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<1>
Accession Number
2042350708
Title
The Effects of Daytime Variation on Short-Term Outcomes of Cardiac
Surgical Patients: A PRISMA-Compliant Systemic Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(2) (pp 492-500),
2026. Date of Publication: 01 Feb 2026.
Author
Yao Y.-T.; Huang S.; Chao M.; More A.
Institution
(Yao, Huang) Department of Anesthesiology, Fuwai Hospital, National Center
for Cardiovascular Diseases, Peking; Union Medical College and Chinese
Academy of Medical Sciences, Beijing, China
(Yao, Huang) Evidence in Cardiovascular Anesthesia (EICA) Group, Beijing,
China
(Yao, Chao, More) Center of Outcomes Research, Department of
Anesthesiology, Critical Care and Pain Medicine, University of Texas,
Houston, TX, United States
(Yao, Chao, More) Outcomes Research Consortium, Houston, TX, United States
Publisher
W.B. Saunders
Abstract
Objective: Circadian rhythms influence cardiovascular physiology and
surgical stress responses, raising the possibility that the timing of
cardiac surgery may affect outcomes. Previous studies have reported
conflicting results regarding whether morning (AM) versus afternoon (AF)
surgery influences perioperative morbidity and mortality. The present
study aimed to systematically evaluate whether the timing of cardiac
surgery, specifically AM versus AF procedures, influences short-term
outcomes. Design(s): A meta-analysis of observational cohort studies.
 Setting(s): Cardiovascular centers. Participant(s): Patients who
underwent elective cardiac surgery. Intervention(s): The AM or the AF
group. Measurements: The primary outcome was hospitalized mortality.
Secondary outcomes included major morbidities (new-onset atrial
fibrillation, myocardial infarction, stroke, renal and infectious
complications, reexploration, mechanical circulatory support) and
postoperative recovery profiles (mechanical ventilation duration, length
of stay [LOS] in the intensive care unit and hospital). Main
Result(s): Fourteen observational studies involving 135,672 patients
(81,391 in the AM group and 54,281 in the AF group) were included. Pooled
analysis showed no significant difference in hospitalized mortality
between the two groups (1.25% [998/79,550] v 1.17% [615/52,442], OR =
1.09, 95% CI = 0.99 to 1.21; p = 0.08]. The incidences of myocardial
infarction, stroke, renal and infectious complications, reexploration, and
mechanical circulatory support use were also comparable. However, AM
surgery was associated with a modestly higher incidence of new-onset
atrial fibrillation (26.05% [2,319/8,907] v 25.50% [1,000/3,921], OR =
1.11, 95% CI = 1.01 to 1.21; p = 0.03). No significant differences were
observed in mechanical ventilation duration [MD = -0.20 hours, 95% CI =
-0.40 to 0.00; p = 0.05], intensive care unit LOS [MD = -0.35 hours, 95%
CI = -6.14 to 5.43; p = 0.90], or hospital LOS [MD = -0.10 days, 95% CI =
-0.39 to 0.19; p = 0.49]. Conclusion(s): These findings suggest that
circadian influences on elective cardiac surgical outcomes are limited.
Future multicenter prospective studies are warranted to further define the
role of surgery timing in high-risk populations. Copyright © 2025
Elsevier Inc.

<2>
Accession Number
2043220501
Title
The effect of postoperative back massage on pain, sleep outcomes and serum
cortisol after open-heart surgery: A randomized controlled trial.
Source
International Journal of Nursing Studies. 176 (no pagination), 2026.
Article Number: 105343. Date of Publication: 01 Apr 2026.
Author
Ozhanli Y.; Gunes A.; Akyuz N.; Uzun S.; Kurt M.; Omay O.; Sik B.Y.; Sahin
Institution
(Ozhanli, Sahin) Kocaeli University Faculty of Health Sciences, Umuttepe
Campus, Kocaeli, Izmit, Turkey
(Gunes) Istanbul Beykent University Faculty of Health Sciences, Beylikduzu
Campus, Istanbul, Beylikduzu, Turkey
(Akyuz) Istanbul University-Cerrahpasa Florence Nightingale Faculty of
Nursing, Abide-i Hurriyet Street, Istanbul, Sisli, Turkey
(Uzun, Kurt) Kocaeli University Research and Practice Hospital,
Cardiovascular Surgery Intensive Care, Umuttepe Campus, Kocaeli, Izmit,
Turkey
(Omay) Kocaeli University Faculty of Medicine, Cardiovascular Surgery
Department, Umuttepe Campus, Kocaeli, Izmit, Turkey
(Sik) Kocaeli University Faculty of Medicine, Biochemistry Department,
Umuttepe Campus, Kocaeli, Izmit, Turkey
Publisher
Elsevier Ltd
Abstract
Background: Massage is widely recognized as an effective
non-pharmacological intervention for reducing pain and anxiety after
cardiac surgery. However, its effects on sleep outcomes and biological
stress markers remain underexplored. Aim(s): To evaluate the impact
of back massage on postoperative pain, subjective and objective sleep
outcomes, and serum cortisol levels in patients undergoing open-heart
surgery. Method(s): A prospective randomized controlled trial was
conducted with 72 patients scheduled for elective open-heart surgery.
Participants were randomized (1:1) to an intervention group (back massage)
or a control group (routine care with light touch). The intervention
consisted of three standardized sessions (15-20 min each) on the first
postoperative day. Outcomes included pain (Numeric Rating Scale-Pain),
subjective sleep quality (Richard-Campbell Sleep Scale), objective sleep
duration (smartwatch measurement), and serum cortisol levels. Data were
analyzed using repeated-measures analysis of variance and Brunner-Langer
tests in a per-protocol population (n = 64). Result(s): Back massage
was associated with significantly longer total sleep duration (p = 0.037)
and greater reduction in pain scores, with significant group, time, and
group x time effects (p = 0.002, p < 0.001, p = 0.048). Cortisol levels
decreased over time in both groups (p < 0.001), but without significant
between-group differences. Subjective sleep quality improved in both
groups, and analgesic use declined, with no significant variation between
groups. No adverse events were observed. Conclusion(s): This
randomized controlled trial demonstrates that back massage is a safe and
feasible intervention after open-heart surgery, improving objectively
measured sleep duration and reducing pain. By incorporating objective
sleep measures and a biological stress marker (serum cortisol), this study
provides novel insights that extend beyond the traditionally reported
outcomes of pain and anxiety, supporting massage as a complementary
strategy within multimodal nursing care. Copyright © 2026
Elsevier Ltd

<3>
Accession Number
2041657969
Title
Sex-Specific Microaxial Flow Pump Use and Outcomes in Infarct-Related
Cardiogenic Shock in the DanGer Shock Trial.
Source
Journal of the American College of Cardiology. 87(6) (pp 704-719), 2026.
Date of Publication: 17 Feb 2026.
Author
Mangner N.; Beske R.P.; Hassager C.; Jensen L.O.; Eiskjaer H.; Linke A.;
Polzin A.; Schulze P.C.; Skurk C.; Nordbeck P.; Clemmensen P.; Panoulas
V.; Zimmer S.; Schafer A.; Werner N.; Engstrom T.; Holmvang L.; Lonborg
J.T.; Udesen N.L.J.; Schmidt H.; Junker A.; Terkelsen C.J.; Schrage B.;
Woitek F.J.; Moller J.E.
Institution
(Mangner, Linke, Woitek) Department of Internal Medicine and Cardiology,
Heart Center Dresden, University Hospital, Technische Universitat Dresden,
Dresden, Germany
(Beske, Hassager, Engstrom, Holmvang, Lonborg, Moller) Department of
Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen,
Denmark
(Hassager, Engstrom, Holmvang, Lonborg) Department of Clinical Medicine,
University of Copenhagen, Copenhagen, Denmark
(Jensen, Udesen, Junker, Moller) Department of Cardiology, Odense
University Hospital, Odense, Denmark
(Jensen, Moller) Department of Clinical Research, University of Southern
Denmark, Odense, Denmark
(Eiskjaer, Terkelsen) Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark
(Polzin) Department of Cardiology, Pulmonology and Vascular Medicine,
University Hospital Dusseldorf, Medical Faculty of the Heinrich Heine
University Dusseldorf, Dusseldorf, Germany and Cardiovascular Research
Institute Dusseldorf (CARID), Dusseldorf, Germany
(Schulze) Department of Internal Medicine I, Cardiology, Angiology and
Intensive Medical Care, University Hospital Jena, Jena, Germany
(Skurk) Department of Cardiology, Angiology and Intensive Care Medicine,
Deutsches Herzzentrum der Charite, Campus Benjamin Franklin, Berlin,
Germany; Deutsches Zentrum fur Herz-Kreislauf-Forschung e.V., Berlin,
Germany
(Nordbeck) Department of Internal Medicine I, University Hospital
Wurzburg, Wurzburg, Germany
(Clemmensen, Schrage) Department of Cardiology, University Heart and
Vascular Center (UHZ), University Clinic Hamburg-Eppendorf (UKE), Center
for Population Health Research (POINT), Hamburg, Germany
(Clemmensen) Department of Cardiology, Zealand University Hospital,
Roskilde and Nykobing Falster, Denmark
(Panoulas) Department of Cardiology, Royal Brompton and Harefield
Hospitals, Guy's and St Thomas' NHS Foundation Trust, Harefield Hospital,
Harefield, United Kingdom
(Zimmer) Department of Cardiology, University Hospital Bonn, Bonn, Germany
(Schafer) Department of Cardiology and Angiology, Hannover Medical School,
Hannover, Germany
(Werner) Department of Internal Medicine III, Heart Center Trier,
Krankenhaus der Barmherzigen Bruder, Trier, Germany
(Schmidt) Department of Anesthesiology and Intensive Care, Odense
University Hospital, Odense, Denmark
Publisher
Elsevier Inc.
Abstract
Background: The microaxial flow pump (mAFP) has been shown to improve
outcomes in selected patients with ST-elevation myocardial infarction
(STEMI) and cardiogenic shock (STEMI-CS), but this effect appears to be
less evident in women compared with men. Objective(s): The objective
of this secondary analysis of the Danish-German Cardiogenic Shock Trial
(DanGer Shock) was to determine sex differences in baseline
characteristics, in-hospital course, and the effectiveness of mAFP in
STEMI-CS. Method(s): This was a prespecified sex-specific secondary
analysis of the international, multicenter, open-label, randomized DanGer
Shock Trial. The primary outcome was 180-day all-cause mortality, analyzed
by sex and randomized treatment assignment. Result(s): From 2013 to
2023, 355 patients (74 [20.8%] women, 281 [79.2%] men) with STEMI-CS
excluding comatose cardiac arrest were enrolled; 179 were randomized to
mAFP (37 women) and 176 to standard care (37 women). In an accompanying
registry of excluded patients (n = 495), women represented 25.7% (P =
0.10). At baseline, women were significantly older, and time from symptom
onset to randomization was 2.2-fold longer in women than in men. Compared
with men, women had significantly higher 180-day all-cause mortality
(64.9% vs 48.8%; P = 0.015). There was no significant interaction for sex
and treatment assignment with respect to 180-day all-cause mortality (P
value for interaction = 0.18), yet women (HR: 1.01 [95% CI: 0.58-1.79])
appeared to derive less benefit from mAFP treatment than male patients
(HR: 0.66 [95% CI: 0.47-0.93]). This difference was attenuated in patients
aged <=76 years: women (n = 41) HR: 0.66 (95% CI: 0.25-1.76) and men (n =
233) HR: 0.61 (95% CI: 0.40-0.92) (P value for interaction = 0.92). Data
from up to 10 years of follow-up support the treatment effect in younger
patients, regardless of sex: women HR: 0.45 (95% CI: 0.19-1.09); men HR:
0.57 (95% CI: 0.40-0.82). Conclusion(s): In DanGer Shock, women with
STEMI-CS were older and presented later after onset of symptoms, resulting
in higher mortality rates. This may have led to the apparent reduced
treatment effect in women, but interaction between treatment allocation
and sex was not significant, and data showing a benefit of mAFP appeared
particularly in younger patients, regardless of sex. As this is a
secondary, nonpowered analysis that includes few women, its results must
be considered hypothesis generating. (Danish Cardiogenic Shock Trial
[DanShock]; NCT01633502) Copyright © 2026 American College of
Cardiology Foundation

<4>
Accession Number
2042845288
Title
Wide variability in studies reporting on digital education interventions
for patients undergoing cardiac procedures: A patient-commissioned mixed
methods systematic review.
Source
Heart and Lung. 78 (no pagination), 2026. Article Number: 102702. Date of
Publication: 01 Jul 2026.
Author
Wells R.; Boulos L.; Gray M.; Keeping S.E.; Devereaux E.J.; Brauer-Chapin
T.; Hariharan A.; Fera G.; DeCoste K.; Hickey M.; Johnson C.; Rubenstein
D.; Hirsch G.M.; Gainer R.; Curran J.A.
Institution
(Wells, Rubenstein) Patient Partner, Patient Advisors Network, 43 Dorval
Road, Toronto, ON, Canada
(Boulos, Keeping, Hariharan, Johnson, Curran) Strengthening Transitions in
Care Lab, IWK Health, 5850/5980 University Avenue, Halifax, NS, Canada
(Gray, Devereaux, Fera, DeCoste) Faculty of Health, Dalhousie University,
5869 University Avenue, P.O. Box 15000, Halifax, NS, Canada
(Keeping, Curran) School of Nursing, Dalhousie University, 5869 University
Avenue, P.O. Box 15000, Halifax, NS, Canada
(Brauer-Chapin, Hirsch, Gainer) Division of Cardiac Surgery & Research and
Innovation, Periop/Surgical Services, Nova Scotia Health, 1796 Summer St,
Halifax, NS, Canada
(Hickey) Implementation Science Team, Nova Scotia Health, 90 Lovett Lake
Court, Halifax, NS, Canada
(Johnson) School of Communication Sciences and Disorders, Dalhousie
University, 5869 University Avenue, P.O. Box 15000, Halifax, NS, Canada
Publisher
Elsevier Inc.
Abstract
Background: Although cardiac rehabilitation is widely acknowledged as the
gold standard for improved outcomes in cardiac procedures, it remains
underutilized. Digital education tools have the potential to improve
access and adherence to cardiac rehabilitation. Objective(s): The
primary objective of this review is to determine the impact of digital
education interventions for patients undergoing cardiac procedures on
patient-level and health system-level outcomes. Method(s):
Conceptualized by a patient partner, a mixed methods systematic review was
conducted using JBI methodology. MEDLINE, Embase, CINAHL, and Scopus were
searched. Studies were included if they reported on a digital education
intervention for adult patients preparing for or recovering from cardiac
procedures, and if they reported primary outcomes related to healthcare
utilization, learning/knowledge, and/or patient-level health.
Interventions were mapped onto the WHO taxonomy of Digital Health
Interventions for Persons. Result(s): 41 studies were included, and
most reported a positive effect across several outcome categories:
knowledge; behavior, attitude, and self-efficacy; physiological;
healthcare utilization; mental health; quality of life; physical function
and activity; and other. Considerable variation in outcomes, measurement
instruments, and intervention characteristics hindered meta-analysis and
made it challenging to draw broad conclusions. Conclusion(s):
Overall, interventions included in this review resulted in a positive
effect on a wide range of outcomes. However, most studies did not report
the use of an educational theory or underlying framework, leading to wide
variability in intervention design and implementation. Future developers
should consider using an educational framework to design and evaluate
digital interventions. Additionally, engaging patients and knowledge users
as co-designers could increase relevance, acceptability, and
uptake. Copyright © 2025

<5>
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Accession Number
2042067838
Title
Percutaneous left atrial appendage closure for stroke prevention in atrial
fibrillation: who should receive it in current clinical practice?.
Source
Current Opinion in Cardiology. 41((1 Pt c)) (no pagination), 2026. Date of
Publication: 01 Jan 2026.
Author
d'Entremont M.-A.; Healy J.S.; Jolly S.S.
Institution
(d'Entremont, Healy, Jolly) Population Health Research Institute, McMaster
University, Hamilton, Canada
(d'Entremont, Healy, Jolly) Hamilton Health Sciences, Hamilton, Ontario,
Canada
(d'Entremont) Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke,
Quebec, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of review Although oral anticoagulation (OAC) remains the
cornerstone therapy for stroke prevention in atrial fibrillation, several
limitations, such as noncompliance and bleeding, limit its effectiveness.
Percutaneous left atrial appendage closure (pLAAC) has emerged as a
promising therapy. We will review current and potential indications for
pLAAC and knowledge gaps. Recent findings Current guidelines recommend
pLAAC for patients who have atrial fibrillation at moderate to high risk
of stroke with a high risk of bleeding or who have a contraindication for
OAC. pLAAC is being investigated as a potential therapeutic option for the
following patient populations: end-stage renal disease, after atrial
fibrillation ablation, and in combination with OAC in patients with a high
risk of breakthrough stroke or in patients with prior stroke on OAC. The
Left Atrial Appendage Occlusion Study IV (LAAOS-IV) (n = 4000) is a
randomized trial that will determine the role of pLAAC and OAC compared to
OAC alone in preventing ischemic stroke or systemic embolism. Summary
pLAAC has a growing role in patients with atrial fibrillation with
moderate to high stroke risk and contraindication to OAC. Multiple
randomized trials are currently underway in different patient populations,
which may expand the role of pLAAC. Copyright © 2025 Wolters
Kluwer Health, Inc. All rights reserved.

<6>
Accession Number
2041055157
Title
Prevention of hemorrhage after implantation of mechanical circulatory
support with a purified von Willebrand factor concentrate: results of the
early terminated randomized controlled trial.
Source
Journal of Thrombosis and Haemostasis. 24(2) (pp 408-417), 2026. Date of
Publication: 01 Feb 2026.
Author
Rauch A.; Lebreton G.; Moussa M.D.; Vincentelli A.; Flecher E.; Bouchot
O.; Dambrin C.; Barandon L.; Rozec B.; Jeanpierre E.; Ajzenberg N.;
Repesse Y.; De Maistre E.; Boissier E.; Smadja D.M.; Fiore M.; Nedelec F.;
Voisin S.; Lenting P.J.; Laporte S.; Labreuche J.; Susen S.
Institution
(Rauch, Jeanpierre, Susen) Department of Hemostasis and Transfusion, Lille
University, Inserm, Centre Hospitalier Universitaire Lille, Institut
Pasteur de Lille, Lille, France
(Lebreton) Department of Cardio-Thoracic Surgery, Pitie Salpetriere
Hospital, Paris, France
(Lebreton) Institut National de la Sante et de la Recherche Medicale,
Sorbonne University, Paris, France
(Lebreton) Institut Hospitalo-Universitaire ICAN, Foundation for
Innovation in Cardio Metabolism and Nutrition, Paris, France
(Moussa) Lille University Hospital, Department of Anesthesiology and
Critical Care Medicine, Lille, France
(Vincentelli) Lille University Hospital, Department of Cardio-Thoracic
Surgery, Lille, France
(Flecher) Pontchaillou University Hospital, Department of Thoracic and
Cardiovascular Surgery, University of Rennes 1, Signal and Image Treatment
Laboratory, Rennes, France
(Bouchot) Dijon University Hospital, Department of Cardiac Surgery, Dijon,
France
(Dambrin) Department of Thoracic and Cardiovascular Surgery, Rangueil
University Hospital, Toulouse, France
(Barandon) Department of Cardiology and Cardio-Vascular Surgery, Hopital
Cardiologique de Haut-Leveque, University Hospital, Bordeaux, France
(Rozec) Department of Anesthesiology and Critical Care, Laennec Hospital,
University Hospital of Nantes (Centre Hospitalier Universitaire Nantes),
France
(Rozec) Nantes University, University Hospital of Nantes (Centre
Hospitalier Universitaire Nantes), Centre National de la Recherche
Scientifique, Institut National de la Sante et de la Recherche Medicale,
Institut du Thorax, Nantes, France
(Ajzenberg) University of Paris, Institut National de la Sante et de la
Recherche Medicale Unite Mixte de Recherche (joint research unit, often
between INSERM/CNRS and a university)-S 1144, Paris, France
(Ajzenberg) Hematology Laboratory, Assistance Publique - Hopitaux de Paris
(Assistance Publique - Hopitaux de Paris), Bichat-Claude Bernard Hospital,
Paris, France
(Repesse) Laboratory of Haematology and Haemostasis, Normandy University,
Caen, France
(De Maistre) Hematology Laboratory, University Hospital of Dijon (Centre
Hospitalier Universitaire Dijon), Dijon, France
(Boissier) LHematology Laboratory, Laennec Hospital, University Hospital
of Nantes (Centre Hospitalier Universitaire Nantes), France
(Smadja) Hematology Laboratory, Assistance Publique - Hopitaux de Paris
(Assistance Publique - Hopitaux de Paris), Hopital Europeen
Georges-Pompidou, Paris, France
(Fiore) Hematology Laboratory, Haut-Leveque Cardiology Hospital,
University Hospital of Bordeaux (Centre Hospitalier Universitaire
Bordeaux), Bordeaux, France
(Nedelec) Hematology Laboratory, Pontchaillou Hospital, Rennes, France
(Voisin) Hematology Laboratory, University Hospital of Toulouse (Centre
Hospitalier Universitaire Toulouse), Toulouse, France
(Lenting) University of Paris-Saclay, Institut National de la Sante et de
la Recherche Medicale, Hemostasis, Inflammation and Thrombosis (HITh) Unit
U1176, Le Kremlin-Bicetre, France
(Laporte) Department of Clinical Pharmacology and Clinical Research Unit,
University Hospital of Saint-Etienne; Unite Mixte de Recherche (joint
research unit, often between INSERM/CNRS and a university) 1059
Dysfonctions Vasculaires et de l'Hemostase-Sainbiose, Jean Monnet
University, Saint-Etienne; Institut National de la Sante et de la
Recherche Medicale French Clinical Research Infrastructure Network
Investigation Network On Venous Thrombo-Embolism Network France
(Labreuche) Department of Biostatistics, Centre Hospitalier Universitaire
Lille, University of Lille, France
Publisher
Elsevier B.V.
Abstract
Background Bleeding complications are frequent under left ventricular
assist device (LVAD) support. LVAD-associated high shear stress induces
increased proteolysis of circulating von Willebrand factor (VWF), which
may contribute to this high bleeding rate. Objectives To assess if a
prophylactic administration of a VWF concentrate could reduce bleeding
rate in LVAD patients Methods In this multicenter open-label randomized
controlled study, we investigated the efficacy, safety, and
pharmacokinetic of a plasma-derived VWF concentrate (WILFACTIN, LFB),
administered prophylactically twice-weekly at 50 IU.kg-1 for 3
months after LVAD implantation, compared with standard of care. The
efficacy end points were the difference in the incidence rate of any,
clinically significant or major bleeding postrandomization. Bleeding and
thrombotic events were reviewed at weeks 1 and 2 and then every 2 weeks.
The study ended prematurely due to deficient recruitment and drug supply
constraints, leading to prioritization of prescriptions for von Willebrand
disease patients. We present the available data. Results Twenty-nine adult
patients (166 planned) were randomized and analyzed. VWF prophylaxis
resulted in a nonsignificant 55% reduction in bleeding incidence rate
compared with standard of care (risk ratio, 0.45; 95% CI, 0.18-1.04; P =
.06). Accordingly, there was a similar reduction of clinically relevant
and major bleeding in VWF arm. Severe adverse events were similar
postrandomization between VWF arm and control arm including deaths (2 and
4, respectively) and thrombotic events (2 in each arm). In pharmacokinetic
analysis, a rapid degradation of WILFACTIN occurred within 24 hours.
Conclusion The lack of observed therapeutic efficacy of VWF prophylaxis in
LVAD setting is likely due to a short-lived prohemostatic effect due to
rapid degradation of VWF concentrate. Copyright © 2025
International Society on Thrombosis and Haemostasis.

<7>
Accession Number
2042635250
Title
Effects of remote ischaemic preconditioning against acute kidney injury in
cardiac surgery patients: a randomized controlled trial.
Source
Perioperative Medicine. 15(1) (no pagination), 2026. Article Number: 9.
Date of Publication: 01 Dec 2026.
Author
Wang H.; Liao Q.; Huang Y.; Miao P.; Guo K.
Institution
(Wang, Liao, Huang, Miao, Guo) Department of Anesthesiology, Zhongshan
Hospital, Fudan University, Shanghai, China
(Wang, Liao, Guo) Shanghai Key Laboratory of Perioperative Stress and
Protection, Shanghai, China
(Guo) ShanghaiChina
Publisher
BioMed Central Ltd
Abstract
Background: Acute kidney injury (AKI) is a well-known, serious
complication of cardiac surgery that is associated with increased
morbidity and mortality. However, the effects of remote ischaemic
preconditioning (RIPC) on AKI after cardiac surgery have shown
inconsistent results. This study was conducted to evaluate the effects of
RIPC on AKI in patients undergoing cardiac surgery with cardiopulmonary
bypass (CPB). Method(s): In this single-centre, prospective,
randomized, double-blind, controlled trial, 240 patients undergoing
elective cardiac surgery were assessed for eligibility. 180 patients were
randomly assigned to either RIPC group or control (Con) group. Finally,
159 patients (79 to Con group and 80 to RIPC group) completed follow-up.
RIPC was performed on an upper limb with repeated 5-min inflation and
5-min deflation for three times. The primary outcome was the proportion of
AKI 48 h after surgery. Secondary outcomes included major clinical
short-term outcomes and the incidences of postoperative complications,
clinical diagnostic indicators serum creatinine (SCr), urinary novel
biomarkers IGFBP7 and TIMP-2. Result(s): The proportion of AKI in
RIPC group was significantly lower than Con group (Con versus RIPC: 26.6%
vs. 13.8%; P = 0.044). In addition, RIPC resulted in a smaller increase in
SCr levels 24 h (Con versus RIPC: 96.6 +/- 35.9 micromol/L vs. 86.2 +/-
24.9 micromol/L; P = 0.035) and 48 h (Con versus RIPC: 93.6 +/- 45.2
micromol/L vs. 75.8 +/- 30.8 micromol/L; P = 0.004) postoperatively. The
postoperative concentrations of urinary biomarkers such as IGFBP7 and
IGFBP7xTIMP-2 were lower in the RIPC group than in the Con group (P =
0.045 and 0.009, respectively). There were no significant differences in
short-term outcomes and postoperative complications. Conclusion(s):
In this trial, RIPC reduced the proportion of AKI and the amplitude of SCr
elevation 48 h postoperatively. RIPC may exert a certain renal protective
effect by enhancing renal recovery in the early postoperative stage. Trial
registration: ClinicalTrials.gov identifier: NCT04433468. Copyright
© The Author(s) 2025.

<8>
Accession Number
2042644598
Title
Contemporary Assessment and Management of Effusive-Constrictive
Pericarditis.
Source
Current Cardiology Reports. 28(1) (no pagination), 2026. Article Number:
13. Date of Publication: 01 Dec 2026.
Author
El Harake L.; Samhan A.; Cremer P.C.; Al Kazaz M.
Institution
(El Harake, Cremer, Al Kazaz) Bluhm Cardiovascular Institute, Division of
Cardiology, Chicago, IL, United States
(Samhan, Cremer, Al Kazaz) Feinberg School of Medicine, Northwestern
University, Chicago, IL, United States
(Al Kazaz) Feinberg School of Medicine, Northwestern University, Bluhm
Cardiovascular Institute, 675 N St Clair St Ste 19-100, Chicago, IL,
United States
Publisher
Springer
Abstract
Purpose of Review: Effusive-constrictive pericarditis (ECP) is a complex
clinical condition that combines features of pericardial
effusion/tamponade and constrictive pericarditis. The classic hemodynamic
definition is persistent elevation of right atrial pressure despite
drainage of a pericardial effusion. This review summarizes recent data on
its epidemiology, pathophysiology, diagnosis, and management. Recent
Findings: Prevalence varies from 2.4% to 14.8% depending on diagnostic
criteria and etiology, reaching up to 50% in tuberculous pericarditis in
endemic regions. Common causes include idiopathic, infectious
(particularly tuberculous and bacterial), malignant, and post-surgical
etiologies. While invasive hemodynamic assessment remains the reference
standard, echocardiography is now the primary diagnostic tool, enabling
recognition of constrictive physiology before and after
pericardiocentesis. Cardiac magnetic resonance adds complementary
information on pericardial thickness, inflammation, and potential for
reversibility, aiding therapeutic decisions. Inflammatory ECP frequently
resolves with medical therapy (NSAIDs, colchicine, corticosteroids, or
IL-1 inhibitors) while tuberculous cases require antimicrobial therapy
with corticosteroids in selected patients. Summary: ECP is a
heterogeneous condition with variable clinical trajectories. Early
identification through multimodality imaging is essential to guide
therapy, target reversible inflammation, and prevent chronic constriction.
Most inflammatory cases respond to anti-inflammatory treatment, whereas
pericardiectomy is reserved for persistent, irreversible constrictive
physiology despite optimal medical therapy. Copyright © The
Author(s) 2025.

<9>
Accession Number
2041116691
Title
Nonsteroidal Anti-Inflammatory Drugs as Part of a Multimodal Postoperative
Pain Management Strategy in Patients Undergoing Cardiac Surgery: A
Meta-Analysis of 11 Randomized Clinical Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(2) (pp 699-709),
2026. Date of Publication: 01 Feb 2026.
Author
Beshr M.S.; Shembesh R.H.; Salama A.H.; Kara A.O.; Arora R.C.; Abuajamieh
M.; Arhaym E.; Grant M.C.; Gregory A.J.; Elhadi M.
Institution
(Beshr) Faculty of Medicine and Health Sciences, Sana'a University,
Sana'a, Yemen
(Shembesh) Faculty of Medicine, Libyan International Medical University,
Benghazi, Libyan Arab Jamahiriya
(Salama) University of Health Sciences, Hamidiye International School of
Medicine, Istanbul, Turkey
(Kara, Arhaym) Faculty of Medicine, University of Benghazi, Benghazi,
Libyan Arab Jamahiriya
(Arora) Division of Cardiac Surgery, Harrington Heart and Vascular
Institute, University Hospitals, Cleveland, Ohio, United States
(Abuajamieh) Faculty of Medicine, Cairo University, Cairo, Egypt
(Grant) Department of Anesthesiology and Critical Care Medicine, Johns
Hopkins University School of Medicine, Baltimore, MD, United States
(Gregory) Department of Anesthesiology, Perioperative and Pain Medicine
and Libin Cardiovascular Institute, Cumming School of Medicine, University
of Calgary, Calgary, AB, Canada
(Elhadi) College of Medicine, Korea University, Seoul, South Korea, South
Korea
Publisher
W.B. Saunders
Abstract
Background: Effective and safe pain management is crucial for optimal
recovery after cardiac surgery. Traditionally, opioids have been the
mainstay for postoperative pain control, but their negative health effects
have led to a recent shift toward multimodal analgesia to minimize opioid
use. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) has been
controversial owing to concerns about bleeding, acute kidney injury (AKI),
graft patency, and cardiovascular risks. Despite these concerns, many
perioperative teams continue to use NSAIDs alongside opioids as part of
multimodal analgesia. This meta-analysis evaluated the efficacy and safety
of NSAIDs as a multimodal pain management tool following cardiac surgery.
 Method(s): An electronic search was conducted on November 15, 2024,
using PubMed, Scopus, Web of Science, Embase, and Cochrane databases. Only
controlled trials that combined NSAIDs with opioids for pain management
following cardiac surgeries were included. The primary outcome was the
visual analog scale (VAS), a 0 to 10 scale measuring pain intensity
assessed at 6, 12, 18, 24, and 48 hours. Total opioid consumption was
measured at 6, 12, 24, and 48 hours. Secondary outcomes included
myocardial infarction, atrial fibrillation, kidney function,
gastrointestinal bleeding, nausea, and vomiting. The mean difference (MD)
was used for continuous outcomes, and the odds ratio (OR) was used for
dichotomous outcomes. A random-effects model was applied for the analysis.
 Result(s): Out of the 1,194 articles screened, 11 articles, totaling
1,463 patients, were included in the meta-analysis. The NSAID group
demonstrated significantly lower VAS scores at the 12-hour (MD, -1.19, 95%
confidence interval [CI], -1.83 to -0.56; p < 0.001), 24-hour (MD, -0.61;
95% CI, -0.97 to -0.24; p = 0.001), 18-hour (MD, -1.43; 95% CI, -2.58 to
-0.28; p = 0.01), and 48-hour (MD, -0.68; 95% CI, -0.87 to -0.49; p <
0.001) time points. However, no significant differences in VAS scores were
observed at the 6-hour mark. Regarding opioid consumption, the NSAID group
demonstrated significantly lower opioid consumption at the 24-hour (MD,
-8.10; 95% CI, -10.60 to -5.61; p < 0.001) and 48-hour (MD, -7.13; 95% CI,
-12.44 to -1.82; p = 0.009); however, no differences were observed at the
6-hour and 12-hour marks. Finally, there were no significant differences
between the NSAID and control groups in the incidence of gastrointestinal
bleeding, atrial fibrillation, myocardial infarction, or AKI.
 Conclusion(s): NSAID use was associated with modestly reduced VAS
scores at 12, 18, 24, and 48 hours, while opioid consumption was
significantly lower at 24 and 48 hours postoperatively. Short-term NSAID
use can be effective in reducing pain and opioid requirements. Although no
significant difference in complications was observed, the analysis was
limited by small sample sizes. More extensive randomized controlled trials
are needed to assess the effectiveness and safety of NSAIDs as part of a
multimodal analgesic strategy. Copyright © 2025 Elsevier Inc.

<10>
Accession Number
2041658879
Title
Ketamine in Cardiac Surgery: A Systematic Review and Meta-Analysis of
Effects on Inflammatory Markers and Clinical Outcomes.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(2) (pp 690-698),
2026. Date of Publication: 01 Feb 2026.
Author
de Lima e Souza P.F.; Neto M.M.C.; Paz M.C.; Ponte R.V.
Institution
(de Lima e Souza) Department of Anesthesiology, Federal University of
Ceara, Fortaleza, Brazil
(Neto, Paz) School of Medicine, State University of Ceara, Fortaleza,
Brazil
(Ponte) Department of Surgery, University of Fortaleza, Fortaleza, Brazil
Publisher
W.B. Saunders
Abstract
Cardiac surgery triggers a systemic inflammatory response, especially when
cardiopulmonary bypass (CPB) is used, which may contribute to
postoperative complications. Ketamine, an NMDA receptor antagonist, has
shown anti-inflammatory potential by inhibiting nuclear factor kappa B and
reducing cytokine release, but its perioperative immunomodulatory effects
remain unclear. This systematic review and meta-analysis assessed
randomized controlled trials (RCTs) comparing intraoperative ketamine to
placebo in cardiac surgery. The primary outcome was interleukin (IL)-6
level; secondary outcomes included C-reactive protein (CRP) level,
intensive care unit (ICU) length of stay, mechanical ventilation duration,
and transfusion requirements. Eight RCTs, including a total of 377
patients, were included in the analysis. Ketamine did not significantly
reduce IL-6 levels at 24 hours postoperatively (standardized mean
difference [SMD], -0.96; 95% confidence interval [CI], -2.56 to 0.65; I2 =
96%), although a significant decrease was observed in off-pump procedures
(mean difference [MD], -59.57 pg/mL; I2 = 0%). IL-6 levels measured
immediately after CPB and CRP levels immediately after surgery also were
reduced, but findings were limited by high heterogeneity. No significant
differences were observed in ICU length of stay (MD, -0.10 days),
ventilation time (MD, -0.86 hours), or transfusion rates (risk ratio,
1.01). The certainty of the evidence was rated low to moderate owing to
imprecision and inconsistency. Although ketamine's immunomodulatory
effects were observed in selected subgroups, they did not translate into
improved clinical outcomes. Current evidence does not support the routine
use of ketamine for inflammation control in cardiac surgery, although its
effect in off-pump procedures warrants further research. Copyright
© 2025 Elsevier Inc.

<11>
Accession Number
2041286515
Title
Impact of Intraoperative Hyperoxia Versus Normoxia on Mortality and Organ
Injury in Cardiac Surgery: A Systematic Review and Meta-analysis of
Randomized Clinical Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(2) (pp 509-521),
2026. Date of Publication: 01 Feb 2026.
Author
Grillo I.T.C.; de Santana E.S.P.; Passos F.S.; Tanimoto L.E.; de Melo
J.C.; Kondo A.M.; Treml R.E.; Caldonazo T.
Institution
(Grillo, Tanimoto, de Melo) University of Buenos Aires, Buenos Aires,
Argentina
(de Santana) Federal University of Bahia, Salvador, Brazil
(Passos) Department of Thoracic Surgery, Mater Dei Hospital, Salvador,
Brazil
(Kondo) Albert Einstein Israeli Faculty of Health Sciences, Sao Paulo,
Brazil
(Treml) Department of Anesthesiology, Perioperative and Pain Medicine,
Stanford University School of Medicine, Stanford, CA, United States
(Caldonazo) Department of Cardiothoracic Surgery, Jena University
Hospital, Jena, Germany
(Caldonazo) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
Publisher
W.B. Saunders
Abstract
Objective: To compare mortality and organ injury associated with
intraoperative hyperoxia and normoxia in cardiac surgery patients.
 Design(s): Systematic review and meta-analysis of randomized clinical
trials (RCTs). Setting(s): Tertiary care. Participant(s):
Patients who underwent cardiac surgery with cardiopulmonary bypass or
off-pump procedures. Intervention(s): Intraoperative hyperoxia or
normoxia. Measurements and Main Results: A systematic search of
PubMed, Embase, and the Cochrane Library identified RCTs comparing
hyperoxia versus normoxia in cardiac surgery. Primary outcomes were
in-hospital and 30-day mortality; secondary outcomes included
postoperative clinical and biochemical measures. Risk ratios (RRs), mean
differences (MDs), and standardized mean differences (SMDs) with 95%
confidence intervals (CIs) were calculated. Trial sequential analysis and
subgroup analysis based on the variable used to define oxygenation
(PaO2-based v FiO2-based thresholds) were performed to address
heterogeneity in oxygenation strategies. Nineteen RCTs (2,001 patients)
were included, with 982 patients (49.1%) experiencing hyperoxia.
In-hospital (9/798 [1.1%] v 10/799 [1.3%], RR 0.84, 95% CI 0.36 to 1.94, p
= 0.684) and 30-day mortality (1/282 [0.4%] v 4/280 [1.4%], RR 0.41, 95%
CI 0.08 to 2.28, p = 0.311) were not different between the groups.
However, the normoxia group had a higher postoperative
PaO<inf>2</inf>/FiO<inf>2</inf> ratio (MD -31.49, 95% CI -47.13 to -15.85,
p < 0.01), whereas creatine kinase-MB (SMD 1.65, 95% CI 0.12 to 3.18, p =
0.03) and malondialdehyde (SMD 3.77, 95% CI 2.99 to 4.55, p < 0.01) were
higher in the hyperoxia group. Conclusion(s): Compared with normoxia,
hyperoxia during cardiac surgery does not impact in-hospital or 30-day
mortality but is associated with worsening physiological and biochemical
parameters. Copyright © 2025 The Authors

<12>
Accession Number
2034362640
Title
Everolimus and sirolimus in the treatment of cardiac rhabdomyomas in
neonates.
Source
Pediatric Research. 98(6) (pp 2045-2057), 2025. Date of Publication: 01
Dec 2025.
Author
Hurtado-Sierra D.; Ramos Garzon J.X.; Romero-Guevara S.L.; Serrano-Garcia
A.Y.; Rojas L.Z.
Institution
(Hurtado-Sierra) Pediatric Cardiology Unit, Instituto del Corazon de
Bucaramanga, Bucaramanga, Colombia
(Ramos Garzon, Romero-Guevara) Nursing School, Universidad Industrial de
Santander, Bucaramanga, Colombia
(Serrano-Garcia, Rojas) Research Center, Fundacion Cardiovascular de
Colombia, Floridablanca, Colombia
Publisher
Springer Nature
Abstract
Background and objectives: Cardiac rhabdomyoma (CR) is the principal
cardiac tumor diagnosed in pediatric age and is commonly associated with
tuberous sclerosis complex. In some patients, these masses can cause heart
failure and difficult-to-control arrhythmias. There are multiple case
reports on use of mammalian target of rapamycin (mTOR) inhibitors,
everolimus or sirolimus, in treatment of CRs. We reviewed the current data
regarding effectiveness of everolimus and sirolimus in treating of CRs in
newborns with hemodynamic repercussions. Method(s): This systematic
review was reported according to the PRISMA guidelines. The EBSCO, PubMed,
EMBASE, and Lilacs databases were searched for full-text articles
reporting the use of everolimus or sirolimus in the treatment of CRs in
neonates and infants. Result(s): Thirty-one articles met inclusion
criteria, totaling 48 patients. Hemodynamic instability prompted treatment
in 89.5% of cases. Everolimus was used in 83.3% of cases and sirolimus in
16.6%. The median treatment duration was 67 days, with a 57 +/- 23%
average CR size reduction. Common adverse events included
hypertriglyceridemia, infections, and hematological abnormalities.
 Conclusion(s): mTOR inhibitors appear effective and safe for treating
CRs in neonates and infants. The average daily doses were 1.03 mg/m2/day
for everolimus and 1.37 mg/m2/day for sirolimus. Randomized controlled
clinical trials are necessary to confirm these findings and establish
optimal treatment protocols. Impact: Currently, there are no results from
randomized clinical trials evaluating the efficacy of mammalian target of
rapamycin inhibitors in patients with symptomatic cardiac rhabdomyomas.
This is the first systematic review that evaluates the efficacy and safety
of the use of everolimus and sirolimus in the non-surgical treatment of
cardiac rhabdomyomas with hemodynamic repercussions in neonates.
Everolimus and sirolimus may be particularly useful in the neonatal period
when the hemodynamic complications caused by cardiac rhabdomyomas are more
severe. Copyright © The Author(s) 2025.

<13>
Accession Number
2042870911
Title
Ultrasound-guided unilateral thoracic paravertebral block for
postoperative analgesia in pediatric patients undergoing thoracoscopic
mediastinal tumor resection: a single-center randomized controlled trial.
Source
World Journal of Surgical Oncology. 24(1) (no pagination), 2026. Article
Number: 58. Date of Publication: 01 Dec 2026.
Author
Sun L.; Wu Z.; Wang F.; Gao Z.; Li L.; Liu H.; Liu G.; Li G.; Zhang J.
Institution
(Sun, Wang, Gao, Li, Liu, Liu, Li, Zhang) Department of Anesthesiology,
Beijing Children's Hospital, Capital Medical University, National Center
for Children's Health, Beijing, China
(Wu) Department of Science and Technology, Beijing Youan Hospital, Capital
Medical University, Beijing, China
Publisher
BioMed Central Ltd
Abstract
Background: Thoracic paravertebral block (TPVB) has rarely been reported
for pediatric mediastinal tumor surgery. This study aimed to evaluate the
efficacy of unilateral TPVB for postoperative analgesia in children
undergoing thoracoscopic mediastinal tumor resection, providing a
potential option for multimodal analgesia in pediatric thoracic oncology
surgery. Method(s): Children aged 4 to 12 years scheduled for
thoracoscopic mediastinal tumor resection were enrolled and randomly
assigned to either the general anesthesia group (GA group) or the general
anesthesia combined with paravertebral block group (TPVB group).
Postoperative pain was assessed using the FLACC (Face, Legs, Activity,
Cry, Consolability) scale at 2, 4, 8, 12, and 24 h after surgery. The
primary outcome was the pain intensity, and secondary outcomes included
pain scores at rest and during activity, postoperative opioid consumption,
adverse events, and recovery quality. Result(s): Of the 120 patients
enrolled and randomized, 110 completed the study (GA group, n = 54; TPVB
group, n = 56).Results showed that the TPVB group had significantly lower
pain intensity compared to the general anesthesia group (1.8 +/- 0.3 vs.
2.2 +/- 0.3, p < 0.001). Pain scores at rest and during activity were
significantly reduced at 2, 4, and 8 h, and pain scores at rest remained
significantly lower at 12 h. Compared with the GA group, the TPVB group
had lower postoperative opioid consumption (0.2 [0.1-0.3] microg/kg vs.
0.3 [0.2-0.4] microg/kg, p = 0.024), a lower incidence of desaturation in
the post-anesthesia care unit (PACU) (2 [3.6%] vs. 12 [22.2%], p = 0.003),
shorter PACU stay (21 [15-27] min vs. 31 [25-35] min, p < 0.001), earlier
chest tube removal (3 [3-4] days vs. 4 [3-4] days, p = 0.013), and a
shorter hospital stay (5 [4-6] days vs. 6 [5-7] days, p < 0.001). There
were no significant differences in adverse events between the two groups.
 Conclusion(s): Unilateral TPVB for pediatric mediastinal tumor
resection significantly reduces overall pain intensity within 24 h and
pain scores within the first 8 h postoperatively, decreases opioid
consumption during the first 24 h, and improves postoperative recovery.
Trial registration: Chinese Clinical Trial Registry ChiCTR2400083377,
registered 23 April 2024. Copyright © The Author(s) 2025.

<14>
Accession Number
2042308555
Title
Exercise Prehabilitation and 90-Day Self-Rated Health Status in Cardiac
Surgery Patients with Poor Early Recovery: A Secondary Analysis of a
Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(2) (pp 769-772),
2026. Date of Publication: 01 Feb 2026.
Author
Yau D.K.W.; Joynt G.M.; Ho K.M.; Lee A.
Institution
(Yau) Department of Rehabilitation Sciences, Hong Kong Polytechnic
University, Hung Hom, Hong Kong
(Yau, Joynt, Ho, Lee) Department of Anaesthesia and Intensive Care, The
Chinese University of Hong Kong, Hong Kong SAR, Shatin, China
Publisher
W.B. Saunders

<15>
Accession Number
2041169559
Title
Recombinant Factor VIIa Versus Prothrombin Complex Concentrate in Patients
Undergoing Cardiac Surgery: A Systematic Review and Meta-analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(2) (pp 676-689),
2026. Date of Publication: 01 Feb 2026.
Author
Cadd M.; Puntis D.; Bullard S.; Green S.; Kilpatrick T.; Hardy B.; Seavill
M.
Institution
(Cadd, Puntis, Green, Kilpatrick, Hardy) Anaesthetic Department, Royal
Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust,
Brighton, United Kingdom
(Bullard) Department of Anaesthesia, Royal Brompton Hospital, Guy's and St
Thomas' NHS Foundation Trust, London, United Kingdom
(Seavill) Department of Anaesthesia, St George's University Hospitals NHS
Foundation Trust, London, United Kingdom
Publisher
W.B. Saunders
Abstract
Perioperative hemorrhage during cardiac surgery is a frequent occurrence
and can result in significant morbidity and mortality for patients.
Prothrombin complex concentrate (PCC) and recombinant factor VIIa (rFVIIa)
are therapies that have been used extensively in cardiac surgery with some
promise, but with some concern around acute kidney injury (AKI) and
thromboembolic disease with rFVIIa use. In this meta-analysis and
systematic review, the authors summarize the evidence regarding the
effects of PCC and rFVIIa on chest tube output, incidence of adverse
events, and mortality of adult patients undergoing cardiac surgery. A
total of 962 patients from seven retrospective observational studies were
included in the pooled analysis. There was a significant reduction in the
primary outcome: total chest tube output (mean difference: -301.01 mL, 95%
confidence interval [CI] -550.54 to -51.48). PCC was associated with a
significant reduction in total thromboembolic disease (odds ratio: 0.55,
95% CI 0.34 to 0.89), deep vein thrombosis (odds ratio 0.28, 95% CI 0.15
to 0.52), and cryoprecipitate transfusion (mean difference: -3.93, 95% CI
-7.64 to -0.21). There were no significant differences between groups in
the incidence of AKI or mortality. Five studies were deemed at moderate
risk of bias, and two at serious risk. PCC has been shown to have a
beneficial effect on reducing chest tube output and incidence of
thromboembolic disease, with no increase in AKI compared with
rFVIIa. Copyright © 2025 Elsevier Inc.

<16>
Accession Number
2042519628
Title
Risk factors for a central-to-peripheral arterial blood pressure gradient
in adults: a systematic review.
Source
Canadian Journal of Anesthesia. 72(11) (pp 1634-1649), 2025. Date of
Publication: 01 Nov 2025.
Author
Chala H.; Daccache N.; Morisson L.; Denault A.; Laferriere-Langlois P.
Institution
(Chala, Daccache, Morisson, Laferriere-Langlois) Maisonneuve-Rosemont
Hospital Research Center, Universite de Montreal, Montreal, QC, Canada
(Denault) Montreal Heart Institute, Universite de Montreal, Montreal, QC,
Canada
Publisher
Springer
Abstract
Purpose: Accurate hemodynamic monitoring is essential for personalized
care in surgical and intensive care unit (ICU) settings, and radial artery
catheters are the gold standard. Nevertheless, central-to-peripheral
arterial blood pressure gradients (CPAPGs) have been reported in up to 77%
of patients, potentially leading to misinformed clinical decisions.
Identifying patients at risk of CPAPGs is crucial to adapt monitoring
strategies. We aimed to identify the risk factors contributing to CPAPGs
and assess their level of consensus in a systematic review of the
literature. Method(s): For this systematic review, we searched
MEDLINE/PubMed, Embase, and Cochrane databases (CENTRAL and Database of
Systematic Reviews) from inception to 15 July 2024. Studies on adult
patients with simultaneous radial and central arterial pressure monitoring
were included. We extracted and analyzed risk factors and assessed the
consistency of the literature for each. Result(s): From 741 retrieved
articles, we included 55 studies (N = 5,598) evaluating the presence of
CPAPGs during cardiopulmonary bypass, hepatic transplant, ICU stay, and
other settings. Overall, 90 unique potential risk factors were evaluated,
with 36 showing a statistically significant association with CPAPGs.
Complex procedures and smaller radial artery diameter were the most
consistent predictors, with both showing significant association with
CPAPGs in the 3 studies evaluating them. Vasopressor usage showed
statistical significance in half the studies evaluating it, and
demographic factors, potentially associated with smaller radial artery
diameter, such as older age, shorter stature, and female sex, were also
statistically significant risk factors in some studies.
 Conclusion(s): The present systematic review identified numerous risk
factors for CPAPGs. In patients with multiple contributing factors,
clinicians should consider using more central arterial cannulation to
minimize the risk of inaccurate pressure measurements. Study registration:
PROSPERO (CRD42024561474); first submitted 10 July 2024. Copyright
© Canadian Anesthesiologists' Society 2026.

<17>
Accession Number
2039269878
Title
Early Invasive or Conservative Strategies for Older Patients With Acute
Coronary Syndromes A Meta-Analysis.
Source
JAMA Internal Medicine. 185(8) (pp 966-975), 2025. Date of Publication: 01
Aug 2025.
Author
Reddy R.K.; Koeckerling D.; Eichhorn C.; Jamil Y.; Ardissino M.; Braun V.;
Abu Sharar H.; Frey N.; Howard J.P.; Ahmad Y.
Institution
(Reddy, Ardissino, Howard) National Heart and Lung Institute, Imperial
College London, London, United Kingdom
(Reddy) Nuffield Department of Population Health, University of Oxford,
Oxford, United Kingdom
(Koeckerling, Abu Sharar, Frey) Department of Cardiology, Angiology and
Respiratory Medicine, Heidelberg University Hospital, Heidelberg, Germany
(Eichhorn) Division of Acute Medicine, University Hospital Basel, Basel,
Switzerland
(Jamil) Inova Heart and Vascular Institute, Inova Fairfax Medical Campus,
Falls Church, VA, United States
(Ardissino) British Heart Foundation Cardiovascular Epidemiology Unit,
Department of Public Health and Primary Care, University of Cambridge,
Cambridge, United Kingdom
(Ardissino) Medical Research Council Laboratory of Medical Sciences,
Imperial College London, London, United Kingdom
(Braun) Medical Faculty Mannheim, University of Heidelberg, Heidelberg,
Germany
(Ahmad) Division of Cardiology, University of California, San Francisco,
United States
Publisher
American Medical Association
Abstract
IMPORTANCE The optimal management strategy for older patients who present
with acute coronary syndrome (ACS) remains unclear due to a paucity of
randomized evidence. New large and longer-term randomized data are
available. OBJECTIVE To test the association of an early invasive strategy
vs a conservative strategy with clinical outcomes for patients 70 years or
older who present with ACS. DATA SOURCES A literature search strategy was
designed in collaboration with a medical librarian. MEDLINE, Embase, and
the Cochrane Central Register of Controlled Trials were systematically
searched,with no language restrictions from inception through October
2024. Bibliographies of previous reviews and conference abstracts from
major cardiovascular scientific meetings were handsearched. STUDY
SELECTION Studies were deemed eligible following review by 2 independent,
masked investigators if they randomly allocated patients 70 years or older
who presented with ACS to early invasive or conservative management and
reported clinical end points. Observational analyses were excluded. No
trials were excluded based on sample size or follow-up duration. DATA
EXTRACTION AND SYNTHESIS Data were extracted independently and in
triplicate. Clinical end points were pooled in meta-analyses that applied
fixed-effects and random-effects modeling to calculate summary estimates
for relative risks (RRs) and hazard ratios, along with their corresponding
95% CIs. MAIN OUTCOMES AND MEASURES The prespecified primary end point was
all-cause death. Secondary end points included recurrent myocardial
infarction (MI), repeated coronary revascularization, major bleeding,
cardiovascular death, death or MI, stroke, heart failure hospitalization,
major adverse cardiac events, major adverse cardiovascular or
cerebrovascular events, and length of hospital stay. RESULTS The sample
size-weighted mean age of participants across included trials was 82.6
years, and 46% were female. In the pooled analysis, there was no
significant difference in all-cause death between the invasive and
conservative strategies (RR, 1.05; 95% CI, 0.98-1.11; P = .15;
I2 = 0%). An early invasive strategy was associated with a
reduced risk of recurrent MI of 22% (RR, 0.78; 95% CI, 0.67-0.91; P =
.001; I2 = 0%) and repeated coronary revascularization during
follow-up of 57% (RR, 0.43; 95% CI, 0.30-0.60; P < .001; I2 =
33.3%). However, an invasive strategy was associated with an increased
risk of major bleeding (RR, 1.60; 95% CI, 1.01-2.53; P = .046;
I2 = 16.7). No differences were observed in secondary end
points. Results in the non-ST-elevation ACS population were consistent
with the overall findings. CONCLUSIONS AND RELEVANCE The results of this
systematic review and meta-analysis suggest that, in older patients with
ACS, an early invasive strategy was not associated with reduced all-cause
death compared with conservative management. An early invasive strategy
was associated with reduced recurrent MI and repeated coronary
revascularization during follow-up but increased risk of major bleeding.
Competing risks associated with an early invasive strategy should be
weighed in shared therapeutic decision-making for older patients with
ACS. Copyright © 2025 American Medical Association. All rights
reserved.

<18>
Accession Number
2043252843
Title
Transcatheter edge-to-edge repair plus guideline-directed medical therapy
versus guideline-directed medical therapy alone for symptomatic functional
mitral regurgitation: a comprehensive, up-to-date meta-analysis of
randomised trials.
Source
EuroIntervention. 22(2) (pp e101-e112), 2026. Date of Publication: 19 Jan
2026.
Author
Ammirabile N.; Giacoppo D.; Mazzone P.M.; Landolina D.; Spagnolo M.;
Capodanno D.
Institution
(Ammirabile, Giacoppo, Mazzone, Landolina, Spagnolo, Capodanno) Division
of Cardiology, Azienda Ospedaliero-Universitaria Policlinico "G.
Rodolico-San Marco", University of Catania, Catania, Italy
(Landolina) Cardiology Unit, Umberto I Hospital, Syracuse, Italy
Publisher
Europa Group
Abstract
BACKGROUND: Transcatheter edge-to-edge repair (TEER) is among the
treatments for functional mitral regurgitation (FMR), but its benefits
over guideline-directed medical therapy (GDMT) alone are discordant. We
conducted a metaanalysis of randomised trials comparing long-term outcomes
between these treatment strategies. AIMS: We aimed to compare long-term
clinical outcomes between TEER plus GDMT and GDMT alone in symptomatic
moderate-to-severe FMR. METHOD(S): Major electronic databases were
searched for randomised trials comparing TEER plus GDMT with GDMT alone in
FMR. The primary outcome was death or first hospitalisation due to heart
failure at 24 months. The key secondary outcome was first hospitalisation
due to heart failure at 24 months. Summary hazard ratios (HRs) with 95%
confidence intervals (CIs) were computed by mixed-effects Cox models based
on reconstructed time-to-first event individual patient data and
random-effects models based on study-level data. RESULT(S): Three
randomised trials (MITRA-FR, COAPT, and RESHAPE-HF2) were included, for a
total of 1,422 patients assigned to TEER plus GDMT (n=703) or GDMT alone
(n=719). The primary outcome was significantly lower in the TEER plus GDMT
group compared with the GDMT-alone group by one-stage analysis (HR 0.72,
95% CI: 0.56-0.92; p=0.010). However, the two-stage analysis marginally
failed to confirm this result (HR 0.72, 95% CI: 0.51-1.00; p=0.052) and
showed substantial heterogeneity (I2=80.3%; p=0.006). Hospitalisation due
to heart failure was significantly lower in the TEER plus GDMT group,
regardless of the statistical method used (one-stage: HR 0.65, 95% CI:
0.48-0.88; p=0.006; two-stage: HR 0.66, 95% CI: 0.45-0.96; p=0.031).
However, heterogeneity was substantial (I2=81.2%; p=0.005). All-cause
death and cardiovascular death at 24 months were not significantly
different between treatment groups but became significant after excluding
MITRA-FR in the leave-one-out analysis. CONCLUSION(S): In symptomatic
moderate-to-severe FMR, TEER plus GDMT significantly reduces death or
hospitalisation due to heart failure and hospitalisation due to heart
failure at 24 months. Copyright © Europa Group 2026. All rights
reserved.

<19>
Accession Number
2042189764
Title
GV effects of diabetes mellitus on clinical outcomes of patients with
acute heart failure: A systematic review and meta-analysis.
Source
PLOS ONE. 20(12 December) (no pagination), 2025. Article Number: e0338653.
Date of Publication: 01 Dec 2025.
Author
Zhao L.; Zhang J.; Liu W.; Dai C.; Li A.
Institution
(Zhao, Liu, Dai, Li) Department of Biochemistry and Molecular Biology,
College of Basic Medicine, Hebei University of Chinese Medicine, Hebei,
Shijiazhuang, China
(Zhang, Li) Hebei Key Laboratory of Chinese Medicine Research on
Cardio-Cerebrovascular Disease, Hebei, Shijiazhuang, China
(Li) Hebei Higher Education Institute Applied Technology Research Center
on TCM Formula Preparation, Hebei, Shijiazhuang, China
Publisher
Public Library of Science
Abstract
Diabetes mellitus (DM) is identified as a potential modifier of clinical
outcomes in acute heart failure (AHF), yet its prognostic impact is not
fully determined. This systematic review and meta-analysis aimed to assess
the prognostic impact of DM on survival outcomes in AHF patients by
synthesizing evidence from 26 studies involving 326,928 subjects collected
from Cochrane Library, PubMed, Web of Science, and Embase databases up to
1 June 2024. Both prospective/retrospective cohort and case-control
studies published since 2000 were included, with outcomes evaluated
through multivariate, univariate, and binary analyses using the
Newcastle-Ottawa Scale for quality assessment. Multivariate analysis
indicated that DM significantly increased the risk of all-cause mortality
in AHF patients (cohort studies: HR = 1.21, 95%CI (1.13, 1.29), OR=1.15,
95%CI (1.05, 1.26); case-control studies: HR = 1.39, 95%CI (1.26, 1.53),
OR=1.43, 95%CI (1.10, 1.84)]. Univariate analysis confirmed this finding
in case-control studies [HR = 1.30, 95%CI (1.01, 1.67)], but not in cohort
studies. In both cohort [RR = 1.27, 95%CI (1.12, 1.43)] and case-control
[OR=1.21, 95%CI (1.08, 1.35)] studies, DM increased the risk of all-cause
mortality. AHF patients with DM had a higher risk of cardiovascular
mortality [cohort studies: HR = 1.85, 95%CI (1.46, 2.33); case-control:
OR=1.70, 95%CI (1.17, 2.47)]. While multivariate analysis showed no
association between DM and in-hospital mortality, case-control studies
indicated an increased risk [OR=1.21, 95%CI (1.03, 1.42)]. DM also
increased the risk of readmission [cohort studies: HR = 1.32, 95%CI (1.14,
1.53); case-control studies: HR = 1.44, 95%CI (1.23, 1.69); binary data:
OR=1.19, 95%CI (1.07, 1.31)]. This updated meta-analysis demonstrates that
DM imposes significant adverse effects on all-cause mortality,
cardiovascular-related mortality, and readmission risk in AHF patients.
However, no significant connection was found between diabetes and survival
outcomes with respect to the co-endpoint of death or readmission and the
endpoint of in-hospital mortality. These findings underscore the necessity
for implementing targeted diabetes management within AHF care protocols to
enhance clinical outcomes, an essential consideration for future
practice. Copyright © 2025 Zhao 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.

<20>
Accession Number
2043296956
Title
TAVR in Bicuspid Aortic Valve Disease: A Meta-Analysis of Surgical
Comparison and Anatomic Predictors.
Source
Heart Lung and Circulation. (no pagination), 2026. Date of Publication:
2026.
Author
Lingamsetty S.S.P.; Thyagaturu H.; Jitta S.R.; Prajapati K.; Ajibade A.;
Alruwaili W.; Muntazir H.; Zeb I.
Institution
(Lingamsetty) Beth Israel Deaconess Medical Center, Harvard Medical
School, Boston, MA, United States
(Thyagaturu, Zeb) Department of Cardiology, West Virginia University,
Heart and Vascular Institute, Morgantown, WV, United States
(Jitta) Department of Internal Medicine, Mercy Hospital, St. Louis, MO,
United States
(Prajapati) Department of Internal Medicine, Metropolitan Hospital Center,
NYC Health + Hospitals, New York, NY, United States
(Ajibade, Alruwaili) Department of Internal Medicine, West Virginia
University, Morgantown, WV, United States
(Muntazir) Binghamton University, State University of New York,
Binghamton, NY, United States
Publisher
Elsevier Ltd
Abstract
Background: Despite the proven efficacy of transcatheter aortic valve
replacement (TAVR) in treating tricuspid aortic valve stenosis, the
bicuspid aortic valve (BAV) population has been excluded from most of the
landmark trials. Aim(s): This study aimed to assess the outcomes of
TAVR compared with those of surgical aortic valve replacement (SAVR) and
examine the impact of BAV type, aortopathy, excess leaflet calcification,
and raphe calcification on BAV TAVR outcomes. Method(s): We searched
PubMed/MEDLINE, Embase, and Cochrane Library for studies that assessed the
outcomes of TAVR in the BAV population. We also included studies of
patients with BAV undergoing TAVR and SAVR, and those assessing anatomical
predictors of TAVR outcomes. Random-effects models were used to calculate
the pooled risk ratios, mean differences, and hazard ratios.
 Result(s): Patients with BAV who underwent TAVR showed significantly
lower risks of major bleeding and acute kidney injury, and shorter
hospital stays than those who underwent SAVR. However, BAV TAVR had a
higher pacemaker implantation rate. Among the BAV types, Type 0 showed a
higher risk of coronary obstruction, whereas Type 1 had a lower risk of
pacemaker implantation following BAV TAVR. Additionally, BAV TAVR had a
higher risk of long-term mortality in patients with aortopathy (ascending
aortic diameter >4.5 cm) and excessive leaflet calcification.
 Conclusion(s): Compared with SAVR, TAVR in BAV is associated with
favourable in-hospital outcomes. Anatomical features, such as BAV type,
aortopathy, excess leaflet calcification, and calcified raphe,
significantly influence the outcomes of TAVR in the BAV
population. Copyright © 2025 Australian and New Zealand Society
of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of
Australia and New Zealand (CSANZ)

<21>
Accession Number
2042916134
Title
Hemodynamic monitoring strategies in cardiac surgery: an update systematic
review.
Source
Journal of Clinical Monitoring and Computing. (no pagination), 2026. Date
of Publication: 2026.
Author
Melo R.; Galindo V.; Gioli-Pereira L.; Joelsons D.; Assuncao M.; Alves B.;
Souza G.; Bravim B.; Passos R.
Institution
(Melo, Gioli-Pereira) Hospital Municipal Gilson de Cassia Marques de
Carvalho, Hospital Israelita Albert Einstein, Av. Albert Einstein,
627/701, SP, Sao Paulo, Brazil
(Galindo, Joelsons, Assuncao, Alves, Bravim, Passos) Department of
Critical Care, Hospital Israelita Albert Einstein, SP, Sao Paulo, Brazil
(Souza) Hospital Ortopedico Do Estado da Bahia, Hospital Israelita Albert
Einstein, BA, Salvador, Brazil
Publisher
Springer Science and Business Media B.V.
Abstract
Hemodynamic monitoring is a cornerstone of perioperative care in cardiac
surgery, where patients are at high risk of cardiovascular instability and
organ hypoperfusion. In recent years, goal-directed therapy (GDT)
protocols have increasingly incorporated advanced monitoring technologies
to optimize perfusion and improve outcomes. This systematic review aims to
critically appraise contemporary hemodynamic monitoring strategies and
their integration into GDT protocols in adult patients undergoing cardiac
surgery. A systematic review of studies published between January 2015 and
May 2025 was conducted using PubMed, Embase, Scopus, and the Cochrane
Library. The last search was conducted on 17 May 2025 in all databases.
Eligible studies included adult cardiac surgical patients managed with
perioperative hemodynamic monitoring strategies that incorporated cardiac
output assessment and structured GDT protocols. A qualitative synthesis of
monitoring modalities, targeted hemodynamic endpoints, and reported
clinical outcomes was performed. Our analysis included 15 studies
comprising 4,224 patients. Monitoring strategies ranged from pulmonary
artery catheters to minimally invasive and noninvasive tools such as
FloTrac/EV1000 and esophageal Doppler. Cardiac index and stroke volume
variation were the most frequently targeted parameters, often in
combination with perfusion markers such as mean arterial pressure or
central venous oxygen saturation. GDT protocols were associated with
reductions in AKI, duration of mechanical ventilation, and ICU/hospital
stay. Mortality benefits were inconsistently reported and not predefined
in most studies. Current evidence supports the physiological rationale for
GDT guided by advanced hemodynamic monitoring in cardiac surgery.
Nonetheless, substantial heterogeneity in strategies and outcomes
highlights the need for standardized protocols and high-quality
multicenter trials to determine the most effective, patient-centered
approaches. Trial registration: PROSPERO registration number:
CRD420251102582, retrospectively registered on 11 July 2025. Copyright
© The Author(s) 2026.

<22>
Accession Number
2043261534
Title
Outcomes of robotic repair for the degenerative mitral valve: a systematic
review and meta-analysis.
Source
Annals of Cardiothoracic Surgery. 15(1) (no pagination), 2026. Article
Number: 1. Date of Publication: 01 Jan 2026.
Author
Eranki A.; Munir L.; Downes D.; Debs C.; Rajesh K.; Muston B.; Ng D.;
Wilson-Smith A.; Gupta A.; Misfeld M.
Institution
(Eranki) Department of Cardiothoracic Surgery, Royal Hobart Hospital,
Hobart, Australia
(Munir) School of Medicine and Dentistry, Griffith University, Gold Coast,
Australia
(Downes) School of Medicine, University of New England, Armidale,
Australia
(Debs) School of Medicine and Surgery, University of Sydney, Sydney,
Australia
(Rajesh) School of Medicine, University of New South Wales, Sydney,
Australia
(Muston, Misfeld) Department of Cardiothoracic Surgery, Royal Prince
Alfred Hospital, Sydney, Australia
(Ng) Department of Cardiothoracic Surgery, Westmead Hospital, Sydney,
Australia
(Wilson-Smith) School of Medicine, Macquarie University, Sydney, Australia
(Gupta) School of Medicine, University of Adelaide, Adelaide, Australia
(Gupta) Department of Cardiothoracic Surgery, John Hunter Hospital,
Newcastle, Australia
Publisher
AME Publishing Company
Abstract
Background: Robotic mitral valve repair (RMVr) provides a minimally
invasive option for degenerative mitral regurgitation (MR), yet durability
signals and patient outcomes remain heterogeneously reported. This current
systematic review and meta-analysis aims to summarize survival and freedom
from reoperation following RMVr in degenerative disease. Method(s):
Five databases were searched from inception through July 2025 for studies
reporting RMVr outcomes in degenerative disease. Cohorts with mixed
etiologies without separable data were excluded. Short-term mortality (<30
days) was the primary outcome, while mid- to long-term survival and
freedom from reoperation were presented using Kaplan-Meier curves.
Secondary endpoints included relevant morbidity outcomes and reoperation
rates. Meta-regression analysis examined associations between cohort size
and adverse outcomes and assessed temporal trends in RMVr technique.
 Result(s): Following independent screening, 15 studies were selected,
including 11,432 patients. Pooled mean follow-up was 60.9 months
(clinical) and 20.0 months (echocardiographic). Kaplan-Meier overall
survival at 1, 3, 5 and 10 years was 98.9%, 98.7%, 97.4% and 92.3%,
respectively. At 1, 3 and 5 years, freedom from reoperation was 97.7%,
96.0% and 96.0%, while freedom from recurrent >=2+ MR was 98.3%, 95.8% and
95.8%. Pooled short-term (<30 days) mortality was 1.3% [95% confidence
interval (CI): 1.1-1.4%]. Postoperative morbidity was low, with
cerebrovascular accident (CVA) in 1.4% and acute kidney injury (AKI) in
1.3%. Reoperation for bleeding and valve dysfunction occurred in 2.3% and
2.2% of patients, respectively. Pooled mean intensive care unit (ICU) stay
was 1.2 days and hospital length of stay (LOS) was 6.0 days.
Meta-regression suggested increasing adoption of neochordae techniques
over time (P=0.015). Heterogeneity was high for several parameters,
reflecting differences in study design, surgeon experience, and follow-up
duration. Conclusion(s): In degenerative mitral disease, RMVr
demonstrates low short-term mortality and complications, with favorable
mid- to long-term durability, including high freedom from recurrent
moderate-to-severe MR and reoperation. These findings support RMVr as an
effective and durable surgical approach to degenerative mitral pathology,
underscoring the need for prospective, standardized studies with robust
echocardiographic follow-up and case-mix adjustment. Copyright ©
AME Publishing Company.

<23>
Accession Number
2042877513
Title
Reperfusion therapy for older patients with acute myocardial infarction
and cardiogenic shock.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2026. Date of
Publication: 2026.
Author
Kiyohara Y.; Minami K.; Freeman L.; Wilson Tang W.H.; Pinney S.P.; Yano
Y.; Naito T.; Miyashita S.
Institution
(Kiyohara) Department of Medicine, Icahn School of Medicine at Mount
Sinai, Mount Sinai Morningside and West, New York, NY, United States
(Minami) Medical Training Center, Saga University Hospital, Saga, Japan
(Freeman) Department of Medicine, Ashikaga Red Cross Hospital, Tochigi,
Japan
(Wilson Tang) Department of Cardiovascular Medicine Heart, Vascular, and
Thoracic Institute Cleveland Clinic Foundation, Cleveland, OH, United
States
(Pinney) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at
Mount Sinai, New York, NY, United States
(Yano, Naito, Miyashita) Department of General Medicine, Juntendo
University Faculty of Medicine, Tokyo, Japan
(Miyashita) Department of Critical Care Medicine, Integrated Hospital Care
Institute, Cleveland Clinic, Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
Background Reperfusion therapy is the cornerstone of treatment for acute
myocardial infarction (AMI) complicated by cardiogenic shock (CS).
However, older adults with AMI and CS face higher risks of adverse
outcomes and procedure-related complications. Since this population is
under-represented in clinical trials, the efficacy of reperfusion therapy
remains unclear. We performed a meta-analysis to evaluate the impact of
reperfusion therapy on mortality in older adults with AMI and CS. Methods
We searched PUBMED and EMBASE through 4/1/2025 for studies comparing
reperfusion therapy with percutaneous coronary intervention (PCI) or
coronary artery bypass graft (CABG) and non-reperfusion therapy for AMI
and CS in patients aged >=75 years. We included prospective and
retrospective observational trials reporting clinical outcomes. The
primary outcome was set as short-term mortality, and the secondary outcome
was long-term mortality. We performed subgroup analysis of the primary
outcome for patients with ST-segment elevation myocardial infarction and
those without. Results Our search identified 14 eligible studies in a
total of 4583 patients. Reperfusion therapy was associated with
significantly reduced short-term mortality, compared with non-reperfusion
therapy with high heterogeneity (odds ratio (OR): 0.47; 95% confidence
interval (CI): 0.30-0.73, I 2 = 76.8%). There was no
significant difference in long-term all-cause mortality between
reperfusion and non-reperfusion therapy (OR: 0.66; 95% CI: 0.34-1.26, I
 2 = 79.7%). The subgroup analyses were largely consistent
with the main findings. Conclusions Reperfusion therapy was associated
with reduced short-term mortality, compared to non-reperfusion therapy for
older patients with AMI and CS. Reperfusion therapy showed a tendency
towards reduced long-term mortality. Copyright © 2026 Elsevier
Inc.

<24>
Accession Number
2043181628
Title
The effects of a nurse-led smartphone-based intervention after coronary
artery bypass grafting: A randomised controlled trial.
Source
International Journal of Nursing Studies. 176 (no pagination), 2026.
Article Number: 105341. Date of Publication: 01 Apr 2026.
Author
Mahmoodi M.; Antikchi M.; Saeidinasab S.; Bakhshi F.
Institution
(Mahmoodi) Intensive Care Nursing, Department of Nursing, School of
Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences,
Yazd, Iran, Islamic Republic of
(Antikchi, Bakhshi) Research Center for Nursing and Midwifery Care,
Comprehensive Research Institute for Maternal and Child Health, Department
of Nursing, School of Nursing and Midwifery, Shahid Sadoughi University of
Medical Sciences, Yazd, Iran, Islamic Republic of
(Saeidinasab) Department of Nursing, School of Nursing and Midwifery,
Shahid Sadoughi University of Medical Sciences, Yazd, Iran, Islamic
Republic of
Publisher
Elsevier Ltd
Abstract
Background: Patients after coronary artery bypass grafting often face
suboptimal recovery, including pain, reduced quality of life, and
haemodynamic instability, worsened by limited self-care knowledge and
inadequate post-discharge support. Nurse-led smartphone-based
interventions may offer a scalable solution for resource-limited settings.
 Objective(s): To evaluate the effects of a nurse-led,
smartphone-based educational and follow-up intervention on pain, quality
of life, and haemodynamic stability in patients undergoing elective
coronary artery bypass grafting. Design(s): Single-blind, randomized
controlled trial. Setting(s): A tertiary cardiac surgery center in
Shiraz, Iran, from July 2024 to April 2025. Participant(s):
Eighty-four adults undergoing elective coronary artery bypass grafting,
randomized (1:1) to intervention or control groups, with 80 completing the
study (40 per group). Method(s): The intervention group received a
three-phase programme: (1) pre-operative education via videos, messages,
and a face-to-face session; (2) in-hospital education and daily symptom
monitoring for pain and self-care; (3) 30-day post-discharge follow-up
with weekly nurse-led calls and real-time messaging. Controls received
standard care with one handout. Outcomes included pain (visual analog
scale), quality of life (SF-36 Health Survey), and hemodynamic indices
(blood pressure, heart rate). Pain and haemodynamic indices were assessed
at baseline, three times daily for four days in the general ward following
post-intensive care unit discharge (12 time points), and weekly
post-discharge (days 7, 14, 21, 30; 4 time points), totaling 17
assessments. Quality of life was assessed at baseline and 30 days
post-discharge. Data were analyzed using Mann-Whitney U tests, t-tests,
and repeated-measures analysis of variance. Result(s): The
intervention group had lower pain scores (in-hospital: 3.96 +/- 0.42 vs.
4.29 +/- 0.35, p < 0.001, d = - 0.85, 95% CI -0.50 to - 0.16;
post-discharge: 1.45 +/- 0.38 vs. 2.01 +/- 0.50, p < 0.001, d = - 1.26,
95% CI -0.76 to - 0.36) and reduced post-discharge blood pressure and
heart rate. Total quality of life scores showed no significant
between-group differences at 30 days (adjusted ANCOVA: adjusted mean
difference = 0.15, 95% CI - 1.27 to 1.57, p = 0.832), while the pain
domain improved significantly in the intervention group (p = 0.002, r = -
0.35). Group-by-time interactions were significant for pain and
haemodynamic outcomes (p < 0.05). Conclusion(s): This nurse-led,
smartphone-based intervention reduced pain, improved pain-related quality
of life, and stabilized haemodynamic parameters post-coronary artery
bypass grafting. Easily integrated into nursing practice, it supports
recovery in resource-limited settings and merits further study.
Registration: Registered at the Iranian Registry of Clinical Trials,
IRCT20240426061574N1, registered June 05, 2024,
https://irct.behdasht.gov.ir/search/result?query=IRCT20240426061574N1.
Social media abstract: Nurse-led smartphone intervention reduces pain and
stabilizes haemodynamics in post-coronary artery bypass grafting patients
over 30 days. Copyright © 2026 Elsevier Ltd

<25>
Accession Number
2037627531
Title
Ultrasound guided internal jugular vein cannulation in pediatric patients:
a randomized controlled trial.
Source
Signa Vitae. 22(1) (pp 85-94), 2026. Date of Publication: 01 Jan 2026.
Author
Wang S.; Sun Y.; Chen X.; Chen W.; Wu P.; Cao J.; Tan Y.; Li Y.; Liu L.
Institution
(Wang, Sun, Chen, Chen, Wu, Cao, Tan, Li, Liu) Department of
Anesthesiology, Children's Hospital of Chongqing Medical University,
Chongqing, China
(Wang, Sun, Chen, Chen, Wu, Cao, Tan, Li, Liu) National Clinical Research
Center for Child Health and Disorders, Chongqing, China
(Wang, Sun, Chen, Chen, Wu, Cao, Tan, Li, Liu) Ministry of Education Key
Laboratory of Child Development and Disorders, Chongqing, China
(Wang, Sun, Chen, Chen, Wu, Cao, Tan, Li, Liu) Chongqing Key Laboratory of
Pediatric Metabolism and Inflammatory Diseases, Chongqing, China
Publisher
Pharmamed Mado Ltd
Abstract
Background: Central venous catheterization is essential for hemodynamic
monitoring and rapid fluid administration during pediatric surgeries, with
the internal jugular vein (IJV) being a preferred site for access.
However, ultrasound-guided IJV cannulation in pediatric patients remains
technically challenging. This study aimed to compare the efficacy and
safety of the modified dynamic needle tip positioning (MDNTP) technique
with the real-time biplane technique in pediatric patients.
 Method(s): This prospective randomized controlled trial enrolled 88
children aged 0-6 years undergoing thoracic or cardiac surgery and
requiring IJV cannulation at Chongqing Children's Hospital (November 2023
to April 2024). Eleven anesthesiology residents received standardized
simulator-based training in both techniques. The patients were randomized
in a 1:1 ratio to either the MDNTP group (using a linear probe) or the
real-time biplane group (using a biplane probe). The primary outcomes were
the first-attempt success rate and cannulation time. Secondary outcomes
included overall success rate, number of puncture attempts, and incidence
of complications. The operators, outcome assessors, and statisticians were
blinded to group assignments. Statistical analyses were performed using
the Mann-Whitney U test and chi-square test. Result(s): The MDNTP
group demonstrated a higher first-attempt success rate (79.5% vs. 54.5%
p=0.022) and shorter cannulation time (82.50 (55.50-115.50) vs. 108.00
(71.80-174.00) s p=0.023) compared to the real-time biplane group, with
fewer required puncture attempts (p=0.015). Both groups achieved similar
overall success rates (97.7%) and demonstrated comparable safety profiles,
with one minor hematoma in the MDNTP group and none in the biplane group
(p=1.000). Conclusion(s): Residents performing ultrasound-guided IJV
cannulation in pediatric patients using the MDNTP technique had a
significantly higher first-attempt success rate and faster cannulation
compared to the real-time biplane technique, without compromising safety.
Clinical Trial Registration: ChiCTR2300077334. Copyright © 2026
The Author(s).

<26>
Accession Number
2043081312
Title
Antithrombotic Treatment After Valve-in-Valve, Valve-in-Ring, and
Valve-in-MAC Procedures: A Systematic Review and Meta-Analysis.
Source
Acta Medica Portuguesa. 38(9) (pp 528-537), 2025. Date of Publication: 01
Sep 2025.
Author
Terleira Batista G.; Costa G.; Delgado Silva J.; Goncalves L.
Institution
(Terleira Batista, Costa, Delgado Silva, Goncalves) Servico de
Cardiologia, Centro Hospitalar e Universitario de Coimbra, Coimbra,
Portugal
(Costa, Delgado Silva, Goncalves) Faculdade de Medicina, Universidade de
Coimbra, Coimbra, Portugal
(Costa, Delgado Silva, Goncalves) Coimbra Institute for Clinical and
Biomedical Research (iCBR), Coimbra, Portugal
Publisher
CELOM
Abstract
While antithrombotic therapy following transcatheter valve implantation
has been extensively studied in various clinical trials, there remains a
notable gap in evidence regarding the optimal approach following
valve-in-valve (ViV), valve-in-ring (ViR) and valve-in-mitral annular
calcification (ViMAC) procedures, warranting further assessment. This gap
is particularly concerning due to the apparent increased risk of
thrombosis associated with ViV interventions. The aim of this systematic
review was to explore the potential benefits of anticoagulation in ViV,
ViR, and ViMAC procedures. We searched PubMed, Embase, and the Cochrane
Central Register of Controlled Trials, as well as the grey literature, for
observational and interventional studies published until December 2023.
Trials were included if a comparative analysis between the two
antithrombotic strategies was feasible and excluded if patients under 18
years old were analysed. The primary efficacy endpoints were incidence of
clinical and total valve thrombosis (VT), major bleeding was the sole
safety primary endpoint. Additional analyses were performed regarding
valves in the mitral position and valve type. The risk of bias was
evaluated using the Newcastle-Ottawa scale. Data was assessed using the
Review Manager 5.4 software. A total of five observational and one case
series were included (n = 614 on anticoagulation and n = 468 on
antiplatelets), comprising a total of 1082 participants. Clinical VT rates
were 4.2% for all procedures, and patients on anticoagulants were
associated with a lower risk of clinical VT (1.1% vs 8.3%; OR: 0.18; 95%
CI: 0.07 - 0.42, I2: 0%) and total VT (1.3% vs 8.5%; OR: 0.16; 95% CI:
0.07 - 0.37, I2: 0%). Regarding bleeding events, the existing literature
did not provide adequate information to enable a thorough analysis. Our
study suggests a potential benefit of anticoagulation regimens to decrease
the high rates of VT following valve-in-valve, valve-in-ring and
valve-in-mitral annular calcification procedures. However, the lack of
randomized controlled trials and data on bleeding and mortality emphasises
the necessity for further research. Copyright © Ordem dos Medicos
2025

<27>
Accession Number
2035758971
Title
Safety review of antithrombotic therapy options after left atrial
appendage occlusion.
Source
Expert Opinion on Drug Safety. 25(2) (pp 223-232), 2026. Date of
Publication: 2026.
Author
Sawhney A.; Gupta R.; Mahajan P.; Agrawal A.; Cossu S.; Lakkireddy D.R.
Institution
(Sawhney) Department of Internal Medicine, Crozer Chester Medical Center,
Upland, PA, United States
(Gupta) Department of Cardiology, Yale New Haven School of Medicine, New
Haven, CT, United States
(Mahajan, Agrawal) Lehigh Valley Health Network, Allentown, PA, United
States
(Cossu, Lakkireddy) Kansas City Heart Rhythm Institute and Research
Foundation, Overland Park, KS, United States
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Left atrial appendage occlusion (LAAO) is a viable
alternative to anticoagulation for treatment in patients with non-valvular
atrial fibrillation (NVAF) who cannot tolerate anticoagulation.
Post-procedure patients are generally prescribed oral anticoagulation
(OAC) for 45 days, while the device is undergoing endothelialization,
following which patients are continued on antiplatelet agents.
Recommendations for antithrombotic agents following LAAO arrived by
consensus, which are not tolerated by all patients. Areas covered: This
review covers the safety profile of antithrombotic therapy options after
LAAO. We discuss the side effect profiles including device-related
thrombosis (DRT), bleeding, and thromboembolic events. The new randomized
controlled trials and meta-analysis compared combinations of DOAC with
single antiplatelet therapy (SAPT), dual antiplatelet therapy (DAPT), VKA,
or only SAPT and studied the incidence of major bleeding, DRT, and
thromboembolic events. This review is a comprehensive summary of different
antithrombotic agents' combinations along with the duration
recommendations and emphasizes the importance of a discussion among
involved team members and patients. Expert opinion: In patients with NVAF
undergoing LAAO, initial post-procedural antithrombotic monotherapy with
DOAC is associated with low rates of thromboembolism, DRT, and major
bleeding followed by DAPT. DAPT is associated with lower incidence of
thromboembolic events in comparison to SAPT. Copyright © 2025
Informa UK Limited, trading as Taylor & Francis Group.

<28>
Accession Number
2036076342
Title
Minimally invasive surgical approaches for pneumothorax: evolution and
current perspectives.
Source
Expert Review of Respiratory Medicine. 20(2) (pp 149-157), 2026. Date of
Publication: 2026.
Author
Mizobuchi T.; Ito Y.; Sobue A.; Tada Y.; Nagato K.; Yamamoto T.
Institution
(Mizobuchi, Ito, Sobue, Tada, Nagato, Yamamoto) Department of General
Thoracic Surgery, Social Welfare Organization Saiseikai Imperial Gift
Foundation, Chibaken Saiseikai Narashino Hospital, Chiba, Japan
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: PubMed was used for a literature search (1990-2025) on the
minimally invasive surgical approaches for pneumothorax, which have
evolved markedly, with video-assisted thoracic surgery (VATS) emerging as
a preferred procedure. Systematic reviews of randomized control trials
indicate that VATS is less invasive than traditional thoracotomy.
Furthermore, uniportal VATS provides less postoperative pain and better
cosmetic outcomes than thoracotomy. Currently, uniportal VATS seems
preferred as the minimally invasive surgical approach for pneumothorax.
New devices such as small-diameter thoracoscopes and forceps, which are
used in uniportal subxiphoid VATS and uniportal subcostal robot-assisted
thoracic surgery, may contribute to reducing the postoperative incidence
of intercostal neuralgia and enhancing satisfaction with the cosmetic
results. Areas covered: The ideal surgical approaches for pneumothorax,
referencing guidelines, and studies from various countries. Expert
opinion: This review explores various aspects of minimally invasive
surgical approaches for pneumothorax. Uniportal VATS for pneumothorax via
the intercostal approach is commonly performed worldwide and ensures high
surgical quality. This review discusses what should be performed within
the thoracic cavity to reduce the postoperative recurrence rate of
pneumothorax, problems associated with thoracic adhesions that may be
disadvantageous for pneumothorax patients in the future, and the latest
surgical approaches that may become mainstream. Copyright © 2025
Informa UK Limited, trading as Taylor & Francis Group.

<29>
Accession Number
648931302
Title
Effects of Early Oral Hydration on Postextubation Thirst, Nausea, and
Vomiting in Cardiac Surgery Patients: A Randomized Controlled Trial.
Source
Journal of perianesthesia nursing : official journal of the American
Society of PeriAnesthesia Nurses. 41(1) (pp 123-129), 2026. Date of
Publication: 01 Feb 2026.
Author
Kim S.; Song Y.
Institution
(Kim) Department of Nursing, Kyungpook National University Chilgok
Hospital, Daegu, South Korea
(Song) Research Institute of Nursing Science, College of Nursing,
Kyungpook National University, Daegu, South Korea
Abstract
PURPOSE: A fasting period of 6 hours is generally maintained after
endotracheal tube extubation to reduce the risk of postoperative nausea
and vomiting in cardiac surgery patients. However, cardiac surgery
patients experience oral discomfort related to thirst, nausea, and
vomiting for a longer duration than patients undergoing other surgeries.
The purpose of this study was to determine the effects of early oral
hydration (EOH) on thirst, nausea, and vomiting in cardiac surgery
patients. DESIGN: Randomized controlled trial design as adopted and guided
by CONSORT. METHOD(S): Seventy-seven cardiac surgery patients were
randomly assigned to either the experimental (EOH; 2-hour fasting; n = 39)
or control group (delayed oral hydration; 6-hour fasting, n = 38). Thirst
was assessed using the Perioperative Thirst Discomfort Scale. Nausea and
vomiting were assessed using the Index of Nausea, Vomiting, and Retching.
Thirst, nausea, and vomiting were assessed immediately after extubation
(T1), as well as at 6 hours (T2) and 12 hours (T3) postextubation.
FINDINGS: Compared with the delayed oral hydration group, the EOH group
showed a significantly greater reduction in thirst over time (P < .001).
Nausea and vomiting were not significantly different between the two
groups (P = .327). CONCLUSION(S): EOH helped reduce thirst. Although
EOH did not aggravate nausea and vomiting relative to conservative oral
hydration, it may help alleviate postextubation discomfort in cardiac
surgery patients. Copyright © 2025 The American Society of
PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

<30>
[Use Link to view the full text]
Accession Number
2043044385
Title
Coronary CTA in Contemporary Percutaneous Coronary Intervention: From
Diagnostic Modality to Decision-Making Toolkit.
Source
Circulation: Cardiovascular Imaging. 19(1) (pp e018931), 2026. Date of
Publication: 01 Jan 2026.
Author
Alqahtani F.; Bianchini E.; Alsubai S.; Sgreva S.; Khair A.M.; Almagal N.;
Onuma Y.; Elzomor H.; Tsung-Ying T.; Sharif R.; Ibrahim M.A.; Serruys
P.W.; Sharif F.
Institution
(Alqahtani, Bianchini, Alsubai, Sgreva, Almagal, Elzomor, Sharif, Sharif)
Sharif Cardiovascular Research Group, University of Galway, Ireland
(Alqahtani, Bianchini, Alsubai, Sgreva, Almagal, Elzomor, Sharif, Sharif)
Discipline of Medical Devices and Artificial Intelligence, School of
Medicine, University of Galway, Ireland
(Onuma, Tsung-Ying, Serruys) CORRIB Research Centre for Advanced Imaging
and Core Lab, University of Galway, Ireland
(Elzomor, Sharif, Sharif) Clinical Research Facility Galway, University of
Galway, Ireland
(Sharif, Sharif) CURAM, University of Galway, Ireland
(Alqahtani, Alsubai) Department of Cardiac Technology, Imam Abdulrahman
bin Faisal University, Dammam, Saudi Arabia
(Bianchini, Sgreva, Sharif) Department of Cardiology, Galway University
Hospital, Ireland
(Khair) Department of Cardiology, University Hospital Waterford, Ireland
(Almagal) Department of Cardiology, Neom Hospital, Sharma, Saudi Arabia
(Ibrahim) Cardiac Centre, King Fahd Military Medical Complex, Dhahran,
Saudi Arabia
Publisher
Lippincott Williams and Wilkins
Abstract
Percutaneous coronary intervention outcomes rely heavily on accurate
lesion assessment and procedural planning. Invasive tools, such as
fractional flow reserve, nonhyperemic pressure ratios, intravascular
ultrasound, and optical coherence tomography, provide essential
physiological and anatomic insights but are resource-intensive, prolong
procedures, and increase contrast and radiation exposure. Coronary
computed tomography (CT) angiography has emerged as a noninvasive modality
with high diagnostic accuracy for coronary artery disease, capable of
detailing plaque composition, lesion length, and vessel geometry. With the
integration of CT-derived fractional flow reserve and CT myocardial
perfusion imaging, coronary CT angiography now offers both anatomic and
functional evaluation, bridging diagnostic and interventional
decision-making. Despite guideline endorsement for coronary artery disease
diagnosis, its role in guiding percutaneous coronary intervention
strategies remains underutilized and absent from revascularization
recommendations. This review outlines a practical, step-by-step framework
for integrating coronary CT angiography into contemporary percutaneous
coronary intervention planning, covering acquisition protocols, software
platforms, lesion assessment, and stent strategy optimization. It also
explores emerging intraprocedural applications, including fusion imaging,
augmented and virtual reality, and holographic visualization. By
synthesizing current evidence and identifying gaps, this review positions
coronary CT angiography as a promising adjunct in precision-based
percutaneous coronary intervention. Copyright © 2025

<31>
Accession Number
2042871841
Title
Effects of Near Infrared Light on Surgical Wound Healing: A Systematic
Review and Meta-Analysis.
Source
International Wound Journal. 23(2) (no pagination), 2026. Article Number:
e70841. Date of Publication: 01 Feb 2026.
Author
Liu J.; Gopal V.; Ellis B.; Ray I.; Pappu S.; Jan Y.-K.
Institution
(Liu, Jan) Department of Health and Kinesiology, University of Illinois at
Urbana-Champaign, Urbana, IL, United States
(Gopal, Ellis, Ray, Pappu) Carle Illinois College of Medicine, University
of Illinois at Urbana-Champaign, Urbana, IL, United States
Publisher
John Wiley and Sons Inc
Abstract
Near infrared (NIR) therapy is increasingly used to enhance postoperative
wound healing, yet clinical trial results remain inconsistent. To evaluate
the effectiveness of NIR therapy on postoperative wound healing and
identify treatment parameters associated with optimal outcomes: This
systematic review and meta-analysis registered at PROSPERO
(CRD420251163415) assessed evidence on comparing NIR therapy (630-1100 nm)
with standard care or placebo on healing of surgical-induced wounds. A
multilevel random-effects meta-analysis of standardised mean differences
(SMDs) was conducted. Moderator analyses examined the wavelength, fluence,
session number, application technique and anatomical site. Risk of bias
was assessed using Cochrane RoB 2.0 and certainty of evidence was rated
with GRADE. Fifty-six trials (N = 4920) were included for systematic
review and 35 trials contributed 69 outcomes to meta-analysis. NIR
significantly improved wound healing (0.78, [0.46-1.09], p < 0.01) and
reduced postoperative pain (0.71, [0.24-1.17], p < 0.01), but
heterogeneity was high and effects varied across studies. Optimal outcomes
were associated with short NIR wavelengths (700-850 nm), 4-10 sessions and
non-contact application. Effects on swelling, scarring and inflammatory
markers were inconsistent. Overall, certainty of evidence was very low.
This first systematic review and meta-analysis indicates that NIR therapy
demonstrates promise for enhancing postoperative healing and reducing
pain, though effects vary by protocols. Copyright © 2026 The
Author(s). International Wound Journal published by Medicalhelplines.com
Inc and John Wiley & Sons Ltd.

<32>
Accession Number
2032635170
Title
Albuminuria Prevalence in Fontan Patients: A Systematic Review and
Meta-Analysis.
Source
Pediatric Cardiology. 47(1) (pp 141-152), 2026. Date of Publication: 01
Jan 2026.
Author
Van Belle H.; Van den Eynde J.; Cieplucha A.; Ladouceur M.; Martinod K.;
Pierard S.; Coats L.; Jansen K.; Opotowsky A.; Van Craenenbroeck A.H.;
Budts W.; Van De Bruaene A.
Institution
(Van Belle, Van den Eynde, Cieplucha, Martinod, Budts, Van De Bruaene)
Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
(Budts, Van De Bruaene) Division of Structural and Congenital Cardiology,
University Hospitals Leuven, Herestraat 49, Leuven, Belgium
(Cieplucha) Department of Cardiology, Poznan University of Medical
Sciences, Poznan, Poland
(Ladouceur) Departement of Cardiology, University Hospital of Geneva,
Geneva, Switzerland
(Pierard) Department of Cardiology, Cliniques Universitaires Saint-Luc,
Brussels, Belgium
(Coats, Jansen) Adult Congenital Heart Unit, Freeman Hospital, Newcastle
upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United
Kingdom
(Coats, Jansen) Population Health Sciences Institute, Newcastle
University, Newcastle Upon Tyne, United Kingdom
(Opotowsky) Department of Pediatrics, Heart Institute, Cincinnati
Children's Hospital, University of Cincinnati College of Medicine,
Cincinnati, OH, United States
(Van Craenenbroeck) Department of Microbiology, Immunology and
Transplantation, Nephrology and Kidney Transplantation Research Group, KU
Leuven, Leuven, Belgium
(Van Craenenbroeck) Department of Nephrology and Kidney Transplantation,
University Hospitals Leuven, Leuven, Belgium
Publisher
Springer
Abstract
Patients with a Fontan circulation are at risk for chronic kidney disease
(CKD), which is defined as persistently reduced glomerular filtration rate
(GFR) <60ml/min/1.732 or elevated marker of kidney injury such
as urinary albumin-to-creatinine ratio (UACR) >30mg/g. We determined the
prevalence of albuminuria in patients with a Fontan circulation. The
MEDLINE, EMBASE, Trip, and Cochrane databases were searched for studies
reporting the prevalence of albuminuria in Fontan patients. Case reports,
reviews, and univentricular patients pre-Fontan completion or post-heart
transplantation were excluded. Studies were assessed for potential
confounders and measurement, patient selection, intervention, and
reporting biases, reported in a table. After systematic review, the pooled
prevalence of albuminuria was calculated using the quality effects model
for meta-analysis. Secondary outcomes were the clinical determinants of
albuminuria. Thirteen studies were included in the systematic review, of
which 11 were included in the meta-analysis (6 prospective, sample size
per study 25-195 patients, 873 patients in total). The pooled prevalence
of albuminuria was 28.4% (95% confidence interval 23.5-33.5%). GFR was
mostly preserved in these patients. Albuminuria was associated with
elevated systemic venous pressure in 5 studies. Other associations were
inconclusive. The main limitations of our study are the predominantly
retrospective and cross-sectional nature of the included studies with
small sample sizes and heterogeneous study populations. Our findings show
albuminuria is more prevalent than reduced GFR in patients with a Fontan
circulation, implicating the potential value of UACR in addition to GFR
when screening for CKD in these patients. Copyright © The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature 2024.

<33>
[Use Link to view the full text]
Accession Number
2039857026
Title
Left Atrial Appendage Closure Versus Oral Anticoagulation for Stroke
Prevention in Atrial Fibrillation: An Updated Systematic Review and
Meta-Analysis.
Source
American Journal of Therapeutics. 33(1) (pp e74-e77), 2026. Date of
Publication: 2026.
Author
Naeem F.; Qamar U.; Waqas M.; Tabassum S.; Munir M.B.; Asad Z.U.A.
Institution
(Naeem) Department of Cardiology, Massachusetts General Hospital, Harvard
Medical School, Boston, MA
(Qamar) Department of Internal Medicine, Mayo Clinic, Rochester, NY
(Waqas) Department of Internal Medicine, Wah Medical College, Wahcantt,
Pakistan
(Tabassum) Department of Internal Medicine, King Edward Medical
University, Lahore, Pakistan
(Munir) Division of Cardiovascular Medicine, University of California
Davis, Sacramento, CA
(Asad) Department of Medicine, Cardiovascular Section, University of
Oklahoma Health Sciences Center, Oklahoma City, OK
Publisher
Lippincott Williams and Wilkins

<34>
[Use Link to view the full text]
Accession Number
649037224
Title
Radial artery occlusion after cardiac catheterization and impact of
anticoagulation as medical treatment: a meta-analysis.
Source
Coronary artery disease. 37(2) (pp 133-141), 2026. Date of Publication: 01
Mar 2026.
Author
Didagelos M.; Papazoglou A.S.; Moysidis D.V.; Pagiantza A.; Afendoulis D.;
Kakderis C.; Daios S.; Anastasiou V.; Theodoropoulos K.C.; Kouparanis A.;
Kartalis A.; Kamperidis V.; Kassimis G.; Ziakas A.
Institution
(Didagelos, Pagiantza, Kakderis, Daios, Anastasiou, Theodoropoulos,
Kouparanis, Kamperidis, Ziakas) First Cardiology Department, AHEPA
University General Hospital
(Papazoglou) Cardiology Department, Athens Naval Hospital, Athens, United
States
(Moysidis, Pagiantza) Cardiology Department, 424 General Military
Hospital, Thessaloniki, Greece
(Afendoulis, Kartalis) Cardiology Department, General Hospital of Chios
'Skylitseio'
(Kassimis) Second Department of Cardiology, Hippokration Hospital,
Thessaloniki, Greece
Abstract
BACKGROUND: Radial artery occlusion (RAO) is one of the most common
complications associated with transradial access in cardiac
catheterization procedures. To date there are no standardized protocols,
and only a few studies have evaluated the use of anticoagulation for RAO
treatment. The current meta-analysis aimed to assess the impact of various
anticoagulation strategies on RAO treatment after cardiac catheterization
via the transradial route. METHOD(S): Literature search was performed
in PubMed, Web of Science, and CENTRAL databases, from inception until
September 2024. The primary outcome of this study was the incidence of
radial artery recanalization. The secondary outcomes were the incidence of
any bleeding events and symptom resolution during patient follow-up.
 RESULT(S): A total of six studies with 398 patients were included in
the analysis. Patients with RAO under anticoagulation had a sevenfold
increased chance of radial artery recanalization [pooled odds ratio (pOR)
= 7.36 (3.82-14.17), P < 0.001]. Regarding the symptom persistence, there
was no statistically significant difference between patients receiving and
not receiving anticoagulation [pOR = 2.61 (0.26-25.86), P = 0.41].
Regarding bleeding events, no pooled data could be extracted; however, no
major bleeding events were reported in any study. CONCLUSION(S): This
meta-analysis provides compelling evidence that anticoagulation therapy
significantly improves radial artery recanalization rates in patients with
RAO without increasing the risk of major bleeding events; however, its
effect on symptom resolution remains limited, suggesting the need for a
comprehensive approach to RAO management. Copyright © 2025
Wolters Kluwer Health, Inc. All rights reserved.

<35>
Accession Number
2034754514
Title
Comparison of Short-Term Outcomes of Extubation in the Operating Room and
Extubating in the Intensive Care Unit After Cardiac Surgery: Systematic
Review and Meta-Analysis.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. 30(1) (pp 46-62),
2026. Date of Publication: 01 Mar 2026.
Author
Naito N.; Takagi H.
Institution
(Naito, Takagi) Department of Cardiovascular Surgery, Shizuoka Medical
Center, Shizuoka, Japan
Publisher
SAGE Publications Inc.
Abstract
Objectives: This study aimed to compare short-term outcomes in patients
extubated in the operating room (ORE) vs those extubated in the intensive
care unit (ICUE) following cardiac surgery. Method(s): A systematic
search of MEDLINE and EMBASE was conducted from inception through
September 2024. Pooled outcome estimates were calculated, and subgroup
analyses were performed focusing on studies utilizing propensity score
matching, weighting, or randomization. Result(s): Fourteen studies
published between 2000 and 2024, encompassing 679,749 patients, were
included. Of these, 6 utilized propensity score matching, 1 applied
overlap weighting, and 1 employed randomization. Overall, ORE group had
shorter aortic cross-clamp (P = 0.02) and cardiopulmonary bypass (P <
0.01) times. ORE patients had shorter ICU (P < 0.01) and hospital stays (P
< 0.01). Rates of reintubation (P = 0.78), reoperation for bleeding (P =
0.18), prolonged mechanical ventilation (P = 0.12), and hospital
readmission (P = 0.71) were comparable between the groups. Postoperative
stroke rate (P < 0.01) and short-term mortality (P = 0.04) were lower in
the ORE group. In the subgroup analysis, ICU stay, hospital stay, and
cardiopulmonary bypass time remained shorter in ORE groupfund, while
reoperation for bleeding was significantly higher (P < 0.01). However, the
differences in postoperative stroke (P = 0.52) and short-term mortality (P
= 0.42) were no longer statistically significant. Conclusion(s): This
meta-analysis demonstrates that ORE after cardiac surgery can be performed
in selected patients, with comparable postoperative outcomes to ICUE. The
ORE strategy may result in shorter ICU and hospital stays. Copyright
© The Author(s) 2025

<36>
Accession Number
2035943213
Title
Effect of peri-operative pharmacological interventions on postoperative
delirium in patients having cardiac surgery: a systematic review and
Bayesian network meta-analysis.
Source
Anaesthesia. 81(2) (pp 274-287), 2026. Date of Publication: 01 Feb 2026.
Author
Queiroz I.; Barbosa L.M.; Gallo Ruelas M.; Araujo B.; Defante M.L.R.;
Tavares A.H.; Florencio de Mesquita C.; Pimentel T.; Ximenes Mendes B.;
Ferreira Felix I.; Rivera A.; Oliva Morgado Ferreira R.; de Oliveira H.M.;
Righetto B.B.; Smischney N.J.; Tong G.; Ma D.
Institution
(Queiroz) Department of Medicine, APAMI Hospital, Vitoria de Santo Antao,
Brazil
(Barbosa) Department of Medicine, Federal University of Minas Gerais, Belo
Horizonte, Brazil
(Gallo Ruelas) Department of Nutrition Sciences, Instituto de
Investigacion Nutricional, Lima, Peru
(Araujo, Rivera) Department of Medicine, Nove de Julho University, Sao
Bernardo do Campo, Brazil
(Defante) Department of Medicine, Redentor University Center, Rio de
Janeiro, Brazil
(Tavares) Department of Medicine, University of Pernambuco, Recife, Brazil
(Florencio de Mesquita, Pimentel) Department of Medicine, Federal
University of Pernambuco, Recife, Brazil
(Ximenes Mendes) Department of Medicine, Unichristus, Fortaleza, Brazil
(Ferreira Felix, Smischney) Department of Medicine, Mayo Clinic,
Rochester, MN, United States
(Oliva Morgado Ferreira) Department of Medicine, Federal University of
Santa Catarina, Florianopolis, Brazil
(de Oliveira) Department of Medicine, Federal University of Mato Grosso,
Sinop, Brazil
(Righetto) Department of Medicine, University Positivo, Valinhos, Brazil
(Tong) Department of Medicine, Yale School of Medicine, New Haven, CT,
United States
(Tong) Department of Statistics, Yale School of Public Health, New Haven,
CT, United States
(Ma) Department of Anesthesiology, Zhejiang University School of Medicine
Children's Hospital, Hangzhou, China
(Ma) Department of Anaesthetics, Imperial College London Chelsea and
Westminster Hospital, London, United Kingdom
(Ma) Department of Anesthesiology, The First Affiliated Hospital of Ningbo
University, Ningbo, China
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Postoperative delirium is a common complication following
cardiac surgery. Despite its known impact on patient outcomes, effective
preventative strategies remain elusive. We aimed to perform a
comprehensive Bayesian network meta-analysis of randomised controlled
trials assessing the effect of pharmacological interventions on the
incidence of postoperative delirium. Method(s): Databases were
searched from inception to September 2024. Our search was updated in
January 2025. Eligible studies included randomised controlled trials
reporting the incidence of postoperative delirium in patients having
cardiac surgery treated with pharmacological interventions. Bayesian
models were used to estimate risk ratios (RR) and mean differences with
95%CrI through Markov chain Monte Carlo. Interventions were ranked using
the surface under the cumulative ranking curve. Sensitivity analyses and
grading of recommendations, assessment, development and evaluation
assessment were conducted to evaluate the robustness and certainty of
evidence. Result(s): Seventy-nine randomised controlled trials
comprising 24,827 patients were included, with 29 pharmacological
interventions compared. Dexmedetomidine combined with melatonin was the
most effective intervention, reducing the incidence of postoperative
delirium compared with placebo (risk ratio 0.31, 95%CrI 0.13-0.69; low
certainty). Dexmedetomidine with melatonin also significantly decreased
intensive care unit stay (2.4 days, 95%CrI -3.50-1.10) and hospital stay
(1.32 days, 95%CrI -2.09 to -0.57). Other interventions, including
ketamine and risperidone, showed potential efficacy but with low or very
low certainty of evidence. Discussion(s): We identified
dexmedetomidine with melatonin as the most effective pharmacological
strategy for preventing postoperative delirium following cardiac surgery.
Whilst these findings highlight potential benefits, the low certainty of
evidence underscores the need for more high-quality primary
evidence. Copyright © 2025 The Author(s). Anaesthesia published
by John Wiley & Sons Ltd on behalf of Association of Anaesthetists.

<37>
Accession Number
2037623505
Title
Efficacy and Safety of Transcatheter Mitral Valve Repair (MitraClip)
Compared to Medical Therapy and Surgery in Patients With Secondary Mitral
Regurgitation: A Systematic Review & Pairwise Meta-analysis.
Source
Journal of the Saudi Heart Association. 37(4) (no pagination), 2025.
Article Number: 52. Date of Publication: 2025.
Author
Younas S.; Rana A.; Beig M.F.A.; Sahu S.; Emanemua C.E.; Reshie A.A.;
Kaukab L.; Duggineni D.; Gokavarapu S.K.S.S.P.A.; Bhavani P.; Khan A.;
Fattal P.G.
Institution
(Younas) Department of Pharmacy, Punjab University College of Pharmacy,
Lahore, Pakistan
(Rana) Department of Internal Medicine, Armed Forces Medical College,
Pune, India
(Beig) Department of Internal Medicine, Community Based Medical College,
Bangladesh
(Sahu) Department of Internal Medicine, JJM Medical College, Devangere,
India
(Emanemua) Department of Internal Medicine, College of Medicine,
University of Benin, Edo State, Nigeria
(Reshie) Department of Internal Medicine, Government Medical College,
Srinagar, India
(Kaukab) Department of Internal Medicine, Deccan College of Medical
Sciences, India
(Duggineni) Department of Internal Medicine, Siddhartha Medical College,
India
(Gokavarapu) Department of Internal Medicine, Kamineni Academy of Medical
Sciences and Research Center, India
(Bhavani) Department of Internal Medicine, Atlantic University School of
Medicine, Saint Lucia
(Khan) Department of Cardiology, Central Michigan University, 1000
Houghton Avenue, Saginaw, MI, United States
(Fattal) Department of Cardiology, University of Michigan Health, 1015 S.
Washington, Saginaw, MI, United States
Publisher
Saudi Heart Association
Abstract
Background: Secondary mitral regurgitation (SMR) worsens outcomes in heart
failure. Transcatheter mitral valve repair (MitraClip/TMVr) is an
established alternative for patients who remain symptomatic on
guideline-directed medical therapy (GDMT), but comparative efficacy versus
GDMT and surgery has been debated. Method(s): We searched MEDLINE,
Embase, and Cochrane through February 2025. To avoid double counting,
quantitative syntheses used unique randomized controlled trials (RCTs)
only; RCT substudies informed qualitative context. Pairwise random-effects
meta-analyses compared MitraClip + GDMT vs GDMT and MitraClip vs surgery.
Primary outcomes were all-cause mortality and heart-failure
hospitalization (HFH). Secondary outcomes included quality of life (Kansas
City Cardiomyopathy Questionnaire (KCCQ), MR <= 2+, stroke/MI, and major
adverse events (MAE). Heterogeneity was explored with
I2/tau2, leave-one-out, and prespecified sensitivity
analyses per Cochrane/JBI guidance. Result(s): Nineteen studies were
included, of which 5 unique Randomized Control Trials (RCTs) (n=1912
randomized) contributed to pooling. Versus GDMT, MitraClip reduced
mortality (RR 0.77, 95 % CI 0.63-0.95; I2=73 %) and (Heart
Failure Hospitalization) HFH (RR 0.76, 0.65-0.89; I2=90 %), and
improved KCCQ (MD +13.7 points, 6.6-20.7). Including all available
comparators across RCTs, mortality remained lower with MitraClip (RR 0.80,
0.65-1.00; p=0.047; I2=26 %). Versus surgery, MitraClip had
fewer 30-day MAE (Major Adverse events) (RR 0.29, 0.21-0.40;
I2=0 %), with no difference in 1-year mortality and similar MR
<= 2+ at ~1 year. Stroke/MI were comparable. Procedural success exceeded
96 %; partial clip detachment occurred in 1-2 %. Conclusion(s): In
contemporary RCTs, MitraClip on top of GDMT lowers mortality and HF
hospitalizations and improves quality of life in SMR. Compared with
surgery, TMVr offers a superior early safety profile with similar MR
reduction at ~1 year. These results support Heart-Team use of MitraClip
after optimized GDMT in anatomically suitable SMR, while reserving surgery
for selected scenarios. Copyright © 2025 Saudi Heart Association.

<38>
Accession Number
2018847596
Title
Effect of cocoa flavanol supplementation for the prevention of
cardiovascular disease events: The COcoa Supplement and Multivitamin
Outcomes Study (COSMOS) randomized clinical trial.
Source
American Journal of Clinical Nutrition. 115(6) (pp 1490-1500), 2022. Date
of Publication: 01 Jun 2022.
Author
Sesso H.D.; Manson J.E.; Johnson L.G.; Moorthy M.V.; Carrick W.R.;
Anderson G.L.; Rist P.M.; Bassuk S.S.; Leboff M.S.; Okereke O.I.; Cook
N.R.; Christen W.; Friedenberg G.; Copeland T.; Hanna J.; Clar A.;
D'Agostino D.; Vinayagamoorthy M.; Gibson H.; Kim E.; Van Denburgh M.;
Kotler G.; Li C.; Bubes V.; Sarkissian A.; Smith D.; Pereira E.C.; Okeke
M.; Roche E.; Ridge C.; Phillips A.; Salvo B.; Wilson A.; Hall L.; Baez
J.; Sim Y.-H.; Cardoso H.; Senor G.; Rudnicki C.; Huynh H.; Nguyen V.;
Terrell N.; Holman B.A.; Walter J.; Johnson L.F.; Casarella A.; O'Connell
J.; Lagerstrom S.R.; Djousse L.; Chandler P.D.; Hazra A.; Tobias D.K.;
Farukhi Z.M.; Wang L.; Zhang X.; Breen K.; Menjin Jr G.V.; Rodriguez R.;
Curry S.; Arsenault L.; Solano O.; Weinberg A.; Coates J.; Kilroe M.;
Zernicke L.; Hasson K.; Matthew K.; Mora S.; Pfeffer C.; Duszlak J.; Bates
D.; Guzman V.; Falcon J.; Romero A.; Kupets H.; Cortez F.; Lesuer J.C.;
Hrbek A.; Bowes E.; Quinn P.; Mele M.; Johnson L.; Tinker L.F.; Aragaki
A.K.; Herndon M.; Mann S.L.; Pettinger M.; Hunt R.P.; Carrick B.;
Szyperski K.; Proulx-Burns L.; Burrows E.; Limacher M.; Hsia J.;
Asaithambi G.; Khan M.; Nagaraja N.; Ocava L.C.; Wold J.; Silver B.;
Connelly S.; Van Lom G.; Garvida C.; Hightower K.; Spaulding P.; Lin W.;
Schoenberg J.; Olee P.; Cohen L.S.; Colton T.; Henderson I.C.; Hulley S.;
Lichtenstein A.H.; Passamani E.R.; Silliman R.A.; Wenger N.; Ludlam S.E.;
Schroeter H.; Fare M.; Ottawani J.; Kwik-Uribe C.; Arnaiz C.; Costanza A.;
Greene J.; Hennessey P.; Vadlamani S.; Karmsetty M.; Martini P.; Van
Klinken J.-W.; Shah A.; Stern L.
Institution
(Sesso, Manson, Rist, Friedenberg, Copeland, Clar, Mora, Moorthy,
Sarkissian) Division of Preventive Medicine, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Sesso, Manson, Rist) Department of Epidemiology, Harvard T.H. Chan School
of Public Health, Boston, MA, United States
(Aragaki, Johnson, Carrick, Anderson) Division of Public Health Sciences,
Fred Hutchinson Cancer Research Center, Seattle, WA, United States
(Mora) Division of Cardiovascular Medicine, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Arnaiz, Costanza, Greene, Hennessey) Contract Pharmacal Corp, United
States
(Vadlamani, Karmsetty, Martini, Van Klinken, Shah, Stern) Pfizer Consumer
Healthcare, United States
(Sesso, Manson, Rist, Lagerstrom, Bassuk, Wang, Hazra, Gibson, Leboff,
Mora, Okereke, Tobias, Cook, Chandler, Christen, Christen, Friedenberg,
Copeland, Hanna, Clar, D'Agostino, Vinayagamoorthy, Gibson, Kim, Van
Denburgh, Kotler, Li, Bubes, Sarkissian, Smith, Pereira, Okeke, Roche,
Bates, Ridge, Phillips, Salvo, Wilson, Hall, Baez, Sim, Cardoso, Senor,
Rudnicki, Huynh, Nguyen, Terrell, Holman, Walter, Johnson, Casarella,
O'Connell, Lagerstrom, Djousse, Chandler, Hazra, Tobias, Farukhi, Wang,
Zhang, Breen, Menjin Jr, Rodriguez, Curry, Mora, Arsenault, Solano,
Weinberg, Coates, Kilroe, Zernicke, Hasson, Matthew, Mora, Pfeffer,
Duszlak, Bates, Guzman, Falcon, Romero, Kupets, Cortez, Lesuer, Hrbek,
Bowes, Quinn, Mele) Brigham and Women's Hospital, United States
(Anderson, Johnson, Tinker, Aragaki, Herndon, Mann, Pettinger, Hunt,
Carrick, Szyperski, Proulx-Burns, Burrows, Limacher, Hsia, Asaithambi,
Khan, Nagaraja, Ocava, Wold, Silver, Connelly, Van Lom, Garvida,
Hightower, Spaulding, Lin, Schoenberg, Olee) Fred Hutchinson Cancer
Research Center, Women's Health Initiative, United States
Publisher
Elsevier B.V.
Abstract
Background: Cocoa extract is a source of flavanols that favorably
influence vascular risk factors in small and short-term trials, yet
effects on clinical cardiovascular events are untested. Objective(s):
We examined whether cocoa extract supplementation decreases total
cardiovascular disease (CVD) among older adults. Method(s): We
conducted a randomized, double-blind, placebo-controlled, 2-by-2 factorial
trial of cocoa extract supplementation and multivitamins for prevention of
CVD and cancer among 21,442 US adults (12,666 women aged >=65 y and 8776
men aged >=60 y), free of major CVD and recently diagnosed cancer. The
intervention phase was June 2015 through December 2020. This article
reports on the cocoa extract intervention. Participants were randomly
assigned to a cocoa extract supplement [500 mg flavanols/d, including 80
mg (-)-epicatechin] or placebo. The primary outcome was a composite of
confirmed incident total cardiovascular events, including myocardial
infarction (MI), stroke, coronary revascularization, cardiovascular death,
carotid artery disease, peripheral artery surgery, and unstable angina.
 Result(s): During a median follow-up of 3.6 y, 410 participants
taking cocoa extract and 456 taking placebo had confirmed total
cardiovascular events (HR: 0.90; 95% CI: 0.78, 1.02; P = 0.11). For
secondary endpoints, HRs were 0.73 (95% CI: 0.54, 0.98) for CVD death,
0.87 (95% CI: 0.66, 1.16) for MI, 0.91 (95% CI: 0.70, 1.17) for stroke,
0.95 (95% CI: 0.77, 1.17) for coronary revascularization, neutral for
other individual cardiovascular endpoints, and 0.89 (95% CI: 0.77, 1.03)
for all-cause mortality. Per-protocol analyses censoring follow-up at
nonadherence supported a lower risk of total cardiovascular events (HR:
0.85; 95% CI: 0.72, 0.99). There were no safety concerns.
 Conclusion(s): Cocoa extract supplementation did not significantly
reduce total cardiovascular events among older adults but reduced CVD
death by 27%. Potential reductions in total cardiovascular events were
supported in per-protocol analyses. Additional research is warranted to
clarify whether cocoa extract may reduce clinical cardiovascular
events. Copyright © 2022 The Author(s) 2022.

<39>
Accession Number
2041594768
Title
Routine versus selective protamine administration to reduce bleeding after
TAVI: Rationale and design of the POPular ACE TAVI trial.
Source
American Heart Journal. 293 (no pagination), 2026. Article Number: 107296.
Date of Publication: 01 Mar 2026.
Author
Overduin D.C.; van Ginkel D.J.; Dubois C.; Lesizza P.; Broeze G.M.;
Montero-Cabezas J.M.; Rosseel L.; van der Kley F.; van Nuland P.J.A.;
Smits T.P.M.; Hemelrijk K.I.; Aarts H.M.; Rensing B.J.W.M.; Timmers L.;
Swaans M.J.; Sonker U.; Veenstra L.; van 't Hof A.W.J.; Peper J.; Tijssen
J.G.P.; Delewi R.; Vriesendorp P.A.; ten Berg J.M.
Institution
(Overduin, van Ginkel, van Nuland, Smits, Rensing, Timmers, Swaans,
Sonker, Peper, ten Berg) Department of Cardiology, St. Antonius Hospital,
Nieuwegein, Netherlands
(Dubois, Lesizza) Department of Cardiovascular Medicine, University
Hospital Leuven, Leuven, Belgium
(Broeze, Hemelrijk, Aarts, Tijssen, Delewi) Department of Cardiology,
Amsterdam UMC, Amsterdam, Netherlands
(Montero-Cabezas, van der Kley) Department of Cardiology, Leiden
University Medical Center, Leiden, Netherlands
(Rosseel) Department of Cardiology, Hartcentrum Aalst, Aalst, Azorg,
Belgium
(Veenstra, van 't Hof, Vriesendorp, ten Berg) Department of Cardiology,
Maastricht University Medical Center, Maastricht, Netherlands
(Veenstra, van 't Hof, Vriesendorp, ten Berg) Cardiovascular Research
Institute Maastricht (CARIM), Maastricht, Netherlands
Publisher
Elsevier Inc.
Abstract
Background Unfractionated heparin is routinely used during transcatheter
aortic valve implantation (TAVI) to reduce catheter thrombosis and
thromboembolism. Protamine reverses the effect of heparin and may lower
bleeding risk, but it can also trigger severe allergic reactions. Robust
data on the safety and efficacy of routine protamine administration after
TAVI is lacking. Methods The ``routine versus selective protamine
administration to reduce bleeding complications after transcatheter aortic
valve implantation (POPular ACE TAVI)'' is an investigator-initiated,
multicenter, double-blind, placebo-controlled, randomized clinical trial.
A total of 1000 patients will be randomized 1:1 to routine versus
selective protamine administration, stratified by study site and
antithrombotic therapy. Primary and secondary outcomes are defined
according to the Valve Academic Research Consortium-3 (VARC-3) criteria.
The primary outcome is a composite of all-cause mortality and clinically
relevant bleeding (type 1-4) within 30 days after TAVI. Ranked secondary
outcomes include clinically relevant bleeding; major, life-threatening or
fatal bleeding (type 2-4); major vascular complications; cardiovascular
mortality; and all-cause mortality. Safety outcomes include anaphylaxis
and thromboembolic events defined as the composite of myocardial
infarction, ischemic stroke, transient ischemic attack, or noncerebral
distal embolization. Recruitment began in November 2023 and will continue
until 1,000 patients are randomized. The trial will end after 30-day
follow-up of the last patient. Conclusion The POPular ACE TAVI trial
(NCT05774691) will evaluate whether routine protamine administration
reduces all-cause mortality or clinically relevant bleeding after TAVI
compared with selective use. Trial registration clinicaltrials.gov .
Unique identifier NCT05774691. Copyright © 2025 Elsevier Inc.

<40>
Accession Number
2043251013
Title
Outcomes of intrapleural fibrinolytic and deoxyribonuclease therapy in
pleural infection: a systematic review and meta-analysis.
Source
European Respiratory Review. 35(179) (no pagination), 2026. Article
Number: 250131. Date of Publication: 01 Jan 2026.
Author
de Almeida M.F.; Guimaraes F.; Rodrigues I.; Lima J.C.; Bastos H.N.; Gomes
R.E.
Institution
(de Almeida, Gomes) Pulmonology Department, Unidade Local de Saude de
Almada Seixal, Hospital Garcia de Orta, Almada, Portugal
(Guimaraes) Pulmonology Department, Unidade Local de Saude do Estuario do
Tejo, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal
(Rodrigues) Pulmonology Department, Unidade Local de Saude de Santo
Antonio, Hospital de Santo Antonio, Porto, Portugal
(Lima) Department of Planning and Management Control, Unidade Local de
Saude de Almada Seixal, Hospital Garcia de Orta, Almada, Portugal
(Bastos) Unidade Local de Saude de Sao Joao, Centro Hospitalar
Universitario Sao Joao, Porto, Portugal
Publisher
European Respiratory Society
Abstract
Introduction Intrapleural enzyme therapy (IET) with fibrinolytics and
deoxyribonuclease (DNase) is increasingly being added to standard care
(SC) for the treatment of pleural infection. Methods A systematic
literature search of the PubMed and Embase databases was conducted from
January 2010 to December 2022 to identify studies reporting treatment
response, safety or mortality of IET or SC in pleural infection. Results
19 studies were included. 12 evaluated treatment response with IET, with a
pooled hospital length of stay (LOS) of 12.9 (95% CI 10.4-15.4) days and
an average surgery requirement of 11.5% (95% CI 7.2-18.0). In SC, six
studies assessed treatment response, with a pooled hospital LOS of 22.7
(95% CI 17.9-27.4) days and a surgery requirement of 23.4% (95% CI
8.3-50.5). The pooled incidence of significant bleeding in the IET group,
assessed in 11 studies, was 3.7% (95% CI 2.9-4.5). In-hospital mortality
rates were 3.7% (95% CI 1.5-9.1) for IET and 13.7% (95% CI 5.6-29.9) for
SC. Conclusions IET demonstrated a favourable treatment response and lower
mortality rate compared to SC, with an acceptable safety
profile. Copyright © The authors 2026.

<41>
Accession Number
2042139742
Title
Effects of Virtual Reality-guided Imagery Relaxation Intervention in
Improving Anxiety Among Lung Cancer Patients: A Randomized Controlled
Trial.
Source
Asian Nursing Research. 19(5) (pp 509-517), 2025. Date of Publication: 01
Dec 2025.
Author
Li H.; Liu F.; Li S.; Li C.; Tian Z.
Institution
(Li, Liu, Li, Li, Tian) The Fourth Hospital of Hebei Medical University,
Hebei Province, Shijiazhuang City, China
Publisher
Korean Society of Nursing Science
Abstract
Purpose: To examine the effectiveness of virtual reality-guided imagery
relaxation (VRGI) intervention in reducing anxiety among lung cancer
surgery patients. Method(s): In a randomized clinical trial, 98
patients were assigned to a control group (CG) receiving routine treatment
and staged care in thoracic surgery, or an experimental group (EG)
receiving additional VRGI in addition to the CG's protocol. Anxiety (using
the State-Trait Anxiety Inventory) and physiological stress markers
[systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart
rate (HR)] were assessed on the day of admission (T1), immediately before
surgery (T2), and at discharge (T3). Result(s): A total of 98
participants were recruited and randomized to the CG (n=53) and EG (n=45).
The age [beta, 6.29; p = .005], education level (beta, 5.57; p = .011),
awareness of the disease (beta, 6.11; p = .007), and gender (beta, 5.75; p
= .018) were the major influencing factors of preoperative anxiety.
Compared with the CG, the EG showed a smaller increase in State Anxiety
Inventory (SAI, t = 2.20; p = .003), SBP (t = 2.75; p = .007), DBP (t =
2.53; p = .013), and HR (t = 2.17; p = .033) at T2, and significant
decreases in SAI (t = 4.79; p < .001), SBP (t = 3.25; p = .0027), DBP (t =
2.96; p = .004), and HR (t = 4.26; p < .001) at T3. The results of the
repeated measures ANOVA demonstrated statistically significant differences
in the SAI score, SBP, DBP, and HR across time effect, group effect and
time x group interaction effect (p < .05), with the EG exhibited superior
outcomes. Conclusion(s): VRGI is a feasible and effective
intervention for reducing perioperative anxiety and physiological stress
in lung cancer surgery patients, warranting further large-scale trials.
Trial registration: This study is retrospectively registered with the
ITMCTR (identifier: ITMCTR2025001481, registered 26 July 2025).
http://itmctr.ccebtcm.org.cn/zh-CN/UserPlatform/ProjectView?Pid=48c26a67-4
e2b-4aea-a504-f379602513b0. Copyright © 2025

<42>
Accession Number
2040377856
Title
Outcomes of Transcatheter Edge-to-Edge Mitral Valve Repair in Hypertrophic
Cardiomyopathy: A Patient-Level Meta-Analysis.
Source
Structural Heart. 9(11) (no pagination), 2025. Article Number: 100664.
Date of Publication: 01 Nov 2025.
Author
Mascarenhas L.; Yang G.; Sharma A.; Bertog S.; Hubers S.; Adabag S.
Institution
(Mascarenhas) Cardiology Division, Baylor College of Medicine, Houston,
TX, United States
(Yang, Sharma, Bertog, Hubers, Adabag) Cardiology Division, Minneapolis
Veterans Affairs Medical Center, Minneapolis, MN, United States
Publisher
Cardiovascular Research Foundation
Abstract
Background Hypertrophic cardiomyopathy (HCM) is commonly associated with
left ventricular outflow tract (LVOT) obstruction and mitral regurgitation
(MR). Transcatheter edge-to-edge repair (TEER) of the mitral valve has
been introduced as a therapeutic alternative for individuals with LVOT
obstruction and concurrent MR, but there are insufficient outcome data. We
aim to perform a systematic review and patient-level meta-analysis of the
studies reporting the outcomes of TEER of the mitral valve in HCM. Methods
Original studies published in PubMed and Google Scholar were included if
>=1 of the following pre- and post-TEER measures were reported: peak
resting or provoked LVOT gradients, MR grade, mitral valve gradient, or
New York Heart Association (NYHA) functional class. One unpublished case
from the Minneapolis Veterans Affairs Medical Center was also included.
Results Nineteen publications and 37 patients (mean age 70.1 [+/-15.2]
years, 50% male, mean follow-up time of 9.2 [+/-6.4] months) were
analyzed. Compared to baseline measurements, there was a significant
reduction in the mean peak resting and provoked LVOT gradients (69.2
[+/-40.3] mmHg vs. 11.7 [+/-8.6] mmHg and 98.2 [+/-53.4] mmHg vs. 14.1
[+/-13.9] mmHg, respectively), median MR grade (4.0 [3.0-4.0] vs. 1.0
[1.0-1.0]), and proportion of patients with an NYHA functional class >=3
(100 vs. 7%) post-TEER (all p < 0.001). There was a significant increase
in mean mitral valve gradients post-TEER (2.2 [+/-1.0] mmHg vs. 4.3
[+/-1.3] mmHg, p < 0.001). Conclusions TEER can be an effective
therapeutic option for improving LVOT obstruction, MR severity, and NYHA
functional class in patients with HCM. Copyright © 2025 .

<43>
Accession Number
2041016656
Title
Autograft reinforcement in the Ross procedure: A systematic review and
patient-level meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 171(1) (pp 259-276.e18),
2026. Date of Publication: 01 Jan 2026.
Author
Mylonas K.S.; Zoupas I.; Sarantou S.; Kourampi I.; Meintanopoulos A.S.;
Iliopoulos D.C.; Stavridis G.T.; Avgerinos D.V.; LaPar D.J.
Institution
(Mylonas, Stavridis, Avgerinos) Department of Cardiac Surgery, Onassis
Cardiac Surgery Center, Athens, Greece
(Zoupas, Sarantou, Kourampi, Meintanopoulos) Cardiothoracic and Vascular
Surgery Working Group, Society of Junior Doctors, Athens, Greece
(Zoupas, Iliopoulos) 4th Department of Cardiac Surgery, Hygeia Hospital,
Athens, Greece
(Zoupas, LaPar) Department of Pediatric and Congenital Heart Surgery,
Children's Heart Institute, Memorial Hermann Children's Hospital,
University of Texas Health Science Center at Houston, McGovern Medical
School, Houston, Tex, United States
(Meintanopoulos) Global Health - Disaster Medicine, National and
Kapodistrian University of Athens, Athens, Greece
(Iliopoulos) Department of Cardiovascular Surgery, University of Texas
Health Science Center at Houston, McGovern Medical School, Houston, Tex,
United States
(Iliopoulos) Division of Cardiac Surgery, National and Kapodistrian
University of Athens, Athens, Greece
Publisher
Elsevier Inc.
Abstract
Background: The Ross procedure is a well-established option for aortic
valve replacement, although progressive autograft dilation remains a
significant long-term complication. Although several reinforcement
techniques have been proposed to address this issue, their effectiveness
has yet to be rigorously evaluated. Method(s): A Preferred Reporting
Items for Systematic reviews and Meta-Analyses-compliant search was
conducted for studies involving reinforced Ross and nonreinforced Ross
procedures. Meta-analysis with individual patient data assessed survival
and freedom from autograft reoperation rates. Subgroup analyses were
conducted for the various reinforcement methods. Result(s): Sixteen
cohort studies comprising 2514 patients with the reinforced Ross procedure
and 595 patients with the nonreinforced Ross procedure were included.
Preoperative and perioperative characteristics were comparable between
groups. Individual patient data analysis of comparative studies
demonstrated superior survival in the reinforced Ross group, with 5-, 10-,
and 15-year survivals of 100%, 98.8%, and 98.8% compared with 95.0%,
93.7%, and 82.6%, respectively, in the nonreinforced group (hazard ratio,
11.9, P = .016). Likewise, freedom from autograft reoperation at 5, 10,
and 15 years was 96.4%, 94.2%, and 86.6% in the reinforced Ross group
versus 95.8%, 87.6%, and 77.7% in the nonreinforced group, respectively
(hazard ratio, 2.06, P < .001). Subgroup analysis showed comparable
outcomes across different reinforcement techniques. Conclusion(s):
Reinforced Ross procedures are associated with improved survival and
freedom from autograft reoperation rates compared with unsupported
pulmonary autografts. Copyright © 2025 The American Association
for Thoracic Surgery

<44>
Accession Number
2041327915
Title
Preventable deaths related to haemorrhage in England and Wales, 2013-2022:
A systematic case series of coroners' reports.
Source
Public Health. 250 (no pagination), 2026. Article Number: 106054. Date of
Publication: 01 Jan 2026.
Author
Hey M.; France H.S.; Portwood C.; Song K.; Jindal J.; Launer D.; Richards
G.C.; Dernie F.
Institution
(Hey, France) Medical Sciences Division, University of Oxford, Oxford,
United Kingdom
(Portwood, Song) Guy's and St Thomas' NHS Foundation Trust, London, United
Kingdom
(Jindal) The Hillingdon Hospitals NHS Foundation Trust, Uxbridge, United
Kingdom
(Launer) East and North Hertfordshire NHS Trust, Stevenage, United Kingdom
(Richards) Institute of Pharmaceutical Science, Faculty of Life Sciences
and Medicine, King's College London, United Kingdom
(Dernie) City St George's, University of London, School of Health &
Medical Sciences, London, United Kingdom
(Dernie) St George's University Hospitals NHS Foundation Trust, London,
United Kingdom
Publisher
Elsevier B.V.
Abstract
Objectives To identify preventable haemorrhage-related deaths, classify
coroner concerns and explore organisational responses. Study design
Retrospective systematic case series of coroners' Prevention of Future
Deaths (PFD) reports from 1st July 2013 to 16 November 2022, in England
and Wales. Methods Reports were acquired from the Courts and Tribunals
Judiciary website and screened for haemorrhage-related deaths using a
reproducible automated computer code. Demographic information, coroners'
concerns, and organisational responses to PFDs were extracted and
analysed, including risk factors predisposing to haemorrhage. Results 339
PFDs (8 % of all PFDs) involved a haemorrhage event contributing to death.
The average age of death was 78 years, and 57 % were male. The majority of
haemorrhages were intracranial (64 %). 31 % of haemorrhage-related PFDs
reported the use of anticoagulation, most often warfarin. Coroners
reported 942 concerns directly relevant to the haemorrhage event,
including failures to follow protocols, guidelines, or risk assessments
(17 %), failures in communication or handovers (14 %), and failures in
providing appropriate care, including investigations and observations (13
%). Just under half (48 %) of PFDs did not have responses published on the
Judiciary website. Of the organisations who responded, 85 % reported plans
to initiate new changes to address these concerns. Improvements most
frequently focused on improving protocols, pathways and guidance
documents, as well as education and training. Conclusions Coroner PFDs
offer unique insights into haemorrhage-related deaths, highlighting the
systems and processes which fail in everyday practice. Improving awareness
and dissemination of these reports to clinicians and policymakers
nationally may improve patient safety and save lives. Copyright ©
2025 The Authors.

<45>
Accession Number
2042352020
Title
Driving Pressure-Guided Tidal Volume Titration Reduces Lung Injury in
Thoracic Surgery With One-Lung Ventilation: A Randomized Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(2) (pp 652-659),
2026. Date of Publication: 01 Feb 2026.
Author
Yan Y.; Liu X.; Liu Z.; Li Z.; Cai H.; Li W.; Zhao J.
Institution
(Yan, Li, Cai, Zhao) Department of Anesthesiology, China-Japan Friendship
Hospital, Chinese Academy of Medical Sciences and Peking Union Medical
College, Beijing, China
(Yan, Liu, Liu, Li, Cai, Li, Zhao) Department of Anesthesiology,
China-Japan Friendship Hospital, Beijing, China
Publisher
W.B. Saunders
Abstract
Objective: The optimal tidal volume for patients undergoing thoracic
surgery with one-lung ventilation (OLV) remains unclear. This study aimed
to evaluate whether driving pressure-guided tidal volume titration could
reduce lung injury in these patients. Design(s): Prospective,
single-center, randomized controlled trial. Setting(s): Single-center
academic hospital in China. Participant(s): A total of 96 patients
undergoing thoracic surgery with OLV. Intervention(s): Patients were
randomly assigned to either the driving pressure-guided tidal volume group
(n = 46) or the control group (n = 50). In the control group, tidal volume
was set at 8 mL/kg of predicted body weight (PBW) during OLV. In the
driving pressure-guided group, tidal volume was adjusted to maintain a
driving pressure between 8 and 10 cm H<inf>2</inf>O, with modifications
within 4 to 8 mL/kg PBW during OLV. Measurements and Main Results:
The primary outcome was the concentration of interleukin 6 (IL-6) in the
dependent lung following OLV. The tidal volume in the driving
pressure-guided group was 4.65 [4.23-5.65] mL/kg at 15 minutes and 4.58
[4.27-5.41] mL/kg at 45 minutes of OLV. The concentration of IL-6 in the
dependent lung after OLV was significantly lower in the driving pressure
group (5.31 [3.62]) compared to the control group (7.37 [5.21]) (mean
difference: -0.46 [-0.86 to -0.05] cm H<inf>2</inf>O; p = 0.025). There
were no significant differences between groups in the incidence of
postoperative pulmonary complications or in the oxygenation index 45
minutes after the start of OLV. Conclusion(s): Driving
pressure-guided tidal volume titration significantly reduces IL-6 levels
in bronchoalveolar lavage fluid from the dependent lung following OLV in
patients undergoing thoracic surgery, compared to conventional ventilation
using 8 mL/kg PBW. Copyright © 2025 Elsevier Inc.

<46>
Accession Number
2042881993
Title
Management of Direct Oral Anticoagulants in Adult Patients Undergoing
Cardiac Surgery: A Joint Consensus Statement by the Society of
Cardiovascular Anesthesiologists and The Society of Thoracic Surgeons.
Source
Annals of Thoracic Surgery. (no pagination), 2026. Date of Publication:
2026.
Author
Budd A.N.; Kertai M.D.; Wyler von Ballmoos M.C.; Raphael J.; Ghadimi K.;
Levy J.H.; Shore-Lesserson L.J.; Mazzeffi M.A.; Sniecinski R.M.; Tanaka
K.A.; Bolliger D.; Abdalla M.; Ural K.G.; Upchurch P.A.; Rozental O.;
Hunter C.B.; Seibert A.R.; Klick J.C.; Carroll D.; Lobner K.; Hensley N.B.
Institution
(Budd) Department of Anesthesiology, Northwestern University Feinberg
School of Medicine, Chicago, IL, United States
(Kertai) Department of Anesthesiology, Vanderbilt University Medical
Center, Nashville, TN, United States
(Wyler von Ballmoos) Department of Cardiovascular and Thoracic Surgery,
Texas Health Fort Worth, Fort Worth, TX, United States
(Raphael) Department of Anesthesiology and Perioperative Medicine, Thomas
Jefferson University Hospital, Sidney Kimmel Medical College,
Philadelphia, PA, United States
(Ghadimi, Levy) Department of Anesthesiology, Duke University School of
Medicine, Durham, NC, United States
(Shore-Lesserson) Department of Anesthesiology, Zucker School of Medicine
at Hofstra/Northwell, Manhasset, NY, United States
(Mazzeffi) Department of Anesthesiology, University of Virginia Health,
Charlottesville, VA, United States
(Sniecinski) Department of Anesthesiology, Emory Healthcare, Atlanta, GA,
United States
(Tanaka) Department of Anesthesiology, University of Oklahoma Health
Sciences Center, Oklahoma City, OK, United States
(Bolliger) Clinic for Anaesthesia, Intermediate Care, Prehospital
Emergency Medicine and Pain Therapy, University Hospital Badel, University
of Basel, Basel, Switzerland
(Abdalla) Department of Anesthesiology and Perioperative Medicine,
University Hospitals Cleveland Medical Center, Cleveland, OH, United
States
(Ural) Department of Anesthesiology and Perioperative Medicine, The
University of Queensland Medical School, Ochsner Clinical School, New
Orleans, LA, United States
(Upchurch) Department of Anesthesiology, Health University of Utah, Salt
Lake City, UT, United States
(Rozental) Department of Anesthesiology, New York Presbyterian/ Weill
Cornell Hospital, New York, NY, United States
(Hunter) Department of Anesthesiology, The Warren Alpert Medical School of
Brown University, Providence, RI, United States
(Seibert) Department of Anesthesiology, Virginia Commonwealth University
School of Medicine, Richmond, VA, United States
(Klick) Department of Anesthesiology, University of Vermont, Larner
College of Medicine, Burlington, VT, United States
(Carroll) Department of Anesthesia and Perioperative Medicine, Medical
University of South Carolina, Charleston, SC, United States
(Lobner) Division of Cardiovascular Surgery, Department of Surgery,
University of Pennsylvania, Philadelphia, PA, United States
(Hensley) Department of Anesthesiology and Critical Care Medicine, Johns
Hopkins Medicine, Baltimore, MD, United States
Publisher
Elsevier Inc.
Abstract
The Society of Cardiovascular Anesthesiologists (SCA) along with The
Society of Thoracic Surgeons (STS) sought to improve the care of adult
patients undergoing cardiac surgery who are taking direct oral
anticoagulants (DOACs), such as factor Xa and direct thrombin inhibitors.
To fulfill this, a systematic review of the literature on cessation of
DOACs before cardiac surgery, options for monitoring DOACs, the need for
bridging, reversal agents, and resuming the medications after surgery was
performed. Additionally, an expert consensus around the management of
these patients was completed. Summary statements were created using
evidence and expert consensus to guide care of patients in each of these
domains, with the ultimate goal to enhance patient safety and
outcomes. Copyright © 2026 The Society of Thoracic Surgeons,
International Anesthesia Research Society.

<47>
Accession Number
2036783414
Title
Melatonin and delirium in the intensive care units: a systematic review
and meta-analysis of randomized controlled trials.
Source
Intensive Care Medicine. 51(11) (pp 2079-2092), 2025. Date of Publication:
01 Nov 2025.
Author
Lakbar I.; Poole D.; Delamarre L.; Chanques G.; Pensier J.; Monet C.;
Belafia F.; Capdevila M.; De Jong A.; Jaber S.
Institution
(Lakbar, Chanques, Pensier, Monet, Belafia, Capdevila, De Jong, Jaber)
Department of Anesthesia and Intensive Care Unit, Regional University
Hospital of Montpellier, St-Eloi Hospital, University of Montpellier,
PhyMedExp, INSERM U1046, CNRS UMR, 9214, Montpellier Cedex 5, France
(Poole) Departmental Operative Unit of Pain Therapy, S. Martino Hospital,
Belluno, Italy
(Delamarre) Department of Anesthesia and Intensive Care Unit, Regional
University Hospital of Montpellier, Gui De Chauliac, Montpellier, France
(Lakbar) Departement d'Anesthesie-Reanimation B (DAR B), Montpellier,
France
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Delirium is frequent in critically ill patients and is
associated with increased mortality. Discrepancies were found in the
results of recent randomized controlled trials (RCTs) regarding the effect
of melatonin to prevent delirium onset in critically ill patients.
 Method(s): We searched MEDLINE, Embase, and Web of Science from
inception to 5 July 2025 for RCTs evaluating melatonin in critically ill
patients. The primary outcome was the incidence of delirium. The main
secondary outcome was mortality. We generated pooled risk ratios (RR). To
base our conclusions on the highest quality of evidence, our primary
analysis was based only on the trials with low to moderate risk of bias
for each outcome. A secondary analysis was conducted, including all the
trials. The study was registered with PROSPERO (CRD420251041661).
 Finding(s): Our primary analysis was based on six RCTs with 2209
patients and did not show any difference in the incidence of delirium
attributable to the treatment with melatonin (RR 0.89, [95% confidence
interval (CI) 0.73-1.09]). This result was consistent with the secondary
analysis including thirteen RCTs with 2830 patients (RR 0.86, [95% CI
0.70-1.04]). No association was found between mortality and melatonin in
the primary (seven RCTs, 2165 patients, RR 0.87, [95% CI 0.73-1.02]) and
secondary (8 RCTs, 2396 patients, RR 0.92, [95% CI 0.79-1.06]) analyses.
 Interpretation(s): The results suggest that compared to placebo,
melatonin does not reduce delirium incidence in critically ill patients.
Similarly, no effect was observed on mortality. Copyright ©
Springer-Verlag GmbH Germany, part of Springer Nature 2025.

<48>
Accession Number
2041749697
Title
Reduction of the risk of complete sternotomy scar dehiscence in cardiac
surgery: a protocol for a randomised, open-label multicentre clinical
investigation comparing negative pressure wound therapy (NPWT) versus
standard dressing (PRISTER study).
Source
BMJ Open. 15(11) (no pagination), 2025. Article Number: e104226. Date of
Publication: 19 Nov 2025.
Author
Jayle C.; Allain G.; Buono A.; Dang Van S.; D'Ostrevy N.; Kermen S.;
Picardo A.; Pelras A.; Drux J.; Corbi P.; Billot M.; Frasca D.
Institution
(Jayle, Allain, Drux, Corbi) CHU Poitiers, Poitiers, France
(Jayle, Buono, Billot) INSERM, Centre d'Investigation Clinique domaine
d'Innovation Technologique, Universite de Poitiers, CHU de Poitiers, 1402,
Poitiers, France
(Dang Van) service de chirurgie cardiaque, Angers University Hospital,
Angers, France
(D'Ostrevy) service de chirurgie Cardio-Vasculaire, CHU Clermont-Ferrand,
Clermont-Ferrand, France
(Kermen) service de chirurgie cardiaque, CHU de Tours, Tours, France
(Picardo) service de chirurgie thoracique et cardio-vasculaire, CHU
Limoges, Limoges, France
(Pelras) Centre de Recherche sur la Cognition et l'Apprentissage UMR7295,
CNRS, Universite de Poitiers, Poitiers, France
Publisher
BMJ Publishing Group
Abstract
Introduction Cardiac surgical procedures are associated with a high
incidence of postoperative infection, a risk attributed to their
inherently invasive nature and extended duration. The goal of this study
is to evaluate the efficacy of negative pressure wound therapy (NPWT)
compared with standard dressings in preventing sternal scar dehiscence in
patients undergoing cardiac surgery via complete vertical midline
sternotomy, comparing a 3 day change system (NPWT 3/7 d) versus a 7day
wear system (NPWT 7d) versus standard dressings. Methods and analysis The
PRISTER study is a prospective open-label multicentre, randomised,
controlled, three-arm trial. Patients aged >=18 years and meeting all the
following inclusion criteria: patients undergoing scheduled or semiurgent
cardiac surgery, with or without extracorporeal circulation, and patients
managed by complete vertical median sternotomy will be recruited. Total
sample size will consist of 660 patients. The primary outcome, surgical
wound dehiscence after complete median sternotomy, expressed as occurrence
or non-occurrence during the first 30 postoperative days, will be assessed
by tablet calibrated photos analysed by an independent blinded staff. The
secondary outcomes will be the number of dressing repairs between D7
(excluding initial protocol) and D90, length of initial hospital stay,
occurrence of surgical site infection and its classification collected on
day 90 (D90), use of an anti-infectious treatment and its duration,
incidence of postoperative mediastinitis defined by dehiscence of the
sternum with positive sternal samples, incidence of surgical revision for
dehiscence of the surgical wound at D90 and collection of all operations
involving surgical revision of the sternotomy wound, number of
rehospitalisations (including hospital consultations) and their duration
(evaluated at D90). Medicoeconomic assessment will be assessed by
evaluation of hospital and extrahospital costs (number of days in
hospital, consultations, rehospitalisations, imaging, biology and drugs),
dressing costs and patient quality of life by EQ-5D-5L. Ethics and
dissemination The study was approved by the French Agency for the Safety
of Health Products (ANSM, Agence National de Securite du Medicament) as
well as by the Ethics Committee (CPP Ile de France VIII) NdegreeID-RCB:
2023-A01782-43. Recruitment began in April 2024 and ended on 26 May
2025. 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.

<49>
Accession Number
2041566778
Title
Postoperative Cost-effectiveness of Prophylactic Amino Acid Therapy for
Renal Protection: A Modeled Economic Evaluation.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(2) (pp 724-731),
2026. Date of Publication: 01 Feb 2026.
Author
Carrandi A.; Faggery M.; Losiggio R.; Pontillo D.; Pruna A.; Landoni G.;
Bellomo R.; Higgins A.M.
Institution
(Carrandi, Faggery, Bellomo, Higgins) Australian and New Zealand Intensive
Care Research Centre (ANZIC-RC), School of Public Health and Preventive
Medicine, Monash University, Melbourne, Australia
(Losiggio, Pontillo, Pruna, Landoni) Department of Anesthesia and
Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
(Landoni) School of Medicine, Vita-Salute San Raffaele University, Milan,
Italy
(Bellomo) Intensive Care Unit, Austin Hospital, Heidelberg, VIC, Australia
(Bellomo) Department of Critical Care, University of Melbourne, Parkville,
VIC, Australia
(Bellomo) Data Analytics Research and Evaluation Centre, Austin Hospital,
Heidelberg, VIC, Australia
Publisher
W.B. Saunders
Abstract
Objective: To assess the cost-effectiveness of intravenous amino acids
(AA) versus placebo in decreasing cardiac surgery-associated acute kidney
injury (AKI) among adult patients after cardiac surgery. Design(s):
Data on resource use and outcomes were obtained from relevant studies
reported in a recent meta-analysis. Cost-effectiveness analyses were
conducted using a decision tree model to quantify the incremental costs
and health outcomes of AA versus placebo. Setting(s):
Cost-effectiveness analyses were conducted separately for Australia, the
United States, China, Italy, and the United Kingdom using local unit
costs. Participant(s): Adult patients after cardiac surgery.
 Intervention(s): Intravenous AA versus placebo. Measurements and
Main Results: The cost-effectiveness analyses expressed outcomes in terms
of cost per instance of AKI averted with an in-hospital time horizon and
from a healthcare payer perspective. The expected total healthcare cost
after surgery in patients treated with AA ranged from $1,871 in China to
$37,692 in the United States versus $2,055 in China to $40,213 in the
United States for the placebo group, with a per patient cost saving
ranging from $184 (95% confidence interval [CI], -$331 to -$32) in China
to $2,521 (95% CI, -$3,770 to -$1,260) in the United States. AA also
resulted in a 5.2% (95% CI, 5.1%-5.3%) absolute risk reduction in AKI. AA
was dominant (cost-saving and cost-effective) across all jurisdictions.
 Conclusion(s): Compared with placebo, AA infusion decreases the
occurrence of AKI and is cost-saving. Perioperative AA therapy is a
rational approach to patient care that simultaneously protects renal
function and decreases healthcare costs. Copyright © 2025 The
Authors

<50>
[Use Link to view the full text]
Accession Number
2038848693
Title
Continued Versus Interrupted Oral Anticoagulation During Transcatheter
Aortic Valve Replacement in Patients With Atrial Fibrillation: A
Meta-Analysis.
Source
American Journal of Therapeutics. 33(1) (pp e31-e38), 2026. Date of
Publication: 2026.
Author
Jain H.; Patel N.; Daoud Tariq M.; Al-Shammari A.S.; Khan R.; Jain J.;
Patel R.; Ahmed F.; Ahmed R.; Alexander T.
Institution
(Jain, Patel, Jain) Department of Cardiology, All India Institute of
Medical Sciences (AIIMS), Jodhpur, India
(Daoud Tariq) Department of Internal Medicine, Foundation University
Medical College, Islamabad, Pakistan
(Al-Shammari) Department of Medicine, College of Medicine, University of
Baghdad, Baghdad, Iraq
(Khan) Department of Internal Medicine, University of Pittsburgh Medical
Center, Harrisburg, PA
(Patel) Department of Internal Medicine, University of North Carolina
Health Blue Ridge, Morganton, NC
(Ahmed) Department of Cardiology, Duke University Hospital, Durham, NC
(Ahmed) Department of Cardiology, National Heart and Lung Institute,
Imperial College London, London, United Kingdom
(Alexander) Department of Cardiology, Corpus Christi Medical Center,
Corpus Christi, TX
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: - A substantial number of patients undergoing transcatheter
aortic valve replacement (TAVR) require long-term oral anticoagulants
(OAC) owing to comorbidities. This study examined whether continuing oral
anticoagulation periprocedurally during TAVR is as safe and effective as
interrupting it. Method(s): - A systematic search of the major
databases was performed to identify relevant studies. Effect estimates
were calculated using risk ratios (RR) and 95% CIs by pooling the data
using the inverse-variance random effects model. Statistical significance
was set at P < 0.05. Result(s): - Four studies were included, with
2962 patients undergoing TAVR with continued OAC (n = 1318) and
interrupted OAC (n = 1644). The pooled analysis demonstrated that TAVR
with continued OAC had comparable risks for all-cause mortality (RR: 0.91;
95% CI, 0.62-1.34; P = 0.64), cardiovascular mortality (RR: 0.89; 95% CI,
0.43-1.84; P = 0.76), stroke (RR: 0.67; 95% CI, 0.42-1.08; P = 0.09),
closure device failure (RR: 0.86; 95% CI, 0.47-1.59; P = 0.64),
major/life-threatening bleeding (RR: 0.93; 95% CI, 0.74-1.15; P = 0.49),
and major vascular complications (RR: 0.97; 95% CI, 0.79-1.20; P = 0.80)
compared with TAVR with interrupted OAC. Conclusion(s): - In patients
undergoing TAVR, continued OAC showed comparable safety and efficacy with
interrupted OAC. These findings demonstrate that continuing OAC in the
periprocedural period may be a viable option in patients with atrial
fibrillation because of comorbidities requiring
anticoagulants. Copyright © 2025

<51>
Accession Number
2040654371
Title
The Effect of Transport Manual and Mechanical Ventilation on Hemodynamics
Change: Randomized Clinical Trial.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. 30(1) (pp 28-36),
2026. Date of Publication: 01 Mar 2026.
Author
Morita Y.; Sakata T.; Nakamura Y.; Kikuchi Y.; Wang J.; Kaneyuki D.;
Kariya T.; Raphael J.
Institution
(Morita, Wang, Raphael) Department of Anesthesiology, Thomas Jefferson
University, Philadelphia, PA, United States
(Sakata, Nakamura, Kikuchi) Department of Surgery, Thomas Jefferson
University, Philadelphia, PA, United States
(Kaneyuki) Department of Surgery, Independence Health System Westmoreland
Hospital, Greensburg, PA, United States
(Kariya) Department of Anesthesiology, University of Tokyo, Tokyo, Japan
Publisher
SAGE Publications Inc.
Abstract
Background: Ventilation methods during ICU transport after cardiac surgery
are critical. This study aimed to assess the effects of manual and
mechanical ventilation on post-transport hypotension in patients
undergoing cardiac surgery. Method(s): This prospective clinical
trial was conducted at a tertiary academic hospital. Adult patients who
underwent open heart surgery were randomized to either (1) manual
ventilation or (2) mechanical ventilation during transport. The primary
outcomes were the hemodynamic parameters change. The secondary outcomes
were the PaO2/FiO2 ratio and PaCO2 change. Result(s): A total of 78
patients were randomized into two groups: manual ventilation (n = 39) and
mechanical ventilation (n = 39). Significant hypotension (>20% drop in
mean arterial pressure post-transport) was noted in nine patients in the
manual ventilation arm, but not in any patient in the mechanical
ventilation arm. In manually ventilated patients, receiver operating
characteristic curve analysis of systemic vascular resistance for
significant hypotension showed that the area under the curve was 0.962
(95% CI, 0.891-1). No mechanically ventilated patients had significant
hypotension. No significant difference was observed in % change in PaO2
and PaCO2 between the manual and mechanical ventilation arms.
 Conclusion(s): This study demonstrated that significant
post-transport hypotension was more common in the manually ventilated arm
than in the mechanically ventilated arm. No significant differences in
oxygenation or ventilation were observed between the groups. The low
systemic vascular resistance showed excellent predictive value for
significant post-transport hypotension. Further research is warranted to
identify patient-specific risk factors to enhance transportation
safety. Copyright © The Author(s) 2025

<52>
[Use Link to view the full text]
Accession Number
2037431828
Title
Use of Protamine for Heparin Reversal in Patients Undergoing Transcatheter
Aortic Valve Implantation: A Systematic Review and Meta-Analysis.
Source
American Journal of Therapeutics. 33(1) (pp e110-e113), 2026. Date of
Publication: 2026.
Author
Ahmed M.; Ahsan A.; Shafiq A.; Burhan M.; Hashmi T.M.; Ahmed R.; Shahid
F.; Alkhouli M.
Institution
(Ahmed, Burhan, Hashmi) Rawalpindi Medical University, Rawalpindi,
Pakistan
(Ahsan) Foundation University Medical College, Islamabad, Pakistan
(Shafiq) Dow University of Health Sciences, Karachi, Pakistan
(Ahmed) Department of Cardiology, Royal Brompton Hospital, London, United
Kingdom
(Ahmed) National Heart and Lung Institute, Imperial College London, United
Kingdom
(Shahid) Department of Interventional Cardiology, Queen Elizabeth
Hospital, Birmingham, United Kingdom
(Alkhouli) Department of Cardiovascular Medicine, Mayo Clinic Alix School
of Medicine, Rochester, MN
Publisher
Lippincott Williams and Wilkins
Abstract
Supplemental Digital Content is Available in the Text. Copyright
© 2025

<53>
Accession Number
2042516361
Title
The Prognostic Value of Right Ventricle-Pulmonary Artery Coupling in Valve
Interventions.
Source
JACC: Cardiovascular Interventions. 19(2) (pp 174-188), 2026. Date of
Publication: 26 Jan 2026.
Author
Androshchuk V.; Long E.; Chehab O.; Montarello N.; Wilcox J.; McDonaugh
B.; Rajani R.; Pibarot P.; Prendergast B.; Patterson T.; Redwood S.
Institution
(Androshchuk, Long, Chehab, Redwood) School of Cardiovascular Medicine &
Sciences, Faculty of Life Sciences & Medicine, King's College London,
London, United Kingdom
(Montarello, Wilcox, McDonaugh, Patterson) Cardiovascular Directorate, St
Thomas' Hospital, London, United Kingdom
(Rajani) School of Biomedical Engineering and Imaging Sciences, Faculty of
Life Sciences & Medicine, King's College London, London, United Kingdom
(Pibarot) Department of Medicine, Quebec Heart and Lung Institute, Laval
University, Quebec City, QC, Canada
(Prendergast) Cleveland Clinic London, London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background Right ventricle-pulmonary artery (RV-PA) coupling is
prognostically important in valvular heart disease. Objectives The authors
performed a systematic review and meta-analysis to quantify the
association of RV-PA coupling with clinical endpoints after intervention
for aortic stenosis (AS), mitral regurgitation (MR), and tricuspid
regurgitation (TR). Methods The primary outcome was all-cause mortality,
and the secondary outcome was a composite of major adverse cardiovascular
events (MACE). A random-effects model was used to compute pooled effect
estimates, and summary receiver-operating characteristic curves identified
optimal RV-PA thresholds. Results In total, 30 interventional studies (N =
12,992) met eligibility criteria, including 14 AS (n = 6,100), 12 MR (n =
5,032), and 4 TR (n = 1,860) studies. Tricuspid annular plane systolic
excursion (TAPSE) to pulmonary artery systolic pressure (PASP) was the
most studied RV-PA coupling index. Reduced TAPSE/PASP was independently
associated with all-cause mortality (AS adjusted HR: 1.69 [95% CI:
1.30-2.20]; MR adjusted HR: 1.94 [95% CI: 1.40-2.69]; P < 0.001) and the
composite MACE (AS adjusted HR: 1.60 [95% CI: 1.29-2.00]; MR adjusted HR:
2.01 [95% CI: 1.54-2.62]; P < 0.001). There were significant nonlinear
associations between TAPSE/PASP and adverse outcomes in AS and MR (P <
0.001). There were insufficient data to estimate a pooled effect-size in
TR. Optimal TAPSE/PASP thresholds to predict all-cause mortality were
<=0.51 mm/mm Hg for AS interventions, <=0.33 mm/mm Hg for MR interventions
and <=0.44 mm/mm Hg for TR interventions. Conclusions TAPSE/PASP is an
independent predictor of outcomes after interventions for AS and MR. The
disease-specific TAPSE/PASP cutoffs could be integrated into
risk-stratification models to better predict mortality before valve
interventions and improve patient selection. Copyright © 2026 .

<54>
Accession Number
2041513507
Title
Association of Hypoxic Burden With Cardiovascular Events: A Risk
Stratification Analysis of the Randomized Intervention With CPAP in
Coronary Artery Disease and Sleep Apnea Cohort.
Source
Chest. 168(6) (pp 1481-1493), 2025. Date of Publication: 01 Dec 2025.
Author
Peker Y.; Celik Y.; Zinchuk A.; Sands S.A.; Redline S.; Azarbarzin A.
Institution
(Peker) Department of Pulmonary Medicine, Koc University School of
Medicine, and Koc University Research Center for Translational Medicine,
Istanbul, Turkey
(Peker, Celik, Sands, Redline, Azarbarzin) Division of Sleep and Circadian
Disorders, Brigham and Women's Hospital & Harvard Medical School, Boston,
MA, United States
(Peker) Division of Pulmonary, Allergy, and Critical Care Medicine,
University of Pittsburgh School of Medicine, Pittsburgh, Palestine
(Peker) Department of Molecular and Clinical Medicine, Institute of
Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg,
Sweden
(Peker) Department of Clinical Sciences, Respiratory Medicine and
Allergology, Faculty of Medicine, Lund University, Lund, Sweden
(Zinchuk) Department of Internal Medicine, School of Medicine, Yale
University, New Heaven, CT, United States
Publisher
Elsevier Inc.
Abstract
Background: The apnea-hypopnea index (AHI), the standard measure of OSA,
has limitations in reflecting disease severity. Research Question: Is high
hypoxic burden (HB) more strongly associated with major cardiovascular and
cerebrovascular adverse events (MACCEs) than AHI of >= 30 events/h? Study
Design and Methods: This secondary analysis of the Randomized Intervention
With CPAP in Coronary Artery Disease and Sleep Apnea observational cohort
included 368 adults with OSA (AHI >= 15 events/h) with (n = 155) and
without (n = 244) excessive daytime sleepiness (EDS), defined as an
Epworth Sleepiness Scale score of >= 10. HB was calculated as the total
area under respiratory event-related desaturations divided by total sleep
time. Patients were classified as having high or low HB based on the
median (60.7%min/h). The primary outcome was the incident of the first
MACCE. Cox proportional hazard models assessed associations in the full
cohort and by CPAP allocation and adherence (nonadherent or no positive
airway pressure [PAP] group, n = 262; adherent [adjusted PAP use >= 4
h/night for all nights at 1-year follow-up], n = 106). In an exploratory
analysis, participants were grouped into 4 categories based on median AHI
and HB (low and low, low and high, high and low, and high and high,
respectively). Result(s): Over a median follow-up of 4.7 years, high
HB was associated with MACCEs (adjusted hazard ratio, 1.87; 95% CI,
1.17-2.98; P = .009), particularly among untreated or nonadherent patients
and those with baseline EDS. AHI of >= 30 events/h was not associated
significantly with MACCEs (P = .366). When modelled continuously, HB and
AHI each were associated with MACCEs; however, compared with low AHI and
low HB, only high HB, regardless of AHI level, was linked to increased
risk. In contrast, high AHI and low HB was not associated with MACCEs.
 Interpretation(s): High HB, but not AHI of >= 30 events/h, was
associated with MACCEs in adults with moderate to severe OSA. Although AHI
was associated with outcomes when modelled continuously, elevated risk
seemed to be driven primarily by high HB. Clinical Trial Registration:
ClinicalTrials.gov; No.: NCT00519597; URL:
www.clinicaltrials.gov Copyright © 2025 The Author(s)

<55>
Accession Number
2038588273
Title
No-touch vein harvesting in coronary artery bypass surgery.
Source
BMJ. 389 (no pagination), 2025. Article Number: r728. Date of Publication:
2025.
Author
Jiang H.
Institution
(Jiang) Department of Cardiac Surgery, Shengjing Hospital of China Medical
University, Shenyang, China
Publisher
BMJ Publishing Group

<56>
Accession Number
2041931998
Title
Clinical characteristics and multimodal imaging insights of coronary
involvement in immunoglobulin G4-related disease.
Source
Frontiers in Immunology. 16 (no pagination), 2025. Article Number:
1685508. Date of Publication: 2025.
Author
Wang G.; Du Y.; Bai Y.; Zhou Y.; Ding S.; Wang X.; Xie Y.; Yang H.-J.; Li
D.; Fan Z.; Fan G.; Lou Z.; Wei J.; Sun Y.
Institution
(Wang, Du, Bai, Zhou, Wang, Fan) Department of Radiology, The First
Hospital of China Medical University, Shenyang, China
(Ding) Department of Rheumatology and Immunology, The First Hospital of
China Medical University, Shenyang, China
(Xie, Yang, Li) Biomedical Imaging Research Institute, Cedars Sinai
Medical Center, Los Angeles, CA, United States
(Fan) Radiology and Radiation Oncology, Keck School of Medicine,
University of Southern California, Los Angeles, CA, United States
(Lou) Department of Echocardiography, The First Hospital of China Medical
University, Shenyang, China
(Wei) Key Laboratory of Cell Biology and Key Laboratory of Medical Cell
Biology, Department of Developmental Cell Biology, China Medical
University, Shenyang, China
(Sun) Department of Cardiovascular Medicine, The First Hospital of China
Medical University, Shenyang, China
Publisher
Frontiers Media SA
Abstract
Introduction: Coronary involvement in immunoglobulin G4-related disease
(IgG4-RD) has remained underexplored despite its risk posed in terms of
major adverse cardiovascular events (MACEs). The study provides a
comprehensive review, particularly focusing on multimodal imaging
characteristics and clinical applicability. Method(s): A systematic
review was conducted on IgG4-related coronary involvement, supplemented by
serial cases from our center included. We analyzed clinical features and
multimodal imaging, focusing on the presence or absence of cardiovascular
symptoms. Result(s): A total of 134 IgG4-RD patients with coronary
involvement were included and analyzed, including 118 from the literature
and 16 from our center. Seven (5%) patients died from secondary myocardial
ischemia/infarction. Coronary anomalies commonly affected the left
anterior descending artery (LAD) (79%) and presented as diffuse wall
thickening or periarterial soft tissue encasement (85%). Stenosis was
frequent (47%) and often secondary. Symptoms, primarily induced by
myocardial ischemia or infarction (84%), were largely due to stenosis
(68%). Chest computed tomography (CT) and coronary computed tomography
angiography (CTA) were the primary imaging modalities (81%), particularly
in symptomatic cases (88%). Positron emission tomography-computed
tomography (PET-CT) was applied in 55 patients (41%) and often in
asymptomatic cases (51%). CMR, though less adopted (23%), demonstrated
potential in detecting coronary lesions (77%). Glucocorticoid therapy is
the most common (76%), with the best response of periarterial encasement
(66%). Surgery was less common (32%), primarily being applied to aneurysms
(63%). Conclusion(s): Coronary involvement in IgG4-RD presents four
phenotypes, sometimes with an insidious onset and as the sole affected
site, poses a potential risk for MACEs. Multimodal imaging is essential
for early diagnosis and effective monitoring, with coronary CMR showing
promise for early detection without the risk of radiation-induced
inflammation and fibrosis. Copyright © 2025 Wang, Du, Bai, Zhou,
Ding, Wang, Xie, Yang, Li, Fan, Fan, Lou, Wei and Sun.

<57>
Accession Number
2039274554
Title
Etiology-specific survival and reoperation trends following surgical
mitral valve repair and replacement: A meta-analysis of reconstructed
time-to-event data.
Source
Trends in Cardiovascular Medicine. 35(8) (pp 485-494), 2025. Date of
Publication: 01 Nov 2025.
Author
Al-Tawil M.; Sicouri S.; Yamashita Y.; Ramlawi B.
Institution
(Al-Tawil, Sicouri, Yamashita, Ramlawi) Department of Cardiothoracic
Surgery Research, Lankenau Institute for Medical Research, Wynnewood, PA,
United States
(Yamashita, Ramlawi) Lankenau Heart Institute, Wynnewood, PA, United
States
Publisher
Elsevier Inc.
Abstract
Current American and European guidelines recommend mitral valve repair
(MVr) over replacement (MVR) whenever feasible. However, these
recommendations are primarily based on data from patients with
degenerative mitral regurgitation (DMR), whereas evidence supporting MVr
in other etiologies, such as infective endocarditis (IE) or ischemic
mitral regurgitation (IMR), remains less conclusive. We systematically
searched for and identified studies published after 2000 that compared MVr
and MVR in patients with specific mitral valve disease etiologies,
including DMR, IE, IMR, and rheumatic heart disease (RHD). A total of 61
records (10 DMR, 21 IE, 18 IMR, and 12 RHD) of 59 studies published
between 2005 and 2024, were included. MVr consistently demonstrated
superior survival compared to MVR in DMR and IE patients. Parametric
time-varying hazard ratios revealed a sustained survival benefit of MVr in
DMR and IE, whereas in IMR and RHD, the survival advantage was
transient-lasting only up to six months and 2.7 years postoperatively,
respectively-after which survival hazards between MVr and MVR became
comparable. This was further corroborated by the results of a two-year
landmark and the propensity-matched subgroup analyses. In DMR, MVr was
associated with lower reoperation rates compared to MVR; however, in IE,
IMR, and RHD, MVr was associated with significantly higher reoperation
rates compared to MVR. Our study supports current guidelines favoring MVr
over MVR, demonstrating sustained survival benefits in DMR. In IE-specific
MR, MVr also showed consistent benefits over MVR, demonstrating that MVr
should be prioritized when feasible. However, in IMR and RHD, there was no
notable survival advantage of MVr over MVR, with higher reoperation rates
observed with MVr. These findings highlight the need for etiology-specific
and individualized surgical planning. Copyright © 2025

<58>
Accession Number
2042451101
Title
Use of Video Laryngoscope to Reduce Complications of Transesophageal
Echocardiography Probe Insertion in Children.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(2) (pp 613-619),
2026. Date of Publication: 01 Feb 2026.
Author
Gayathri G.; Divya Jacob P.; Nayanar V.K.N.; Vipin Raj V.; Babu S.;
Unnikrishnan K.P.; Koshy T.
Institution
(Gayathri, Divya Jacob, Nayanar, Vipin Raj, Babu, Unnikrishnan, Koshy)
Division of Cardiothoracic and Vascular Anaesthesia, Sree Chitra Tirunal
Institute for Medical Sciences and Technology, Thiruvananthapuram, India
Publisher
W.B. Saunders
Abstract
Objectives: To test the hypothesis of whether using a video laryngoscope
reduces complications related to transesophageal echocardiography (TEE)
probe insertion in children. Design(s): Randomized controlled study.
 Setting(s): Pediatric cardiac surgical operating rooms in a tertiary
care level hospital. Participant(s): One hundred thirty children aged
0 to 18 years undergoing elective cardiac surgery. Intervention(s):
TEE probe insertion. Measurements and Main Results: The patients were
randomized into 2 groups: conventional (C) group (n = 64) and video
laryngoscopy (VL) group (n = 66). The primary endpoint of the study was
the incidence of oropharyngeal injury. The secondary endpoints were the
number of attempts required for successful TEE probe insertion and the
relation between the esophageal inlet and the larynx. The overall
incidence of oropharyngeal injuries was 7.7%, with 4 injuries (6.3%)
occurring in the C group and 6 injuries (9.1%) occurring in the VL group
(p = 0.543). Most children (90.8%) required only 1 attempt to insert the
TEE probe, with no significant difference between groups (p = 0.579). A
higher percentage increase in mean blood pressure during probe insertion
and a higher heart rate increase after probe insertion were observed in
the VL group (p < 0.05). The most common relationship with the larynx was
posterior (62%), followed by left posterolateral (20.9%) and right
posterolateral (17.1%). Conclusion(s): VL does not demonstrate
superiority over conventional methods of TEE probe insertion in children
regarding injury incidence or first-attempt success rate. Copyright
© 2025 Elsevier Inc.

<59>
Accession Number
2041865801
Title
Effect of esketamine on postoperative depression and anxiety in patients
undergoing cardiac valve surgery: A randomised, placebo-controlled,
double-blinded clinical trial.
Source
Pharmacological Research. 222 (no pagination), 2025. Article Number:
108047. Date of Publication: 01 Dec 2025.
Author
Zhang Z.-N.; Hao X.-Y.; Cai C.; Sun L.; Zhang Z.-Y.; Wang M.; Wu Y.-S.;
Wang Y.; Cao J.-B.; Liu Y.-H.; Lou J.-S.; Fu Q.; Jiang S.-L.; Han R.-Q.;
Mi W.-D.; Tong L.
Institution
(Zhang, Hao, Cai, Zhang, Wang, Cao, Liu, Lou, Fu, Mi, Tong) Department of
Anesthesiology, The First Medical Center of Chinese PLA General Hospital,
Beijing, China
(Zhang, Hao, Cai) Medical School of Chinese PLA General Hospital, Beijing,
China
(Sun) Department of Anesthesiology, The Sixth Medical Center of Chinese
PLA General Hospital, Beijing, China
(Wu, Han) Department of Anesthesiology, Beijing Tiantan Hospital, Capital
Medical University, Beijing, China
(Wang) Department of Psychosomatic Medicine, Honghui Hospital, Xi'an
Jiaotong University, China
(Jiang) Department of Cardiovascular Surgery, The First Medical Center of
Chinese PLA General Hospital, Beijing, China
(Mi) National Clinical Research Center for Geriatric Diseases, Chinese PLA
General Hospital, Beijing, China
Publisher
Academic Press
Abstract
This randomized, double-blind, parallel-group trial evaluated the efficacy
of a single intravenous dose of esketamine (0.3 mg/kg) administered at
anesthesia induction in reducing postoperative depression and anxiety
among patients undergoing cardiac valve surgery. A total of 142 patients
from three centers were randomly assigned to receive esketamine or saline.
The primary outcomes were the prevalence of depression and anxiety at
postoperative day (POD) 7, assessed by the Hospital Anxiety and Depression
Scale (HADS). Key secondary outcomes included delirium incidence, pain and
insomnia scores, and quality of recovery. Results showed that the
esketamine group had significantly lower rates of depression (7.0 % vs.
31.0 %; P < 0.001) and anxiety (11.3 % vs. 35.2 %; P < 0.001) at POD 7,
along with reduced delirium incidence (9.8 % vs. 22.5 %; P = 0.040).
Improvements were also observed in pain, sleep, and recovery quality.
Mechanistic analyses revealed that esketamine reduced inflammatory markers
(IL-6, CRP) and neuronal injury marker (S100beta), while increasing
brain-derived neurotrophic factor (BDNF). No significant differences in
adverse events were observed. In conclusion, a single low dose of
esketamine during induction effectively alleviates early postoperative
depression and anxiety, possibly through modulating neuroinflammation and
promoting neurotrophic signaling. (Clinicaltrials.gov, ID Number:
NCT06608030). Copyright © 2025 The Authors

<60>
Accession Number
2037369419
Title
Minimally invasive thoracoscopically-guided right minithoracotomy versus
conventional sternotomy for mitral valve repair: the UK Mini Mitral
multicentre RCT.
Source
Health Technology Assessment. 29(55) (no pagination), 2025. Date of
Publication: 2025.
Author
Akowuah E.F.; Maier R.H.; Hancock H.C.; Wagnild J.; Vale L.;
Fernandez-Garcia C.; Kharati E.; Ogundimu E.; Mathias A.; Walmsley Z.;
Howe N.; Graham R.; Ainsworth K.; Zacharias J.
Institution
(Akowuah, Graham, Ainsworth) Department of Cardiac Surgery, The James Cook
University Hospital, South Tees NHS Foundation Trust, Middlesbrough,
United Kingdom
(Akowuah) Newcastle University Translational and Clinical Research
Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
(Maier) Academic Cardiovascular Unit, The James Cook University Hospital,
South Tees NHS Foundation Trust, Middlesbrough, United Kingdom
(Hancock, Mathias, Walmsley, Howe) Newcastle Clinical Trials Unit,
Population Health Sciences Institute, Newcastle University, Newcastle Upon
Tyne, United Kingdom
(Wagnild, Kharati) Department of Anthropology, Durham University, Durham,
United Kingdom
(Vale, Fernandez-Garcia) Health Economics Group, Population Health
Sciences Institute, Newcastle University, Newcastle Upon Tyne, United
Kingdom
(Ogundimu) Department of Mathematical Sciences, Durham University, Durham,
United Kingdom
(Zacharias) The Lancashire Cardiac Centre, Blackpool Teaching Hospitals
NHS Foundation Trust, Blackpool, United Kingdom
Publisher
NIHR Journals Library
Abstract
Background: The safety, effectiveness and cost-effectiveness of mitral
valve repair via thoracoscopically guided minithoracotomy compared with
conventional median sternotomy (Sternotomy) in patients with degenerative
mitral valve regurgitation is uncertain and widely debated.
 Objective(s): To determine if Mini was more effective than Sternotomy
in terms of physical functioning and associated return to usual activities
and was cost-effective compared with Sternotomy. Design(s): A
pragmatic, multicentre, expertise-based, superiority, randomised trial.
 Participant(s): Adults with degenerative mitral valve regurgitation
undergoing mitral valve repair surgery. Setting(s): Ten tertiary care
institutions in the United Kingdom. Intervention(s): Mini or
Sternotomy mitral valve repair performed by an expert surgeon. Blinding:
Primary outcome measure [Short Form 36-item Health Survey, version 2
(SF-36v2) physical functioning score] was measured by an independent
assessor, blinded to allocation. Echocardiographic findings were measured
in a core laboratory, blinded to allocation. Outcome Measures: Primary
outcomes were physical functioning and associated return to usual
activities measured by change from baseline in SF-36v2 physical function
domain at 12 weeks following index surgery. The primary economic measure
was incremental cost per quality-adjusted life-year over the year
following surgery. Secondary outcomes included recurrent mitral
regurgitation grade, physical activity and quality of life measured at
time points to 1 year. Safety outcomes included death, repeat mitral valve
surgery or heart failure hospitalisation up to 1 year. Result(s):
Between November 2016 and January 2021, 330 participants were randomised;
166 to Mini and 164 to Sternotomy. Of these, 309 underwent surgery and 294
reported the primary outcome. Thirty per cent were female. At 12 weeks,
mean difference between groups in the change in SF-36v2 physical function
T-scores was 0.68 (95% confidence interval -1.89 to 3.26). Valve repair
rates (96%) were similar in both groups. Echocardiography demonstrated
mitral regurgitation severity as none or mild for 92% of participants at 1
year in both groups. The composite safety outcome occurred in 5.4% (9/166)
of Mini and 6.1% (10/163) of Sternotomy participants at 1 year. On
average, Mini was more costly 29,424 (95% confidence interval 26,909 to
31,940) versus 27,397 (95% confidence interval 25,172 to 29,620) and more
effective 0.81 quality-adjusted life-years (95% confidence interval 0.78
to 0.84) versus 0.78 (95% confidence interval 0.75 to 0.81) than
Sternotomy. The adjusted incremental cost-effectiveness ratio was 74,863
per quality-adjusted life-year for the comparison between Mini and
Sternotomy. Mini has a probability of < 50% of being cost-effective at the
range of willingness-to-pay values considered. Limitation(s): To
minimise bias, SF-36v2 and all echocardiographic measures were
independently assessed by personnel blinded to allocation. Expertise-based
randomisation was important to address the limitations of previous
studies; however, it is possible that it may have introduced potential
confounders. Conclusion(s): Mini is not superior to Sternotomy in
recovery of physical function at 12 weeks. Mini achieves high rates and
quality of valve repair and has similar safety outcomes at 1 year to
Sternotomy. The balance of probabilities favoured Sternotomy as the
preferred surgical procedure in the base-case analysis over the range of
willingness-to-pay values society might consider worthwhile for a
quality-adjusted life-year. Nevertheless, additional factors such as
equity or patient preferences for one procedure over another may need to
also be taken into account. Results provide high-quality evidence to
inform shared decision-making and treatment guidelines. Future work: Work
is ongoing to disseminate findings and influence guidelines; patients have
consented to longer-term follow-up. From an economics perspective, the
currently available evidence shows that further research into patient
preferences is important to inform the choice of surgical procedure. Trial
registration: This trial is registered as ISRCTN 13930454. Copyright
© 2025, NIHR Journals Library. All rights reserved.

<61>
Accession Number
2039160214
Title
Ablation of atrial fibrillation and risk of stroke: A meta-analysis.
Source
Heart Rhythm. 23(1) (pp 44-55), 2026. Date of Publication: 01 Jan 2026.
Author
Providencia R.; Ali H.; Barra S.; Creta A.; Kukendrarajah K.; Kanagaratnam
P.; Farkowski M.M.; Cappato R.
Institution
(Providencia, Creta, Kukendrarajah) Institute of Health Informatics
Research, University College London, London, United Kingdom
(Providencia, Creta, Kukendrarajah) Barts Heart Centre, St Bartholomew's
Hospital, London, United Kingdom
(Ali, Cappato) Arrhythmia and Clinical Electrophysiology Center, IRCCS,
MultiMedica Group, Sesto San Giovanni, Milan, Italy
(Barra) Department of Cardiology, Hospital da Luz Arrabida, Vila Nova de
Gaia, Portugal
(Kanagaratnam) Imperial College Healthcare NHS Trust, London, United
Kingdom
(Kanagaratnam) Imperial College, London, United Kingdom
(Farkowski) Department of Cardiology, Ministry of Interior and
Administration, National Medical Institute, Warsaw, Poland
Publisher
Elsevier B.V.
Abstract
BACKGROUND Despite treatment with anticoagulants, patients with atrial
fibrillation (AF) remain exposed to a relevant residual risk of stroke. It
remains to be proven whether catheter ablation of AF can lead to an
additional stroke protection benefit in these patients. OBJECTIVE This
study aimed to investigate a possible stroke protective benefit by
catheter ablation in AF. METHODS This is a systematic review of
contemporary randomized controlled trials (RCTs) comparing catheter
ablation with medical treatment. We searched MEDLINE, Embase, and Cochrane
Central Register of Controlled Trials in February 2025, pooled data
through relative risks (RRs) with 95% confidence intervals, and calculated
the number needed to treat. Quality of evidence was assessed using the
Grading of Recommendations Assessment, Development, and Evaluation
framework. Subgroup and sensitivity analyses were performed for
presence/absence of heart failure, CHA<inf>2</inf>DS<inf>2</inf>-VASc of
>=2 or <2, paroxysmal/persistent AF, early ablation, studies allowing
discontinuation of oral anticoagulation after ablation, higher/lower
quality, published <=5 vs >5 years ago, and >=12- vs <12-month follow-up.
RESULTS We identified 18 eligible RCTs, including 5877 patients. Catheter
ablation was associated with a significant reduction in stroke (RR 0.63,
95% confidence interval 0.45-0.87, P 5 .006; quality of evidence,
moderate), low heterogeneity observed (I2 5 0), and a number
needed to treat of 78.7 patients to prevent 1 stroke. Subgroup and
sensitivity analyses yielded similar estimates with 30%-40% RR reduction
for all subanalyses, except for trials with less than 1 year of follow-up.
CONCLUSION Pooling of high-quality RCT data suggests that catheter
ablation may lead to significant stroke reduction. A confirmatory trial
will be required to provide a conclusive answer to this
matter. Copyright © 2026 Elsevier B.V.. All rights reserved.

<62>
Accession Number
2041469132
Title
Expanding frontiers in surgical science and practice.
Source
Surgery (United States). 187 (no pagination), 2025. Article Number:
109841. Date of Publication: 01 Nov 2025.
Author
Hicks C.W.; Wexner S.D.
Publisher
Elsevier Inc.

<63>
Accession Number
2041593385
Title
Optimising adherence to inpatient rehabilitation trial protocols: A
mixed-methods systematic review.
Source
Clinical Trials. 22(6) (pp 728-744), 2025. Date of Publication: 01 Dec
2025.
Author
Logan A.; Marsden J.; Freeman J.; Cork E.; Kent B.
Institution
(Logan, Cork) Royal Devon University Healthcare NHS Foundation Trust,
Devon, United Kingdom
(Logan, Marsden, Freeman, Cork, Kent) Faculty of Health, University of
Plymouth, Devon, United Kingdom
(Kent) Centre of Implementation Science, University of Plymouth, A JBI
Centre of Excellence, Devon, United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Background: The results of rehabilitation clinical trials can be
negatively affected by adherence to trial protocols. Adherence is
multi-factorial, but studies often look at adherence factors separately.
Therefore, a systematic review to appraise and synthesise the evidence is
warranted to determine the barriers, facilitators and predictors
associated with adherence to inpatient rehabilitation trial protocols,
whether and how factors interact with one another, and how adherence to
rehabilitation protocols can be optimised. Method(s): A mixed-methods
systematic review was conducted and reported in accordance with Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
Databases searched were PubMed (Ovid), EMBASE (Ovid), MEDLINE (Ovid),
CINAHL (Ovid), PsycINFO (Ovid), Cochrane Library, Health Technology
Assessment Database, Web of Science and grey literature up to April 2024.
A cohesive, integrated methodology was employed, leveraging the
Consolidated Framework for Implementation Research (CFIR) 2.0, to
transform, synthesise and integrate data from various methodologies to
address the review objectives. Result(s): Twenty-seven studies met
the inclusion criteria (randomised controlled trials, qualitative studies
related to randomised controlled trials or mixed-methods). Most of the
studies were in stroke (n = 17), but other studies included neurological,
respiratory, cardiovascular, post-surgical, osteoarthritis and elderly
medical. Multiple factors affecting adherence protocols were identified.
Adherence was measured in various ways, and setting pre-specified
adherence levels was uncommon. Conclusion(s): Adherence to inpatient
rehabilitation trial protocols is multi-dimensional and multi-factorial.
Consensus of adherence measurement and interpretation of adherence levels
is needed to make meaningful comparisons between trials. A standardised
approach, including adopting a traffic light system, would enable
trialists to implement changes mid-trial or stop the trial to avoid
research waste. Adopting approaches from behavioural science in the design
and conduct of inpatient rehabilitation trials may overcome some of the
behavioural barriers identified and optimise adherence for those
delivering and receiving the intervention. Review registration:
Prospective Register of Systematic Reviews, registration number
CRD42021270121. Copyright © The Author(s) 2025

<64>
Accession Number
2043229573
Title
The PROTECT trial: Effect of titrated versus conventional induction of
general anaesthesia using a target-controlled infusion system on
haemodynamics in patients undergoing non-cardiac surgery - protocol for a
multicentre, expertise-based randomised controlled trial.
Source
BMJ Open. 16(1) (no pagination), 2026. Article Number: e110452. Date of
Publication: 28 Jan 2026.
Author
Funk S.; Lohri M.D.; Lugli A.K.; Schindler C.; Wiencierz A.; Mnich K.;
Schlapfer M.; Gaberdiel A.P.; Puhan M.A.; Steiner L.A.; Gomes N.V.;
Dell-Kuster S.
Institution
(Funk, Lohri, Gaberdiel, Steiner, Gomes, Dell-Kuster) Department of Acute
Medicine, University Hospital Basel, Basel, Switzerland
(Funk, Lohri, Wiencierz, Gaberdiel, Steiner, Gomes, Dell-Kuster)
Department of Clinical Research, University of Basel, Basel, Switzerland
(Lohri) Intensive Care Unit, Department of Acute Medicine, University
Hospital Basel, Basel, Switzerland
(Lugli) Department of Anaesthesiology and Intensive Care, Kantonsspital
Baden, Baden, Switzerland
(Schindler) Swiss Tropical and Public Health Institute, Allschwil,
Switzerland
(Schindler) University of Basel, Basel, Switzerland
(Mnich) Department of Perioperative Medicine (Anaesthesiology, Intensive
Care Medicine, Pain Medicine and Prehospital Emergency Medicine),
Kantonsspital Olten, Olten, Switzerland
(Schlapfer) Department of Anaesthesiology, Kantonsspital Graubunden, Chur,
Switzerland
(Schlapfer) Institute of Anaesthesiology, University Hospital Zurich,
Zurich, Switzerland
(Schlapfer) Institute of Physiology, University of Zurich, Zurich,
Switzerland
(Puhan, Dell-Kuster) Epidemiology, Biostatistics and Prevention Institute,
University of Zurich, Zurich, Switzerland
(Gomes) Department of Anaesthesia and Intensive Care, Royal Papworth
Hospital NHS Foundation Trust, Cambridge, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Hypotension is a frequent complication after induction of
general anaesthesia leading to end-organ injury, for which elderly and
multimorbid patients are particularly susceptible. The extent of
hypotension depends, among other factors, on the dose and rate of propofol
administration. Target-controlled infusion systems are widely used to
administer short-acting anaesthetics such as propofol and remifentanil.
Commonly, induction is started with a fixed effect-site concentration.
Titration, an alternative method of induction using an incremental
augmentation of propofol, leads to a reduced induction dose and rate of
propofol. We hypothesise that the titration method improves haemodynamic
stability compared with conventional induction. Methods and analysis This
multicentre, expertise-based randomised controlled trial takes place at
four Swiss hospitals. Patients >=55 years of age undergoing non-cardiac
surgery under general anaesthesia using propofol target-controlled
infusion are randomised to either a conventional or a titrated anaesthesia
induction method. Patients, statisticians and, if resources allow, outcome
assessors will be blinded. The primary endpoint is the mean arterial
pressure under the individual baseline mean arterial pressure (area under
threshold) during the first 30 min after start of induction. Secondary
endpoints include the maximum deviation from baseline mean arterial
pressure, haemodynamic rescue methods, propofol consumption and
neurocognitive recovery after regaining consciousness. A total of 320
patients are required to have an 80% chance of observing superiority of
titration for the area under the threshold as significant at the 5% level,
assuming a true difference of 100 mm Hg*min. The area under threshold and
the maximum deviation will be compared between arms using mixed linear
regression models. Ethics and dissemination Ethical approval has been
obtained from all responsible ethics committees (BASEC2025-01007). The
results will be presented at international meetings and published in
peer-reviewed journals and may contribute to a change in clinical practice
for anaesthesia induction using target-controlled infusion systems with
propofol. Copyright © Author(s) (or their employer(s)) 2026.
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ Group.

<65>
Accession Number
2042512427
Title
The feasibility of an education video for preventing disease-related
malnutrition among home-living older adults after discharge from a
surgical hospital department - a randomised controlled feasibility trial.
Source
Pilot and Feasibility Studies. 12(1) (no pagination), 2026. Article
Number: 6. Date of Publication: 01 Dec 2026.
Author
Hansen M.C.; Uhrenfeldt L.; Ingstad K.; Pedersen P.U.
Institution
(Hansen) Faculty of Nursing and Health Sciences, Nord University,
Universitetsalleen 11, Bodo, Norway
(Uhrenfeldt) Orthopaedic department, Kolding Hospital, Kolding, Denmark
(Uhrenfeldt) Department of Regional Health Science, Southern Danish
University, Odense, Denmark
(Ingstad) Faculty of Nursing and Health Sciences, Nord University,
Levanger, Norway
(Pedersen) Centre of Clinical Guidelines, Department of Clinical Medicine,
Aalborg University, Aalborg, Denmark
Publisher
BioMed Central Ltd
Abstract
Background: Older adults can have limited knowledge about their specific
needs for protein and energy and the importance of nutrition for physical
functioning after hospital discharge. This study aimed to examine the
feasibility of recruitment, technology access, and data collection
procedures in an educational video aimed at improving the nutritional
status of live-at-home older adults after discharge from a surgical
hospital department. Method(s): This seven-month single-centre,
two-arm feasibility trial was conducted in a rural area in northern Norway
from May 2022 to January 2023. The participants were live-at-home older
adults 65 years of age or older, who were recruited from three surgical
departments in a non-university hospital. The participants were randomised
using a free web service. The intervention group received access to a
six-minute nutrition education video focusing on energy and protein-rich
diets for malnourished older adults. The control group did not receive any
intervention. Data were collected on the study feasibility recruitment
rate (goal: 5 people every 2 weeks over 28 weeks), retention rate (goal:
82%), and access to the video (goal: 90%) as well as the feasibility
of-collecting data on the participants' nutritional knowledge, body mass
index, mid-arm circumference, triceps skinfold thickness, mid-arm muscle
circumference, and hand grip strength. Result(s): Forty-four
participants were randomised to the intervention group (n = 24) or the
control group (n = 20). The recruitment rate was, on average, 3 patients
every 2 weeks. The overall retention rate was 68%, respectively 71% (17),
in the intervention group and 65% (13) in the control group. Collecting
the desired data was feasible with specific muscle strength and fat mass
adjustments. No adverse events related to participation in the study were
observed. Conclusion(s): Delivery of the education video was
feasible. However, the study revealed methodological challenges with
recruitment and access to the video that must be addressed before a
full-scale trial. The results indicate that nutrition education videos can
be a good source of knowledge and contribute to a better nutritional
situation for older malnourished adults. Still, it is necessary to conduct
a full-scale trial in the future to conclude whether, or not, the
nutrition education video's is effective. Trial registration: This study
was retrospectively registered in ClinicalTrials.gov ID
NCT05860140. Copyright © The Author(s) 2025.

<66>
Accession Number
2042664922
Title
Meta-analysis and external validation of a risk model for gastrointestinal
bleeding after percutaneous coronary intervention.
Source
BMC Medicine. 24(1) (no pagination), 2026. Article Number: 41. Date of
Publication: 01 Dec 2026.
Author
Ma H.; Peng C.; Liu X.; Huang Y.; Liu J.; Liang H.; Deng L.; Zhang Y.;
Chen D.; Yang Q.
Institution
(Ma, Liu, Huang, Liu, Liang, Yang) Jinan University, Guangdong, Guangzhou,
China
(Peng) Zhongshan City People's Hospital, Guangdong, Zhongshan, China
(Deng, Zhang) Cardiovascular Surgery Department, The First Affiliated
Hospital of Jinan University, Guangdong, Guangzhou, China
(Chen) Chuanbu Town Health Center, Guangdong Province, Yunfu, China
Publisher
BioMed Central Ltd
Abstract
Background: Percutaneous coronary intervention (PCI) is a cornerstone in
the management of coronary artery disease; however, postoperative
gastrointestinal bleeding (GIB) represents a significant complication that
adversely impacts patient prognosis. Numerous factors influence GIB, yet
no comprehensive meta-analysis has synthesized these to date. Current
predictive tools, such as the CRUSADE and PRECISE-DAPT scores, exhibit
limited efficacy in forecasting GIB following PCI, underscoring the urgent
need for a more precise model to enhance risk management. Method(s):
This study employed a meta-analysis to identify risk factors for GIB
post-PCI and subsequently developed predictive models based on these
findings. The meta-analysis incorporated 77 studies encompassing a total
of 7,211,114 patients with PCI. Ten predictive models were constructed
from the analysis and validated in an external cohort of 3425 patients
with PCI from two tertiary hospitals. Result(s): A total of 129
influencing factors were included, with a meta-analysis conducted on 71,
identifying 60 factors significantly associated with GIB. Model I, the
most clinically applicable model comprising nine risk factors (female sex,
advanced age, smoking, prior gastrointestinal ulcer, renal insufficiency,
non-use of proton pump inhibitors, anticoagulant use, anemia, and
glycoprotein IIb/IIIa receptor antagonist administration), demonstrated
superior performance in external validation with an AUC of 0.842. This
outperformed the CRUSADE score (AUC = 0.770) and PRECISE-DAPT score (AUC =
0.772), with DeLong's test, significant positive Net Reclassification
Improvement Index, and Integrated Discrimination Improvement further
confirming its enhanced clinical utility. Conclusion(s): GIB
following PCI is influenced by a multitude of factors. Model I excels in
predicting this complication, surpassing existing scoring systems, and
offers substantial clinical value by enabling personalized risk management
to improve patient outcomes. All nine predictors are routinely available
at the bedside or in the electronic health record, facilitating immediate
clinical implementation without additional testing. Copyright ©
The Author(s) 2025.

<67>
Accession Number
2043136227
Title
The Surgical Objective Structured Clinical Examination: A Literature
Review.
Source
Journal of Surgical Education. 83(4) (no pagination), 2026. Article
Number: 103856. Date of Publication: 01 Apr 2026.
Author
Charron B.P.; Norkum C.; Rasoulinejad P.; Singh S.; Beveridge T.; Morash
K.; Deweyert A.
Institution
(Charron, Rasoulinejad, Singh) Department of Orthopedic Surgery, Western
University, London, Canada
(Norkum, Beveridge, Deweyert) Department of Anatomy and Cell Biology,
Schulich School of Medicine and Dentistry, London, Canada
(Morash) Department of Orthopedic Surgery, Dalhousie University, Halifax,
Canada
Publisher
Elsevier Inc.
Abstract
Background: As competency-based medical education (CBME) gains prominence,
assessment tools that integrate both theoretical knowledge and technical
skill have become essential, particularly in surgical training.
Traditional tools such as the objective structured clinical examination
(OSCE) and the Objective Structured Assessment of Technical Skills (OSATS)
are limited in scope, prompting the development of the Surgical Objective
Structured Clinical Examination (S-OSCE). The S-OSCE integrates
knowledge-based and technical assessments to align with competency-based
medical education (CBME) goals, including those outlined in the CanMEDS
and ACGME frameworks. This review examines S-OSCE implementation and
highlights trends that can inform future assessment strategies in surgical
curricula. Method(s): A comprehensive literature search was conducted
across PubMed, Web of Science, and Scopus using defined keywords.
Inclusion criteria encompassed all surgical disciplines and study designs
that employed both theoretical and technical assessments. After screening
1101 articles, 16 studies were identified that met the inclusion criteria
for S-OSCEs. Result(s): The 16 studies spanned 6 specialties: general
surgery, orthopedics, obstetrics and gynecology, oral and maxillofacial
surgery, otolaryngology, and thoracic surgery. Most employed
multiple-choice or short-answer theoretical assessments (n=12) and
practical evaluations using OSATS or global rating scales (n=9).
Video-based assessments were increasingly incorporated to reduce evaluator
bias and logistical barriers. Canadian programs conducted the highest
proportion of studies (37.5%). Discussion(s): S-OSCEs show strong
potential to provide valid and reliable assessment of surgical competency.
However, widespread adoption is limited by logistical, financial, and
staffing constraints. Video-based formats offer a promising solution,
allowing asynchronous review and enhanced feedback while reducing costs
and time requirements. Conclusion(s): S-OSCEs offer a comprehensive
framework for evaluating surgical trainees across theoretical and
technical domains. Future research should focus on validating scalable
models, particularly those incorporating video-based assessment, to
support broader integration into surgical training programs. Copyright
© 2026

<68>
Accession Number
2041718975
Title
Bilateral renal artery embolism following trauma: A case report and
systematic review.
Source
Medicine (United States). 104(45) (pp e45723), 2025. Date of Publication:
07 Nov 2025.
Author
Tang J.; He L.; Xu Y.-A.; Zhang Q.; Chao S.; Liu Y.
Institution
(Tang, Zhang, Chao) Department of Thyroid and Breast Surgery, Nanxishan
Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
(Tang, Chao) School of Clinical Medicine, Guilin Medical University,
Guilin, China
(He) Department of Emergency Medicine, Nanxishan Hospital of Guangxi
Zhuang Autonomous Region, Guilin, China
(Xu) Department of Emergency Medicine, The Second Affiliated Hospital
Zhejiang University School of Medicine, Hangzhou, China
(Liu) Department of Hospital Office, Guangxi Orthopaedic Hospital,
Nanning, China
Publisher
Lippincott Williams and Wilkins
Abstract
Rationale: - Post-traumatic renal artery embolism (RAE) represents a rare
vascular emergency with diagnostic challenges due to its nonspecific
presentation. This study aims to enhance clinical recognition through a
comprehensive analysis of a bilateral RAE case and contemporary management
strategies. Patient concerns: - A 23-year-old male was admitted to the
Emergency Department of the Second Affiliated Hospital, Zhejiang
University School of Medicine, with acute chest and back pain and
disturbance of consciousness following blunt abdominal trauma. Diagnoses:
- The diagnostic workup included contrast-enhanced computed tomography
angiography and serum biomarkers. Intervention(s): - Upon admission
to the Emergency Intensive Care Unit, the patient underwent immediate
continuous renal replacement therapy, vasoactive drugs, fluid replacement,
alkalization of urine, and symptomatic treatment. After the patient's
condition improved, the spinal surgery performed thoracic vertebra
reduction and internal fixation surgery. Outcome(s): - Serial renal
function monitoring demonstrated complete functional recovery. Lessons: -
In the evaluation of post-traumatic abdominal pain, RAE should be
systematically considered in the differential diagnosis following
exclusion of acute surgical abdomen. Copyright © 2025

<69>
Accession Number
2042684174
Title
Effects of rhomboid intercostal and sub-serratus plane block on
perioperative analgesic efficacy and diaphragm excursion in video-assisted
thoracic surgery: a prospective, randomized controlled trial.
Source
BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 50. Date
of Publication: 01 Dec 2026.
Author
Zhao S.-F.; Chang Q.-Y.; Zheng Y.-R.; Qiu L.; Shen J.
Institution
(Zhao, Chang, Zheng, Qiu, Shen) Department of Anesthesiology, The Third
Affiliated Hospital of Soochow University, Jiangsu, Changzhou, China
(Chang, Zheng, Qiu, Shen) Department of Anesthesiology, Changzhou First
People's Hospital, Jiangsu, Changzhou, China
(Zhao) Department of Anesthesiology, Changzhou Fourth People's Hospital,
Jiangsu, Changzhou, China
Publisher
BioMed Central Ltd
Abstract
Background: Rhomboid intercostal and sub-serratus plane (RISS) block is a
novel nerve block technique that provides good analgesia, but overall
research is scarce. This study aimed to investigate the effect of
ultrasound-guided RISS block on postoperative analgesia and diaphragmatic
excursion (DE) after video-assisted thoracic surgery (VATS) for lung
cancer. Method(s): One hundred patients who underwent VATS lung
resection participated in this study and were randomized to a RISS group
(Group R) or a control group (Group C). Group R underwent
ultrasound-guided RISS block with 0.25% ropivacaine hydrochloride 0.5
ml/kg immediately after surgery. Group C was given standard general
anaesthesia, and patient-controlled intravenous analgesia (PCIA) was used
in the postoperative period in both groups. The visual analogue scores
(VAS) at rest and during movement at 2 hours(h), 24 h, and 48 h
postoperatively were used as the primary outcome measures. Secondary
outcomes included postoperative consumption of sufentanil; preoperative
and postoperative left and right-sided DE during calm and deep breathing,
and the occurrence of adverse effects such as postoperative nausea and
vomiting (PONV), dizziness, somnolence, puncture site infection, and
hematoma. Result(s): At 2 h, 24 h, and 48 h postoperatively, patients
in Group R had lower VAS scores at rest (median [Q1, Q3]: 1.00 [1.00,
1.00]; 1.00 [1.00, 1.00]; 0.00 [0.00, 1.00]) and during movement (2.00
[2.00, 3.00]; 2.00 [2.00, 2.00]; 2.00 [1.00, 2.00]) than those in Group C
(resting: 2.00 [2.00, 2.00]; 2.00 [2.00, 2.00]; 1.00 [1.00, 2.00];
movement: 3.00 [3.00, 4.00]; 3.00 [3.00, 4.00]; 3.00 [2.00, 4.00]) (all P
< 0.0001). Sufentanil consumption at 2 h, 24 h, and 48 h postoperatively
was also significantly lower in Group R (P = 0.0002, P < 0.0001, P <
0.0001). Preoperatively, no significant difference in DE existed between
the groups (P > 0.05). At 30 min post-extubation and 2 h and 24 h
postoperatively, during both calm and deep breathing on both sides, Group
R had significantly greater DE than Group C (P < 0.05). At 48 h
postoperatively, the right-sided DE during calm breathing showed no
significant difference between the groups. PONV incidences did not differ
significantly (P = 0.2662), and Group R had less dizziness, somnolence,
higher satisfaction post-surgery, and showed no cases of puncture site
infection or hematoma. Conclusion(s): Ultrasound-guided RISS block
can modestly reduce postoperative pain in patients undergoing VATS, with
clinically relevant benefits, and may help alleviate diaphragmatic
dysfunction caused by surgical or anesthetic factors. Trial registration:
The trial was registered at the China Clinical Trial Registry
(http://www.chictr.org.cn, ChiCTR2300070842) on 24/04/2023. Copyright
© The Author(s) 2025.

<70>
Accession Number
2037632697
Title
Meta-Analysis of Durable Compared to Temporary Left Ventricular Assist
Devices Compared to Venoarterial Extracorporeal Membrane Oxygenation for
Bridging to Heart Transplantation or Treatment of Primary Graft
Dysfunction.
Source
Reviews in Cardiovascular Medicine. 26(12) (no pagination), 2025. Article
Number: 45064. Date of Publication: 01 Dec 2025.
Author
Saemann L.; Maier S.; Kohl M.; Simm A.; Szabo G.
Institution
(Saemann, Simm, Szabo) Department of Cardiac Surgery, University Hospital
Halle, Halle (Saale), Germany
(Maier) Department of Cardiac Surgery, University Hospital Freiburg,
Faculty of Medicine, University of Freiburg, Freiburg, Germany
(Kohl) Faculty III: Health, Medical Life Sciences, Furtwangen University
of Applied Sciences, Villingen-Schwenningen, Germany
(Szabo) Department of Cardiac Surgery, University Hospital Heidelberg,
Heidelberg, Germany
Publisher
IMR Press Limited
Abstract
Background: Patients bridged to heart transplantation (HTx) and patients
with primary graft dysfunction (PGD) after HTx are typically treated with
circulatory support. However, the survival of patients in both indications
might depend on the type of circulatory support. Thus, this meta-analysis
aimed to investigate the survival of HTx patients supported during
bridging with a durable left ventricular assist device (d-LVAD), a
temporary LVAD (t-LVAD), or venoarterial extracorporeal membrane
oxygenation (VA-ECMO). We also investigated the survival rate of patients
with PGD by type of circulatory support device. Method(s): We
performed a random-effects meta-analysis. Result(s): We included four
studies evaluating bridging to HTx (n=1678 patients) and three studies for
the PGD analysis (n=35 patients). The 1-year survival after HTx was
significantly higher in patients bridged with a t-LVAD (92.7% 95%
confidence interval (CI): 89.2 to 95.6% p=0.027) and with a d-LVAD (86.8%
95% CI: 75.8 to 94.8% p=0.001) compared to VA-ECMO (71.6% 95% CI: 63.7 to
78.9%). The 30-day survival in patients with PGD and t-LVAD was 100% (95%
CI: 59.2-100%), while with PGD and VA-ECMO, survival was 92.4% (95% CI: 66
to 100%). Conclusion(s): Both d-LVAD and t-LVAD bridging methods
appear to have comparable 1-year survival rates, which are higher than
those after VA-ECMO bridging. Nonetheless, more prospective clinical
studies are needed to investigate outcomes after using circulatory support
devices for PGD after HTx. The PROSPERO registration: CRD420251149065,
https://www.crd.york.ac.uk/PROSPERO/view/CRD420251149065. Copyright
© 2025 The Author(s).

<71>
Accession Number
2042805451
Title
Anticipating stroke in patients undergoing transcatheter aortic valve
replacement.
Source
Expert Review of Medical Devices. (no pagination), 2026. Date of
Publication: 2026.
Author
Hajj J.; Zalaquett Z.; Harb S.; Kapadia S.
Institution
(Hajj, Zalaquett, Harb, Kapadia) Department of Cardiovascular Medicine,
Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH,
United States
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Transcatheter aortic valve replacement (TAVR) has
transformed treatment of severe aortic stenosis, offering a less invasive
alternative to surgery. Despite advances, stroke remains a serious
complication, impacting morbidity, mortality, and long-term cognitive
function, thus the need for effective prevention strategies. Areas
covered: Based on a targeted review of the PubMed literature, this review
addresses mechanisms and risk factors for stroke after TAVR and evaluates
current preventive approaches. Cerebral embolic protection devices
(CEPDs), particularly the Sentinel system, are discussed alongside other
devices. Antithrombotic strategies before, during, and after TAVR are also
reviewed, emphasizing the balance between thromboembolic protection and
bleeding risk in an elderly population. Expert opinion: While some studies
suggest CEPDs may reduce stroke, randomized trials have not confirmed
broad and robust benefit, and high cost limits routine adoption. Future
work should focus on high-risk subgroups, device refinement, and
large-scale trials. For now, individualized antithrombotic therapy and
selective CEPD use remain central to stroke prevention in
TAVR. Copyright © 2026 Informa UK Limited, trading as Taylor &
Francis Group.

<72>
Accession Number
650121557
Title
Balloon- Versus Self-Expanding Transcatheter Valves for Failed Small
Surgical Aortic Bioprostheses: 3-Year Results of the LYTEN Trial.
Source
Circulation. Cardiovascular interventions. (pp e016255), 2026. Date of
Publication: 02 Feb 2026.
Author
Cepas-Guillen P.; Abbas A.E.; Serra V.; Vilalta V.; Nombela-Franco L.;
Regueiro A.; Al-Azizi K.M.; Iskander A.; Conradi L.; Forcillo J.; Lilly
S.; Calabuig A.; Fernandez-Nofrerias E.; Mohammadi S.; Giuliani C.;
Pelletier-Beaumont E.; Pibarot P.; Rodes-Cabau J.
Institution
(Cepas-Guillen, Mohammadi, Giuliani, Pelletier-Beaumont, Pibarot,
Rodes-Cabau) Quebec Heart and Lung Institute, Laval University, C.G.,
E.P.-B., Canada
(Cepas-Guillen, Regueiro, Rodes-Cabau) Clinic Cardiovascular Institute,
Hospital Clinic de Barcelona, Institut d'Investigacions Biomediques August
Pi i Sunyer, University of Barcelona, A.R
(Abbas) William Beaumont University Hospital, Royal Oak, Corewell Health
East
(Serra, Calabuig) Hospital Universitari Vall d'Hebron, Barcelona,
Philippines
(Vilalta, Fernandez-Nofrerias) Hospital Universitari Germans Trias i
Pujol, Badalona, Spain
(Nombela-Franco) Cardiovascular Institute, Hospital Clinico San Carlos,
IdISSC, Madrid, Spain
(Al-Azizi) Baylor Scott and White the Heart Hospital Plano
(Iskander) SJH Cardiology Associates, Syracuse, United States
(Conradi) University Heart and Vascular Center, Germany (L.C.), Hamburg,
Germany
(Forcillo) Centre Hospitalier Universitaire de Montreal, QC, Canada
(Lilly) OSU Heart and Vascular Research Organization, Richard M. Ross
Hospital, Columbus, United States
Abstract
BACKGROUND: Data comparing valve systems in the valve-in-valve
transcatheter aortic valve replacement field have been obtained from
retrospective studies. This prespecified secondary analysis of the LYTEN
randomized trial (Comparison of the Balloon-Expandable Edwards Valve and
Self-Expandable CoreValve Evolut R or Evolut PRO System for the Treatment
of Small, Severely Dysfunctional Surgical Aortic Bioprostheses) aims to
compare the 3-year hemodynamic performance and clinical outcomes between
balloon-expandable valves (BEV) SAPIEN 3/ULTRA (Edwards Lifesciences) and
self-expanding valves (SEV) Evolut R/PRO/PRO+ (Medtronic) in
valve-in-valve transcatheter aortic valve replacement. METHOD(S):
Patients with a failed small (<=23 mm) surgical valve undergoing
valve-in-valve transcatheter aortic valve replacement were randomized to
receive a SEV or a BEV. Patients had a clinical and valve hemodynamic
(Doppler echocardiography) evaluation at 3-year follow-up. Study outcomes
were defined according to VARC (Valve Academic Research
Consortium)-2/VARC-3 criteria. Intended performance of the valve was
defined as mean gradient <20 mm Hg, peak velocity <3 m/s, Doppler velocity
index >=0.25, and less than moderate AR. RESULT(S): Ninety-eight
patients underwent transcatheter aortic valve replacement (46 BEV-SAPIEN
3/ULTRA-, 52 SEV-Evolut R-PRO-PRO+). At 3 years, patients receiving a SEV
had a higher rate of intended valve performance (BEV: 27.6% versus SEV:
82.4%; P<0.001), with lower mean gradients (BEV: 20.40+/-9.12 versus SEV:
13.12+/-8.56 mm Hg; P=0.002), and larger indexed effective orifice area
(BEV: 0.69+/-0.27 versus SEV: 0.93+/-0.32 cm2/m2; P=0.002). The rate of
moderate aortic regurgitation was 0% in the BEV group versus 2.9% in the
SEV group (P=0.582). Functional status and quality of life improved
similarly in both groups. No differences were observed in the composite
end point of death, stroke, or heart failure-related hospitalization (BEV:
32.6% versus SEV: 25.5%; P=0.489). Mortality was also not statistically
different between groups (BEV: 23.3% versus SEV: 15.7%; P=0.375). No
significant differences were observed in other adverse events.
 CONCLUSION(S): In patients undergoing valve-in-valve transcatheter
aortic valve replacement for failed small aortic bioprostheses, SEV
demonstrated a superior valve hemodynamic performance at 3-year follow-up,
with similar clinical outcomes and functional improvement compared with
BEV. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier:
NCT03520101.

<73>
Accession Number
2037658329
Title
Towards Green Cardiovascular Care: Carbon Footprint Analysis in the
Management of Coronary Artery Disease.
Source
Korean Circulation Journal. 56(1) (pp 1-8), 2026. Date of Publication: 01
Jan 2026.
Author
Go Y.-H.; Yang S.; Hwang D.; Koo B.-K.
Institution
(Go) Department of Internal Medicine, Seoul National University College of
Medicine, Seoul, South Korea
(Yang, Hwang, Koo) Department of Internal Medicine and Cardiovascular
Center, Seoul National University Hospital, Seoul National University
College of Medicine, Seoul, South Korea
Publisher
Korean Society of Cardiology
Abstract
Greenhouse gas emissions drive climate change, which in turn threatens
human health through various pathways, including cardiovascular disease,
respiratory illness, and infectious disease. Despite the healthcare sector
accounting for 4.4% of global carbon emissions, carbon footprint analysis
within the field remains limited. This perspective addresses the
importance of carbon footprint assessment in healthcare, particularly in
cardiovascular medicine, and illustrates the use of randomized controlled
trial (RCT) data for carbon footprint comparison. Unlike other sectors,
healthcare carbon footprint analysis must consider not only the emissions
generated directly by medical interventions but also those produced during
the subsequent clinical course and follow-up. Data routinely collected
during RCT follow-up periods can be used to estimate total emissions
associated with different treatment strategies. In the cardiovascular
field, where procedures themselves are carbon-intensive and where serious
clinical events frequently occur during long-term follow-up, such analyses
are particularly relevant. For instance, based on RCT data comparing
fractional flow reserve (FFR) and intravascular ultrasonography for
intermediate coronary artery stenosis, we estimated that the FFR group had
a lower carbon footprint during the 2-year follow-up period. Extending the
analysis with a long-term simulation model over 30 years similarly
revealed that the cumulative carbon emissions remained lower in the FFR
group. Comparing the carbon footprint between treatment strategies using
RCT data can provide meaningful insights to guide environmentally
responsible healthcare decisions. Building more accurate carbon footprint
databases specific to healthcare interventions and fostering greater
awareness among healthcare professionals will be essential to advance this
effort. Copyright © 2026. The Korean Society of Cardiology.

<74>
Accession Number
650106718
Title
SAFETY OF LAA CLOSURE BY MINIMALLY INVASIVE PROCEDURE VS OACS IN PATIENTS
WITH ATRIAL FIBRILLATION -AN UMBRELLA META-ANALYSIS.
Source
Journal of Hospital Medicine. Conference: SHM Converge 2025. Las Vegas, NV
United States. 20(Supplement 1) (pp S216-S217), 2025. Date of Publication:
01 Apr 2025.
Author
Parvataneni T.; Dirisanala S.; Sripathi K.; Reddy S.M.V.; Rajgopal S.;
Patel R.; Aboukhreis M.; Harshabhargav V.; Shah P.; Gandhi A.; Patel U.;
Yarlagadda B.
Institution
(Parvataneni) Department of Family Medicine, Aiken Regional Medical
Center, SC, United States
(Dirisanala) Department of Internal Medicine, North East Georgia Medical
Center, Gainesville, GA, United States
(Sripathi) Arkansas College of Osteopathic Medicine, Mercy Hospital, Fort
Smith, AR, United States
(Reddy) Aiken Regional Medical, United States
(Rajgopal) Avalon University School of Medicine, Willemstad, United States
(Patel) Department of Internal Medicine, Creighton University, Omaha, NE,
United States
(Aboukhreis) Yeditepe University, Faculty of Medicine, Istanbul, Turkey
(Harshabhargav) University of Perpetual Help System Delta, Las Pinas,
Philippines
(Shah) Department of Internal Medicine, Reading Hospital, Tower Health,
West Reading, PA, United States
(Gandhi) UCD School of Medicine, University College Dublin, Ireland
(Patel) Department of Public Health, Icahn School of Medicine at Mount
Sinai, New York, NY, United States
(Yarlagadda) Department of Internal Medicine, MUSC, Camden, SC, United
States
Publisher
John Wiley and Sons Inc
Abstract
Background: This umbrella meta-analysis assesses the safety of left atrial
appendage (LAA) closure by minimal invasive procedures compared to oral
anticoagulants (OACs) in patients with atrial fibrillation (AF),
concentrating on adverse events and overall clinical outcomes. The results
seek to elucidate the most effective treatment. This umbrella
meta-analysis intends to evaluate the safety and efficacy of minimally
invasive LAA closure in comparison to OAC in AF. Method(s): We
adhered to the PRISMA protocol to perform an umbrella meta-analysis of
published meta-analyses comparing the outcomes of LAA occlusion using the
Watchman or Amulet devices vs OACs in patients with atrial fibrillation
(AF). Relevant studies were identified through PubMed using MeSH terms.
Non-human studies, non-English publications, studies that were not
meta-analyses, and those lacking outcome data were excluded based on
predefined inclusion and exclusion criteria. Data analysis was conducted
using RevMan 5.4, employing the inverse variance method and a
randomeffects model to calculate pooled odds ratios (ORs) with 95%
confidence intervals (CIs). Forest plots and heterogeneity (I2)
were also generated, with statistical significance defined at an alpha
level of 0.05. Risk of bias assessed by Newcastle-Ottawa Scale (NOS).
 Result(s): Of 19 studies, 12 had data on outcomes. Watchman or Amulet
devices had reduced odds of mortality [aOR: 0.65, 95%CI: 0.59-0.71,
I2: 0%, p < 0.00001] [all cause mortality (0.70, 0.62-0.79, 0%,
p < 0.00001), CV mortality (0.58, 0.50-0.67, 0%, p < 0.00001)], risk of
stroke [0.77, 0.60-0.98, 75%, p = 0.06], and major bleeding [0.76,
0.59-0.96, 61%, p = 0.02] in comparison with OACs. NOS suggested a
moderate risk of bias. Conclusion(s): Watchman and Amulet devices
provide safer left atrial appendage (LAA) closure than oral anticoagulants
(OACs) in atrial fibrillation patients. All-cause, cardiovascular, stroke,
and severe bleeding death rates are much lower. More prospective studies
and clinical trials will help with risk stratification and cohort
selection who may get the most benefit out of these procedures.

<75>
Accession Number
650107290
Title
STREPTOCOCCUS EQUINUS (BOVIS GROUP) SEPSIS WITH ENDOCARDITIS IN A PATIENT
WITH TAVR.
Source
Journal of Hospital Medicine. Conference: SHM Converge 2025. Las Vegas, NV
United States. 20(Supplement 1) (pp S59), 2025. Date of Publication: 01
Apr 2025.
Author
Scheel R.; Howlett L.; Colbenson G.A.
Institution
(Scheel) Mayo Clinic, Rochester, United States
(Howlett) Mayo Clinic Alix, School of Medicine, United States
(Colbenson) Mayo Clinic, United States
Publisher
John Wiley and Sons Inc
Abstract
Case Presentation: A 71-year-old man with history of coronary artery
disease, aortic stenosis status post transcatheter aortic valve
replacement (TAVR) two years ago, ankylosing spondylitis presented to the
emergency department for evaluation of 3 days of subjective fevers,
worsening generalized weakness requiring oneperson assist for ambulation,
tachycardia on his smart watch in the setting of three weeks of
generalized weakness myalgias. In the ED he was febrile to 39.1degreeC,
tachycardic, tachypneic with no oxygen requirement. Initial labs were
notable for a WBC of 9.8 K/muL, normal lactate, initial troponin of 16
ng/L (upper limit of normal 15 ng/L) with 2 hour recheck 16 ng/L.
SARS-CoV-2 PCR was positive, Influenza A, B, RSV PCR were negative. Chest
X-ray showed no evidence of pneumonia. He was admitted to medicine started
on remdesivir for COVID-19 infection. Blood cultures grew Streptococcus
equinus (bovis group) in two of two bottles after 9 hours ceftriaxone was
initiated. The Infectious Disease team was consulted. Suspicion for
infective endocarditis (IE) was high given the propensity of the organism
to cause IE, the increased risk from theTAVR, the duration of his
symptoms. Due to COVID-19 isolation precautions, transesophageal
echocardiogram (TEE) was deferred until day 5. He underwent initial
evaluation with a transthoracic echocardiogram (TTE) subsequentTEE both of
which did not demonstrate evidence of IE. Because clinical index of
suspicion remained elevated, the patient underwent Fluorodeoxyglucose
(FDG) positron emission tomography (PET) imaging which demonstrated
diffuse near-circumferential activity surrounding the TAVR suggestive of
infection. He completed six weeks of ceftriaxone follow-up cultures two
weeks after completion of therapy were negative. Outpatient colonoscopy
demonstrated a tubular adenoma with high-grade dysplasia negative margins.
 Discussion(s): This case highlights the critical importance of
maintaining a high index of suspicion for infective endocarditis (IE) in
patients with S. equinus bacteremia, especially those with prosthetic
heart valves. Despite negative transthoracic transesophageal
echocardiograms, the patient's prolonged symptoms bacteremia with an
organism known for endocardial involvement warranted further investigation
the utilization of FDG-PET/CT was pivotal. In 2023, the International
Society for Cardiovascular Infectious Diseases updated the Modified Duke
Criteria to include FDG-PET/CT findings as a major criterion for
diagnosing IE, particularly in prosthetic valve endocarditis (PVE) [1].
Meta-analyses report FDG-PET/ CT sensitivity of 86% specificity of 84% in
PVE, increasing diagnostic sensitivity from 52-70% to 91-97% when
incorporated into the Modified Duke Criteria [2]. While the patient tested
positive for SARS-CoV-2, his symptoms were not fully explained by
COVID-19, emphasizing the importance of avoiding premature diagnostic
closure. Conclusion(s): This case emphasizes the importance of a
thorough inpatient workup in diagnosing complex infections like IE,
particularly in patients with prosthetic valves. FDG-PET should be
considered in select cases when suspicion for infective endocarditis
remains high despite other negative diagnostics. This case underscores the
need for coordinated inpatient outpatient care to ensure successful
treatment follow-up, including cancer screening through colonoscopy in
patients with S. equinus bacteremia.

<76>
Accession Number
2043353129
Title
Outcomes of durable versus biodegradable polymer drug-eluting stents in
patients with coronary artery disease.
Source
IJC Heart and Vasculature. 63 (no pagination), 2026. Article Number:
101882. Date of Publication: 01 Apr 2026.
Author
Skos C.; Rogozarski J.; Dizdarevic A.M.; M.Steiner-Gager G.; Postula M.;
Eyileten C.; Toma A.; Speidl W.S.; Skoro-Sajer N.; Gerges C.; Lang I.M.;
Siller-Matula J.M.
Institution
(Skos, Rogozarski, Dizdarevic, M.Steiner-Gager, Toma, Speidl, Skoro-Sajer,
Gerges, Lang, Siller-Matula) Department of Medicine II, Division of
Cardiology, Medical University of Vienna, Vienna, Austria
(Postula, Eyileten) Department of Experimental and Clinical Pharmacology,
Center for Preclinical Research and Technology CEPT, Medical University of
Warsaw, Poland
Publisher
Elsevier Ireland Ltd
Abstract
Background: Percutaneous coronary intervention (PCI) is among the most
common cardiovascular procedures, but stents still pose risks of
restenosis or thrombosis. Drug-eluting stents (DES) with polymer coatings
have improved long-term outcomes. Aim(s): This study evaluated
whether the latest biodegradable polymer DES (BP-DES) offer improved
safety over durable polymer DES (DP-DES). Method(s): Data were
collected from a single-centre registry at the Medical University of
Vienna, including patients who underwent PCI between 2015 and 2020.
Patients were categorized by stent type and PCI indication (All Comer,
CCS-PCI, ACS-PCI). The primary endpoint comprised of major adverse cardiac
events (MACE), including target lesion revascularization (TLR), target
vessel revascularization (TVR), stent thrombosis (ST), and all-cause
death. Result(s): 2118 patients were eligible for further analysis.
1232 patients (58.2%) received a DP-DES. In the all-comer cohort, 5-year
MACE rates were 12% for BP-DES vs 14.5% for DP-DES. Multivariate analysis
showed no significant difference in MACE for the use of BP-DES (OR 0.941,
95% CI 0.734-1.207, p = 0.631). However, TLR rates were significantly
lower in patients treated with BP-DES (3.4% vs 6.8%, OR 0.567, 95% CI
0.372-0.865, p = 0.008), mainly driven by lower rates of TLR within the
ACS PCI cohort (1.5% vs 4.9%, OR 0.364, 95% CI 0.158-0.841, p = 0.018). In
CCS PCI patients, MACE and TLR rates demonstrated no significant
differences. Conclusion(s): BP-DES and DP-DES show a similar
long-term safety profile regarding MACE. BP-DES demonstrate a lower risk
of TLR in the all-comer cohort, driven by reduced rates in ACS-PCI
patients. Copyright © 2026 The Author(s)

<77>
Accession Number
2042802634
Title
Colchicine therapy in transcatheter aortic valve replacement: Modulating
inflammation and outcomes.
Source
International Journal of Cardiology: Cardiovascular Risk and Prevention.
29 (no pagination), 2026. Article Number: 200575. Date of Publication: 01
Jun 2026.
Author
Abdul-Hafez H.A.; Awashra A.; Ahmad M.; Hawawrah A.R.; Mahafdah B.;
AbuBaha M.; Alazizi I.; Shubietah A.; Elgendy M.S.; Emara A.
Institution
(Abdul-Hafez, Awashra, Ahmad, Hawawrah, AbuBaha, Alazizi) Department of
Medicine, Faculty of Medicine and Health Sciences, An-Najah National
University, Nablus, Palestine
(Mahafdah) Faculty of Medicine, Yarmouk University, Irbid, Jordan
(Shubietah) Department of Medicine, Advocate Illinois Medical Center,
Chicago, IL, United States
(Elgendy) Faculty of Medicine, Tanta University, Tanta, Egypt
(Emara) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Publisher
Elsevier B.V.
Abstract
Background Transcatheter aortic valve replacement (TAVR) is frequently
accompanied by inflammation-related complications, including conduction
disturbances, atrial fibrillation, and subclinical leaflet thrombosis.
Colchicine, with its anti-inflammatory and antithrombotic properties, has
emerged as a potential adjunctive therapy to mitigate these
post-procedural events. However, its specific role in the TAVR population
remains insufficiently defined. Methods A narrative review approach was
used. Searches of PubMed, Scopus, Web of Science, and Google Scholar were
performed through September 2025 using terms related to "transcatheter
aortic valve replacement," "TAVR," and "colchicine." Randomized trials,
observational studies, mechanistic investigations, and guideline documents
were screened. Findings were organized thematically to summarize
mechanisms, therapeutic rationale, and clinical outcomes. Results Only one
randomized controlled trial and one observational study have directly
evaluated colchicine after TAVR. Both demonstrated reductions in
inflammatory biomarkers and signals toward improved conduction-related
parameters, but clinical endpoints such as pacemaker implantation,
sustained arrhythmias, and imaging-confirmed leaflet thrombosis remain
insufficiently studied. Mechanistic and perioperative cardiac evidence
from non-TAVR settings supports colchicine's potential by targeting
inflammasome activity, microtubule regulation, and early
thrombo-inflammatory remodeling. Conclusions Colchicine is a promising
adjunctive strategy for attenuating inflammation-related complications
after TAVR. Its multimodal actions align with the pathways implicated in
conduction disturbances, atrial fibrillation, and leaflet thrombosis.
However, current evidence is preliminary, with only two post-TAVR
intervention studies available. Larger trials are needed to determine
whether colchicine can translate mechanistic advantages into clinically
meaningful improvements in post-TAVR outcomes. Copyright © 2026
The Authors.

<78>
Accession Number
650106999
Title
PARADOXICAL STROKE IN YOUNG MALE WITH SEVERE HYPERCOAGUABLE STATE STATUS
POST CAUDA EQUINA SYNDROME.
Source
Journal of Hospital Medicine. Conference: SHM Converge 2025. Las Vegas, NV
United States. 20(Supplement 1) (pp S675), 2025. Date of Publication: 01
Apr 2025.
Author
Grewal A.; Malik S.
Institution
(Grewal, Malik) Abrazo Health, United States
Publisher
John Wiley and Sons Inc
Abstract
Case Presentation: This is a 37-year-old male presented to ED with
bilateral leg numbness and incontinence. An MRI was done that revealed
herniation of nucleus pulposus of lumbar intervertebral disc with sciatica
and he was taken to the OR for an emergent Full L4 laminectomy, bilateral
L4-5 microdiscectomies, bilateral foraminotomies of the S1 nerve roots,
bilateral medial facetectomies to correct his cauda equina syndrome. On
hospital day 3, he complained of chest pain and had a syncopal event when
attempting to ambulate. Rapid response was then called due to severe
hypoxia. STAT troponin was drawn and a CTA of the chest was done revealing
submissive bilateral pulmonary embolisms. The patient was taken into the
IR suite to have an emergent mechanical thrombectomy to remove the
bilateral submissive PE's and R femoropopliteal DVT. The patient was
brought to the ICU and heparinized. A neuro exam was done on the patient
the following morning that showed substantial change from his baseline and
STAT head CT was done. The patient suffered 2 embolic strokes. In addition
to that, a large hematoma, ranging from T12-L4 was found at the
laminectomy site and required evacuation. heparin stopped as the immediate
risk of bleeding outweighed the threat of another VTE and the patient was
placed on SCDs. US Doppler revealed another DVT that developed 1 day, SQ
heparin was then initiated but despite that, an additional 2 DVTs were
found now on the left lower extremity in the posterior tibial and
popliteal veins. A TEE with bubble study was done to work up the
paradoxical stroke in the setting of TPA and IV Heparin however it
initially came back negative. A repeat TEE but this time in the cath lab
which finally yielded positive results of a small Patent Foramen Ovale
explaining how these paradoxical embolic strokes occurred. However, due to
the emergent need for heparinization, we were unable to obtain a proper
coagulopathy workup. Discussion(s): Patients with a PFO have been
reported to have a significantly higher risk of ischemic stroke compared
to those without a PFO. Additionally, these patients are more likely to
experience large vessel territory strokes. and exhibit greater
stroke-related neurological deficits, as measured by the U.S. National
Institutes of Health Stroke Scale. A recent meta-analysis encompassing
20.8 million patients evaluated the perioperative stroke risk associated
with PFO during noncardiac surgery. The findings revealed a significantly
higher incidence of stroke among patients with PFO undergoing orthopedic,
general, genitourinary, neurosurgical, and thoracic procedures compared to
their non-PFO counterparts. Conclusion(s): Increased Stroke Risk in
PFO Patients-Patients with a PFO are at significantly higher risk of
ischemic stroke compared to those without a PFO, especially during the
perioperative period of noncardiac surgeries. This highlights the
importance of considering PFO status in preoperative evaluations. Higher
Risk in Specific Surgery Types-Certain types of noncardiac surgeries,
including orthopedic, general, genitourinary, neurosurgical, and thoracic
procedures, are associated with particularly high odds of perioperative
stroke in PFO patients. This suggests that these patients may require
tailored perioperative management. Severity of Neurological Outcomes-PFO
strokes are more likely to involve large vessel territories and result in
more severe neurological deficits, as indicated by higher NIHSS scores.
This underscores the potential for significant morbidity in this patient
population.

<79>
Accession Number
2042908073
Title
Minimally invasive aortic valve replacement in morbidly obese patients:
outcomes from a cohort study and pooled data analysis.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2026. Article
Number: 1659991. Date of Publication: 2026.
Author
Amanov L.; Ali-Hasan-Al-Saegh S.; Rad A.A.; Jauken A.A.; Athanasiou T.;
Salman J.; Ius F.; Rumke S.; Schmack B.; Ruhparwar A.; Zubarevich A.;
Weymann A.
Institution
(Amanov, Ali-Hasan-Al-Saegh, Jauken, Salman, Ius, Rumke, Schmack,
Ruhparwar, Zubarevich, Weymann) Department of Cardiothoracic,
Transplantation and Vascular Surgery, Hannover Medical School, Hannover,
Germany
(Rad, Athanasiou) Department of Cardiothoracic Surgery, Oxford Heart
Centre, John Radcliffe Hospital, Oxford University NHS Foundation Trust,
Oxford, United Kingdom
Publisher
Frontiers Media SA
Abstract
Background: In the context of cardiac surgery, morbid obesity poses
several perioperative challenges. Some surgeons consider obesity a
relative contraindication for minimally invasive aortic valve replacement
(MIAVR) due to anatomical and technical complexities. Although MIAVR is
increasingly used in standard-risk populations, evidence supporting its
safety and efficacy in morbidly obese patients remains limited.
 Method(s): This retrospective cohort consisted of 920 patients who
underwent MIAVR via partial upper ministernotomy at a high-volume cardiac
surgery center between 2010 and May 2025. Patients were categorized into
three groups based on BMI: Class I obesity (BMI 30-35 kg/m2; n
= 164), Class II-III obesity (BMI > 35 kg/m2; n = 54), and a
non-obese control group (n = 702). Key clinical outcomes,
echocardiographic parameters, postoperative complications, and long-term
mortality rates were compared. Additionally, a pairwise meta-analysis was
conducted, incorporating five studies to assess outcomes of MIAVR vs.
conventional full sternotomy in obese individuals. Result(s): There
were no significant differences in most of postoperative outcomes.
However, higher rates of pneumothorax and arrhythmias were observed in
Class II-III obesity. Multivariate regression did not identify obesity as
an independent predictor of adverse outcomes. Meta-analysis confirmed
comparable operative times and a trend toward shorter ICU stays and lower
respiratory complications in the MIAVR group. Conclusion(s): This
study argues that (i) obesity alone should not delay, deter, or preclude
appropriate candidates from being referred for surgical aortic valve
replacement, and (ii) partial upper ministernotomy should be considered
the preferred access route in obese patients, as it consistently
facilitates recovery without compromising safety. Copyright 2026
Amanov, Ali-Hasan-Al-Saegh, Rad, Jauken, Athanasiou, Salman, Ius, Rumke,
Schmack, Ruhparwar, Zubarevich and Weymann.

<80>
Accession Number
650119061
Title
Anticoagulation for pregnant individuals with mechanical heart valves: a
methodological review of systematic reviews.
Source
The Canadian journal of cardiology. (no pagination), 2026. Date of
Publication: 30 Jan 2026.
Author
Ashraf R.; Clarfield L.; Sayfi S.; Keepanasseril A.; Bhatia K.; Shehata
N.; Shah P.S.; Hwang M.; Giannarakos A.; Brignardello-Petersen R.; Beyene
J.; D'Souza R.
Institution
(Ashraf, D'Souza) Department of Obstetrics and Gynaecology, McMaster
University, Hamilton, Canada; Department of Health Research Methods,
Evidence and Impact, McMaster University, Hamilton, Canada; Department of
Obstetrics and Gynaecology, University of Toronto, Toronto, Canada
(Clarfield) Department of Obstetrics and Gynaecology, University of
Toronto, Toronto, Canada
(Sayfi) Department of Obstetrics and Gynaecology, McMaster University,
Hamilton, Canada; Department of Health Research Methods, Evidence and
Impact, McMaster University, Hamilton, Canada
(Keepanasseril) Department of Obstetrics and Gynaecology, Jawaharlal
Institute of Postgraduate Medical Education & Research, Pondicherry,
Dhanvantri Nagar, India
(Bhatia) Department of Anaesthesiology, St. Mary's Hospital, University of
Manchester, United Kingdom
(Shehata) Departments of Medicine, Laboratory Medicine and Pathobiology,
Mount Sinai Hospital, Toronto, Canada
(Shah) Department of Pediatrics, University of Toronto, Mount Sinai
Hospital, Toronto, Canada
(Hwang, Giannarakos) Library & Knowledge Services, Trillium Health
Partners, Mississauga, Canada
(Brignardello-Petersen, Beyene) Department of Health Research Methods,
McMaster University, Hamilton, Canada
Abstract
We aimed to describe methodological variations in systematic reviews (SRs)
that estimated clinical outcomes with different anticoagulant strategies
for pregnant individuals with mechanical heart valves (MHVs), and to
provide most reliable risk estimates. We identified eligible SRs through a
search involving eight databases and critically appraised (a) study
quality using A MeaSurement Tool to Assess systematic Reviews (AMSTAR-2)
(b) search strategies using Peer Review of Electronic Search Strategies
(PRESS) guidelines and operationalized criteria of SR searches, and (c)
meta-analytic approaches using a self-designed checklist. We determined
most reliable estimates for clinical outcomes using an algorithm
considering AMSTAR-2 scores, quality of search strategy and recency of
publication. Of the 12 eligible SRs, most (9/12) were of critically low
quality based on AMSTAR-2. Of the 4 that published search strategies, 3
were of low quality based on PRESS guidelines. Meta-analytic approaches
varied widely. The most reliable risk estimates with VKAs were 0.9% [95%
Confidence Interval (CI 0.1-1.6%)] for maternal mortality, 2.7% (1.4-4.0%)
for thromboembolism, 35.5% (19.8-51.2%) for fetal loss and 2.0% (0.3-3.7%)
for congenital anomalies. These risks with sequential therapy were 2.0%
(0.8-3.1%), 5.8% (3.8-7.7%), 20.1% (14.4-25.7%) and 1.4% (0.3-2.5%), and
with LMWH, they were 2.9% (0.2-5.7), 8.7% (3.9-13.4), 8.0% (2.0-13.9) and
0.0% (0.0-0.0) respectively. SRs on anticoagulation for pregnant
individuals with MHVs demonstrate considerable heterogeneity in terms of
study quality, search strategies, and meta-analytical approaches. The
provided risk estimates could inform shared decision-making and clinical
practice guidelines. Copyright © 2026. Published by Elsevier Inc.

<81>
Accession Number
2042966699
Title
The impact of thoracic paravertebral nerve block at different positions on
pain relief in patients undergoing single-port thoracoscopic partial lung
resection: study protocol for a randomized controlled trial.
Source
Trials. 27(1) (no pagination), 2026. Article Number: 99. Date of
Publication: 01 Dec 2026.
Author
Zhu X.; Peng P.; Guo J.; Zhang L.; Zhong H.; Zhu J.; Xie H.
Institution
(Zhu, Peng, Guo, Zhang, Zhong, Zhu, Xie) Department of Anesthesiology, The
Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road,
Jiangsu, Suzhou, China
Publisher
BioMed Central Ltd
Abstract
Background: Despite the widespread adoption of uniportal video-assisted
thoracoscopic surgery (VATS), postoperative pain associated with this
procedure remains a significant concern. Effective postoperative analgesia
is essential for facilitating the recovery of patients undergoing thoracic
surgery. Thoracic paravertebral block (TPVB) is widely recognized as an
extremely effective method of analgesia in such surgeries. Our previous
study has demonstrated that the diffusion of local anesthetic during nerve
blocks is related to body position. Therefore, this study aimed to
evaluate the impact of thoracic paravertebral nerve block in various body
positions on the analgesic outcomes for patients undergoing single-port
thoracoscopic lung resection. Method(s): A randomized controlled
trial was conducted to assess the impact of different body positions
during thoracic paravertebral nerve blocks on the analgesic effect in
patients undergoing single-port thoracoscopic partial lung resection.
Patients scheduled for thoracoscopic lung resection will be included in
this study. Participants (n = 200) will undergo thoracic paravertebral
nerve block under ultrasound guidance. After the injection of the drug,
they will be placed in either a supine position or a lateral position with
the puncture side up. The NRS scores will be assessed at 1 h, 2 h, 8 h, 12
h, 24 h, and 48 h postoperatively. Postoperative opioid consumption,
rescue analgesia time and frequency, patient satisfaction, incidence of
adverse reactions, and length of hospital stay will also be recorded.
 Discussion(s): This research project mainly aimed to investigate the
impact of different perioperative positions for thoracic paravertebral
nerve block on the analgesic effects in patients undergoing single-port
thoracoscopic lung resection. The results may provide important
implications for the development of effective analgesic strategies and
robust clinical evidence to support the recovery of patients undergoing
thoracic surgery. Trial registration: ClinicalTrials.gov NCT06789276.
Registered on 10 January 2025. Copyright © The Author(s) 2026.

<82>
Accession Number
2042963353
Title
A randomised controlled trial comparing of the efficacy and safety of left
lung isolation for minimally invasive direct coronary artery surgery using
video-imaging double-lumen endobronchial tube with a bronchial blocker
paced through a video-imaging single-lumen tracheal tube.
Source
BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 83. Date
of Publication: 01 Dec 2026.
Author
Fang Y.; Wang M.; Liu T.; Han P.; Zhao M.; Deng Y.; Shi C.; Han B.; Zhang
J.; Li M.; Ling Y.; Guo X.; Zhou Y.; Han Y.
Institution
(Fang, Wang, Liu, Han, Zhao, Deng, Shi, Han, Zhang, Li, Guo, Zhou, Han)
Department of Anesthesiology, Peking University Third Hospital, Beijing,
China
(Ling) Department of Cardiac Surgery, Peking University Third Hospital,
Beijing, China
Publisher
BioMed Central Ltd
Abstract
Background and objectives: Minimally invasive coronary artery bypass
grafting (MIDCAB) requires effective left lung isolation, yet evidence
comparing video-imaging single-lumen tracheal tubes with bronchial
blockers (VSLT + BB) and video-imaging double-lumen endotracheal tubes
(VDLT) remains limited. This randomized controlled trial aimed to: (1)
quantitatively compare time efficiency for device placement and lung
isolation between VSLT + BB and VDLT; (2) evaluate perioperative airway
complications; and (3) assess differential impacts on postoperative
recovery, including postoperative sore throat, hoarseness, and Quality of
Recovery-15 (QoR-15) scores. Method(s): In this single-blind
randomized controlled trial, 97 MIDCAB patients were allocated to VSLT +
BB or VDLT groups. Primary outcomes were tube positioning time; secondary
outcomes included total intubation time, oxygenation parameters,
hemodynamic variables, and postoperative complications. Result(s):
VDLT exhibited shorter tube positioning time (128 +/- 37 vs. 159 +/- 58 s;
p < 0.001) but longer total intubation time (192 +/- 40 vs. 159 +/- 58 s;
p < 0.001). VSLT + BB demonstrated higher PaO2 at 10-min post-OLV (226.0
vs. 168.0 mmHg; p = 0.035) with lower airway pressures (p < 0.05).
Postoperative sore throat (33% vs. 13%; OR 2.84, 95% CI 1.04, 7.71; p =
0.018) and hoarseness at 48 h (55% vs. 31%; OR 2.45, 95% CI 1.08, 5.59; p
= 0.018) were higher with VDLT. Lung collapse quality, hypoxemia rates,
pulmonary complications, and QoR-15 scores showed no significant
differences (all p > 0.05). Conclusion(s): In MIDCAB surgery, VDLT
demonstrated significantly shorter tube positioning time compared with
VSLT + BB. However, VSLT + BB exhibited shorter total intubation time than
VDLT by avoiding postoperative tube exchange. Both techniques provided
clinically acceptable lung isolation with comparable lung collapse quality
and hypoxemia incidence. VSLT + BB exhibited lower airway pressures and
higher oxygenation indices during early OLV, whereas VDLT was associated
with higher rates of minor airway complications (sore throat, hoarseness).
No significant differences were observed in pulmonary complications,
hemodynamic stability, or recovery quality. Trial registration:
ChiCTR2300072124, 3/6/2023. Copyright © The Author(s) 2026.

<83>
Accession Number
2043345414
Title
Axillary Versus Sternotomy Access in Minimally Invasive Mitral Valve
Surgery: A Systematic Review and Meta-Analysis.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. (no pagination), 2026. Date of Publication: 2026.
Author
Almehandi A.; Ramadhan M.; Ali Y.; Almhanedi A.; Al-Naseem A.O.; Gonnah
A.; Awad A.; Fischer J.; Kirov H.; Doenst T.; Nazer R.I.; Caldonazo T.
Institution
(Almehandi) Department of Cardiovascular Science, University College
London, United Kingdom
(Ramadhan, Almhanedi, Al-Naseem) Department of Surgery, Jaber Al Ahmad Al
Jaber Al Sabah Hospital, Surra Al Asimah Governorate, Kuwait
(Ali) Faculty of Life Science and Medicine, Kings College London, United
Kingdom
(Gonnah) Imperial College Healthcare NHS Trust, London, United Kingdom
(Awad) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Fischer, Kirov, Doenst, Caldonazo) Department of Cardiothoracic Surgery,
Friedrich-Schiller-University Jena, Germany
(Nazer) Department of Cardiac Science, King Fahad Cardiac Centre, College
of Medicine, King Saud University, Riyadh, Saudi Arabia
(Caldonazo) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
Publisher
SAGE Publications Ltd
Abstract
Objective: Minimally invasive cardiac surgery for mitral valve (MV)
disease is a rising strategy. Axillary access is linked to reduced pain
and faster recovery, but its efficacy and safety compared with median
sternotomy for MV surgery (MVS) remain unclear. We conducted a
meta-analysis comparing the clinical outcomes of MVS via axillary access
and median sternotomy. Method(s): Four databases were analyzed. The
primary endpoint was perioperative mortality. Secondary endpoints included
cardiopulmonary bypass (CPB) and cross-clamp times, rethoracotomy, wound
complications, mechanical ventilation duration, stroke, hospital and
intensive care unit (ICU) stay, and residual moderate mitral
regurgitation. A random-effects model was used. Result(s): We
included 2,129 patients from 4 studies, with 1,135 (53.3%) undergoing
axillary access. Perioperative mortality was comparable between approaches
(odds ratio [OR] = 0.34, 95% confidence interval [CI]: 0.09 to 1.23, P =
0.10). Axillary access was associated with longer CPB times (mean
difference [MD] = 16.38, 95% CI: 6.42 to 26.34, P = 0.001), fewer wound
complications (OR = 0.41, 95% CI: 0.21 to 0.80, P = 0.009), shorter
ventilation time (MD = -4.93, 95% CI: -8.79 to -1.08, P < 0.01), and
shorter hospital (MD = -0.78, 95% CI: -1.41 to -0.14, P = 0.02) and ICU
stays (MD = -10.84, 95% CI: -19.54 to -2.14, P = 0.01). No difference was
found in cross-clamp time, rethoracotomy, stroke, or residual mitral
regurgitation. Conclusion(s): Axillary access for MVS shows
comparable mortality to median sternotomy, with benefits in wound
complications, ventilation, and recovery but longer CPB times. Further
research is needed to confirm long-term safety and efficacy. Copyright
© The Author(s) 2026. This article is distributed under the terms of
the Creative Commons Attribution-NonCommercial 4.0 License
(https://creativecommons.org/licenses/by-nc/4.0/) which permits
non-commercial use, reproduction and distribution of the work without
further permission provided the original work is attributed as specified
on the SAGE and Open Access page
(https://us.sagepub.com/en-us/nam/open-access-at-sage).

<84>
Accession Number
2043341775
Title
Mechanical ventilation strategies and lung protection during
cardiopulmonary bypass: A scoping review.
Source
Perfusion (United Kingdom). (no pagination), 2026. Date of Publication:
2026.
Author
Wang Y.; Lu S.; Zhang X.; Huang C.; Li Y.; Zhang N.
Institution
(Wang, Zhang) Healthy Examination & Management Center, The Second Hospital
& Clinical Medical School, Lanzhou University, Lanzhou, China
(Wang, Lu, Zhang, Huang, Li) Department of Cardiac Surgery, The Second
Hospital & Clinical Medical School, Lanzhou University, Lanzhou, China
(Wang, Lu, Zhang, Huang, Li, Zhang) The Second Hospital & Clinical Medical
School, Lanzhou University, Lanzhou, China
Publisher
SAGE Publications Ltd
Abstract
Objective: Cardiopulmonary bypass (CPB), which induces pulmonary injury,
significantly impacts the quality of life in patients undergoing cardiac
surgery. Preventing and treating pulmonary complications has become a
critical clinical issue. Optimizing ventilation strategies during the
preoperative, intraoperative, and postoperative stages is essential for
adequate lung protection and preventing CPB-related pulmonary injury.
 Method(s): A comprehensive search of multiple databases including
PubMed, Embase, and the Cochrane Library was conducted. After removing the
duplicate studies, full-text review was performed, and all studies that
reported mechanical ventilation strategies and lung protection during CPB
were included. Result(s): This review systematically examines
ventilation strategies during CPB, outlining optimized parameters and
pharmacologic approaches across pre-, intra-, and post-CPB phases to
reduce lung injury. Various modes - including volume control ventilation
(VCV), pressure control ventilation (PCV), and pressure-controlled
ventilation-volume guaranteed (PCV-VG) - demonstrate unique benefits and
limitations. When combined with protective measures (low tidal volume
[LTV], moderate positive end-expiratory pressure [PEEP], and recruitment
maneuvers), they show clinical efficacy in lung protection. Pharmacologic
agents like ambroxol, neutrophil elastase inhibitors, and sivelestat
further enhance protection, underscoring the promise of combined
mechanical-pharmacological strategies against CPB-induced lung injury.
 Conclusion(s): A comprehensive approach integrating individualized
ventilation management and pharmacological intervention is key to reducing
CPB-induced lung injury, enhancing postoperative respiratory function, and
improving patient outcomes. Copyright © The Author(s) 2026

<85>
Accession Number
650104203
Title
Interdisciplinary and cross-sectoral perioperative care model in cardiac
surgery: ERAS implementation in the setting of minimally-invasive heart
valve surgery (INCREASE) - results of a randomized controlled trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2026.
Date of Publication: 31 Jan 2026.
Author
Petersen J.; Stock S.; Brettschneider C.; Dolata L.; Dumps C.; Lowe B.;
Nijman E.; Ozga A.-K.; Reichenspurner H.; Elisabeth Schmid M.;
Schulte-Uentrop L.; Vettorazzi E.; Zapf A.; Zastrow I.; Klotz S.G.R.;
Girdauskas E.
Institution
(Petersen, Reichenspurner, Girdauskas) Department of Cardiovascular
Surgery, University Heart and Vascular Center, University Medical Center
Hamburg-Eppendorf, Hamburg, Germany
(Petersen, Reichenspurner, Girdauskas) DZHK (German Centre for
Cardiovascular Research), partner site Hamburg/Kiel/Lubeck, Hamburg,
Germany
(Stock, Elisabeth Schmid, Girdauskas) Department of Cardiothoracic
Surgery, University Hospital Augsburg, Augsburg, Germany
(Brettschneider) Department of Health Economics and Health Services
Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Dolata, Zastrow) Department of Patient and Care Management, University
Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Dumps) Anesthesiology and Operative Intensive Care, Faculty of Medicine,
University of Augsburg, Augsburg, Germany
(Lowe) Department of Psychosomatic Medicine and Psychotherapy, University
Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Nijman) Department of Physiotherapy and Occupational Therapy, University
Hospital Augsburg, Augsburg, Germany
(Ozga, Vettorazzi, Zapf) Institute of Medical Biometry and Epidemiology,
University Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Schulte-Uentrop) Department of Anesthesiology, Center of Anesthesiology
and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf,
Hamburg, Germany
(Klotz) Department of Physiotherapy, University Medical Center
Hamburg-Eppendorf, Hamburg, Germany
Abstract
OBJECTIVES: Enhanced recovery after surgery (ERAS) protocols are
patient-centered, interprofessional perioperative care models aimed at
reducing hospital stays, complications, healthcare costs, and improving
patient satisfaction. Evidence for ERAS in cardiac surgery is scarce;
therefore, we aimed to assess its efficacy and safety in minimally
invasive heart valve surgery (MIHS). METHOD(S): INCREASE is a
randomized-controlled trial that compares ERAS with standard care in MIHS.
The intervention group (IG) received ERAS-based treatment; the control
group (CG) standard care. Co-primary endpoints were in-hospital stay for
cardiovascular reasons within one year postoperatively (superiority
hypothesis) and physical performance (six-minute walk test (6MWT)) at
discharge (non-inferiority hypothesis). Superiority hypothesis was tested
primarily in surgically treated patients (modified intention to treat
population), while non-inferiority hypothesis was tested in per protocol
population. RESULT(S): In total, 201 patients scheduled for MIHS were
randomized (IG: 101; CG: 100). Total weighted in-hospital stay within one
year was non-significantly shorter in the IG (adjusted mean difference
-2.7 days, 95% confidence interval (CI) (-6.3, 0.9), one-sided p = 0.07).
Sensitivity analyses favoured the IG (adjusted ratio 0.71, 95%CI (0.6,
0.85)). For 6MWT, adjusted mean difference was -14%, 95%CI (-43%, 15%)
exceeding the non-inferiority margin of -15% (one-sided p = 0.48). Without
baseline adjustment, 6MWT values revealed a mean difference between groups
of -1%, 95%CI (-10%, 8%), reaching non-inferiority of the IG. Safety
outcomes were comparable with the exception of an unexpected higher rate
of post-operative atrial fibrillation in patients randomized to ERAS.
 CONCLUSION(S): ERAS is feasible and safe in MIHS. The trial did not
demonstrate a reduction in length of hospital stay in the population
studied. Exploratory analyses suggest that further evaluation of ERAS
concepts is justified. Copyright © The Author(s) 2026. Published
by Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<86>
Accession Number
2042904298
Title
Effects of Preoperative Stellate Ganglion Block on Postoperative Sore
Throat and Hoarseness in Patients Undergoing Double-Lumen Endobronchial
Intubation: Protocol for a Prospective Randomized Controlled Trial.
Source
Journal of Pain Research. 19 (pp 1-11), 2026. Date of Publication: 2026.
Author
Chen Z.; Tan Y.; Cong P.; Jin Y.; Li N.
Institution
(Chen, Cong) Department of Anesthesiology, The Second Qilu Hospital,
Cheeloo College of Medicine, Shandong University, 247 Bei Yuan Street,
Shandong, Jinan, China
(Chen, Tan, Li) Department of Anesthesiology and Perioperative Medicine,
Shandong Public Health Clinical Center, Shandong University, 2999 Gangxing
West Road, Shandong, Jinan, China
(Jin) Department of Epidemiology and Biostatistics, School of Public
Health, Wannan Medical College/ Institute of Chronic Disease Prevention
and Control, Wuhu, China
(Jin) Department of Anesthesiology and Perioperative Medicine, Shandong
Public Health Clinical Center, Shandong University, Shandong, Jinan, China
Publisher
Dove Medical Press Ltd
Abstract
Background: Postoperative sore throat (POST) is a common complication
after general anesthesia, especially following double-lumen endobronchial
tube (DLT) intubation in thoracic surgery, adversely affecting recovery.
Stellate ganglion block (SGB) modulates sympathetic tone and inflammation,
potentially reducing airway complications, but its efficacy for POST and
hoarseness after DLTs remains unclear. Objective(s): To evaluate the
impact of preoperative SGB on the incidence and severity of POST and
hoarseness in patients undergoing DLT intubation, and to explore its
effects on postoperative sleep, anxiety, depression, and hemodynamics.
 Method(s): In this single-center, prospective, randomized controlled
trial, 124 patients scheduled for thoracic surgery with left DLT
intubation are to be included. Patients will be randomly assigned in a 1:1
ratio to the SGB group or the control group. Patients in the SGB group
will receive ultrasound-guided right SGB (5 mL of 0.5% ropivacaine)
approximately 30 minutes before anesthesia induction. In the control
group, ultrasound-guided scanning of the stellate ganglion will be
conducted without performing SGB, and local lubrication with 1% tetracaine
gel will be administered prior to intubation. The primary outcome is the
incidence of POST at 6 hours after surgery. Discussion(s): This trial
will determine whether SGB can effectively reduce POST and hoarseness
after DLT intubation, potentially offering a multimodal strategy to
improve postoperative recovery in thoracic surgery patients. Clinical
Trial Registration: Chinese Clinical Trial Registry
(ChiCTR2400092313). Copyright © 2026 Chen et al.

<87>
Accession Number
650097621
Title
Postoperative Stress Accelerates Atherosclerosis Through Inflammatory
Remodeling of the HDL Proteome and Impaired Reverse Cholesterol Transport.
Source
Advanced science (Weinheim, Baden-Wurttemberg, Germany). (pp e11121),
2026. Date of Publication: 30 Jan 2026.
Author
Boucher D.M.; Lorant V.; Rochon V.; Carter A.; Stotts C.; Nguyen M.-A.;
Laval T.; Emerton C.; Joyce N.; Vinayak N.; Scaffidi M.; Cook D.; Rayner
K.J.; Auer R.C.; Gordon S.M.; Ouimet M.I.
Institution
(Boucher, Lorant, Rochon, Stotts, Nguyen, Laval, Joyce, Scaffidi, Rayner,
Auer, Ouimet) Department of Biochemistry, Microbiology and Immunology,
University of Ottawa, Ottawa, ON, Canada
(Boucher, Lorant, Rochon, Stotts, Nguyen, Laval, Emerton, Joyce, Vinayak,
Rayner, Ouimet) University of Ottawa Heart Institute, Ottawa, ON, Canada
(Carter, Gordon) Saha Cardiovascular Research Center and Department of
Physiology, University of Kentucky, Lexington, KY, United States
(Scaffidi, Cook, Auer) Cancer Therapeutics Program, Ottawa Hospital
Research Institute, Ottawa, ON, Canada
(Auer) Division of General Surgery, Department of Surgery, University of
Ottawa, Ottawa, ON, Canada
Abstract
Over 10 million patients undergoing non-cardiac surgery each year face
major cardiovascular complications within 30 days, many due to
destabilized atherosclerotic plaques. Reverse cholesterol transport (RCT),
driven by HDL and Apoa1, protects against plaque progression, but the
effects of surgical inflammation on this pathway remain unclear. Using an
abdominal laparotomy model in ApoE-/- mice on a Western diet, we isolated
the impact of surgical inflammation without confounding blood loss.
Surgery acutely impaired RCT and cholesterol efflux, with inflammatory
remodeling of HDL marked by elevated SAA1/2 and reduced Apoa1. Plaques
exhibited higher intracellular lipids, PLIN2 expression, and cleaved
caspase-3, indicating lipid-driven apoptosis. Both leukocytic and
non-leukocytic foam cells showed increased PLIN2, with apoptosis
concentrated in PLIN2hi cells. Using a novel dual-label, dual-cell-type in
vivo RCT model, we found that surgery significantly impaired macrophage
RCT while VSMC RCT remained largely unaffected, highlighting foam cell
subtype-specific vulnerability to surgical inflammation. These findings
were mirrored in general surgery patients, whose postoperative plasma
exhibited markedly reduced cholesterol efflux capacity. In mice, rh-APOA1
treatment partially restored RCT and reduced plaque lipid accumulation.
Surgical inflammation rapidly disrupts HDL function and RCT, promoting
foam cell apoptosis and plaque destabilization. Timely Apoa1 restoration
may help reduce postoperative cardiovascular risk. Copyright ©
2026 The Author(s). Advanced Science published by Wiley-VCH GmbH.

<88>
Accession Number
650101799
Title
Impact of Sternal Precautions on Clinical and Patient-Reported Outcomes in
Patients Undergoing Cardiac Surgery via Sternotomy: A SCOPING REVIEW.
Source
Journal of cardiopulmonary rehabilitation and prevention. (no
pagination), 2026. Date of Publication: 02 Feb 2026.
Author
Blakoe M.; Gottlieb R.; Hojskov I.E.; Olsen D.B.; Damgaard S.; Christensen
J.
Institution
(Blakoe, Hojskov) Department of Cardiology, Copenhagen University
Hospital, Rigshospitalet, Copenhagen, Denmark
(Blakoe) Department of Anaesthesia and Intensive Care, Bispebjerg and
Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
(Gottlieb, Christensen) Department of Occupational Therapy and
Physiotherapy, Copenhagen University Hospital, Rigshospitalet, Copenhagen,
Denmark
(Olsen, Damgaard) Department of Cardiothoracic Surgery, Copenhagen
University Hospital, Rigshospitalet, Copenhagen, Denmark
(Christensen) Department of Public Health, Section of Social Medicine,
Copenhagen University, Copenhagen, Denmark
Abstract
PURPOSE: Patients undergoing cardiac surgery via sternotomy are typically
advised to follow sternal precautions for 8 to 12 weeks post-operatively.
These precautions vary across surgical centers, and current
recommendations are primarily based on heterogeneous studies and expert
opinion. This scoping review aimed to map the impact of upper body
movement and sternal precaution strategies on clinical and
patient-reported outcomes within 1 year post-operatively in adult patients
undergoing cardiac surgery via sternotomy. REVIEW METHODS: The review was
reported based on the PRISMA-ScR (Systematic Reviews and Meta-Analyses
extension for Scoping Reviews) guidelines. Eligible studies included
randomized controlled trials; nonrandomized controlled trials;
quasi-experimental, prospective, and retrospective cohort studies; mixed
methods studies; case studies; case-control studies; and cross-sectional
studies. Studies were considered eligible if they included patients >=18
years undergoing cardiac surgery via sternotomy and examined the
relationship between sternal precautions or upper body movement strategies
within 12 weeks post-operatively and any clinical or patient-reported
outcomes within 1 year post-operatively. The systematic literature search
was conducted in March 2025 in 6 databases. SUMMARY: Of 16 464 unique
records screened, 12 studies involving 2853 patients were included. These
studies found that neither weighted upper body movement strategies nor
less restrictive sternal precautions negatively affect sternal wound
infections, sternal stability, pain, length of hospital stay,
readmissions, or health-related quality of life. Positive improvements
were found in functional status and discharge disposition in patients
following a less restrictive sternal regimen. The body of evidence
indicates that weighted upper body movement strategies and less
restrictive sternal precautions do not negatively affect the investigated
clinical or patient-reported outcomes post-sternotomy. Copyright
© 2026 Wolters Kluwer Health, Inc. All rights reserved.

<89>
Accession Number
650101412
Title
Hypoalbuminaemia contributes to postoperative pulmonary complications and
mortality: a systematic review and meta-analysis.
Source
BMC anesthesiology. (no pagination), 2026. Date of Publication: 30 Jan
2026.
Author
Wang X.; Tang H.; Zheng M.; Xu F.
Institution
(Wang, Tang, Zheng, Xu) Department of Critical Care Medicine, First
Affiliated Hospital of Chongqing Medical University, China
Abstract
OBJECTIVE: This review aimed to assess whether hypoalbuminaemia can
predict postoperative pulmonary complications (PPCs) and mortality in
patients receiving general anaesthesia for surgery. METHOD(S):
PubMed, Web of Science, EMBASE, and the Cochrane Library were searched for
relevant articles published up to 18 July 2024. Three authors
independently reviewed the studies and assessed the quality of related
articles via the Newcastle-Ottawa Scale. The data were recorded, and a
meta-analysis was performed using Review Manager version 5.4.1.
 RESULT(S): A total of 40 studies with 477,701 patients were included
in the meta-analysis. Adjusted data were pooled to calculate the odds
ratio (OR). A sensitivity test was conducted. A meta-analysis of 18
studies demonstrated that hypoalbuminaemia was a significant predictor of
PPCs and mortality after general anaesthesia (OR: 2.88, 95% CI 2.50 to
3.32, P < 0.01, I2 = 90%). The 40 studies were divided into 4 groups based
on surgical site: the orthopaedic surgery group (OR: 4.03, 95% CI 3.49 to
4.64, P < 0.01, I2 = 43%), the thoracic surgery group (OR: 1.82, 95% CI
1.46 to 2.26, P < 0.01, I2 = 23%), the abdominal surgery group (OR: 2.48,
95% CI 1.81 to 3.40, P < 0.01, I2 = 95%) and the other surgery group (OR:
2.34, 95% CI 1.66 to 3.29, P < 0.01, I2 = 87%). In addition, patients with
hypoalbuminaemia had increased mortality (OR: 4.31, 95% CI 4.124.51, P, I2
= 68%). CONCLUSION(S): Preoperative hypoalbuminaemia is significantly
associated with postoperative pulmonary complications and has different
correlation coefficients in different types of surgeries. TRIAL
REGISTRATION: This systematic review and meta-analysis was registered at
the International Prospective Register of Systematic Reviews (Number
CRD42024540493). Copyright © 2025. The Author(s).

<90>
Accession Number
2042947683
Title
Comparative Effectiveness of Single-Dose Epidural Esketamine versus
Hydromorphone in Thoracic and Upper Abdominal Surgery: A Randomized Trial.
Source
Drug Design, Development and Therapy. 20 (pp 1-10), 2026. Date of
Publication: 2026.
Author
Song Y.; Wang C.; Huang N.; He H.; Hong W.; Wu J.; Yao M.; Miao C.; Liang
C.
Institution
(Song, Wang, Huang, He, Hong, Wu, Yao, Miao, Liang) Department of
Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: This study aimed to evaluate the effectiveness of a single
epidural dose of esketamine versus hydromorphone in patients undergoing
abdominal and thoracic surgeries. Patients and Methods: Patients
undergoing elective abdominal and thoracic surgery were randomly assigned
to receive either a single epidural injection of 15 mg esketamine (Group
E) or 0.5 mg hydromorphone (Group H) at the end of surgery. All patients
received intravenous patient-controlled analgesia postoperatively. The
primary outcome was hydromorphone consumption within 48 hours after
surgery. Secondary outcomes included time to first rescue analgesia,
hydromorphone consumption within 0-24, 24-48, and 48-72 hours, numerical
rating scale (NRS) pain scores, postoperative recovery scores, and
complications. Result(s): In total, 205 patients were enrolled, with
186 randomly assigned to either group E (n = 93) or group H (n = 93).
Hydromorphone consumption within 48 hours postoperatively was
significantly higher in group E than in group H. The time to first rescue
analgesia was significantly longer in group H compared to group E. Within
the first 24 hours postoperatively, patients in group E required more
hydromorphone than those in group H. No significant difference in
hydromorphone consumption between the two groups at 24-48 and 48-72 hours
postoperatively. The NRS scores during movement were significantly higher
in group E than in group H at 3 and 6 hours postoperatively.
 Conclusion(s): Single-dose epidural esketamine for postoperative
analgesia resulted in higher hydromorphone consumption and a shorter time
to first rescue analgesia compared to hydromorphone. Copyright ©
2026 Song et al.

<91>
Accession Number
2042960981
Title
Collaborative neurocardiology board meetings for decision-making in stroke
care: a real-world experience.
Source
Neurological Research and Practice. 8(1) (no pagination), 2026. Article
Number: 4. Date of Publication: 01 Dec 2026.
Author
Mafael V.; Buck T.; Stengl H.; Hellwig S.; Klammer M.G.; Endres M.;
Reinthaler M.; Barbieri F.; Audebert H.J.; Leistner D.M.; Landmesser U.;
Dohner W.; Skurk C.; Scheitz J.F.
Institution
(Mafael, Buck, Stengl, Hellwig, Klammer, Endres, Audebert, Scheitz)
Department of Neurology, Charite-Universitatsmedizin Berlin,
Hindenburgdamm 30, Berlin, Germany
(Stengl, Hellwig, Klammer, Endres, Barbieri, Audebert, Dohner, Scheitz)
Center for Stroke Research Berlin (CSB), Charite-Universitatsmedizin
Berlin, Berlin, Germany
(Endres, Landmesser, Scheitz) German Centre for Cardiovascular Research
(DZHK), partner site Berlin, Berlin, Germany
(Reinthaler, Barbieri, Landmesser, Dohner, Skurk) Department of
Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum
der Charite, Charite - Universitatsmedizin Berlin (DHZC), Berlin, Germany
(Leistner) Department of Cardiology, Universitares Herz- und Gefaszentrum
Frankfurt, Universitatsmedizin Frankfurt, Frankfurt am Main, Germany
(Dohner) German Centre for Cardiovascular Research (DZHK), partner site
Rhein/Main, Frankfurt am Main, Germany
(Dohner) Institute of Active Polymers, Center for Regenerative Therapies,
Helmholtz- Zentrum Hereon, Teltow, Germany
(Endres) German Center for Neurodegenerative Diseases (DZNE), partner site
Berlin, Berlin, Germany
(Endres) German Center for Mental Health (DZPG), partner site Berlin,
Berlin, Germany
Publisher
BioMed Central Ltd
Abstract
Background: Interdisciplinary collaboration between neurologists and
cardiologists is needed to provide state-of-the art stroke care and
individualized decisions about secondary prevention strategies. This
highlights the need to establish working structures for joint
decision-making between cardiologists and stroke neurologists. At present,
studies describing the real-world decision-making as part of such
brain-heart teams are scarce. Method(s): We established a structured
heart-brain team approach with monthly virtual neurocardiology board (NCB)
meetings within a neurovascular network. We conducted a retrospective
analysis of the implementation phase of NCB meetings between 2021 and
2024. We describe the structure of board meetings, patient characteristics
and therapeutic and diagnostic recommendations. Result(s): During the
study period, 46 board meetings were held, and 255 patients were
discussed. The number of referred patients increased from 32 in 2021 to 89
in 2024. The majority of patients were evaluated for patent foramen ovale
(PFO) closure (n = 189, 74.1%, median age 56 years, 59.8% female) and left
atrial appendage occlusion (LAAO) (n = 32, 12.5%, median age 83 years, 50%
female). Further questions centered around other individual secondary
prevention strategies. Among patients referred to discuss PFO closure,
closure was not recommended in 43.4% of patients (n = 82), recommended
depending on additional diagnostic measures in 13.8% (n = 26), considered
optional in 19.6% (n = 37) and clrearly recommended in 23.3% (n = 44).
Patients for whom it was not recommended were older, had more
cardiovascular risk factors and were less likely to have a large PFO
shunt. The main reason for the recommendation against closure was that the
PFO was not considered causal for the stroke (80.5%). Among LAAO patients,
participation in a randomized controlled trial was recommended in 68.8%.
 Conclusion(s): We successfully established and steadily expanded
regular NCB meetings to provide a platform for interdisciplinary exchange
and personalized stroke treatment, in particular discussion of indications
for interventional procedures against cardiac embolism. Our approach may
serve as a blueprint for similar collaborative approaches. Future studies
are needed to assess adherence to recommendations and patient outcomes as
this study lacks follow-up data. Copyright © The Author(s) 2026.

<92>
Accession Number
2042706576
Title
Effect of single-injection thoracic paravertebral block with liposomal
bupivacaine on the quality of recovery after thoracic surgery: a protocol
for an open-label, randomized controlled trial.
Source
Frontiers in Medicine. 12 (no pagination), 2026. Article Number: 1734331.
Date of Publication: 2026.
Author
Ma W.; Wang L.; Zhang H.; Zou M.; Feng S.; Liu Y.; Wang P.
Institution
(Ma, Wang, Zhang, Zou, Feng, Liu, Wang) Department of Anesthesiology, The
Affiliated Hospital of Qingdao University, Qingdao, China
(Ma, Feng) Department of Clinical Medicine, Qingdao University, Shandong,
Qingdao, China
Publisher
Frontiers Media SA
Abstract
Background: Postoperative pain management plays a crucial role in
determining the quality of recovery following thoracic surgery. However,
achieving high-quality postoperative analgesia that facilitates
satisfactory recovery remains challenging due to suboptimal pain control
and side effects associated with conventional analgesic strategies. This
study aims to evaluate the effect of single-injection thoracic
paravertebral block with liposomal bupivacaine on the overall quality of
recovery in patients undergoing thoracic surgery. Method(s): This
single-center, open-label, randomized controlled trial will enroll 162
patients scheduled for video-assisted thoracic surgery. Participants will
be randomly allocated in a 1:1:1 ratio to three groups (n = 54 each):
Group L will receive ultrasound-guided thoracic paravertebral block with
liposomal bupivacaine; Group R will receive ropivacaine-based
paravertebral block combined with opioid-based patient-controlled
intravenous analgesia; and Group P will receive opioid-based
patient-controlled intravenous analgesia alone. The primary outcome is the
quality of recovery assessed by patient-reported Quality of Recovery-15
scores on postoperative days 1-3. Between-group differences will be
analyzed using generalized estimating equations. Secondary outcomes
include: pain-free interval; resting and cough-induced pain intensity at
6, 12, 24, 48, and 72 h; worst pain scores at 24, 48, and 72 h;
perioperative opioid use; time to first rescue analgesia and times of
request; patient confidence in coughing and ambulation; anxiety and sleep
quality at 24, 48, and 72 h; patient satisfaction; postoperative nausea
and vomiting incidence/severity and rescue antiemetic use. Safety outcomes
comprise block-related complications and postoperative complications. All
adverse events will be documented throughout the study.
 Discussion(s): This study aims to provide high-quality evidence on
the efficacy of a single-injection thoracic paravertebral block with
liposomal bupivacaine for post-thoracic surgery analgesia, compared with
opioid-based intravenous analgesia alone and the combination of
ropivacaine paravertebral block with systemic opioid analgesia. Clinical
trial registration: Identifier: ChiCTR2500107787. Copyright ©
2026 Ma, Wang, Zhang, Zou, Feng, Liu and Wang.

<93>
Accession Number
2042800156
Title
Effects of erythropoietin administration on allogeneic blood transfusion
requirements in adults undergoing surgery: a systematic review and
meta-analysis.
Source
Frontiers in Medicine. 12 (no pagination), 2026. Article Number: 1712121.
Date of Publication: 2026.
Author
Chen J.; Liu B.; Cao H.; Tian T.; He J.
Institution
(Chen, Cao, Tian, He) Department of Laboratory Medicine, Chongqing
Jiangjin District Second People's Hospital, Chongqing, China
(Liu) Department of Urology, Chongqing Jiangjin District Second People's
Hospital, Chongqing, China
Publisher
Frontiers Media SA
Abstract
Background: Erythropoietin is commonly integrated into blood management
strategies for surgical patients, yet its administration may lead to
adverse outcomes. This systematic review and meta-analysis assesses the
impact of erythropoietin administration on perioperative transfusion
requirements and adverse events. Method(s): A comprehensive search
across four databases was conducted from inception to 30 July 2025 to
identify randomized controlled trials involving adult surgical patients.
The methodological quality of the included studies was evaluated using the
Cochrane Risk of Bias Assessment Tool. The outcome measures included
transfusion rates, volume of allogeneic red blood cell transfusions per
patient unit, mortality rates, postoperative infection rates,
transfusion-related complications, venous thromboembolism rates, and
length of hospital stay. Effect sizes were reported using relative risk
(RR) and standardized mean difference (SMD). We used GRADE to assess the
quality of evidence for each outcome. Result(s): Preoperative
erythropoietin administration reduces transfusion rates (RR = 0.63, 95% CI
= 0.53-0.75, p = 0.000) and mean transfusion volumes (SMD = -0.33, 95% CI
= -0.42 to -0.24, p = 0.000) in surgical patients. No significant impact
was observed on mortality, postoperative infection incidence,
postoperative complications, adverse reactions, venous thromboembolic
events, and length of hospital stay. Subgroup analyses showed significant
reductions in transfusion rates for cardiac surgery, orthopedic surgery,
gastrointestinal surgery, gynecological abdominal surgery, and other types
of surgery. Conclusion(s): The available evidence supports the
efficacy of preoperative human erythropoietin administration in reducing
transfusion requirements and the average number of transfusion units in
adult surgical patients. No significant differences were observed in
postoperative mortality, complication rate, adverse event rate, venous
thromboembolic events (including deep vein thrombosis and pulmonary
embolism), and hospital stay after preoperative administration of
erythropoietin. Copyright © 2026 Chen, Liu, Cao, Tian and He.

<94>
Accession Number
2042950528
Title
Autologous atrial appendage micrografts transplanted during coronary
artery bypass surgery: design of the AAMS2 randomized, double-blinded, and
placebo-controlled trial.
Source
Trials. 27(1) (no pagination), 2026. Article Number: 97. Date of
Publication: 01 Dec 2026.
Author
Sikorski V.; Nummi A.; Kuuva A.; Wilkman E.; Rajala H.; Stewart J.;
Junttila J.; Lindgren K.; Kervinen K.; Teittinen K.; Kohonen K.; Oksaharju
K.; Okkonen M.; Holmstrom M.; Lehtinen M.; Mulari S.; Taskinen P.; Simonen
P.; Karvonen P.; Kastell P.; Karja-Koskenkari P.; Kandolin R.; Kesavuori
R.; Kaarlenkaski S.; Vaara S.; Dahlbacka S.; Syrjala S.; Syvaranta S.;
Juvonen T.; Erkinaro T.; Makela T.; Karjalainen P.; Kankuri E.; Vento A.;
Nykanen A.
Institution
(Sikorski, Mulari, Kankuri) Faculty of Medicine, Department of
Pharmacology, University of Helsinki, Helsinki, Finland
(Nummi, Teittinen, Kohonen, Oksaharju, Lehtinen, Mulari, Dahlbacka,
Syrjala, Juvonen, Vento, Nykanen) Department of Cardiothoracic Surgery,
Heart and Lung Center, Helsinki University Hospital and University of
Helsinki, P.O. Box 340, Haartmaninkatu 4, Helsinki, Finland
(Kuuva) EpiHeart Oy, Helsinki, Finland
(Wilkman) Department of Anesthesiology, Intensive Care and Pain Medicine,
University of Helsinki and Helsinki University Hospital, Helsinki, Finland
(Rajala, Stewart, Simonen, Kandolin, Karjalainen) Division of Cardiology,
Heart and Lung Center, Helsinki University Hospital and University of
Helsinki, Helsinki, Finland
(Junttila, Lindgren, Karja-Koskenkari) Division of Cardiology, Department
of Internal Medicine, Oulu University Hospital, Oulu, Finland
(Kervinen) Heart Unit, Oulu University Hospital, Oulu, Finland
(Okkonen, Karvonen, Kastell, Kaarlenkaski) Research Unit of Internal
Medicine, Medical Research Center Oulu, University of Oulu and University
Hospital of Oulu, Oulu, Finland
(Holmstrom, Kesavuori, Vaara, Syvaranta) Radiology, HUS Diagnostic Center,
University of Helsinki and Helsinki University Hospital, Helsinki, Finland
(Taskinen) Department of Cardiothoracic Surgery, Oulu University Hospital,
University of Oulu, Oulu, Finland
(Erkinaro) Research Group of Anesthesiology, Medical Research Center Oulu,
Oulu University Hospital and University of Oulu, Oulu, Finland
(Makela) Anesthesia and Intensive Care, Research Unit of Surgery,
University of Oulu and Medical Research Center, Oulu, Finland
Publisher
BioMed Central Ltd
Abstract
Background: The AAMS open-label clinical study demonstrated the safety and
feasibility of epicardial transplantation of autologous right atrial
appendage micrografts (AAMs) during coronary artery bypass grafting (CABG)
surgery. The study also provided the first indications of therapeutic
efficacy of the AAMs, as delivered within an extracellular matrix patch,
to reduce ischemic scar and increase viable ventricular wall thickness. To
further evaluate the initial beneficial effects observed in the AAMS
study, we designed the randomized, double-blinded, and placebo-controlled
AAMS2 trial. Focusing on patients with ischemic heart disease (IHD) and
myocardial scar, the AAMS2 trial aims to generate state-of-the-art
structural and functional imaging data of the myocardium treated with an
AAMs-patch during CABG. Method(s): The AAMS2 trial recruits IHD
patients who are set to undergo non-urgent CABG and present with an
ischemic myocardial scar in preoperative cardiac magnetic resonance
imaging (CMRI) with late gadolinium enhancement. Patients are randomized
(1:1) to receive a collagen-based matrix patch (Hemopatch), with or
without AAMs, epicardially onto the scar border. The primary endpoint,
assessed by CMRI preoperatively and at 6 months post-operative follow-up,
focuses on the left ventricle scar mass. The secondary endpoints center on
the change in scar mass by the AAMs-patch site and evaluation of therapy
safety and feasibility as well as its effects on myocardial structure and
function by echocardiography. Change in blood N-terminal-pro-BNP levels in
the timeframe is the co-primary endpoint. Discussion(s): Data from
the AAMS2 trial provides the first randomized, blinded, and
placebo-controlled evaluation of efficacy on epicardial AAMs
transplantation for ischemic myocardial scar. This data will pave the road
towards rational design of larger AAMs therapeutic efficacy-addressing
trial(s). Trial registration: ClinicalTrials.gov, NCT05632432, registered
30 November 2022,
https://clinicaltrials.gov/study/NCT05632432. Copyright © The
Author(s) 2026.

<95>
Accession Number
2042931235
Title
Epidural Anesthesia as a Protective Factor in Cardiac Surgery: A
Prospective Randomized Study.
Source
Anesthesiology Research and Practice. 2026(1) (no pagination), 2026.
Article Number: 1869099. Date of Publication: 2026.
Author
Sanchez D.N.; Diez E.R.; Renna N.F.
Institution
(Sanchez) Head of Anesthesiology Service, Hospital Central de Mendoza,
Mendoza, Argentina
(Sanchez) Department of Surgery, School of Medicine, UNCuyo, Mendoza,
Argentina
(Diez) Area of Physiology, Department of Scientific Foundations in Health,
School of Medicine, UNCuyo, IMBECU-CONICET, Mendoza, Argentina
(Renna) Area of Pathological Physiology, Department of Scientific
Foundations in Health, School of Medicine, UNCuyo, IMBECU-CONICET,
Mendoza, Argentina
(Renna) Department of Cardiology, Hospital Espanol de Mendoza, Mendoza,
Argentina
Publisher
John Wiley and Sons Ltd
Abstract
Background: Epidural anesthesia (EA) has gained prominence in rapid
postoperative recovery protocols for cardiac surgery, aiming to reduce
opioid use, shorten intensive care stays, and improve patient outcomes.
This prospective randomized controlled trial evaluated the protective
effects of EA combined with general anesthesia (GA + EA) compared to GA
alone in patients undergoing off-pump coronary artery bypass grafting
(CABG). Method(s): Sixty male patients undergoing elective off-pump
CABG were randomized into two groups: GA (n = 30) and GA + EA (n = 30).
Surgical procedures were standardized using bilateral internal mammary
arteries skeletonized with an ultrasonic scalpel. Patients in the GA + EA
group received thoracic EA at the T2-T3 level, confirmed radiologically,
with continuous bupivacaine infusion. Result(s): Significant benefits
were observed in the GA + EA group, including shorter mechanical
ventilation duration (4.59 vs. 5.72 h; p = 0.011) and reduced hospital
stay (5.43 vs. 6.73 days; p = 0.001). Internal mammary artery blood flow
measurements were significantly higher in the GA + EA group (p < 0.001).
Plasma aldosterone levels were significantly lower in GA + EA patients,
indicating reduced stress-induced hormonal responses (left artery: 13.38
vs. 17.68 ng/dL, p = 0.005; right artery: 12.77 vs. 18.37 ng/dL, p =
0.003). Long-term outcomes demonstrated superior major adverse
cardiovascular event (MACE)-free survival in the GA + EA group (p <
0.001). Cox regression analysis confirmed that GA + EA independently
reduced cardiovascular risk, even after adjusting for age, ejection
fraction, and dopamine levels (HR = 0.0118, p < 0.001). Higher aldosterone
levels significantly correlated with increased MACE risk (p < 0.05).
 Conclusion(s): The study highlights aldosterone suppression as a
potential mechanism underlying EA's cardioprotective effects, emphasizing
its role in enhancing recovery and reducing cardiovascular complications.
Despite limitations such as small sample size and single-center design,
findings strongly support integrating EA into cardiac surgical
practice. Copyright © 2026 Diego Nicolas Sanchez et al.
Anesthesiology Research and Practice published by John Wiley & Sons Ltd.

<96>
Accession Number
650091068
Title
Does Language Matter? The Impact of English Proficiency on Healthcare
Outcomes After Cardiac Surgery: A Scoping Review.
Source
Anesthesia and analgesia. (no pagination), 2026. Date of Publication: 29
Jan 2026.
Author
Rios-Monterrosa J.; Castro S.; Aguiar C.; Tanvir A.; Woodward A.; Sun
L.Y.; Milam A.J.
Institution
(Rios-Monterrosa, Castro, Sun) From the Department of Anesthesiology and
Perioperative Medicine, Stanford University School of Medicine, Stanford,
CA, United States
(Aguiar) Department of Clinical Science, California Northstate University
College of Medicine, Elk Grove, CA, United States
(Tanvir) Department of Anesthesiology, Mayo Hospital, Lahore, Pakistan
(Woodward) Lane Medical Library, Stanford University School of Medicine,
Stanford, CA, United States
(Milam) Department of Anesthesiology and Perioperative Medicine, Mayo
Clinic, Phoenix, AZ, United States
Abstract
Health care disparities, particularly among minoritized groups, pose
significant challenges within health care systems, including the field of
cardiac surgery. Limited English proficiency (LEP) is an often-overlooked
factor contributing to these disparities. As key members of the
preoperative evaluation, intraoperative management, and postoperative care
of cardiac surgery patients, anesthesiologists have both ethical and
economic responsibilities to understand, recognize, and address
disparities to ensure equitable care for all patients. The objective of
this scoping review is to summarize the literature on how LEP impacts the
utilization of health services and outcomes after cardiac surgery. More
specifically, the review will map how LEP is defined in the literature,
summarize the patient populations that have been studied, and describe the
health care outcomes in patients with LEP after cardiac surgery. A
comprehensive literature search strategy was developed in collaboration
with a medical librarian and was registered before conducting the search.
Studies were eligible for inclusion in our current study if (i) the
patient population was composed of adults (>or = 18), (ii) the study
reported health care outcomes before or after cardiac surgery, and (iii)
results were stratified by a patient's English proficiency. All randomized
control trials, systematic reviews, observational studies, and
cross-sectional studies published in English were included in our study.
If conference abstracts met the inclusion criteria, they were included for
full-text review. Opinion articles and case reports were excluded. The
search produced 2401 articles with 13 articles meeting the inclusion
criteria. All studies were conducted in either North America or
Australia/New Zealand. The number of patients included in each study
ranged from 204 to 21,789, with 4 studies having less than 1500 patients
and 2 studies having greater than 10,000 patients. Through a systematic
review of the literature on this topic, we identified 3 overarching themes
that were inferred from the collective body of studies. First, a
significant barrier to studying this topic is the absence of a universal
definition of LEP. Second, the heterogeneity in several aspects of the
available studies makes it difficult to draw conclusions from the results.
Finally, there is a general scarcity of research done on the impact of LEP
on cardiac surgery outcomes. Ultimately, our scoping review reveals an
area of health disparity research that requires more attention. If
disparities are found, then health care leaders may begin investigating
which interventions can help mitigate these disparities. Copyright
© 2026 International Anesthesia Research Society.

<97>
Accession Number
650095994
Title
Per-Protocol Analysis of Chlorthalidone Versus Hydrochlorothiazide for
Cardiovascular Event Prevention-Diuretic Comparison Project.
Source
Journal of the American Heart Association. (pp e046142), 2026. Date of
Publication: 30 Jan 2026.
Author
Anand S.T.; Hau C.; Davenport M.J.; Ishani A.; Cushman W.C.; Glassman
P.A.; Taylor A.A.; Lew R.A.; Ferguson R.E.; Leatherman S.M.
Institution
(Anand, Hau, Davenport, Lew, Ferguson, Leatherman) Cooperative Studies
Program Coordinating Center, VA Boston Healthcare System Boston MA
(Ishani) Minneapolis VA Healthcare System Minneapolis MN
(Ishani) Department of Medicine University of Minnesota MN
(Cushman) Medical Service, Memphis VA Medical Center Memphis TN
(Cushman) Department of Preventive Medicine University of Tennessee Health
Science Center Memphis TN
(Glassman) Pharmacy Benefits Management Services, Department of Veterans
Affairs Washington DC
(Glassman) VA Greater Los Angeles Healthcare System Los Angeles CA
(Glassman) David Geffen School of Medicine at UCLA Los Angeles CA
(Taylor) Michael E. DeBakey VA Medical Center Houston TX
(Taylor) Department of Medicine Baylor College of Medicine Houston TX
(Lew, Leatherman) Department of Biostatistics Boston University School of
Public Health Boston MA
(Ferguson, Leatherman) Department of Medicine Boston University Chobanian
and Avedisian School of Medicine Boston MA
Abstract
BACKGROUND: The DCP (Diuretic Comparison Project), a pragmatic trial,
evaluated whether chlorthalidone compared with hydrochlorothiazide would
reduce the risk of nonfatal cardiovascular disease or noncancer-related
death. The intent-to-treat analysis found no difference in such comparison
(hazard ratio, 1.04 [95% CI, 0.94-1.16]). The objective of the current
study is to estimate the per-protocol effect of chlorthalidone (12.5/25 mg
daily) compared with hydrochlorothiazide (25/50 mg daily) in preventing
major adverse cardiovascular events among older patients with
hypertension. METHOD(S): The effect of adhering to treatment
strategies was assessed by censoring at first instance of nonadherence,
defined as a gap (>90-day gap in drug coverage), switch (switching between
study medications), and discontinuation (stop taking
chlorthalidone/hydrochlorothiazide altogether for >90 days before the end
of the study). The primary outcome was a composite of nonfatal myocardial
infarction, stroke, heart failure resulting in hospitalization, urgent
coronary revascularization for unstable angina, and noncancer-related
death. Using inverse probability weighting, we evaluated the per-protocol
effect of chlorthalidone and hydrochlorothiazide using DCP trial data.
 RESULT(S): Nonadherence was found in 5476 (40%) participants; among
8047 (60%) adherents, 3905 (49%) were randomized to chlorthalidone and
4142 (51%) to hydrochlorothiazide. After censoring time when participants
deviated from the assigned treatments, the estimated 5-year risk ratio of
the composite primary outcome of nonfatal cardiovascular disease and
noncancer-related death was 1.36 (95% CI, 0.96-2.12) in chlorthalidone
compared with hydrochlorothiazide. CONCLUSION(S): The per-protocol
analysis indicated a lower risk with hydrochlorothiazide compared with
chlorthalidone in preventing nonfatal cardiovascular disease and
noncancer-related death; however, this difference was not statistically
significant using dispensation data to identify adherence. REGISTRATION:
URL: https://www.clinicaltrials.gov; Unique identifier: NCT02185417.

<98>
Accession Number
2042833775
Title
Technology-Enabled (P)rehabilitation for Patients Undergoing Cancer
Surgery: A Systematic Review and Meta-Analysis.
Source
Cancers. 18(2) (no pagination), 2026. Article Number: 296. Date of
Publication: 01 Jan 2026.
Author
Tsoukalas T.R.; Bai Z.; Jeon C.; Huynh R.; Gu E.; Alexander K.; Beckenkamp
P.R.; Boscolo A.; Brown K.; Butow P.; Carey S.; Chen F.; Cummins M.;
Dhillon H.M.; Dragoje V.; Gorman K.; Halpin M.; Haynes A.; Juraskova I.;
Karunaratne S.; Keck J.; Kim B.; Koh C.; Li Q.; Lipton L.; Liu X.; Macedo
J.; Mercieca-Bebber R.; Moreton R.; Morton R.L.; Redfern J.; Riedel B.;
Ritchie A.; Sandroussi C.; Slattery C.; Smith A.B.; Solomon M.; Tao F.;
White K.; Wilson K.; Wolsley K.; Yu K.; Steffens D.
Institution
(Tsoukalas, Bai, Alexander, Brown, Carey, Karunaratne, Koh, Redfern,
Sandroussi, Solomon, White, Wilson, Steffens) Faculty of Medicine and
Health, Central Clinical School, The University of Sydney, Sydney, NSW,
Australia
(Tsoukalas, Bai, Jeon, Huynh, Gu, Alexander, Brown, Carey, Karunaratne,
Koh, Sandroussi, Solomon, White, Wilson, Steffens) Surgical Outcomes
Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown,
Sydney, NSW, Australia
(Beckenkamp) Sydney School of Health Sciences, Faculty of Medicine and
Health, The University of Sydney, Sydney, NSW, Australia
(Boscolo, Halpin, Moreton, Tao) Sydney Local Health District, Sydney, NSW,
Australia
(Brown, Carey, Koh, Sandroussi, Solomon, Wilson, Steffens) Institute of
Academic Surgery (IAS), Royal Prince Alfred Hospital, Sydney, NSW,
Australia
(Brown, Koh, Solomon) Department of Colorectal Surgery, Royal Prince
Alfred Hospital, Sydney, NSW, Australia
(Butow, Juraskova) Centre for Medical Psychology and Evidence-Based
Decision-Making (CeMPED), School of Psychology, Faculty of Science, The
University of Sydney, Sydney, NSW, Australia
(Butow, Dhillon, Juraskova) Psycho-Oncology Cooperative Research Group,
School of Psychology, Faculty of Science, The University of Sydney,
Sydney, NSW, Australia
(Butow, Juraskova) School of Psychology, The University of Sydney, Sydney,
NSW, Australia
(Chen, Yu) The Data Science Institute, University of Technology Sydney,
Sydney, NSW, Australia
(Cummins, Wolsley) NeuroEndocrine Cancer Australia, Blairgowrie, VIC,
Australia
(Dragoje) Sydney Health Care Interpreter Service, Sydney Local Health
District, Sydney, NSW, Australia
(Gorman) Bowel Cancer Australia, Sydney, NSW, Australia
(Haynes) Institute for Musculoskeletal Health, Sydney Local Health
District, Sydney, NSW, Australia
(Haynes) School of Public Health, Faculty of Medicine and Health, The
University of Sydney, Sydney, NSW, Australia
(Keck) Department of Colorectal Surgery, St Vincent's Private Hospital,
Fitzroy, VIC, Australia
(Kim, Smith) The Daffodil Centre, The University of Sydney and Cancer
Council NSW, Sydney, NSW, Australia
(Li, Liu) The George Institute for Global Health, University of New South
Wales, Sydney, NSW, Australia
(Lipton) Cabrini Health, Malvern, VIC, Australia
(Macedo, Slattery) Rare Cancers Australia, Bowral, NSW, Australia
(Mercieca-Bebber, Morton) NHMRC Clinical Trials Centre, The University of
Sydney, Sydney, NSW, Australia
(Redfern) Institute for Evidence-Based Healthcare, Bond University,
Robina, QLD, Australia
(Riedel) Department of Anaesthesia, Perioperative Medicine, and Pain
Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
(Riedel) The Sir Peter MacCallum Department of Oncology, The University of
Melbourne, Melbourne, VIC, Australia
(Riedel) The Department of Critical Care, Critical Care, The University of
Melbourne, Parkville, VIC, Australia
(Ritchie) Health Informatics Unit, Sydney Local Health District,
Camperdown, NSW, Australia
(Ritchie) Concord Clinical School, Faculty of Medicine and Health, The
University of Sydney, Sydney, NSW, Australia
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: (P)rehabilitation, comprising structured exercise,
nutritional optimisation, and/or psychological support delivered pre- or
postoperatively, has demonstrated efficacy in improving outcomes across
the cancer care continuum. However, access remains limited.
Technology-enabled (p)rehabilitation offers a novel solution with the
potential to enhance equity and continuity of care. This systematic review
aimed to evaluate the efficacy of technology-enabled (p)rehabilitation on
perioperative and patient-reported outcomes among individuals undergoing
thoracic and/or abdominopelvic cancer surgery. Method(s): Six
databases were search from inception to October 2024. Eligible studies
were randomised controlled trials (RCTs) comparing technology-enabled
(p)rehabilitation with usual care, placebo, or non-technology-based
interventions in adults undergoing thoracic and/or abdominopelvic cancer
surgery. Outcomes included postoperative complications, hospital
readmissions, hospital length of stay (LOS), quality of life (QoL), pain,
anxiety, depression, fatigue, distress, and satisfaction. Higher scores
indicated improved QoL or worse symptom severity. Risk of bias was
assessed using the revised Cochrane tool, and evidence strength was
determined using GRADE methodology. Relative risks (RR) and mean
differences (MD) were calculated using random-effects meta-analysis.
 Result(s): Seventeen RCTs (18 publications, n = 1690) were included.
Trials most commonly evaluated application-based platforms (n = 8) and the
majority exhibited some risk of bias. Technology-enabled (p)rehabilitation
was associated with a significant reduction in LOS (MD = 1.33 days; 95%
CI: 0.59-2.07; seven trials), and improvements in pain (MD = 6.12; 95% CI:
3.40-8.84; four trials), depression (MD = 2.82; 95% CI: 0.65-4.99; five
trials), fatigue (MD = 10.10; 95% CI: 6.97-13.23; three trials) and
distress (MD = 1.23; 95% CI: 0.30-2.16; single trial) compared with
controls. Conclusion(s): Technology-enabled (p)rehabilitation shows
promise in reducing LOS and improving selected patient-reported outcomes
following thoracic and abdominopelvic cancer surgery. Although evidence is
limited due to the small number of studies, modest sample sizes,
methodological heterogeneity, and intervention variability, the overall
findings justify further investigation. Large-scale, adequately powered
clinical trials are required to confirm efficacy and guide clinical
effectiveness and implementation studies. Copyright © 2026 by the
authors.

<99>
Accession Number
2043229537
Title
Femoral versus radial arterial pressure monitoring in cardiac surgery
patients: protocol for a randomised controlled multicentric superiority
trial (FERARI).
Source
BMJ Open. 16(1) (no pagination), 2026. Article Number: e111663. Date of
Publication: 28 Jan 2026.
Author
Guinot P.-G.; Bronnert R.; Grelet T.; Bouhemad B.; Nguyen M.; Besch G.
Institution
(Guinot, Bouhemad, Nguyen) Department of Anesthesiology and Intensive
Care, University Hospital Centre Dijon Bourgogne Francois Mitterrand
Hospital, Dijon, France
(Guinot, Bouhemad, Nguyen) University of Burgundy Europe, Dijon, France
(Guinot, Bouhemad, Nguyen) Center for Translational and molecular Medicine
(CTM), Lipness Team, UMR1231, Dijon, France
(Bronnert, Besch) Universite Marie et Louis Pasteur, SINERGIES (EA 4662),
Besancon, France
(Bronnert, Besch) CHU de Besancon, Departement d'Anesthesie Reanimation
Chirurgicale, Besancon, France
(Bronnert, Besch) Inserm CIC 1431, Besancon, France
(Grelet) Universite Marie et Louis Pasteur, Besancon, France
Publisher
BMJ Publishing Group
Abstract
Background Accurate arterial pressure monitoring is critical in cardiac
surgery to guide haemodynamic management and vasopressor therapy. Radial
arterial pressure monitoring may systematically underestimate central
aortic pressure compared with femoral monitoring, potentially leading to
inappropriate vasopressor escalation and associated complications. Recent
evidence demonstrates that excessive norepinephrine exposure is associated
with acute kidney injury and increased mortality in cardiac surgery
patients. Objective To determine whether femoral arterial pressure
monitoring reduces norepinephrine use compared with radial monitoring in
cardiac surgery patients. Methods and analysis This is a prospective,
randomised, controlled, single-blind, superiority trial conducted at two
French university hospitals (CHU Besancon and CHU Dijon). Adult patients
undergoing cardiac surgery with cardiopulmonary bypass will be randomised
1:1 to receive either femoral or radial arterial pressure monitoring. The
primary endpoint is the proportion of patients treated with norepinephrine
from anaesthetic induction to postoperative day 7. Secondary endpoints
include acute kidney injury according to KDIGO criteria, cardiac
complications, vasoactive-inotropic scores, duration of vasopressor
therapy, vascular complications, and 7-day and 30-day mortality. Sample
size calculation indicates 340 patients (170 per group) are needed to
detect a 15% absolute reduction in norepinephrine use with 90% power and
alpha=0.05, and an anticipated loss to follow-up rate of 5%. Ethics and
dissemination The study has been approved by the French Ethics Committee
(Comite de Protection des Personnes Nord-Ouest II, no. 2024/897) and will
be conducted according to the Declaration of Helsinki and Good Clinical
Practice guidelines. Results will be submitted for publication in
peer-reviewed journals and presented at international
conferences. Copyright © Author(s) (or their employer(s)) 2026.

<100>
Accession Number
650091330
Title
Management of Direct Oral Anticoagulants in Adult Patients Undergoing
Cardiac Surgery: A Joint Consensus Statement by the Society of
Cardiovascular Anesthesiologists and The Society of Thoracic Surgeons.
Source
The Annals of thoracic surgery. (no pagination), 2026. Date of
Publication: 29 Jan 2026.
Author
Budd A.N.; Kertai M.D.; Wyler von Ballmoos M.C.; Raphael J.; Ghadimi K.;
Levy J.H.; Shore-Lesserson L.J.; Mazzeffi M.A.; Sniecinski R.M.; Tanaka
K.A.; Bolliger D.; Abdalla M.; Ural K.G.; Upchurch P.A.; Rozental O.;
Hunter C.B.; Seibert A.R.; Klick J.C.; Carroll D.; Lobner K.; Hensley N.B.
Institution
(Budd) Department of Anesthesiology, Northwestern University Feinberg
School of Medicine, Chicago, IL, United States
(Kertai) Department of Anesthesiology, Vanderbilt University Medical
Center, Nashville, TN, United States
(Wyler von Ballmoos) Department of Cardiovascular and Thoracic Surgery,
Texas Health Fort Worth, Fort Worth, TX, United States
(Raphael) Department of Anesthesiology and Perioperative Medicine, Thomas
Jefferson University Hospital, Sidney Kimmel Medical College,
Philadelphia, PA, United States
(Ghadimi, Levy) Department of Anesthesiology, Duke University School of
Medicine, Durham, NC, United States
(Shore-Lesserson) Department of Anesthesiology, Zucker School of Medicine
at Hofstra/Northwell, Manhasset, NY, United States
(Mazzeffi) Department of Anesthesiology, University of Virginia Health,
Charlottesville, VA, United States
(Sniecinski) Department of Anesthesiology, Emory Healthcare, Atlanta,
Georgia
(Tanaka) Department of Anesthesiology, University of Oklahoma Health
Sciences Center, Oklahoma City, OK, United States
(Bolliger) Intermediate Care, Prehospital Emergency Medicine and Pain
Therapy, University Hospital Badel, University of Basel, Basel,
Switzerland
(Abdalla) Department of Anesthesiology and Perioperative Medicine,
University Hospitals Cleveland Medical Center, Cleveland, OH, United
States
(Ural) Department of Anesthesiology and Perioperative Medicine, University
of Queensland Medical School, Ochsner Clinical School, New Orleans, LA,
United States
(Upchurch) Department of Anesthesiology, Health University of Utah, Salt
Lake City, UT, United States
(Rozental) Department of Anesthesiology, New York Presbyterian/ Weill
Cornell Hospital, NY, United States
(Hunter) Department of Anesthesiology, Warren Alpert Medical School of
Brown University, Providence, RI, United States
(Seibert) Department of Anesthesiology, Virginia Commonwealth University
School of Medicine, Richmond, VA, United States
(Klick) Department of Anesthesiology, University of Vermont, Larner
College of Medicine, Burlington, VT, United States
(Carroll) Department of Anesthesia and Perioperative Medicine, Medical
University of South Carolina, Charleston, SC, United States
(Lobner) Division of Cardiovascular Surgery, Department of Surgery,
University of Pennsylvania, Philadelphia, PA, United States
(Hensley) Department of Anesthesiology and Critical Care Medicine, Johns
Hopkins Medicine, Baltimore, MD, Liberia
Abstract
The Society of Cardiovascular Anesthesiologists (SCA) along with The
Society of Thoracic Surgeons (STS) sought to improve the care of adult
patients undergoing cardiac surgery who are taking direct oral
anticoagulants (DOACs), such as factor Xa and direct thrombin inhibitors.
To fulfill this, a systematic review of the literature on cessation of
DOACs before cardiac surgery, options for monitoring DOACs, the need for
bridging, reversal agents, and resuming the medications after surgery was
performed. Additionally, an expert consensus around the management of
these patients was completed. Summary statements were created using
evidence and expert consensus to guide care of patients in each of these
domains, with the ultimate goal to enhance patient safety and
outcomes. Copyright © 2026 The Society of Thoracic Surgeons,
International Anesthesia Research Society. Published by Elsevier Inc. All
rights reserved.

<101>
Accession Number
2042855717
Title
Heyde Syndrome: A Literature Review.
Source
Health Science Reports. 9(2) (no pagination), 2026. Article Number:
e71778. Date of Publication: 01 Feb 2026.
Author
Gupta Y.; Khan A.R.S.; Shetty V.; Krishna Y.M.; Maqsood A.; Ahmad M.H.;
Ali M.; Samuel B.; Gohar A.; Waheed A.; Afzal M.B.; Ahmad R.N.; Maqsood S.
Institution
(Gupta, Krishna, Samuel) Department of Medicine, Gadag Institute of
Medical Sciences, Gadag, India
(Khan, Gohar, Waheed) Department of Medicine, Lahore General hospital,
Lahore, Pakistan
(Shetty) Department of Medicine, Bangalore Medical College and Research
Institute, Bengaluru, India
(Maqsood, Ali, Maqsood) Department of Internal Medicine, Faisalabad
Medical University, Punjab, Faisalabad, Pakistan
(Ahmad) St. Tentishev Asian Medical Institute, Kant, Kyrgyztan
(Afzal) Department of Medicine, Mukhtar A Sheikh Hospital, Multan,
Pakistan
(Ahmad) KEMU, Lahore, Pakistan
Publisher
John Wiley and Sons Inc
Abstract
Background and Aims: Heyde syndrome, a triad of anemia from
gastrointestinal (GI) bleeding, aortic valve stenosis, and acquired von
Willebrand syndrome, primarily affects individuals over 65. Management
requires a multidisciplinary approach, including medical therapy,
endoscopic intervention, and valve replacement. Despite advances, many
aspects remain unclear. This review explores the epidemiology,
pathophysiology, and management of Heyde syndrome while highlighting areas
for future research. Method(s): A comprehensive search of PubMed and
Google Scholar focused on English-language human studies, including case
reports, clinical trials, reviews, and expert guidelines. Additional
literature on Von Willebrand syndrome and GI angiodysplasia was reviewed.
The final search was completed on April 5, 2025. Result(s): Aortic
valve replacement improves outcomes and hematologic abnormalities.
Transcatheter aortic valve replacement (TAVR) showed lower rates of
life-threatening bleeding, fewer perioperative complications, and reduced
transfusions compared to surgical replacement. Guidelines recommend dual
antiplatelet therapy (DAPT) for 3-6 months post-TAVR, with 79%-86% of
patients experiencing no recurrence of GI bleeds. Management of intestinal
angiodysplasia often shows high recurrence rates due to persistent lesions
and vWS-2A. Surgical valve replacement also improves bleeding control,
even with anticoagulation. Aortic valve replacement should be first-line
therapy in severe aortic stenosis with chronic GI bleeding.
 Conclusion(s): Heyde syndrome remains a complex and often
underrecognized condition in elderly populations. Continued research is
critical to deepen understanding and improve patient outcomes, allowing
for more personalized and effective care strategies. Copyright ©
2026 The Author(s). Health Science Reports published by Wiley Periodicals
LLC.

<102>
Accession Number
2043271705
Title
Postoperative Atrial Fibrillation in Patients Undergoing Non-Cardiac
Surgery.
Source
American Journal of Cardiology. 263 (pp 53-62), 2026. Date of Publication:
15 Mar 2026.
Author
Roozbehi K.; Semirani-Nezhad D.; Soleimani H.; Soltani P.; Saeidi S.;
Farahvash Y.; Nikoohemmat M.; Bahiraie P.; Tayebi S.; Lakkireddy D.;
Mattumpuram J.; Hosseini K.
Institution
(Roozbehi, Semirani-Nezhad, Soleimani, Soltani, Saeidi, Farahvash,
Bahiraie) Cardiovascular Diseases Research Institute, Tehran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Roozbehi, Semirani-Nezhad, Soleimani, Soltani, Saeidi, Farahvash,
Bahiraie, Hosseini) Tehran Heart Center, Cardiovascular Diseases Research
Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Nikoohemmat) Research Institute for Endocrine Sciences, Shahid Beheshti
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Tayebi) Centre for Clinical Research Sormland, Uppsala University,
Uppsala, Sweden
(Lakkireddy) Kansas City Heart Rhythm Institute and Research Foundation,
Overland Park, KS, United States
(Mattumpuram) Division of Cardiology, University of Louisville School of
Medicine, Louisville, Kentucky, United States
Publisher
Elsevier Inc.
Abstract
Postoperative atrial fibrillation (POAF) occurs in approximately 5-10% of
patients undergoing noncardiac surgery, yet its long-term impact compared
to patients without POAF (nPOAF) remains uncertain. This study aimed to
assess the incidence of cardiovascular outcomes in patients with new-onset
POAF. A systematic search of PubMed, EMBASE, and Scopus up to August 2025
identified studies including adults who developed AF within the first
postoperative week. Outcomes analyzed were AF recurrence, cardiac-related
hospitalization, stroke, and all-cause mortality. Pooled analyses were
performed using random-effects models, reconstructed time-to-event data,
and Restricted Mean Survival Time (RMST). A total of 14 studies comprising
3,622,824 patients were included, with 61,305 experiencing POAF. Compared
to nPOAF patients, POAF was associated with significantly higher risks of
stroke at 1 year (HR 2.34, 95% CI, 1.46-3.21), in-hospital mortality (HR
3.29, 95% CI, 2.90-3.67), and 1-year mortality (HR 1.64, 95% CI,
1.56-1.71). The cumulative incidence of hospitalization or stroke was
greater in the POAF group (HR 1.75, 95% CI, 1.18-2.61). Time-to-event
analysis showed frequent AF recurrence within days of surgery, with risk
persisting over 1 year. RMST analysis indicated that POAF patients
experienced hospitalization or stroke an average of 14.77 days earlier
than nPOAF patients during follow-up. New-onset POAF after noncardiac
surgery is strongly associated with increased risks of stroke, mortality,
and recurrent hospitalization. These findings underscore the importance of
early recognition and management, and highlight the need for further
research into preventive and therapeutic strategies, including the role of
anticoagulation. Copyright © 2025 Elsevier Inc.

<103>
Accession Number
2041796065
Title
Reassessing Acute Normovolemic Hemodilution in Cardiac Surgery: Beyond the
Randomized Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(2) (pp 766-767),
2026. Date of Publication: 01 Feb 2026.
Author
Saito J.; Hirota K.
Institution
(Saito) Department of Anesthesiology, Hirosaki University Graduate School
of Medicine, Hirosaki, Japan
(Hirota) Department of Anesthesiology, Aomori Prefectural Central
Hospital, Aomori, Japan
(Hirota) Department of Perioperative Stress Management, Hirosaki
University Graduate School of Medicine, Hirosaki, Japan
Publisher
W.B. Saunders

<104>
Accession Number
650092690
Title
High-exchange ULTrafiltration to enhance Recovery After pediatric cardiac
surgery: the ULTRA Randomized Clinical Trial.
Source
The Annals of thoracic surgery. (no pagination), 2026. Date of
Publication: 27 Jan 2026.
Author
Bierer J.D.; Stanzel R.; Henderson M.; Krmpotic K.; Andreou P.; Marshall
J.S.; Sapp J.; Horne D.
Institution
(Bierer, Horne) Division of Cardiac Surgery, Dalhousie University, Canada
(Stanzel, Henderson) Department of Clinical Perfusion, Nova Scotia Health
Authority, Canada
(Krmpotic) Department of Critical Care, Dalhousie University, Canada
(Andreou) Department of Community Health & Epidemiology, Dalhousie
University, Canada
(Marshall) Department of Microbiology & Immunology, Dalhousie University,
Canada
(Sapp) Division of Cardiology, Dalhousie University, Canada
Abstract
BACKGROUND: Pediatric cardiac surgery with cardiopulmonary bypass (CPB) is
associated with systemic inflammation. This trial aims to determine
whether continuous high-exchange ultrafiltration during CPB has a clinical
immunomodulatory effect. METHOD(S): This single-center,
double-blinded trial enrolled pediatric patients less than 15 kg
undergoing cardiac surgery, who were randomly allocated to continuous
high-exchange subzero-balance ultrafiltration (H-SBUF, 60 ml/kg/hr
effluent extraction) or continuous low-exchange subzero-balance
ultrafiltration (L-SBUF, 6 ml/kg/hr effluent extraction) administered
during CPB. The primary outcome was peak post-operative
vasoactive-ventilation-renal (VVR) score. Secondary outcomes included
acute kidney injury, low cardiac output syndrome, health care utilization
and inflammatory mediator fold change throughout CPB. RESULT(S): A
total of 104 patients were randomly allocated to H-SBUF (n=52) or L-SBUF
(n=52). The primary outcome was similar between groups as the peak VVR was
26.9 (2.1 - 77.9) in the H-SBUF group and 27.8 (0.8 - 76.7) in the L-SBUF
group (p = 0.67). There were no operative mortalities and no significant
differences in acute kidney injury, low cardiac output syndrome,
ventilation time, inotrope use time, ICU or hospital length of stay (p >
0.05). The H-SBUF group had a higher fold change for IL-1alpha,
P-selectin, and VCAM-1 (p < 0.05), while thirty-six other mediators were
not significantly different between groups (p > 0.05). CONCLUSION(S):
Among pediatric patients undergoing cardiac surgery with CPB, continuous
high-exchange SBUF did not reduce peak VVR when compared to low-exchange
SBUF. Furthermore, there were no differences in secondary clinical
outcomes, and the immunologic profile was largely similar between
groups. Copyright © 2026. Published by Elsevier Inc.

<105>
Accession Number
650085266
Title
Bidirectional nexus between metabolic disease and aortic valve
calcification: from pathogenic mechanisms to integrated multimorbidity
management.
Source
Expert opinion on therapeutic targets. (no pagination), 2026. Date of
Publication: 28 Jan 2026.
Author
Wang X.; Yu M.; Chen J.; Xu J.; Liu Y.; Wang Z.
Institution
(Wang, Yu, Chen, Xu, Liu, Wang) Department of Cardiology, Affiliated
Hospital of Jiangsu University, Zhenjiang, China
(Wang, Yu, Chen, Xu, Liu, Wang) Institute of Cardiovascular Diseases,
Jiangsu University Zhenjiang, China
Abstract
INTRODUCTION: Calcified aortic valve disease (CAVD) imposes a severe
global health burden, and there is currently no effective pharmacotherapy,
which urgently requires a new understanding of pathophysiology to guide
treatment. AREAS COVERED: This review systematically evaluates the
epidemiological association and common mechanistic pathways between
metabolic diseases and aortic valve calcification (AVC) through the
proposed 'calcification-metabolic axis' framework. We conducted a
comprehensive literature search, covering the PubMed database up to
December 2025, with a focus on studies related to CAVD, metabolism,
inflammation, and calcification signaling. EXPERT OPINION: Future
management strategies must transition toward early, multi-disease
co-governance strategies. At the same time, targeted drugs will be
developed for specific pathways on this axis, surpassing the current
treatment status of relying solely on valve replacement surgery.

<106>
Accession Number
2042900695
Title
Perioperative dexmedetomidine and renal outcomes in adult cardiac surgery:
an updated systematic review and meta-analysis.
Source
Frontiers in Medicine. 12 (no pagination), 2026. Article Number: 1737121.
Date of Publication: 2026.
Author
Wen J.; Jiang F.
Institution
(Wen) Department of Emergency, Clinical Medical College & Affiliated
Hospital of Chengdu University, Sichuan, Chengdu, China
(Jiang) Department of Nursing, Pengzhou Peoples's Hospital, Sichuan,
Pengzhou, China
Publisher
Frontiers Media SA
Abstract
Background: Acute kidney injury (AKI) is a common complication following
cardiac surgery, associated with increased morbidity and mortality.
Dexmedetomidine (DEX), a highly selective alpha-2 adrenoceptor agonist,
has shown potential renal protective effects, but evidence remains
inconsistent. This study aims to evaluate the efficacy of DEX in
preventing AKI and improving renal outcomes in cardiac surgery patients
through a systematic review and meta-analysis of randomized controlled
trials (RCTs). Method(s): A comprehensive search of PubMed, Cochrane
Library, Embase, and Web of Science was conducted until April 2025. PICOS
criteria were applied to select studies comparing DEX with placebo/normal
saline in cardiac surgery patients. Primary outcomes included AKI
incidence; secondary outcomes encompassed intraoperative parameters,
postoperative recovery, and complications. Result(s): Bibliometric
analysis highlighted China and the USA as leading contributors, with
emerging trends in pediatric and mechanistic research. Among 16 RCTs (n =
2,882), DEX significantly reduced AKI incidence [RR 0.58; 95% CI 0.37 to
0.91; I2 = 74%, p = 0.02], particularly at 0.6-0.1 mug/kg/h
doses [RR 0.43; 95% CI 0.26 to 0.71; I2 = 0%, p = 0.001].
Subgroup analysis revealed 0.4 mug/kg/h doses failed to yield a
statistically significant benefit [RR 0.65; 95% CI 0.36 to 1.17;
I2 = 84%; p = 0.15]. DEX also shortened ICU stay [MD -1.23; 95%
CI -2.17 to -0.30; I2 = 93%; p = 0.01], mechanical ventilation
duration [MD -1.24; 95% CI -2.15 to -0.33; I2 = 97%; p =
0.008], and hospital stays [MD -0.33; 95% CI -0.54 to -0.13; I2
= 86%; p = 0.01]. However, it did not affect mortality or intraoperative
times. Conclusion(s): DEX demonstrates significant renal protection
and improves postoperative recovery in cardiac surgery patients, though
optimal dosing requires further investigation. These findings support its
integration into perioperative protocols but underscore the need for
standardized dosing regimens. Systematic review registration: Identifier,
INPLASY2025120019. Copyright © 2026 Wen and Jiang.

<107>
Accession Number
2043178995
Title
Computed tomography coronary angiography to facilitate clinical
decision-making and selective invasive angiography in patients with prior
bypass grafting presenting with acute coronary syndromes.
Source
Heart. (no pagination), 2026. Article Number: heartjnl-2025-326961. Date
of Publication: 2026.
Author
Kelham M.; Beirne A.-M.; Learoyd A.E.; Rathod K.S.; Choudry F.; Guttmann
O.; Davies C.; Pugliese F.; Hussain S.T.; Keeble T.; Collet C.; Spratt
J.C.; Tsigkas G.; Mathur A.; Jones D.A.; Abdelaziz H.; Akhtar M.M.;
Apostolos A.; Baumbach A.; Bhatti Y.; Bogle R.; Bouisset F.; Choudhury T.;
Clesham G.; Davies J.; Good R.; Gulati A.; Hamshere S.; Hurrell H.; Jabbar
A.; Jones J.; Karamasis G.V.; Karanasos A.; Karthikeyan V.J.; Kelly D.;
Seshasai S.R.K.; Kumar A.; Ladwiniec A.; Modi B.; McCaughan V.; Moulias
A.; Myat A.; Ohashi H.; Papafaklis M.; Patel B.; Patel K.; Ramaseshan R.;
Rees P.; Routledge H.; Saberwal B.; Smith D.; Tabbara R.; Wragg A.; Yazdi
A.
Institution
(Kelham, Beirne, Rathod, Choudry, Guttmann, Davies, Pugliese, Mathur,
Jones) Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom
(Kelham, Beirne, Rathod, Pugliese, Mathur, Jones) Centre for
Cardiovascular Medicine and Devices, Queen Mary University of London,
William Harvey Research Institute, London, United Kingdom
(Kelham, Beirne, Rathod, Pugliese, Mathur, Jones) NIHR Barts Biomedical
Research Centre, Barts Heart Centre, William Harvey Research Institute,
Queen Mary University of London, London, United Kingdom
(Learoyd, Mathur, Jones) Barts Cardiovascular Clinical Trials Unit,
Faculty of Medicine & Dentistry, Queen Mary University of London, London,
United Kingdom
(Hussain) Department of Cardiovascular Sciences, University of Leicester,
NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester,
United Kingdom
(Keeble) Essex Cardiothoracic Centre, MSE, Basildon, United Kingdom
(Keeble) MTRC, Anglia Ruskin University, Chelmsford, United Kingdom
(Collet) Cardiovascular Center OLV Aalst, Aalst, Belgium
(Spratt) City St George's University of London, London, United Kingdom
(Tsigkas) Department of Cardiology, University General Hospital of Patras,
Patras, Greece
Publisher
BMJ Publishing Group
Abstract
Background Patients with prior coronary artery bypass grafting (CABG)
account for around 10% of non-ST-elevation acute coronary syndromes
(NSTE-ACS), but the optimal diagnostic and management strategy remains
uncertain. Invasive coronary angiography (ICA) in this group is
technically challenging, carries increased risk and often does not lead to
percutaneous coronary intervention (PCI). CT coronary angiography (CTCA)
may help identify which patients benefit from ICA and reduce unnecessary
invasive procedures. Methods In the BYPASS-CTCA (Randomised Controlled
Trial to Assess Whether Computed Tomography Cardiac Angiography Can
Improve Invasive Coronary Angiography in Bypass Surgery Patients) study,
patients with prior CABG undergoing ICA were randomised to CTCA plus ICA
or ICA alone. For this analysis, anonymised case vignettes and CTCA
reports from 150 patients with NSTE-ACS were independently reviewed by 50
experienced interventional cardiologists (median 17 years
post-qualification; 5103 total case reviews). Agreement on management
strategy before and after CTCA was assessed using Fleiss' kappa statistic.
Results Based on clinical information alone, respondents chose medical
therapy in 13.2% of cases, with poor agreement on management strategy
(kappa=0.14, 95% CI 0.11 to 0.17). After reviewing CTCA, agreement
improved to moderate (kappa=0.53, 95% CI 0.48 to 0.58; p<0.001), and
medical management was selected in 39.3% (p<0.001). When invasive
management was selected post-CTCA, PCI was required in 85% of cases, and a
selective angiographic approach was planned in 79%. Conclusions Management
decisions for post-CABG NSTE-ACS vary widely among experienced
cardiologists. Incorporating CTCA into the diagnostic pathway
substantially improves consensus, reduces unnecessary invasive angiography
and enables targeted, lower-risk procedures. These findings support
evaluation of a CTCA-guided strategy in a prospective randomised
trial. Copyright © Author(s) (or their employer(s)) 2026. No
commercial re-use. See rights and permissions. Published by BMJ Group.

<108>
Accession Number
650084356
Title
Prevalence and clinical implications of angiodysplasia in patients with
aortic stenosis: a systematic review and meta-analysis.
Source
European journal of gastroenterology & hepatology. (no pagination), 2026.
Date of Publication: 22 Jan 2026.
Author
Abdel-Gawad M.; Almansoury Y.; Nagdy H.; El-Raey F.; El-Kassas M.
Institution
(Abdel-Gawad) Hepatology, Gastroenterology, Infectious Diseases
Department, Assiut Faculty of Medicine, Al-Azhar University
(Almansoury) Gastroenterology and Hepatology Division, Internal Medicine
Department, South Valley University, Qena, Egypt
(Nagdy) Internal Medicine Department, College of Medicine, Arab Academy
for Science and Technology and Maritime Transport, Alexandria, Egypt
(El-Raey) Hepatogastroenterology and Infectious Diseases Department,
Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt
(El-Raey) Clinical Science Department, College of Medicine, Suliman
Alrajhi University, Al Qassim, Al Bukayriyah, Saudi Arabia
(El-Kassas) Endemic Medicine Department, Faculty of Medicine, Helwan
University, Cairo, Egypt
(El-Kassas) Applied Science Research Center. Applied Science Private
University, Amman, Jordan
Abstract
Gastrointestinal angiodysplasia is frequently observed in patients with
aortic stenosis and may present with bleeding and anemia. We conducted a
systematic review and meta-analysis to estimate its prevalence in this
population and to summarize outcomes after valve intervention. Following
PRISMA 2020, we searched PubMed, Scopus, and Web of Science and registered
the protocol in PROSPERO (CRD42024550839). Eligible observational studies
reporting angiodysplasia, von Willebrand factor abnormalities, or both in
aortic stenosis were appraised for quality and pooled using a random
effects model; heterogeneity and publication bias were assessed with I2
and Egger's test. Eleven studies were included. The pooled prevalence of
gastrointestinal angiodysplasia among patients with aortic stenosis was
6.3% (95% confidence interval: 4.51-8.38, I2 = 98.68, P < 0.0001), with no
evidence of publication bias. Across studies that reported longitudinal
outcomes, aortic valve replacement or transcatheter aortic valve
implantation was associated with a reduction in lesion burden and lower
rates of gastrointestinal bleeding, anemia, transfusion, and readmission,
although early postprocedural bleeding could occur and typically declined
over follow-up. These findings indicate that angiodysplasia is a
clinically relevant comorbidity in aortic stenosis and support proactive
gastrointestinal evaluation in patients with anemia or unexplained
bleeding. Standardized diagnostic criteria and prospective studies are
needed to clarify long-term outcomes after valve therapy and to define
screening and management pathways. Copyright © 2026 Wolters
Kluwer Health, Inc. All rights reserved.

<109>
[Use Link to view the full text]
Accession Number
650086859
Title
Pre-TAVI CT Angiography for Coronary Artery Disease Assessment: A
Systematic Review and Meta-Analysis of Clinical Outcomes.
Source
Circulation. Cardiovascular interventions. (pp e016074), 2026. Date of
Publication: 29 Jan 2026.
Author
Rahmati S.; Nasrollahizadeh A.; Kolte D.; Khalique O.K.; Biering-Sorensen
T.; Hosseini K.
Institution
(Rahmati, Nasrollahizadeh, Hosseini) Tehran Heart Center, Cardiovascular
Diseases Research Institute, Tehran University of Medical Sciences, Iran,
Islamic Republic of
(Kolte) Cardiology Division, Massachusetts General Hospital
(Khalique) St Francis Hospital and Heart Center, Roslyn, United States
(Biering-Sorensen, Hosseini) Department of Cardiology, Copenhagen
University Hospital-Herlev and Gentofte, Denmark
(Biering-Sorensen, Hosseini) Department of Biomedical Sciences, Center for
Translational Cardiology and Pragmatic Randomized Trials, Faculty of
Health and Medical Sciences, University of Copenhagen, Denmark
(Biering-Sorensen) Department of Cardiology, Copenhagen University
Hospital-Rigshospitalet, Denmark
(Biering-Sorensen) Steno Diabetes Center Copenhagen, Herlev, Denmark

<110>
[Use Link to view the full text]
Accession Number
650086291
Title
Potential Double Counting in Meta-Analysis of Combined Heart-liver
Transplantation.
Source
Transplantation. (no pagination), 2026. Date of Publication: 30 Jan 2026.
Author
Nakayama T.; Attia A.; Ahn D.J.; Sasaki K.
Institution
(Nakayama) Division of Abdominal Transplantation, Stanford Transplant
Outcomes Research Center (STORC), Stanford University Medical Center,
Stanford, CA, United States

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