the DTPVB group (Group D, n =
34) or the UTPVB group (Group U, n = 34). Both groups received a 10 mL
injection of 0.75% ropivacaine at the T4 and T7 interspaces. Primary
outcomes were cumulative sufentanil equivalents from the start of lung
manipulation to 24 hours postoperatively, with group differences assessed
against a non-inferiority margin of 5 mug (DELTA). Secondary outcomes
include postoperative pain scores, analgesic consumption, patient
satisfaction, adverse effects, and other related indicators.
 Result(s): The cumulative use of sufentanil equivalents from the
start of lung manipulation to 24 hours postoperatively was 35.0 +/- 6.1
mug in Group D and 33.2 +/- 5.6 mug in Group U, with no significant
difference (P = 0.217). The difference in cumulative sufentanil
equivalents (Group D minus Group U) was 1.8 (95% CI -1.07, 4.65), within
the non-inferiority margin of 5 (DELTA). Postoperative pain scores,
analgesic consumption, adverse effects, and complications were similar
were similar between groups. However, DTPVB was associated with lower
anxiety and higher satisfaction (P<0.001). At 15 minutes post-block,
ropivacaine plasma concentrations were higher in Group D (P=0.024).
 Conclusion(s): DTPVB, via transmural pleural puncture, was
non-inferior to UTPVB in analgesic efficacy from the beginning of the
manipulation of the lungs in operation to 24h postoperatively. DTPVB
provides a good alternative, especially for patients who are anxious
before surgery, have difficulty cooperating with UTPVB, or in cases where
UTPVB puncture fails. However, when using high concentrations of
ropivacaine, greater vigilance for toxicity is required. Copyright
© 2025 Tong et al.

<39>
Accession Number
2037975438
Title
Impact of Transcatheter or Surgical Aortic Valve Performance on 5-Year
Outcomes in Patients at >= Intermediate Risk.
Source
Journal of the American College of Cardiology. 85(13) (pp 1419-1430),
2025. Date of Publication: 08 Apr 2025.
Author
Yakubov S.J.; Van Mieghem N.M.; Oh J.K.; Ito S.; Grubb K.J.; O'Hair D.;
Forrest J.K.; Gada H.; Mumtaz M.; Deeb G.M.; Tang G.H.L.; Rovin J.D.; Jain
R.; Windecker S.; Skelding K.A.; Kleiman N.S.; Chetcuti S.J.; Dedrick A.;
Boatman S.V.; Popma J.J.; Reardon M.J.
Institution
(Yakubov) Riverside Methodist, Ohio Health, Columbus, OH, United States
(Van Mieghem) Erasmus University Medical Center, Rotterdam, Netherlands
(Oh, Ito) Mayo Clinic, Rochester, MN, United States
(Grubb) Emory University School of Medicine, Atlanta, GA, United States
(O'Hair) Boulder Community Health, Boulder, CO, United States
(Forrest) Yale University School of Medicine, New Haven, CT, United States
(Gada, Mumtaz) University of Pittsburgh Medical Center Pinnacle Heath,
Harrisburg, PA, United States
(Deeb, Chetcuti) University of Michigan Hospitals, Ann Arbor, MI, United
States
(Tang) Mount Sinai Health System, New York, NY, United States
(Rovin) Morton Plant Hospital, Clearwater, FL, United States
(Jain) Aurora Healthcare, Milwaukee, WI, United States
(Windecker) Inselspital, University of Bern, Bern, Switzerland
(Skelding) Jersey City Medical Center, RWJBarnabas Health, Jersey City,
NJ, United States
(Kleiman, Reardon) Houston Methodist-DeBakey Heart and Vascular Center,
Houston, TX, United States
(Dedrick, Boatman, Popma) Structural Heart and Aortic, Medtronic,
Minneapolis, MN, United States
Publisher
Elsevier Inc.
Abstract
Background: The incidence and clinical importance of bioprosthetic valve
dysfunction (BVD) in patients undergoing supra-annular, self-expanding
transcatheter aortic valve replacement (TAVR) or surgery is not well
understood. Objective(s): The purpose of this study was to evaluate
the 5-year incidence and clinical outcomes of BVD in patients undergoing
CoreValve/Evolut TAVR or surgery. Method(s): This post hoc analysis
pooled data from the U.S. High Risk Pivotal (n = 726) and SURTAVI (n =
1,618) randomized controlled trials (RCTs), the Extreme Risk Pivotal trial
(n = 608), and CoreValve Continued Access Study (n = 2,654). The primary
endpoint was the incidence of BVD through 5 years from the RCTs. The
association of BVD with 5-year clinical outcomes was evaluated in the
pooled RCT and non-RCT populations. Result(s): Of 5,606 patients
evaluated, 3,070 (54.8%) were men, and the mean age was 82.2 +/- 7.4
years. A total of 2,344 RCT patients, including 1,227 who received TAVR
and 1,117 who received surgery, and 3,262 non-RCT TAVR patients were
included. The rate of BVD was lower in RCT patients undergoing
CoreValve/Evolut TAVR compared with surgery (9.7% vs 15.3%;
subdistribution HR: 0.57; 95% CI: 0.45-0.73; P < 0.001). In the pooled RCT
and non-RCT cohort, BVD was associated with increased 5-year all-cause
mortality (HR: 1.49; 95% CI: 1.32-1.68; P < 0.001), cardiovascular
mortality (HR: 1.76; 95% CI: 1.52-2.03; P < 0.001), and hospitalization
for valve disease or worsening heart failure (HR: 1.48; 95% CI: 1.23-1.78;
P < 0.001). Conclusion(s): Five-year valve performance was
significantly better after CoreValve/Evolut TAVR compared with surgery.
Development of BVD in TAVR and surgery patients was associated with
worsened 5-year clinical outcomes. (Safety and Efficacy Study of the
Medtronic CoreValve System in the Treatment of Symptomatic Severe Aortic
Stenosis in High Risk and Very High Risk Subjects Who Need Aortic Valve
Replacement, NCT01240902; Safety and Efficacy Study of the Medtronic
CoreValve System in the Treatment of Severe, Symptomatic Aortic Stenosis
in Intermediate Risk Subjects Who Need Aortic Valve Replacement [SURTAVI],
NCT01586910; Safety and Efficacy Continued Access Study of the Medtronic
CoreValve System in the Treatment of Symptomatic Severe Aortic Stenosis in
Very High Risk Subjects and High Risk Subjects Who Need Aortic Valve
Replacement, NCT01531374) Copyright © 2025 American College of
Cardiology Foundation

<40>
Accession Number
2029693781
Title
Improved tricuspid regurgitation after transcatheter aortic valve
replacement is associated with better survival: Systematic review and
meta-analysis with reconstructed time-to-event data.
Source
Perfusion (United Kingdom). 40(3) (pp 621-630), 2025. Date of Publication:
01 Apr 2025.
Author
Naito N.; Takagi H.
Institution
(Naito, Takagi) Department of Cardiovascular Surgery, Shizuoka Medical
Center, Shizuoka, Japan
Publisher
SAGE Publications Ltd
Abstract
Background: This meta-analysis compared survival outcomes among patients
experiencing improvement in untreated significant tricuspid regurgitation
(TR) following transcatheter aortic valve replacement (TAVR) for severe
aortic stenosis, in contrast to those without improvement. Method(s):
MEDLINE and EMBASE were searched through January 2024. Pooled hazard
ratios (HR) with 95% confidence intervals (CI) were computed. Employing
network meta-analysis, a comparison involving four post-procedural TR
categories (improved, no improvement, worsened, and no change) was
executed. Subsequently, these categories were amalgamated into two groups
(less TR after TAVR and same or greater TR after TAVR), and a standard
meta-analysis was conducted. Kaplan-Meier curves depicting long-term
all-cause mortality were reconstructed utilizing individual patient data
derived from the studies. Result(s): A systematic review identified
seven non-randomized studies encapsulating 698 patients. Network
meta-analysis revealed that improved TR after TAVR correlated with
significantly lower long-term all-cause mortality compared to the
remaining cohorts. Similarly, pooled all-cause mortality of standard
meta-analysis demonstrated significant reduction in patients whose TR was
sub-baseline than those exhibiting same or greater TR after TAVR (HR [95%
CI] = 0.43 [0.32-0.58], p <.01). The hazard ratio, derived from
reconstructed time-to-event data, showed a lower long-term all-cause
mortality in patients with less TR after TAVR relative to the other cohort
(HR [95% CI] = 0.46 [0.32-0.67], p <.01). Conclusion(s): This
meta-analysis revealed that improved TR after TAVR correlates with
superior long-term survival. The benefits of simultaneous or staged
intervention on the tricuspid valve in individuals undergoing TAVR warrant
validation in future investigations. Copyright © The Author(s)
2024.

<41>
Accession Number
2031446364
Title
A Study of Safety and Effectiveness of Evicel Fibrin Sealant as an
Adjunctive Hemostat in Pediatric Surgery.
Source
European Journal of Pediatric Surgery. 34(6) (pp 512-521), 2024. Date of
Publication: 01 Dec 2024.
Author
Kenny S.; Gabra H.; Hall N.J.; Flageole H.; Illie B.; Barnett E.;
Kocharian R.; Sharif K.
Institution
(Kenny) Department of Paediatric Surgery, Alder Hey Children's Hospital,
Merseyside, Liverpool, United Kingdom
(Gabra) Department of Children's Surgery, Great North Children's Hospital,
Newcastle, United Kingdom
(Hall) Department of Neonatal and Paediatric Surgery, Southampton
Children's Hospital, Southampton, United Kingdom
(Flageole) Department of Pediatric Surgery, McMaster Children's Hospital,
Hamilton, ON, Canada
(Illie, Kocharian) Department of Scientific Affairs, Ethicon Inc, Raritan,
NJ, United States
(Barnett) Department of Scientific Affairs, Ethicon UK, Livingston, United
Kingdom
(Sharif) Department of Paediatric Surgery, Birmingham Children's Hospital
NHS Foundation Trust, Birmingham, United Kingdom
Publisher
Georg Thieme Verlag
Abstract
Introduction Data on the use of fibrin sealants to control intraoperative
bleeding in children are scarce. Evicel Fibrin Sealant (Ethicon Inc.,
Raritan, New Jersey, United States) was found safe and effective in
clinical trials of adults undergoing various surgery types. We evaluated
the safety and efficacy of Evicel versus Surgicel Absorbable Hemostat
(Ethicon Inc.) as adjunctive topical hemostats for mild/moderate
raw-surface bleeding in pediatric surgery. Methods A phase III randomized
clinical trial was designed as required by the European Medicines Agency's
Evicel Pediatric Investigation Plan: 40 pediatric subjects undergoing
abdominal, retroperitoneal, pelvic, or thoracic surgery were randomized to
Evicel or Surgicel, to treat intraoperative mild-to-moderate bleeding.
Descriptive analyses included time-to-hemostasis and rates of treatment
success (4, 7, 10 minutes), intraoperative treatment failure, rebleeding,
and thromboembolic events. Results Forty of 130 screened subjects aged 0.9
to 17 years were randomized 1:1 to Evicel or Surgicel. Surgeries were
predominantly open abdominal procedures. The median bleeding area was 4.0
cm 2 for Evicel and 1.0 cm 2 for Surgicel. The
median time-to-hemostasis was 4.0 minutes for both groups. The 4-, 7-, and
10-minute treatment success rates were 80.0% versus 65.0%, 100.0% versus
80.0%, and 95.0% versus 90.0%, whereas treatment failure rates were 5.0%
versus 25.0%, for Evicel and Surgicel, respectively. No deaths or
thrombotic events occurred. Re-bleeding occurred in 5.0% of Evicel and
10.0% of Surgicel subjects. Conclusions In accordance with adult clinical
trials, this randomized study supports the safety and efficacy of Evicel
for controlling mild-to-moderate surgical bleeding in a broad range of
pediatric surgical procedures. Copyright © 2024. The Author(s).

<42>
[Use Link to view the full text]
Accession Number
2020871887
Title
A Multicenter, Phase 2, Randomized, Placebo-Controlled, Double-Blind,
Parallel-Group, Dose-Finding Trial of the Oral Factor XIa Inhibitor
Asundexian to Prevent Adverse Cardiovascular Outcomes After Acute
Myocardial Infarction.
Source
Circulation. 146(16) (pp 1196-1206), 2022. Date of Publication: 18 Oct
2022.
Author
Rao S.V.; Kirsch B.; Bhatt D.L.; Coppolecchia R.; Eikelboom J.; James
S.K.; Jones W.S.; Merkely B.; Keller L.; Hermanides R.S.; Campo G.;
Ferreiro J.L.; Mundl H.; Alexander J.H.; Hengstenberg C.; Steinwender C.;
Alber H.; Steringer-Mascherbauer R.; Schober A.; Auer J.; Roithinger F.X.;
Von Lewinski D.; Moertl D.; Huber K.; Coussement P.; Hoffer E.; Beauloye
C.; Janssens L.; Vranckx P.; De Raedt H.; Vanassche T.; Vrolix M.; Rokyta
R.; Parenica J.; Pelouch R.; Motovska Z.; Alan D.; Kettner J.; Polasek R.;
Cermak O.; Sedlon P.; Hanis J.; Novak M.; Belohlavek J.; Horacek T.;
Leggewie S.; Wenzel P.; Vom Dahl J.; Sievers B.; Pulz J.; Schellong S.;
Clemmensen P.; Muller-Hennessen M.; Rassaf T.; Falukozi J.; Ruzsa Z.;
Tomcsanyi J.; Csanadi Z.; Herczeg B.; Koszegi Z.; Vorobcsuk A.; Kiss R.;
Baranyai C.; Dezsi C.; Lupkovics G.; Rossini R.; Scherillo M.; Sergio Saba
P.; Calo L.; Nassiacos D.; Quadri G.; Sciahbasi A.; Silvio Marenzi G.C.;
Reimers B.; Perna G.P.; Sacca S.; Fattore L.; Brunelli C.; Picchi A.;
Kuramochi T.; Kondo K.; Aoyama T.; Kudoh T.; Yamamoto T.; Takaya T.; Mukai
Y.; Fukui K.; Morioka N.; Ando K.; Yamamuro A.; Morita Y.; Koga Y.;
Watanabe T.; Sakamoto T.; Shibasaki T.; Maebuchi D.; Takahashi A.; Yonetsu
T.; Kakuta T.; Nishina H.; Oemrawsingh R.; Dorman R.; Oude Ophius T.;
Prins P.; Al Windy N.Y.Y.; Zoet-Nugteren S.K.; Hermanides R.; Van Eck M.;
Scherptong R.; Cornel J.H.; Damman P.; Bech G.; Torquay R.; Kietselaer B.;
Grzelakowski P.; Krzysztof D.; Budaj A.; Miekus P.; Przybylski A.;
Zarebinski M.; Balsam P.; Szachniewicz J.; Gierlotka M.; Tycinska A.;
Iniguez Romo A.; Fernandez Ortiz A.; Carrasquer Cucarella A.; Sanmartin
Fernandez M.; Sionis A.; Bueno Zamora H.; Ferreiro Gutierrez J.L.; Almenar
L.; Ferreira Gonzalez I.; Pascual Figal D.A.; Almendro Delia M.; Jimenez
Fernandez M.; Skeppholm M.; Zedigh C.; Angeras O.; Lauermann J.; Erlinge
D.; Gustafsson R.; Mooe T.; Utreras A.; James S.; Grimfjard P.; Pedrazzini
G.; Mach F.; Fournier S.; Haegeli L.; Beer J.H.; Leibundgut G.; Kobza R.;
Kaiser C.; Kunadian V.; Al-Lamee R.; Gorog D.; Khan S.; Trevelyan J.; Toor
I.; Smith J.; Purushottam B.; Treasure C.; Arena F.; Vedere A.; Henderson
D.; Gilani S.; Jones A.; Carrillo-Jimenez R.; Gillespie E.; Marhefka G.;
Wang D.; Olson C.; Bloom S.; Iftikhar F.; Brabham D.; McGinty J.; Thompson
C.; Talano J.; Ginete W.; Williams M.; Masud A.; Ariani M.; Bitar F.; Wang
T.; Samuelson B.
Institution
(Rao) New York University Langone Health System, New York, NY, United
States
(Jones, Alexander) Duke Clinical Research Institute, Duke University
School of Medicine, Durham, NC, United States
(Kirsch, Keller, Mundl) Bayer Ag, Wuppertal, Germany
(Bhatt) Brigham and Women's Hospital, Harvard Medical School, Boston, MA,
United States
(Budaj) Centre of Postgraduate Medical Education, Grochowski Hospital,
Warsaw, Poland
(Coppolecchia) Bayer Us Llc, Whippany, NJ, United States
(Eikelboom) Population Health Research Institute, McMaster University,
Hamilton, ON, Canada
(James) Department of Medical Sciences, Uppsala Clinical Research Center,
Uppsala University, Sweden
(Merkely) Heart and Vascular Center, Semmelweis University, Budapest,
Hungary
(Hermanides) Isala Hospital, Zwolle, Netherlands
(Campo) Cardiovascular Institute, Azienda Ospedaliero-Universitaria di
Ferrara, Cona, Italy
(Ferreiro) Department of Cardiology, Bellvitge University Hospital,
BIOHEART: Cardiovascular Diseases Group-IDIBELL, CIBERCV, l'Hospitalet de
Llobregat, Barcelona, Spain
(Shibasaki) Saitama Sekishinkai Hospital, Saitama, Japan
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Oral activated factor XI (FXIa) inhibitors may modulate
coagulation to prevent thromboembolic events without substantially
increasing bleeding. We explored the pharmacodynamics, safety, and
efficacy of the oral FXIa inhibitor asundexian for secondary prevention
after acute myocardial infarction (MI). Method(s): We randomized 1601
patients with recent acute MI to oral asundexian 10, 20, or 50 mg or
placebo once daily for 6 to 12 months in a double-blind,
placebo-controlled, phase 2, dose-ranging trial. Patients were randomized
within 5 days of their qualifying MI and received dual antiplatelet
therapy with aspirin plus a P2Y12 inhibitor. The effect of asundexian on
FXIa inhibition was assessed at 4 weeks. The prespecified main safety
outcome was Bleeding Academic Research Consortium type 2, 3, or 5 bleeding
comparing all pooled asundexian doses with placebo. The prespecified
efficacy outcome was a composite of cardiovascular death, MI, stroke, or
stent thrombosis comparing pooled asundexian 20 and 50 mg doses with
placebo. Result(s): The median age was 68 years, 23% of participants
were women, 51% had ST-segment-elevation MI, 80% were treated with aspirin
plus ticagrelor or prasugrel, and 99% underwent percutaneous coronary
intervention before randomization. Asundexian caused dose-related
inhibition of FXIa activity, with 50 mg resulting in >90% inhibition. Over
a median follow-up of 368 days, the main safety outcome occurred in 30
(7.6%), 32 (8.1%), 42 (10.5%), and 36 (9.0%) patients receiving asundexian
10 mg, 20 mg, or 50 mg, or placebo, respectively (pooled asundexian versus
placebo: hazard ratio, 0.98 [90% CI, 0.71-1.35]). The efficacy outcome
occurred in 27 (6.8%), 24 (6.0%), 22 (5.5%), and 22 (5.5%) patients
assigned asundexian 10 mg, 20 mg, or 50 mg, or placebo, respectively
(pooled asundexian 20 and 50 mg versus placebo: hazard ratio, 1.05 [90%
CI, 0.69-1.61]). Conclusion(s): In patients with recent acute MI, 3
doses of asundexian, when added to aspirin plus a P2Y12 inhibitor,
resulted in dose-dependent, near-complete inhibition of FXIa activity
without a significant increase in bleeding and a low rate of ischemic
events. These data support the investigation of asundexian at a dose of 50
mg daily in an adequately powered clinical trial of patients who
experienced acute MI. Copyright © 2022 American Heart
Association, Inc.

<43>
[Use Link to view the full text]
Accession Number
2035023290
Title
A Randomized Controlled Trial Comparing Effectiveness of Different
Fibrinogen Preparations in Restoring Clot Firmness.
Source
Anesthesia and Analgesia. 140(4) (pp 966-973), 2025. Date of Publication:
01 Apr 2025.
Author
Baryshnikova E.; Aloisio T.; Di Dedda U.; Anguissola M.; Barbaria A.;
Caravella G.; Ranucci M.
Institution
(Baryshnikova, Aloisio, Di Dedda, Anguissola, Barbaria, Ranucci)
Departments of Cardiovascular Anesthesia and Intensive Care, IRCCS
Policlinico San Donato, Milan, San Donato Milanese, Italy
(Caravella) Departments of Pharmacy Service, IRCCS Policlinico San Donato,
Milan, San Donato Milanese, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Different preparations of fibrinogen concentrate are currently
available. Two in vitro studies demonstrated the superiority of FibCLOT
(LFB) in increasing clot firmness with respect to RiaSTAP (CSL Behring).
The present trial involved a clinical model to test the hypothesis of
superiority, with the increase in clot firmness as the primary end point.
 METHOD(S): Forty cardiac surgery patients were randomly allocated to
receive a dose of 30 mg/kg FibCLOT or RiaSTAP after protamine
administration in the presence of microvascular bleeding and a FIBTEM
maximum clot firmness (MCF) <10 mm. Viscoelastic parameters were measured
before and after fibrinogen supplementation: FIBTEM MCF, EXTEM MCF, and
EXTEM clotting time (CT). RESULT(S): The mean increase in FIBTEM MCF
was 4 +/- 1.2 mm (mean and standard deviation) in the FibCLOT group and 4
+/- 1.6 mm in the RiaSTAP group (P = 1.000); the mean decrease in CT was
11. 2 +/- 12.2 (mean and standard deviation) seconds in the FibCLOT group
and 14. 8 +/- 13 seconds in the RiaSTAP group (P = .372). In both groups,
fibrinogen supplementation induced a significant (P = .001) increase in
the FIBTEM MCF and EXTEM CT. The proportions of patients who did not
experience an increase of 4 mm in the RiaSTAP group and the FibCLOT group
were not statistically significantly higher (35% vs 20%, respectively,
relative risk 2.15, 95% confidence interval 0.52-9.00, P = .288).
 CONCLUSION(S): In contrast to previous in vitro studies, we found
that the effect of FibCLOT on MCF and CT was not significantly greater
than that of RiaSTAP in cardiac surgery patients. Further studies in other
clinical settings are warranted. Copyright © 2025 International
Anesthesia Research Society.

<44>
Accession Number
2033695680
Title
Interpreting clinical outcomes using different strut thickness in coronary
artery disease: insights from vascular imaging analysis.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1491607. Date of Publication: 2025.
Author
Kwun J.-S.; Park J.J.; Kang S.-H.; Kim S.-H.; Yoon C.-H.; Suh J.-W.; Youn
T.-J.; Cha K.S.; Lee S.-H.; Hong B.-K.; Rha S.-W.; Kang W.C.; Chae I.-H.
Institution
(Kwun, Park, Kang, Kim, Yoon, Suh, Youn, Chae) Cardiovascular Center,
Department of Internal Medicine, Seoul National University Bundang
Hospital, Seongnam-si, South Korea
(Cha) Cardiovascular Center, Department of Internal Medicine, Pusan
National University Hospital, Busan, South Korea
(Lee) Division of Cardiology, Department of Internal Medicine, Wonju
Severance Hospital, Yonsei University College of Medicine, Seongnam-si,
South Korea
(Hong) Cardiovascular Center, Department of Internal Medicine, Gangnam
Severance Hospital, Yonsei University College of Medicine, Seoul, South
Korea
(Rha) Cardiovascular Center, Department of Internal Medicine, Korea
University Guro Hospital, Seoul, South Korea
(Kang) Cardiovascular Center, Department of Internal Medicine, Gachon
University Gil Medical Center, Incheon, South Korea
Publisher
Frontiers Media SA
Abstract
Background: Coronary artery disease is a global health concern that
necessitates treatments, such as percutaneous coronary intervention (PCI)
with drug-eluting stents (DES). Recent advancements in biodegradable
polymer-coated DES have improved long-term outcomes by reducing neointimal
hyperplasia. Superior long-term outcomes in patients with ultrathin-strut
sirolimus-eluting Orsiro stent (BP-SES) compared with those with
thick-strut biolimus-eluting BioMatrix stent (BP-BES) have been shown.
This study aimed to explore the mechanisms underlying these differences by
using quantitative coronary angiography (QCA) and optical coherence
tomography (OCT). Method(s): This sub-analysis of the BIODEGRADE
trial, a prospective, randomized, multi-center study, compared BP-SES and
BP-BES in patients who underwent PCI between July 2014 and September 2017.
Patients with positive stress test results, ischemic symptoms, or those
who consented to routine follow-up angiography were included. QCA and OCT
were used to evaluate the lumen diameter, cross-sectional areas and stent
apposition or coverage. OCT images were analyzed at 1 mm intervals within
5 mm proximal and distal to the stented segment. Result(s): Of the
2,341 patients, 689 underwent follow-up angiography between 18- and
36-months post-PCI, and 929 stents were analyzed via QCA. OCT images of 61
participants were available. The BP-SES group exhibited a significantly
larger minimal lumen diameter and reduced late lumen loss compared to the
BP-BES group (0.34 +/- 0.45 mm vs. 0.42 +/- 0.44 mm, P = 0.005). OCT
analysis showed significantly less neointimal hyperplasia in the BP-SES
group (0.04 +/- 0.4 mm2 vs. 0.64 +/- 0.54 mm2, P <
0.001), with no significant differences in stent strut coverage or
inflammation markers, than in the BP-BES group. Conclusion(s): QCA
and OCT analyses revealed less neointimal growth with BP-SES than with
BP-BES, without delayed healing or increased inflammation. These findings
underscore the importance of stent design characteristics and suggest that
thinner struts may enhance clinical success by reducing restenosis and
improving long-term vessel patency. Clinical Trial Registration:
https://clinicaltrials.gov/study/NCT02299011 (NCT02299011). Copyright
2025 Kwun, Park, Kang, Kim, Yoon, Suh, Youn, Cha, Lee, Hong, Rha, Kang and
Chae.

<45>
Accession Number
2033703294
Title
A Randomized Controlled Trial Comparing Elastic Compressive Dressing and
the TR Band After Transradial Coronary Intervention.
Source
Journal of Interventional Cardiology. 2025(1) (no pagination), 2025.
Article Number: 2864005. Date of Publication: 2025.
Author
Daralammouri Y.; Awwad F.; Azamtta M.; A. Salim H.; M. Zakaria G.; Musmar
B.; S. Mosleh Y.; Alkaissi A.
Institution
(Daralammouri, Azamtta, A. Salim, M. Zakaria, Musmar, S. Mosleh)
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah
National University, State of Palestine, Nablus, Palestine
(Daralammouri, Azamtta) Department of Cardiology, An-Najah National
University Hospital, State of Palestine, Nablus, Palestine
(Awwad, Alkaissi) Department of Nursing, College of Medicine and Health
Sciences, An-Najah National University, State of Palestine, Nablus,
Palestine
Publisher
John Wiley and Sons Inc
Abstract
Background: Transradial coronary intervention has been shown to be both
safe and effective, with several benefits, such as limited access to site
complications and earlier patient discharge. Radial compression devices,
on the other hand, add to the total expense of the procedure and have not
been adequately compared to traditional compressive dressings. The purpose
of this study is to compare the safety and efficacy of elastic compressive
dressing with gauze swabs and crepe bandages to balloon compression
devices with the TR Band (Terumo) for maintaining radial hemostasis
following cardiac procedures. Method(s): A total of 402 patients were
randomly assigned to receive either a TR band or an elastic compressive
dressing for radial hemostasis following cardiac intervention in a
prospective, partially blinded, randomized clinical study. The main
outcome was the hemostasis time and the occurrence of hematoma. Patient
satisfaction, postprocedure pain, vascular problems, and the cost of the
compression device used were all secondary outcomes. Result(s): The
two groups had similar baseline characteristics and procedural data. The
majority of patients (79%) were very satisfied with both hemostasis
techniques. The elastic dressing group achieved hemostasis significantly
faster than the TR band group (83.8 +/- 142.8 min vs. 116.3 +/- 122.7, p =
0.017). Significant differences in the incidence of hematoma (8% elastic
dressing vs. 18.4% TR band, p = 0.003) and postprocedural pain (0.84 +/-
1.2 elastic dressing vs. 1.39 +/- 1.4 TR band, p <= 0.001) were observed.
The incidence of early radial artery occlusion was higher in the elastic
dressing group (7 patients) than in the TR band group (2 patients),
although the difference was not statistically significant (p = 0.09).
Finally, the TR band was significantly more expensive than the elastic
dressing used in the trial. Conclusion(s): Elastic compressive
dressings are a safe, low-cost, and effective alternative to TR band. They
decrease hemostasis time, enhance patient comfort, and reduce both the
number and size of hematomas. When compared to the TR band, these
dressings have a similar rate of radial artery patency at discharge. Trial
Registration: ClinicalTrials.gov identifier: NCT05409716. Copyright
© 2025 Yunis Daralammouri et al. Journal of Interventional Cardiology
published by John Wiley & Sons Ltd.

<46>
Accession Number
2026729530
Title
Impact of diabetic versus non-diabetic patients undergoing coronary artery
bypass graft surgery on postoperative wound complications: A
meta-analysis.
Source
International Wound Journal. 21(3) (no pagination), 2024. Article Number:
e14495. Date of Publication: 01 Mar 2024.
Author
He L.; Liu M.; He Y.; Guo A.
Institution
(He) Operating Room, Xiang'an Hospital, Xiamen University, Xiamen, China
(Liu) Department of Endocrinology Hospital of Xiamen University, School of
Medicine, Xiamen University, Xiamen, China
(He) Department of Rheumatology and Immunology, Run Run Shaw Hospital of
the School of Medicine of Zhejiang University, Hangzhou, China
(Guo) Department of Cardiac Surgery, Xiangan Hospital Affiliated to Xiamen
University, Xiamen, China
Publisher
John Wiley and Sons Inc
Abstract
The effect of diabetes mellitus (DM) on the incidence of postoperative
wound complications in patients with coronary artery bypass grafting
(CABG) is still unclear. Thus, we performed a meta-analysis of CABG in DM
patients to evaluate existing data from both prospective and historical
cohorts. The objective of this trial was to assess the relevance and
extent of the effect of diabetes on the outcome of previous CABG
procedures. Data sources like Embase and Pubmed were found throughout the
research, and the language was limited to English through manual search.
The searches were performed up to August 2023. The data were extracted
from the study of the inclusion/exclusion criteria, the features of the
population, the statistical approach and the clinical results. A
qualitative evaluation of the qualifying studies has been carried out. Out
of the 1874 studies identified, 21 cohort studies were chosen for
analysis. Meta-analyses were performed in 258 454 patients (71 351
diabetic and 187 103 non-diabetic). Twenty-one studies on deep sternal
wound infections in CABG patients showed a lower rate of deep sternal
wound infections in non-diabetes group compared with those with diabetes
(OR, 2.13; 95% CI: 1.97, 2.31, p < 0.00001). And 16 studies of superficial
wound infections in patients undergoing CABG were found to be associated
with a lower rate of superficial injury (OR, 1.93; 95% CI: 1.53, 2.43, p <
0.00001) compared with those with diabetes; In five trials, perfusion time
during CABG (MD, 2.31; 95% CI: -0.16, 4.79, p = 0.07) was observed, and
there were no significant differences between diabetes and non-diabetes.
Currently, there is a higher risk for CABG in diabetes than in
non-diabetes patients with sternal infections and superficial injuries.
Future randomized trials will concentrate on the treatment of such
perioperatively related complications, which will lower the risk of
postoperative wound infection in diabetes. Copyright © 2023 The
Authors. International Wound Journal published by Medicalhelplines.com Inc
and John Wiley & Sons Ltd.

<47>
Accession Number
2025978909
Title
Effect of skeletonisation and pedicled bilateral internal mammary artery
grafting in coronary artery bypass surgery on post-operative wound
infection: A meta-analysis.
Source
International Wound Journal. 21(2) (no pagination), 2024. Article Number:
e14424. Date of Publication: 01 Feb 2024.
Author
Nie C.; Deng Y.; Lu Y.
Institution
(Nie, Lu) Traditional Chinese Medicine University of Guangzhou, Guangzhou,
China
(Deng) Zhongnan University of Economics and Law, Wuhan, China
Publisher
John Wiley and Sons Inc
Abstract
The results showed that different internal thoracic artery (ITA) was
associated with the rate of postoperative wound infection and the severity
of pain following coronary artery bypass grafting (CABG). In order to
ascertain if there was any genuine difference in the rate of postoperative
infection and severity of the pain, we conducted a meta-analysis to
evaluate if there was any actual difference in the wound complication that
had been identified with the ITA method. Through EMBASE, Cochrane Library
and Pubmed, and so forth, we systematically reviewed the results by August
2023, which compared the impact of skeletonised versus pedicled internal
mammary artery (IMA) on wound complications following CABG. The trial data
have been pooled and analysed in order to determine if a randomisation or
fixed-effect model should be applied. The meta-analysis of data was
performed with Revman 5.3 software. The results of this meta-study
included 252 related articles from four main databases, and nine articles
were chosen to be extracted and analysed. A total of 3320 patients were
treated with coronary artery transplantation. Based on current data
analysis, we have shown that the rate of postoperative wound infections is
reduced by the use of the skeletonised internal mammary artery (SIMA) (OR,
1.84; 95% CI, 1.13, 3.01; p = 0.01). But the results showed that there
were no statistically significant differences in the post-operation pain
score of the patients (MD, 0.09; 95% CI, -0.58, 0.76; p = 0.79).
Furthermore, the duration of the operation was not significantly different
between the SIMA and pedicled internal mammary artery (PIMA) (MD, 3.30;
95% CI, -3.13, 9.73; p = 0.31). Overall, the SIMA decreased the rate of
postoperative wound infection in CABG patients than the
PIMA. Copyright © 2023 The Authors. International Wound Journal
published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

<48>
Accession Number
2025580386
Title
Effects of negative pressure wound therapy on surgical site wound
infections after cardiac surgery: A meta-analysis.
Source
International Wound Journal. 21(2) (no pagination), 2024. Article Number:
e14398. Date of Publication: 01 Feb 2024.
Author
Tao Y.; Zhang Y.; Liu Y.; Tang S.
Institution
(Tao) Department of Cardiovascular Medicine, The First Affiliated Hospital
of Guizhou University of Traditional Chinese Medicine, Guiyang, China
(Zhang) Interventional Surgery of Radiology, The First Affiliated Hospital
of Guizhou University of Traditional Chinese Medicine, Guiyang, China
(Liu) Department of Scientific Research Division, The First Affiliated
Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang,
China
(Tang) Department of Anaesthesia, The First Affiliated Hospital of Guizhou
University of Traditional Chinese Medicine, Guiyang, China
Publisher
John Wiley and Sons Inc
Abstract
We conducted a comprehensive analysis to evaluate the benefits of negative
pressure wound therapy (NPWT) versus traditional dressings in preventing
surgical site infections in patients undergoing cardiac surgery. We
thoroughly examined several databases, including PubMed, EMBASE, Cochrane
Library, China National Knowledge Infrastructure (CNKI), VIP, Chinese
Biomedical Literature Database (CBM) and Wanfang, from inception until
July 2023. Two independent researchers were responsible for the literature
screening, data extraction and quality assessment; analyses were performed
using RevMan 5.4 software. Thirteen studies comprising 8495 patients were
deemed relevant. A total of 2685 patients were treated with NPWT, whereas
5810 received conventional dressings. The findings revealed that NPWT was
more effective in reducing surgical site infections after cardiac surgery
than conventional dressings (4.88% vs. 5.87%, odds ratio [OR]: 0.50, 95%
confidence intervals [CIs]: 0.40-0.63, p < 0.001). Additionally, NPWT was
more effective in reducing deep wound infections (1.48% vs. 4.15%, OR:
0.36, 95% CI: 0.23-0.56, p < 0.001) and resulted in shorter hospital stays
(SMD: -0.33, 95% CIs: -0.54 to -0.13, p = 0.001). However, the rate of
superficial wound infections was not significantly affected by the method
of wound care (3.72% vs. 5.51%, OR: 0.63, 95% CI: 0.32-1.23, p = 0.180).
In conclusion, NPWT was shown to be advantageous in preventing
postoperative infections and reducing hospital stay durations in patients
undergoing cardiac surgery. Nonetheless, given the limitations in the
number and quality of the included studies, further research is
recommended to validate these findings. Copyright © 2023 The
Authors. International Wound Journal published by Medicalhelplines.com Inc
and John Wiley & Sons Ltd.

<49>
[Use Link to view the full text]
Accession Number
2037332181
Title
Stepwise Provisional Versus Systematic Dual-Stent Strategies for Treatment
of True Left Main Coronary Bifurcation Lesions.
Source
Circulation. 151(9) (pp 612-622), 2025. Date of Publication: 04 Mar 2025.
Author
Arunothayaraj S.; Egred M.; Banning A.P.; Brunel P.; Ferenc M.; Hovasse
T.; Wlodarczak A.; Pan M.; Schmitz T.; Silvestri M.; Erglis A.; Kretov E.;
Lassen J.F.; Chieffo A.; Lefevre T.; Burzotta F.; Cockburn J.; Darremont
O.; Stankovic G.; Morice M.-C.; Louvard Y.; Hildick-Smith D.
Institution
(Arunothayaraj, Cockburn, Hildick-Smith) Department of Cardiology, Sussex
Cardiac Centre, University Hospitals Sussex NHS Trust, Brighton, United
Kingdom
(Egred) Department of Cardiology, Freeman Hospital and Newcastle
University, Newcastle upon Tyne, United Kingdom
(Banning) Department of Cardiology, Oxford Heart Centre, Oxford University
Hospitals NHS Foundation Trust, Oxford, United Kingdom
(Brunel) Interventional Cardiology Unit, Clinique de Fontaine, Dijon,
France
(Ferenc) Department of Cardiology and Angiology, University Heart Center
Freiburg-Bad Krozingen, Germany
(Hovasse, Lefevre, Morice, Louvard) Department of Cardiology, Institut
Cardiovasculaire Paris Sud, Ramsay Sante, Massy, France
(Wlodarczak) Department of Cardiology, Poland Miedziowe Centrum Zdrowia
Lubin, Poland
(Pan) Department of Cardiology, Reina Sofia Hospital, University of
Cordoba, Spain
(Schmitz) Contilia Heart and Vascular Center, Elisabeth Krankenhaus Essen,
Germany
(Silvestri) Department of Cardiology, GCS Axium, Rambot, Aix en Provence,
France
(Erglis) Department of Cardiology, Pauls Stradins Clinical University
Hospital, University of Latvia, Riga, Latvia
(Kretov) Interventional Cardiology Unit, Sibirskiy Federal Biomedical
Research Center Novosibirsk, Russian Federation
(Lassen) Department of Cardiology, Odense University Hospital, Denmark
(Chieffo) Interventional Cardiology Unit, San Raffaele Scientific
Institute, Milan, Italy
(Burzotta) Department of Cardiovascular Sciences, Fondazione Policlinico
Universitario A. Gemelli IRCCS, Universita Cattolica del Sacro Cuore,
Rome, Italy
(Darremont) Department of Cardiology, Clinique Saint-Augustin-Elsan,
Bordeaux, France
(Stankovic) Department of Cardiology, University Clinical Center of
Serbia, Faculty of Medicine, University of Belgrade, Serbia
(Ferenc) Institute of Heart Diseases, Wroclaw Medical University, Poland
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: The optimal coronary stenting technique for true left main
bifurcation lesions is uncertain. EBC MAIN (European Bifurcation Club Left
Main Trial) aimed to evaluate clinical outcomes of a stepwise provisional
strategy compared with a systematic dual-stent approach. METHOD(S):
EBC MAIN was a randomized, investigator-initiated, open-label,
multicenter, parallel-group trial conducted across 35 hospitals in 11
European countries. A total of 467 participants undergoing percutaneous
coronary intervention for unprotected true left main bifurcation lesions
were randomly assigned to the stepwise provisional strategy (n=230) or an
upfront dual-stent approach (n=237). The mean (SD) age was 71 (10) years
and 23% of participants were women. The primary end point was a composite
of major adverse cardiac events, defined as all-cause mortality, all
myocardial infarction, or clinically driven target lesion
revascularization. Events were adjudicated by an independent clinical
events committee and all analyses were by the intention-to-treat
principle. RESULT(S): At 3 years, the primary end point occurred in
54 of 230 (23.5%) stepwise provisional and 70 of 237 (29.5%) dual-stent
patients (hazard ratio, 0.75 [95% CI, 0.53-1.07]; P=0.11). There was no
significant difference in all-cause mortality (10.0% versus 13.1%) or
myocardial infarction (12.2% versus 11.0%). However, target lesion
revascularization was significantly lower in the stepwise provisional
group (8.3% versus 15.6%; hazard ratio, 0.50 [95% CI, 0.29-0.86];
P=0.013). In this population, the mean side vessel diameter by
quantitative angiography was 2.9 mm, and median side vessel lesion length
was 5 mm. Significant interactions were identified between the assigned
bifurcation strategy and both side vessel diameter and lesion length with
respect to the primary outcome (P=0.009 and P=0.005, respectively), with
smaller vessels (<3.25 mm diameter) and shorter lesions (<10 mm length)
favoring the provisional approach. CONCLUSION(S): In a European
population with true left main stem bifurcation coronary disease requiring
intervention, there was no difference in major adverse cardiovascular
events between stepwise provisional and systematic dual-stent strategies
at 3 years. Target lesion revascularization was significantly less
frequent with the stepwise provisional approach, which should be the
default strategy for noncomplex left main bifurcation coronary
intervention. Copyright © 2025 American Heart Association, Inc.

<50>
Accession Number
2037977885
Title
Impact of Intensified Outpatient Follow-Up on Rehospitalization After
Transcatheter Aortic Valve Implantation: Results From the HOSPITAVI Trial.
Source
American Journal of Cardiology. 245 (pp 17-24), 2025. Date of Publication:
15 Jun 2025.
Author
Baekke P.S.; Jorgensen T.H.; Bieliauskas G.; Sondergaard L.; De Backer O.
Institution
(Baekke, Jorgensen, Bieliauskas, De Backer) The Heart Center, Copenhagen,
Rigshospitalet, Denmark
(Sondergaard) Abbott, Santa Clara, California, United States
Publisher
Elsevier Inc.
Abstract
Patients undergoing transcatheter aortic valve implantation (TAVI) are at
increased risk of rehospitalization in the early period after discharge
from TAVI. The HOSPITAVI study aimed to compare the impact of a standard
versus intensified outpatient follow-up on rehospitalization rates within
90 days after TAVI discharge. Patients were 1:1 randomized to either a
standard or intensified outpatient follow-up after TAVI discharge. The
primary endpoint was the 90-day hospital rehospitalization rate. In total,
300 patients were included: 150 patients were randomized to standard
follow-up and 150 patients to intensified outpatient follow-up. The study
population had a median age of 79 years, a median EuroSCORE II of 2.9%,
and 72% were discharged the day after TAVI. Within 90 days after
discharge, the mean number of all-cause hospital readmissions per patient
was 0.44 versus 0.35 (HR 0.8 [95% CI, 0.6-1.2], p = 0.23) in the standard
versus intensified group, respectively. The mean number of cardiovascular
(CV) readmissions per patient was 0.27 versus 0.15 (HR 0.6 [95% CI,
0.4-1.0], p = 0.04) in the standard versus intensified group,
respectively. This resulted in a mean number of CV readmission days per
patient of 1.52 days versus 0.49 days within the first 90 days in the
standard versus intensified group, respectively (p < 0.05). Following TAVI
discharge, there was no significant difference in all-cause
rehospitalization rates using a standard versus intensified outpatient
follow-up approach. However, an intensified outpatient follow-up reduces
the burden of early CV rehospitalization after TAVI discharge.
(Rehospitalization after transcatheter aortic valve implantation
[HOSPITAVI]; NCT05670041). Copyright © 2025 The Author(s)

<51>
Accession Number
2037938909
Title
Prospective Randomized Comparative Study of Outcomes in Off-Pump CABG with
Low Ejection Fraction (<40%), Priorly Optimized With Levosimendan versus
Dobutamine.
Source
European Journal of Cardiovascular Medicine. 15(3) (pp 516-521), 2025.
Date of Publication: 01 Mar 2025.
Author
Chenikala S.; Nagiredi N.R.; Ahmed S.; Banda D.P.
Institution
(Chenikala) Department of Cardiovascular and Thoracic Surgery, KIMS
Hospital, Andhrapradesh, Srikakulam, India
(Nagiredi, Ahmed) Department of Cardiothoracic and Vascular Surgery,
Yashoda Hospital, Secunderabad, India
(Banda) Department of Cardiothoracic and vascular Surgery, Yashoda
Hospital, Malakpet, India
Publisher
Healthcare Bulletin
Abstract
Background: Coronary artery bypass grafting in patients with reduced left
ventricular function remains a surgical challenge. Inotropes may improve
hemodynamics in patients with low cardiac output syndrome. This study
testifies the hypothesis that prior optimization with Levosimendan
produces beneficial hemodynamic effects during and after off- pump CABG
(OPCAB) in patients with low ejection fraction compared with Dobutamine.
 Method(s): This is a prospective and randomized study was conducted
Department of Cardiothoracic surgery at Yashoda hospital, Secunderabad.
Total 100 patients of which 50 patients were randomized to Dobutamine
group and 50 patients to Levosimendan group. All-cause mortality,
haemodynamic improvement at the end of the drug infusion and Major adverse
cardiac and cerebrovascular events (MACCEs) were analysed. Result(s):
The mean age of the patients was 55.56+/-7.73 in Dobutamine group and
55.24+/-7.99 in Levosimendan group (p=0.83). The baseline characteristics
were compared between the groups and were found to be statistically
insignificant. Intraoperative characteristics were analysed between the
groups. Significant difference were observed between the groups in the
usage of grafts (Dobutamine 3.38+/-0.85 vs Levosimendan 3.68+/-0.68),
p=0.05. One (2%) mortality was observed in Dobutamine group and none in
Levosimendan group (p=0.31) with no statistically significant difference
between the groups. Atrial fibrillation occurred more in Dobutamine group
(22%) compared to Levosimendan group (8%) (p=0.04), means of Ventilator
support (p=0.03), means of ICU (p=0.002) and hospital stay (p=0.04) were
more in Dobutamine group compare to Levosimendan group. MAP (P=0.0001),
MPAP (0.0001) and mPCWP (0.0001) showed significant differences favouring
the use of Levosimendan over Dodutamine after 12 hrs of infusion.
 Conclusion(s): Pre-treatment with Levosimendan in patients undergoing
surgical myocardial revascularization with left ventricular dysfunction
resulted in lower postoperative mortality, a shorter length of Ventilator
support, ICU stay and hospital stay with significant improvement in
cardiac indices compared with Dobutamine treatment. Copyright ©
2025 Healthcare Bulletin. All rights reserved.

<52>
Accession Number
2035934552
Title
The Effects of Different Ciprofol Doses on Hemodynamics During Anesthesia
Induction in Patients Undergoing Cardiac Surgery: A Randomized,
Double-Blind, Controlled Study.
Source
Drug Design, Development and Therapy. 19 (pp 1671-1679), 2025. Date of
Publication: 2025.
Author
Zhou Y.; Liu Z.; Li Q.; Ni P.; Li Z.; Yang J.; Xie Y.; Yu B.; Zhang M.
Institution
(Zhou, Liu, Li, Ni, Yang, Xie, Zhang) Department of Anesthesiology, The
First Affiliated Hospital of USTC, Division of Life Sciences and Medicine,
University of Science and Technology of China, Anhui, Hefei, China
(Li, Yu) First Clinical Medical College, Gannan Medical University,
Jiangxi, Ganzhou, China
Publisher
Dove Medical Press Ltd
Abstract
Objective: To evaluate the effects of different ciprofol doses on
hemodynamics in patients undergoing cardiac surgery. Method(s): 209
patients were randomly divided into four groups: 0.2 mg/kg etomidate group
(group E, n = 50), 0.2 mg/kg, 0.3mg/kg, 0.4mg/kg ciprofol group (group A,
n = 53, group B, n = 51, group C, n = 54). Mean arterial pressure (MAP),
heart rate (HR), cardiac output (CO), stroke volume (SV), systemic
vascular resistance (SVR), and bispectral index were recorded at the
following time points: 5 minutes after entering the operating room
(T<inf>0</inf>); before anesthesia induction (T<inf>1</inf>); immediately
after induction (T<inf>2</inf>); 1 minute and 2 minutes after induction
(T<inf>3</inf> ~T<inf>4</inf>); at intubation (T<inf>5</inf>); 1 minute, 3
minutes, 5 minutes and 10 minutes after intubation (T<inf>6</inf>
~T<inf>9</inf>); at skin incision (T<inf>10</inf>). The incidence of
hypotension and bradycardia and the doses of vasoactive drugs were
recorded. Result(s): Compared with T<inf>0</inf>, HR, MAP, SV, CO all
decreased to varying degrees after administration, and the decrease time
in Group B and Group C were earlier than that in other two groups (P <
0.05). SVR increased slowly after T<inf>4</inf> in all groups, but there
was no significant differences (P > 0.05). Compared with group E, the
norepinephrine dose was significantly lower in groups A and B (both P <
0.05). Group C showed a greater decline in CO and SV than the other three
groups from T<inf>7</inf> to T<inf>10</inf> (P < 0.05), while there was no
significant difference between groups A and E in CO and groups A, B, and E
in SV (P > 0.05). No significant differences were observed in MAP, SVR,
and the incidences of hypotension and bradycardia among the four groups (P
> 0.05). Conclusion(s): 0.2 mg/kg ciprofol has the least impact on
hemodynamics in patients undergoing cardiac surgery, and reduced
norepinephrine use. Copyright © 2025 Zhou et al.

<53>
Accession Number
2037186026
Title
Continuous serratus anterior block for sternotomy analgesia after cardiac
surgery: a single-centre feasibility study.
Source
British Journal of Anaesthesia. 134(4) (pp 1161-1169), 2025. Date of
Publication: 01 Apr 2025.
Author
Bailey J.G.; Hendy A.; Neira V.; Chedrawy E.; Uppal V.
Institution
(Bailey, Hendy, Neira, Uppal) Department of Anesthesia, Pain Management &
Perioperative Medicine, Dalhousie University, Halifax, NS, Canada
(Chedrawy) Division of Cardiac Surgery, Dalhousie University, Halifax, NS,
Canada
Publisher
Elsevier Ltd
Abstract
Background: Moderate-to-severe pain is common after cardiac surgery,
peaking during the first and second postoperative days. Several nerve
blocks for sternotomy have been described; however, the optimal location
for continuous catheters has not been established. This study assessed the
feasibility of a larger trial evaluating the efficacy of serratus anterior
plane (SAP) catheter analgesia for sternotomy pain. Method(s): This
double-blinded trial included patients undergoing cardiac surgery via
sternotomy. Bilateral SAP catheters were placed in all participants, and
randomised to ropivacaine or placebo. We assessed feasibility based on
predetermined endpoints: (1) average recruitment rate >4 per month; (2)
protocol adherence rate >90%; (3) primary outcome measurement rate >90%;
and (4) significant catheter-related adverse event rate <=2%. The quality
of recovery index (QoR-15) was compared using an independent t-test.
 Result(s): Of 52 participants randomised, feasibility data were
available for 50. A definitive study was deemed 'not feasible' in our
standalone centre owing to a low recruitment rate (2.4 per month) and a
high adverse event rate (pneumothorax rate 12%). There were no major
protocol deviations but minor deviations in 12% of participants. Pain,
opioid consumption, complications, and quality of recovery were not
different between groups. Long-term pain at 3 months was low in both
groups. Conclusion(s): A single-centre trial was deemed not feasible
for our setting. With limited data, the quality of recovery was not
different with ropivacaine dosing of bilateral SAP catheters for
sternotomy pain. Clinical trial registration: NCT04648774. Copyright
© 2025 The Author(s)

<54>
Accession Number
2036442680
Title
Goal-directed Perfusion to Reduce Acute Kidney Injury After Pediatric
Cardiac Operation.
Source
Annals of Thoracic Surgery. 119(4) (pp 891-898), 2025. Date of
Publication: 01 Apr 2025.
Author
Long F.; Zhang Y.; Luo M.; Liu T.; Qin Z.; Wang B.; Zhou Y.; Zhou R.
Institution
(Long, Zhang, Luo, Liu, Qin, Wang, Zhou) Department of Anesthesiology,
West China Hospital of Sichuan University, Sichuan, Chengdu, China
(Zhou) Department of Clinical Medicine, Henan Medical College of Zhengzhou
University, Zhengzhou, China
Publisher
Elsevier Inc.
Abstract
Background: Although goal-directed perfusion (GDP) during cardiopulmonary
bypass (CPB) has been discussed extensively in adult studies, no pediatric
indexed oxygen delivery (DO<inf>2</inf>i) thresholds are universally
accepted, and no pediatric randomized controlled trial has been reported.
This study aimed to determine whether the GDP initiative (maintaining
DO<inf>2</inf>i >=360 mL/min/m2 during CPB) could reduce the
incidence of acute kidney injury (AKI) after pediatric cardiac operation
and improve clinical outcomes. Method(s): This single-center
randomized controlled trial enrolled 312 pediatric patients, who were
randomized to receive either the GDP strategy or a conventional perfusion
strategy during CPB. The primary outcome was the rate of postoperative
AKI. Secondary outcomes included major postoperative complications,
all-cause mortality within 30 days, and short-term clinical outcomes after
operation. Result(s): AKI occurred in 43 patients (28.1%) in the GDP
group and in 65 patients (42.2%) in the control group (relative risk,
0.67; 95% CI, 0.49-0.91; P =.010). In the subgroup analysis, the GDP group
had a lower AKI rate compared with the control group among patients aged
less than 1 year, with a nadir temperature greater than 32 degreeC and a
nadir hemoglobin value less than 8 g/L during CPB, with preoperative
cyanosis, and with CPB duration from 60 to 120 minutes.
 Conclusion(s): The GDP strategy aimed at maintaining DO<inf>2</inf>i
>=360 mL/min/m2 during CPB is effective in reducing the risk of
AKI after pediatric cardiac operation. Copyright © 2025 The
Society of Thoracic Surgeons

<55>
Accession Number
2033587666
Title
Clinical Outcomes of Immediate Versus Staged Revascularization of
Nonculprit Arteries in Patients With Acute Coronary Syndrome: A Systematic
Review and Meta-Analysis.
Source
Clinical Cardiology. 48(3) (no pagination), 2025. Article Number: e70105.
Date of Publication: 01 Mar 2025.
Author
Yasmin F.; Zaidi S.F.; Moeed A.; Shahzad M.; Asghar M.S.; Sadiq M.; Iqbal
J.; Surani S.; Alraies M.C.
Institution
(Yasmin) Yale School of Medicine, New Haven, CT, United States
(Zaidi, Moeed, Shahzad, Sadiq) Dow Medical College, Karachi, Pakistan
(Asghar) AdventHealth, Sebring, FL, United States
(Iqbal) Nursing Department, Hamad Medical Corporation, Doha, Qatar
(Surani) Texas A&M University, College Station, TX, United States
(Alraies) Detroit Medical Center, Cardiovascular Institute, DMC Heart
Hospital, Detroit, MI, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Recent guidelines for acute coronary syndrome (ACS) with
multivessel coronary artery disease (MVD) recommend revascularization of
non-culprit lesions following primary percutaneous coronary intervention
(PCI). However, the optimal timing for this procedure-whether immediate or
staged-remains uncertain. Method(s): A comprehensive search using
PubMed (MEDLINE), Cochrane Central, and Google Scholar was conducted to
identify studies comparing clinical outcomes between immediate and staged
revascularization approaches in patients with MVD undergoing PCI. A random
effects model was used to calculate risk ratios (RRs) for dichotomous
outcomes with 95% confidence intervals (CIs). The primary outcome was
1-year all-cause mortality. Result(s): A total of 10 randomized
controlled trials (RCTs), comprising 3886 patients (1964 in the immediate
revascularization group and 1940 in the staged revascularization group),
with a median follow-up of 12 months, were included in the analysis. No
significant difference in the risk of 1-year mortality was noted between
the two approaches. The risk of target vessel revascularization (TVR) at
1-year follow-up was significantly lower in the immediate
revascularization group compared to the staged revascularization group
(RR: 0.64; 95% CI: 0.47-0.86; I2: 0%; p = 0.03). Additionally, the
immediate revascularization group had a significantly lower risk of
myocardial infarction (MI) at 1-year follow-up than the staged approach
(RR: 0.57; 95% CI: 0.37-0.88; I2: 10%; p = 0.01). Conclusion(s): This
meta-analysis suggests that immediate revascularization is associated with
a significantly lower risk of TVR and MI at 1-year compared to staged
revascularization. Copyright © 2025 The Author(s). Clinical
Cardiology published by Wiley Periodicals, LLC.

<56>
Accession Number
2032823852
Title
Perioperative esketamine combined with butorphanol versus butorphanol
alone for pain management following video-assisted lobectomy: a randomized
controlled trial.
Source
International Journal of Clinical Pharmacy. 47(2) (pp 452-461), 2025. Date
of Publication: 01 Apr 2025.
Author
Wang H.; Wang Z.; Zhang J.; Wang X.; Fan B.; He W.; Hu X.
Institution
(Wang, Fan, Hu) Department of Anesthesiology, The Second Affiliated
Hospital of Anhui Medical University, No. 678 Furong Road, Hefei Economic
and Technological Development District, Anhui, Hefei, China
(Wang, Wang, Zhang, Wang, He) Department of Anesthesiology, The Second
People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical
University, Yaohai District, No. 246 Heping Road, Anhui, Hefei, China
(Wang) Fifth Clinical Medical College, Anhui Medical University, No. 81
Meishan Road, Shushan District, Anhui, Hefei, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: The analgesic efficacy of esketamine combined with butorphanol
in thoracoscopic surgery remains unclear. Aim(s): This study explored
the effects of perioperative esketamine combined with butorphanol versus
butorphanol alone on acute and chronic postoperative pain in patients who
underwent video-assisted lobectomy. Method(s): A total of 181
patients were enrolled, with 90 in the esketamine-butorphanol group (Group
BK) receiving intraoperative esketamine infusion and postoperative
patient-controlled intravenous analgesia (PCIA) (esketamine 1.5 mg/kg,
butorphanol 0.15 mg/kg, azasetron 20 mg). The remaining 91 patients in the
butorphanol group (Group B) received normal saline and PCIA with
butorphanol (0.15 mg/kg) and azasetron (20 mg). Primary endpoints included
Visual Analog Scale (VAS) scores in the first week and chronic pain
incidence at three months. Secondary endpoints included intraoperative
vital signs, morphine consumption, postoperative adverse events, and
15-item Quality of Recovery-15 (QoR-15) scores. Result(s): Group BK
demonstrated significantly lower VAS scores within 48 h at rest and within
24 h during coughing postoperatively (P < 0.001). However, no significant
differences were observed in VAS scores [(Group B, 5 (0-12)) vs. (Group
BK, 5 (0-9)), P = 0.517] or chronic pain incidence [(Group B, 34.1%) vs.
(Group BK, 23.3%), P = 0.111] between the two groups at the three-month
follow-up. Patients in Group BK exhibited improved postoperative stability
of vital signs and higher QoR-15 scores. Conclusion(s): Perioperative
administration of esketamine significantly mitigates acute postoperative
pain and enhances recovery quality in patients undergoing video-assisted
lung resection. Trial registration: This trial protocol is registered with
ClinicalTrials.gov (NCT06398834, date: 2024-05-01). Copyright ©
The Author(s), under exclusive licence to Springer Nature Switzerland AG
2025.

<57>
Accession Number
2038063608
Title
Different antithrombotic strategies after left atrial appendage closure
with the LACbes occluder: Protocol of the DAAL trial.
Source
BMJ Open. 15(3) (no pagination), 2025. Article Number: e084351. Date of
Publication: 18 Mar 2025.
Author
Zhang T.; Zhou J.; Zhang K.; Zhang C.; Chen K.; Han Z.; Tang Z.; Zhang Z.;
Zhang Q.; He Q.; Zhang J.
Institution
(Zhang, Zhou, Zhang, Zhang, Chen, Han, Tang, Zhang, Zhang, He, Zhang)
Department of Cardiology, Shanghai Jiao Tong University, School of
Medicine, Affiliated Ninth People's Hospital, Shanghai, China
Publisher
BMJ Publishing Group
Abstract
Introduction The purpose of this study is to evaluate the safety and
efficacy of two different antithrombotic strategies, dual antiplatelet
therapy (DAPT, aspirin and ticagrelor) and direct oral anticoagulant
(DOAC, rivaroxaban), after left atrial appendage closure (LAAC) using the
LACbes occluder. Methods and analysis This study is a prospective,
randomised, controlled and multicentre clinical trial that will compare
the clinical efficacy of antiplatelet and anticoagulation therapy after
LAAC with the LACbes occluder. It is planned to enrol 296 subjects with
non-valvular atrial fibrillation (NVAF) who complete transcatheter closure
of the left atrial appendage successfully. All subjects who pass the
screening process and sign informed consent forms will be randomised in a
1:1 ratio to the DAPT group (aspirin 100 mg/day and ticagrelor 90 mg two
times a day) or the DOAC group (rivaroxaban 15 mg/day). Baseline data
within 24 hours after the operation and follow-up information at 3, 6 and
12 months will be recorded to investigate the difference in the incidence
of device-related thrombosis, clinical thrombotic events, bleeding and
other adverse events. Ethics and dissemination Ethics approval has been
obtained from the Ethics Committee of Shanghai Ninth People's Hospital,
Shanghai Jiao Tong University School of Medicine, Shanghai, China
(Approval number SH9H-2022-T426-1). The protocol (Version: V1, 20230105)
has also been submitted and approved by the institutional ethics committee
at each participating centre. Results are expected in 2025 and will be
disseminated through peer-reviewed journals and presentations at national
and international conferences. Copyright © Author(s) (or their
employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use.
See rights and permissions. Published by BMJ Group.

<58>
Accession Number
2038099793
Title
Protocol and design of the REPOSE study: A double-blinded, randomised,
placebo-controlled trial to evaluate the efficacy of suvorexant to improve
postoperative sleep and reduce delirium severity in older patients
undergoing non-cardiac surgery.
Source
BMJ Open. 15(3) (no pagination), 2025. Article Number: e091099. Date of
Publication: 13 Mar 2025.
Author
Fallon J.M.; Hashemaghaie M.; Peterson C.E.; Tran D.; Wu S.R.; Valdes
J.M.; Pedicini N.M.; Adams M.E.; Soltis M.; Mansour W.; Wright M.C.;
Raghunathan K.; Treggiari M.M.; Sasannejad C.; Devinney M.J.
Institution
(Fallon, Valdes, Pedicini) Duke University, Trinity College of Arts and
Sciences, Durham, NC, United States
(Hashemaghaie, Peterson, Adams, Wright, Raghunathan, Treggiari, Devinney)
Department of Anesthesiology, Duke University School of Medicine, Durham,
NC, United States
(Tran) Louisiana State University School of Medicine, New Orleans, LA,
United States
(Wu) Duke University Pratt School of Engineering, Durham, NC, United
States
(Soltis, Sasannejad) Department of Neurology, Duke University School of
Medicine, Durham, NC, United States
(Mansour) Department of Medicine, Duke University School of Medicine,
Durham, NC, United States
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative delirium occurs in up to 40% of older surgical
patients and has been associated with prolonged hospital stays, long-Term
cognitive impairment and increased 1-year postoperative mortality.
Postoperative sleep disturbances may increase the risk of delirium, but
studies investigating pharmacotherapies to improve postoperative sleep to
prevent delirium remain limited. Suvorexant is a selective antagonist of
orexin 1 and 2 receptors and is approved for insomnia pharmacotherapy by
the Food and Drug Administration. It has the potential to improve
postoperative sleep and reduce postoperative delirium rates, but
randomised controlled trials (RCTs) are needed to determine the efficacy
of postoperative suvorexant administration. The REPOSE study (reducing
delirium by enhancing postoperative sleep with suvorexant) is a
single-centre, randomised, double-blinded RCT that aims to evaluate the
efficacy of suvorexant in increasing total sleep time (TST) and decreasing
delirium severity in older patients undergoing non-cardiac surgery.
Methods and analysis REPOSE will enroll 130 patients (aged >=65 years)
undergoing non-cardiac surgery with a planned postoperative inpatient
stay. Participants will be randomised to receive 20 mg oral suvorexant or
placebo nightly on postoperative nights 0, 1 and 2. The primary endpoint
is TST on the first postoperative night, as measured using an
electroencephalography headband. The secondary endpoint is peak
postoperative delirium severity as measured by the 3-minute diagnostic
interview for the confusion assessment method severity scores. Primary
endpoint data will be analysed with a two-sample t-Test using an
intent-To-Treat approach to compare TST on the first night that a patient
received a study drug dose. Secondary and exploratory endpoint data will
be analysed using two-sample t-Tests between groups. Ethics and
dissemination Ethical approval was obtained from the Duke Institutional
Review Board (protocol #00111869). Results of the REPOSE study will be
published in a peer-reviewed journal and presented at academic
conferences. Trial data will be deposited in ClinicalTrials.gov. Trial
registration number NCT05733286. Copyright © 2025 BMJ Publishing
Group. All rights reserved.

<59>
Accession Number
2038130004
Title
Postoperative Brain Attack: Current Perspectives and Future Directions.
Source
Seminars in Thoracic and Cardiovascular Surgery. (no pagination), 2025.
Date of Publication: 2025.
Author
Quinlan M.; Arora R.; Cho S.M.
Institution
(Quinlan, Cho) Division of Neurosciences Critical Care, Department of
Anesthesiology & Critical Care Medicine, Johns Hopkins University School
of Medicine, Baltimore, Maryland, United States
(Quinlan, Cho) Department of Neurology, Johns Hopkins University School of
Medicine, Baltimore, Maryland, United States
(Quinlan, Arora, Cho) Case Western Reserve University, Department of
Surgery, Cleveland, Ohio, United States
(Arora) Harrington Heart and Vascular Institute, Division of Cardiac
Surgery, University Hospitals, Cleveland, Ohio, United States
(Cho) Division of Cardiac Surgery, Department of Surgery, Johns Hopkins
University School of Medicine, Baltimore, Maryland, United States
Publisher
W.B. Saunders
Abstract
The incidence of stroke after cardiac surgery poses significant
challenges. This expert review piece explores current knowledge,
challenges, future directions, and offers insights into improving patient
outcomes through optimal prevention, early recognition, and management
strategies. By addressing the challenges and opportunities in this area,
we can enhance patient care, reduce long-term disabilities, and improve
the overall quality of life for affected individuals. This expert review
aims to provide a comprehensive framework for managing postoperative
stroke: mechanisms, risk factors, diagnosis, treatment, systems of care,
and ethical considerations. Copyright © 2025 Elsevier Inc.

<60>
Accession Number
2032214947
Title
Review of Association between Urinary Tract Infections and
Immunosuppressive Drugs after Heart Transplantation.
Source
Reviews on Recent Clinical Trials. 20(1) (pp 18-26), 2025. Date of
Publication: 2025.
Author
Tolou-Ghamari Z.
Institution
(Tolou-Ghamari) Nutrition and Food Security Research Center, Deputy of
Research and Technology, Isfahan University of Medical Sciences, Isfahan,
Iran, Islamic Republic of
Publisher
Bentham Science Publishers
Abstract
Management of infections in heart transplant recipients is complex and
crucial. In this population, there is a need for a better understanding of
immunosuppressive trough levels (C0), infectious complications, and
urinary tract infections (UTIs). The purpose of this review was to
understand the association between immunosuppressive trough levels and
UTIs after heart transplantation. A review of scientific literature (n=
100) was conducted based on the topic of interest by searching PUBMED.Gov
(https://pubmed.ncbi.nlm.nih.gov/), Web of Science, and Scopus. The
analysis of bacterial pulmonary infection required the occurrence of new
or deteriorating pulmonary infiltrates and the development of organisms in
cultures of sputum specimens. The diagnosis of UTIs was based on the
result of related signs, pyuria, and a positive urine culture. The
incidence of UTIs was reported as 0.07 episodes/1000 regarding heart
transplantation days. An eightfold increase in the rate of rejection was
noted in heart transplant recipients with higher variability in tacrolimus
C0. There are associations between C0 of immunosuppressive drugs and
clinical presentation of infection complications. Recipients with a low
metabolism of immunosuppressive drugs are more susceptible to infectious
complications. Attention to the biology of herpes viruses, Escherichia
coli, Enterococcus spp., Pseudomonas aeruginosa, and Staphylococcus
saprophyticus after heart transplantation are important, in which some of
them are the most common pathogens responsible for UTIs. Pneumocystis and
cytomegalovirus affect all transplant recipients. Pneumonia due to
bacterial, viral, protozoa, and fungal infections, in addition to UTIs,
are more specific reported types of infections in heart transplant
recipients. Bacterial infections produced by extensively drug-resistant
Enterobacteriaceae, vancomycin-resistant enterococci, and non-fermenting
gram-negative bacteria were reported to increase after
transplantation. Copyright © 2025 Bentham Science Publishers.

<61>
Accession Number
2036017338
Title
Transcatheter Edge-to-Edge Repair for Severe Mitral Regurgitation in
Patients With Cardiogenic Shock: A Systematic Review and Meta-Analysis.
Source
Journal of the American Heart Association. 14(6) (no pagination), 2025.
Article Number: e034932. Date of Publication: 18 Mar 2025.
Author
Dimitriadis K.; Soulaidopoulos S.; Pyrpyris N.; Sagris Mu.; Aznaouridis
K.; Beneki E.; Theofilis P.; Tsioufis P.; Tatakis F.; Fragkoulis C.; Shuvy
M.; Chrysohoou C.; Aggeli K.; Tsioufis K.
Institution
(Dimitriadis, Soulaidopoulos, Pyrpyris, Sagris, Aznaouridis, Beneki,
Theofilis, Tsioufis, Tatakis, Fragkoulis, Chrysohoou, Aggeli, Tsioufis)
First Cardiology Department, Hippokration General Hospital, School of
Medicine, National and Kapodistrian University of Athens, Athens, Greece
(Shuvy) Jesselson Integrated Heart Centre, Shaare Zedek Medical Center and
Faculty of Medicine, Hebrew University, Jerusalem, Israel
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Patients with severe mitral regurgitation and cardiogenic
shock demonstrate a poor prognosis. Mitral transcatheter edge-to-edge
repair could alter patient management. METHODS AND RESULTS: We
systematically reviewed PubMed/Medline, Scopus, and Cochrane Library until
January 2023, including studies assessing transcatheter edge-to-edge
repair in patients with severe mitral regurgitation and cardiogenic shock.
Studies with <5 patients were excluded. The primary outcome was device
success and all-cause death, while secondary outcomes included myocardial
infarction, stroke, and heart failure hospitalization rates at 30-day and
intermediate-term follow-up. A fixed-effects meta-analysis was used to
estimate pooled rates. Risk of bias was assessed with the Newcastle-
Ottawa Scale. A total of 24 studies and 5428 patients were included, with
a mean age of 71.2+/-3.3 years and a high mean Society of Thoracic Surgery
score (15.2+/-8.9). Device success was achieved in 86% (95% CI, 85%-87%)
and mitral regurgitation <=2+ in 89% (95% CI: 88%-90%). The 30-day
all-cause mortality rate was 14% (95% CI, 13%-15%). Stroke, myocardial
infarction, and heart failure hospitalization rates were 2% (95% CI,
1%-2%), 15% (95% CI, 13%-18%), and 9% (95% CI, 8%- 10%), respectively.
Patients with acute myocardial infarction had similar device success (81%
[95% CI, 74%-87%]), a 30-day mortality rate of 20% (95% CI, 16%-25%), and
intermediate-term mortality rate of 14% (95% CI, 9%-19%). In
non-myocardial infarction populations, the 30-day mortality rate was 13%
(95% CI, 13%-14%), and the intermediate-term mortality rate was 35% (95%
CI, 34%-36%). CONCLUSION(S): In patients with mitral regurgitation
and cardiogenic shock, transcatheter edge-to-edge repair is associated
with favorable 30-day and intermediate-term outcomes. Limitations,
including the observational design of included studies and considerable
heterogeneity, necessitate further research in this setting. Copyright
© 2025 The Author(s). Published on behalf of the American Heart
Association, Inc., by Wiley.

<62>
Accession Number
2038114003
Title
Perioperative Bleeding Is Not an Independent Risk Factor for Acute Kidney
Injury in On-pump Cardiac Surgery-A Post-hoc Analysis of a Randomized
Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Vlasov H.E.; Petaja L.M.; Wilkman E.M.; Talvasto A.T.; Ilmakunnas M.K.;
Raivio P.M.; Hiippala S.T.; Suojaranta R.T.; Juvonen T.S.; Pesonen E.J.
Institution
(Vlasov, Petaja, Wilkman, Talvasto, Ilmakunnas, Hiippala, Suojaranta,
Pesonen) Department of Anesthesiology and Intensive Care Medicine,
University of Helsinki and Helsinki University Hospital, Helsinki, Finland
(Ilmakunnas) Finnish Red Cross Blood Service, Finland
(Raivio, Juvonen) Department of Cardiac Surgery, Heart and Lung Center,
University of Helsinki and Helsinki University Hospital, Helsinki, Finland
Publisher
W.B. Saunders
Abstract
Objectives: To study the association between bleeding and acute kidney
injury (AKI). Design(s): Post-hoc study of a randomized trial of 4%
albumin versus Ringer's acetate for cardiopulmonary bypass priming and
perioperative volume replacement. Setting(s): Single-center study.
 Patient(s): 1,386 on-pump cardiac surgical patients. Measurements and
Results: AKI was defined by the Kidney Disease: Improving Global Outcomes
creatinine criteria, and bleeding by the Universal Definition of
Perioperative Bleeding (UDPB) classification. With univariably independent
factors, two logistic regression analyses (Model 1: AKI Risk Score,
EuroSCORE II, and UDPB class; Model 2: risk scores, components of the UDPB
classification, and factor VIII/von Willebrand factor concentrate) and a
mediation analysis (Model 3: risk scores, UDPB class, and perioperative
factors) were performed. A total of 139 (10%) patients developed AKI. In
Model 1, UDPB class "severe" (odds ratio: 2.16, 95% confidence interval:
1.19-3.89), "massive" bleeding (6.78, 1.8-25.33), and AKI Risk Score
(1.51, 1.29-1.78) were associated with AKI. In Model 2, AKI Risk Score
(1.55, 1.33-1.82) and fresh frozen plasma transfusion (1.29, 1.06-1.58)
were associated with AKI. In Model 3, the combined UDPB classes "severe"
and "massive" bleeding did not have a direct effect (regression
coefficient: 0.32, 95% confidence interval: -0.26 to 0.91), while mean
arterial pressure (0.08, 0.003-0.21) and fluid balance (0.12, 0.17-0.27)
had indirect effects on AKI. Conclusion(s): In on-pump cardiac
surgery, perioperative bleeding was not an independent risk factor for AKI
but manifested as AKI via hypotension and higher fluid balance. Prevention
of bleeding may reduce AKI in cardiac surgery. Copyright © 2025
The Author(s)

<63>
Accession Number
2036017347
Title
Impact of Lipoprotein(a) on Valvular and Cardiovascular Outcomes in
Patients With Calcific Aortic Valve Stenosis.
Source
Journal of the American Heart Association. 14(6) (no pagination), 2025.
Article Number: e038955. Date of Publication: 18 Mar 2025.
Author
Girard A.S.; Paulin A.; Manikpurage H.D.; Lajeunesse E.; Clavel M.-A.;
Pibarot P.; Krege J.H.; Mathieu P.; Theriault S.; Arsenault B.J.
Institution
(Girard, Paulin, Manikpurage, Lajeunesse, Clavel, Pibarot, Mathieu,
Theriault, Arsenault) Centre de recherche de l'Institut universitaire de
cardiologie et de pneumologie de Quebec-Universite Laval, Quebec, QC,
Canada
(Clavel, Pibarot, Arsenault) Department of Medicine, Faculty of Medicine,
Universite Laval, Quebec, QC, Canada
(Krege) Eli Lilly, Indianapolis, IN, United States
(Mathieu) Department of Surgery, Faculty of Medicine, Faculty of Medicine,
Universite Laval, Quebec, QC, Canada
(Theriault) Department of Molecular Biology, Medical Biochemistry and
Pathology, Faculty of Medicine, Universite Laval, Quebec, QC, Canada
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Lp(a) (lipoprotein(a)) is an independent risk factor for
calcific aortic valve stenosis (CAVS). Whether patients with CAVS and high
Lp(a) levels are at higher risk of valvular or cardiovascular events is
unknown. The aim of this study is to determine whether higher Lp(a) levels
are associated with valvular and cardiovascular outcomes in patients with
CAVS. METHODS AND RESULTS: We identified 1962 patients from the UK Biobank
with an electronic health record or self-reported CAVS diagnosis but who
did not previously undergo aortic valve replacement (AVR) and had a
minimal follow-up time of 2.5 years. Cox proportional hazard regression
was used to evaluate the effect of Lp(a) on AVR, AVR or cardiac death, and
valvular or cardiovascular events (AVR, cardiac death, myocardial
infarction, stroke, heart failure, or coronary artery bypass grafting).
The maximal follow-up time was set to 5 years. During the follow-up, 198
patients underwent AVR, 260 had AVR or cardiac death, and 435 had at least
1 valvular or cardiovascular event. Patients with Lp(a) levels >=125
versus <125 nmol/L were at higher risk of AVR (hazard ratio [HR], 1.58
[95% CI, 1.17-2.12]), AVR or cardiac death (HR, 1.43 [95% CI, 1.10-1.86]),
and cardiovascular or valvular events (HR, 1.36 [95% CI, 1.11-1.68]).
Point estimates were comparable in men versus women, younger versus older
patients, and in patients with higher versus lower plasma C-reactive
protein levels. CONCLUSION(S): In patients with CAVS, Lp(a) levels
predicted a higher risk of valvular and cardiovascular outcomes. The
impact of Lp(a)-lowering therapies on valvular and cardiovascular health
should be assessed in a long-term randomized clinical trial. Copyright
© 2025 The Author(s).

<64>
Accession Number
2034059495
Title
Combination of urinary biomarkers can predict cardiac surgery-associated
acute kidney injury: a systematic review and meta-analysis.
Source
Annals of Intensive Care. 15(1) (no pagination), 2025. Article Number: 45.
Date of Publication: 01 Dec 2025.
Author
Kiss N.; Papp M.; Turan C.; Koi T.; Madach K.; Hegyi P.; Zubek L.; Molnar
Z.
Institution
(Kiss, Papp, Turan, Koi, Madach, Hegyi, Zubek, Molnar) Centre for
Translational Medicine, Semmelweis University, 78 Ulloi Str., Budapest,
Hungary
(Kiss) Heart and Vascular Centre, Semmelweis University, Budapest, Hungary
(Kiss, Papp, Turan, Madach, Zubek, Molnar) Department of Anaesthesiology
and Intensive Therapy, Semmelweis University, Budapest, Hungary
(Papp) Department of Anaesthesiology and Intensive Therapy, Saint John's
Hospital, Budapest, Hungary
(Koi) Department of Stochastics, Budapest University of Technology and
Economics, Budapest, Hungary
(Hegyi) Institute for Translational Medicine, Medical School, University
of Pecs, Pecs, Hungary
(Hegyi) Institute of Pancreatic Diseases, Semmelweis University, Budapest,
Hungary
(Molnar) Poznan University of Medical Sciences, Poznan, Poland
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Introduction: Acute kidney injury (AKI) develops in 20-50% of patients
undergoing cardiac surgery (CS). We aimed to assess the predictive value
of urinary biomarkers (UBs) for predicting CS-associated AKI. We also
aimed to investigate the accuracy of the combination of UB measurements
and their incorporation in predictive models to guide physicians in
identifying patients developing CS-associated AKI. Method(s): All
clinical studies reporting on the diagnostic accuracy of individual or
combined UBs were eligible for inclusion. We searched three databases
(MEDLINE, EMBASE, and CENTRAL) without any filters or restrictions on the
11th of November, 2022 and reperformed our search on the 3rd of November
2024. Random and mixed effects models were used for meta-analysis. The
main effect measure was the area under the Receiver Operating
Characteristics curve (AUC). Our primary outcome was the predictive values
of each individual UB at different time point measurements to identify
patients developing acute kidney injury (KDIGO). As a secondary outcome,
we calculated the performance of combinations of UBs and clinical models
enhanced by UBs. Result(s): We screened 13,908 records and included
95 articles (both randomised and non-randomised studies) in the analysis.
The predictive value of UBs measured in the intraoperative and early
postoperative period was at maximum acceptable, with the highest AUCs of
0.74 [95% CI 0.68, 0.81], 0.73 [0.65, 0.82] and 0.74 [0.72, 0.77] for
predicting severe CS-AKI, respectively. To predict all stages of CS-AKI,
UBs measured in the intraoperative and early postoperative period yielded
AUCs of 0.75 [0.67, 0.82] and 0.73 [0.54, 0.92]. To identify all and
severe cases of acute kidney injury, combinations of UB measurements had
AUCs of 0.82 [0.75, 0.88] and 0.85 [0.79, 0.91], respectively.
 Conclusion(s): The combination of urinary biomarkers measurements
leads to good accuracy. Copyright © The Author(s) 2025.

<65>
Accession Number
2034065399
Title
A Current Perspective on Left Atrial Appendage Closure Device Infections:
A Systematic Review.
Source
PACE - Pacing and Clinical Electrophysiology. (no pagination), 2025. Date
of Publication: 2025.
Author
Sener Y.Z.; Ozer S.F.; Karahan G.
Institution
(Sener) Department of Cardiology, Thoraxcentrum, Erasmus MC, Rotterdam,
Netherlands
(Ozer) Department of Cardiology, Karaman Training and Research Hospital,
Karaman, Turkey
(Karahan) Department of Infectious Diseases and Clinical Microbiology,
University of Health Sciences Gaziosmanpasa Training and Research
Hospital, Istanbul, Turkey
Publisher
John Wiley and Sons Inc
Abstract
Purpose: Left atrial appendage (LAA) closure has become the standard of
care for patients with atrial fibrillation (AF) at high risk of
thromboembolism who are intolerant or unwilling to take anticoagulants.
LAA occlusion device infection is a challenging complication, and there is
a paucity of data on the management and outcomes of LAA occlusion device
infection. We aimed to summarize the existing literature and highlight the
knowledge gap in this area. Method(s): A detailed search was
conducted through the databases PubMed/MEDLINE, EMBASE, Web of Science,
CINAHL, and Cochrane Central using the relevant keywords. All cases with
presented data regarding diagnosis, treatment, and outcome were included
from the reports. Result(s): The analysis included 12 case reports
encompassing a total of 12 patients. The mean age was 73.6 +/- 11.0 years,
and 50% of the cases were male. The most commonly implanted device was the
Watchman (in eight of the 12 cases). The median time between LAA closure
and infection was 6.6 (0.2-36) months. Transesophageal echocardiography
was diagnostic in all cases, and positron emission tomography/computed
tomography (PET/CT) was useful in diagnosis in three cases. The most
common pathogen was Staphylococcus aureus (n = 7). The LAAC device was
removed in seven cases; one patient refused surgery, and in the other
three cases, removal of the device was not considered appropriate due to
the patient's poor condition. Data on whether the device was removed could
not be retrieved for one patient. Mortality occurred in three cases (25%),
and all deaths occurred during hospitalization. Conclusion(s): LAA
closure device infections are rare but carry a high risk of complications
and mortality. Treatment should include device removal in appropriate
cases, and antibiotherapy alone should be considered only in selected
cases. Further studies are needed to clarify diagnostic and treatment
strategies based on the causative pathogens and patient
status. Copyright © 2025 Wiley Periodicals LLC.

<66>
Accession Number
2036004964
Title
Comparative Analysis of Ultrasound-Guided Pain Management Approaches for
Sternotomy in Cardiac Surgeries-Transversus Thoracic Muscle Plane Block vs
Pecto-Intercostal Fascial Block.
Source
Ochsner Journal. 25(1) (pp 11-16), 2025. Date of Publication: 01 Mar 2025.
Author
Vanjare H.; Deshmukh C.P.; Barasker S.K.; Kassim A.M.; Arya B.
Institution
(Vanjare, Barasker, Arya) Department of Anaesthesia, Sri Aurobindo Medical
College & PG Institute, Madhya Pradesh, Indore, India
(Deshmukh) Department of Community Medicine, Sri Aurobindo Medical College
& PG Institute, Madhya Pradesh, Indore, India
(Kassim) Department of Anaesthesia, Jawaharlal Institute of Postgraduate
Medical Education and Research, Pondicherry,, Tamil Nadu, India
Publisher
Ochsner Clinic
Abstract
Background: Pain management after sternotomy in cardiac surgery is vital
for recovery. Opioids are commonly used, but they carry risk. Central
neuraxial techniques and nerve blocks are options for a multimodality
approach. Fascial plane blocks such as the transversus thoracic muscle
plane block (TTMPB) and the pecto-intercostal fascial block (PIFB) are a
relatively new way to relieve pain, and their popularity has increased
with the use of ultrasound for precise anatomic visualization. Because the
effectiveness of both blocks is similar, we conducted this study to
compare the pain management of the TTMPB and the PIFB after sternotomy in
cardiac surgery. Method(s): This randomized double-blind study
included 118 patients who underwent cardiac surgery. In the TTMPB group
(n=59), 20 mL of 0.2% ropivacaine was injected bilaterally using
ultrasound assistance in the transversus thoracic plane. In the PIFB group
(n=59), 20 mL of 0.2% ropivacaine was injected in the pecto-intercostal
plane. Study outcomes were opioid consumption in the first 24 hours and
pain scores at 0, 3, 6, 12, and 24 hours postoperatively. Result(s):
Patient characteristics in the 2 groups were similar. Opioid consumption
was similar in both groups (P=0.672), and we found no difference in pain
scores between the 2 groups at any of the time intervals.
 Conclusion(s): The TTMPB and the PIFB were similarly effective in
treating acute poststernotomy pain in our patient
population. Copyright © 2025 by the author(s).

<67>
Accession Number
2034017681
Title
A Review on the Etiologies of the Development of Atrial Fibrillation After
Cardiac Surgery.
Source
Biomolecules. 15(3) (no pagination), 2025. Article Number: 374. Date of
Publication: 01 Mar 2025.
Author
Ballas C.; Katsouras C.S.; Tourmousoglou C.; Siaravas K.C.; Tzourtzos I.;
Alexiou C.
Institution
(Ballas, Tourmousoglou, Alexiou) Department of Cardiac Surgery, University
Hospital of Ioannina, Ioannina, Greece
(Katsouras, Siaravas) 1st Department of Cardiology, University Hospital of
Ioannina, Ioannina, Greece
(Tzourtzos) 2nd Department of Cardiology, University Hospital of Ioannina,
Ioannina, Greece
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Postoperative atrial fibrillation (POAF) is the most common arrhythmia
following cardiac surgery. This review critically explores the interplay
between cardiopulmonary bypass (CPB) and aortic cross-clamping (ACC) times
in POAF development. CPB disrupts systemic homeostasis by inducing
inflammatory cascades, oxidative stress, and ischemia-reperfusion injury.
Prolonged ACC times further exacerbate myocardial ischemia and structural
remodeling, with durations exceeding 60-75 min consistently linked to an
increased POAF risk. However, variability in outcomes across studies
reveals the complex, multifactorial nature of POAF pathogenesis.
Patient-specific variables, such as baseline comorbidities and myocardial
protection strategies, modulate these risks, emphasizing the need for
personalized surgical approaches. Despite advancements in myocardial
protection techniques and anti-inflammatory strategies, the incidence of
POAF remains persistently high, indicating a gap in translating
mechanistic insights into effective interventions. Emerging biomarkers,
including microRNAs (e.g., miR-21, miR-483-5p, etc.) and markers of
myocardial injury like troponin I, offer potential for enhanced risk
stratification and targeted prevention. However, their clinical
applicability requires further validation in diverse patient populations.
This review underscores the critical need for integrative research that
combines clinical, molecular, and procedural variables to elucidate the
nuanced interplay of factors driving POAF. Future directions include
leveraging advanced intraoperative monitoring tools, refining thresholds
for CPB and ACC times, and developing individualized perioperative
protocols. Copyright © 2025 by the authors.

<68>
Accession Number
2034059623
Title
Incidence of stroke in patients with atrial fibrillation undergoing
surgical treatment: a meta-analysis.
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
233. Date of Publication: 01 Dec 2025.
Author
Lin D.; Cheng Y.; Yu S.; Liu X.; Yan C.; Cheng W.
Institution
(Lin, Cheng, Yu, Liu, Yan, Cheng) Department of Cardiac Surgery, Southwest
Hospital, Third Military Medical University (Army Medical University),
Chongqing, China
Publisher
BioMed Central Ltd
Abstract
Introduction: Atrial fibrillation (AF) is self-limiting condition, but it
may also increase the risk of stroke and death. The association between AF
and surgery with stroke was assessed both subjectively and statistically
using systematic review and meta-analysis. Method(s): For data
collection, a thorough search was made in PubMed, EMBASE, Science Direct,
Google Scholar, and Cochrane Library using searching keywords
"postoperative ischemic stroke, atrial fibrillation, stroke, cardiac
surgery, brain ischemia, and heart surgery". Direct and indirect
comparisons were made using random-effect network meta-analysis.
 Result(s): 16-studies were identified comprising of 132,208 patient,
64% male, median age > 63 years and follow-up > 1.5 years. Pooling the
results from the random-effects model showed odds ratios associated with
the risk of stroke of surgical processes (CABG) in patients with AF. The
odds ratio OR = 1.1 (0.65-1.54, P < 0.001) and heterogeneity (I2 = 17%, P
= 0.13) exposing higher risk of the stroke. Odds ratio (HR 1.5, 0.9-1.71)
without heterogeneity showed greater risk of stroke after heart valve
surgery in patients with AF. Study 8 didn't show any risk of the stroke
after left atrial appendage (LAA) clipping intervention, but the outcomes
were biased. A pooled analysis showed odd ratio OR, 2 (1.7-2.1, P <
0.0001), without heterogeneity indicating higher stroke risk in general
cardiac surgery. The patients undergone cardiac surgery from three studies
with pooled analysis study-5 OR 2 (1.7-2.1, P > 0.001), study-6 OR 1.8
(1.7-1.9, P > 0.001), and study-14 OR 7.8 (6.2-8.1, P > 0.0001).
 Conclusion(s): The study clearly defines stroke outcomes when they
are quantified, however, further research is required. Copyright
© The Author(s) 2025.

<69>
Accession Number
2034025714
Title
Effect of Combined Vitamin C and Thiamine Therapy on Myocardial and
Inflammatory Markers in Cardiac Surgery: A Randomized Controlled Clinical
Trial.
Source
Nutrients. 17(6) (no pagination), 2025. Article Number: 1006. Date of
Publication: 01 Mar 2025.
Author
Saetang M.; Wasinwong W.; Oofuvong M.; Tanasansutthiporn J.;
Rattanapittayaporn L.; Petsakul S.; Duangpakdee P.; Rodneam P.; Boonthum
P.; Khunakanan S.; Churuangsuk C.; Sriwimol W.; Chantarokon A.; Nuanjun
K.; Yongsata D.
Institution
(Saetang, Wasinwong, Oofuvong, Tanasansutthiporn, Rattanapittayaporn,
Petsakul, Chantarokon, Nuanjun, Yongsata) Department of Anesthesiology,
Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
(Duangpakdee, Rodneam, Boonthum, Khunakanan) Department of Surgery,
Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
(Churuangsuk) Department of Internal Medicine, Faculty of Medicine, Prince
of Songkla University, Songkhla, Thailand
(Sriwimol) Department of Pathology, Faculty of Medicine, Prince of Songkla
University, Songkhla, Thailand
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Oxidative stress and systemic inflammation during cardiac
surgery can lead to postoperative complications. Although vitamin C and
thiamine (vitamin B1) have individually demonstrated protective effects,
their combined effects remain underexplored. This study aimed to evaluate
the efficacy of combined vitamin C and B1 therapy versus that of vitamin C
alone in reducing inflammatory and cardiac biomarkers and improving
postoperative outcomes in patients undergoing cardiac surgery.
 Method(s): In this prospective, double-blind, randomized controlled
trial, 64 patients scheduled for elective cardiac surgery at a tertiary
care center were randomized to receive either 1000 mg vitamin C or a
combination of 1000 mg vitamin C and 100 mg vitamin B1 at four
perioperative time points. Primary outcomes included changes in
inflammatory biomarkers [C-reactive protein, interleukin-6 (IL-6), and
white blood cells], and cardiac biomarkers [creatine kinase-MB,
Troponin-I, and lactate dehydrogenase]. Secondary outcomes included
hemodynamic parameters and left ventricular function. Result(s):
Compared with vitamin C alone, combined vitamin B1 and vitamin C
significantly reduced postoperative cardiac biomarker levels. IL-6 levels
were significantly lower immediately in the combined group; however, this
effect was not sustained at 24 h post-surgery. Up to 24 h after surgery,
no significant differences in hemodynamic stability or left ventricular
ejection were observed between the groups. Notably, the combined therapy
group demonstrated a lower incidence of postoperative arrhythmias and
shorter dobutamine duration within 24 postoperatively. Conclusion(s):
Combined vitamin C and B1 therapy significantly reduced markers of
myocardial injury and early inflammatory responses (IL-6) in patients
undergoing cardiac surgery, suggesting its potential as a protective
agent. Copyright © 2025 by the authors.

<70>
Accession Number
2034016057
Title
Real World Sex Differences in Patients Undergoing Ascending Aortic
Aneurysm Surgery-A Systematic Review and Meta-Analysis of Reconstructed
Time-to-Event Data.
Source
Journal of Clinical Medicine. 14(6) (no pagination), 2025. Article Number:
1908. Date of Publication: 01 Mar 2025.
Author
Al-Tawil M.; Geragotellis A.; Alroobi A.; Aboabdo M.; Alaila D.; Sulaiman
W.A.; Ghaben N.; Salim H.T.; Friedrich C.; Rusch R.; Haneya A.
Institution
(Al-Tawil, Haneya) Department of Cardiac and Thoracic Surgery, Heart
Center Trier, Krankenhaus der Barmherzigen Bruder, Trier, Germany
(Geragotellis) Faculty of Health Sciences, University of Cape Town, Cape
Town, Observatory, South Africa
(Alroobi, Aboabdo, Alaila, Sulaiman, Ghaben, Salim) Faculty of Medicine,
Al-Quds University, East Jerusalem, Palestine
(Friedrich) Department of Cardiovascular Surgery, University Hospital of
Schleswig-Holstein, Kiel, Germany
(Rusch) Department of Vascular Surgery, University Hospital of
Schleswig-Holstein, Kiel, Germany
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Men are known to have a higher incidence of acute
cardiovascular events, while women are recognized for their increased
mortality following diagnosis or intervention for these conditions. The
aim of this study is to explore the sex differences in clinical profiles
and outcomes of patients undergoing ascending aortic aneurysm (AscAA)
surgery. Method(s): A PRISMA compliant literature search and data
extraction were conducted using PubMed, EMBASE, and SCOPUS. Observational
cohort or retrospective registries that compared a defined number of male
and female adults undergoing ascending aortic surgery for AscAA were
included. Data analysis was conducted in compliance with Cochrane methods.
 Result(s): A total of 11 unique studies met the inclusion criteria,
from which 13636 patients were included, with a distribution of 9124 males
(67%) and 4512 females (33%). Overall, 91% underwent elective surgery.
Male patients had significantly lower 30-day mortality, (RR: 0.68, 95% Cl
[0.57, 0.81], p < 0.0001) and shorter stays in the intensive care unit,
with a mean difference (MD) of -0.48 days ([-0.84, -0.13], p = 0.008).
Males were significantly younger at the time of surgery (MD: -3.94 years,
95% CI [-5.58, -2.31], p < 0.00001). Male patients had significantly more
frequent concomitant CABG (21% vs. 14.5%; p < 0.0001), while females had
more frequent isolated supra-coronary ascending aortic replacement (22%
vs. 36%; p = 0.004). Female patients who underwent AscAA surgery had
significantly lower long-term survival (HR: 1.25, [1.05, 1.50], p =
0.013). Conclusion(s): Women undergo surgery for AscAA at older ages
and face greater mortality. The disparities in preoperative age and timing
of surgery between males and females can be explained by differences in
comorbidity profiles and the need for concomitant surgery. Copyright
© 2025 by the authors.

<71>
Accession Number
2038049344
Title
Care guided by tissue oxygenation and haemodynamic monitoring in off-pump
coronary artery bypass grafting (Bottomline-CS): Assessor blind, single
centre, randomised controlled trial.
Source
BMJ. (no pagination), 2025. Article Number: e082104. Date of Publication:
2025.
Author
Han J.; Zhai W.; Wu Z.; Zhang Z.; Wang T.; Ren M.; Liu Z.; Sessler D.I.;
Guo Z.; Meng L.
Institution
(Han, Zhai, Zhang, Wang) Department of Anesthesiology, Tianjin Chest
Hospital, Tianjin University, Tianjin, China
(Wu) Department of Critical Care, Tianjin Chest Hospital, Tianjin
University, Tianjin, China
(Ren) Tianjin Research Institute of Cardiovascular Disease, Tianjin, China
(Liu) Department of Biostatistics and Health Data Science, Indiana
University School of Medicine, Indiana University, Indianapolis, IN,
United States
(Sessler) Department of Anesthesiology and Center for Outcomes Research,
UTHealth, Houston, TX, United States
(Guo) Department of Cardiovascular Surgery, Tianjin Chest Hospital,
Tianjin University, Tianjin, China
(Meng) Department of Anesthesia, Indiana University School of Medicine,
Indianapolis, IN, United States
Publisher
BMJ Publishing Group
Abstract
Objective: To assess whether perioperative management guided by
near-infrared spectroscopy to determine tissue oxygen saturation and
haemodynamic monitoring reduces postoperative complications after off-pump
coronary artery bypass grafting. Design(s): Assessor blinded, single
centre, randomised controlled trial (Bottomline-CS trial).
 Setting(s): A tertiary teaching hospital in China.
 Participant(s): 1960 patients aged 60 years or older who were
scheduled for elective off-pump coronary artery bypass grafting.
 Intervention(s): All patients had multisite monitoring of tissue
oxygen saturation (bilateral forehead and unilateral forearm
brachioradialis) and haemodynamic monitoring. Both groups received usual
care, including arterial blood pressure, central venous pressure,
electrocardiography, and transoesophageal echocardiography when indicated.
Guided care aimed to maintain tissue oxygenation within 10% above or below
preoperative baseline values, established 24-48 hours before surgery, from
the start of anaesthesia until extubation or for up to 24 hours
postoperatively. In the usual care group, tissue oximetry and haemodynamic
data were concealed, and care was routine. Main Outcome Measure(s):
The primary outcome was the incidence of a composite of 30 day
postoperative complications, which were cerebral, cardiac, respiratory,
renal, infectious, and mortality complications. Secondary outcomes
included the individual components of the composite outcome, new-onset
atrial fibrillation, and hospital length of stay. Result(s): Of 1960
patients randomly assigned, data from 967 guided care and 974 usual care
patients were analysed. During anaesthesia, the area under the curve for
tissue oxygen saturation measurements outside the plus and minus 10%
baseline range was significantly smaller with guided care than only usual
care: left forehead 32.4 versus 57.6 (%xmin, P<0.001), right forehead 37.9
versus 62.6 (P<0.001), and forearm 14.8 versus 44.7 (P<0.001). The primary
composite outcome occurred in 457/967 (47.3%) patients in the guided care
group and 466/974 (47.8%) patients in the usual care group (unadjusted
risk ratio 0.99 (95% confidence interval 0.90 to 1.08), P=0.83). No
secondary outcomes differed significantly between groups. The largest
observed difference was in incidence of pneumonia, which was less frequent
in the guided care group (88/967, 9.1%) than in the usual care group
(121/974, 12.4%) and not statistically significant after adjusting for
multiple comparisons. Conclusion(s): Guided care by use of multisite
near-infrared spectroscopy and haemodynamic monitoring effectively
maintained tissue oxygenation near baseline levels compared with usual
care. However, no clear evidence was noted that this approach reduced the
incidence of major postoperative complications. These findings do not
support the routine use of near-infrared spectroscopy and haemodynamic
monitoring to maintain tissue oxygenation during off-pump coronary artery
bypass grafting. Trial registration: ClinicalTrials.gov
NCT04896736. Copyright © Author(s) (or their employer(s)) 2019.

<72>
Accession Number
2038114832
Title
Postoperative Pain Intensity After Single-port, Double-port, and
Triple-port Video-assisted Lung Lobectomy: A Three-arm Parallel Randomized
Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Kosinski S.; Putowski Z.; Stachowicz J.; Czajkowski W.; Wilkojc M.;
Zietkiewicz M.; Zielinski M.
Institution
(Kosinski, Stachowicz, Czajkowski, Wilkojc, Zielinski) Klara Jelska's
Pulmonary Hospital, Zakopane, Poland
(Kosinski) Jagiellonian University Medical College,
Orthopaedic-Rehabilitation University Hospital, Zakopane, Poland
(Putowski) Jagiellonian University Medical College, Centre for Intensive
and Perioperative Care, Cracow, Poland
(Zietkiewicz) Jagiellonian University Medical College, John Paul II
Hospital, Cracow, Poland
Publisher
W.B. Saunders
Abstract
Objective: Video-assisted thoracic surgery (VATS) has evolved from a
multiport approach to a one-port approach to reduce the degree of surgical
trauma. However, there is no consensus on the number of incisions leading
to less postoperative pain. Early postoperative pain was compared after
three technical variants of VATS lobectomy under multimodal analgesia,
including thoracic epidural analgesia. Design(s): This study was
designed as a prospective, randomized, controlled clinical trial with
three parallel arms. Setting(s): Single-center study.
 Participant(s): A total of 112 adult patients with ASA statuses I to
III who were scheduled to undergo elective VATS lobectomy for early-stage
non-small cell lung cancer were enrolled. Intervention(s): Patients
were randomly assigned to one of three groups: single-port, double-port,
and triple-port VATS lobectomy. The same postoperative analgesia protocol
was used in each group. Measurements and Main Results: The primary
outcome was postoperative pain intensity at rest and when coughing within
the first 72 hours after surgery. The secondary outcomes were cumulative
opioid consumption and the composite rate of postoperative complications.
A total of 112 patients were enrolled in the study, 91 of whom completed
the study protocol. There were no significant differences between the
study groups in terms of pain intensity either at rest (p = 0.319) or when
coughing (p = 0.202). There was no difference in the incidence of
postoperative complications. Conclusion(s): This study revealed no
differences in pain intensity in the early postoperative period between
three different technical variants of VATS lobectomy when an analgesia
protocol based on thoracic epidural anesthesia was used. Copyright
© 2025 Elsevier Inc.

<73>
Accession Number
2037970347
Title
Outcomes of periprocedural continuation vs interruption of oral
anticoagulation in transcatheter aortic valve replacement.
Source
World Journal of Cardiology. 17(3) (no pagination), 2025. Article Number:
104000. Date of Publication: 26 Mar 2025.
Author
Goyal A.; Shoaib A.; Fareed A.; Jawed S.; Khan M.T.; Salim N.; Zameer U.;
Siddiqui A.; Thakur T.; Sulaiman S.A.
Institution
(Goyal) Department of Internal Medicine, Seth GS Medical College, KEM
Hospital, Maharashtra, Mumbai, India
(Shoaib, Fareed, Jawed, Khan, Salim, Zameer, Siddiqui) Department of
Internal Medicine, Karachi Medical and Dental College, Sindh, Karachi,
Pakistan
(Thakur) Department of Internal Medicine, Government Medical College,
Punjab, Patiala, India
(Sulaiman) Department of Internal Medicine, The University of Jordan,
Amman, Jordan
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND Up to one-third of patients undergoing transcatheter aortic
valve replacement (TAVR) have an indication for oral anticoagulation
(OAC), primarily due to underlying atrial fibrillation. The optimal
approach concerning periprocedural continuation vs interruption of OAC in
patients undergoing TAVR remains uncertain, which our meta-analysis aims
to address. AIM To explore safety and efficacy outcomes for patients
undergoing TAVR, comparing periprocedural continuation vs interruption of
OAC therapy. METHODS A literature search was conducted across major
databases to retrieve eligible studies that assessed the safety and
effectiveness of TAVR with periprocedural continuous vs interrupted OAC.
Data were pooled using a random-effects model with risk ratio (RR) and
their 95% confidence interval (CI) as effect measures. All statistical
analyses were conducted using Review Manager with statistical significance
set at P < 0.05.RESULTS Four studies were included, encompassing a total
of 1813 patients with a mean age of 80.6 years and 49.8% males. A total of
733 patients underwent OAC interruption and 1080 continued. Stroke
incidence was significantly lower in the OAC continuation group (RR =
0.62, 95%CI: 0.40-0.94; P = 0.03). No significant differences in major
vascular complications were found between the two groups (RR = 0.95,
95%CI: 0.77-1.16; P = 0.60) and major bleeding (RR = 0.90, 95%CI:
0.72-1.12; P = 0.33). All-cause mortality was non-significant between the
two groups (RR = 0.83, 95%CI: 0.57-1.20; P = 0.32). CONCLUSION
Continuation of OAC significantly reduced stroke risk, whereas it showed
trends toward lower bleeding and mortality that were not statistically
significant. Further large-scale studies are crucial to determine clinical
significance. Copyright ©The Author(s) 2025. Published by
Baishideng Publishing Group Inc. All rights reserved.

<74>
Accession Number
2038089304
Title
Outcomes of transcatheter vs surgical aortic valve replacement in
pre-existing chronic liver disease patients: A meta-analysis of
observational studies.
Source
IJC Heart and Vasculature. 58 (no pagination), 2025. Article Number:
101651. Date of Publication: 01 Jun 2025.
Author
Ali A.; Ali M.A.; Khattak A.I.; Khattak F.; Afridi A.; Azeem T.; Shabbar
Banatwala U.S.; Alam U.; Khan A.; Jalal U.; Moeez A.; Khan M.W.Z.; Collins
P.; Ahmed R.
Institution
(Ali, Ali, Khattak, Afridi, Azeem, Alam, Moeez, Khan) Khyber Medical
College, Peshawar, Pakistan
(Khattak) Bacha Khan Medical College, Pakistan
(Shabbar Banatwala) Dow University of Health Sciences, Pakistan
(Khan) Dow International Medical College, Pakistan
(Jalal) Allama Iqbal Medical College, Pakistan
(Collins, Ahmed) National Heart and Lung Institute, Imperial College
London, United Kingdom
Publisher
Elsevier Ireland Ltd
Abstract
Aortic valve stenosis in patients with chronic liver diseases,
particularly liver cirrhosis and End-Stage Liver Disease, poses
significant management challenges due to the interplay between
cardiovascular and hepatic dysfunction. This systematic review and
meta-analysis compared the safety and efficacy of Transcatheter Aortic
Valve Replacement (TAVR) and Surgical Aortic Valve Replacement in this
high-risk population. An extensive search of PubMed, Embase, and Web of
Science (inception to January 5, 2025) identified 11 retrospective studies
comprising 19,097 patients. Risk ratios for dichotomous outcomes and mean
differences (MD) for continuous outcomes, each with 95% confidence
intervals, were calculated using random-effects models. The analysis
revealed that TAVR significantly reduced hospital mortality (RR 0.36, 95 %
CI: 0.30-0.42; I2 = 7.6 %), acute kidney injury (RR 0.51, 95 %
CI: 0.33-0.78; I2 = 57.2 %), bleeding (RR 0.33, 95 % CI:
0.28-0.39; I2 = 0.0 %), stroke (RR 0.35, 95 % CI: 0.23-0.51;
I2 = 6.1 %), and blood transfusion (RR 0.48, 95 % CI:
0.40-0.57; I2 = 7.6 %). TAVR was also associated with shorter
hospital stays (MD -6.77 days, 95 % CI: -9.17 to -4.38; I2 =
97.5 %). No significant differences were observed in vascular
complications requiring surgery or hospital charges and post-operative
infections. These findings suggest TAVR offers significant advantages over
SAVR in reducing complications such as mortality, acute kidney injury, and
bleeding in patients with liver disease. However, further randomized
trials are necessary to confirm long-term outcomes and establish optimal
treatment strategies for this high-risk population. Copyright ©
2025 The Author(s)

<75>
Accession Number
2038062868
Title
How do type of preoperative P2Y 12 receptor inhibitor and withdrawal time
affect bleeding? Protocol of a systematic review and individual patient
data meta-analysis.
Source
BMJ Open. 12(3) (no pagination), 2022. Article Number: e060404. Date of
Publication: 28 Mar 2022.
Author
Schoerghuber M.; Pregartner G.; Berghold A.; Lindenau I.; Zweiker R.;
Voetsch A.; Mahla E.; Zirlik A.
Institution
(Schoerghuber, Lindenau, Mahla) Division of Anesthesiology for
Cardiovascular Surgery and Intensive Care Medicine, Medical University of
Graz, Graz, Austria
(Pregartner, Berghold) Institute for Medical Informatics, Statistics and
Documentation, Medical University of Graz, Graz, Austria
(Lindenau) Department of Anesthesiology and Intensive Care Medicine,
Hospital Hochsteiermark, Steiermarkische Krankenanstaltengesellschaft MbH,
Leoben, Austria
(Zweiker, Zirlik) Division of Cardiology, Department of Internal Medicine,
Medical University of Graz, Graz, Austria
(Voetsch) Department of Cardiovascular and Endovascular Surgery,
Paracelsus Medical University Salzburg, Salzburg, Austria
Publisher
BMJ Publishing Group
Abstract
Introduction In order to reduce the risk of bleeding in patients on P2Y 12
receptor inhibitors presenting for non-emergent coronary artery bypass
grafting (CABG), current guidelines recommend a preoperative
discontinuation period of at least three, five and seven days for
ticagrelor, clopidogrel and prasugrel, respectively, to allow for recovery
of platelet function. However, there is still substantial
interinstitutional variation in preoperative management and relevant
covariates of CABG-related bleeding are largely elusive so far. Methods
and analysis We will search PubMed (July 2013 to November 2021) and EMBASE
(January 2014 to November 2021) using the following terms, MeSH terms and
their synonyms: Clopidogrel, prasugrel, ticagrelor, dual antiplatelet, P2Y
12 receptor inhibitor, CABG, bleeding, haemorrhage. Two independent
reviewers will screen all abstracts and full papers for eligibility.
Disagreements will be solved by consulting with a third reviewer. The
primary outcome is the incidence of Bleeding Academic Research Consortium
type-4 bleeding depending on type of P2Y 12 receptor inhibitor and
preoperative withdrawal period. The secondary outcomes are mortality and
ischaemic events according to the Academic Research Consortium 2 Consensus
Document. We will perform an individual patient data meta-analysis
(IPD-MA) with drug-specific preoperative withdrawal time and adjust for
demographic and procedural variables. Subgroup analyses will be performed
for anaemic patients and patients undergoing non-emergent versus
urgent/emergent surgery. Ethics and dissemination This IPD-MA consists of
secondary analyses of existing non-identifiable data and meets the
criteria for waiver of ethics review by the local Research Ethics
Committee. Data sharing and transfer will be subject to a confidentiality
agreement and a data use agreement. Findings will be disseminated through
peer-reviewed publication and conference presentation. PROSPERO
registration number CRD42022291946. Copyright © Author(s) (or
their employer(s)) 2022.

<76>
Accession Number
2038089342
Title
Aortic Valve Replacement for Asymptomatic Severe Aortic Stenosis: Is
Enthusiasm Exceeding the Evidence?.
Source
Journal of the American College of Cardiology. 85(14) (pp 1511-1514),
2025. Date of Publication: 15 Apr 2025.
Author
Kaul S.
Institution
(Kaul) Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles,
CA, United States
Publisher
Elsevier Inc.

<77>
Accession Number
2038070070
Title
The effects of sodium-glucose transporter 2 inhibition on cardiac
surgery-associated acute kidney injury: An open-label randomized pilot
study.
Source
Journal of Clinical Anesthesia. 103 (no pagination), 2025. Article Number:
111811. Date of Publication: 01 Apr 2025.
Author
Snel L.I.P.; Oosterom-Eijmael M.J.P.; Rampanelli E.; Lankadeva Y.R.;
Plummer M.P.; Preckel B.; Hermanides J.; van Raalte D.H.; Hulst A.H.
Institution
(Snel, Oosterom-Eijmael, Preckel, Hermanides, Hulst) Department of
Anesthesiology, Amsterdam University Medical Center, Amsterdam,
Netherlands
(Snel, Oosterom-Eijmael, van Raalte) Department of Endocrinology,
Amsterdam University Medical Center, Amsterdam, Netherlands
(Snel, Oosterom-Eijmael, Rampanelli, Hulst) Amsterdam Cardiovascular
Sciences Research Institute, Amsterdam, Netherlands
(Snel, Oosterom-Eijmael, Preckel, Hermanides) Amsterdam Public Health
Research Institute, Quality of Care, Amsterdam, Netherlands
(Rampanelli, van Raalte) Department of Experimental Vascular Medicine,
Amsterdam University Medical Center, Amsterdam, Netherlands
(Rampanelli, Hulst) Amsterdam Gastroenterology Endocrinology Metabolism
Research Institute, Amsterdam, Netherlands
(Lankadeva) Preclinical Critical Care Unit, Florey Institute of
Neuroscience and Mental Health, The University of Melbourne, Melbourne,
VIC, Australia
(Lankadeva, Plummer, Hulst) Department of Critical Care, Melbourne Medical
School, The University of Melbourne, Melbourne, VIC, Australia
(Plummer) Intensive Care Unit Research, Royal Adelaide Hospital, Adelaide,
SA, Australia
Publisher
Elsevier Inc.
Abstract
Background: Sodium-glucose transporter-2 (SGLT2) inhibitors reduced the
incidence of acute kidney injury in large cardiovascular outcome trials in
patients with chronic heart and kidney failure. Acute kidney injury is a
common complication following cardiac surgery. We hypothesized that
perioperative SGLT2 inhibition could reduce kidney injury after cardiac
surgery, measured with the biomarker neutrophil gelatinase-associated
(NGAL). Method(s): In this open-label phase IV, randomized,
parallel-group, pilot study, adult patients undergoing elective cardiac
surgery with cardiopulmonary bypass were randomized to receive either an
SGLT2 inhibitor, empagliflozin (10 mg; oral) once daily, from three days
before surgery until postoperative day two, or standard-of-care. The
primary outcome was the between-group difference of serum NGAL on the
second postoperative day. Moreover, other biomarkers for acute kidney
injury were measured, including serum kidney injury molecule-1 (KIM-1),
hypoxia-inducible factor-1 alpha (HIF-1alpha), and urine NGAL/Creatinine
and KIM-1/Creatinine ratios. Additional outcomes included acute kidney
injury incidence within the first seven days following cardiac surgery
according to Kidney Disease: Improving Global Outcomes criteria and
metabolic parameters, including ketone body concentrations and glycemic
control. Result(s): Between March 2022 and April 2023, 55 patients
were included (sex: 73 % male, age: 66 +/- 10 years, BMI: 28 +/- 4
kg/m2, empagliflozin n = 25, control n = 30) in the
intention-to-treat analysis. There were no significant between-group
differences in serum and urine NGAL or KIM-1. However, empagliflozin
significantly reduced the incidence of acute kidney injury (20 % vs 66.7
%; absolute difference 46.7 %, 95 % CI, -69.7 - -23.6; P < .001). A
significant increase in serum HIF-1alpha after surgery was solely observed
in the control group. We observed no between-group differences in the
incidence of (euglycemic) ketoacidosis or hypoglycemic events.
 Conclusion(s): In this pilot study, perioperative SGLT2 inhibition
was not associated with lower NGAL levels. We observed that SGLT2
inhibition reduced the incidence of acute kidney injury in this small
study population. As the results of this pilot study are
hypotheses-generating, further validation is needed in a large-scale,
double-blind, placebo-controlled, randomized trial, which is currently
ongoing. Copyright © 2024

<78>
Accession Number
2038039135
Title
The place of cardiac troponin assessment in perioperative management: a
narrative review.
Source
Acta Anaesthesiologica Belgica. 76(1) (pp 37-45), 2025. Date of
Publication: 01 Mar 2025.
Author
De Hert S.; de Paula-Garcia W.N.
Institution
(De Hert) Department of Basic and Applied Medical Sciences, Faculty of
Medicine and Health Sciences, Ghent University, Ghent, Belgium
(de Paula-Garcia) AC Camargo Cancer Center, Sao Paulo, Brazil
Publisher
BeSARPP
Abstract
The recent 2022 European Society of Cardiology Guidelines on
cardiovascular assessment and management of patients undergoing
non-cardiac surgery emphasize the role of cardiac troponin assessment in
the evaluation and management of potential perioperative myocardial
injury. This central role is however challenged. The current contribution
assesses the current knowledge on the place of cardiac troponin in the
assessment of perioperative myocardial injury in non-cardiac surgery
patients. Additionally, it explores the implications of routine cardiac
troponin surveillance for healthcare systems, focusing on costs, resource
allocation, and organisational challenges. Copyright © 2025
BeSARPP. All rights reserved.

<79>
Accession Number
2038062341
Title
Impact of anesthetic technique on troponin I levels in pediatric cardiac
surgery: a randomized clinical trial.
Source
Brazilian Journal of Anesthesiology (English Edition). 75(3) (no
pagination), 2025. Article Number: 844603. Date of Publication: 01 May
2025.
Author
Barelli J.V.G.; Araujo D.D.; Zeferino S.P.; Dantas G.M.; Galas F.B.
Institution
(Barelli, Araujo, Zeferino, Dantas) Faculdade de Medicina da Universidade
de Sao Paulo, SP, Sao Paulo, Brazil
(Galas) Faculdade de Medicina da Universidade de Sao Paulo, Departamento
de Anestesia, SP, Sao Paulo, Brazil
Publisher
Elsevier Editora Ltda
Abstract
Background: This study aimed to evaluate the effects of the inhalational
anesthetic sevoflurane on postoperative myocardial injury and renal
function in children under 2 years old with congenital heart disease
(RACHS 1, 2, and 3) undergoing cardiac surgery with extracorporeal
circulation. Method(s): A randomized clinical trial was conducted
with 66 patients divided into two groups: one receiving sevoflurane and
the other Total Intravenous Anesthesia (TIVA). The primary outcome was the
serum troponin I levels within the first 48 hours postoperatively.
Secondary outcomes included urine output and serum urea levels.
 Result(s): The median troponin I levels at 48 hours were 10.5 ng.mL-1
(IQR: 8.2-12.7) in the sevoflurane group and 11.0 ng.mL-1 (IQR:
8.7-13.0) in the TIVA group (p = 0.336). The sevoflurane group showed
higher urine output on the second postoperative day (median: 800 mL [IQR:
420-913] vs. 541 mL [IQR: 312-718], p = 0.034) and lower serum urea levels
(median: 24 mg.dL-1 [IQR: 16-35] vs. 36 mg.dL-1
[IQR: 23-49], p = 0.030). Conclusion(s): While sevoflurane did not
significantly impact myocardial injury markers, it demonstrated potential
renal protective effects in this patient population. Further research is
necessary to confirm these findings across different pediatric age groups
and surgical contexts. Copyright © 2025 Sociedade Brasileira de
Anestesiologia

<80>
Accession Number
2038074236
Title
Mitral Valve Surgery After Failed Transcatheter Edge-to-Edge Repair: A
Meta-Analysis.
Source
Canadian Journal of Cardiology. (no pagination), 2025. Date of
Publication: 2025.
Author
Cabrucci F.; Baudo M.; Magouliotis D.E.; Yamashita Y.; Kjelstrom S.;
Bacchi B.; Bonacchi M.; Dokollari A.; Sicouri S.; Ramlawi B.
Institution
(Cabrucci, Baudo, Magouliotis, Yamashita, Kjelstrom, Dokollari, Sicouri,
Ramlawi) Department of Cardiac Surgery Research, Lankenau Institute for
Medical Research, Main Line Health, Wynnewood, PA, United States
(Yamashita, Ramlawi) Department of Cardiac Surgery, Lankenau Heart
Institute, Main Line Health, Wynnewood, PA, United States
(Bacchi, Bonacchi) Department of Cardiac Surgery, AOU Careggi University
Hospital, Firenze, Italy
(Dokollari) Department of Cardiac Surgery, St Boniface Hospital,
University of Manitoba, Winnipeg, Canada
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter edge-to-edge repair (TEER) is increasingly used
for mitral regurgitation (MR), particularly in high-risk patients.
However, when TEER fails, patients often require mitral valve surgery,
which remains challenging because of patients' compromised condition. This
study aims to evaluate short- and long-term surgical outcomes following
failed TEER. Method(s): This meta-analysis included observational
studies with reported outcomes of mitral valve surgery after failed TEER
published until September 2024. Multivariable meta-regressions were
performed to predict short- and long-term mortality. Kaplan-Meier function
was reconstructed from individual studies. Result(s): Sixteen studies
were included with a total sample of 892 patients. The mean age was 74.8
years (55% males), with most patients (87.8%) in New York Heart
Association class III or IV before surgery. Pooled mean Society of
Thoracic Surgeons (STS) predicted risk of mortality score before index
TEER was 6.3%. Surgical indications were recurrent MR >=3+ (93%), mitral
stenosis (17%), and endocarditis (2.7%). The average time between TEER and
surgery was 6.4 months. Mitral valve replacement was performed in 83.8% of
cases. Thirty-day all-cause mortality was 12.2% but significantly lower
for elective cases (2.5%). At a mean follow-up of 14.7 months, mortality
was 28.3%. Preoperative incidence of coronary artery disease, lower left
ventricle ejection fraction (LVEF), rate of concomitant procedures, and
functional mitral regurgitation were predictors of short- and long-term
outcomes. Conclusion(s): Mitral valve surgery after failed TEER
presents significant challenges, yet acceptable outcomes are achievable,
particularly in elective cases. Complete treatment of concomitant lesions
may improve outcomes in patients with preserved LVEF. Future research
should stratify outcomes based on emergent vs elective surgery and MR
etiology to guide tailored surgical strategies. Copyright © 2025
Canadian Cardiovascular Society

<81>
Accession Number
2033038333
Title
Ischemic stroke prevention in patients with atrial fibrillation and a
recent ischemic stroke, TIA, or intracranial hemorrhage: A World Stroke
Organization (WSO) scientific statement.
Source
International Journal of Stroke. (no pagination), 2025. Date of
Publication: 2025.
Author
Sposato L.A.; Cameron A.C.; Johansen M.C.; Katan M.; Murthy S.B.;
Schachter M.; B Sur N.; Yaghi S.; Aspberg S.; Caso V.; Hsieh C.-Y.; J Hilz
M.; Nucera A.; Seiffge D.J.; Sheppard M.N.; Martins S.C.O.; Bahit M.C.;
Scheitz J.F.; Shoamanesh A.
Institution
(Sposato) Department of Clinical Neurological Sciences, Western
University, London, ON, Canada
(Sposato) Department of Epidemiology & Biostatistics, Western University,
London, ON, Canada
(Sposato) Department of Anatomy and Cell Biology, Western University,
London, ON, Canada
(Sposato) Heart & Brain Lab, Western University, London, ON, Canada
(Sposato) Robarts Research Institute, London Health Sciences Centre,
University Hospital, Western University, London, ON, Canada
(Cameron) School of Cardiovascular and Metabolic Health, University of
Glasgow, Glasgow, United Kingdom
(Johansen) Department of Neurology, School of Medicine, Johns Hopkins
University, Baltimore, MD, United States
(Katan) Department of Neurology, Stroke Center, University Hospital Basel,
University of Basel, Basel, Switzerland
(Murthy) Clinical and Translational Neuroscience Unit, Department of
Neurology, Feil Family Brain and Mind Research Institute, Weill Cornell
Medicine, New York, NY, United States
(Schachter) Neurocritical Care, Piedmont Healthcare, Atlanta, GA, United
States
(B Sur) Department of Neurology, Stroke Division, Miller School of
Medicine, University of Miami, Miami, FL, United States
(Yaghi) Department of Neurology, Brown University, Providence, RI, United
States
(Aspberg) Division of Cardiovascular Medicine, Department of Clinical
Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
(Caso) Stroke Unit, Santa Maria Della Misericordia Hospital, University of
Perugia, Perugia, Italy
(Hsieh) Department of Neurology, Tainan Sin Lau Hospital, Tainan, Taiwan
(Republic of China)
(J Hilz) Department of Neurology, University of Erlangen-Nuremberg,
Erlangen, Germany
(J Hilz) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Nucera) Neurovascular Treatment Unit, Spaziani Hospital, Frosinone, Italy
(Seiffge) Department of Neurology, Inselspital University Hospital,
University of Bern, Bern, Switzerland
(Sheppard) Cardiovascular and Genetics Research Institute, St George's,
University of London, London, United Kingdom
(Martins) Neurology Department, Hospital Moinhos de Vento, Porto Alegre,
Brazil
(Bahit) INECO Neurociencias, Rosario, Argentina
(Scheitz) Department of Neurology and Center for Stroke Research, Charite
Universitatsmedizin, Berlin, Germany
(Shoamanesh) Division of Neurology, Population Health Research Institute,
McMaster University, Hamilton, ON, Canada
Publisher
SAGE Publications Inc.
Abstract
Background: Secondary stroke prevention in patients with atrial
fibrillation (AF) is one of the fastest growing areas in the field of
cerebrovascular diseases. This scientific statement from the World Stroke
Organization Brain & Heart Task Force provides a critical analysis of the
strength of current evidence on this topic, highlights areas of current
controversy, identifies knowledge gaps, and proposes priorities for future
research. Method(s): We select topics with the highest clinical
relevance and perform a systematic search to answer specific practical
questions. Based on the strength of available evidence and knowledge gaps,
we identify topics that need to be prioritized in future research. For
this purpose, we adopt a novel classification of evidence strength based
on the availability of publications in which the primary population is
patients with recent (<6 months) cerebrovascular events, the primary study
endpoint is a recurrent ischemic stroke, and the quality of the studies
(e.g. observational versus randomized controlled trial). Summary:
Priority areas include AF screening, molecular biomarkers, AF subtype
classification, anticoagulation in device-detected AF, timing of
anticoagulation initiation, effective management of breakthrough strokes
on existing anticoagulant therapy, the role of left atrial appendage
closure, novel approaches, and antithrombotic therapy post-intracranial
hemorrhage. Strength of currently available evidence varies across the
selected topics, with early anticoagulation being the one showing more
consistent data. Conclusion(s): Several knowledge gaps persist in
most areas related to secondary stroke prevention in AF. Prioritizing
research in this field is crucial to advance current knowledge and improve
clinical care. Copyright © 2025 World Stroke Organization.

<82>
Accession Number
646852111
Title
Mitral repair with annuloplasty for moderate ischemic mitral regurgitation
in people undergoing coronary artery bypass surgery.
Source
Cochrane Database of Systematic Reviews. 2025(3) (no pagination), 2025.
Article Number: CD015777. Date of Publication: 21 Mar 2025.
Author
Paez R.P.; Rocco I.S.; Guizilini S.; Flumignan R.L.G.; Carmo A.C.F.D.;
Gomes W.J.
Institution
(Paez, Rocco, Guizilini, Gomes) Postgraduation Program in Cardiology,
Universidade Federal de Sao Paulo, Sao Paulo, Brazil
(Rocco, Guizilini, Gomes) Division of Cardiovascular Surgery, Universidade
Federal de Sao Paulo, Sao Paulo, Brazil
(Flumignan) Department of Surgery, Division of Vascular and Endovascular
Surgery, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
(Carmo) Regional Medicine Library (BIREME), Universidade Federal de Sao
Paulo, Sao Paulo, Brazil
Publisher
John Wiley and Sons Ltd
Abstract
Objectives: This is a protocol for a Cochrane Review (intervention). The
objectives are as follows:. To assess the effects of mitral repair with
annuloplasty for moderate ischemic mitral regurgitation in people
undergoing coronary artery bypass grafting. Copyright © 2025 The
Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

<83>
[Use Link to view the full text]
Accession Number
2038035869
Title
Biomarkers of RV Dysfunction in HFrEF Identified by Direct Tissue
Proteomics: Extracellular Proteins Fibromodulin and Fibulin-5.
Source
Circulation: Heart Failure. 18(3) (pp 285-297), 2025. Date of Publication:
01 Mar 2025.
Author
Behounek M.; Lipcseyova D.; Vit O.; Zacek P.; Talacko P.; Huskova Z.;
Kikerlova S.; Tykvartova T.; Wohlfahrt P.; Melenovsky V.; Benes J.; Petrak
J.
Institution
(Behounek, Lipcseyova, Vit, Petrak) First Faculty of Medicine,
Biotechnology and Biomedicine Center of the Academy of Sciences and
Charles University (BIOCEV), Charles University, Prague, Czechia
(Zacek, Talacko, Huskova) Proteomic Core Facility, Faculty of Science,
Biotechnology and Biomedicine Center of the Academy of Sciences and
Charles University (BIOCEV), Charles University, Prague, Czechia
(Huskova, Kikerlova) Center of Experimental Medicine, Institute for
Clinical and Experimental Medicine (IKEM), Prague, Czechia
(Tykvartova, Wohlfahrt, Melenovsky, Benes) Department of Cardiology,
Institute for Clinical and Experimental Medicine (IKEM), Prague, Czechia
(Benes) Division of Cardiovascular Medicine, University of Utah School of
Medicine, Salt Lake City, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: Right ventricular dysfunction (RVD) is common in patients with
heart failure with reduced ejection fraction, and it is associated with
poor prognosis. However, no biomarker reflecting RVD is available for
routine clinical use. METHOD(S): Proteomic analysis of myocardium
from the left ventricle and right ventricle (RV) of patients with heart
failure with reduced ejection fraction with (n=10) and without RVD (n=10)
who underwent heart transplantation was performed. Concentrations of 2 ECM
(extracellular matrix) proteins with the highest myocardial upregulation
in RVD, FMOD (fibromodulin) and FBLN5 (fibulin-5), were assayed in the
blood and tested in a separate cohort of patients with heart failure with
reduced ejection fraction (n=232) to test for the association of the 2
proteins with RV function and long-term outcomes. RESULT(S):
Multivariable linear regression revealed that plasma concentrations of
both FMOD and FBLN5 were significantly associated with RV function
regardless of the RV function assessment method. No association of FMOD or
FBLN5 with left ventricular dysfunction, cardiac index, body mass index,
diabetes status, or kidney function was found. Plasma levels of FMOD and
FBLN5 were significantly associated with patient outcomes (P=0.005;
P=0.004). Area under the curve analysis showed that the addition of FBLN5
or FMOD to RV function assessment had a significantly higher area under
the curve after 4 years of follow-up (0.653 and 0.631, respectively)
compared with RV function alone (0.570; P<0.05 for both). Similarly, the
combination of MAGGIC (Meta-Analysis Global Group in Chronic Heart
Failure) score, FBLN5, and FMOD had a significantly larger area under the
curve (0.669) than the combination of MAGGIC score+RVD grade (0.572;
P=0.02). The Kaplan-Meier analysis demonstrated that patients with the
elevation of both FMOD and FBLN5 (ie, FMOD >64 ng/mL and FMOD >27 ng/mL)
had a worse prognosis than those with the elevation of either FBLN5 or
FMOD (P=0.03) demonstrating the additive prognostic value of both
proteins. CONCLUSION(S): Our study proposes that circulating levels
of FMOD and FBLN5 may serve as new biomarkers of RVD in patients with
heart failure with reduced ejection fraction. Copyright © 2025
The Authors.

<84>
[Use Link to view the full text]
Accession Number
2038032113
Title
Transcatheter aortic valve implantation vs. surgery for failed
bioprosthesis: A meta-analysis of over 20000 patients.
Source
Journal of Cardiovascular Medicine. 26(3) (pp 153-166), 2025. Date of
Publication: 01 Mar 2025.
Author
Comentale G.; Ahmadi-Hadad A.; Moldon H.J.; Carbone A.; Manzo R.; Franzone
A.; Piccolo R.; Bossone E.; Esposito G.; Pilato E.
Institution
(Comentale, Ahmadi-Hadad, Moldon, Pilato) Division of Cardiac Surgery,
University of Naples Federico II, Italy
(Manzo, Franzone, Piccolo, Esposito) Division of Cardiology, Department of
Advanced Biomedical Sciences, University of Naples Federico II, Italy
(Carbone) Division of Cardiology, University of Campania L. Vanvitelli,
Italy
(Bossone) Department of Public Health, University of Naples Federico II,
Naples, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
ObjectivesValve-in-valve transcatheter aortic valve implantation
(ViV-TAVI) has gained popularity as a less invasive alternative to a redo
surgical aortic valve replacement (redo-SAVR); which one is the preferred
technique in these cases, however, remains a topic of debate, as the
available data refer to retrospective studies with few patients or limited
follow-up. The present metanalysis aimed to compare the short-term and
long-term outcomes of the two techniques in the setting of a failed
surgical bioprosthesis.MethodsPubMed, MEDLINE, and Embase were searched on
10 November 2023 yielding 355 results (PROSPERO ID: CRD42023490612), of
which 27 were suitable for meta-analysis. The primary outcomes were
short-term and long-term all-causes and cardiovascular mortality.
Logarithmic risk ratio (Log RR) and mean difference were used for
categorical and continuous data, respectively.ResultsBoth redo-SAVR and
ViV-TAVI exhibited similar procedural and short-term mortality. However,
ViV-TAVI demonstrated lower 1-year mortality [RR: 0.74, 95% confidence
interval (CI) (0.57-0.96), P=0.02], acute kidney injury (RR: 0.47,
P<0.001), bleeding (RR: 0.44, P<0.001), stroke (RR: 0.70, P<0.05), and new
pacemaker implantation (RR: 0.69, P<0.05). Conversely, redo-SAVR
demonstrated more favorable mean postoperative aortic valve gradients
[mean difference 2.59, 95% CI (0.86-4.31), P<0.01].ConclusionShort-term
mortality was similar between the groups, but ViV-TAVI showed better
survival at 1year as well as reduced rates of acute kidney injury,
bleeding, stroke, and pacemaker implantation. However, redo-SAVR leads to
a better hemodynamic profile. Even if collected data come from
retrospective studies, the present results could help to guide the choice
of the best approach case-by-case according to the patient's clinical
profile. Copyright © 2025 The Author(s). Published by Wolters
Kluwer Health, Inc. on behalf of the Italian Federation of Cardiology.

<85>
[Use Link to view the full text]
Accession Number
2038032221
Title
Mechanical heart valves between myths and new evidence: A systematic
review and meta-analysis.
Source
Journal of Cardiovascular Medicine. 26(1) (pp 18-28), 2025. Date of
Publication: 01 Jan 2025.
Author
Santarpino G.; Serraino G.F.; Cardetta F.; Di Mauro M.; De Feo M.;
Menicanti L.; Paparella D.; Mastroroberto P.; Sorrentino S.; Speziale G.;
Pollari F.; Mauro M.; Torella M.; Coscioni E.; Chello M.; Barili F.;
Parolari A.
Institution
(Santarpino, Serraino, Mastroroberto, Mauro) Department of Experimental
and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro,
Italy
(Santarpino) Department of Cardiac Surgery, Citta di Lecce Hospital, GVM
Care and Research, Lecce, Italy
(Santarpino, Pollari) Department of Cardiac Surgery, Klinikum Nurnberg,
Paracelsus Medical University Nuremberg, Nuremberg, Germany
(Cardetta, Chello) Department of Cardiac Surgery, University Campus
Biomedico, Rome, Italy
(Di Mauro) Faculty of Health, Medicine and Life Sciences Maastricht
University, Maastricht, Netherlands
(De Feo, Torella) Department of Translational Medical Sciences, University
of Campania Luigi Vanvitelli, Naples, Italy
(Menicanti, Parolari) Department of Cardiac Surgery, IRCCS Policlinico San
Donato, Milan, Italy
(Paparella) Department of Medical and Surgical Sciences, Division of
Cardiac Surgery, University of Foggia, Foggia, Italy
(Paparella) Division of Cardiac Surgery, Santa Maria Hospital, GVM Care &
Research, Bari, Italy
(Sorrentino) Department of Medical and Surgical Sciences, Magna Graecia
University of Catanzaro, Catanzaro, Italy
(Speziale) Division of Cardiac Surgery, Anthea Hospital, GVM Care &
Research, Bari, Italy
(Coscioni) Division of Cardiac Surgery, AOU San Giovanni di Dio e Ruggi
d'Aragona, Salerno, Italy
(Barili) Department of Biomedical and Clinical Sciences, Universita Degli
Studi di Milano, Italy
(Barili) IRCCS Ospedale Galeazzi-sant'Ambrogio, Milan, Italy
(Barili) Department of Epidemiology, Harvard T.H. Chan School of Public
Health, Boston, MA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
AimsThe use of mechanical valve prostheses in cardiac surgery remains a
necessary and indicated intervention in a large number of patients.
However, predicted results associated with their use, on which current
guideline recommendations have been developed, are based on dated studies
at risk of bias (e.g. use of old generation models, very high
international normalized ratio regimes).MethodsA comprehensive search in
multiple electronic databases was conducted from January 1995 to January
2024 using predefined criteria. The primary outcomes included all-cause
death, bleeding events and thromboembolic events (i.e. stroke) at
follow-up.ResultsOverall, 38 studies were included in the meta-analysis.
Cumulative meta-analysis results for mortality, thromboembolic events and
bleeding events were initially extremely variable and tended to become
more consistent over time. A meta-regression for the impact of age and sex
on mortality showed no difference, whereas a meta-regression for the
impact of age and sex on thromboembolic events and on bleeding events
showed a higher risk in the elderly and in female patients,
respectively.ConclusionThe lack of fundamental information on the type of
anticoagulant treatment (e.g. dosage, monitoring method) in the studies
published to date does not allow us to draw any definitive conclusions on
the outcomes of mechanical valve prostheses. The most recent studies have
provided more consistent results, which in the past were highly variable,
probably due to overcoming the bias in the use of prosthetic models of
different generations. Copyright © 2025 Lippincott Williams and
Wilkins. All rights reserved.

<86>
Accession Number
2034000613
Title
Common Risk Factors for Atrial Fibrillation After Transcatheter Aortic
Valve Implantation: A Systematic Review from 2009 to 2024.
Source
Journal of Cardiovascular Development and Disease. 12(3) (no pagination),
2025. Article Number: 90. Date of Publication: 01 Mar 2025.
Author
Montenegro-Palacios J.F.; Vidal-Canas S.; Murillo-Benitez N.E.;
Quintana-Ospina J.; Cardona-Murillo C.A.; Liscano Y.
Institution
(Montenegro-Palacios, Vidal-Canas, Murillo-Benitez, Quintana-Ospina,
Cardona-Murillo, Liscano) Specialization in Internal Medicine, Department
of Health, Universidad Santiago de Cali, Cali, Colombia
(Montenegro-Palacios, Murillo-Benitez, Quintana-Ospina, Cardona-Murillo)
Genetics, Physiology, and Metabolism Research Group (GEFIME), Universidad
Santiago de Cali, Ciencias de la Salud, Cali, Colombia
(Vidal-Canas, Liscano) Grupo de Investigacion en Salud Integral (GISI),
Departamento Facultad de Salud, Universidad Santiago de Cali, Cali,
Colombia
(Murillo-Benitez) Department of Research and Education, Clinica de
Occidente S.A., Cali, Colombia
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Transcatheter Aortic Valve Implantation (TAVI) is an effective treatment
for severe aortic stenosis in high-risk patients; however, atrial
fibrillation (AF) is a common complication associated with the procedure.
New-Onset Atrial Fibrillation (NOAF) after TAVI is linked to increased
mortality and additional complications. This study aimed to evaluate the
incidence of NOAF following TAVI and identify risk factors associated with
mortality and the development of thromboembolic events. A systematic
review of 18 studies was conducted using databases such as MEDLINE/PubMed,
EMBASE, Web of Science, Scopus, Cochrane Library, Google Scholar, Wiley
Online Library, SciELO, and Redalyc. No language restrictions were
applied, and the search covered studies from 2009 to 2024. The follow-up
period ranged from 48 h to 730 days, with a mean of 180 days. Early
monitoring and management of AF are essential in patients undergoing TAVI.
The incidence of NOAF ranged up to 29.04%, meaning about 29 out of every
100 patients were affected. AF rates varied between 7.2% and 37%, with an
average of around 20. Standardizing anticoagulation strategies is
important to reduce complications. Randomized studies are needed to
evaluate the relationship between AF and post-TAVI mortality and to
determine whether AF is a marker of higher risk or an independent factor
in these patients. Copyright © 2025 by the authors.

<87>
Accession Number
2037901514
Title
Ovarian cancer and isolated cardiophrenic lymph nodes metastases: a
systematic review.
Source
Journal of the Turkish-German Gynecological Association. 26(1) (pp 49-54),
2025. Date of Publication: 01 Mar 2025.
Author
Psomiadou V.; Fotiou A.; Iavazzo C.
Institution
(Psomiadou, Iavazzo) Metaxa Memorial Cancer Hospital, Piraeus, Greece
(Fotiou) Department of Obstetrics and Gynecology, Attikon Hospital,
National and Kapodistrian University, Athens Medical School, Athens,
Greece
Publisher
Turkish-German Gynecological Association
Abstract
Currently, there is limited information available on the best course of
action for advanced epithelial ovarian cancer (OC) with isolated
extra-peritoneal disease in the cardiophrenic lymph nodes. Recently, there
have been numerous reports of successful surgical removal of metastatic
cardiophrenic lymph nodes in patients with OC, mostly during primary or
interval cytoreduction procedures. However, the optimal management of
isolated, extra-peritoneal cardiophrenic lymph node metastasis (ICLNM)
remains unclear, since this clinical scenario is rather uncommon in OC and
chemotherapy is so far the indicated treatment for patients with from
advanced stage disease. We searched the English-language literature for
cases of OC with ICLNM or recurrence, evaluating the feasibility and
safety of surgical excision. From 2009 to 2022 only 11 cases were
reported. In seven the tumor was of serous histology. ICLN was detected in
five cases with primary disease and in the remaining six it was recurrence
of OC. The primary disease was treated in 10/11 patients with primary
cytoreduction while the other received systemic chemotherapy. The ICLNM
was removed in all the patients, in 10 via video-assisted thoracic surgery
and in one via transdiaphragmatic incision. Median follow-up was 10
months. Copyright© 2025 The Author.

<88>
Accession Number
2036002708
Title
Mini-Sternotomy vs. Right Anterior Mini-Thoracotomy for Surgical Aortic
Valve Replacement - A Systematic Review and Meta-Analysis.
Source
Brazilian Journal of Cardiovascular Surgery. 40(3) (no pagination), 2025.
Article Number: e20240211. Date of Publication: 2025.
Author
Starvridis D.; Rad A.A.; Montanhesi P.K.; Kirov H.; Wacker M.; Tasoudis
P.; Mukharyamov M.; Treml R.E.; Wippermann J.; Doenst T.; Sultan I.; Sa
M.P.; Caldonazo T.
Institution
(Starvridis, Wacker, Wippermann) Department of Cardiothoracic Surgery,
University Clinic Magdeburg, Magdeburg, Germany
(Rad) Medical Sciences Division, University of Oxford, Oxford, United
Kingdom
(Montanhesi) Hospital Israelita Albert Einstein, Sao Paulo, Sao Paulo,
Brazil
(Kirov, Mukharyamov, Doenst, Caldonazo) Department of Cardiothoracic
Surgery, Jena University Hospital, Jena, Germany
(Tasoudis) Division of Cardiothoracic Surgery, University of North
Carolina, Chapel Hill, NC, United States
(Treml) Department of Anesthesiology and Intensive Care Medicine,
Friedrich Schiller University Jena, Jena, Germany
(Sultan, Sa) Department of Cardiothoracic Surgery, University of
Pittsburgh, Pittsburgh, PA, United States
(Sultan, Sa) UPMC Heart and Vascular Institute, University of Pittsburgh
Medical Center, Pittsburgh, PA, United States
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Minimally invasive techniques for aortic valve replacement
have become increasingly popular. The most common minimally invasive
approaches are mini-sternotomy and right anterior mini-thoracotomy. We
aimed to review the literature and compare clinical outcomes for these two
approaches. Method(s): Three databases were assessed. The primary
endpoint was perioperative mortality. The secondary endpoints were
reoperation for bleeding, stroke, operation duration, intensive care unit
length of stay, cardiopulmonary bypass time, cross-clamping time, hospital
length of stay, paravalvular leak, renal complications, conversion to full
sternotomy, permanent pacemaker implantation, and wound infection. Random
effects models were performed. Result(s): Ten studies were included
in the meta-analysis (30,524 patients). There was no difference in
perioperative mortality between groups (odds ratio: 0.83; 95% confidence
interval 0.57-1.21; P=0.33). In comparison with mini-sternotomy, right
anterior mini-thoracotomy showed higher rates of reoperation for bleeding
(odds ratio: 0.69; 95% confidence interval 0.50-0.97; P=0.03), lower rates
of stroke (odds ratio: 1.27; 95% confidence interval 1.01-1.60; P=0.04),
and longer operation duration (standard mean difference:-0.58; 95%
confidence interval-1.01 to-0.14; P=0.01). Other secondary endpoints were
not statistically significant. Conclusion(s): The results suggest
that both techniques present similar perioperative mortality rates for
aortic valve replacement. However, right anterior mini-thoracoto-my is
associated with higher rates of reoperation for bleeding, lower rates of
stroke, and longer operation duration time. Copyright © 2025,
Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved.

<89>
Accession Number
2033975200
Title
Surgical pulmonary valve redo versus transcatheter pulmonary valve
replacement for Tetralogy of Fallot patients.
Source
Expert Review of Cardiovascular Therapy. (no pagination), 2025. Date of
Publication: 2025.
Author
Penteris M.; Lampropoulos K.
Institution
(Penteris) Department of Medicine, Democritus University of Thrace,
Alexandroupolis, Greece
(Lampropoulos) School of Medicine, European University of Cyprus, Nicosia,
Cyprus
Publisher
Taylor and Francis Ltd.
Abstract
Objectives: To perform a systematic review to compare the efficacy and
safety of transcatheter pulmonary valve replacement (TPVR) and surgical
pulmonary valve replacement (SPVR) in managing pulmonary valve dysfunction
in Tetralogy of Fallot (TOF) patients. Method(s): This review
investigates through three different databases for randomized control
trials or observational studies evaluating TOF patients who underwent TPVR
or SPVR until November 2024. The outcomes of interest were hemodynamic
improvement, reduction in pulmonary regurgitation or stenosis,
complications, quality of life, and long-term outcomes. Result(s):
Four retrospective studies (1919 procedures) were analyzed. TPVR was
non-inferior to SPVR, with a comparable safety profile. The durability of
bioprosthetic valves was similar between TPVR and SPVR (HR: 0.97, 95% CI:
0.55-1.73; p = 0.93) and was influenced by patients' age at PVR (HR: 0.78
per 10 years from <1 year; 95% CI: 0.63-0.96; p = 0.02) and true inner
valve diameter. Conclusion(s): TPVR is a safe and less-invasive
alternative to SPVR with comparable efficacy in reducing pulmonary
regurgitation. Complication rates are similar and valve durability is
primarily age- and valve size-dependent. Although further research on long
term outcomes is needed, TPVR may be integrated into routine practices,
offering a viable alternative for high-risk TOF patients. Registration:
This systematic review was registered on the international prospective
register of systematic reviews (PROSPERO; #CRD42024615871). Copyright
© 2025 Informa UK Limited, trading as Taylor & Francis Group.

<90>
Accession Number
2033457025
Title
Effect of Multi-trace Elements Supplementation on Biochemical Markers and
Postoperative Outcome in Patients Undergoing Elective Cardiac Surgery.
Source
Recent Advances in Inflammation and Allergy Drug Discovery. 19(1) (pp
110-117), 2025. Article Number: e37918. Date of Publication: 2025.
Author
Amirizadeh M.; Eslami G.; Shafaei-Bajestani N.; Soleimani A.; Habtemariam
S.; Hashemi J.; Sahebnasagh A.
Institution
(Amirizadeh) Department of Pharmacotherapy, Faculty of Pharmacy, Lorestan
University of Medical Sciences, Khorramabad, Iran, Islamic Republic of
(Eslami) Department of Clinical Pharmacy, Pharmaceutical Sciences Research
Center, Faculty of Pharmacy, Mazandaran University of Medical Sciences,
Sari, Iran, Islamic Republic of
(Shafaei-Bajestani) Department of Pharmacology, Faculty of Medicine,
Gonabad University of Medical Sciences, Gonabad, Iran, Islamic Republic of
(Soleimani) Department of Anesthesiology, Faculty of Medicine, Mazandaran
University of Medical Sciences, Sari, Iran, Islamic Republic of
(Habtemariam) Pharmacognosy Research and Herbal Analysis Services, UK,
Central Avenue, Chatham-Maritime, Kent, United Kingdom
(Hashemi) Department of Pathobiology and Laboratory Sciences, School of
Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran,
Islamic Republic of
(Sahebnasagh) Clinical Research Center, Department of Internal Medicine,
North Khorasan University of Medical Sciences, Bojnurd, Iran, Islamic
Republic of
Publisher
Bentham Science Publishers
Abstract
Background: Coronary Artery Bypass Graft (CABG) surgery is employed to
increase the lifespan of patients with Coronary Artery Disease (CAD). The
low serum levels of essential elements have a negative effect on patients
undergoing CABG. Objective(s): This clinical trial aimed to
investigate the effect of trace elements supplements on postoperative
outcomes after coronary artery bypass graft. Method(s): Two hundred
patients underwent on-pump CABG to randomly receive either
Addamel©, which contains essential trace elements, or
isotonic saline for 3 days. We measured postoperative plasma Zn, Se, Cu,
Mn, Se, and Fe concentrations, and the levels of highly sensitive
C-reactive Protein (hs-CRP) on days 0, 1, and 2. Duration of hospital and
Intensive Care Unit (ICU) stay, 30-day mortality, and the incidence of
Arterial Fibrillation (AF) have been evaluated as secondary outcomes.
 Result(s): In the supplemented group, the plasma levels of Cu and Mn
increased by day 3, and plasma hs-CRP increased by day 1 in both groups,
but it decreased in patients who received trace elements supplementation
on day 2. The Addamel group had a lower mortality rate, though the
difference did not reach a significant level. There was a significant
negative correlation observed between plasma Zn level and 30-day
mortality, along with another significant negative link between plasma CRP
level before operation and Sepsis-related Organ Failure Assessment (SOFA)
score. Other measured parameters were similar between the intervention and
placebo groups. Conclusion(s): The patients undergoing CABG appeared
to benefit from trace element supplementation. A brief period of Addamel
administration following CABG could prevent a decrease in the serum
concentration of trace elements and reduce the circulating plasma CRP.
Clinical Trial Registration Number: IRCT2015110924975N1 Copyright
© 2025 Bentham Science Publishers.

<91>
Accession Number
2033503656
Title
A randomised trial comparing usual versus strict home blood pressure
control in elderly patients with hypertension: protocol and initial
progress.
Source
Blood Pressure. 34(1) (no pagination), 2025. Article Number: 2472192. Date
of Publication: 2025.
Author
Zhang D.-Y.; Zhang Y.-Q.; An D.-W.; Cheng Y.-B.; Tang S.-T.; Liu M.; Li
J.; Staessen J.A.; Wang J.-G.; Li Y.
Institution
(Zhang, Zhang, An, Cheng, Staessen, Wang, Li) Department of Cardiovascular
Medicine, Shanghai Institute of Hypertension, Shanghai Key Laboratory of
Hypertension, National Research Centre for Translational Medicine, State
Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong
University School of Medicine, Shanghai, China
(Tang) Liaobu Community Health Center, Guangdong Province, Dongguan City,
China
(Liu) Henan Province People's Hospital, Henan, Zhengzhou, China
(Li) Department of Epidemiology, Tongji University School of Medicine,
Shanghai, China
(Staessen) Non-Profit Research Association Alliance for the Promotion of
Preventive Medicine, Mechelen, Belgium
(Staessen) Biomedical Research Group, Faculty of Medicine, University of
Leuven, Leuven, Belgium
Publisher
Taylor and Francis Ltd.
Abstract
Objective: The optimal level of home blood pressure (HBP) for the
prevention of cardiovascular complications is unknown. The Home Blood
Pressure Intervention in the Community Trial (HomeBP, [NCT05858944]) is
addressing this issue by randomising elderly hypertensive patients to
standard or tight HBP control. Methods and analysis: HomeBP is an
investigator-initiated randomised clinical trial with open design and
blinded endpoint evaluation. Eligible patients of either sex, aged 60-80
years, having uncontrolled home hypertension (>=135/85 mm Hg) after
medication for at least 2 weeks will be recruited nationwide in China at
up to 200 community healthcare centres. After stratification for centre
and the presence of office hypertension (>=140/90 mm Hg), 10,000 patients
will be randomised in a 1:1 proportion to a target HBP of 125-134/75-84 mm
Hg or <125/75 mm Hg and followed up for 4 years. The primary outcome is a
composite of cardiovascular death, non-fatal myocardial infarction,
coronary revascularisation, unstable angina pectoris or heart failure
requiring hospitalisation, and non-fatal stroke. Follow-up visits are
scheduled monthly for 3 months after randomisation and 3-monthly
thereafter. Patients record HBP for 7 consecutive days before every visit.
A unique feature of the trial is the information technology setup,
allowing the secure and instantaneous flow of HBP and other data to the
study coordinating centre, where a standardised HBP report is generated.
Hypertension specialists at Ruijin Hospital, Shanghai and at local
tertiary hospitals provide treatment recommendations, which are
transmitted to the caregivers at the community centres, who then fine-tune
the treatment recommendations in a shared decision process with the
patients to meet the values and clinical needs of the patients. Currently,
2281 patients have been randomised with no between-group differences in
the baseline characteristics. Trial registration number. URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT05858944. Copyright © 2025 The Author(s). Published by Informa
UK Limited, trading as Taylor & Francis Group.

<92>
Accession Number
2033728323
Title
Hemodynamic Effects of Altering Tidal Volume During Positive Pressure
Ventilation in the Fontan Circulation: A Randomized Crossover Trial.
Source
Paediatric Anaesthesia. (no pagination), 2025. Date of Publication: 2025.
Author
Navaratnam M.; Schmidt A.R.; Kaplinski M.; De Souza E.; Beattie M.J.; Rowe
E.V.; Punn R.; Ramamoorthy C.
Institution
(Navaratnam, Rowe, Ramamoorthy) Department of Anesthesiology,
Perioperative and Pain Medicine, Stanford Children's Hospital, Stanford
University Medical Center, Palo Alto, CA, United States
(Schmidt) Department of Pediatric Anesthesiology, University Children's
Hospital Zurich-Eleonore Foundation, Zurich, Switzerland
(Kaplinski, Beattie, Punn) Department of Pediatric Cardiology, Stanford
Children's Hospital, Stanford University Medical Center, Palo Alto, CA,
United States
(De Souza) Department of Anesthesiology, Perioperative and Pain Medicine,
Stanford University School of Medicine, Stanford, CA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Primary determinants of pulmonary blood flow in the Fontan
circulation are low transpulmonary gradient and pulmonary vascular
resistance (PVR). Changes in intrathoracic pressure during intermittent
positive pressure ventilation can influence the transpulmonary gradient,
PVR, pulmonary blood flow, and cardiac output. The aim of this study was
to evaluate the effect of low (5 mL/kg) versus high (10 mL/kg) tidal
volume (V<inf>T</inf>) ventilation on Fontan circulation hemodynamics.
 Method(s): Postoperative patients with a Fontan circulation were
enrolled in this single-center, randomized crossover trial. Patients,
randomized to group 1 or 2, underwent a ventilation study sequence
(baseline ventilation [7 mL/kg], then high V<inf>T</inf> [10 mL/kg] or low
V<inf>T</inf> [5 mL/kg], then washout ventilation [7 mL/kg], followed by
low [5 mL/kg] or high V<inf>T</inf> [10 mL/kg]) in the operating room at
the end of the cardiac surgical procedure. Respiratory, hemodynamic, and
transesophageal (TEE) measurements were recorded after 5 min in each
ventilation condition. The primary aim of this study was to evaluate the
effect of low V<inf>T</inf> ventilation (5 mL/kg) versus high
V<inf>T</inf> ventilation (10 mL/kg) on transpulmonary gradient (Fontan
pressure minus left atrial pressure). The secondary aim was to compare TEE
measurements of pulmonary blood flow, stroke volume, and Fontan flow
between low and high V<inf>T</inf> ventilation. We also compared standard
hemodynamic and ventilation parameters for all ventilation conditions.
Analysis was of paired data, calculating the between-treatment difference
within participants across ventilation conditions. Result(s): Eleven
patients were included in the final data analysis with a median [IQR] age
of 5 [4, 11] years and weight of 16.3 [13.8, 31.6] kg. The mean (+/-SD)
peak inspiratory pressure during low and high V<inf>T</inf> ventilation
was 15.3 (+/-2.9) cmH<inf>2</inf>O and 22.2 (+/-3.7) cmH<inf>2</inf>O,
respectively (difference -6.9, 95% CI -7.8, -5.9, p < 0.001). The mean
airway pressure during low and high V<inf>T</inf> ventilation was 7.3 +/-
0.8 and 8.7 +/- 0.9 (difference -1.5, 95% CI -2.1, -0.8, p = 0.001) with a
mean inspiratory time of 0.62 (+/-0.22) s and 1.21 (+/-0.55) s (difference
-0.59, 95% CI -0.84, -0.34, p < 0.001), respectively. During low
V<inf>T</inf> ventilation, the mean Fontan pressure was 13.3 (+/-1.8) mmHg
compared to 12.3 (+/-2.5) mmHg for high V<inf>T</inf> ventilation
(difference 0.8, 95% CI -0.5, 2.1, p = 0.18). The mean transpulmonary
gradient was 7.0 +/- 1.3 mmHg compared to 6.8 +/- 1.2 mmHg during low and
high V<inf>T</inf> ventilation, respectively (difference 0.2, 95% CI -0.2,
0.6, p = 0.21). We found no significant differences between low and high
V<inf>T</inf> ventilation in TEE measures of pulmonary blood flow, stroke
volume, and Fontan flow. Conclusion(s): This randomized, crossover
pilot trial of Fontan patients showed that a low V<inf>T</inf> ventilation
(5 mL/kg) resulted in significantly lower peak and mean airway pressure
compared with a high V<inf>T</inf> ventilation (10 mL/kg). However, there
were no significant changes in transpulmonary gradient, mean Fontan
pressure, or TEE parameters of stroke volume, pulmonary blood flow, or
Fontan flow. Clinical Trials Registration Number: NCT04633343. Principal
Investigator: Manchula Navaratnam. Date of Registration: November 11,
2020. Clinical Trials Registration Registry URL:
https://clinicaltrials.gov/study/NCT04633343?term=Fontan%20ventilation&ran
k=3. Prior Presentations: Congenital Cardiac Anesthesia Society Annual
Meeting Top Oral Abstract Presentation. Presenter: Alexander R Schmidt,
March 30th, 2023. Copyright © 2025 John Wiley & Sons Ltd.

<93>
Accession Number
2033532313
Title
RETRACTION: Effects of Negative Pressure Wound Therapy on Surgical Site
Wound Infections after Cardiac Surgery: A Meta-Analysis (International
Wound Journal, 2024, 21, 2, (e14398), 10.1111/iwj.14398).
Source
International Wound Journal. 22(3) (no pagination), 2025. Article Number:
e70320. Date of Publication: 01 Mar 2025.
Author
Anonymous
Publisher
John Wiley and Sons Inc
Abstract
The above article, published online on 23 September 2023, in Wiley Online
Library (http://onlinelibrary.wiley.com/), has been retracted by agreement
between the journal Editor in Chief, Professor Keith Harding; and John
Wiley & Sons Ltd. Following an investigation by the publisher, all parties
have concluded that this article was accepted solely on the basis of a
compromised peer review process. The editors have therefore decided to
retract the article. The authors did not respond to our notice regarding
the retraction. Copyright © 2025 The Author(s). International
Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons
Ltd.

<94>
Accession Number
646878424
Title
Comparative Analysis of Pressure and Volume Controlled Ventilation Modes
During One Lung Ventilation for Empyema Thoracis.
Source
Anesthesia and Analgesia. Conference: 18th World Congress of
Anaesthesiologists. Singapore Singapore. 139(6 Supplement 2) (pp 442-444),
2024. Date of Publication: 01 Dec 2024.
Author
Chandra D.; Gautam S.; Kumar S.; Prakash R.; Singh D.
Institution
(Kumar) Medanta Hospital, Lucknow, India
(Chandra, Gautam, Prakash, Singh) King George's Medical University,
Lucknow, India
(Kumar) General Surgery, King George's Medical University, Lucknow, India
Publisher
Lippincott Williams and Wilkins
Abstract
Background and Objectives: One lung ventilation (OLV) is crucial for
thoracic surgery, yet it poses challenges, such as intrapulmonary shunting
causing arterial hypoxemia. Previous studies suggest that lower airway
pressures during OLV reduce the risk of acute lung injury (ALI) by
improving oxygenation through reducing the shunt fraction of the dependent
lung. This study aims to compare pressure and volume-controlled
ventilation modes during OLV for empyema thoracis patients, focusing on
oxygenation, airway pressures, airway compliance, and post-operative
complications. Method(s): After Clinical Trial Registry of India
registration (CTRI/2021/02/031499) and institutional ethical committee
approval (IRB NUMBER-ECR/262/Inst/UP/2013/RR-19) this prospective,
randomized controlled study was conducted for 1 year involving 50 ASA
category I, II, and III patients aged 20-70 years undergoing decortication
surgery for empyema thoracis. Patients were randomly assigned to
volumecontrolled (V) or pressure-controlled (P) ventilation groups during
OLV. Various parameters, including arterial blood gases, airway pressures,
and hemodynamic monitoring, were assessed throughout the surgery.
Intraoperative multimodal analgesia was employed. Post-operative
complications were recorded, considering factors like re-intubation,
bronchospasm, hospital stay, and hypoxemia. Result(s): Both the
groups were comparable in terms of age, sex, weight, severity of disease
and socioeconomic status. Disease was more common in men and low
socioeconomic status. 1. Oxygenation: - Pre-op PaO2 showed no significant
Difference between group-V and group-P. - Intra-op PaO2 significantly
favored group-P (p<0.0001*). - Post-OP PaO2 also significantly favored
group-P (p<0.0001*), indicating superior oxygenation with
pressurecontrolled ventilation. 2. Airway Pressures: - Peak pressure was
significantly lower in group-P (p=0.0186*) and so were plateau pressure
(p=0.0151*), suggesting improved airway compliance with
pressure-controlled ventilation. 3. Airway Compliance: - There was
superior lung compliance in group- P (p=0.0144*). 4. Post-operative
Complications: - Group-P showed fewer complications, including
post-operative shifting to mechanical ventilation and bronchospasm. - The
mean Difference was statistically insignificant (p=0.3902), indicating a
potential advantage with pressure-controlled ventilation. Discussion and
 Conclusion(s): Arterial hypoxemia is a common concern during OLV, and
this study affirms that pressure-controlled ventilation offers better
oxygenation and airway pressures compared to volume-controlled
ventilation. The mechanical effects of pressure-controlled ventilation,
delivering a set tidal volume with lower airway pressures, contribute to
reduced barotrauma and improved oxygenation. The study highlights that
pressure-controlled ventilation can be an effective alternative to
volume-controlled ventilation during one-lung anesthesia, especially in
patients with respiratory illnesses.The comparable demographic profiles of
the study groups enhance the reliability of the findings. The observed
trends suggest that pressurecontrolled ventilation may be preferable,
particularly for patients with existing respiratory illnesses. The
insignificantly lower post-operative complications in the
pressure-controlled group further support its potential advantages. In
conclusion, this study contributes valuable insights into optimizing
ventilation strategies during OLV for empyema thoracis patients. The
preference for pressure-controlled ventilation emerges, emphasizing its
role in improving oxygenation, airway pressures, and potentially reducing
post-operative complications. Further research could delve deeper into
patient-specific factors influencing the choice of ventilation mode during
thoracic surgeries.

<95>
Accession Number
646875627
Title
Simulation Based Teaching Versus Point Of Care Teaching Of Basic
Transthoracic Echocardiography - A Prospective Randomised Superiority
Study.
Source
Anesthesia and Analgesia. Conference: 18th World Congress of
Anaesthesiologists. Singapore Singapore. 139(6 Supplement 2) (pp 901-904),
2024. Date of Publication: 01 Dec 2024.
Author
Goyal A.; Kumar A.; Singi Y.; Rao S.
Institution
(Goyal) Cardiovascular and Thoracic Anaesthesia, Sri Sathya Sai Sanjeevani
Hospital, Naya Raipur, India
(Kumar) Cardiovascular and Thoracic Anaesthesia, AIIMS Rishikesh,
Rishikesh, India
(Singi) Forensic Medicine, AIIMS Bilaspur, Bilaspur, India
(Rao) AIIMS Rishikesh, Rishikesh, India
Publisher
Lippincott Williams and Wilkins
Abstract
Background and Objectives: Achieving competence and accreditation in
echocardiography, most widely used non-invasive cardiac imaging technique
is a time-consuming endeavor that necessitates a structured pathway
requiring extensive patient scanning, a task often hindered by the
constraints of a busy clinical setting. Additionally,the training process
encompasses both technical and cognitive skills, traditionally imparted
through didactic instruction, observational learning, and independent
examinations. Unfortunately, lack of standardization and reproducibility,
coupled with discomfort and anxiety experienced by patients during live
training sessions, further complicates the training process.These
challenges in echocardiography training can be eXectively mitigated by
utilizing simulation, whichhas evolved to oXer numerous advantages over
conventional teaching methods for both transthoracic echocardiography
(TTE) and transesophageal echocardiography (TEE). While studies have
investigated the impact of simulator-based TEE training compared to
traditional methods, limited research has explored this in the context of
TTE education.Hence, we initiated a prospective randomized superiority
study to compare cognitive and psychomotor knowledge acquired by residents
in two diXerent methods of training in Basic TTE Methods: Participants: 68
clinical residents of Anesthesia, Neuroanesthesia, Emergency Medicine and
Cardiothoracic surgery without prior exposure to echocardiography. The
flowchart of the process undertaken during the research is attached.
 Result(s): There was statistically significant diXerence in the MCQ
score for the pre and post-tests in both the groups (p<0.001) however both
groups did not diXer in terms of MCQ score at any timepoints (Table
1).Between post training test and follow up test 2 week later between the
groups, there was no significant improvement in image acquisition time and
test score (Table 1). There was a significant diXerence between
participants and experts. Discussion and Conclusion(s): Several
researchers have compared the eXectiveness of training using simulator
with traditional methods of teaching such as didactic lectures, textbook
readings, demonstrations, hands on exposure etc for training health care
professional in echocardiography. Though many have compared it training in
TEE [1-13], few have also have compared it for training in TTE
[14-18].Most of them observed that simulation based training had advantage
of acquiring better skill in terms of TTE image acquisition and anatomy
identification. However every study had diXerent study design wherein
simulation was compared with either textbook learning [16], e-learning
[11], lecture based video learning [8,13,14,17], demonstration in
operating room [7,9].We conclude that simulation with point of care (POC)
teaching is as eXicacious as isolated conventional point of care teaching
for initial training of residents about basic trans-thoracic
echocardiographic views, if not better with safety in place. This method
of training where probes are given to trainee during training and asked to
visualize and interpret the images, i.e. a hand-eye-head model help
trainees quickly establish correlation between three-dimensional
anatomical structures and two-dimensional echocardiographic views,
allowing them to have a deeper understanding rather than just
memorization. Secondly, as the trainee begins to control the probe, the
information from the didactic lecture is simulated and reorganized in
their minds. Therefore, it is recommended that TTE training using both
point of care and on simulator should be included in the post-graduate
curriculum.

<96>
Accession Number
646876339
Title
Intraoperative Hypotension Is Associated with Postoperative Infections in
Elderly Patients Undergoing Major Surgery: A Post-Hoc Analysis.
Source
Anesthesia and Analgesia. Conference: 18th World Congress of
Anaesthesiologists. Singapore Singapore. 139(6 Supplement 2) (pp
2082-2087), 2024. Date of Publication: 01 Dec 2024.
Author
Chen N.-P.; Li Y.-W.; Wang D.-X.
Institution
(Chen, Li, Wang) Anesthesiology, Peking University First Hospital,
Beijing, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background and Objectives: Postoperative infection is a significant
challenge for patients who undergo thoracic and abdominal surgery. The
hemodynamic status during the perioperative period can vary greatly,
especially during the operation. The primary hypothesis of this study is
that intraoperative hypotension (IOH) is associated with the overall
postoperative infections. Secondary hypotheses include the association of
IOH with the number of postoperative infections and specific types of
infections. Method(s): This study is a post-hoc analysis of a
previous randomized controlled trial. The relationship between the lowest
mean arterial pressure (MAP) recorded during the operation for different
durations (1, 3, 5, and 10 minutes) and the overall occurrence of
postoperative infections was assessed using restricted cubic spline
analysis. Multivariable logistic regression models were used to analyze
these relationships. Result(s): A total of 1556 patients were
included in the study, and 101 (6.5%) of them experienced postoperative
infectious complications during their hospital stay. These complications
included severe sepsis in 52 (3.3%) patients, pneumonia/urinary tract
infection in 36 (2.3%) patients, and wound/body cavity infection in 31
(2.1%) patients. Restrictive cubic spline models showed that MAP <60 mmHg
was potentially harmful threshold for overall postopeative infections.
Binary logistic regression analysis revealed a significant association
between area under the curve (AUC) of MAP <60 mmHg for >100 mmHg-min and
overall postoperative infection (adjusted odds ratio [aOR] 1.89; 95%
confidence interval [CI] 1.15 to 3.02, P=0.010). For the subgroup
infections, AUC of MAP <60 mmHg for >100 mmHg-min showed the similar
association with pneumonia/urinary tract infection (aOR 3.16, 95% CI 1.52
to 6.47, P=0.004). The ordinal logistic regression analysis showed
significant association between the same exposure with the number of
postoperative infections. (aOR 1.81, 95% CI 1.19 to 2.69, P=0.004).
Discussion and Conclusion(s): In elderly patients undergoing major
surgery, intraoperative hypotension is associated with the overall
postoperative .

<97>
Accession Number
646875754
Title
A Prospective Randomized Placebo Controlled Trial of Erector Spinae Plane
Catheters in Cardiac Surgery Patients: Cytokine Profiles and Pain
Outcomes.
Source
Anesthesia and Analgesia. Conference: 18th World Congress of
Anaesthesiologists. Singapore Singapore. 139(6 Supplement 2) (pp
2296-2297), 2024. Date of Publication: 01 Dec 2024.
Author
Baca Q.; Brodt J.; Nasiri M.; Kasimova K.; Tsui B.
Institution
(Baca, Brodt, Nasiri, Kasimova, Tsui) Stanford University, Stanford, CA,
United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background and Objectives: Regional anesthesia techniques including
Erector Spinae Plane (ESP) blocks have potential to provide chest wall
analgesia. However, the level of evidence for the applicability of this
technique remains low and the eUects of this nerve block on patient
cytokine profiles have not been described. The RACER (Regional Anesthesia
for Cardiothoracic Enhanced Recovery) study used placebo control, double
blinding, and randomization, to determine if the use of lidocaine via ESP
catheters changed postoperative opioid requirements, pain scores, cytokine
profiles, or other measures of recovery in patients undergoing sternotomy.
 Method(s): Following institutional review board approval (protocol ID
47647) and registration on clinicaltrials.gov (NCT03781440), patients
scheduled for elective coronary and/or aortic or mitral valve surgery were
recruited between January 2020 and September 2021. All participants
received bilateral ultrasound guided thoracic ESP catheters prior to their
procedure. Before incision, patients received an ESP catheter bolus of
study drug (either saline or lidocaine 0.5%, 0.75mg/kg per side). After
surgery, the ESP catheters were dosed via infusion pump with boluses every
2 hours (lidocaine 0.5%, 0.5mg/kg) until chest tube removal or POD5. Blood
samples were drawn preoperatively, 6h postoperatively, and 24h and 48h
after surgery. Samples were analyzed in duplicate using a multiplexed
human inflammatory cytokine panel including cytokines IL-6, IL-1beta,
TNFalpha, IFNgamma, and anti-inflammatory cytokine IL-10. Statistical
analysis was completed in R and Excel (t-test for continuous variables and
Fisher's exact test for categorical comparisons). Result(s): Sixty
patients were recruited and randomized, with 28 in the treatment arm and
32 in the control arm. Total opioid consumption (POD0-5, morphine
equivalents(meq)) was not significantly diUerent: treatment group (142
+/-n; 151mg, range 0-670mg), control group (185 +/-n; 180mg, range
16-716mg) (p = 0.33). There were no significant diUerences in median or
maximum pain scores between the two groups. The treatment group had 0/28
(0%) patients with intolerable pain versus 3/32 (9%) in the control group
(p = 0.16). The treatment group had 3/28 (11%) patients who required no
opioids in the postoperative period versus 0/32 (0%) in the control group
(p = 0.11) Peak increase in pro- and anti-inflammatory cytokines occurred
at 6h postop with partial resolution towards baseline by POD 2. Patient
treated with lidocaine had significantly higher anti-inflammatory IL-10
levels 6h postop (73.8 +/-n; 109.4pg/ml vs 38.3 +/-n; 31.5pg/ml, p=0.04).
Levels of proinflammatory IL-6, IL- 1beta, TNFalpha, and IFNgamma were
similar between treatment and control groups. In both groups, patients
with lower preoperative ratios of IL-6 to IL-10 used less opioids
postoperatively (POD1-POD5). Patients in the lowest quartile of
preoperative IL-6/IL-10 used 78.7 +/-n; 75.1meq versus those in the
highest quartile of IL-6/IL-10 used 196.9 +/-n; 187.5meq, p=0.03.
Discussion and Conclusion(s): We quantified changes in patient
cytokine profiles after sternotomy. Increased levels of IL-10 in the
treatment arm at 6h post-surgery suggest a mechanism for a systemic
antiinflammatory eUect of lidocaine. Lower preoperative ratios of
proinflammatory IL-6 to antiinflammatory IL-10 were associated with less
postoperative opioid usage. This suggests an opportunity to use a
preoperative blood test to anticipate postoperative opioid requirements.

<98>
Accession Number
646878360
Title
Comparative Study of Conventional Versus Ultrasound Assisted Femoral
Arterial Cannulation: A Prospective Observational Study.
Source
Anesthesia and Analgesia. Conference: 18th World Congress of
Anaesthesiologists. Singapore Singapore. 139(6 Supplement 2) (pp 413-414),
2024. Date of Publication: 01 Dec 2024.
Author
Kumar V.
Institution
(Kumar) DR Ram Manohar Lohia institute of medical sciences vibhuti khand
gomati nagar lucknow U.P. India, Lucknow, India
Publisher
Lippincott Williams and Wilkins
Abstract
Background and Objectives: Common femoral artery (CFA) is one of the most
frequently used vascular access site for diagnostic and therapeutic
coronary interventions. Primary objective is to compare the two methods,
namely conventional and ultrasound assisted for femoral arterial
cannulation on the basis of incidence of complications, Secondary: - To
compare the angle of insinuation of arterial puncture among Different
methods of cannulations, time taken for successful cannulation, first pass
success rate, number of skin punctures needed. Method(s): our study
was prospective comparative observational type conducted in patients
undergoing femoral arterial cannulations for various indications such as
coronary angiography in cath lab and in routine cardiac surgery patients,
at tertiary care medical institute; from march 2020 to august 2021. After
obtaining institutional ethical clearance (IEC No 62/18/ RMLIMS/2019),
with C.T.R.I. number CTRI/2021/02/031328. And written consent from
participant, 100 patients were allocated for study and divided into two
groups of 50 each, namely There were two groups of patients, C Group:
Patients undergoing femoral arterial catheterisation by conventional
method, U Group: Patients undergoing femoral arterial catheterisation
under ultrasound guidance, Results: The mean time for cannulation in
conventional group is higher compared to ultrasound-guided group, with
significant Difference (P <0.001), numbers of skin punctures for
cannulation in ultrasound group were lower compared to conventional group
with significant Difference (P <0.018), The mean first pass success rate
was higher in group U than group (P <0.028), There was no incidence of
posterior wall puncture in group U in comparison with 1 incidence in
conventional group, The incidence of femoral vein punctures was lower
group U, than group C (P<0.022), post-op hematoma were lower in group U as
compared with group C (P <0.046). Discussion and Conclusion(s): We
found that a significant Difference in time required for cannulation
between these two groups with a (P <0.001) as mean time for cannulation in
conventional group is 100.90 seconds compared to 78.16 seconds in
ultrasound guided group which is shown in table-1. The mean first pass
success rate of ultrasound guided cannulations was 32 compared to 21 in
conventional group showing a significant number of first pass success in
ultrasound guided group with a (P < 0.028) as shown in table- 1. Murat
Gedikoglu et al. (17) in 2013 Compared Ultrasound Guidance with the
Traditional Palpation and Fluoroscopy Method for the Common Femoral Artery
Puncture. The time for successful Ultrasound-guided cannulation was
significantly lower 53 sec, time for the palpation-guided method 74 sec
(p< 0.003). Like this in our study also we found that time for cannulation
is lesser in U group.Hence we conclude that USG cannulation of femoral
artery was easier to performed took fewer attempts, shorter time, fewer
number of skin punctures, fewer complications like hematoma formation and
posterior wall / FEM vein puncture and larger angle of insinuation than
the conventional method. Further studies using a randomised allocation in
age-matched patients are recommended to draw more robust conclusions.

<99>
Accession Number
646878322
Title
Retrospective Comparative Study of Topical Tranexamic acid v/s Intravenous
Tranexamic acid in Off-pump Coronary Artery Bypass Grafting.
Source
Anesthesia and Analgesia. Conference: 18th World Congress of
Anaesthesiologists. Singapore Singapore. 139(6 Supplement 2) (pp 394-396),
2024. Date of Publication: 01 Dec 2024.
Author
Sakhare V.J.; Umbarkar S.
Institution
(Sakhare, Umbarkar) Cardiac Anaesthesia, K.E.M. Hospital, Mumbai, India
Publisher
Lippincott Williams and Wilkins
Abstract
Background and Objectives: CABG is a surgical procedure used to treat CAD,
and although generally safe and effective, it carries potential
perioperative complications. Most common complication include bleeding. To
reduce bleeding and the need for blood transfusions in CABG surgeries,
tranexamic acid (TXA) is commonly used. TXA can be administered either
topically or systemically. Aim- Assess the efficacy of Intravenous v/s
Topical Tranexamic Acid in patients posted for Off-pump CABG. Primary
Objective- Amount of postoperative mediastinal drain in first 72 hrs after
surgery. Secondary Objectives- Number and frequency of blood product
transfusion. Reexploration for bleeding. Duration of ICU stay Major
cardiac events (Myocardial infarction, Stroke, Death, Acute lung injury)
Methods: Study Design- Retrospective, comparative study. Study Setting-
Department of Cardiovascular and Thoracic Anaesthesia, Seth G.S. Medical
College and K.E.M. Hospital, Mumbai. Study population- Adult patients
(18-75 yrs)posted for elective off-pump CABG under general anaesthesia. 60
Patients operated for off-pump CABG were included in the study. The data
was collected from Medical Record Department. Group A patients, 10mg/kg of
intravenous tranexamic acid was given at the end of suturing the skin
layer. Group B patients, 2 gm of Tranexamic acid in 100 ML 0.9% normal
saline was poured into the pericardial cavity while closure. Data was
collected under following headings-Total mediastinal drain amount recorded
at 2 hours, 6 hours, 12 hours, 24 and 72 hours in the I.C.U., Blood
transfusion, if required, Complications, Duration of ICU stay.
 Result(s): We collected data for 30 cases in topical group and 30
cases in intravenous group. The average hospital stay was 5.30 days among
intravenous groups and 4.43 days among topical group. (p<0.05). The
average ICU stay among topical and intravenous group were 4.30 days and
3.43 days respectively. (p<0.05). The number of blood transfusions was
significantly higher among intravenous group when compared to topical
group. (p<0.05). The intra operative haemoglobin levels among the
intravenous group were 9.03 and among topical group were 9.21. (p>0.05).
The post operative drain among intravenous group was 476.20 ml and among
topical group was 401.97 ml. (p>0.05) Discussion and Conclusion(s):
Discussion- Wang G et al(2012) evaluated the effects of an
antifibrinolytic, tranexamic acid, on postoperative bleeding and
transfusion requirements in patients undergoing OPCAB surgery. In
comparison with the placebo group, the patients receiving tranexamic acid
had a significant reduction in chest tube drainage at 6 hours (270 +/- 118
mL vs 416 +/- 179 mL, P < 0.001) and 24 hours (654 +/- 224 mL vs 891 +/-
295 mL, P < 0.001). There was also a significant reduction in allogeneic
red blood cell transfusions (47 vs 31.9%, P = 0.019) and fresh frozen
plasma (29.6% vs 17.2%, P = 0.027) transfusions. Conclusion- In the
present study, the postoperative drain was significantly higher among
intravenous group when compared to topical group. The number of blood
transfusions was significantly higher among intravenous group when
compared to topical group. But over all intra operative haemoglobin was
similar in both the groups.

<100>
Accession Number
646876209
Title
Acute Spontaneous SDH Complicating Post-operative Laparoscopic
Cholecystectomy: a Rare occurrence Case Report.
Source
Anesthesia and Analgesia. Conference: 18th World Congress of
Anaesthesiologists. Singapore Singapore. 139(6 Supplement 2) (pp
2185-2187), 2024. Date of Publication: 01 Dec 2024.
Author
Datye A.V.
Institution
(Datye) Sevasadan Lifeline Superpeciality Hospital, Anaesthesia and
Critical Care, Sangli, India
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Acute spontaneous subdural hematoma (SDH) as a postoperative
complication in an elective laparoscopic cholecystectomy is yet not
reported. Traumatic SDH is known in patients on DAPT (dual
antiplatelet)1-3. Age, IHD, CVA increase the risk of perioperative
complications. Case Description: 60year male previously treated for gall
bladder empyema with antibiotic and pigtail catheter, was posted for
elective laparoscopic cholecystectomy after 4 weeks. Comorbid diabetes
mellitus, ischaemic heart disease and operated coronary angioplasty 6
months ago, he was on DAPT, OHA, diuretic and beta blocker. Clopidogrel
was stopped 5 days prior and ecosprin for 3 days4 , 5 . GA was given using
fentanyl, etomidate, midazolam and vecuronium, with ETT 8.5 portex and
maintained on sevoflurane, air + oxygen. Initial Laparoscopy was abandoned
due to difficult calot's triangle dissection and proceeded to open surgery
in total took 4 hours. Patient was extubated on table and transferred to
critical care, modified aldret score of 8. GCS 11, 2 hours'
post-operative, a repeat ABG showed hypercapnia 110 and acidosis 6.9 pH.
Immediately intubated and hyperventilated, acidosis was corrected. Next
day weaning was started with ABG showing PCO2 45. The patients' GCS was
still 11-12. GCS didn't improve a CT brain was done to rule out structural
disease. The scan showed rim of subdural haematoma on right frontal side
7.8mm. No sensory motor deficit was noted, patient remained drowsy,
arousable to command. Neurosurgery opinion was done, case conserved. FAST
HUG BID instituted. POD 4, patient was weaned off ventilator, extubated
after successful SBT. Chest physiotherapy initiated. POD 6, shifted to
step down ICU. Drains were minimal, peristalsis present, water and clear
liquids instituted day 6 after RT removal. Patient was discharged POD 10
without neurodeficit and any other complication. Discussion(s): The
metaanalysis by Connelly BJ et al 1and Bakheet MF3 et discuss the aspirin
and clopidogrel therapy and risk of subdural hematoma respectively. Trials
so far propose higher risk in those on DAPT versus single therapy to none.
traumatic SDH are known however acute spontaneous SDH is very rare
0.02-1/1000 patient years. American and European guidelines have been well
established for use of DAPT in post PCI patients undergoing non cardiac
surgery4 - 5.Presence of co-existing factors for low GCS hypercapnia,
uraemia, hepatic encephalopathy might delay diagnosis of structural
disease and increase morbidity.6-8.

<101>
Accession Number
646878457
Title
Effect of Volatile Versus Intravenous Anesthesia on Acute Kidney Injury
after Cardiac Surgery: Secondary Analysis of a Randomized Controlled
Trial.
Source
Anesthesia and Analgesia. Conference: 18th World Congress of
Anaesthesiologists. Singapore Singapore. 139(6 Supplement 2) (pp 352),
2024. Date of Publication: 01 Dec 2024.
Author
Xu Y.; Yu H.
Institution
(Xu, Yu) Department of Anesthesiology, West China Hospital of Sichuan
University, Chengdu, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background and Objectives: On-pump cardiac surgery is burden with a
relatively high risk of acute kidney injury (AKI) after surgery. The
choice of anesthetic agent may influence regulation of renal perfusion and
function. We therefore evaluated the effect of anesthetic regimen
(volatile anesthesia versus propofol-based intravenous anesthesia) on
renal outcomes following on-pump cardiac surgery. Method(s): This is
a secondary analysis of a randomized controlled trial. Patients scheduled
for on-pump cardiac surgery were randomized to receive anesthesia
maintenance with either volatile anesthetics or propofol. The primary
outcome was the incidence of AKI. Levels of serum creatinine, cystatin C,
blood urea nitrogen (BUN) were also measured at baseline, upon ICU
admission, at 24 and 48 hours after sugery. Result(s): A total of
1332 patients were included in the final analysis. The incidence of
postoperative AKI was 17.4% (117 of 671) in the volatile anesthesia group
versus 17.5% (116 of 661) in the propofol anesthesia group (risk ratio,
0.99/hazard ratio; 95% confidence interval, 0.79-1.26; P=0.957). The AKI
stage did not Differ significantly between groups (P=0.334). The level of
cystatin C was lower in the volatile anesthesia group than in the propofol
group (P=0.049), with no significant variation over the time points. Serum
creatinine and BUN were elevated postoperatively compared with baseline
(P<0.001), but not significantly Different between two groups. Discussion
and Conclusion(s): The incidence and stage of AKI after on-pump
cardiac surgery was similar with volatile and propofol-based intravenous
anesthesia. The choice of primary anesthetic regimen may have no clinical
impact on postoperative renal outcome. However, volatile anesthesia was
associated with a reduced level of cystatin C (i.e., a marker of renal
impairment), which deserve further research.

<102>
Accession Number
646876211
Title
Association of Intraoperative Dexmedetomidine Administration with
Postoperative In-Hospital Mortality.
Source
Anesthesia and Analgesia. Conference: 18th World Congress of
Anaesthesiologists. Singapore Singapore. 139(6 Supplement 2) (pp
2040-2042), 2024. Date of Publication: 01 Dec 2024.
Author
Lei C.
Institution
(Lei) Xijing Hospital, Anesthesiology and Perioperative Medicine, Xi'an,
China
Publisher
Lippincott Williams and Wilkins
Abstract
Background and Objectives: Dexmedetomidine has been widely used
perioperatively. Although adjunctive use of dexmedetomidine provides
better postoperative prognosis in cardiac surgery patients, little is
known about the patient-centered outcomes associated with perioperative
dexmeditomidine use in all-type surgery. To assess the association of
intraoperative administration of dexmedetomidine with in-hospital
all-cause mortality in patients undergoing all types of surgery under
general anesthesia. Method(s): Retrospective cohort study of 488,574
in-hospital patients from five tertiary hospitals in China who underwent
surgical procedures between January 1, 2014 and June 30, 2018.
Intraoperative combined use of propofol and dexmedetomidine as compared to
the use of propofol only. The primary outcome was the composite outcomes
of in-hospital all-cause mortality and discharged to hospice or sent back
home. The secondary outcomes were postoperative adverse events which
indicating the injury or dysfunction of different vital organs. The
exposure to dexmedetomidine and the primary outcome was modeled using
logistic regression model. The propensity score based overlap
weighting(OW) were used to minimize potential bias and variance.
 Result(s): A total of 488,574 patients underwent general anesthesia
assisted surgery were included in the analysis. The mean(SD) age was 52.0
[41.0;62.0] years old; 278,550 procedures (56.6%) were performed in female
patients. Dexmedetomidine was used in 313,737 procedures (64.21%).
Patients exposed to dexmedetomidine had a higher prevalence of
comorbidities (57.7% vs 54,5%), higher prevalence of chronic medication
history (39.9% vs 31.3%), higher ASA and procedure classification, and
longer surgery duration (1.83 [1.15;2.93] vs 1.67 [0.98;2.82] hours) than
patients not exposed to dexmedetomidine. After applying overlap weighting,
baseline and surgeryrelated characteristics were well balanced between
groups. A total of 2,321 (0.48%) patients died or were discharged to
hospice, including 1,140 (0.37%) exposed to dexmedetomidine and 1,181
(0.67%) not exposed to dexmedetomidine. In the primary analysis, patients
with perioperative dexmedetomidine exposure had a lower risk of
postoperative in-hospital mortality and discharged to hospice (overlap
propensity score-weighted risk reduction [95%CI], -0.301% [-0.345%;
-0.209%]; odds ratio [95%CI] 0.62 [0.56; 0.68]). Discussion and
 Conclusion(s): Among surgical patients in this cohort study, the risk
of adverse prognosis as of in-hospital mortality and discharged to hospice
was lower in patients with intraoperative dexmedetomidine exposure
compared with patients who were not exposed to dexmedetomidine
intraoperatively. However, the findings should be further verified in
randomized clinical trials.

<103>
Accession Number
646878296
Title
Functional Intervention Following Cardiac Surgery to Prevent Postoperative
Delirium in Older Patients (FEEL WELL Study).
Source
Anesthesia and Analgesia. Conference: 18th World Congress of
Anaesthesiologists. Singapore Singapore. 139(6 Supplement 2) (pp 379-382),
2024. Date of Publication: 01 Dec 2024.
Author
Wittmann M.; Guttenthaler V.; Kunsorg A.; Dogan T.D.; Schewe J.-C.
Institution
(Wittmann, Guttenthaler, Kunsorg, Dogan) University Hospital Bonn, Bonn,
Germany
(Schewe) Anaesthesiology,Intensive Care Medicine and Pain Therapy,
University Medical Centre Rostock, Rostock, Germany
Publisher
Lippincott Williams and Wilkins
Abstract
Background and Objectives: Postoperative delirium frequently occurs in
patients following cardiac surgery, particularly among older individuals.
This condition is characterized by disruptions in attention and
consciousness and can result in elevated postoperative health issues, an
extended requirement for caregiving, and even mortality1. Multisensory
stimulation is used for patients with Alzheimer's disease.2 This study's
objective is to explore the potential of multisensory stimulation in
preventing postoperative delirium in cardiac surgery patients.
 Method(s): In this monocentric, prospective, randomized, controlled,
nonpharmacological interventional study 186 patients, 65 years and older,
that underwent elective cardiac surgery at the University Hospital Bonn
from September 2021 until July 2022 were included. This study was carried
out in accordance with the Helsinki Declaration. An ethics vote was
provided by the Ethics Commitee of the Medical Faculty of the University
Bonn (#293/21). Trial was registered at the DRKS: DRKS00026909. Written
informed consent to the study was obtained from each patient before
surgery. Then patients were randomized either to the intervention or
control group. In both groups, postoperative delirium was assessed with
the 3-Minute Diagnostic Interview for Confusion Assessment Method (CAM 3D)
on the first five days after surgery. Multisensory stimulation was
performed 20 minutes a day for the first three postoperative days in the
intervention group. Result(s): The incidence of postoperative
delirium was 22.6% in the intervention group and 49.5% in the control
group (p<0.001) (Table 1). Duration of postoperative delirium was
significantly shorter in the intervention group (p<0.001). Stay in the
intensive care unit was significantly longer in the control group
(p=0.006). Logistic regression was performed to examine the effect of the
intervention on POD development. Included factors were intervention, pain
score on day 1 (NRS score), gender, ventilation time, age in increments of
five years and ASA classification, and served as independent variables.
Our regression model revealed that intervention (adj. OR 2.67), NRS score
on day 1 (adj. OR 1.16), age (adj. OR 1.62) and ventilation time (adj. OR
1.12) were significantly associated with POD (p=0.007; p=0.032; p=0.006;
p=0.006 respectively). Discussion and Conclusion(s): As a result of
extended human lifespans and aging populations POD is a growing and
challenging health care problem and prevention, early diagnosis and
treatment are of great importance. The outcomes of the study conducted on
cardiac surgery patients suggest that a personalized multisensory
stimulation lasting for 20 minutes, administered during the initial three
days following surgery, may have the potential to decrease both the
frequency and duration of postoperative delirium, especially in older
patients. A positive influence of the treatment on the incidence of
delirium in other patient groups, patient's length of stay in the
intensive care unit, and postoperative pain should be confirmed in further
clinical studies.

<104>
Accession Number
646876001
Title
Association between Storage Time of Transfused Red Blood Cells and
Infection after Clean-Contaminated Surgery: a Retrospective Cohort Study.
Source
Anesthesia and Analgesia. Conference: 18th World Congress of
Anaesthesiologists. Singapore Singapore. 139(6 Supplement 2) (pp
2005-2006), 2024. Date of Publication: 01 Dec 2024.
Author
Xu X.; Zhang Y.; Yu X.; Huang Y.
Institution
(Xu, Zhang, Yu, Huang) Anesthesiology, Peking Union Medical, College
Hospital, Beijing, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background and Objectives: Storage lesions of red blood cells (RBCs) can
aggravate transfusion-related immunomodulation and create additional risks
of infections.[1] Very few randomized controlled trials (RCT) have
investigated the association between storage time of transfused RBCs and
clinical outcomes in non-cardiac surgical patients. According to the
definition of the American College of Surgeons, clean-contaminated
surgeries are surgeries that involved entry into the respiratory,
alimentary, or genitourinary tract under controlled condition. We
hypothesized a longer storage time was associated with increased risks of
infections after clean-contaminated surgery. Method(s): This is a
retrospective cohort study conducted at Peking Union Medical College
Hospital, a general tertiary referral center in China. We studied the
records of adult patients who had undergone clean-contaminated surgery
from 2014 to 2018 and received allogeneic RBC transfusion from
preoperative Day 30 to postoperative Day 30. We excluded patients with
acute infections within 14 preoperative days or those who had rare blood
types. Since some patients received multiple RBC transfusion episodes, we
conducted analysis on both episode-level and patient-level data. In
transfusion episode-level analysis, the exposure was the storage time of
each transfusion episode. In patient-level analysis, the exposures were
the mean, weighted mean, and maximum storage time, and the Scalar Age of
Blood Index of RBCs transfused into each patient. The primary outcome was
infection that developed after transfusion within postoperative Day 30.
This outcome was defined by the criteria of healthcare-associated
infection issued by the Centre for Disease Control and Prevention[2], and
identified based on diagnoses, antibiotic regimens, microbiological tests,
serological tests, and radiological examinations. We selected 17
confounders that might affect the selection of RBC units and infection
risks, including age, volume of RBC transfusion, surgery site, surgery
duration, diabetes, and anemia. In the episode-level analysis, a
generalized estimating equation logistic model was used to account for the
cluster effect of different transfusion episodes in the same individual.
In the patient-level analysis, a multivariable logistic regression model
was used. Result(s): The 4046 included patients received 11604
transfusion episodes. Of these, 1025 (25.3%) patients developed
postoperative infections. An increased storage time of transfused RBCs was
not associated with increased odds of postoperative infections in either
transfusion episode-level analysis [odds ratio (OR) 1.03 per five days,
95% confidence interval (CI) 0.95 to 1.11, P=0.551] or patient-level
analysis (mean: OR 1.02 per five days, 95% CI 0.95 to 1.10, P=0.648;
weighted mean: OR 1.02, 95% CI 0.95 to 1.10, P=0.643; maximum: OR 1.06,
95% CI 0.98 to 1.14, P=0.137; Scalar Age of Blood Index: OR 0.99, 95% CI
0.96 to 1.03, P=0.687), after adjusting 17 confounders. Discussion and
 Conclusion(s): This observational study did not reveal a significant
association between the RBC storage time and infections after
clean-contaminated surgery. Unlike previous studies that only performed
patient-level analysis[3], our transfusion episode-level analysis captured
the impact of each storage time without omissions. Our results do not
support benefits of transfusing fresh RBCs for reducing the risks of
postoperative infections. An RCT in a similar study population can provide
stronger evidence in the future.

<105>
Accession Number
646876645
Title
Randomized Clinical Trial of Continuous Transversus Thoracis Muscle Plane
Blockfor Patients Undergoing Open Cardiac Surgery.
Source
Anesthesia and Analgesia. Conference: 18th World Congress of
Anaesthesiologists. Singapore Singapore. 139(6 Supplement 2) (pp
2501-2502), 2024. Date of Publication: 01 Dec 2024.
Author
Chen S.
Institution
(Chen) First AUiliated Hospital, Nanchang University, Nanchang, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background and Objectives: The optimal analgesia regimen after open
cardiac surgery is unclear. The aim of this study was to investigate the
beneficial eUects of continuous transversus thoracis muscle plane (TTMP)
blocks initiated before operation on outcomes following open cardiac
surgery. Method(s): A group of 110 patients were randomly allocated
to either receive bilateral continuous TTMP blocks (TTP group) or no nerve
block (SAL group). The primary endpoint was the length of hospital stay.
The secondary outcome measures included postoperative pain at 4,8,16,24,
48,72 h after extubation at rest and exercise; analgesia requirements
(sufentanil and flurbiprofen axetil consumption); time to extubation;
length of stay in the ICU; incidence of postoperative nausea and vomiting
(PONV); time until return of bowel function; time to mobilization; urinary
catheter removal Results: The length of stay in the ICU and length of
hospital stay was significantly longer in the SAL group than in the TTP
group. NRS scores at rest and exercise were significantly lower in TTP
group compared with SAL group at all time points. The TTP group required
significantly less intraoperative and postoperative sufentanil
consumption,postoperative dynastat consumption than the SAL groups. Time
to extubation; time to first flatus; time until mobilization; time until
urinary catheter removal were significantly earlier in the TTP group than
in the SAL group. The incidence of PONV was significantly lower in the SAL
group. Discussion and Conclusion(s): Bilateral continuous TTMP blocks
reduced the length of hospital stay and provide eUective postoperative
pain for three days.

<106>
Accession Number
646878300
Title
Does Heparin Rebound lead to Postoperative Blood Loss in Patients
undergoing Cardiac Surgery with Cardiopulmonary Bypass.
Source
Anesthesia and Analgesia. Conference: 18th World Congress of
Anaesthesiologists. Singapore Singapore. 139(6 Supplement 2) (pp 383-385),
2024. Date of Publication: 01 Dec 2024.
Author
Rijpkema M.; Vlot E.A.; Stehouwer M.C.; Bruins P.
Institution
(Rijpkema) Medical Centre Leeuwarden, Leeuwarden, Netherlands
(Rijpkema, Vlot, Bruins) St. Antonius Hospital, Nieuwegein, Netherlands
(Stehouwer) Perfusion Department, St. Antonius Hospital, Nieuwegein,
Netherlands
Publisher
Lippincott Williams and Wilkins
Abstract
Background and Objectives: Heparin rebound is a common observed phenomenon
after cardiac surgery with CPB and is associated with increased
postoperative blood loss. However, the administration of extra protamine
may lead to increased blood loss as well. Therefore, we want to
investigate the relation between heparin rebound and postoperative blood
loss and the necessity to provide extra protamine to reverse heparin
rebound. Method(s): We searched PubMed, Cochrane, EMBASE, Google
Scholar and Web of Science to review the question: ?Does heparin rebound
lead to postoperative blood loss in patients undergoing cardiac surgery
with cardiopulmonary bypass.? Combination of search words were framed
within four major categories: heparin rebound, blood loss, cardiac surgery
and cardiopulmonary bypass. All studies that met our question were
included. Quality assessment was performed using the Cochrane risk of bias
(RoB2) tool for randomized controlled trials and the risk of bias in
non-randomized studies of intervention (ROBINS-I) for non-randomised
trials. Result(s): 4 randomized (Kaul TK et al., 1979; Martin et al.,
1992; Pardanani et al., 1970; Purandare et al., 1979) and 17
non-randomized (Abuelkasem et al., 2019; Ellison et al., 1974; Esposito et
al., 1983; Galeone et al., 2013; Gollub S, 1967; Gravlee et al., 1992;
Ichikawa et al., 2014; Kesteven et al., 1986; Kuitunen et al., 1991;
Pifarre et al., 1989; Radulovic V et al., 2015; Shore- Lesserson et al.,
1998; Subramaniam et al., 1995; Taneja et al., 2009; Teoh et al., 1993,
2004; Umlas et al., 1983) studies were included. The mean incidence of
heparin rebound was 40%. The postoperative heparin levels, due to heparin
rebound, were often below or equal to 0.2 IU/mL. We could not demonstrate
an association between heparin rebound and postoperative blood loss or
transfusion requirements. However the quality of evidence was poor due to
a broad variety of definitions of heparin rebound, measured by various
coagulation tests and studies with small sample sizes. Discussion and
 Conclusion(s): The influence of heparin rebound on postoperative
bleeding seems to be negligible, but might get significant in conjunction
with incomplete heparin reversal or other coagulopathies. For that reason,
it might be useful to get a picture of the entire coagulation spectrum
after cardiac surgery, as can be done by the use of a viscoelastic test in
conjunction with an aggregometry test.

<107>
Accession Number
646878334
Title
Deep Parasternal Intercostal Plane Block for Intraoperative Pain Control
In Cardiac Surgical Patients for Sternotomy: A Prospective Randomised
Controlled Trial.
Source
Anesthesia and Analgesia. Conference: 18th World Congress of
Anaesthesiologists. Singapore Singapore. 139(6 Supplement 2) (pp 517-519),
2024. Date of Publication: 01 Dec 2024.
Author
Wong H.M.K.; Chen P.Y.; Tang G.C.C.; Chiu S.L.C.; Mok L.Y.H.; Au S.S.W.;
Wong R.H.L.
Institution
(Wong, Chen, Tang, Chiu, Mok, Au) Department of Anaesthesia and Intensive
Care, Prince of Wales Hospital, Chinese University Of Hong Kong, Hong
Kong, Hong Kong
(Wong) Division of Cardiothoracic Surgery, Department of Surgery, Prince
of Wales Hospital, Hong Kong, Hong Kong
Publisher
Lippincott Williams and Wilkins
Abstract
Background and Objectives: Sternotomy pain is significant after cardiac
surgery1. The transversus thoracis muscle plane (TTMP) block is a novel
technique2 that provides analgesia to the anterior chest wall. The aim of
this study was to investigate the analgesic effect of bilateral TTMP
blocks on intraoperative pain and hemodynamics control in cardiac surgery.
 Method(s): This was a single-center, double-blinded, randomized
controlled trial (Oct 2020-Dec 2022). 86 elective cardiac surgical
patients were randomly divided into TTMP or control group. The sealed
envelopes for randomization were prepared by a third party who took no
further part in the study. Either 20ml 0.25% levobupivacaine or 0.9%
normal saline was injected for the TTMP under ultrasound guidance after
induction of general anaesthesia. The TTMP block syringes were prepared
under strict septic techniques by a nurse not involved in the study. TTMP
block was performed by a single anaesthetist who was blinded to group
allocation. The primary outcome was intraoperative opioid consumption and
hemodynamic changes at sternotomy. Secondary outcomes included
postoperative morphine consumption, postoperative pain and time to
tracheal extubation. Result(s): Intraoperative opioids requirement,
converted into morphine equivalent dose, was reduced from a median (IQR)
of 21.4mg (13.8-24.3mg) in control group to 9.5mg (7.3-11.2mg) in the TTMP
group (P<0.001) (Table 1). Hemodynamic parameters were more stable in TTMP
group at sternotomy, as evidenced by lower percentage changes in systolic,
diastolic and mean arterial blood pressure from baseline (Table 1). No
Difference was observed in time to tracheal extubation, postoperative
morphine consumption, postoperative pain score (Figure 1) and spirometry.
Discussion and Conclusion(s): Bilateral TTMP block provides effective
intraoperative analgesia and opioid-sparing, yet achieving a more stable
hemodynamic during sternotomy. It effectively blunted the sympathetic
response associated with sternotomy which is desirable for cardiac
surgical patients, and would be important as part of the multimodal
analgesia for enhanced recovery in cardiac surgery. The failure to
demonstrate a Difference in postoperative pain score could be related to
the limitation of TTMP block in CABG, with leakage of local anaesthetics
from disruption of endothoracic fascia during harvesting of internal
mammary artery.3 Since a significant percentage of the patients in this
study had CABG, future trials could be considered evaluating analgesic
efficacy of the block in non-CABG cardiac surgical patients, or consider
the timing of the block in CABG.

<108>
Accession Number
646878277
Title
Non-Intubated Uniportal Video-Assisted Thoracoscopic Lung Resection: A
Case Report.
Source
Anesthesia and Analgesia. Conference: 18th World Congress of
Anaesthesiologists. Singapore Singapore. 139(6 Supplement 2) (pp 493-494),
2024. Date of Publication: 01 Dec 2024.
Author
Tumurbaatar B.; Chadraa Y.; Baatarjav G.-E.; Dondov G.
Institution
(Tumurbaatar) Second State Central Hospital, Department of Anesthesiology
and Intensive Care, Ulaanbaatar, Mongolia
(Chadraa, Baatarjav) Second State Central Hospital, Department of General
Surgery, Ulaanbaatar, Mongolia
(Dondov) Institute of Medical Sciences, Mongolian National University of
Medical Sciences, Department of Oncology, Ulaanbaatar, Mongolia
Publisher
Lippincott Williams and Wilkins
Abstract
Background: In the recent decade, video-assisted thoracoscopic surgery
(VATS) has been extensively performed and it is considered a minimally
invasive approach for lung resection. Perioperative anesthetic management
presents itself as a new challenge for the spontaneous pneumothorax, which
is intended for unilateral lung collapse to provide a steady surgical
field, and the ensuing physiologic derangement involving ventilatory and
hemodynamic aspects. Case Description: A 21-year-old presented chest pain,
dyspnea, cough with sputum, and vomiting. The patient has no allergies, or
hereditary history /-/, and does not use alcohol or tobacco. X-ray and
contrast-enhanced CT revealed leftsided apical bullae. No significant
changes in blood test, coagulogram, ECG, spirogram, and general
urinalysis. We performed bullectomy through uniportal video-assisted
thoracic surgery under thoracic epidural anesthesia (nonintubated). He was
assigned a class to II of the ASA classification. The procedure was
explained to the patients in detail and Informed consent was obtained. In
theatre, baseline values were as follows: pulse rate 80/minute, blood
pressure 120/80 mmHg, and SpO2 92%. In the sitting position, a midline
thoracic epidural was performed at the T5/T6 interspinous space, using a
16-G Tuohy needle. The epidural space was found at 4 cm of a catheter, 5
cm of the catheter left in the epidural space, and the catheter was
threaded at 11 cm. After a test dose of 4 mL of 1% lidocaine without
adrenaline, a loading dose of bupivacaine 15 mL of 0.5% was given. Fifteen
minutes later, a sensory block height of T1 was achieved bilaterally, and
the surgery was started. Oxygen was given via a face mask at 6 L/minute
throughout the duration of the surgery, which lasted for 50 minutes. The
patient's hemodynamics were stable during the surgery, including a pulse
rate of 60/minute, and blood pressure of 110/90. We performed mild
sedation using propofol 1%-20 ml, and fentanyl 100 mcg. Normal saline was
infused with a total of 1.5 L. The patient was discharged from the
hospital on the fifth postoperative day. This was the first case of
non-invasive uniportal videoassisted thoracic surgery for the management
of partial lung resection in our hospital. Discussion(s):
Non-intubated VATS has been shown to be a safe alternative to standard
intubated general anesthesia when used with appropriate monitoring,
sedation, vagal block, and ventilatory support. A meta-analysis results
showed that non-intubated VATS had a significantly shorter hospital stay
and chest-tube placement time compared with intubated VATS. There were no
significant Differences in postoperative complication rate, surgical
duration, and the number of dissected lymph nodes. However, through the
analysis of highly selected patients with lung cancer in early stage, the
rate of postoperative complication in the non-intubated VATS was
significantly lower than intubated VATS. Learning Point: Non-intubated
uniportal video-assisted thoracic surgery might be an alternative and
feasible technique for lung resection or major thoracic surgery. The
assessment of the safety and feasibility of patients undergoing
nonintubated VATS needs further multi-center prospective clinical trials.

<109>
Accession Number
646878344
Title
Intraoperative Paravertebral Or Intravenous Lidocaine Versus Control
During Lung Resection Surgery On Postoperative Complications: A Randomized
Control Trial.
Source
Anesthesia and Analgesia. Conference: 18th World Congress of
Anaesthesiologists. Singapore Singapore. 139(6 Supplement 2) (pp 523-525),
2024. Date of Publication: 01 Dec 2024.
Author
De la Gala F.; Garutti I.; Reyes A.; Pineiro P.
Institution
(De la Gala, Garutti, Reyes, Pineiro) Hospital General Universitario
Gregorio Maranon, Madrid, Spain
Publisher
Lippincott Williams and Wilkins
Abstract
Background and Objectives: An exaggerated perioperative inflammatory
response during lung resection surgery (LRS) has been associated with the
appearance of postoperative complications (PC). Use of video-assisted
thoracoscopy (VATS) has been associated with improvements in both pain
management and quality of life compared to thoracotomy. Its use has been
proposed in programs for enhanced recovery after surgery. However, there
is little information about the best type of analgesia in this context.The
main goal of the present study was to compare the proportion of patients
included in the Different scales of the Clavien-Dindo classification of PC
between patients undergoing LRS who have received intraoperatively either
intravenously or paravertebral lidocaine versus saline. Furthermore, we
compared the perioperative pulmonary and systemic inflammatory response.
 Method(s): A prospective, randomized single-center phase IV study was
designed (NCT 03905837; EudraCT 2016-004271-52) and approved by the local
Ethics Committee. The calculated study population comprises 156 patients
undergoing LRS through a VATS approach. The patients were randomly
assigned to one of the following study groups: intravenous lidocaine
(1.5mg/Kg/h) with more paravertebral thoracic (PVT) saline (group 1), PVT
lidocaine 2% (0.1mL/Kg/h) with more intravenous saline (group 2), or
intravenous remifentanil (0.1mg/Kg/min) with more PVT saline (group 3).
All the patients were managed with the same anesthetic protocol. In double
lung ventilation: volume-controlled ventilation (VCV), tidal volume (TV) 8
ml/kg, PEEP 5 cmH2O, FiO2 0.4-0.5 and respiratory rate to maintain end
tidal CO2 30-35 mmHg. In one-lung ventilation (OLV), TV 6 ml/kg, PEEP 5
cmH20, permissive hypercapnia and FiO2 0.6-1 to maintain SatO2>90%.
Fiberoptic bronchoalveolar lavage (BAL) was performed in the dependent
lung before and after OLV for analysis of inflammatory markers. Arterial
blood was drawn for measurement of respiratory gases and the same
inflammatory markers analysed in BAL at baseline (before OLV); at 30
minutes after initiation of OLV; at the end of OLV; and 24 hours after
surgery. Release of inflammatory markers was measured using Western Blot.
ANOVA and a post hoc Bonferroni test were applied for variables with
normal distribution and the Kruskal-Wallis test and Mann-Whitney test for
variables without normal distribution. We recorded hospital stay,
postoperative pain intensity, postoperative cognitive dysfunction and PC
(surgical, cardiac, renal and pulmonary). Result(s): 156 patients
were recruited. 2 patients in group 1 were excluded because the protocol
was violated. The three groups were similar in terms of their preoperative
and intraoperative data. Levels of inflammatory markers increased in all
groups after OLV. Expression of TNF alpha, IL-1, MMP-9, NME was more
pronounced in group 3 (p<0.05). Patients in whom only intravenous
remifentanil was used had a significance worse postoperative course
evaluated by the Clavien-Dindo classification than patients who received
intravenous or paravertebral lidocaine (table 1). No Differences were
found for hospital stay and for postoperative pain parameters. Discussion
and Conclusion(s): Our results suggest that the immunomodulatory
effect of lidocaine (intravenously or paravertebral) results in a better
clinical outcome than intravenous remifentanil.

<110>
Accession Number
646878426
Title
The Efficacy of Risperidone for Reducing the Incidence and Severity of
Postoperative Delirium in Vascular Patients: A Randomized Controlled
Trial.
Source
Anesthesia and Analgesia. Conference: 18th World Congress of
Anaesthesiologists. Singapore Singapore. 139(6 Supplement 2) (pp 332-334),
2024. Date of Publication: 01 Dec 2024.
Author
Rangsaritwutikul V.; Pongraweewan O.; Pukrittakayamee P.; Suphathamwit A.;
Jirativanon T.; Chaibanjongwat T.
Institution
(Rangsaritwutikul, Pongraweewan, Suphathamwit, Jirativanon,
Chaibanjongwat) Department of Anesthesiology, Siriraj Hospital, Mahidol
University, Bangkok, Thailand
(Pukrittakayamee) Department of Psychiatry, Siriraj Hospital, Mahidol
University, Bangkok, Thailand
Publisher
Lippincott Williams and Wilkins
Abstract
Background and Objectives: Postoperative delirium(POD) is an emerging
condition in our aging world. POD has a high incidence among elderly
vascular patients and leads to an increase in morbidity, surgical
complications, and length of hospital stay. Risperidone is an atypical
antipsychotic agent that can reduce the incidence of POD in cardiac
surgical patients undergoing cardiopulmonary bypass from previous studies.
It has few side effects, is inexpensive, and has a long duration of
action. The objective of this study is to determine the efficacy of
preoperative oral solution of risperidone in preventing POD and reducing
the severity of POD in geriatric vascular patients. Method(s): This
study is a double-blinded, placebo-controlled trial. One hundred and forty
elderly vascular patients undergoing vascular surgeries lasting more than
2 hours were included in the study after obtaining written informed
consent. They were randomly divided into two groups. The risperidone group
received a 0.5mg oral solution of risperidone within 1 hour before
surgery, while the control group received water. POD was assessed daily
using DSM-5 criteria, and its severity was measured with the Delirium
Rating Score (DRS) for the first three days after surgery by a designated
psychiatrist who was blinded to the group randomization. The incidence and
severity of POD were compared between the two groups, potential side
effects of risperidone, and the length of hospital stay were also
recorded. Result(s): There were no statistical differences in
demographic data between the two groups. Although the incidence of POD was
lower in the risperidone group compared to the placebo group, this
difference did not reach statistical significance (10.6% vs. 21.2%,
p-value=0.096). However, the severity of POD, as measured by the Delirium
Rating Score(DRS), was significantly lower in the risperidone group(2.0
vs. 6.0, p-value=0.025). The length of hospital stay showed no significant
differences between the two groups. Among the side effects of risperidone,
one patient experienced mild extrapyramidal symptoms, and another showed
asymptomatic QT prolongation. Discussion and Conclusion(s): The
overall incidence of POD in this study without intervention was 21.2%. The
preoperative administration of a single low-dose oral risperidone (0.5mg)
reduced the severity of POD but did not affect the incidence of POD or the
length of hospital stay in the elderly vascular patients. A single dose of
0.5mg of oral risperidone solution may be insufficient to prevent overall
POD in this population when compared to the 1mg dose used in a previous
study. Strengths of this study include utilizing the DSM-V criteria for
diagnosis of POD, assessment conducted by only one psychiatrist, and the
assessment period spanning three consecutive days. Limitations of this
study include the fact that POD assessment was performed once daily, which
might underdetect delirium due to its fluctuating course, and the
incidence of delirium was lower than anticipated.

<111>
Accession Number
2033981818
Title
Intra-operative ventilation strategies and their impact on clinical
outcomes: a systematic review and network meta-analysis of randomised
trials.
Source
Anaesthesia. (no pagination), 2025. Date of Publication: 2025.
Author
Jivraj N.K.; Lakbar I.; Sadeghirad B.; Muller M.M.; Sohn S.Y.; Peel J.K.;
Jaffer A.; Phoophiboon V.; Trivedi V.; Chaudhuri D.; Lu C.; Liu Y.;
Giammarioli B.; Einav S.; Burns K.E.A.
Institution
(Jivraj) Department of Anesthesiology and Pain Medicine and Department of
Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON,
Canada
(Jivraj, Burns) Interdepartmental Division of Critical Care Medicine,
Temerty School of Medicine, University of Toronto, Toronto, ON, Canada
(Lakbar) Anesthesiology and Intensive Care; Anesthesia and Critical Care
Department B, Saint Eloi Teaching Hospital, PhyMedExp, University of
Montpellier, Montpellier, France
(Sadeghirad) Department of Anesthesia and Department of Health Research
Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
(Sadeghirad) Michael DeGroote Institute for Pain Research and Care,
Hamilton, ON, Canada
(Muller) Institute of Intensive Care Medicine, University Hospital Zurich,
Zurich, Switzerland
(Sohn) Department of Anesthesiology, Perioperative and Pain Medicine,
Brigham and Women's Hospital, Boston, MA, United States
(Peel) Department of Anesthesiology and Pain Medicine, University of
Toronto, Toronto, ON, Canada
(Jaffer) Cumming School of Medicine, University of Calgary, Calgary, AB,
Canada
(Phoophiboon, Giammarioli) Division of Critical Care Medicine, Unity
Health Toronto - St. Michael's Hospital, Li Ka Shing Knowledge Institute,
Toronto, ON, Canada
(Phoophiboon, Burns) Division of Critical Care Medicine, Department of
Medicine, Chulalongkorn University, Bangkok, Thailand
(Trivedi) Institute for Better Health, Trillium Health Partners,
Mississauga, ON, Canada
(Chaudhuri) Division of Critical Care, Intensive Care Unit, Department of
Medicine, McMaster University, St Joseph's Healthcare Hamilton, Hamilton,
ON, Canada
(Lu) Keenan Research Centre for Biomedical Science, St. Michael's
Hospital, Toronto, ON, Canada
(Liu) Department of Laboratory Medicine and Pathobiology, University of
Toronto, ON, Canada
(Einav) Maccabi Healthcare Services Sharon Region, Hebrew University
Faculty of Medicine and Medint Medical Intelligence, Jerusalem, Israel
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Postoperative pulmonary complications are common and
associated with significant morbidity and mortality; however, the optimal
intra-operative ventilation strategy to prevent postoperative pulmonary
complications remains unclear. The aim of this study was to evaluate the
effect of intra-operative ventilation strategy, including tidal volumes,
positive end-expiratory pressure (PEEP) and use of recruitment manoeuvres
on the incidence of postoperative pulmonary complications in adults having
non-cardiothoracic surgery. Method(s): Relevant databases were
searched to identify randomised controlled trials that directly compared
intra-operative ventilation strategies among surgical patients who were
followed up for > 24 hours postoperatively and reported at least one
outcome of interest. Result(s): A total of 51 randomised controlled
trials were included. Compared with a high tidal volume/zero PEEP
strategy, low tidal volume strategies likely reduced the risk of
postoperative pulmonary complications when combined with: high PEEP (risk
ratio (RR) 0.44, 95%CI 0.22-0.87); high PEEP with recruitment manoeuvres
(RR 0.60, 95%CI 0.49-0.75); personalised PEEP with recruitment manoeuvres
(RR 0.53, 95%CI 0.42-0.69); low PEEP (RR 0.63, 95%CI 0.50-0.78); and low
PEEP with recruitment manoeuvres (RR 0.65, 95%CI 0.46-0.93) (all moderate
certainty evidence). Compared with a low tidal volume/low PEEP strategy, a
low tidal volume strategy with personalised PEEP likely reduces the risk
of postoperative pulmonary complications (RR 0.85, 95%CI 0.73-0.99,
moderate certainty). Discussion(s): Among patients undergoing
non-cardiothoracic surgery, the use of intra-operative low tidal volume
ventilation with a range of acceptable PEEP levels likely reduced the risk
of postoperative pulmonary complications compared with high tidal volumes
and zero PEEP. This study highlights the need for implementation research
at both the provider and system levels to improve intra-operative
adherence to lung protective ventilation strategies. Copyright ©
2025 The Author(s). Anaesthesia published by John Wiley & Sons Ltd on
behalf of Association of Anaesthetists.

<112>
[Use Link to view the full text]
Accession Number
646865428
Title
Cost-Effectiveness of Aortic Valve Replacement in Low- and
Intermediate-Risk Chinese Patients With Severe Aortic Stenosis.
Source
Circulation. Cardiovascular quality and outcomes. (pp e010858), 2025.
Date of Publication: 18 Mar 2025.
Author
Peng J.; Zheng X.; Jiang M.; Yao X.; Ma Y.; Fu M.; Ma T.; Shang X.; Yan
Y.; Thourani V.H.; Fang Y.
Institution
(Peng, Jiang, Yao, Ma, Fu, Fang) Department of Pharmacy Administration and
Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, China.
(J.P., M.F., China
(Peng, Jiang, Yao, Ma, Fu, Fang) Center for Drug Safety and Policy
Research, Xi'an Jiaotong University, China. (J.P., M.F., China
(Peng, Jiang, Yao, Ma, Fu, Fang) Shaanxi Center for Health Reform and
Development Research, China (J.P., M.F., Xi'an, China
(Peng, Jiang, Yao, Ma, Fu, Fang) Research Institute for Drug Safety and
Monitoring, Institute of Pharmaceutical Science and Technology, China
(J.P., M.F., Western China Science and Technology Innovation Harbor,
Xi'an, China
(Zheng, Ma, Shang, Yan) Department of Cardiovascular Surgery, First
Affiliated Hospital of Xi'an Jiaotong University, China (X.Z., China
(Jiang) Institute for Global Health and Development, Peking University,
China (M.J.), Beijing, China
(Thourani) Department of Cardiovascular Surgery, Marcus Heart and Vascular
Center, Piedmont Heart Institute, Atlanta, United States
Abstract
BACKGROUND: Transcatheter aortic valve replacement (TAVR) remains debated
as an alternative to surgical aortic valve replacement (SAVR). We aimed to
evaluate the cost-effectiveness of aortic valve replacement strategies in
low- and intermediate-risk patients with severe aortic stenosis in China.
 METHOD(S): A decision-analytic model combining decision tree and
Markov model was developed to compare outcomes of universal SAVR,
universal TAVR, and a risk-based strategy (SAVR in low-risk patients and
TAVR in intermediate-risk patients) in a hypothetical cohort of
75-year-old patients with aortic stenosis within the perspective of the
Chinese health care system. A meta-analysis was performed to derive the
clinical inputs; the 2019 to 2021 claims data from Shaanxi Province were
used for cost analysis, and quality of life was measured using EuroQoL-5D.
One-way and probabilistic (10 000 Monte Carlo simulations) sensitivity
analyses were conducted to examine the robustness of model results.
Primary outcomes included total costs, quality-adjusted life-years
(QALYs), and incremental cost-effectiveness ratio (ICER). RESULT(S):
Universal TAVR gained the most QALYs (6.76 QALYs) with the highest costs
(USD 58 949). Compared with universal SAVR, the risk-based strategy gained
0.12 additional QALYs at higher costs (USD 14 046); the ICER (117 048
USD/QALY) exceeded the willingness-to-pay threshold (37 657 USD/QALY,
3-fold gross domestic product per capita in China). The ICER of universal
TAVR versus universal SAVR (80 526 USD/QALY) also exceeded the
willingness-to-pay threshold. Sensitivity analysis showed that universal
TAVR would be cost-effective if TAVR valve costs were <USD 21 477 (>44.23%
cost reduction). Subgroup analysis showed that universal TAVR and
risk-based strategy remained not cost-effective compared with universal
SAVR in both low-risk (ICER of 64 414 USD/QALY) and intermediate-risk
(ICER of 124 851 USD/QALY) patients. In 10 000 Monte Carlo simulations,
the probabilities of being cost-effective for universal SAVR, universal
TAVR, and risk-based strategy were 89.81%, 10.14%, and 0.05%,
respectively. CONCLUSION(S): The risk-based strategy and universal
TAVR appeared not to be cost-effective versus universal SAVR in low- and
intermediate-risk patients with severe aortic stenosis in China.

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