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<1>
Accession Number
648722608
Title
Post-operative atrial fibrillation and stroke after non-cardiac surgery: a
systematic review and meta-analysis.
Source
European heart journal. Cardiovascular pharmacotherapy. 11(8) (pp
682-697), 2025. Date of Publication: 16 Dec 2025.
Author
Donati J.; Morrone D.; Verheugt F.W.A.; De Caterina R.
Institution
(Donati, Morrone, De Caterina) University of Pisa and Cardiovascular
Division, Pisa University Hospital, Via Paradisa, Pisa, Italy
(Verheugt) Emeritus Professor of Cardiology, Amsterdam, Netherlands
Abstract
Post-operative atrial fibrillation (POAF) is common after non-cardiac
surgery. Because often transient, there are uncertainties on the
associated risk of stroke, possibly driving the need for long-term
anticoagulation. We performed a systematic PubMed search until 16 January
2025, related to the incidence of stroke in patients with POAF after
non-cardiac surgery. We included papers reporting outcomes, excluding
studies only dealing with epidemiology, mechanisms, management, and
treatment. We excluded studies reporting on POAF after cardiac surgery.
Risk of bias was assessed for each study, and the certainty of evidence
was evaluated using the GRADE methodology. We retrieved and included 40
studies (including review papers) for the systematic review. These were
then further selected to create a final list of 19 studies included in the
meta-analysis. The reported incidence of stroke after POAF was found to be
widely variable, ranging between 0.4% and 16.7% at 1 year. Stroke
incidence also varies widely according to the type of surgery and patient
characteristics. With only three exceptions, all studies, however,
reported a risk of stroke higher in the POAF group than in the no-POAF
group, with a mean odds ratio of 3.02. POAF on average triples the risk of
stroke, with variations related to patient characteristics and type of
surgery. Patients after non-cardiac surgery should be monitored at least
during hospitalisation to detect POAF. Future studies are necessary to
evaluate optimal duration and modalities of monitoring, as well as to
assess the relevance of symptomatic vs asymptomatic AF
episodes. Copyright © The Author(s) 2025. Published by Oxford
University Press on behalf of European Society of Cardiology.

<2>
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Accession Number
2039662921
Title
Multimodal prehabilitation as. strategy to reduce postoperative
complications in cardiac surgery.
Source
European Journal of Anaesthesiology. 42(11) (pp 987-996), 2025. Date of
Publication: 01 Nov 2025.
Author
Lopez-Hernandez A.; Gimeno-Santos E.; Navarro-Ripoll R.; Arguis M.J.;
Lopez-Baamonde M.; Sanz-de la Garza M.; Sandoval E.; Castella M.;
Martinez-Palli G.
Institution
(Lopez-Hernandez) Universitat de Barcelona, Spain
(Lopez-Hernandez, Navarro-Ripoll, Arguis, Lopez-Baamonde, Martinez-Palli)
Anaesthesiology Department
(Lopez-Hernandez, Gimeno-Santos, Navarro-Ripoll, Lopez-Baamonde)
Prehabilitation Unit, Hospital Clinic de Barcelona, Spain
(Gimeno-Santos, Arguis, Sanz-de la Garza, Sandoval, Castella,
Martinez-Palli) Fundacio de Recerca Clinic Barcelona - Institut
d'Investigacions Biomediques August Pi. Sunyer (FRCB-IDIBAPS) , Spain
(Sandoval, Castella) Cardiovascular Institute (MSdlG) and Cardiovascular
Surgery Department, Hospital Clinic de Barcelona, Barcelona, Spain
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND - Prehabilitation has shown efficacy in improving postoperative
outcomes in abdominal surgery. Data on cardiac surgery are
controversial.OBJECTIVE - To determine if. multimodal prehabilitation
programme reduces the rate of postoperative complications after elective
cardiac surgery.DESIGN - Randomised controlled trial.SETTING -
Single-centre study in. tertiary hospital with inclusion period spanned
from March 2018 to June 2021.PATIENTS - One hundred and fifty-one
patients, with an expected waiting time before surgery of 6 weeks or more,
completed the study. Excluded were those with functional, anatomical or
cognitive impairment; cardiac instability; dynamic left ventricle outflow
tract obstruction or proven exercise-induced arrhythmias.INTERVENTION -
Four to six weeks of. multimodal prehabilitation programme, including
exercise training, psychological and nutritional support.MAIN OUTCOME -
Incidence of postoperative complications.RESULTS - No differences were
found in the rate of postoperative complications (80% in both groups, P =
0.968), most of which were mild, with. Comprehensive Complication Index of
21 and more than 70% with Clavien-Dindo grade. or II. Prehabilitated
patients showed. significant improvement in endurance time assessed by.
constant-work rate cycling exercise test: preintervention vs.
postintervention (301 +/- 109 vs. 578 +/- 257 s, P = 0.001), and in 6-min
walk test (6MWT) (487 +/- 77 vs. 504 +/- 74 min, P = 0.001). No patients
experienced adverse events attributable to the intervention.. sub-analysis
restricted to prehabilitated patients who showed. meaningful response to
exercise assessed by the 6MWT (increase >= 30 m) showed. reduction in the
number and severity of postoperative complications, compared to
nonresponders (1.1 +/- 0.9 vs. 2 +/- 2 complications per patient, P =
0.038); and the Comprehensive Complication Index (16 +/- 15 vs. 25 +/- 19,
P = 0.044).CONCLUSION -. multimodal prehabilitation programme before
elective cardiac surgery did not reduce the incidence of postoperative
complications. Nevertheless, when analysis was restricted to meaningful
responders to intervention,. significant reduction in postoperative
complications and their severity was observed.TRIAL REGISTRATION -
ClinicalTrials.gov (NCT03466606). Copyright © 2025 European
Society of Anaesthesiology and Intensive Care. Unauthorized reproduction
of this article is prohibited.

<3>
Accession Number
2041627732
Title
Rationale and Design of the EPISODE Trial: A Randomized Controlled Trial
on the Effect of PCSK9 Inhibitors in Calcific Aortic Valve Stenosis.
Source
Journal of the American Heart Association. 14(19) (no pagination), 2025.
Article Number: e042112. Date of Publication: 19 Sep 2025.
Author
Zheng Y.; Li Q.; Yang Y.; Yang J.; Liu Z.; Ma X.; Wang Z.
Institution
(Zheng, Li, Yang, Yang, Liu, Ma, Wang) Department of Cardiology, Beijing
Anzhen Hospital, Clinical Center for Coronary Heart Disease, Capital
Medical University, Beijing, China
(Ma, Wang) Beijing Institute of Heart Lung and Blood Vessel Disease,
Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic
Disease, Clinical Center for Coronary Heart Disease, Capital Medical
University, Beijing, China
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Calcific aortic valve stenosis (CAVS) can lead to cardiac
adverse outcomes; however, currently, no effective pharmacological
interventions are available to prevent or delay disease progression.
Emerging evidence has identified significant associations between CAVS and
key biomarkers, including Lp(a) (lipoprotein [a]), low-density lipoprotein
cholesterol, and PCSK9 (proprotein convertase subtilisin/kexin type 9).
However, robust evidence from randomized controlled trials is still
lacking to substantiate these associations. METHOD(S): The EPISODE
(Effect of PCSK9 Inhibitors on Calcific Aortic Valve Stenosis) trial is a
prospective, evaluator-blinded, randomized controlled trial designed to
assess the therapeutic efficacy of PCSK9 inhibitors in patients with CAVS.
A total of 160 patients with mild-to-moderate or asymptomatic severe CAVS
will be randomly assigned to receive either statin monotherapy or a
combination of statins and PCSK9 inhibitors. Participants will undergo
follow-up assessments at 3-month intervals for 24 months, including
transthoracic ultrasonic cardiogram, computed tomography, and quality-of-
life evaluations using the EuroQol-5 Dimension-3 Level questionnaire. The
primary end point is the annualized change in peak aortic jet velocity,
whereas secondary end points encompass changes in aortic valve area,
calcification score, incidence of heart valve surgery, and quality of
life. Safety end points include all-cause mortality and cardiovascular
events. CONCLUSION(S): The trial aims to evaluate the efficacy of
PCSK9 inhibitors in modulating disease progression, reducing adverse
cardiovascular events, and improving clinical outcomes in patients with
CAVS. The anticipated findings are expected to provide critical insights
for developing novel therapeutic strategies for early intervention in
CAVS. Copyright © The Author(s). Published on behalf of the
American Heart Association, Inc., by Wiley. This is an open access article
under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs
License, which permits use and distribution in any medium, provided the
original work is properly cited, the use is non-commercial and no
modifications or adaptations are made.

<4>
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 .

<5>
Accession Number
2040917514
Title
Digital twins in cardiovascular disease: a scoping review.
Source
International Journal of Medical Informatics. 206 (no pagination), 2026.
Article Number: 106138. Date of Publication: 01 Feb 2026.
Author
Zou H.; Zheng X.; Wu L.; Zhang S.; Chang P.; Chen Y.
Institution
(Zou, Zheng, Wu, Zhang, Chen) Xiamen Cardiovascular Hospital of Xiamen
University, School of Medicine, Xiamen University, Xiamen, China
(Zheng) School of Nursing, Fujian University of Traditional Chinese
Medicine, Fuzhou, China
(Chang) Institute of Biomedical Informatics, National Yang-Ming Chiao-Tung
University, Taipei, Taiwan (Republic of China)
Publisher
Elsevier Ireland Ltd
Abstract
Background: Digital twin technology in healthcare is an emerging approach
that creates virtual representations of patients and disease-specific
conditions, with the potential to clarify treatment objectives and enable
more personalized, precision-based care, to help to clarify treatment
objectives and to facilitate personalised and precision treatment
management. Objective(s): This scoping review was conducted to
analyse the application of digital twin technology in cardiovascular
disease, focusing on implementation steps, clinical applications, and
challenges to guide future research. Method(s): A systematic search
was conducted in eight databases (PubMed, EBSCO, Web of Science, WILEY,
China WanFang Database, China National Knowledge Infrastructure, China
Weipu Database, and SinoMed) for studies published, with a time frame of
database construction to May 2025. Data were summarised and analysed based
on predefined criteria. Result(s): A total of 31 cardiovascular
studies were included. Their implementation was categorised into five
stages: data acquisition, model construction and personalisation, model
calibration and validation, simulation analysis, and result application
for decision support or medical education. Clinical applications involved
personalised health management (13 %), precise individual treatment
effects (42 %), individual risk prediction (26 %), clinical trial
optimisation (23 %), and medical education (3 %). Key challenges included
data limitations, model construction and validation complexities, and
barriers to clinical application. Conclusion(s): Digital twins
demonstrate potential in cardiovascular care by advancing personalised
health management and precision medicine. However, their widespread
adoption and practical implementation are still in their early stages.
Broader implementation necessitates improved data sharing, algorithm
optimisation, enhanced model generalizability, and ethical
safeguards. Copyright © 2025 Elsevier B.V.

<6>
Accession Number
2037437143
Title
Novel Triple-Cuff versus Conventional Double-Cuff Double-Lumen
Endobronchial Tube in Patients with Risk Factors for Tube Misdirection.
Source
Yonsei Medical Journal. 66(12) (pp 866-873), 2025. Date of Publication: 01
Dec 2025.
Author
Kim N.; Oh Y.J.; Kim H.J.; Lee K.
Institution
(Kim, Oh, Kim, Lee) Department of Anesthesiology and Pain Medicine, Yonsei
University College of Medicine, Seoul, South Korea
(Kim, Oh, Kim, Lee) Anesthesia and Pain Research Institute, Yonsei
University College of Medicine, Seoul, South Korea
Publisher
Yonsei University College of Medicine
Abstract
Purpose: Accurate positioning of the double-lumen endobronchial tube (DLT)
is crucial for successful lung isolation during thoracic surgery. However,
misdirection of the left-sided DLT into the right main bronchus frequently
occurs in short, obese females with narrow airways. A novel triple-cuff
DLT features an additional carinal cuff positioned on the right side of
the tube, which differentiates it from conventional double-cuff DLTs. We
hypothesized that inflating the carinal cuff would direct the bronchial
tip of the triple-cuff DLT toward the left main bronchus, thereby reducing
the likelihood of DLT misdirection when compared to the conventional
double-cuff DLT. Material(s) and Method(s): In this single-center,
unblinded randomized controlled trial, short, obese females with narrow
airways were randomly assigned to either the triple-cuff or double-cuff
group (n=77 each) and were intubated with the respective DLTs. The DLT
misdirection rate, adjustment depth for optimal positioning, intubation
time, and the incidence of hypoxia, airway injury, and postoperative
airway complications were assessed. Result(s): Data from 143 patients
were analyzed. The triple-cuff group exhibited a lower DLT misdirection
rate compared to the doublecuff group (15.3% vs. 46.5%, odds ratio 4.81,
95% confidence interval 2.18-10.64, p<0.001). Triple-cuff DLT was also
associated with fewer adjustments, shorter intubation times, and lower
incidences of hypoxia, airway injury, and sore throat than double-cuff
DLT. Conclusion(s): Triple-cuff DLT was superior to conventional DLT
in reducing DLT misdirection in short, obese females with narrow airways.
Furthermore, it facilitated a faster intubation process and reduced airway
complications, thereby enhancing patient safety. Clinical Trial
Registration: NCT06061055 (ClinicalTrials.gov). © Copyright:
Yonsei University College of Medicine 2025.

<7>
Accession Number
2040475624
Title
Hiding in Plain Sight: Pulmonary Vein Stenosis Following Pediatric Heart
Transplantation.
Source
Pediatric Transplantation. 29(7) (no pagination), 2025. Article Number:
e70199. Date of Publication: 01 Nov 2025.
Author
O'Halloran C.P.; Hauck A.; Joong A.; Tannous P.
Institution
(O'Halloran, Hauck, Joong, Tannous) Ann & Robert H. Lurie Children's
Hospital of Chicago, Chicago, IL, United States
(O'Halloran, Hauck, Joong, Tannous) Northwestern University Feinberg
School of Medicine, Chicago, IL, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Pulmonary vein stenosis (PVS) after pediatric heart
transplantation (PHT) is an observed phenomenon with previously unknown
incidence, risk factors, treatment, and outcome. Method(s): This is a
review of three recent publications describing PVS after PHT.
 Result(s): In total, 712 PHT recipients from four centers, over a
combined 43 years, are reviewed. Thirty-one new cases of PVS after PHT, in
addition to six patients with preexisting PVS, are described. PVS
diagnosis occurred in the first year after PHT for most patients.
Left-sided PVS were more than twice as common as right-sided PVS. Nearly
half (43%) experienced multivessel PVS. Major risk factors of PVS after
PHT included younger age, history of congenital heart disease (CHD), and
history of anomalous pulmonary venous return. The treatment of PVS after
PHT varied, reflecting uncertainty in the management of PVS generally.
With a median follow-up of less than 3 years, 19% of patients with PVS
after PHT died. Conclusion(s): PVS after PHT complicated
approximately 4.4% of cases in these reports. PVS is more common after PHT
in younger patients with a history of CHD. PVS is generally diagnosed in
the first year after PHT. We recommend careful evaluation for PVS in the
first year after PHT in patients with known risk factors. Copyright
© 2025 The Author(s). Pediatric Transplantation published by Wiley
Periodicals LLC.

<8>
Accession Number
2041011138
Title
Fractional flow reserve vs angiography to guide percutaneous coronary
intervention: an individual patient data meta-analysis.
Source
European Heart Journal. 46(39) (pp 3851-3859), 2025. Date of Publication:
14 Oct 2025.
Author
Mangiacapra F.; Paolucci L.; De Bruyne B.; Rioufol G.; Hahn J.-Y.; Chen
S.-L.; Koo B.-K.; Tonino P.A.L.; Van 't Veer M.; Motreff P.; Angoulvant
D.; Lee J.M.; Hwang D.; Yang S.; Pijls N.H.J.; Barbato E.
Institution
(Mangiacapra, Paolucci) Department of Medicine and Surgery, Universita
Campus Bio-Medico di Roma, Rome, Italy
(Mangiacapra) Fondazione Policlinico Universitario Campus Bio-Medico,
Rome, Italy
(De Bruyne) Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium
(Rioufol) Hospices Civils de Lyon, Carmen INSERM 1060, Lyon, France
(Hahn, Lee) Heart Vascular Stroke Institute, Samsung Medical Center,
Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, South Korea
(Chen) Nanjing First Hospital, Nanjing Medical University, Nanjing, China
(Koo, Hwang, Yang) Seoul National University Hospital, Seoul National
University College of Medicine, Seoul, South Korea
(Tonino, Van 't Veer, Pijls) Department of Cardiology, Catharina Hospital,
Eindhoven, Netherlands
(Motreff) Cardiology Department, Centre Hospitalier Universitaire de
Clermont-Ferrand, Clermont-Ferrand, France
(Angoulvant) Cardiology Department, Trousseau Hospital, Francois Rabelais
University of Tours, Tours, France
(Barbato) Department of Clinical and Molecular Medicine, Sapienza
University of Rome, Via di Grottarossa 1035, Rome, Italy
(Barbato) Cardiology Unit, Sant'Andrea University Hospital, Via di
Grottarossa 1035, Rome, Italy
Publisher
Oxford University Press
Abstract
Background and Aims Several randomized controlled trials (RCTs) have
compared fractional flow reserve (FFR)-guided percutaneous coronary
intervention (PCI) with angiography-guided PCI in different clinical
settings, yielding mixed results. This individual patient data
meta-analysis focused on trials where FFR was used to assess intermediate
coronary lesions in chronic coronary syndrome (CCS) or non-culprit vessels
in non-ST-elevation acute coronary syndromes (NSTE-ACS). Methods
Randomized controlled trials comparing FFR- vs angiography-guided PCI with
a minimum follow-up of 1 year were searched. Studies lacking angiographic
inclusion criteria or using FFR for culprit arteries in NSTE-ACS were
excluded. Studies including patients with ST-elevation myocardial
infarction (MI) or undergoing surgical revascularization could be included
after censoring these two subgroups. The primary outcome was the 1-year
rate of major adverse cardiac events (MACE), defined as a composite of
all-cause death, MI, and repeat revascularization. The secondary outcomes
were a composite of all-cause death and MI, the individual components of
the primary outcome, cardiac death, spontaneous MI, and procedural MI. The
present study is registered with PROSPERO (CRD42024553676). Results Five
RCTs were selected, including 2493 patients: 1241 in the angiography arm
and 1252 in the FFR arm. More vessels underwent PCI in the angiography
group (45.1% vs 30.2%, P < .001), with more stents implanted per patient
[2.0 (2.0-3.0) vs 1.5 (1.0-2.0), P < .001]. One-year MACE occurred in
14.7% of patients in the angiography group and 12.1% in the FFR group
[hazard ratio (HR) .80, 95% confidence interval (CI) .64-.99; P = .046].
The risk of MI was significantly reduced in the FFR-guided group (HR .71,
95% CI .53-.96; P = .031). These outcomes were driven by a reduction in
peri-procedural MI with FFR guidance, with no significant difference
between groups in non-procedural MI, MACE between 30 days and 1 year, and
secondary outcomes. Conclusions Fractional flow reserve-guided PCI was
associated with reduced major adverse events in patients with CCS and
NSTE-ACS due mainly to fewer peri-procedural MIs, with no differences in
mortality or MACE beyond 30 days. Copyright © The Author(s) 2025.
Published by Oxford University Press on behalf of the European Society of
Cardiology. All rights reserved.

<9>
Accession Number
2041165616
Title
Aortic Dissection Following Endovascular Aneurysm Repair - A Systematic
Review and Management Algorithm.
Source
Vascular and Endovascular Surgery. 60(2) (pp 135-144), 2026. Date of
Publication: 01 Feb 2026.
Author
Pegler A.; Sivakumaran Y.
Institution
(Pegler, Sivakumaran) Princess Alexandra Hospital, Brisbane, QLD,
Australia
Publisher
SAGE Publications Inc.
Abstract
Background: Aortic dissection following endovascular aneurysm repair
(EVAR) may be iatrogenic or a de-novo event. This study aims to
systematically review all cases of dissection following EVAR to identify
complications specific to each scenario and develop a management algorithm
depending on the clinical presentation. Method(s): A comprehensive
literature search of MEDLINE, Embase, and CENTRAL databases was performed
for all studies relating to dissection following EVAR or
fenestrated/branched EVAR (F/BrEVAR). Data collected included timing
(differentiating iatrogenic and de-novo events), entry tear location,
endograft involved, complications, management, and subsequent outcomes.
Due to limited data availability, descriptive data was collected and
outcomes compared depending on dissection type and timing. Risk of bias
was assessed using a standardised tool for case reports. Result(s):
46 patients in 37 studies were included. Complications included endograft
compression (52.2%), endoleak (15.2%), and rupture (13.0%). Compression
was less likely in endografts with proximal fixation (41.9%), compared to
those without (69.2%). Type A dissection after EVAR required cardiac
surgery with a high mortality (20.0%). In Type B dissection, 2 cases were
diagnosed intra-operatively during F/BrEVAR, 1 died. 8 were diagnosed <4
weeks post-operatively, all managed medically with no complications or
mortality. 31 were diagnosed >4 weeks, with mortality of 25.8% and high
rates of endograft compression (58.1%), endoleak (16.1%), and rupture
(19.4%). Conclusion(s): Aortic dissection following EVAR may cause
endograft compression, endoleak, or rupture, with significant mortality.
Complications are more frequent following Type A dissection and late Type
B dissection. Early Type B dissection may be amenable to medical
management. Copyright © The Author(s) 2025

<10>
Accession Number
2042302295
Title
Prevention of Infections in Cardiac Surgery (PICS)-Prevena Study - A
pilot/vanguard factorial cluster cross-over RCT.
Source
PLOS ONE. 20(12 December) (no pagination), 2025. Article Number: e0338300.
Date of Publication: 01 Dec 2025.
Author
Scheier T.C.; Whitlock R.; Loeb M.; Devereaux P.J.; Lamy A.; McGillion M.;
Quantz M.; Copland I.; Lee S.-F.; Mertz D.
Institution
(Scheier, Whitlock, Loeb, Devereaux, Lamy, McGillion, Copland, Lee, Mertz)
Population Health Research Institute, McMaster University and Hamilton
Health Sciences, Hamilton, ON, Canada
(Whitlock, Loeb, Devereaux, Lee, Mertz) Department of Health Research
Methodology, Evidence, and Impact, Faculty of Health Sciences, McMaster
University, Hamilton, ON, Canada
(Loeb, Mertz) Division of Infectious Diseases, Department of Medicine,
McMaster University, Hamilton, ON, Canada
(Devereaux) World Health Research Trust, Hamilton, ON, Canada
(Lamy) Department of Surgery, McMaster University, Hamilton, ON, Canada
(Quantz) Department of Surgery, Division of Cardiac Surgery, Schulich
School for Medicine & Dentistry, London, ON, Canada
Publisher
Public Library of Science
Abstract
Sternal surgical site infections after cardiac surgery can lead to
significant morbidity, mortality, and cost. The effects of negative
pressure wound management and adding vancomycin as perioperative
antimicrobial prophylaxis are unknown. The PICSPREVENA pilot/vanguard
trial, a 2x2 factorial, open label, cluster-randomized crossover trial
with 4 periods, was conducted at two major cardiac surgery hospitals in
Ontario, Canada. Sites were randomized to one of eight sequences of the
four study arms (Cefazolin or Cefazolin + Vancomycin (not analyzed) and
standard wound dressing or a negative pressure 3M Prevena incision
management system (Prevena). Only diabetic or obese patients were eligible
for the latter comparison. This trial investigated feasability including
adherence to protocol of each intervention (goal: > 90% each) and loss to
follow-up (goal: < 10%). Among the 4107 included patients, 2230 were
obese/diabetic (1208 standard wound dressing period, 1022 during Prevena
period). Compliance to wound management and antimicrobial prophylaxis was
68.1% and 98.7%, respectively. Loss to follow-up was 3.6%.
Deep/organ-space sternal surgical site infections occurred in 16 (1.6%)
patients in the Prevena allocated periods and in 17 (1.4%) patients in the
standard wound dressing allocated periods (OR= 1.11, 95% CI: 0.56-2.20).
Other clinical outcomes did not suggest a difference and a post-hoc
as-treated analysis showed similar results. This study showed challenges
with introducing a novel technology as standard of care, with
non-compliance mostly driven by one of the sites. No firm conclusions
should be drawn regarding the effectiveness of Prevena, as this vanguard
trial was not powered for clinical outcomes. Copyright © 2025
Scheier 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.

<11>
Accession Number
2041795042
Title
Assessing the impact of bariatric surgery on cardiovascular risk in type 2
diabetes: a systematic review and meta-analysis using OMICs data.
Source
Diabetology and Metabolic Syndrome. 17(1) (no pagination), 2025. Article
Number: 448. Date of Publication: 01 Dec 2025.
Author
Almazrouei B.; Mousa M.; Al Dain Marzouka N.; Barajas-Gamboa J.S.; Abril
C.; Al Safar H.
Institution
(Almazrouei, Mousa, Al Dain Marzouka, Al Safar) Center for Biotechnology,
Khalifa University of Science and Technology, Abu Dhabi, United Arab
Emirates
(Almazrouei, Al Safar) Department of Biomedical Engineering &
Biotechnology, Khalifa University of Science and Technology, Abu Dhabi,
United Arab Emirates
(Barajas-Gamboa, Abril) Department of General Surgery, Digestive Disease
Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
Publisher
BioMed Central Ltd
Abstract
Type 2 diabetes (T2D) is a complex, multifactorial metabolic disorder, and
while bariatric surgery has emerged as a promising intervention for
obesity-related T2D with significant metabolic benefits, its long-term
durability and potential for remission vary among patients. This
systematic review and meta-analysis explore how omics modalities-such as
genomics, epigenomics, transcriptomics, metabolomics, proteomics, and gut
microbiome-can reveal potential biomarkers linked to cardiovascular
disease (CVD) of T2D patients who undergo bariatric surgery. Following
PRISMA 2020 guidelines, a systematic search in PubMed identified 49
eligible studies. The meta-analysis of eight proteomic biomarkers, showed
significant post-surgery improvements in total cholesterol (mean
difference (MD) 0.44 (95% CI: 0.06-0.82), p = 0.02), triglycerides (MD
1.00 (0.77-1.24), p < 0.00001), LDL cholesterol (MD 0.27 (0.02, 0.52), p =
0.03), HDL cholesterol (MD -0.22 (-0.30, -0.15), p < 0.00001), hsCRP (MD
0.64 (0.44, 0.84), p < 0.00001), C peptide levels (MD 1.29 (0.96, 1.61), p
< 0.0001), and IL-6 (MD 1.84 (0.85, 2.84), p = 0.0003). These findings
highlight the value of integrated omics in developing personalized
diagnostics, predicting disease risks, and designing targeted therapies.
The present study is the first systematic review presenting the omics
disciplines that offer a comprehensive view of the effectiveness of
bariatric surgery in managing T2D, subsequently reducing the risk of
CVD. Copyright © The Author(s) 2025.

<12>
Accession Number
2041740529
Title
Prevalence of Radial Artery Variants and Their Relationship with Clinical
Considerations of the Antebrachial Region: Systematic Review and
Meta-Analysis.
Source
Diagnostics. 15(23) (no pagination), 2025. Article Number: 2984. Date of
Publication: 01 Dec 2025.
Author
Sanchis-Gimeno J.; Loaiza-Giraldo J.P.; Alruiz Y.; Vergara M.; Navia M.F.;
Roman C.; Suazo-Santibanez A.; Nova-Baeza P.; Orellana-Donoso M.;
Oyanedel-Amaro G.; Rodriguez-Luengo M.; Bruna-Mejias A.;
Valenzuela-Fuenzalida J.J.; Leon-Rojas J.E.; Granite G.
Institution
(Sanchis-Gimeno) GIAVAL Research Group, Department of Anatomy and Human
Embryology, Faculty of Medicine, University of Valencia, Valencia, Spain
(Loaiza-Giraldo) Facultad de Ciencias de la Salud, Unidad Central del
Valle del Cauca (UCEVA), Valle del Cauca, Tulua, Colombia
(Alruiz, Vergara, Navia, Roman, Nova-Baeza, Rodriguez-Luengo,
Valenzuela-Fuenzalida) Departamento de Morfologia, Facultad de Medicina,
Universidad Andres Bello, Santiago, Chile
(Suazo-Santibanez) Faculty of Health and Social Sciences, Universidad de
Las Americas, Santiago, Chile
(Orellana-Donoso) Escuela de Medicina, Universidad Finis Terrae, Santiago,
Chile
(Orellana-Donoso) Universidad San Sebastian, Chile
(Oyanedel-Amaro) Facultad de Ciencias de la Salud, Universidad Autonoma de
Chile, Santiago, Chile
(Bruna-Mejias) Departamento de Ciencias y Geografia, Facultad de Ciencias
Naturales y Exactas, Universidad de Playa Ancha, Valparaiso, Chile
(Valenzuela-Fuenzalida) Departamento de Ciencias Quimicas y Biologicas,
Facultad de Ciencias de la Salud, Universidad Bernardo O'Higgins,
Santiago, Chile
(Leon-Rojas) Cerebro, Emocion y Conducta (CEC) Research Group, Escuela de
Medicina, Universidad de las Americas (UDLA), Quito, Ecuador
(Granite) Department of Surgery, Uniformed Services University of the
Health Sciences, Bethesda, MD, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: The radial artery (RA) is one of the terminal branches of the
brachial artery, extending along the lateral forearm, crossing the
anatomical snuffbox, and contributing to the palmar arches. Anatomical
variations in the RA are of great clinical relevance due to their
implications in procedures such as transradial catheterization, arterial
cannulation, and bypass grafting. These variants may alter the course,
branching pattern, or origin of the vessel, potentially increasing
procedural complexity and the risk of iatrogenic injury. In critically ill
patients and in surgical or interventional settings, accurate
identification of RA anatomy is essential. The objective of this study was
to systematically identify and describe RA variants reported in the
scientific literature and to analyze their clinical relevance.
 Method(s): A systematic search was conducted across six electronic
databases: Medline, Scopus, Web of Science, Google Scholar, Cumulative
Index to Nursing and Allied Health Literature (CINAHL), and Latin American
and Caribbean Literature in Health Sciences (LILACS), covering
publications up to July 2025. Eligible studies included anatomical,
radiological, and surgical investigations reporting RA variants. Study
quality was evaluated using the Assessment of Quality in Anatomical
Studies (AQUA) tool. Quantitative synthesis was performed using a
random-effects model to estimate the pooled prevalence of RA variants and
subgroup differences. Twenty-three studies met the inclusion criteria, and
eleven were included in the meta-analysis, encompassing a total of 6320
participants. Result(s): Radial artery variants were categorized into
three main types: variations in origin, course, and branching pattern. The
pooled global prevalence of RA variants was 12% (95% CI: 6-18%), with
substantial heterogeneity (I2 = 97.7%). Higher prevalence was
found in imaging-based studies (14%) compared with donor-based studies
(12%). Sex-based subgroup analysis revealed a higher prevalence in females
(18%; CI: 9-28%) compared with males (3%; CI: 3-4%), with moderate
heterogeneity (I2 = 61.3%). Regionally, European populations
demonstrated a higher prevalence (20%) than Asian populations (11%), both
showing high heterogeneity (I2 > 98%). Notably, only one study
from the Americas and none from Africa or Oceania were identified,
representing a major geographical limitation in the available data. The
findings of this study highlight the considerable variability in RA
anatomy across populations. Such variations hold significant clinical
importance, particularly in the context of transradial interventions,
arterial cannulation, and reconstructive procedures where vascular
integrity is critical. The high degree of heterogeneity observed may
reflect differences in population genetics, sample size, and imaging or
dissection methodologies. The limited representation of certain regions
underscores the need for further anatomical and radiological studies to
obtain a more comprehensive understanding of global RA variability.
Preoperative or pre-procedural imaging using Doppler ultrasonography or
computed tomography angiography is recommended to identify anomalous
patterns and minimize iatrogenic complications. Conclusion(s): Radial
artery variants are frequent and diverse. Their recognition is fundamental
for the safety and success of invasive and surgical procedures in the
upper limb. A standardized approach to vascular evaluation, particularly
through preoperative imaging, is essential to improve procedural outcomes
and reduce the risk of arterial injury in clinical practice. Copyright
© 2025 by the authors.

<13>
Accession Number
2041717781
Title
Fluid overload-associated large B-cell lymphoma: two case report and
review of literature.
Source
Frontiers in Oncology. 15 (no pagination), 2025. Article Number: 1724247.
Date of Publication: 2025.
Author
Chang L.; Yang Z.; Yang C.; Wang Y.; Li D.; Wang H.; Zang L.; Zhang Y.
Institution
(Chang, Wang, Li, Wang) School of Clinical Medicine, Shandong Second
Medical University, Weifang, China
(Chang, Wang, Li, Wang, Zhang) Department of Hematology, Linyi People's
Hospital, Shandong Second Medical University, Shandong, Linyi, China
(Yang) Spine surgery, Linyi People's Hospital, Shandong Second Medical
University, Shandong, Linyi, China
(Yang) Department of Pathology, Linyi People's Hospital, Shandong Second
Medical University, Shandong, Linyi, China
(Zang) Pharmaceutical laboratory, Department of Pharmacy, Linyi People's
Hospital, Shandong Second Medical University, Shandong, Linyi, China
Publisher
Frontiers Media SA
Abstract
Background: Fluid overload-associated large B-cell lymphoma (FO-LBCL) is
an exceptionally rare lymphoma characterized by predominant involvement of
serous body cavities-such as the pleura, peritoneum, and pericardium-in
the absence of a solid tumor mass. Its low incidence and nonspecific
clinical presentation, which often includes symptoms like dyspnea due to
effusion, contribute to diagnostic challenges in early stages. This study
aims to address current gaps in the understanding of FO-LBCL by reporting
two new cases and reviewing the clinical features, treatment regimens, and
outcomes of 57 documented patients. Furthermore, through a detailed
analysis of FO-LBCL characteristics, this work discusses relevant
differential diagnoses and potential treatment strategies. Method(s):
A literature search of PubMed and Web of Science was performed using the
following search queries: (1) "Fluid overload-associated large B-cell
lymphoma" OR "FO-LBC"; (2) "Human herpesvirus 8-unrelated" AND "effusion
lymphoma"; (3) "HHV8-unrelated" AND "effusion lymphoma". Result(s):
This study included a total of 57 patients. Fluid accumulation most
commonly affected the pleural cavity (84.2%), followed by the pericardial
(31.6%) and peritoneal (21.1%) cavities. The predominant clinical
manifestation was dyspnea (55.8%). Chemotherapy was the primary treatment
modality (56.1%), with the R-CHOP regimen representing the most commonly
administered protocol. CD20 expression was the most significant favorable
prognostic factor (P = 6x10-7). Other factors associated with improved
survival included the absence of CD138 expression (P = 0.0009), age >= 65
years (P = 0.0015), LDH <= 500 U/L (P = 0.0064), the presence of pleural
effusion (P = 0.0099), and CD79a expression (P = 0.0411). Treatment with
rituximabcontaining chemotherapy regimens was also a significant favorable
factor (P = 0.0036). Conclusion(s): FO-LBCL often presents with
dyspnea caused by fluid effusion. Routine laboratory tests typically show
no significant abnormalities, making timely pathological examination
essential for a definitive diagnosis. Clinicians should enhance their
understanding of FO-LBCL characteristics to improve early diagnostic
accuracy. It is crucial to select appropriate treatment strategies based
on prognostic factors. Copyright © 2025 Chang, Yang, Yang, Wang,
Li, Wang, Zang and Zhang.

<14>
Accession Number
2041694505
Title
Age-Stratified Effect of Rivaroxaban Monotherapy for Atrial Fibrillation
in Stable Coronary Artery Disease: A Post Hoc Analysis of the AFIRE
Randomized Clinical Trial.
Source
JAMA Cardiology. 10(10) (pp 990-999), 2025. Date of Publication: 08 Oct
2025.
Author
Yamaguchi J.; Arashi H.; Hagiwara N.; Yasuda S.; Kaikita K.; Akao M.; Ako
J.; Matoba T.; Nakamura M.; Miyauchi K.; Matsui K.; Nakamura A.; Tamiya
E.; Yamamoto T.; Suetake S.; Noguchi T.; Nakamura S.; Kojima J.; Yamaguchi
H.; Suwa S.; Yasu T.; Nakajima A.; Yamada T.; Arai H.; Hata Y.; Sakanashi
T.; Tateishi H.; Nakayama T.; Nozaki Y.; Okumura Y.; Tokue M.; Kuroki N.;
Maruyama Y.; Suzuki H.; Nishida Y.; Ajioka M.; Yumoto K.; Shimizu S.;
Shimomura H.; Takeda T.; Oshiro K.; Sugishita N.; Shibata Y.; Otonari T.;
Shimizu M.; Kihara H.; Ogawa H.; Ono A.; Hazama M.; Tsukahara K.; Haruta
S.; Haruna T.; Ito M.; Fujii K.; Atsuchi N.; Sata M.; Wakeyama T.; Hasebe
N.; Kobayasi Y.; Osato K.; Hironaga K.; Naganuma Y.; Anzaki K.; Okazaki
S.; Nakagawa Y.; Tokuhiro K.; Tanaka K.; Momose T.; Fukushima Y.; Kametani
R.; Kawamitsu K.; Saito Y.; Akashi S.; Kumagai K.; Eshima K.; Tobaru T.;
Seo T.; Okuhara K.; Kozuma K.; Ikari Y.; Takahashi T.; Oiwa K.; Michishita
I.; Fujikura H.; Momomura S.; Yamamoto Y.; Otomo K.; Matsubara T.; Tashiro
H.; Inoue T.; Ishihara M.; Shiojima I.; Tachibana E.; Sumii K.; Yamamoto
N.; Omura N.; Takahashi N.; Morita Y.; Watanabe K.; Fujinaga H.; Maruyama
M.; Oka T.; Shirayama T.; Amano T.; Fukui K.; Ando K.; Oshima S.; Kagiyama
S.; Teragawa H.; Yuge M.; Ono S.; Koga T.; Fujiu K.; Kuwabara M.; Oya Y.;
Yumoto Y.; Kuji N.; Ikemura M.; Kario K.; Chatani K.; Sato K.; Miyagi H.;
Murakami M.; Saito K.; Hoshiga M.; Sato S.; Kubo N.; Sakamoto Y.; Ashida
K.; Sakamoto H.; Murasaki S.; Uehara H.; Akasaka T.; Oba Y.; Nakahara S.;
Hanaoka Y.; Nishimiya T.; Tsunoda R.; Onuma Y.; Higuchi S.; Tani A.; Wada
A.; Kato M.; Obata H.; Higuchi Y.; Endo T.; Kato R.; Matsunaga T.;
Matsuoka T.; Noguchi H.; Usui M.; Hayashi T.; Otsuji Y.; Osaki T.; Zaizen
H.; Yoshihara H.; Kadota K.; Hirose T.; Miyazawa T.; Mori A.; Takano M.;
Shimizu W.; Wake M.; Oriso S.; Yoshiyama M.; Kakinoki S.; Nishioka T.;
Ozaki T.; Nomoto K.; Seki K.; Kawai K.; Ozaki Y.; Miura S.; Kawasaki M.;
Funada R.; Dote K.; Okamoto S.; Owada T.; Doke T.; Matsumura T.; Kubo T.;
Horiuchi M.; Nagano T.; Takaishi A.; Yamamoto M.; Nakashima H.; Murozono
Y.; Munemasa M.; Sakata Y.; Inoue N.; Ota T.; Hamano Y.; Abe N.; Tsubokura
T.; Goto M.; Kubota I.; Yano M.; Umetani K.; Date T.; Morimoto H.; Noda
T.; Goto S.; Hibi K.; Nakano A.; Hiramitsu S.; Kihara Y.; Sugi M.; Shiba
N.; Izumi D.; Sato T.; Ajiki K.; Oishi M.; Kiryu M.; Ko T.; Ando H.;
Miyazaki S.; Kinugawa T.; Otake H.; Kitaoka H.; Tayama S.; Hirata Y.;
Honda S.; Manita M.; Ishii Y.; Oka H.; Nanba Y.; Nishino M.; Sakamoto T.;
Saito T.; Sakai H.; Ichikawa M.; Namiuchi S.; Matsui T.; Inoue K.;
Komiyama N.; Akashi Y.; Matsumura A.; Nakamura Y.; Komaru T.; Hosokawa T.;
Chikamori T.; Tanaka H.; Suzuki A.; Arasaki O.; Aonuma K.; Wakasa Y.;
Yoshizawa T.; Sugano T.; Yokota N.; Kakutani A.; Suzuki T.; Abe Y.;
Kataoka T.; Okayama H.; Yokoi H.; Chin K.; Hasegawa K.; Tomita H.; Honzyo
H.; Kawai H.; Morino Y.; Tsujiyama S.; Yoshimura M.; Hamasaki S.; Niijima
Y.; Aoyama T.; Mizuno Y.; Maki A.; Tanabe K.; Murohara T.; Nakamura T.;
Naomi S.; Matsumoto N.; Minamino T.; Sairenji H.; Miyamoto N.; Arikawa M.;
Ito H.; Matsuura Y.; Hata S.; Nakatsu Y.; Onodera T.; Kato T.; Amano H.;
Tokutake E.; Kasao M.; Moriguchi M.; Yamamoto K.; Tsuji M.; Yamamoto H.;
Yanbe Y.; Iwasawa T.; Suzuki M.; Mori H.; Shibahashi E.; Takita M.; Kimura
K.
Institution
(Yamaguchi, Arashi, Hagiwara) Department of Cardiology, Tokyo Women's
Medical University, Tokyo, Japan
(Yasuda) Department of Cardiovascular Medicine, Tohoku University,
Graduate School of Medicine, Miyagi, Japan
(Yasuda) National Cerebral and Cardiovascular Center, Osaka, Japan
(Kaikita) Department of Cardiovascular Medicine, Graduate School of
Medical Sciences, Kumamoto University, Kumamoto, Japan
(Kaikita) Division of Cardiovascular Medicine and Nephrology, Department
of Internal Medicine, Faculty of Medicine, University of Miyazaki,
Miyazaki, Japan
(Akao) Department of Cardiology, National Hospital Organization, Kyoto
Medical Center, Kyoto, Japan
(Ako) Department of Cardiovascular Medicine, Kitasato University, School
of Medicine, Kanagawa, Japan
(Matoba) Department of Cardiovascular Medicine, Faculty of Medical
Sciences, Kyushu University, Fukuoka, Japan
(Nakamura) Division of Cardiovascular Medicine, Toho University, Ohashi
Medical Center, Tokyo, Japan
(Miyauchi) Department of Cardiovascular Medicine, Juntendo Tokyo Koto
Geriatric Medical Center, Tokyo, Japan
(Matsui) Department of General Medicine and Primary Care, Kumamoto
University Hospital, Kumamoto, Japan
(Ogawa) Kumamoto University, Kumamoto, Japan
(Nakamura) Iwate Prefectural Central Hospital, Japan
(Tamiya) Koto Hospital, Japan
(Yamamoto) Hokkaido Cardiovascular Hospital, Japan
(Suetake) Kaetsu Hospital, Japan
(Noguchi) National Cerebral and Cardiovascular Center, Japan
(Nakamura) Hitoyoshi Medhical Center, Japan
(Matsumura) Kameda Medical Center, Japan
(Kojima) Kojima Clinic, Japan
(Yamaguchi) Hiroshi YamaguchI Clinic, Japan
(Suwa) Juntendo University Shizuoka Hospital, Japan
(Yasu) Dokkyo Medhical University Nikko Medical Center, Japan
(Nakajima) New Tokyo Hospital, Japan
(Yamada) Osaka General Medical Center, Japan
(Arai) Kanoya Heart Center, Japan
(Hata) Minamino Cardiovascular Hospital, Japan
(Sakanashi) Sakanashi Heart Clinic, Japan
(Tateishi) Koyo Newtown Hospital, Japan
(Nakayama) Nakayama Clinic, Japan
(Nozaki) Hokkokinen Hospital, Japan
(Okumura) Nihon University Itabashi Hospital, Japan
(Tokue) Toho University Medical Center Ohashi Hospital, Japan
(Kuroki) Tokyo Metropolitan Bokutoh Hospital, Japan
(Maruyama) Iwatsuki-minami Hospital, Japan
(Suzuki) Showa University Fujigaoka Hospital, Japan
(Nishida) Kouseikai Takai Hospital, Japan
(Ajioka) Tosei General Hospital, Japan
(Yumoto) Yokohama Rosai Hospital, Japan
(Shimizu) Mashiko Hospital, Japan
(Aoyama) Fukui Prefectural Hospital, Japan
(Shimomura) Fukuoka Tokushukai Hospital, Japan
(Takeda) Koto Memorial Hospital, Japan
(Oshiro) Ohama Dai-ichi Hospital, Japan
(Sugishita) Sugishita Clinic, Japan
(Shibata) Miyazaki Medical Association Hospital, Japan
(Otonari) Otonari Clinic, Japan
(Shimizu) International Goodwill Hospital, Japan
(Kihara) Kihara Cardiovascular Clinic, Japan
(Ogawa) Kitaakita Municipal Hospital, Japan
(Ono) Medical Corporation Shoikai Kasai Shoikai Hospital, Japan
(Hazama) Nijigaoka Hospital, Japan
(Tsukahara) Fujisawa City Hospital, Japan
(Haruta) Fukuyama Cardiovascular Hospital, Japan
(Haruna) Kitano Hospital, Tazuke Kofukai Medical Research Institute, Japan
(Ito) Mie University Hospital, Japan
(Fujii) Sakurabashi Watanabe Hospital, Japan
(Atsuchi) Tenyokai Central Clinic, Japan
(Sata) Tokushima University Hospital, Japan
(Wakeyama) Tokuyama Central Hospital, Japan
(Hasebe) Asahikawa Medical University Hospital, Japan
(Kobayasi) Chiba University Hospita, Japan
(Osato) Fukui CardioVascular Center, Japan
(Hironaga) Fukuoka City Hospital, Japan
(Naganuma) Hachinohe Red Cross Hospital, Japan
(Anzaki) Izumi Regional Medical Center, Japan
(Okazaki) Juntendo University Hospital, Japan
(Nakagawa) Kawanishi City Hospital, Japan
(Tokuhiro) Misato Central General Hospital, Japan
(Tanaka) Miyoshi Central Hospital, Japan
(Momose) Nagano Matsushiro General Hospital, Japan
(Fukushima) Nagatsuda Kosei General Hospital, Japan
(Kametani) Nagoya Tokushukai General Hospital, Japan
(Kawamitsu) Nanbu Tokushukai Hospital, Japan
(Saito) Nara Medical University, Japan
(Akashi) National Hospital Organization Hamada Medical Center, Japan
(Kumagai) Odawara Cardiovascular Hospital, Japan
(Eshima) Saga-Ken Medical Centre Koseikan, Japan
(Tobaru) Sakakibara Heart Institute, Japan
(Seo) Seo Heart Clinic, Japan
(Okuhara) Shobara Red Cross Hospital, Japan
(Kozuma) Teikyo University Hospital, Japan
(Ikari) Tokai University Hospital, Japan
(Takahashi) Tokyo Saiseikai Central Hospital, Japan
(Oiwa) Yokohama Chuo Hospital, Japan
(Michishita) Yokohama Sakae Kyosai Hospital, Japan
(Fujikura) Fujikura Clnic, Japan
(Momomura) Jichi Medical University Saitama Medical Center, Japan
(Yamamoto) Kansai Medical University Medical Center, Japan
(Otomo) Ome Municipal Hospital, Japan
(Matsubara) Shinrakuen Hospital, Japan
(Tashiro) St.Mary's Hospital, Japan
(Inoue) Dokkyo Medical University Hospital, Japan
(Ishihara) Hyogo College of Medicine College Hospital, Japan
(Shiojima) Kansai Medical University Hospital, Japan
(Tachibana) Kawaguchi Municipal Medical Center, Japan
(Sumii) MAZDA Hospital, Japan
(Yamamoto) Miyazaki Prefectural Nobeoka Hospita, Japan
(Omura) Nakata Clinic, Japan
(Nakamura) National Hospital Organization Kyushu Medical Center, Japan
(Takahashi) Oita University Hospital, Japan
(Morita) SAGAMIHARA NATIONAL HOSPITAL, Japan
(Watanabe) Saiseikai Matsuyama Hospital, Japan
(Fujinaga) Tokushima Prefectural Central Hospital, Japan
(Maruyama) Toyama Prefectural Central Hospital, Japan
(Oka) Tsuyama Chuo Hospital, Japan
(Shirayama) University Hospital, Kyoto Prefectural University of Medicine,
Japan
(Amano) Aichi Medical University Hospital, Japan
(Fukui) Kanagawa Cardiovascular and Respiratory Center, Japan
(Ando) Kokura Memorial Hospital, Japan
(Oshima) Kumamoto Chuo Hospital, Japan
(Kagiyama) Kyushu Central Hospital of the Mutual Aid Association of
Public, Japan
(Teragawa) Medical Corporation JR Hiroshima Hospital, Japan
(Yuge) Odawara Municipal Hospital, Japan
(Ono) Saiseikai Yamaguchi Hospita, Japan
(Koga) Steel Memorial Yawata Hospital, Japan
(Fujiu) The University of Tokyo Hospital, Japan
(Kuwabara) Toranomon Hospital, Japan
(Oya) University of the Ryukyus Hospital, Japan
(Yumoto) Fuji Hospital, Japan
(Kuji) Good Heart Clinic, Japan
(Ikemura) Ikemura Medical Clinic, Japan
(Kario) Jichi Medical University Hospital, Japan
(Chatani) Kawasaki Municipal Tama Hospital, Japan
(Sato) Kumamoto City Hospital, Japan
(Miyagi) Miyagi Clinic, Japan
(Murakami) Murakami Clinic, Japan
(Saito) Nishiarai Heart Center Hospital, Japan
(Hoshiga) Osaka Medical College Hospital, Japan
(Sato) Saiseikai Imabari Hospital, Japan
(Kubo) Saitama Medhical Center, Japan
(Sakamoto) Sakamoto Cardiovascular Clinic, Japan
(Ashida) Seirei Yokohama Hospital, Japan
(Sakamoto) Shizuoka Prefectural Hospital, Japan
(Murasaki) Tama-Hokubu Medical Center, Japan
(Uehara) Urasoe General Hospital, Japan
(Akasaka) Wakayama Medical University Hospital, Japan
(Oba) Chihaya Hospital, Japan
(Nakahara) Dokkyo Medical University Saitama Medical Center, Japan
(Hanaoka) Hanaoka Cardiovascular Clinic, Japan
(Nishimiya) Japanese Red Cross Asahikawa Hospital, Japan
(Tsunoda) Japanese Red Cross Kumamoto Hospital, Japan
(Onuma) JR Sapporo Hospital, Japan
(Higuchi) Kamiamakusa General Hospital, Japan
(Tani) Kano General Hospital, Japan
(Wada) Kusatsu General Hospital, Japan
(Kato) Mie Heart Center, Japan
(Obata) National Hospital Organization Obihiro Hospital, Japan
(Higuchi) Osaka Police Hospital, Japan
(Endo) Saiseikai Yokohamashi Nanbu Hospital, Japan
(Kato) Saitama Medical University International Medical Center, Japan
(Matsunaga) Suizenji Tohya Hospital, Japan
(Matsuoka) Uji Tokushukai Medical Center, Japan
(Noguchi) Fukuoka Wajiro Hospital, Japan
(Usui) Hamanomachi Hospital, Japan
(Hayashi) Hayashi Medical Clinic, Japan
(Otsuji) Hospital of the University of Occupational and Environmental
Health, Japan
(Osaki) Iwate Prefectual Kuji Hospital, Japan
(Zaizen) JA Oita Koseiren TsurumiI Hospital, Japan
(Yoshihara) JA Toride Medical Center, Japan
(Kadota) Kurashiki Central Hospital, Japan
(Hirose) Minamata City Hospital & Medical Center, Japan
(Miyazawa) Miyazawa Heart Clinic, Japan
(Mori) National Hospital Organization Iwakuni Clinical Center, Japan
(Takano) Nippon Medical School Chiba Hokusoh Hospital, Japan
(Shimizu) Nippon Medical School Hospital, Japan
(Wake) Okinawa Prefectural Chubu Hospital, Japan
(Oriso) Oriso Internal Medicine & Cardiology Clinic, Japan
(Yoshiyama) Osaka City University Hospital, Japan
(Kakinoki) Otaru Kyokai Hospital, Japan
(Nishioka) Saitama-Medhical Center, Japan
(Ozaki) Sapporo Orthopaedics and Cardiovascular Hospital, Japan
(Nomoto) Tokyo Rinkai Hospital, Japan
(Seki) Yamaguchi Rosai Hospital, Japan
(Kawai) Chikamori Hospital, Japan
(Ozaki) Fujita Health University Hospital, Japan
(Miura) Fukuoka University Hospital, Japan
(Kawasaki) Gifu University Hospital, Japan
(Funada) Gunma University Hospital, Japan
(Dote) Hiroshima City Asa Citizens Hospital, Japan
(Okamoto) Iwasaki Hospital, Japan
(Owada) Japanese Red Cross Society Fukushima Hospital, Japan
(Doke) Kohka Public Hospital, Japan
(Matsumura) Kumamoto Rosai Hospital, Japan
(Kubo) Japanese Red Cross Matsuyama Hospital, Japan
(Horiuchi) Medical Association Sugimura Hospital, Japan
(Nagano) Iwasa Hospital Iwasa Maternity, Japan
(Takaishi) Mitoyo General Hospital, Japan
(Yamamoto) National Center for Global Health and Medicine, Japan
(Nakashima) National Hospital Organization Kagoshima Medical Center, Japan
(Murozono) Japanese Red Cross Oita Hospital, Japan
(Munemasa) National Hospital Organization Okayama Medical Center, Japan
(Sakata) Osaka University Hospital, Japan
(Inoue) Sendai Kousei Hospital, Japan
(Ota) Takanohara Central Hospital, Japan
(Hamano) Tawaramachi Hamano Hospital, Japan
(Abe) Tokyo Medical University Ibaraki Medical Center, Japan
(Tsubokura) Tsubokura Cardiovascular Clinic, Japan
(Goto) Watanabe Hospital, Japan
(Kubota) Yamagata University Hospital, Japan
(Yano) Yamaguchi University Hospital, Japan
(Umetani) Yamanashi Prefectural Central Hospital, Japan
(Date) Date Naika Clinic, Japan
(Morimoto) Fukagawa Municipal Hospital, Japan
(Noda) Gifu Prefectural General Medical Center, Japan
(Goto) Goto Clinic, Japan
(Hibi) Gumyoji Eye Heart Clinic, Japan
(Nakano) Hikone Municipal Hospital, Japan
(Hiramitsu) Hiramitsu Heart Clinic, Japan
(Kihara) Hiroshima University Hospital, Japan
(Sugi) Imaki City Medical Center, Japan
(Shiba) International University of Health and Welfare Hospital, Japan
(Izumi) Japanese Red Cross Ise Hospital, Japan
(Sato) Japanese Red Cross Okayama Hospital, Japan
(Ajiki) JR Tokyo General Hospital, Japan
(Oishi) Kagoshima University Hospital, Japan
(Kiryu) Kanagawa Cardiovascular Medicine, Japan
(Ko) Kashima Heart Clinic, Japan
(Ando) Keiai Hospital, Japan
(Miyazaki) Kindai University Hospital, Japan
(Kinugawa) Kinugawa Cardiology Clinic, Japan
(Otake) Kobe University Hospital, Japan
(Kitaoka) Kochi Medical School Hospital, Japan
(Tayama) JCHO Kumamoto General Hospital, Japan
(Hirata) Kumamoto Regional Medical Center, Japan
(Honda) Minami Municipal National Insurance Hospital, Japan
(Manita) Naha City Hospital, Japan
(Ishii) Ogikubo Hospital, Japan
(Oka) Oka Clinic, Japan
(Nanba) Okayama Rosai Hospital, Japan
(Nishino) Osaka Rosai Hospital, Japan
(Sakamoto) Saiseikai Kumamoto Hospital, Japan
(Saito) Saito Clinic, Japan
(Sakai) Sakai Clinic, Japan
(Ichikawa) Sekishindo Hospital, Japan
(Namiuchi) Sendai Open Hospital, Japan
(Matsui) JCHO Shiga Hospital, Japan
(Inoue) South Miyagi Medical Center, Japan
(Komiyama) St. Luke's International Hospital, Japan
(Akashi) St. Marianna University School of Medicine Hospital, Japan
(Matsumura) Awa Regional Medical Center, Japan
(Nakamura) Takeda General Hospital, Japan
(Komaru) Tohoku Medical and Pharmaceutical University Hospital, Japan
(Hosokawa) Tokyo Haert Center, Japan
(Chikamori) Tokyo Medical University Hospital, Japan
(Tanaka) Tokyo Metropolitan Tama Medical Center, Japan
(Suzuki) JCHO Tokyo Yamate Medical Center, Japan
(Arasaki) Tomishiro Central Hospital, Japan
(Aonuma) University of Tsukuba Hospital, Japan
(Wakasa) Wakasa Medical Clinic, Japan
(Yoshizawa) Yamato Municipal Hospital, Japan
(Sugano) Yokohama City University Hospital, Japan
(Yokota) Yokota Naika, Japan
(Kakutani) Yoshinoawa Medical Center, Japan
(Suzuki) Aizawa Hospital, Japan
(Abe) Akeno Clinic, Japan
(Kataoka) Bellland General Hospital, Japan
(Okayama) Ehime Prefectural Central Hospital, Japan
(Yokoi) Fukuoka Sanno Hospital, Japan
(Chin) Hakuai Clinic, Japan
(Hasegawa) Hasegawa Outpatients Clinic for Cardiovascular Disease, Japan
(Tomita) Hirosaki University Hospital, Japan
(Honzyo) Honzyo Medical Hospital, Japan
(Kawai) Hyogo Brain and Heart CenterAt Himeji, Japan
(Yamamoto) Iida Municipal Hospital, Japan
(Morino) Iwate Medical University Hospital, Japan
(Tsujiyama) JA Hiroshima General Hospital, Japan
(Yoshimura) The Jikei University Hospital, Japan
(Hamasaki) Kagoshima City Hospital, Japan
(Niijima) Kan-etsu Chu-oh Hospital, Japan
(Aoyama) Kizawa Memorial Hospital, Japan
(Mizuno) Kumamoto Kinoh Hospital, Japan
(Maki) Maki Clinic, Japan
(Tanabe) Mitsui Memorial Hospital, Japan
(Murohara) Nagoya University Hospital, Japan
(Nakamura) Nakamura Clinic, Japan
(Naomi) Naomi Medicinal Clinic, Japan
(Matsumoto) Nihon University Hospital, Japan
(Minamino) Niigata University Medical & Dental Hospital, Japan
(Sairenji) Nishiyama Ichou Jyunkanki Geka Clinic, Japan
(Miyamoto) NTT-East Sapporo Hospital, Japan
(Arikawa) National Hospital Organization Oita Medical Center, Japan
(Ito) Okayama University Hospital, Japan
(Matsuura) Sakaemachi Clinic, Japan
(Hata) Sasebo City General Hospital, Japan
(Nakatsu) Shioda Memorial Hospital, Japan
(Onodera) Shizuoka City Shizuoka Hospital, Japan
(Kato) National Hospital Organization Tochigi Medical Center, Japan
(Amano) Toho University Omori Medical Center, Japan
(Tokutake) Tokutake Clinic, Japan
(Kasao) Tokyo Metropolitan Police Hospital, Japan
(Moriguchi) Toshiba Rinkan Hospital, Japan
(Yamamoto) Tottori University Hospital, Japan
(Tsuji) Tsuji Internal Medicine and Cardiology and Dental Clinic, Japan
(Yamamoto) Yamamoto Clinic, Japan
(Yanbe) Yokohama General Hospital, Japan
(Iwasawa) Yokohama General Hospital Uwamachi, Japan
(Suzuki) Yokohama Minami Kyousai Hospital, Japan
(Mori) Yokohama Sotetsu Building Clinic, Japan
(Shibahashi) Tokyo Women's Medical University, Japan
(Takita) Mebix, Japan
(Kimura) Yokohama City University Medical Center, Japan
Publisher
American Medical Association
Abstract
Importance: Antithrombotic therapy is crucial for older patients with
coronary artery disease (CAD) and atrial fibrillation (AF) who are at a
high risk of bleeding and thrombotic events. Objective(s): To examine
the age-stratified effects of rivaroxaban monotherapy compared with those
of rivaroxaban plus antiplatelet agent combination therapy. Design,
Setting, and Participant(s): This was a post hoc secondary analysis of the
Atrial Fibrillation and Ischemic Events With Rivaroxaban in Patients With
Stable Coronary Artery Disease (AFIRE) open-label randomized clinical
trial. This was a multicenter study conducted in Japan from February 23,
2015, to July 31, 2018. Patients with AF and stable CAD who had undergone
percutaneous coronary intervention or coronary artery bypass grafting 1 or
more years earlier or who had angiographically confirmed CAD that did not
require revascularization were enrolled. Participants were stratified into
4 groups by age (<70 years, 70-74 years, 75-79 years, and >=80 years).
Study data were analyzed from August 2024 to July 2025.
 Intervention(s): Rivaroxaban monotherapy or rivaroxaban plus
antiplatelet agent therapy. Main Outcomes and Measures: The primary
efficacy end point was a major adverse cardiovascular event, defined as a
composite of stroke, systemic embolism, myocardial infarction, unstable
angina requiring revascularization, or death from any cause. The primary
safety end point was major bleeding. Result(s): This study included a
total of 2215 participants (mean [SD] age, 74.3 [8.2] years; 1751 male
[79.1%]). The incidence of primary efficacy end points per patient-year
for rivaroxaban monotherapy vs rivaroxaban plus antiplatelet agent therapy
was 3.2% vs 4.3% (<70 years), 3.2% vs 2.8% (70-74 years), 3.8% vs 5.3%
(75-79 years), and 6.2% vs 10.3% (>=80 years). The hazard ratios were 0.74
(95% CI, 0.40-1.37) for those younger than 70 years, 1.16 (95% CI,
0.55-2.45) for those aged 70 to 74 years, 0.72 (95% CI, 0.41-1.26) for
those aged 75 to 79 years, and 0.61 (95% CI, 0.40-0.93) for those 80 years
and older (P for interaction =.51). For the primary safety end points, the
incidence was 0.5% vs 2.3% (<70 years), 2.2% vs 2.4% (70-74 years), 1.1%
vs 2.1% (75-79 years), and 2.9% vs 4.3% (>=80 years). The hazard ratios
were 0.23 (95% CI, 0.06-0.79) for those younger than 70 years, 0.91 (95%
CI, 0.39-2.15) for those aged 70 to 74 years, 0.52 (95% CI, 0.19-1.42) for
those aged 75 to 79 years, and 0.67 (95% CI, 0.35-1.27) for those 80 years
and older (P for interaction =.33). Conclusions and Relevance:
Results of this post hoc analysis of the AFIRE randomized clinical trial
reveal that rivaroxaban monotherapy reduced the risk of major
cardiovascular events and major bleeding across the broad range of age in
patients with AF and stable CAD. Possible age-related differences in
trends, with more pronounced efficacy in older patients and more
pronounced safety in younger patients, should be considered as hypothesis
generating and require further research. Copyright © 2025
American Medical Association.

<15>
Accession Number
2041773379
Source
Journal of Inflammation Research. 18 (pp 17309-17318), 2025. Date of
Publication: 2025.
Author
Hong M.; Xiang W.; Kong L.; Wang X.; Fu L.; Chen L.; Liu F.
Institution
(Hong, Xiang, Kong, Wang, Fu, Chen, Liu) Cardiovascular Center, Beijing
Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua
University, Beijing, China
Publisher
Dove Medical Press Ltd
Abstract
Background: Corynebacterium striatum (CS) is an uncommon but potentially
fatal pathogen of infective endocarditis (IE). The literature on the
patterns and clinical progression of Corynebacterium striatum infective
endocarditis (CSIE) is limited. This article aims to provide insights into
the clinical presentation and management of CSIE through a retrospective
analysis of documented cases. Method(s): An electronic search was
conducted across various databases including PubMed, China National
Knowledge Infrastructure (CNKI), China Science and Technology Journal
Database, and Wanfang database to identify relevant articles in both
English and Chinese literature documenting CSIE. Subsequently,
patient-level data were extracted and subjected to analysis.
 Result(s): The systematic search yielded 38 patients from 35
articles. The median age was 68 [IQR 54, 73] years, and 63.2% of patients
were men. A history of heart disease was present in 55.3% of cases, while
15.8% had a history of cardiovascular electronic device implantation. The
mitral valve was the most commonly affected site, accounting for 52.8%.
The misdiagnosis or missed diagnosis rate of CSIE was 28.9%.
Microbiological confirmation by 16S ribosomal ribonucleic acid (16S rRNA)
or metagenomic next-generation sequencing (mNGS) was present in 13.2% of
cases. Vancomycin was the most effective antibiotic, with 41.7% of the CS
isolates showing resistance to multiple drugs. Surgical intervention was
performed in 55.3% of the CSIE patients, and the overall fatality rate was
37.8%, both of which were higher than those reported in standard IE due to
common pathogens such as Staphylococcus aureus (surgical intervention rate
37.8%, fatality rate 22.4%) and viridans streptococci (surgical
intervention rate 29.5%, fatality rate 36.6%). Conclusion(s): CSIE
often presents with nonspecific symptoms, making it prone to misdiagnosis
or underdiagnosis. Echocardiography and blood cultures remain the primary
diagnostic tools, but advanced approaches such as 16S rRNA and mNGS
improve accuracy in pathogen identification. Compared to IE caused by
common microorganisms (eg, Staphylococcus aureus, viridans streptococci),
CSIE is associated with higher rates of surgical intervention and
mortality, underscoring the urgent need for increased clinical vigilance
and prompt, targeted management. Copyright © 2025 Hong et al.

<16>
Accession Number
2042202820
Title
Comparison of low- and high-pressure balloon valvuloplasty in dogs with
severe pulmonary valve stenosis.
Source
Journal of Veterinary Cardiology. 63 (pp 81-90), 2026. Date of
Publication: 01 Feb 2026.
Author
Lytle B.; Hogan D.; McManamey A.; Mantovani M.; Dos Santos L.
Institution
(Lytle, Hogan, McManamey, Dos Santos) Purdue University, College of
Veterinary Medicine, Department of Veterinary Clinical Sciences, 625
Harrison Street, West Lafayette, IN, United States
(Mantovani) Federal University of Uberlandia, Av. Joao Naves de Avila,
2121 - Santa Monica, MG, Uberlandia, Brazil
Publisher
Elsevier B.V.
Abstract
Introduction/objectives: Balloon valvuloplasty (BVP) is considered a
standard treatment for severe pulmonary valve stenosis (PS) in dogs. The
efficacy and safety of low-pressure (LP) and high-pressure (HP) balloon
catheters for BVP have not been compared. It was hypothesized there would
be no difference in pressure gradient reduction between HP and LP, while
cardiac troponin I would be higher with HP than with LP immediately
following BVP. Animals, Material(s) and Method(s): Twenty-five
client-owned dogs with severe PS were included in the study. A
prospective, randomized study with animals matched based on pulmonic
annulus size was conducted. Echocardiographic measures of PS severity
included peak transvalvular pressure gradient (PG<inf>max</inf>) and
aorta-to-pulmonary artery velocity time integral ratio at baseline, 18-24
h following BVP, and at the initial follow-up. Serum cardiac troponin I
was measured at each time point. Result(s): No differences were found
between groups in sex, age, weight, or PS severity at any time point
(baseline, 18-24 h post BVP, and follow-up; all P>0.9). Only three dogs
had annular hypoplasia. Cardiac troponin values did not differ between LP
and HP groups at any stage (P>0.1). Complication rates were also
comparable (P=0.201). Study Limitations: The limited sample size may have
reduced statistical power to detect modest yet clinically relevant
differences. Small and homogeneous sample, lack of standardized HP
catheters, inconsistent atenolol use, and variable follow-up timing may
have influenced results. Conclusion(s): No significant difference
between LP and HP catheters was observed in PS severity reduction or
myocardial injury. High-pressure catheters offer no added benefit over LP
catheters for treating severe PS in dogs without annular
hypoplasia. Copyright © 2025 The Author(s)

<17>
[Use Link to view the full text]
Accession Number
2041216073
Title
Prevention of postoperative acute kidney injury: insights from recent
clinical trials.
Source
Current Opinion in Nephrology and Hypertension. (no pagination), 2025.
Date of Publication: 09 Oct 2025.
Author
Benyahia R.; Klein J.; Faguer S.
Institution
(Benyahia, Faguer) Department of Nephrology and Organ Transplantation,
Referral Centre for Rare Kidney Diseases, French Intensive Care Renal
Network, University Hospital of Toulouse
(Benyahia, Klein, Faguer) National Institute of Health and Medical
Research (INSERM), U1297, Institute of Metabolic and Cardiovascular
Diseases (I2MC), Renal Fibrosis Lab
(Benyahia, Klein, Faguer) Faculty of Health, University of Toulouse,
Toulouse, France
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of review - Postoperative acute kidney injury (PO-AKI) is a common
complication associated with increased morbidity and mortality. Despite
its frequency, guidelines for the prevention of PO-AKI are relatively
recent and still based on weak or contradictory evidence. This review aims
to summarize large recent studies published in the past 2 years that have
attempted to address these gaps. Recent findings - While the POST-CABGDM
and Stop-or-Not trials have provided additional evidence on the
preoperative prescription of RAAS and SGLT2 inhibitors in selected
surgical settings, future research must integrate preoperative risk
profiling to personalize therapy. Likewise, although the POISE-3 trial
seems to suggest that maintaining a mean arterial pressure of at least 60
mmHg is crucial in noncardiac surgery, it does not explore how targets
might be personalized. In cardiac surgery, both the SIRAKI02 trial (i.e.,
extracorporeal blood purification membrane connected to the
cardiopulmonary bypass) and the PROTECTION trial (i.e., intraoperative
amino-acid infusion) demonstrated benefit only for mild AKI, raising
questions about their mechanistic basis and clinical significance. Summary
- "Prevention is better than cure, " a principle that holds particularly
true for PO-AKI, a common complication that still lacks effective curative
treatments. Although the recent abovementioned trials have yielded
important findings, they concurrently underscore the significant obstacles
in conducting clinical trials on PO-AKI and in formulating robust
recommendations based on their outcomes. Copyright © 2025

<18>
Accession Number
2041865152
Title
Impact of clonal hematopoiesis of indeterminate potential on prognosis in
patients with severe aortic valve stenosis: a meta-analysis.
Source
Clinical Research in Cardiology. (no pagination), 2025. Date of
Publication: 2025.
Author
Sun H.; Li R.; Cao X.; Wang H.; Ding P.; Ang Y.; Guo X.
Institution
(Sun, Li, Cao, Wang, Ding, Ang, Guo) Department of Cardiology, The First
Affiliated Hospital of Kunming Medical University, Yunnan Province, 295
Xichang Road, Kunming, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Clonal hematopoiesis of indeterminate potential (CHIP),
commonly involving TET2 and DNMT3A mutations, is increasingly recognized
as a cardiovascular risk factor, but its prognostic role in severe aortic
valve stenosis (AVS) remains unclear. This study aimed to systematically
evaluate the impact of CHIP on survival in AVS patients undergoing valve
replacement. Method(s): A systematic search of PubMed, Embase, Web of
Science, and Scopus through May 2025 identified observational studies of
CHIP in AVS patients undergoing valve replacement. Eligible studies used
validated genomic sequencing methods to identify CHIP and reported
mortality outcomes. Two reviewers independently extracted study
characteristics, outcomes, and related variables. Pooled hazard ratios
(HRs) were calculated, with subgroup analyses by mutation type and
geographic region, and meta-regression to assess effect modifiers. Risk of
bias was assessed using the Newcastle-Ottawa Scale, and sensitivity and
publication bias analyses were also assessed. Result(s): Five studies
with 1,175 patients were included. CHIP showed a non-significant trend
toward increased all-cause mortality (HR = 1.58; 95% CI: 0.97-2.57; P =
0.0687; I2 = 64.8%). When defined by TET2 mutations, CHIP was
significantly associated with worse survival (HR = 1.91; 95% CI:
1.43-2.56; P < 0.001, I2 = 0%), whereas DNMT3A mutations were
not. In Western cohorts, CHIP was significantly associated with increased
mortality (HR = 1.65; 95% CI: 1.28-2.12; P < 0.0001; I2 =
38.7%). Meta-regression identified body mass index (BMI) as a significant
modifier of the CHIP-mortality association (P = 0.0069).
 Conclusion(s): CHIP, particularly TET2-related mutations, is
associated with poorer survival in patients with severe AVS undergoing
valve replacement. In Western populations, CHIP was significantly
associated with increased mortality. Higher BMI further strengthened this
association across all patients. These findings indicate that CHIP may be
a potential marker for risk stratification and preventive strategies, but
confirmation in larger and more diverse cohorts is required. Copyright
© Springer-Verlag GmbH Germany, part of Springer Nature 2025.

<19>
Accession Number
2040841260
Title
Minimally Invasive Mitral Valve Repair With Adjustable Chords.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 20(6) (pp 593), 2025. Date of Publication: 01 Nov 2025.
Author
Babliak O.; Babliak D.; Yatsuk S.
Institution
(Babliak, Babliak, Yatsuk) Diagnostic and Treatment Center for Children
and Adults, Dobrobut Medical Network, Kyiv, Ukraine
Publisher
SAGE Publications Ltd

<20>
Accession Number
2040343278
Title
Impact of evolocumab on coronary physiology and microstructure in de-novo
heart transplant recipients.
Source
Journal of Heart and Lung Transplantation. 45(1) (pp 26-36), 2026. Date of
Publication: 01 Jan 2026.
Author
Karim S.R.; Jensen N.M.; Holck E.N.; Clemmesen T.S.; Christiansen E.H.;
Jakobsen L.; Chen Z.; Sonka M.; Karason K.; Broch K.; Solberg O.G.;
Eiskjaer H.
Institution
(Karim, Jensen, Holck, Clemmesen, Christiansen, Jakobsen, Eiskjaer)
Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
(Broch, Solberg) Department of Cardiology, Oslo University Hospital, Oslo,
Norway
(Karason) Transplant Institute, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Chen, Sonka) Iowa Institute for Biomedical Imaging, University of Iowa,
Iowa City, IA, United States
(Karim) Department of Cardiology, Viborg Regional Hospital, Viborg,
Denmark
Publisher
Elsevier Inc.
Abstract
Background Cardiac allograft vasculopathy, characterized by arterial
intima thickening and microvascular dysfunction, compromises survival
after heart transplantation. We investigated the impact of evolocumab on
invasive coronary physiology and microstructure after de-novo
transplantation. Methods In the EVOLVD trial (NCT03734211), the effect of
12 months of evolocumab vs placebo on maximal coronary intimal thickness
was assessed using intracoronary ultrasound. For this substudy, optical
coherence tomography (OCT), fractional flow reserve (FFR), coronary flow
reserve (CFR), microvascular resistance reserve (MRR), and index of
microcirculatory resistance (IMR) were performed at baseline (4-8 weeks
post-transplant) and at 12 months post-transplant. Results Seventy-five
de-novo heart transplant recipients were included, randomized to placebo (
n = 36) or evolocumab ( n = 39). Over 12 months, no between-group
differences were observed in changes in coronary physiology (FFR: DELTA
0.001 [IQR -0.03 to 0.02], p = 0.42; CFR: DELTA 0.59 [IQR -1.33 to 1.90],
p = 0.69; IMR: DELTA 0.76 [IQR -6.86 to 8.32], p = 0.09; MRR: DELTA 0.19
[IQR -1.85 to 2.60], p = 0.70) or coronary microstructure (lumen area:
DELTA -1.37 mm2 [IQR -3.53 to 0.09], p = 0.38; intima area: DELTA 0.05 mm2
[IQR 0.02 to 0.17], p = 0.88. Among all patients, OCT showed a lumen area
decrease of -1.37 [IQR -3.53 to -0.69] mm2 ( p < 0.01) and intima area
increasse of 0.04 [IQR 0.01 to 0.17] mm2 ( p < 0.01) from baseline to
follow-up. Conclusions Evolocumab did not affect coronary physiology or
OCT measurements 12 months after de-novo heart transplantation. OCT
revealed progressive intimal proliferation and luminal narrowing in both
groups, while coronary physiology remained unchanged and did not differ
between treatment arms. Copyright © 2025 The Authors.

<21>
Accession Number
2042281131
Title
Surgically Treated Left Ventricular Myxomas: A 75-Year Systematic Review
of Patient Demographics, Tumour Characteristics, and Outcomes.
Source
Interdisciplinary Cardiovascular and Thoracic Surgery. 40(12) (no
pagination), 2025. Article Number: ivaf248. Date of Publication: 01 Dec
2025.
Author
Abdul-Hafez H.A.; Sarama A.; Safadi T.; Khadra M.N.; Salman H.H.; Darwazah
A.K.; Alkhatib H.
Institution
(Abdul-Hafez, Sarama, Khadra) Department of Medicine, Faculty of Medicine
and Public Health, An-Najah National University, Nablus, Palestine
(Safadi, Alkhatib) Department of Cardiothoracic Surgery, Al-Makassed
Charitable Society Hospital, Jerusalem, Israel
(Salman) Cardiac Surgery Department, Alrazi Hospital, Jenin, Palestine
(Darwazah) Department of Cardiac Surgery, Palestine Medical Complex,
Ramallah, Palestine
Publisher
Oxford University Press
Abstract
Objectives Cardiac myxomas are rare primary heart tumours, most commonly
originating in the left atrium. A smaller proportion occurs in the left
ventricle, where they are even more uncommon and present unique diagnostic
and therapeutic challenges. This systematic review aims to characterize
the clinical features, management strategies, and outcomes of left
ventricular cardiac myxomas. Methods A systematic search of the PubMed
database was conducted to identify articles published up to May 2025. A
total of 174 cases of surgically treated left ventricular myxomas were
included. Data were extracted on patient demographics, tumour
characteristics, surgical approaches, and follow-up outcomes. Results
Patients showed a broad geographic distribution, with the highest number
of cases reported from the United States. The mean age was 38.2 +/- 20.37
years, with a slight female predominance (48.9%). Tumours were most
commonly attached to the left ventricular wall (43.7%) and
inter-ventricular septum (25.3%). Complete surgical excision was achieved
in 92.5% of cases and was strongly associated with survival; nearly all
patients with complete resection survived, compared to only 20% among
those without. Overall postoperative survival was high (83.9%), with a low
mortality rate (2.9%). Survival rates were comparable across genders and
age groups, although paediatric patients had a slightly higher mortality
rate (9.1%). Conclusions This systematic review represents the most
comprehensive analysis to date of surgically treated left ventricular
myxomas. The findings highlight the importance of complete excision in
achieving favourable outcomes and highlight demographic and geographic
patterns that can inform clinical suspicion, surgical planning, and
patient counselling. Copyright © The Author(s) 2025. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<22>
Accession Number
2041015426
Title
Major Clinical Outcomes in Patients With Carotid Artery Stenosis
Undergoing Transcatheter Aortic Valve Replacement: A Systematic Review and
Meta-analysis.
Source
American Journal of Cardiology. 256 (pp 145-154), 2025. Date of
Publication: 01 Dec 2025.
Author
Theodoropoulou T.; Vythoulkas-Biotis N.; Apostolos A.; Ktenopoulos N.;
Koliastasis L.; Synetos A.; Drakopoulou M.; Tsalamandris S.; Latsios G.;
Tsioufis K.; Toutouzas K.
Institution
(Theodoropoulou, Apostolos, Ktenopoulos, Koliastasis, Synetos,
Drakopoulou, Tsalamandris, Latsios, Tsioufis, Toutouzas) Unit for
Structural Heart Diseases and Valvulopathies, First Department of
Cardiology, Athens School of Medicine, Hippokration Hospital, Athens,
Greece
(Vythoulkas-Biotis) Third Departmnent of Cardiology, Athens School of
Medicine, Sotiria Thoracic Diseases Hospital of Athens, Athens, Greece
(Apostolos) Department of Cardiology, Harefield Hospital, Royal Brompton
and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust,
London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Data on carotid artery stenosis (CAS) prevalence in patients undergoing
transcatheter aortic valve replacement (TAVR) are limited. It remains
unclear whether CAS serves as a predictor of worse outcomes following
TAVR. This meta-analysis aims to assess the impact of CAS on major
clinical outcomes in this population. A comprehensive literature search
was conducted across 3 databases to identify relevant studies. The primary
endpoint was the 30-day incidence of Stroke or Transient Ischemic Attack
(TIA) in patients with CAS>=50% and CAS>=70%, respectively. Secondary
endpoints included in-hospital Stroke/TIA, in-hospital mortality, 30-day
mortality, bleeding events, myocardial infarction (MI), acute kidney
injury (AKI), periprocedural vascular complications, and permanent
pacemaker implantation (PPM) up to 30 days. A total of 15 studies,
involving 129,155 patients, were included in the meta-analysis. CAS was
associated with higher rates of 30-day Stroke/TIA: 1) CAS >=50% (Risk
Ratio (RR): 1.38, 95% Confidence Intervals (CI): 1.19, 1.59), 2) CAS >=70%
(RR: 1.61, 95% CI: 1.10, 2.36). CAS comorbidity was also linked to
increased risk for in-hospital stroke/TIA (RR: 1.73, 95% CI: 1.28, 2.33),
30-day mortality (RR: 1.29, 95% CI: 1.13, 1.47), and 30-day bleeding
events (RR: 1.15, 95% CI: 1.08, 1.23). No differences were observed in the
rest secondary endpoints. In conclusion, CAS was associated with a higher
risk of 30-day and in-hospital cerebrovascular events following TAVR.
Patients with CAS are at an increased risk of 30-day all-cause mortality
without any impact on in-hospital mortality. Further studies are required
to validate our results. Copyright © 2025

<23>
Accession Number
2042281911
Title
Efficacy and safety of PM-AR-T versus edwards MC3 rings in tricuspid
regurgitation: A non-inferiority, randomized controlled trial.
Source
PLOS ONE. 20(12 December) (no pagination), 2025. Article Number: e0333891.
Date of Publication: 01 Dec 2025.
Author
Xu Z.; Li J.; Xu W.; Zong Q.; Ji W.; Xu Y.; Su Y.; Li K.; Wang D.; Pan J.
Institution
(Xu, Xu, Zong, Ji, Xu, Su, Li, Wang, Pan) Department of Cardiothoracic
Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing
University Medical School, Nanjing, China
(Li) Department of Ultrasound Imaging, Surgery, Nanjing Drum Tower
Hospital, The Affiliated Hospital of Nanjing University Medical School,
Nanjing, China
Publisher
Public Library of Science
Abstract
Objectives Tricuspid valve repair, particularly with annuloplasty rings,
is increasingly recognized as an effective treatment. PM-AR-T is a
semi-rigid annuloplasty ring based on a nickel-titanium alloy which has
made progress in animal models, however, studies on PM-AR-T's performance
in patients with tricuspid regurgitation (TR) are lacking. This study
aimed to compare the efficacy and safety of the PM-AR-T with the Edwards
MC3 ring for the TR treatment. Methods A non-inferiority, randomized
controlled trial was conducted in 20 centers across China, enrolling
patients with tricuspid valve disease requiring surgical repair. Patients
were randomized to receive either PM-AR-T or Edwards MC3 ring. The primary
endpoint was the success rate of valve repair at 6 months. Results A total
of 164 patients underwent valve annuloplasty, 83 and 81 in the PM-AR-T and
Edwards MC3 groups. Valve repair success rates were 92.8% and 93.8% in the
PM-AR-T and Edwards MC3 groups, demonstrating non-inferiority with a
difference of -1.1% (95% confidence interval [CI]: -9.5 to 7.4), which was
less than the pre-specified non-inferiority margin of -10%. No significant
intergroup differences were found in valve regurgitation,
echocardiographic parameters, and New York Heart Association (NYHA)
functional classification at any postoperative time point. At 12 months,
the proportions of patients without regurgitation were comparable, 30.4%
and 27.8% in the PM-AR-T and Edwards MC3 groups (P = 0.705). Improvement
to NYHA functional class I status was detected in 46.2% and 45.6% of the
two groups by 12 months (P = 0.893). Both rings exhibited comparable
safety profiles, with no device-related serious adverse events,
cardiovascular deaths, major bleeding events, severe structural damage,
infective endocarditis, or thromboembolic events. Conclusions The PM-AR-T
tricuspid valve semi-rigid ring is effective in improving TR,
demonstrating non-inferiority to the Edwards MC3 ring, with a favorable
safety profile. Copyright © 2025 Xu 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.

<24>
Accession Number
2041686929
Title
Midterm Outcomes of the Self-Expanding Navitor Transcatheter Heart Valve:
A Systematic Review and Meta-Analysis.
Source
Structural Heart. 10(1) (no pagination), 2026. Article Number: 100750.
Date of Publication: 01 Jan 2026.
Author
Samimi S.; Kharsa C.; Kritya M.; Aoun J.; Zaid S.; Faza N.N.; Little S.H.;
Kleiman N.S.; Reardon M.J.; Goel S.S.
Institution
(Samimi, Zaid) Department of Cardiology, Baylor College of Medicine,
Houston, TX, United States
(Kharsa, Kritya, Aoun, Faza, Little, Kleiman, Goel) Department of
Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston,
TX, United States
(Reardon) Department of Cardiovascular Surgery, Houston Methodist
Hospital, Houston, TX, United States
Publisher
Cardiovascular Research Foundation

<25>
Accession Number
2041803736
Title
Peri-operative risk of non-cardiac surgery in patients with aortic
stenosis: a systematic review and meta-analysis.
Source
Anaesthesia. (no pagination), 2025. Date of Publication: 2025.
Author
Place A.; Rodrigues T.S.; Naimo P.S.; Lee M.G.Y.; Batchelor R.J.; Weinberg
L.; Miles L.F.; Lefkovits J.; Koshy A.N.
Institution
(Place, Naimo, Lee, Batchelor, Lefkovits, Koshy) Department of Cardiology,
The Royal Melbourne Hospital, Melbourne, VIC, Australia
(Rodrigues, Naimo, Lee, Koshy) Department of Medicine, Melbourne Medical
School, The University of Melbourne, Melbourne, VIC, Australia
(Rodrigues, Weinberg, Miles, Koshy) Department of Cardiology, Austin
Health, Melbourne, VIC, Australia
(Weinberg, Miles) Department of Anaesthesia, Austin Health, Melbourne,
VIC, Australia
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Aortic stenosis is a risk factor for adverse outcomes
following non-cardiac surgery; however, existing data regarding
peri-operative morbidity and mortality in this patient cohort remain
conflicted. This systematic review and meta-analysis aimed to quantify the
peri-operative risks in patients with aortic stenosis undergoing
non-cardiac surgery. Method(s): Following the development of our
search strategy, we searched databases for relevant studies. The primary
endpoint was all-cause in-hospital or 30-day mortality associated with
aortic stenosis in patients undergoing non-cardiac surgery. Secondary
endpoints included: myocardial infarction; heart failure; stroke;
delirium; venous thromboembolism; and acute kidney injury. Result(s):
Nineteen studies involving 100,486 patients were included. The estimated
all-cause mortality was 3.8% (95%CI 3.7-3.9%) for patients with any degree
of aortic stenosis and 9.6% (95%CI 7.7-12.1%) for those with severe aortic
stenosis. A meta-analysis of 14 comparative studies involving 2,885,254
patients revealed significantly increased mortality in patients with
aortic stenosis compared with those without aortic stenosis (relative risk
1.58, 95%CI 1.18-2.12, p < 0.001). Aortic stenosis was also associated
with an elevated risk of postoperative myocardial infarction (relative
risk 1.79, 95%CI 1.2-2.67, p < 0.001) and heart failure (relative risk
2.06, 95%CI 1.19-3.59, p < 0.001). Discussion(s): Aortic stenosis in
patients undergoing non-cardiac surgery is associated with a three-fold
relative increase in the risk of mortality. These results highlight the
need for further delineation of which surgical procedures are associated
with the greatest risk of poor peri-operative outcomes to guide heightened
surveillance protocols, optimised peri-operative management and thresholds
for pre-operative intervention. Copyright © 2025 Association of
Anaesthetists.

<26>
Accession Number
2042297298
Title
1-Year Outcomes of Novel Balloon-Expandable vs Contemporary Transcatheter
Heart Valves in Severe Aortic Stenosis: The LANDMARK Trial.
Source
Journal of the American College of Cardiology. (no pagination), 2025.
Date of Publication: 2025.
Author
Serruys P.W.; Tobe A.; van Royen N.; Amat-Santos I.J.; Hudec M.; Bunc M.;
Van den Branden B.J.L.; Laanmets P.; Unic D.; Merkely B.; Hermanides R.S.;
Ninios V.; Protasiewicz M.; Rensing B.J.W.M.; Martin P.L.; Feres F.; De
Sousa Almeida M.; van Belle E.; Linke A.; Ielasi A.; Montorfano M.;
Webster M.; Toutouzas K.; Teiger E.; Bedogni F.; Voskuil M.; Pan M.;
Angeras O.; Kim W.-K.; Rothe J.; Abdel-Wahab M.; Kristic I.; Peral V.;
Garg S.; Tsai T.-Y.; Thakkar A.; Chandra U.; Smits P.C.; Morice M.-C.;
Onuma Y.; Baumbach A.
Institution
(Serruys, Tobe, Tsai, Onuma) Department of Cardiology, School of Medicine,
University of Galway, Galway, Ireland
(van Royen) Department of Cardiology, Radboud University Hospital,
Nijmegen, Netherlands
(Amat-Santos) Centro de Investigacion Biomedica en Red de Enfermedades
Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
(Amat-Santos) Department of Cardiology, Hospital Clinico Universitario de
Valladolid, Valladolid, Spain
(Hudec) Department of Acute Cardiology, Middle-Slovak Institute of
Cardiovascular Diseases, Banska Bystrica, Slovakia
(Bunc) Department of Cardiology, University Medical Centre Ljubljana,
Ljubljana, Slovenia
(Van den Branden) Department of Cardiology, Amphia Hospital, Breda,
Netherlands
(Laanmets) Department of Invasive Cardiology, North Estonia Medical
Centre, Tallinn, Estonia
(Unic) Department of Cardiac and Transplant Surgery, University Hospital
Dubrava, Zagreb, Croatia
(Merkely) Heart and Vascular Center, Semmelweis University, Budapest,
Hungary
(Hermanides) Department of Cardiology, Isala Hospital, Zwolle, Netherlands
(Ninios) Department of Cardiology, European Interbalkan Medical Center,
Thessaloniki, Greece
(Protasiewicz) Department of Cardiology, Institute of Heart Diseases,
Wroclaw Medical University, Wroclaw, Poland
(Rensing) Department of Cardiology, St Antonius Hospital, Nieuwegein,
Netherlands
(Martin) Department of Interventional Cardiology, University Hospital of
Gran Canaria Dr Negrin, Las Palmas de Gran Canaria, Spain
(Feres) Department of Invasive Cardiology, Instituto Dante Pazzanese, Sao
Paulo, Brazil
(De Sousa Almeida) CHRC, NOVA Medical School, NOVA University Lisbon,
Lisbon, Portugal
(van Belle) Department of Interventional Cardiology, Lille University,
Lille, France
(Linke) Department of Internal Medicine and Cardiology, University Clinic,
Heart Center Dresden, University of Technology Dresden, Dresden, Germany
(Ielasi) Department of Interventional Cardiology, IRCCS Ospedale Galeazzi
Sant'Ambrogio, Milan, Italy
(Montorfano) School of Medicine, Vita-Salute San Raffaele University,
Milan, Italy
(Montorfano) Interventional Cardiology Unit, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Webster) Department of Cardiology, Auckland City Hospital, Auckland, New
Zealand
(Toutouzas) Department of Cardiology, Hippokration Hospital, Athens,
Greece
(Teiger) Department of Interventional Cardiology, Henri Mondor University
Hospital, Creteil, France
(Bedogni) Department of Clinical Cardiology, San Donato Hospital, Milan,
Italy
(Voskuil) Department of Cardiology, University Medical Center Utrecht,
Utrecht, Netherlands
(Pan) Department of Cardiology, University Hospital Reina Sofia,
University of Cordoba, IMIBIC, Centro de Investigacion Biomedica en Red de
Enfermedades Cardiovasculares, Cordoba, Spain
(Angeras) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Angeras) Department of Molecular and Clinical Medicine, Institute of
Medicine, University of Gothenburg, Gothenburg, Sweden
(Kim) Department of Cardiology and Angiology, University of Giessen and
Marburg, Giesen, Germany
(Kim) Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim,
Germany
(Rothe) Department of Cardiology and Angiology, Campus Bad Krozingen,
University Heart Center-University of Freiburg, Bad Krozingen, Germany
(Rothe) Faculty of Medicine, University of Freiburg, Freiburg, Germany
(Abdel-Wahab) Department of Structural Heart Disease, University Hospital
Leipzig, Leipzig, Germany
(Kristic) Department of Cardiology, University Hospital of Split, Split,
Croatia
(Peral) Department of Cardiology University Hospital Son Espases, Health
Research Institute of the Balearic Islands, Palma de Mallorca, Spain
(Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn,
United Kingdom
(Garg) School of Medicine, University of Central Lancashire, Preston,
United Kingdom
(Thakkar, Chandra) Department of Clinical Research, Meril Life Sciences
Pvt Ltd, Vapi, India
(Smits, Morice) Cardiovascular European Research Center, Massy, France
(Morice) Institut Cardiovasculaire Paris Sud, Hopital Prive Jacques
Cartier, Massy, France
(Baumbach) Centre for Cardiovascular Medicine and Devices, William Harvey
Research Institute, Queen Mary University of London and Barts Heart
Centre, London, United Kingdom
(Baumbach) Cleveland Clinic, London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: In the LANDMARK trial, the Myval balloon-expandable
transcatheter heart valve (THV) series was noninferior to the most
commonly used contemporary SAPIEN and Evolut Series THVs for the 30-day
early safety endpoint in participants with symptomatic severe native
aortic stenosis. Objective(s): The current report from the LANDMARK
trial describes clinical outcomes, hemodynamic performances, and quality
of life at 1 year. Method(s): This open-label, noninferiority trial
enrolled 768 participants across 31 hospitals in Europe, New Zealand, and
Brazil. Participants were randomly assigned (1:1) to receive either a
Myval THV series or a contemporary THV (SAPIEN or Evolut series). The
composite endpoint at 1 year included all-cause mortality, all strokes,
and procedure- or valve-related hospitalizations. Clinical efficacy was
defined as freedom from the composite endpoint. As recommended in Valve
Academic Research Consortium-3, the previous composite endpoint combined
with the assessment of quality of life at baseline and 1 year with the
12-Item Short Form Health Survey was reported as an extended composite
endpoint. The noninferiority hypothesis was prespecified for the
assessment of the primary endpoint at 30 days. Considering the specific
1-year composite endpoints of Valve Academic Research Consortium-3 and the
event rate of 27.23% derived from recent studies, an a posteriori
descriptive and exploratory noninferiority hypothesis was introduced with
a noninferiority margin of 10.89%. The analysis was performed in the
intention-to-treat population. Result(s): The mean age was 80 years,
48% were women, and the median Society of Thoracic Surgeons Predicted Risk
of Mortality score was 2.6%. There was no significant difference in the
Kaplan-Meier estimates of freedom from the composite endpoint at 365 days
(Myval THV 87.0% vs contemporary THVs 86.9%). The Myval THV series was
noninferior to the contemporary THVs for the composite endpoint
(difference: -0.1%; 1-sided 95% CI: 3.9%; P<inf>noninferiority</inf> <
0.0001). Similarly, there were no significant differences in freedom from
the extended composite endpoint (80.5% vs 77.3%; difference: 3.2%; 95% CI:
-2.9% to 9.2%; P = 0.33). Conclusion(s): In the treatment of
symptomatic severe native aortic stenosis, the clinical and hemodynamic
outcomes of the Myval THV series were comparable to those of contemporary
THVs for the 1-year composite of all-cause mortality, all strokes, or
procedure- or valve-related hospitalizations. (LANDMARK Trial: a
Randomised Controlled Trial of Myval THV [LANDMARK];
NCT04275726) Copyright © 2025 The Authors

<27>
Accession Number
2040964193
Title
The overlooked challenge of perioperative hypertension: unveiling
pathophysiology and redefining management strategies.
Source
Current Medical Research and Opinion. 41(10) (pp 1763-1773), 2025. Date of
Publication: 2025.
Author
Saputra P.B.T.; Widarti W.; Yolanda S.; Hidayat R.A.; Putra R.M.;
Kriswidyatomo P.; Faizah N.N.; Alkaff F.F.
Institution
(Saputra, Hidayat, Putra) Department of Cardiology and Vascular Medicine,
Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
(Saputra, Hidayat, Putra) Department of Cardiology and Vascular Medicine,
Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
(Widarti) Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
(Yolanda) Universitas Airlangga Hospital, Universitas Airlangga, Surabaya,
Indonesia
(Kriswidyatomo) Department of Anesthesiology and Reanimation, Faculty of
Medicine, Universitas Airlangga-Universitas Airlangga Hospital, Surabaya,
Indonesia
(Faizah) Division of Cardiovascular Medicine, Graduate School of Medicine,
Kobe University, Kobe, Japan
(Alkaff) Division of Nephrology, Department of Internal Medicine,
University of Groningen, University Medical Center Groningen, Groningen,
Netherlands
(Alkaff) Division of Pharmacology and Therapy, Department of Anatomy,
Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga,
Surabaya, Indonesia
Publisher
Taylor and Francis Ltd.
Abstract
Hypertension, defined as systolic blood pressure (BP) >=140 mmHg or
diastolic BP >=90 mmHg, presents a significant challenge in perioperative
settings. Perioperative hypertension is highly prevalent, affecting 25% of
patients undergoing non-cardiac procedures and up to 80% of cardiac
surgeries. This review aims to provide an in-depth examination of
perioperative hypertension, emphasizing its impact on patient outcomes,
current management strategies, and the need for standardized guidelines.
Evidence from observational studies, clinical trials, and expert
guidelines is analyzed to highlight gaps and best practices in
perioperative BP control. A comprehensive literature review was conducted
using scientific databases. Studies examining the incidence,
complications, and management strategies of perioperative hypertension
were included. Perioperative hypertension significantly increases the risk
of adverse cardiovascular events, including myocardial infarction, stroke,
and renal failure, contributing to longer hospital stays and higher
healthcare costs. Patients with significant intraoperative systolic BP
elevations had markedly higher risks of adverse outcomes, including
approximately 1.5-fold higher mortality and a doubling of renal failure
risk. Additionally, hypertension is a leading cause of elective surgery
postponement. Despite its high prevalence, comprehensive management
guidelines remain inadequate, resulting in inconsistent BP control
strategies and suboptimal patient outcomes. The management of
perioperative hypertension requires a more standardized and evidence-based
approach. Current strategies emphasize individualized BP targets,
optimization of antihypertensive therapy, and intraoperative haemodynamic
stability. However, the lack of universally accepted guidelines hinders
effective BP management. Future research should focus on developing
standardized protocols to improve perioperative outcomes and reduce
complications related to hypertension. Copyright © 2025 Informa
UK Limited, trading as Taylor & Francis Group.

<28>
Accession Number
2037189157
Title
The Role of TBX20 Gene Mutations in the Pathogenesis of Congenital Heart
Disease: Functional Analysis and Genetic Association Study.
Source
Cardiology (Switzerland). 150(5) (pp 549-566), 2025. Date of Publication:
01 Oct 2025.
Author
Sun Q.; Li Q.; Qin Z.; Wen Y.; Liu C.
Institution
(Sun) Department of Pediatrics, Shanxi Medical University, Taiyuan, China
(Li, Qin, Wen, Liu) Department of Cardiothoracic Surgery, Children's
Hospital of Shanxi, Taiyuan, China
Publisher
S. Karger AG

<29>
Accession Number
2040515803
Title
Contemporary Outcomes of Ventricular Tachycardia Ablation in Left
Ventricular Assist Device Therapy: A Meta-Analysis.
Source
Journal of Cardiovascular Electrophysiology. 36(12) (pp 3270-3285), 2025.
Date of Publication: 01 Dec 2025.
Author
Barrera N.; Kushnir Y.; Solorzano M.; Gallegos-Koyner F.; Lynch P.T.;
Queiroga F.; Giorgi J.; Brigido A.R.D.; de Carvalho G.D.; Chelu M.G.;
Colombo P.C.; D'Avila A.
Institution
(Barrera, Colombo) Division of Cardiology, Columbia University College of
Physicians and Surgeons, New York Presbyterian Hospital, New York, NY,
United States
(Kushnir, Solorzano, Gallegos-Koyner) Department of Medicine, SBH Health
System, New York, NY, United States
(Lynch, Chelu) Department of Medicine (Division of Cardiology), Baylor
College of Medicine, Houston, TX, United States
(Queiroga) Deparment of Medicine, Emory University School of Medicine,
Atlanta, GA, United States
(Giorgi) Division of Cardiology, Sirio Libanes Hospital, Sao Paulo, Sao
Paulo, Brazil
(Brigido) Division of Cardiology, Heart Institute (InCor), Hospital das
Clinicas, Faculty of Medicine, Sao Paulo, Sao Paulo, Brazil
(de Carvalho) Division of Cardiac Arrhythmias and Electrophysiology, Dante
Pazzanese Institute of Cardiology, Sao Paulo, Brazil
(Chelu) Cardiovascular Research Institute, Houston, TX, United States
(Chelu) Division of Cardiology, Texas Heart Institute at Baylor College of
Medicine and Baylor St. Luke's Medical Center, Houston, TX, United States
(D'Avila) Division of Cardiology, Beth Israel Deaconess Medical Center,
Harvard Medical School, Boston, MA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background and Objective: Ventricular arrhythmias (VAs) remain a pervasive
and deadly arrhythmia in patients with left ventricular assist devices
(LVADs). Catheter ablation has emerged as a treatment option for
refractory VAs, yet evidence in the era of the HeartMate 3 (HM3) remains
limited. This review aims to synthesize contemporary evidence for VA
ablation in LVAD recipients. Method(s): A systematic review was
performed across major electronic databases. The primary efficacy outcome
was the recurrence of ventricular tachycardia (VT), and the primary safety
outcome was the rate of procedural complications. The secondary outcomes
were inability to induce any VT, all-cause mortality at 12 months,
orthotropic heart transplantation (OHT). Sub-analyses were performed for
patients with HM3 LVADs. Result(s): Twenty-seven studies encompassing
300 LVAD recipients undergoing 325 VT ablations, after a mean follow-up of
327 +/- 175 days post VT ablation, VT recurred in 38% (95% CI, 28% to 49%)
of cases and the complication rate was 8% (95% CI, 1.6% to 15.7%). VT was
non-inducible in 61% of cases. One-year all-cause mortality was 26%, and
16% had OHT. Among HM3 recipients, electromagnetic interference (EMI)
occurred in 51%, and no cases of device thrombosis were reported; one
stroke was observed. Conclusion(s): Catheter ablation is a safe and
feasible treatment for refractory VAs in LVAD patients as evidenced by low
complication rates and reasonable acute success. Yet, the persistence of
considerable VT recurrence and all-cause mortality reflects the clinical
complexity of this population. Procedural challenges include mapping
limitations caused by EMI, particularly in the HM3 era. Copyright
© 2025 Wiley Periodicals LLC.

<30>
Accession Number
2042034656
Title
Comparative Outcomes of Right Anterior Minithoracotomy and Ministernotomy
for Aortic Valve Replacement: An Updated Meta-Analysis.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 20(6) (pp 534-546), 2025. Date of Publication: 01 Nov 2025.
Author
Santos K.; Campoverde Farez C.; Zecchin Ferrara V.; Oya K.; Samaniego
M.A.; Chacon Quiros M.; Lopez Barrios V.; Plonek T.
Institution
(Santos, Plonek) Department of Cardiothoracic Surgery, Medisch Spectrum
Twente, Enschede, Netherlands
(Santos) New Vision University School of Medicine, Tbilisi, Georgia
(Campoverde Farez) Faculty of Medical Sciences, Universidad de Cuenca,
Ecuador
(Zecchin Ferrara) University of Padova, Italy
(Oya) National Center for Global Health and Medicine, Tokyo, Japan
(Samaniego) Universidad Autonoma Metropolitana, Ciudad de Mexico, Mexico
(Chacon Quiros) Universidad de Costa Rica, San Jose, Costa Rica
(Lopez Barrios) Centro Cardiovascular SM, San Jose, Costa Rica
Publisher
SAGE Publications Ltd
Abstract
Objective: Right anterior minithoracotomy (RAMT) and ministernotomy (MS)
are established approaches for minimally invasive aortic valve replacement
(MIAVR). There is no consensus about which technique offers better
results. Method(s): A literature search was conducted in MEDLINE,
Scopus, and Cochrane Library, focusing on studies that compared RAMT and
MS for MIAVR. RevMan 8.13.0 (The Cochrane Collaboration, London, UK) was
used to calculate effect estimates reported as odds ratios (ORs) or mean
differences (MDs) with 95% confidence intervals (CIs). Result(s): We
included 21 studies with 6,986 patients, of whom 45.8% underwent RAMT.
RAMT was associated with a shorter hospital stay (MD = -0.8 days, 95% CI:
-1.4 to -0.2, P = 0.002) and reduced blood loss (MD = -22.3 mL, 95% CI:
-32.8 to -11.8, P < 0.001), transfusion rates (OR = 0.7, 95% CI: 0.5 to
0.9, P = 0.01), and incidence of acute kidney injury (AKI; OR = 0.7, 95%
CI: 0.5 to 0.9, P = 0.02). However, RAMT was also associated with a
slightly longer cardiopulmonary bypass (CPB) time (MD = 9.0 min, 95% CI:
0.7 to 17.3, P = 0.03, I2 = 97%) and incisional pain score (standardized
MD = 0.5, 95% CI: 0.4 to 0.6, P < 0.001). Mortality, stroke, and other
complications were similar between the 2 techniques. Conclusion(s):
RAMT offers advantages including shorter hospital stay and reduced blood
loss, transfusion, and AKI rates but at the cost of slightly longer CPB
time and greater incisional pain. These findings underscore the need for
individualized patient selection based on surgical risk, anatomical
considerations, and recovery priorities. Copyright © The
Author(s) 2025

<31>
Accession Number
2042216836
Title
Prophylactic norepinephrine infusion to reduce severe hypotension during
induction of anaesthesia in patients undergoing cardiac surgery: a
randomised controlled single-centre clinical trial.
Source
British Journal of Anaesthesia. (no pagination), 2025. Date of
Publication: 2025.
Author
Gaillard C.; Breul L.; Foucher A.; Rigal J.-C.; David C.-H.; Souab F.;
Canevet M.; Ryan M.; Bailly A.; Morin H.; Cadiet J.; Geay C.; Rozec B.;
Vourc'h M.
Institution
(Gaillard, Breul, Rigal, Souab, Canevet, Ryan, Bailly, Morin, Cadiet,
Rozec, Vourc'h) Anesthesie et reanimation chirurgie cardiaque, Hopital
Laennec, Centre Hospitalier Universitaire de Nantes, Nantes Universite,
Nantes, France
(Foucher) Anesthesie et reanimation Polyvalente, Hopital Laennec, Centre
Hospitalier Universitaire de Nantes, Nantes Universite, Nantes, France
(David) Department of Thoracic and Cardiovascular Surgery, l'Institut du
Thorax, Hopital Laennec, Centre Hospitalier Universitaire de Nantes,
Nantes Universite, Nantes, France
(Geay) Plateforme de Methodologie et Biostatistique, Direction de la
Recherche et de l'Innovation, Centre Hospitalier Universitaire, Nantes,
France
(Rozec) Nantes Universite, CNRS, InsERM, l'institut du thorax, Nantes,
France
(Vourc'h) INSERM CIC 0004 Immunologie et infectiologie, Nantes Universite,
Nantes, France
Publisher
Elsevier Ltd
Abstract
Background: The EPITUBE trial aimed to determine whether a prophylactic
infusion of norepinephrine reduced severe hypotension after induction of
general anaesthesia and tracheal intubation in patients undergoing cardiac
surgery. Method(s): We performed a randomised controlled
single-centre clinical trial including patients undergoing cardiac
surgery. In the experimental group, infusion of norepinephrine started
from the start of preoxygenation at an infusion rate of 0.06 mug
kg-1 min-1, secondarily titrated to maintain mean
arterial pressure (MAP) between 65 and 80 mm Hg. In the control group,
ephedrine was administered if MAP decreased <65 mm Hg. Primary outcome was
the occurrence of MAP <55 mm Hg. Secondary measures included tracheal
intubation-related complications, postoperative complications, duration of
ICU stay, and mortality. Result(s): Of 210 patients randomised and
analysed in the intention-to-treat analysis, the incidence of severe
hypotension was not different between the groups: 43.8% in the
norepinephrine group vs 44.8% in the control group (odds ratio 0.96, 95%
confidence interval [CI] 0.56-1.66, P=0.99). The incidence of MAP <65 mm
Hg was lower in the norepinephrine group than in the control group: 63.8%
vs 78.1% (odds ratio 0.49, 95% CI 0.26-0.90, P=0.02). The rate of
intubation-related complications was not different between the
norepinephrine and control groups, 22.9% vs 32.4%, respectively (odds
ratio 0.62, 95% CI 0.33-1.14, P=0.13). There was no difference in
postoperative outcomes including acute kidney injury, time on ventilator,
or length of stay in the ICU. Conclusion(s): In patients undergoing
cardiac surgery, infusion of norepinephrine before general anaesthesia at
a starting dose of 0.06 mug kg-1 min-1 did not
reduce severe hypotension compared with on-demand ephedrine. Clinical
trial registration: ClinicalTrials.gov Identifier:
NCT05335954. Copyright © 2025 British Journal of Anaesthesia

<32>
Accession Number
2037405832
Title
Prophylactic Negative Pressure Therapy in Reducing the Risk of Sternal
Wound Infection after Cardiac Surgery.
Source
Cor et Vasa. 67(5) (pp 572-575), 2025. Date of Publication: 2025.
Author
Timbilla S.; Gofus J.; Smolak P.; Cermakova E.; Mandak J.; Vojacek J.
Institution
(Timbilla, Gofus, Smolak, Mandak, Vojacek) Department of Cardiac Surgery,
Faculty of Medicine and University Hospital in Hradec Kralove, Charles
University, Hradec Kralove, Czechia
(Cermakova) Department of Medical Biophysics, Faculty of Medicine Hradec
Kralove, Charles University, Charles University, Faculty of Medicine in
Hradec Kralove, Hradec Kralove, Czechia
Publisher
Czech Society of Cardiology Z.S
Abstract
Background: Postoperative sternal wound infections and dehiscence are
serious complications of cardiac surgery that increase the length of
hospital stay and healthcare costs. Standard wound care may be
insufficient for preventing these complications in high-risk patients.
 Method(s): We conducted a prospective, randomized study comparing the
efficacy of closed incisional negative pressure wound therapy (ciNPWT)
using Prevena (study group) versus standard wound dressing (control group)
in patients at high risk of sternal wound infections following cardiac
surgery. Primary outcomes included the incidence of sternal wound
infection at seven days and three months postoperatively, and length of
hospital stay. Result(s): The study cohort comprised 80 patients (64
male, 16 female; mean age 65.4 years) randomized into two groups with 40
patients in each. At 7 days post-operation, there were four patients with
sternal wound infection in the study group (10 %) and seven in the control
group (17.5%) (p-value=0.52). At 3 months, deep wound infections were
present in 1 patient in the study group (2.5%) and 2 in the control group
(5%) (p = 1.00). Median length of hospital stay was comparable between the
study (12 days) and control (11 days) groups (p-value = 0.75).
 Conclusion(s): Preventive negative pressure wound treatment showed a
trend towards reducing the incidence of wound healing complications in
high-risk patients following cardiac surgery, although the differences
were not statistically significant. Further large-scale studies are
warranted to establish the efficacy and cost--effectiveness of this
preventive strategy. Copyright © 2025, Czech Society of
Cardiology Z.S. All rights reserved.

<33>
[Use Link to view the full text]
Accession Number
2041765752
Title
Timing and Safety of Anticoagulation Reinitiation After Intracranial
Hemorrhage in Patients With Mechanical Valves.
Source
Neurology. 105(8) (no pagination), 2025. Date of Publication: 25 Sep 2025.
Author
D'Anna L.; Prandin G.; Pirera E.; Sacco S.; Veltkamp R.; Korompoki E.;
Gigli M.; Paciaroni M.; Gorog D.A.; Favruzzo F.; Kanagaratnam P.; Lim B.;
Zhang L.; Simister R.J.; Valente M.; Gigli G.L.; Foschi M.; Merlino G.
Institution
(D'Anna) Department of Stroke and Neuroscience, Charing Cross Hospital,
Imperial College London NHS Healthcare Trust, United Kingdom
(D'Anna, Veltkamp, Korompoki) Department of Brain Sciences, Imperial
College London, United Kingdom
(Prandin) Clinical Unit of Neurology, Department of Medicine, Surgery and
Health Sciences, University Hospital and Health Services of Trieste,
ASUGI, University of Trieste, Italy
(Pirera) Internal Medicine and Stroke Care Ward, Department of Promoting
Health, Maternal-Infant, Excellence and Internal and Specialized Medicine
(ProMISE) "G. D'Alessandro, " University of Palermo, Italy
(Sacco, Foschi) Department of Biotechnological and Applied Clinical
Sciences, University of L'Aquila, Italy
(Veltkamp) Department of Neurology, Alfried-Krupp Krankenhaus Essen,
Germany
(Veltkamp) Department of Neurology, University Hospital Heidelberg,
Germany
(Korompoki) Department of Clinical Therapeutics, National and Kapodistrian
University of Athens, Greece
(Gigli) Cardiovascular Department, Azienda Sanitaria-Universitaria
Giuliano Isontina (ASUGI), Trieste, Italy
(Paciaroni) Department of Neurosciences and Rehabilitation, University of
Ferrara, Italy
(Gorog) Faculty of Medicine, National Heart and Lung Institute, Imperial
College, London, United Kingdom
(Gorog) School of Life and Medical Sciences, Postgraduate Medical School,
University of Hertfordshire, United Kingdom
(Favruzzo) Comprehensive Stroke Center, Ospedale dell'Angelo, Azienda ULSS
3 Serenissima, Mestre, Italy
(Kanagaratnam, Lim) Department of Cardiology, Hammersmith Hospital,
Imperial College London NHS Healthcare Trust, United Kingdom
(Zhang) Stroke Unit, Department of Neuroscience, George's University of
London, United Kingdom
(Simister) Comprehensive Stroke Service, University College London
Hospital, United Kingdom
(Valente, Gigli, Merlino) Clinical Neurology, Udine University Hospital
and Department of Medicine (DMED), University of Udine, Italy
(Merlino) SOSD Stroke Unit, Department Head, Neck, and Neurosciences,
Udine University Hospital, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
Background and Objectives - In patients with mechanical heart valves
(MHVs), anticoagulation (AC) interruption after intracranial hemorrhage
(ICH) poses a clinical dilemma because of competing risks of ischemic
complications and hemorrhagic recurrence. To date, the optimal timing for
resuming vitamin K antagonists (VKAs) remains unclear. The aim of this
meta-analysis was to quantify the risks of ischemic stroke and recurrent
ICH associated with VKA resumption in this population and explore the
temporal risk dynamics.Methods - We systematically searched PubMed,
Embase, and Cochrane Library from inception to December 2023 for studies
reporting ischemic or hemorrhagic outcomes in adults with MHVs who
experienced ICH and were considered for VKA resumption. Primary outcomes
were ischemic stroke before AC resumption and recurrent ICH after AC
resumption. Random-effects meta-analyses were performed. Meta-regressions
assessed whether timing of resumption influenced risk. Risk trajectories
were estimated using a model-based approach.Results - Nine studies were
included, comprising 435 patients with MHVs with confirmed ICH included in
the pooled analysis. The mean age ranged from 54.1 to 75 years; 31.3% were
female. The pooled incidence of recurrent ICH after AC reinitiation was
11.4% (95% CI 8.2-15.6; I2 = 0%), the incidence of ischemic
stroke during AC suspension was 6.1% (95% CI 4.1-8.9; I2 = 0%),
valve thrombosis occurred in 3.3% (95% CI 1.9-5.6; I2 = 0%),
and mortality occurred in 4.9% (95% CI 2.0-11.5; I2 = 37%).
Meta-regression demonstrated a significant inverse association between
time to AC resumption and risk of recurrent ICH (regression coefficient
-0.039; 95% CI -0.093 to 0.015; p = 0.13), corresponding to an approximate
50% relative reduction in risk at 11 days after ICH. No significant
time-dependent association was observed for ischemic stroke (coefficient
-0.013; 95% CI -0.065 to 0.039; p = 0.61).Discussion - In patients with
MHVs who experienced an ICH, this meta-analysis found that resumption of
AC was associated with a recurrent ICH rate of 11.4% and an ischemic
stroke rate of 6.1% during AC suspension. Meta-regression suggested a
lower risk of recurrent ICH with later AC resumption, with a potential
risk reduction at approximately 11 days after ICH. No time-dependent
increase in ischemic stroke was observed. Limitations include the
retrospective design of most studies and heterogeneous AC timing across
cohorts. Copyright © 2025 American Academy of Neurology

<34>
Accession Number
2042209163
Title
Cold-stored platelets: A systematic review of recovery in healthy adults
and chest drain output in cardiothoracic surgery patients.
Source
Hematology, Transfusion and Cell Therapy. 48(1) (no pagination), 2026.
Article Number: 106226. Date of Publication: 01 Jan 2026.
Author
Keane C.; Sharif H.; Jackson D.
Institution
(Keane, Sharif, Jackson) Thrombosis and Vascular Diseases Laboratory,
School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC,
Australia
Publisher
Elsevier Editora Ltda
Abstract
Cold-stored platelets were abandoned in the 1960s after demonstration of
an increased clearance in vivo due to an irreversible activated phenotype.
Difficulties in storage, logistics, and the increased requirement of
therapeutic platelet transfusions for haemostasis have sparked renewed
interest in cold-stored platelets. This systematic review compared two
primary outcomes: in vivo recovery for autologous cold-stored platelets
versus room-temperature platelets in healthy volunteers, and chest drain
output at 24 h for allogeneic cold-stored platelets versus
room-temperature platelets after complex cardiothoracic surgery. A total
of 4215 articles were found in the ProQuest, PubMed, Scopus, Embase, and
Cochrane electronic databases. Seven eligible papers were included in this
meta-analysis. Cold-stored platelets showed a decreased in vivo recovery
two hours after retransfusion following storage for two to seven days
compared to a room-temperature platelet control group (mean difference:
-25.85 %; 95 % confidence interval: -41.98 to -9.71 %; p-value = 0.002).
Further, cold-stored platelets showed a decreased chest cavity output when
transfused within 24 h after complex cardiothoracic surgery (mean
difference: 249.68 mL; 95 % confidence interval: 85.68 to 413.67 mL;
p-value = 0.003). While cold-stored platelets are not a substitute for
room-temperature platelets in a prophylactic scenario, their ability to
significantly reduce chest cavity output suggests they may be optimal for
the management of bleeding in surgical patients, especially in the context
of logistical difficulties. Copyright © 2025 Associacao
Brasileira de Hematologia, Hemoterapia e Terapia Celular

<35>
Accession Number
2042118300
Title
Strategy Optimization for a Combined Procedure in Patients With Atrial
Fibrillation The COMBINATION Randomized Clinical Trial.
Source
JAMA Network Open. 7(11) (no pagination), 2024. Article Number: e2445084.
Date of Publication: 01 Nov 2024.
Author
Du X.; Chu H.; Yang B.; Zhong J.; Ruan Z.; Chen Q.; Leng B.; Tao S.; Lai
H.; Liang J.; Xie R.; Ye P.; Zhou X.; Li Y.; Li J.; Zhao Y.; Zou C.; Sun
H.; Li X.; Rong B.; Chen G.; Hu J.; Jia J.; Fang Y.; Xia Z.; Liu Q.; Zuo
T.; Zhu X.; Xu L.; Yang S.; Luo C.; Shen C.; Feng M.; Jiang Y.; Fu G.;
Wang B.; Yu X.; Chen X.
Institution
(Du, Chu, Luo, Shen, Feng, Jiang, Fu, Wang, Yu, Chen) Arrhythmia Center,
The First Affiliated Hospital of Ningbo University, Ningbo First Hospital,
Ningbo, China
(Du, Chu, Luo, Shen, Feng, Jiang, Fu, Wang, Yu, Chen) Key Laboratory of
Precision Medicine for Atherosclerotic Diseases of Zhejiang Province,
Ningbo, China
(Yang, Li) Department of Cardiology, Shanghai East Hospital, Tongji
University, Shanghai, China
(Zhong, Rong) Department of Cardiology, Qilu Hospital, Shandong
University, Jinan, China
(Ruan, Chen) Department of Cardiology, Jiangsu Taizhou People's Hospital,
Taizhou, China
(Chen, Hu) Department of Cardiovascular Medicine, The Second Affiliated
Hospital of Nanchang University, Nanchang, China
(Leng) Department of Cardiology, Ningbo Taikang Hospital, Ningbo, China
(Tao, Jia) Department of Cardiology, The Affiliated Hospital of Yunnan
University, Kunming, China
(Lai, Fang) Department of Cardiology, Jiangxi Provincial People's
Hospital, The First Affiliated Hospital of Nanchang Medical College,
Nanchang, China
(Liang, Xia) Department of Cardiology, The Second People's Hospital of
Foshan, Foshan, China
(Xie, Liu) Department of Cardiology, The Second Hospital of Hebei Medical
University, Shijiazhuang, China
(Ye, Zuo) Department of Cardiology, The Central Hospital of Wuhan, Tongji
Medical College, Huazhong University of Science and Technology, Wuhan,
China
(Zhou, Li) Department of Pacing and Electrophysiology, The First
Affiliated Hospital of Xinjiang Medical University, Urumqi, China
(Li, Zhu) Department of Cardiology, The Affiliated Yantai Yuhuangding
Hospital of Qingdao University, Yantai, China
(Zhao, Xu, Yang) Department of Cardiology, Henan Cardiovascular Hospital
Affiliated to Southern Medical University, The Seventh People's Hospital
of Zhengzhou, Zhengzhou, China
(Zou) Department of Cardiology, The First Affiliated Hospital of Soochow
University, Suzhou, China
(Sun) Department of Cardiology, Cixi People's Hospital, Ningbo, China
Publisher
American Medical Association
Abstract
IMPORTANCE The optimal strategy of combining left atrial appendage
occlusion (LAAO) with catheter ablation (CA) in patients with atrial
fibrillation (AF) during a single procedure remains unclear. OBJECTIVE To
determine the effects of ablation-first vs occlusion-first strategies on
long-term clinical outcomes among patients with atrial fibrillation
undergoing a combined LAAO and CA procedure. DESIGN, SETTING, AND
PARTICIPANTS The prospective, multicenter COMBINATION randomized clinical
trial was conducted in 14 high-volume centers in China. Enrollment of
patients with nonvalvular AF referred for the combined procedure began on
July 24, 2020, and concluded on January 20, 2022. INTERVENTIONS Patients
were randomly assigned to either the ablation-first group or the
occlusion-first group. Outcomes of LAAO using an occlusion device and CA
using a contact force-sensing catheter following different combination
strategies during long-term follow-up were evaluated. MAIN OUTCOMES AND
MEASURES The primary end point was a composite of thromboembolic events
including stroke or transient ischemic attack, device-related thrombus
(DRT), clinically relevant bleeding, and cardiovascular rehospitalization
or death. Freedom from AF or atrial tachyarrhythmia (ATA) after a single
procedure without antiarrhythmic drugs, at both 1 year and long-term
follow-up, was also evaluated. RESULTS Of the 202 patients enrolled, 194
(96.0%) completed the trial (97 in the ablation-first group and 97 in the
occlusion-first group). The mean (SD) age of the cohort was 67.3 (9.2)
years, and 110 patients (56.7%) were male. All procedures achieved acute
successful LAAO and restoration of sinus rhythm, with similar incidences
of periprocedural complications. Compared with the ablation-first group,
the occlusion-first group exhibited significantly higher event-free
survival of the primary end point (83.5% vs 71.1%; hazard ratio [HR], 0.53
[95% CI, 0.29-0.95]; log-rank P = .04) during the median 2.5 (IQR,
2.3-2.8) years of follow-up. Subgroup analysis indicated that male
patients and those with higher CHA<inf>2</inf>DS<inf>2</inf>-VASc scores
(a composite of factors associated with stroke risk; higher scores
indicate higher risk) were at lower risk of thromboembolic events. Rates
of long-term freedom from AF (77.3% vs 63.5%; HR, 0.58 [95% CI,
0.34-0.97]; log-rank P = .04) and from ATA (70.1% vs 55.7%; HR, 0.62 [95%
CI, 0.39-0.99]; log-rank P = .04) were higher in the occlusion-first group
vs the ablation-first group. Additionally, a higher incidence of chronic
peridevice leak (15 [15.5%] vs 5 [5.2%]; P = .03) and DRT (8 [8.2%] vs 1
[1.0%]; P = .04) was observed in the ablation-first group vs the
occlusion-first group. CONCLUSIONS AND RELEVANCE In this randomized
clinical trial, the occlusion-first approach was superior due to its
higher event-free survival of the primary end point and long-term freedom
from ATA. These findings suggest that the occlusion-first approach should
be recommended for combined procedures with plug-like device
implantation. Copyright © 2024 Du X et al.

<36>
[Use Link to view the full text]
Accession Number
648446003
Title
Ticagrelor and Aspirin or Aspirin Alone after Coronary Surgery for Acute
Coronary Syndrome.
Source
The New England journal of medicine. 393(23) (pp 2313-2323), 2025. Date of
Publication: 11 Dec 2025.
Author
Jeppsson A.; James S.; Moller C.H.; Malm C.J.; Dalen M.; Vanky F.; Modrau
I.S.; Andersen K.; Anttila V.; Atroshchenko G.V.; Barbu M.; Dreifaldt M.;
El-Akkawi A.I.; Friberg O.; Gudbjartsson T.; Gunn J.; Haaverstad R.;
Halonen J.; Hansson E.C.; Holm J.; Husso A.; Juvonen T.; Jakobsen O.;
Jideus L.; Johannesson E.; Jonsson Holmdahl A.; Jonsson K.; Kolseth S.M.;
Krasniqi L.; Makela T.; Mennander A.; Mohagen Krogstad L.-E.; Rafiq S.;
Raivio P.; Riber L.; Tahir A.; Thorsen C.; Tonnessen T.; Wahba A.;
Zindovic I.; Pivodic A.; Nielsen S.J.; Erlinge D.; Alfredsson J.; Sartipy
U.
Institution
(Jeppsson, Malm, Hansson, Jonsson, Nielsen) Department of Cardiothoracic
Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
(Jeppsson, Malm, Hansson, Jonsson, Nielsen) Department of Molecular and
Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University
of Gothenburg, Gothenburg, Sweden
(James) Department of Medical Sciences, Cardiology, Uppsala University,
Uppsala, Sweden
(Moller, Rafiq) Department of Cardiothoracic Surgery, University Hospital,
Copenhagen, Denmark
(Dalen, Sartipy) Department of Cardiothoracic Surgery, Karolinska
University Hospital, Stockholm, Sweden
(Dalen, Sartipy) Department of Molecular Medicine and Surgery, Karolinska
Institutet, Stockholm, Sweden
(Vanky, Holm) Department of Cardiothoracic and Vascular Surgery, Linkoping
University Hospital, Linkoping, Sweden
(Vanky, Holm) Department of Health, Medicine, Caring Sciences, Unit of
Cardiovascular Medicine, Linkoping University, Linkoping Sweden, Sweden
(Modrau, El-Akkawi) Department of Cardiothoracic and Vascular Surgery,
Aarhus University Hospital, Aarhus, Denmark
(Modrau, El-Akkawi) Department of Clinical Medicine, Aarhus University,
Aarhus, Denmark
(Andersen) Department of Cardiology, Landspitali University Hospital,
Reykjavik, Iceland
(Andersen, Gudbjartsson) Faculty of Medicine, University of Iceland,
Reykjavik, Iceland
(Anttila) Heart Center, Turku University Hospital and University of Turku,
Turku, Finland
(Atroshchenko) Department of Cardiothoracic Surgery, Aalborg University
Hospital, Aalborg, Denmark
(Barbu, Thorsen) Department of Cardiology and Cardiothoracic Surgery,
Blekinge Hospital, Karlskrona, Sweden
(Dreifaldt, Friberg) Department of Cardiothoracic and Vascular Surgery,
Orebro University Hospital, Sweden
(Dreifaldt, Friberg) Faculty of Medicine and Health, Orebro University,
Sweden
(Gudbjartsson) Department of Cardiothoracic Surgery, Landspitali
University Hospital, Reykjavik, Iceland
(Gunn) Department of Emergency Services, Turku University Hospital and
University of Turku, Turku, Finland
(Haaverstad, Kolseth) Department of Heart Disease, Haukeland University
Hospital, Bergen, Norway
(Halonen, Husso) Department of Cardiac Surgery, Heart Center, Kuopio
University Hospital, Kuopio, Finland
(Halonen) University of Eastern Finland, Kuopio, Finland
(Juvonen, Raivio) Department of Cardiac Surgery, Heart and Lung Center,
Helsinki University Hospital and University of Helsinki, Helsinki, Finland
(Jakobsen) Department of Clinical Medicine, Arctic University of Norway,
Tromso, Norway
(Jakobsen) Department of Cardiothoracic and Vascular Surgery, University
Hospital of North Norway, Tromso, Norway
(Jideus) Department of Cardiothoracic Surgery, Uppsala University
Hospital, Uppsala, Sweden
(Johannesson, Zindovic) Department of Cardiothoracic Surgery, Skane
University Hospital, Lund, Sweden
(Johannesson, Zindovic) Department of Clinical Sciences, Lund University,
Lund, Sweden
(Jonsson Holmdahl) Department of Cardiothoracic Surgery, Umea University
Hospital, Umea, Sweden
(Jonsson Holmdahl) Department of Public Health and Clinical Medicine,
Medical Faculty, Umea University, Umea, Sweden
(Krasniqi, Riber) Department of Cardiac, Vascular, Thoracic Surgery,
Odense University Hospital, Odense, Denmark
(Krasniqi, Riber) Department of Clinical Research, University of Southern
Denmark, Odense, Denmark
(Makela) Research Unit of Translational Medicine, Medical Research Center
Oulu, Oulu University Hospital, Oulu, Finland
(Makela) Department of Cardiothoracic Surgery, Oulu University Hospital,
Oulu, Finland
(Mennander) Tampere University Heart Hospital, Tampere, Finland
(Mennander) Tampere University, Tampere, Finland
(Mohagen Krogstad, Wahba) Department of Cardio-Thoracic Surgery, St.
Olav's University Hospital, Trondheim, Norway
(Tahir, Tonnessen) Department of Cardiothoracic Surgery, Oslo University
Hospital, Oslo, Norway
(Tahir, Tonnessen) University of Oslo, Oslo, Norway
(Wahba) Department of Circulation and Medical Imaging, Norwegian
University of Science and Technology, Trondheim, Norway
(Pivodic) Molndal, Sweden
(Pivodic) Center for Person-Centered Care, Sahlgrenska Academy, University
of Gothenburg, Gothenburg, Sweden
(Erlinge) Department of Cardiology, Clinical Sciences, Lund University,
Lund, Sweden
(Alfredsson) Department of Health, Medicine, Caring Sciences, Linkoping
University, Linkoping, Sweden
(Alfredsson) Department of Cardiology, Linkoping University, Linkoping,
Sweden
Abstract
BACKGROUND: Patients benefit from antiplatelet therapy after
coronary-artery bypass grafting (CABG) for an acute coronary syndrome.
Whether the addition of ticagrelor to aspirin, as compared with aspirin
alone, further reduces the risk of adverse cardiovascular outcomes is
unclear. METHOD(S): In this open-label, registry-based, clinical
trial conducted at 22 Nordic cardiothoracic surgery centers, we randomly
assigned patients in a 1:1 ratio to receive either ticagrelor plus aspirin
or aspirin alone for 1 year after CABG for an acute coronary syndrome. The
primary outcome was a composite of death, myocardial infarction, stroke,
or repeat revascularization, evaluated at 1 year. A key secondary outcome
was net adverse clinical events, defined as a primary-outcome event or
major bleeding. RESULT(S): A total of 2201 patients were randomly
assigned to receive ticagrelor plus aspirin (1104 patients) or aspirin
alone (1097 patients). The mean age of the patients was 66 years, and
14.4% were women. A primary-outcome event occurred in 53 patients (4.8%)
in the ticagrelor-plus-aspirin group and 50 (4.6%) in the aspirin-alone
group (hazard ratio, 1.06; 95% confidence interval [CI], 0.72 to 1.56; P =
0.77). Net adverse clinical events occurred in 9.1% of patients in the
ticagrelor-plus-aspirin group and 6.4% in the aspirin-alone group (hazard
ratio, 1.45; 95% CI, 1.07 to 1.97). Major bleeding occurred in 4.9% of
patients in the ticagrelor-plus-aspirin group and 2.0% in the
aspirin-alone group (hazard ratio, 2.50; 95% CI, 1.52 to 4.11).
 CONCLUSION(S): Among patients who underwent CABG for an acute
coronary syndrome, ticagrelor plus aspirin did not result in a lower
incidence of death, myocardial infarction, stroke, or repeat coronary
revascularization than aspirin alone at 1 year. (Funded by the Swedish
Research Council and others; TACSI ClinicalTrials.gov number, NCT03560310;
EudraCT number, 2017-001499-43; EU Clinical Trials number,
2023-508551-40-00.). Copyright © 2025 Massachusetts Medical
Society.

<37>
Accession Number
2042225509
Title
Acute Kidney Injury in Cardiac Surgery: A Comprehensive Review of
Perioperative Strategies and Emerging Biomarkers.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Cuttone G.; La Via L.; SenussiTesta T.; Sinatra N.; Deana C.; Roberti E.;
Montisci A.; Pappalardo F.
Institution
(Cuttone) Anesthesia and Intensive Care, 'Abele Ajello' Hospital, ASP
Trapani, Mazara del Vallo, Italy
(La Via) Department of Anesthesia and Intensive Care, University Hospital
Policlinico G. Rodolico-San Marco, Catania, Italy
(SenussiTesta) Department of Cardiac Anesthesia and Intensive Care,
Cardiovascular Network, IRCCS Policlinico San Martino Hospital, Genova,
Italy
(Sinatra) Nephrology and Dialysis Unit, "Paolo Borsellino" Hospital, ASP
Trapani, Marsala, Italy
(Deana) Anesthesia and Intensive Care 1, Department of Emergency, Academic
Hospital "S.M. della Misericordia", Health Integrated Agency of Friuli
Centrale, Udine, Italy
(Roberti) Department of Anesthesia, Intensive Care and Emergency Medicine,
ASST Spedali Civili, Brescia, Italy
(Montisci) Division of Cardiothoracic Intensive Care, ASST Spedali Civili,
Brescia, Italy
(Pappalardo) Faculty of Medicine and Surgery, Kore University of Enna,
Enna, Italy
(Pappalardo) Centro Cuore GB Morgagni, Catania, Italy
Publisher
W.B. Saunders
Abstract
Acute kidney injury (AKI) is a significant complication following cardiac
surgery, affecting 20% to 30% of patients and contributing to increased
morbidity and mortality. Cardiac surgery-associated AKI (CSA-AKI) is
linked to higher short-term mortality rates, extended intensive care unit
stays, and substantial health care costs. This review examines the
multifactorial pathophysiology of CSA-AKI, which includes renal
hypoperfusion, systemic inflammatory response, and nephrotoxic exposures.
Current definitions of AKI, primarily based on KDIGO criteria, highlight
the limitations of serum creatinine as a diagnostic marker. Preoperative
optimization is essential for risk stratification, using validated
prediction models like the Cleveland Clinic score and EuroSCORE II. The
article discusses the importance of volume status assessment and careful
management of nephrotoxic medications. Intraoperative strategies, such as
surgical technique selection and hemodynamic optimization, are crucial for
preventing AKI during surgery. Postoperatively, maintaining fluid balance
and avoiding nephrotoxin exposure are vital. Implementing KDIGO care
bundles has demonstrated effectiveness in reducing AKI incidence. Emerging
biomarkers, such as NGAL and KIM-1, offer promising avenues for early
detection of renal injury, potentially enabling timely interventions. In
conclusion, comprehensive prevention of AKI in cardiac surgery demands a
multimodal approach, integrating preoperative risk assessment,
intraoperative management, and postoperative care. Advances in biomarker
research and monitoring technologies may facilitate earlier and more
effective interventions, ultimately reducing the incidence of AKI in
high-risk patients. Copyright © 2025 Elsevier Inc.

<38>
Accession Number
2042234648
Title
Current status of left main stem disease revascularization.
Source
Cirugia Cardiovascular. (no pagination), 2025. Date of Publication: 2025.
Author
Urso S.; Dayan V.; Sadaba R.
Institution
(Urso) Servicio de Cirugia Cardiaca, Hospital Universitario Dr. Negrin,
Las Palmas de Gran Canaria, Spain
(Dayan) Servicio de Cirugia Cardiaca, Centro Cardiovascular Universitario,
Hospital de Clinicas, Montevideo, Uruguay
(Sadaba) Servicio de Cirugia Cardiaca, Hospital Universitario de Navarra,
Navarra, Pamplona, Spain
Publisher
Sociedad Espanola de Cirugia Cardiovascular y Endovascular (SECCE)
Abstract
The latest review of the chapter on the management of the left main stem
disease in the guidelines for myocardial revascularization, published by
the European societies of cardiothoracic surgery and cardiology in 2022,
downgrades the indication for percutaneous intervention from class I to
class IIa in patients with left main stem disease and a low SYNTAX score.
The superiority of coronary surgery over percutaneous intervention is
solidly based on the evidence from randomized clinical trials and
validated by international registries. These show that surgical myocardial
revascularization, compared to percutaneous intervention, provides better
outcomes, especially in terms of reducing the risk of mid-terms
spontaneous myocardial infarction and repeat revascularization in patients
with left main stem disease. This fact reinstates coronary surgery as a
fundamental and indispensable procedure in the field of myocardial
revascularization. Ignoring the current scientific evidence by local Heart
teams, therefore, exposes patients with left main stem disease to an
unacceptable risk of adverse cardiovascular events. Copyright ©
2025 Sociedad Espanola de Cirugia Cardiovascular y Endovascular. Published
by Elsevier Espana, S.L.U. This is an open access article under the CC
BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/

<39>
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.

<40>
Accession Number
2040694363
Title
Outcomes of Scar-Related Ventricular Tachycardia Ablation With
Percutaneous Left Ventricular Assist Device Support.
Source
JACC: Clinical Electrophysiology. 11(12) (pp 2673-2684), 2025. Date of
Publication: 01 Dec 2025.
Author
Kawamura I.; Koruth J.S.; Kusa S.; Iwasawa J.; Lam J.; Ellsworth B.;
Watanabe K.; Nies M.; Lampert J.; Maan A.; Musikantow D.R.; Turagam M.K.;
Moss N.; Whang W.; Miller M.A.; Reddy V.Y.; Dukkipati S.
Institution
(Kawamura, Koruth, Kusa, Iwasawa, Lam, Ellsworth, Watanabe, Nies, Lampert,
Maan, Musikantow, Turagam, Whang, Miller, Reddy, Dukkipati) Helmsley
Electrophysiology Center, Department of Cardiology, Icahn School of
Medicine at Mount Sinai, New York, NY, United States
(Kawamura) Department of Cardiovascular Medicine, Institute of Science
Tokyo, Tokyo, Japan
(Kusa) Cardiovascular Center, Tsuchiura Kyodo Hospital, Ibaraki, Japan
(Iwasawa) Department of Cardiology, Heart Rhythm Center, International
University of Health and Welfare Mita Hospital, Tokyo, Japan
(Moss) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School
of Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: Percutaneous left ventricular assist devices (pLVADs) are
often used in critically ill patients undergoing scar-related ventricular
tachycardia (VT) ablation. However, there are no randomized controlled
trials evaluating their benefits. Objective(s): The goal of this
study was to compare outcomes between pLVAD- and non-pLVAD-supported VT
ablation using a propensity score matching analysis. Method(s): This
retrospective analysis comprised 481 scar-related VT patients who
underwent catheter ablation (175 pLVAD and 306 non-pLVAD). A 1:1
propensity score matching was conducted to balance baseline
characteristics for comparison of procedural and long-term outcomes.
 Result(s): A propensity score analysis generated 115 matched pairs in
each group. Baseline characteristics of the matched cohorts were
comparable (mean left ventricular ejection fraction 27%, 40% NYHA
functional class >=III, and 36% electrical storm). Compared with the
non-pLVAD, more patients in the pLVAD group had at least 1 VT termination
during ablation. Despite including a higher use of advanced ablation
strategies and a longer procedure time, the pLVAD group had a
postprocedural VT inducibility similar to that of the non-pLVAD group. The
incidence of periprocedural major complications was higher among pLVAD
patients (29.6% vs 13.9%; P = 0.004), largely driven by vascular
complications requiring intervention and periprocedural heart failure.
During a median follow-up of 326 days, Kaplan-Meier curves showed no
statistically significant differences in composite outcome
(hospitalization for VT or worsening heart failure requiring
hospitalization, LVAD implantation, orthotopic heart transplantation, and
all-cause mortality), and VT recurrence. Conclusion(s): The use of
pLVADs during VT ablation is associated with longer procedures and higher
procedural complications without any benefit in acute or long-term
outcomes. Copyright © 2025 American College of Cardiology
Foundation

<41>
Accession Number
2041744500
Title
The effect of perioperative erythropoietin-stimulating agents and
intravenous iron on patient outcomes following solid organ
transplantation: A systematic review.
Source
Transfusion Medicine. (no pagination), 2025. Date of Publication: 2025.
Author
Lee F.; Eichbaum Q.; Cserti-Gazdewich C.; Mullane D.; Lombard F.W.; Jacobs
J.W.; Pavenski K.; Englesakis M.; Dotto A.; Cho T.; Leonard-Reixa A.;
Trudeau J.; Shih A.W.; Bartoszko J.
Institution
(Lee, Bartoszko) Department of Anesthesiology and Pain Medicine,
University of Toronto, Toronto, ON, Canada
(Eichbaum, Jacobs) Vanderbilt University School of Medicine, Nashville,
TN, United States
(Eichbaum, Jacobs) Department of Pathology, Microbiology, and Immunology,
Vanderbilt University Medical Center, Nashville, TN, United States
(Cserti-Gazdewich, Pavenski) Department of Laboratory Medicine and
Pathobiology, University of Toronto, Toronto, ON, Canada
(Mullane, Dotto, Trudeau) Department of Anesthesiology, Pharmacology, &
Therapeutics, The University of British Columbia, Vancouver, BC, Canada
(Lombard) Department of Anesthesiology, Vanderbilt University Medical
Center, Nashville, TN, United States
(Englesakis) Library & Information Services, University Health
Network-Toronto General Hospital, Toronto, ON, Canada
(Cho) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Leonard-Reixa, Bartoszko) Department of Anesthesia and Pain Management,
Sinai Health System, Women's College Hospital, University Health Network,
Toronto, ON, Canada
(Shih) Department of Pathology and Molecular Medicine, McMaster
University, Hamilton, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Solid organ transplant is associated with high rates of anaemia and
transfusion, but there is little comparative data on interventions such as
erythropoietin-stimulating agents (ESAs) and intravenous (IV) iron. We
conducted a systematic review examining the association of ESAs and IV
iron with outcomes in adults undergoing solid organ transplant. This
review was registered with PROSPERO (CRD42023474722). EMBASE and MEDLINE
were searched from inception to April 11, 2025. Identified studies
included adults (>=18 years of age) undergoing heart, liver, lung, or
kidney transplant who received any ESA and/or IV iron before, during, or
up to 1 month following solid organ transplant surgery compared to
patients who did not. Article screening, full text review and data
extraction were performed by two independent reviewers. The primary
outcome of interest was transfusion volume, with secondary outcomes
including haematological parameters, graft-related outcomes and rates of
major morbidity and mortality. Results were analysed descriptively and
compiled into tables, and the risk of bias was assessed using the CLARITY
framework. From 1693 studies identified, 22 were included (kidney
transplant, n = 16; heart transplant or Left Ventricular Assist Device as
a bridge to transplant, n = 4; liver transplant, n = 2). Due to
heterogeneity in design, interventions and outcomes, meta-analysis was not
attempted. The quality of evidence was graded as Very Low. On the whole, a
comprehensive strategy implementing ESAs and IV iron may improve
haematological parameters and facilitate transfusion avoidance.
High-quality prospective studies assessing the impact of protocols for
haemoglobin optimisation and transfusion avoidance in solid organ
transplant are needed. Copyright © 2025 The Author(s).
Transfusion Medicine published by John Wiley & Sons Ltd on behalf of
British Blood Transfusion Society.

<42>
Accession Number
2041550428
Title
Effect of Intraoperative Blood Pressure Levels on Postoperative Recovery
in Frail Elderly Patients: A Randomized Controlled Trial.
Source
Clinical Interventions in Aging. 20 (pp 2255-2265), 2025. Date of
Publication: 2025.
Author
Wang Y.; Fan Q.; Cheng Z.; Xue X.; Zhou Z.; Liao M.; Wang X.; Li Y.; Tian
M.; Zhang X.
Institution
(Wang, Fan, Cheng, Xue, Zhang) Department of Anesthesiology, Lianyungang
Clinical College of Nanjing Medical University, Jiangsu, Lianyungang,
China
(Zhou, Wang, Li) Department of Anesthesiology, The Affiliated Lianyungang
Hospital of Xuzhou Medical University, Jiangsu, Lianyungang, China
(Liao) Department of Anesthesiology, Maoming People's Hospital, Guangdong,
Maoming, China
(Tian) Department of Anesthesiology, Surgery and Pain Management, Zhongda
Hospital, School of Medicine, Southeast University, Jiangsu, Nanjing,
China
(Zhang) Department of Anesthesiology, The First Affiliated Hospital of
Kangda College of Nanjing Medical University, Jiangsu, Lianyungang, China
Publisher
Dove Medical Press Ltd
Abstract
Background: Frailty is a clinical syndrome characterized by a reduction in
the functional capacity of multiple physiological systems, which increases
the body's vulnerability to stressors and reduces the capacity of elderly
patients to recover from stressful events such as anesthesia and surgery.
 Method(s): A total of 142 elderly frailty patients scheduled for
total knee arthroplasty were randomly assigned to either the low-level
(Group L) or high-level group (Group H). Group L maintained intraoperative
mean arterial pressure (MAP) at 65-85 mmHg, while Group H targeted 85-100
mmHg. The primary outcome was the Quality of Recovery-15 (QoR-15) score on
postoperative day (POD) 1. Secondary outcomes include the time-weighted
average mean arterial pressure (TWA-MAP) intraoperatively, QoR-15 scores
on POD2-5, the abbreviated mental test score (AMTS) at 30 days and 1-year
postoperatively, the incidence of myocardial injury after noncardiac
surgery (MINS) and acute kidney injury (AKI), 1-year mortality
postoperatively. Result(s): There was no significant difference in
QoR-15 values on POD1 between Group L and Group H (mean [SD] 99 [9.89] vs
98 [12.82], mean difference 95% confidence interval (CI) 0.91
(-3.08-4.91)). TWA-MAP was 93.1 +/- 2.29 mmHg in Group H and 78.6 +/- 2.97
mmHg in Group L (P < 0.05, mean difference 95% CI -14.5 (-15.4, -13.6)),
indicating a statistically significant difference between the two groups.
 Conclusion(s): Maintaining higher or lower MAP intraoperatively had
no significant effect on the quality of postoperative recovery in elderly
frailty patients undergoing knee arthroplasty under the conditions studied
in this trial. Copyright © 2025 Wang et al.

<43>
[Use Link to view the full text]
Accession Number
649566506
Title
Sodium-Glucose Cotransporter-2 Inhibitors Following Transcatheter Aortic
Valve Replacement: A Meta-Analysis.
Source
Cardiology in review. (no pagination), 2025. Date of Publication: 16 Dec
2025.
Author
Jain H.; Soni K.; Jain J.; Goyal A.; Passey S.; Goldsweig A.M.
Institution
(Jain) From the Department of Medicine, All India Institute of Medical
Sciences, Jodhpur, India
(Soni) Department of Internal Medicine, SUNY Upstate Medical University,
Syracuse, NY, United States
(Jain) Department of Internal Medicine, Allegheny General Hospital,
Pittsburgh, PA, United States
(Goyal) Department of Internal Medicine, Cleveland Clinic Foundation,
Cleveland, OH, United States
(Passey) Department of Internal Medicine, University of Connecticut Health
Center, Farmington, CT, United States
(Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center
and Division of Cardiovascular Medicine, University of
Massachusetts-Baystate, Springfield, MA, United States
Abstract
Sodium-glucose cotransporter-2 inhibitors (SGLT2is) reduce heart failure
(HF)-associated admissions; however, the data on patients with aortic
stenosis following transcatheter aortic valve replacement (TAVR) is
limited. This systematic review and meta-analysis compares clinical
outcomes in patients with and without SGLT2i following TAVR. Major
electronic databases were systematically searched through April 2025 for
studies evaluating SGLT2i following TAVR. Risk ratios (RR) with 95%
confidence intervals (CI) were pooled using a random-effects model. A P
value of <=0.05 was considered statistically significant. Two studies with
1534 patients undergoing TAVR (679: SGLT2i; 855: no SGLT2i) were included.
SGLT2i therapy led to a significant reduction in HF hospitalization (RR:
0.56; 95% CI: 0.32-0.99; P = 0.05); however, no differences in all-cause
(RR: 0.48; 95% CI: 0.13-1.72; P = 0.26) and cardiovascular mortality (RR:
0.53; 95% CI: 0.19-1.48; P = 0.22) were noted. SGLT2i are associated with
a statistically and clinically significant reduction in HF
hospitalization; however, no reduction in mortality was observed following
TAVR. Further randomized controlled trials are warranted to support future
guideline recommendations regarding SGLT2i following TAVR. Copyright
© 2025 Wolters Kluwer Health, Inc. All rights reserved.

<44>
Accession Number
2042340649
Title
Impact of Intravenous Hydrocortisone on Postoperative Atrial Fibrillation
and Outcomes in Patients Receiving Vasopressor Support Following On-Pump
Coronary Artery Bypass Grafting.
Source
Hospital Pharmacy. (no pagination), 2025. Date of Publication: 2025.
Author
Paytes E.; Mefford B.; Love B.; Amick A.; Cox J.
Institution
(Paytes) Cone Health, Greensboro, NC, United States
(Mefford, Amick, Cox) Prisma Health Richland Hospital, Columbia, SC,
United States
(Love, Amick, Cox) University of South Carolina, Columbia, SC, United
States
(Love) Center for Outcomes Research and Evaluation, Columbia, SC, United
States
Publisher
SAGE Publications Ltd
Abstract
Background: Although 2019 EACTS Guidelines on Cardiopulmonary Bypass in
Adult Cardiac Surgery recommend against routine use of prophylactic
corticosteroids, perioperative glucocorticoids are still often used to
mitigate hypotension, cardiac arrhythmias and respiratory failure
following surgery with cardiopulmonary bypass (CPB). Limited data exists
on safety and efficacy of intravenous (IV) hydrocortisone in this setting.
 Objective(s): To assess the impact of intravenous hydrocortisone on
postoperative complications after on-pump coronary artery bypass grafting
(CABG). Method(s): This was a single-center, retrospective chart
review between 2021 and 2023. Adult patients with on-pump CABG requiring
vasopressor therapy postoperatively were included. Result(s): Of 153
patients included, 39 received IV hydrocortisone and 114 did not. The
hydrocortisone group had significantly lower cortisol levels (15.8 mcg/dL
vs 23.9 mcg/dL, P < 0.001) and higher incidence of a past medical history
of atrial fibrillation (23.1% vs 2.6%, P < 0.001) compared to the control
group. Rates of postoperative atrial fibrillation (POAF) were similar
between groups with 23.1% in the hydrocortisone group and 21.9% in the
control group (P = 0.88), which maintained after controlling for age,
history of atrial fibrillation, sex, and propensity score (P = 0.86). Mean
cumulative norepinephrine equivalents (NEE) were similar between
hydrocortisone group and control (10.4 mcg/min vs 8.9 mcg/min, P = 0.12).
Hydrocortisone administration was associated with longer durations of
vasopressor therapy (45.8 vs 28.9 hours, P = 0.001), insulin therapy
(149.4 vs 82.2 hours, P = 0.003), and total mechanical ventilation time
(59.3 vs 19.4 hours, P = 0.049). There were no differences in surgical
site infections between the hydrocortisone group versus control group
(5.2% vs 5.2%, P = 1.00), including both non-infectious (2.6% vs 2.6%, P =
1.00) and infectious surgical site complications (2.6% vs 2.6%, P = 1.00).
 Conclusion(s): After controlling for sex, age, history of atrial
fibrillation/flutter, and propensity score, there was no significant
association between the administration of IV hydrocortisone and POAF in
patients receiving vasopressor support following on-pump CABG. Further
prospective studies are needed to confirm these findings. Copyright
© The Author(s) 2025

<45>
Accession Number
649558064
Title
Combined AF ablation and left atrial appendage occlusion for atrial
fibrillation and bleeding diathesis.
Source
Journal of Cardiovascular Electrophysiology. Conference: 29th Annual
International Atrial Fibrillation Symposium. Boston, MA United States.
35(6) (pp 1281), 2024. Date of Publication: 01 Jun 2024.
Author
Kanagaratnam P.; Kailey B.; Koa-Wing M.; Qureshi N.
Institution
(Kanagaratnam, Kailey, Koa-Wing, Qureshi) Imperial College 6, Fitzjames
Avenue West Kensington, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Introduction Objectives: Patients with AF and likelihood of bleeding can
undergo left atrial appendage occlusion (LAAO) as an alternative method of
stroke prophylaxis. Short-term anti-thrombotic drugs are used
postprocedure to offset the risk of device-related thrombus. We
investigated optimal post-implant antithrombotic strategy in high
bleeding-risk patients undergoing combined AF ablation and LAAO.
 Method(s): Peri-operative drug therapy was advised by a
multidisciplinary physician panel. Those deemed to be at higher risk of
bleeding from anti-thrombotic drugs were assigned to minimal treatment
with no antithrombotics or aspirin-alone. The remaining patients received
standard care (STG) with a 12 week course of dualantiplatelets or
anticoagulation post-implant. AF ablation was advised in combination with
LAAO, where standard recommendations for AF ablation were met. We compared
mortality, device-related thrombus, ischemic stroke and bleeding events
during the 90 days post-implant and long-term. Event-free survival was
assessed using Kaplan-Meier survival analysis, with logrank testing for
statistical significance. Result(s): Seventy-five pts underwent LAAO
of whom 63pts (84%) had a prior serious bleeding event. 59/75 (79%) also
underwent pulmonary vein isolation. 42pts were on minimal treatment and
were older (74.3+/-7.7 vs. 71.2+/-7.2) with higher HASBLED score
(3.6+/-0.9 vs. 3.3+/-1.2) than the 33pts having standard care. There were
no device-related thrombi or strokes in either group at 90 days
postprocedure; STG had more bleeding events (5/33 vs. 0/42, p = .01) with
associated deaths (3/33 vs. 0/ 42, p = .05). During long-term follow up
(median 2.2 yrs), all patients transitioned onto no antithrombotic drugs
(43pts [61%]) or a single-antiplatelet (29pts [39%]). There was no
evidence of early minimal treatment adversely affecting long-term
outcomes. AF recurrence was 26/59 (44%) by annual ECG/Holter at 2.0+/-1.9
yrs in the patients undergoing ablation. Conclusion(s): Combined AF
ablation and LAAO is feasible and safe without short term anti-thrombotic
drugs and in patients with high bleeding risk and could be harmful.
Larger, prospective studies would be warranted to test these findings.

<46>
Accession Number
2041905354
Title
Rationales Behind Physiology-Guided Revascularization.
Source
JACC: Cardiovascular Interventions. (no pagination), 2025. Date of
Publication: 2025.
Author
Zhang R.; Wang H.-Y.; Song L.; Guan C.; Yin D.; Zhu C.; Feng L.; Jin Z.;
Yu B.; Fu G.; Zhou Y.; Wang J.; Chen Y.; Pu J.; Chen L.; Qu X.; Zhao Y.;
Wang Y.; Liu W.; Qiao S.; Tu S.; Wijns W.; Dou K.
Institution
(Zhang, Wang, Dou) Cardiometabolic Medicine Center, National Clinical
Research Center for Cardiovascular Diseases, Fuwai Hospital, National
Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences
and Peking Union Medical College, Beijing, China
(Zhang, Wang, Song, Yin, Zhu, Feng, Qiao, Dou) Department of Cardiology,
National Clinical Research Center for Cardiovascular Diseases, Fuwai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences and Peking Union Medical College, Beijing, China
(Zhang, Wang, Song, Yin, Zhu, Feng, Qiao, Dou) Coronary Heart Disease
Center, Fuwai Hospital, National Center for Cardiovascular Diseases,
Chinese Academy of Medical Sciences and Peking Union Medical College,
Beijing, China
(Zhang, Wang, Dou) State Key Laboratory of Cardiovascular Disease,
Beijing, China
(Song, Guan) Catheterization Laboratories, Fuwai Hospital, National Center
for Cardiovascular Diseases, Chinese Academy of Medical Sciences and
Peking Union Medical College, Beijing, China
(Jin) Department of Cardiology, Beijing Tiantan Hospital, Capital Medical
University, Beijing, China
(Yu) Department of Cardiology, Second Affiliated Hospital of Harbin
Medical University, Harbin, China
(Fu) Department of Cardiology, Sir Run Run Shaw Hospital, Zhejiang
University School of Medicine, Hangzhou, China
(Zhou) Department of Cardiology, Beijing Anzhen Hospital, Capital Medical
University, Beijing, China
(Wang) Department of Cardiology, Second Affiliated Hospital, Zhejiang
University School of Medicine, Hangzhou, China
(Chen) Department of Cardiology, Sixth Medical Centre, Chinese PLA General
Hospital, Beijing, China
(Pu) Department of Cardiology, Renji Hospital, School of Medicine,
Shanghai Jiao Tong University, Shanghai, China
(Chen) Department of Cardiology, Fujian Medical University Union Hospital,
Fuzhou, China
(Qu) Department of Cardiology, Huadong Hospital Affiliated to Fudan
University, Shanghai, China
(Zhao, Wang) Medical Research and Biometrics Center, National Center for
Cardiovascular Diseases, Beijing, China
(Liu) State Key Laboratory for Complex, Severe, and Rare Diseases, Peking
Union Medical College Hospital, Chinese Academy of Medical Sciences,
Beijing, China
(Tu) Biomedical Instrument Institute, School of Biomedical Engineering,
Shanghai Jiao Tong University, Shanghai, China
(Wijns) The Lambe Institute for Translational Medicine and Curam,
University of Galway, Galway, Ireland
Publisher
Elsevier Inc.
Abstract
Background The optimization of a treatment plan developed on the basis of
coronary angiography alone is recognized as one of the underlying
rationales for the clinical benefits of physiology-guided percutaneous
coronary intervention (PCI). Objectives The aim of this study was to
investigate the diagnostic impact of quantitative flow ratio (QFR) through
a post hoc analysis of the multicenter randomized FAVOR (Comparison of
Quantitative Flow Ratio Guided and Angiography Guided Percutaneous
Intervention in Patients With Coronary Artery Disease) III China trial.
Methods In FAVOR III China, operators were required to declare all target
vessels intended for PCI before randomization (prerandomization declared
treatment plan). After randomization, the actual treatment strategy was
performed with online QFR or angiographic guidance (randomized
allocation). In this study, prerandomization treatment plan and
postrandomization treatment strategy were adjudicated using off-line QFR
by independent core laboratory to determine physiological concordance. The
primary outcome of interest for the present study was major adverse
cardiac events. Results Among 3,768 pooled patients with available
off-line QFR, 2,601 (69.0%) had prerandomization physiology-concordant
plans, proportions of which were comparable between the online QFR-guided
and angiography-guided groups (70.9% [1,340 of 1,891] vs 67.2% [1,261 of
1,877], standardized mean difference = 0.087). Physiological concordance
was reclassified in 447 (23.6%) and 87 (4.6%) patients with online QFR and
angiographic guidance, respectively, and a significant between-group
difference was identified in terms of achieving postrandomization
physiological concordance (92.3% vs 67.2%, standardized mean difference =
0.665). A significant interaction was identified between prerandomization
physiological concordance and randomized allocation for 2-year major
adverse cardiac events (P for interaction = 0.002). Patients with older
age, multivessel disease, left circumflex or right coronary artery
involved, and lower SYNTAX (Synergy Between PCI With Taxus and Cardiac
Surgery) scores were found more likely to have prerandomization
physiological nonconcordance. Conclusions In the FAVOR III China trial,
approximately 30% of patients showed discrepancies between
angiography-based treatment plans and physiological ischemia. The
mechanistic insight underlying the benefits of QFR-guided PCI is
reclassification following online QFR guidance, which leads to a shift
from initially flawed plans toward physiology-concordant decisions. (The
FAVOR III China Study [FAVORIII]; NCT03656848) Copyright © 2025
American College of Cardiology Foundation.

<47>
Accession Number
2040999773
Title
Neoaortic outcomes after the arterial switch operation: A systematic
review and meta-analysis.
Source
Archives of Cardiovascular Diseases. (no pagination), 2025. Date of
Publication: 2025.
Author
Negm S.; Mahmoud A.B.; Desnous B.; Elatafy E.E.; Fouilloux V.; Gran C.;
Mace L.; Lenoir M.
Institution
(Negm, Desnous, Fouilloux, Gran, Mace, Lenoir) Department of
Cardio-Thoracic Surgery, Hopital de la Timone Enfants et Adultes, AP-HM,
Aix-Marseille University, Marseille, France
(Negm, Mahmoud, Elatafy) Department of Cardio-Thoracic Surgery, Faculty of
Medicine, Tanta University, Tanta, Egypt
Publisher
Elsevier Masson s.r.l.
Abstract
Background The arterial switch operation has become the treatment of
choice for neonates with transposition of great arteries. Aim This
systematic review and meta-analysis aimed to summarize the current
evidence regarding neoaortic root dilatation and aortic valve
insufficiency as long-term outcomes after the arterial switch operation,
and to identify associated risk factors. Methods A systematic search of
PubMed, EMBASE and Cochrane databases was conducted for human studies
published in English or French until May 2024. Results Out of 1480
identified records, 80 studies were included in the final analysis. The
total incidence of moderate-to-severe aortic insufficiency was 588 out of
20,338 patients (2.89%). The total number of neoaortic reinterventions was
306 in 11,291 patients (2.71%). The total number of neoaortic
reinterventions for aortic insufficiency was 78 in 4757 patients (1.63%).
Distensibility of both the aortic root and the ascending aorta in patients
after the arterial switch operation was significantly lower than in the
normal population. Several factors were significantly associated with an
increased risk of moderate-to-severe aortic insufficiency: ventricular
septal defect (P < 0.001); pulmonary artery banding (P = 0.007);
aortopulmonary mismatch (P < 0.001); and neoaortic root dilatation (P <
0.001). Coronary anomalies showed a borderline association (P = 0.055),
and the trapdoor technique was significant in one study (P = 0.0005).
Distensibility of both the aortic root and the ascending aorta was found
to be significantly reduced in patients after the arterial switch
operation compared with healthy controls, reflecting increased vascular
stiffness. Conclusions Significant neoaortic valve insufficiency and
reintervention remain relatively rare after the arterial switch operation.
However, measurable risk factors-including ventricular septal defect,
pulmonary artery banding, aortopulmonary mismatch and coronary
anomalies-are associated with an increased long-term risk of valve
dysfunction or surgical reintervention. Copyright © 2025 The
Authors.

<48>
Accession Number
2041808848
Title
Efficacy and safety of transcatheter aortic valves in patients with aortic
stenosis: a network meta-analysis.
Source
Future Cardiology. (no pagination), 2025. Date of Publication: 2025.
Author
Adnan M.; Ahmed Usman M.; Akhtar M.; Hameed H.; Hussain Bakhtiari M.I.;
Hamza M.; Zaheer W.; Shoaib I.; Saleem A.; Basit J.; Alraies M.C.
Institution
(Adnan, Ahmed Usman, Akhtar, Hameed, Hussain Bakhtiari, Zaheer, Shoaib,
Saleem) Department of Medicine, Gujranwala Medical College, Gujranwala,
Pakistan
(Hamza) Department of Hospital Medicine, Guthrie Medical Group, Cortland,
NY, United States
(Basit) Department of Medicine, Rawalpindi Medical University, Rawalpindi,
Pakistan
(Alraies) Detroit Medical Center, Wayne State University, Detroit, MI,
United States
Publisher
Taylor and Francis Ltd.
Abstract
Background: Patients with aortic stenosis have a high mortality risk
treatable by transcatheter aortic valve replacement (TAVR). We conducted a
network meta-analysis to compare the efficacy and safety of transcatheter
aortic valves in aortic stenosis patients. Method(s): A systematic
search of PubMed, Embase, and Cochrane was conducted. Randomized
controlled trials (RCTs) that included adult patients with aortic stenosis
undergoing TAVR, which compared clinical efficacy and safety between any
of the transcatheter aortic valves, were included. Random effects
meta-analysis was employed. Result(s): A total of 4687 patients from
9 RCTs were included. Sapien XT had a significantly higher risk of stroke
compared to Sapien 3 RR = 31.38 (95% CI: 1.12 to 876, p = 0.043), while
other devices showed no significant differences. Evolut had a
significantly increased risk of permanent pacemaker placement compared to
Sapien 3 RR = 1.36 (95% CI: 1.07-1.74, p = 0.013). No significant
differences were observed between valves for any of the other analyzed
outcomes. Conclusion(s): While most TAVR devices showed comparable
safety profiles, Evolut was associated with increased pacemaker
implantation risk. The higher stroke risk with Sapien XT should be
interpreted with caution. Protocol Registration: This review was
registered with PROSPERO (CRD42024563628). Copyright © 2025
Informa UK Limited, trading as Taylor & Francis Group.

<49>
Accession Number
2041876236
Title
Left atrial appendage occlusion vs standard of care in high stroke risk
atrial fibrillation patients ineligible for anticoagulation: COMPARE-LAAO.
Source
Netherlands Heart Journal. (no pagination), 2025. Date of Publication:
2025.
Author
Aarnink E.W.; Huijboom M.F.M.; van der Kley F.; Folkeringa R.; de Groot
J.R.; van der Voort P.H.; Blaauw Y.; Chaldoupi M.; Stevenhagen J.;
Vlachojannis G.J.; van Mieghem N.M.; Swaans M.J.; van Dijk V.F.; Dijkgraaf
M.G.; van Dijk E.J.; Tijssen J.G.P.; Boersma L.V.A.
Institution
(Aarnink, Huijboom, Swaans, van Dijk, Boersma) Department of Cardiology,
St. Antonius Hospital, Nieuwegein, Netherlands
(van der Kley) Department of Cardiology, Leiden University Medical Center,
Leiden, Netherlands
(Folkeringa) Department of Cardiology, Medical Center Leeuwarden,
Leeuwarden, Netherlands
(de Groot, Boersma) Department of Cardiology, Amsterdam University Medical
Center, location AMC, Amsterdam, Netherlands
(van der Voort) Department of Cardiology, Catharina Hospital, Eindhoven,
Netherlands
(Blaauw) Department of Cardiology, University Medical Center Groningen,
Groningen, Netherlands
(Chaldoupi) Department of Cardiology, Maastricht University Medical
Center, Maastricht, Netherlands
(Stevenhagen) Department of Cardiology, Medical Spectrum Twente, Enschede,
Netherlands
(Vlachojannis) Department of Cardiology, University Medical Center
Utrecht, Utrecht, Netherlands
(van Mieghem) Department of Cardiology, Erasmus University Medical Center,
Rotterdam, Netherlands
(Dijkgraaf) Department of Epidemiology and Data Science, Location AMC,
Amsterdam University Medical Center, Amsterdam, Netherlands
(van Dijk) Department of Neurology, Radboud University Medical Center,
Nijmegen, Netherlands
(Tijssen) Department of Cardiology, Clinical Epidemiology & Biostatistics,
Amsterdam University Medical Center, Amsterdam, Netherlands
(van Dijk) Department of Neurology, University Medical Center Utrecht,
Utrecht, Netherlands
Publisher
Bohn Stafleu van Loghum
Abstract
Introduction: The left atrial appendage is the dominant source of
cardioembolic stroke in patients with atrial fibrillation (AF).
Contemporary guidelines recommend considering left atrial appendage
occlusion (LAAO) in AF patients contraindicated to oral anticoagulation
therapy (OAC), but randomized controlled trial (RCT) data for this
subpopulation are lacking. Method(s): COMPARE LAAO was designed as an
event-driven, multicenter, prospective, randomized, open, blinded endpoint
(PROBE) trial that randomized AF patients with an increased thromboembolic
risk and a contraindication to OAC 2:1 to LAAO or standard-of-care (SOC).
The co-primary endpoints comprised 1) time to first occurrence of
ischemic/hemorrhagic/undetermined stroke and 2) time to first occurrence
of all-cause stroke/TIA/SE. The trial aimed to enroll 609 patients.
 Result(s): After randomization of 69 patients, the trial was
terminated prematurely by the sponsor due to a slow inclusion rate.
Results are discussed briefly without formal statistical testing.
All-cause stroke occurred in 7/48 and 2/21 patients randomized to LAAO and
SOC, respectively. According to the as-treated principle, all-cause stroke
occurred in 5/41 and 4/28 patients treated with LAAO and SOC. The
composite of all-cause stroke/TIA/SE occurred in 10/48 and 4/21 patients
randomized to and 8/41 and 6/28 patients treated with LAAO and SOC.
 Conclusion(s): Insufficient statistical power of COMPARE LAAO impedes
drawing any conclusions. Among other factors, the loss of perceived
clinical equipoise among physicians proved problematic for successful
trial completion. Conducting an RCT on LAAO vs SOC in OAC-ineligible
patients appears infeasible globally, which threatens to preclude
reimbursement in the Netherlands for these patients that have no proven
alternative. Copyright © The Author(s) 2025.

<50>
Accession Number
2041868768
Title
Comprehensive Multimodal Prehabilitation for Lung Cancer: A Systematic
Review of Randomized Controlled Trials.
Source
Therapeutics and Clinical Risk Management. 21 (pp 1735-1745), 2025. Date
of Publication: 2025.
Author
Mania K.; Pieczynska A.; Hojan K.
Institution
(Mania) Department of Occupational Therapy, Poznan University of Medical
Sciences, Poznan, Poland
(Pieczynska, Hojan) Poznan University of Medical Sciences, Department of
Occupational Therapy, Poznan, Poland
(Hojan) Greater Poland Cancer Centre, Department of Rehabilitation,
Poznan, Poland
(Hojan) Greater Poland Provincial Hospital in Poznan, Neurorehabilitation
Ward, Poznan, Poland
Publisher
Dove Medical Press Ltd
Abstract
Introduction: Surgical resection is a cornerstone of curative treatment
for early-stage lung cancer. Multimodal prehabilitation, a comprehensive,
patient-centered program integrating physical exercise, nutritional
status, and psychological support, has emerged as a promising approach to
enhance patients' physiological and psychological resilience prior to
surgery. While multimodal prehabilitation is valuable for optimizing
patients' tolerance of oncological treatment, there is a scarcity of
studies incorporating multimodal interventions, likely due to the absence
of clear guidelines for lung cancer patients. This systematic review aimed
to assess the comprehensiveness and effectiveness of prehabilitation
activities for lung cancer patients undergoing thoracic surgery.
 Evidence Acquisition: A systematic literature search was conducted
according to PRISMA guidelines. The search was performed in PubMed, Google
Scholar, PEDro, and Cochrane Library, with additional publications
identified from reference lists. The search was completed on February 27,
2024. Studies published between 2019 and 2024 were included to capture the
most recent evidence. The study was registered in PROSPERO (registration
number CRD42024499622). Evidence Synthesis: Out of 1233 identified
studies, 10 randomized controlled trials were included. Prehabilitation
programs varied in duration and setting. Only three studies (Liu et al,
2020; Yao et al, 2022; Ferreira et al, 2021) employed a comprehensive
multimodal approach integrating physical exercise, psychological care, and
nutrition interventions. Prehabilitation was associated with improved
exercise capacity (eg, increased 6MWT distance), reduced postoperative
complications, and potential benefits for quality of life and
psychological well-being. However, the impact on length of stay and
cognitive function remains unclear. Conclusion(s): This review
highlights a significant gap in the implementation of comprehensive
multimodal prehabilitation for lung cancer patients. While physical
exercise is widely adopted, psychological and nutritional components are
often overlooked. Further research is needed to establish clear guidelines
and elucidate the full benefits of a comprehensive multimodal
prehabilitation approach, particularly regarding its impact on mental
health, quality of life, and long-term outcomes in lung cancer
patients. Copyright © 2025 Mania et al.

<51>
Accession Number
2041051413
Title
Automated annular suture device versus conventional annular suture
technique in endoscopic aortic valve replacement: A propensity
score-matched analysis.
Source
JTCVS Techniques. (no pagination), 2025. Date of Publication: 2025.
Author
Salamate S.; El-Sayed Ahmad A.; Bayram A.; Sirat S.; Akhavuz O.; Amer M.;
Kruse J.; Silaschi M.; Doss M.; Bakhtiary F.
Institution
(Salamate, El-Sayed Ahmad, Akhavuz, Kruse, Silaschi, Bakhtiary) Department
of Cardiac Surgery, University Hospital Bonn, Bonn, Germany
(Bayram, Sirat, Doss) Division of Cardiac Surgery, Heart Centre Siegburg,
Siegburg, Germany
(Amer) Division of Cardiac Surgery, Helios Klinikum Wuppertal, Wuppertal,
Germany
Publisher
Elsevier Inc.
Abstract
Objective To overcome some of the challenges of endoscopic aortic valve
replacement, an automated annular suturing device has been developed and
used in aortic valve replacement surgeries. The current study compares the
early clinical outcomes of patients who received endoscopic aortic valve
replacement with the help of the RAM device (LSI Solutions) versus the
conventional annular suture technique. Methods From March 2017 to March
2025, 1280 patients underwent endoscopic aortic valve replacement via
right anterior minithoracotomy in 3 cardiac referral centers in Germany.
The RAM automated suture device was used in 259 cases, and the
conventional annular suture technique was used in 1021 patients. A
propensity score analysis was performed in 259 matched pairs. Results The
mean age in the matched cohort was 61.87 +/- 11.24 years, and mean body
mass index was 27.04 +/- 4.83 kg/m2 across both genders. Mean
aortic crossclamping time was significantly lower in the RAM group: 54.67
+/- 16.42 minutes versus 62.02 +/- 24.72 minutes ( P < .001). Mean
cardiopulmonary bypass time was also lower in the RAM group (83.75 +/-
23.29 minutes vs 97.22 +/- 36.45 minutes, P < .001). Reexploration for
bleeding occurred more often in the conventional suture group (7.3%
without RAM vs 2.3% with RAM ( P = .004). There were no significant
differences in the incidence of paravalvular leak between groups (RAM 0%
vs conventional 0.4%, P = .5). Conclusions The use of the RAM device in
endoscopic aortic valve replacement is as safe, feasible, and effective as
the conventional annular suture technique and yields excellent early
outcomes. After a short learning curve, the RAM device was associated with
reduced surgical time by facilitating annular suturing in endoscopic
fashion. Copyright © 2025 The Author(s).

<52>
Accession Number
2042143982
Title
Cryopreserved vs Liquid-Stored Platelets for the Treatment of Surgical
Bleeding: The CLIP-II Randomized Noninferiority Clinical Trial.
Source
JAMA. (no pagination), 2025. Date of Publication: 2025.
Author
Reade M.C.; Marks D.C.; Howe B.D.; Bailey M.J.; Bannon P.G.; Eastwood
G.M.; French C.J.; Gattas D.J.; Higgins A.M.; Holley A.D.; Hu R.T.; Irving
D.O.; Johnson L.; McGuinness S.P.; McQuilten Z.K.; Royse A.G.; Smith J.A.;
Weinberg L.; Wood E.M.
Institution
(Reade, Holley) Medical School, University of Queensland, Brisbane, QLD,
Australia
(Reade, Holley) Joint Health Command, Australian Defence Force, Canberra,
ACT, Australia
(Marks, Irving, Johnson) Australian Red Cross Lifeblood, Alexandria, NSW,
Australia
(Howe, Bailey, French, Higgins) Australian and New Zealand Intensive Care
Research Centre, Monash University, Melbourne, VIC, Australia
(Bannon, Gattas) Royal Prince Alfred Hospital, Sydney, NSW, Australia
(Bannon, Gattas) Sydney Medical School, Sydney, NSW, Australia
(Eastwood, Hu, Weinberg) Austin Hospital, Melbourne, VIC, Australia
(Eastwood, Hu, Royse, Weinberg) University of Melbourne, Melbourne, VIC,
Australia
(French) Western Hospital, Melbourne, VIC, Australia
(McGuinness) Cardiothoracic and Vascular Intensive Care and High
Dependency Unit, Auckland, New Zealand
(McQuilten) School of Public Health and Preventive Medicine, Monash
University, Melbourne, VIC, Australia
(Royse) Royal Melbourne Hospital, Melbourne, VIC, Australia
(Royse) Australian Army, Melbourne, VIC, Australia
(Smith) Victorian Heart Hospital, Melbourne, VIC, Australia
(Smith) Monash University, Melbourne, VIC, Australia
(Wood) Transfusion Research Unit, Monash University, Melbourne, VIC,
Australia
Publisher
American Medical Association
Abstract
Importance Liquid-stored platelets have a shelf-life of 5 to 7 days,
limiting availability and resulting in wastage. Objective To assess the
effectiveness and safety of dimethyl sulfoxide-cryopreserved platelets,
which have a shelf-life of 2 years, as a treatment for cardiac surgery
bleeding. Design, Setting, and Participants The Cryopreserved vs Liquid
Platelets II (CLIP-II) trial was a multicenter, randomized, double-blind,
parallel-group noninferiority trial, which enrolled patients between
August 2021 and April 2024 at 11 Australian tertiary hospitals, with
follow-up completed in July 2024. Patients at high risk of platelet
transfusion were eligible. Patients were excluded if they had a history of
deep vein thrombosis or pulmonary embolism, were coagulopathic, or were
females aged 18 to 55 years who were rhesus D (RhD) negative or of unknown
RhD status. Of 879 patients meeting inclusion criteria, 182 were excluded
and 285 did not consent, leaving 412. Of these, 388 were randomized and
202 received study platelets. Interventions Patients received up to 3
units of either group O cryopreserved platelets or conventional
liquid-stored platelets, commencing intraoperatively or in the first 24
postoperative hours. Main Outcomes and Measures The primary outcome was
postsurgical chest drain bleeding within the first 24 hours following
intensive care unit admission. Noninferiority was defined prospectively as
less than 20% greater bleeding in this period. Five secondary and 42
tertiary outcomes were defined a priori. Results Of the 202 transfused
patients (mean [SD] age, 64.4 [13] years; 75.7% male), 61 (30.2%)
underwent nonelective surgery. The primary outcome did not differ between
groups (605 mL in cryopreserved platelet group vs 535 mL in liquid-stored
platelet group; ratio of geometric means [cryopreserved to liquid ratio],
1.13 [95% CI, 0.96-1.34]; P = .07). As the confidence interval includes
bleeding exceeding the noninferiority margin, noninferiority was not
established. Cryopreserved platelet transfusion was associated with higher
intraoperative and total perioperative blood loss (ratio of geometric
means [cryopreserved to liquid ratio], 1.42 [95% CI, 1.12-1.80]; 1.31 [95%
CI, 1.07-1.60], respectively), and increased red cell, plasma, and
cryoprecipitate transfusion. While there were no differences in the
incidence of prespecified adverse events, patients receiving cryopreserved
platelets experienced longer times to extubation and intensive care
unit/hospital discharge (median [IQR] duration of ventilation, 25.5 hours
[16.1-77.3] vs 23.6 hours [13.1-52.8]; median [IQR] intensive care unit
length of stay, 3.8 days [2.0-6.0] vs 3.0 days [1.9-4.9]; median hospital
length of stay, 10.9 days [7.87-17.0] vs 9.1 [6.9-14.9]). Conclusions and
Relevance Cryopreserved platelets did not meet the predefined threshold
for noninferiority in hemostatic effectiveness at 24 hours after ICU
admission. Additional predefined end points consistently indicated
diminished hemostatic effectiveness, although prespecified adverse events
were comparable. Copyright © 2026 American Medical Association.
All rights reserved, including those for text and data mining, AI
training, and similar technologies. American Medical Association.

<53>
Accession Number
2041866618
Title
Efficacy and safety of postoperative autologous blood transfusion in
cardiac surgery (RESCUE): Rationale, design, and study protocol of a
multicenter randomized controlled trial.
Source
American Heart Journal. 293 (no pagination), 2026. Article Number: 107313.
Date of Publication: 01 Mar 2026.
Author
Shan J.; Gao J.; Chen Y.; Ji H.
Institution
(Shan, Gao, Chen, Ji) Department of Anesthesiology, Fuwai Hospital,
Chinese Academy of Medical Sciences and Peking Union Medical College,
Beijing, China
(Ji) Department of Anesthesiology, Chinese Academy of Medical Sciences
Fuwai Hospital Shenzhen Hospital, Guangdong, China
Publisher
Elsevier Inc.
Abstract
Background Postoperative bleeding is a major concern in cardiac surgery,
often leading to significant transfusion requirements. Despite this high
transfusion demand, the use of postoperative autologous blood transfusion
(PABT) remains underexplored. Methods and Results This large-scale,
single-blind randomized controlled trial with a 30-day follow-up enrolls
patients undergoing elective on- or off-pump coronary artery bypass
grafting. Patients with shed mediastinal blood volumes over 500 mL within
the first 6 hours postoperatively are randomly assigned 1:1 to either the
PABT group or the standard care group. The PABT group receives
postoperative autotransfusion and additional allogeneic RBC transfusions
if needed, while the standard care group receives allogeneic RBC
transfusions only when clinically necessary, without postoperative
autotransfusion. The primary efficacy endpoint is the postoperative
allogeneic RBC transfusion volume, defined as the cumulative amount
transfused from the day of surgery to discharge. Secondary efficacy
endpoints include postoperative allogeneic RBC and non-RBC transfusion
rates, perioperative hematologic recovery, drainage volume, mechanical
ventilation duration, ICU and hospital length of stay. The primary safety
endpoint is the incidence of a composite of postoperative infections
(pneumonia, bloodstream infections, and surgical site infections).
Secondary safety endpoints include a composite of other postoperative
complications (renal dysfunction, myocardial infarction, stroke, deep vein
thrombosis, and all-cause mortality), individual components of these
composites, and 30-day mortality and morbidity. The estimated sample size
is 1,232 participants. Patient recruitment is planned from January 2026 to
December 2029 and is currently in the preparatory phase. The study is
registered at the Chinese Clinical Trial Registry (ChiCTR2500103269,
https://www.chictr.org.cn/ ) and was registered on May 27, 2025.
Conclusions The study is designed to identify the efficacy and safety of
PABT after cardiac surgery. We hypothesize that PABT has superior efficacy
and noninferior safety to the standard care. Copyright © 2025 The
Author(s).

<54>
Accession Number
2037446828
Title
End-tidal CO<inf>2</inf> response to passive leg raise for fluid
management in lung resections: A randomized controlled trial.
Source
Pakistan Journal of Medical Sciences. 41(12) (pp 3393-3398), 2025. Date of
Publication: 01 Dec 2025.
Author
Uzan H.S.A.; Yuceyar L.; Sayilgan N.C.
Institution
(Uzan) Department of Anesthesiology and Reanimation, Edirne State
Hospital, Saglik Mah. Dr. Sadik Ahmet Cad. No: 8, Edirne, Turkey
(Uzan, Yuceyar, Sayilgan) Department of Anesthesiology and Reanimation,
Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul,
Fatih, Turkey
(Yuceyar, Sayilgan) Cerrahpasa Medical Faculty, Istanbul
University-Cerrahpasa, Istanbul, Fatih, Turkey
Publisher
Professional Medical Publications
Abstract
Objective: To evaluate whether changes in end-tidal carbon dioxide (EtCO2)
following passive leg raise (PLR) can predict fluid responsiveness and
guide fluid therapy in patients undergoing Lung Resection Surgery (LRS).
Methodology: This prospective randomized controlled trial was conducted at
Istanbul University-Cerrahpasa Medical Faculty Hospital, Istanbul, Turkey,
between August 2020 and March 2021. Fifty patients undergoing elective LRS
were enrolled. After anesthesia induction, EtCO<inf>2</inf> was measured
before and one minute after PLR. A >=2 mmHg increase was considered
responsive. Responders were randomized into a study group (fluid bolus)
and a control group (maintenance fluid only); non-responders formed a
third group. Hemodynamic parameters, fluid balance, urea, creatinine and
lactate levels were recorded perioperatively. Result(s): The
proportion of fluid responders was 62%. The study group received
significantly more intravenous fluid and showed no cases of acute kidney
injury (AKI), while AKI was observed in the control and unresponsive
groups. Postoperative urea levels increased significantly only in the
control group. Lactate levels rose intraoperatively in all groups but
normalized within 24 hours. A positive correlation was found between
surgical duration and lactate levels. EtCO<inf>2</inf> and heart rate did
not differ significantly between groups. Conclusion(s):
EtCO<inf>2</inf> changes in response to PLR may provide a simple,
non-invasive indicator of fluid responsiveness in thoracic surgery.
Targeted fluid supplementation in responsive patients appears to improve
renal outcomes. Further studies are needed to validate these
findings. Copyright © 2025, Professional Medical Publications.
All rights reserved.

<55>
Accession Number
649562763
Title
Effectiveness of Early Mobility Interventions for the Management of
Cardiac Surgery Patients: A Meta-analysis.
Source
Journal of perianesthesia nursing : official journal of the American
Society of PeriAnesthesia Nurses. (no pagination), 2025. Date of
Publication: 15 Dec 2025.
Author
Yu J.; Wei L.; Li P.; Zhang S.
Institution
(Yu, Wei, Li) Department of Cardiovascular and Macrovascular, Shandong
Provincial Third Hospital, Jinan, Shandong, China
(Zhang) Department of Cardiovascular and Macrovascular, Shandong
Provincial Third Hospital, Jinan, Shandong, China
Abstract
PURPOSE: Early mobility interventions are increasingly recognized as a
critical component of postoperative care for cardiac surgery patients.
These interventions aim to improve functional recovery, reduce
complications, and optimize resource utilization. However, the
effectiveness of early mobility programs on outcomes such as the 6-minute
walk distance (6-MWD), hospital and intensive care units (ICU) length of
stay, and in-hospital mortality remains unclear. DESIGN: Systematic review
and meta-analysis. METHOD(S): This review was conducted following
Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020
guidelines to evaluate the effectiveness of early mobility interventions
in cardiac surgery patients. Relevant studies were identified from PubMed,
Scopus, Web of Science, and EMBASE databases. Random-effects meta-analyses
were performed to pool standardized mean differences (SMD) or odds ratios
with 95% confidence intervals (CIs) for 6-MWD, length of hospital and ICU
stay, and in-hospital mortality. Heterogeneity was assessed using the I2
statistic. FINDINGS: Twenty studies including 2,523 participants were
analyzed. Early mobility interventions significantly improved 6-MWD (SMD:
1.22; 95% CI: 0.62 to 1.82; P < .001) and reduced hospital (SMD: -0.55;
95% CI: -0.85 to -0.24; P < .001) and ICU (SMD: -0.48; 95% CI: -0.93 to
-0.03; P = .036) length of stay. Substantial heterogeneity was observed
across studies (I2 > 85%). No significant reduction in in-hospital
mortality was found (odds ratios: 0.56; 95% CI: 0.13 to 2.42; P = .437).
 CONCLUSION(S): Early mobility interventions improve functional
recovery and reduce hospital and ICU stays in cardiac surgery patients.
These findings support the integration of structured mobility programs
into postoperative care to optimize outcomes, though further research is
needed to address heterogeneity and long-term impacts. Copyright
© 2025 The American Society of PeriAnesthesia Nurses. Published by
Elsevier Inc. All rights reserved.

<56>
Accession Number
2042307442
Title
Rationale, Design, and Baseline Clinical Characteristics of the
Ziltivekimab Cardiovascular Outcomes Trial: Interleukin-6 Inhibition and
Atherosclerotic Event Rate Reduction.
Source
JAMA Cardiology. (no pagination), 2025. Date of Publication: 2025.
Author
Ridker P.M.; Baeres F.M.M.; Hveplund A.; Engelmann M.M.D.; Hovingh G.K.;
Lincoff A.M.; Marx N.; Navar A.M.; Sattar N.; Tuttle K.; Perkovic V.
Institution
(Ridker) Center for Cardiovascular Disease Prevention, Brigham and Women's
Hospital, Cardiovascular Disease Prevention, Brigham and Women's Hospital,
Harvard Medical School, 900 Commonwealth Ave, Boston, MA, United States
(Ridker) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, Boston, MA, United States
(Baeres, Hveplund, Engelmann, Hovingh) Novo Nordisk, Copenhagen, Denmark
(Lincoff) Department of Cardiovascular Medicine, Cleveland Clinic,
Cleveland, OH, United States
(Marx) Department of Internal Medicine I, University Hospital RWTH Aachen,
Aachen, Germany
(Navar) Department of Medicine, UT Southwestern Medical Center, Dallas,
TX, United States
(Navar) JAMA Cardiology, United States
(Sattar) School of Cardiovascular and Metabolic Health, University of
Glasgow, Glasgow, United Kingdom
(Tuttle) Providence Medical Research Center, Providence Inland Northwest
Health, Spokane, WA, United States
(Perkovic) University of New South Wales Sydney, Sydney, NSW, Australia
Publisher
American Medical Association
Abstract
IMPORTANCE Cardiovascular inflammation is a major determinant of
atherosclerotic disease, and inhibition of the central signaling cytokine,
interleukin 6 (IL-6), is a promising target for intervention. Patients
with chronic kidney disease (CKD) commonly have plasma elevations of
inflammatory biomarkers, such as high-sensitivity C-reactive protein
(hsCRP) and IL-6, and are at high risk for life-threatening
atherosclerotic events as well as loss of kidney function and might
therefore benefit from IL-6 inhibition. OBSERVATIONS The Ziltivekimab
Cardiovascular Outcomes Trial (ZEUS; NCT05021835) will determine the
safety and efficacy of IL-6 inhibition with ziltivekimab among patients
with atherosclerotic cardiovascular disease (ASCVD), CKD, and systemic
inflammation. ZEUS is a multinational, double-blind, placebo-controlled,
event-driven, randomized clinical trial inclusive of 6376 participants
with ASCVD, CKD, and an hsCRP level greater than or equal to 2mg/L who
were randomized in a 1:1 fashion to receive either ziltivekimab, 15mg,
administered subcutaneously every month or matching placebo. At
randomization, mean age was 69.5 years, 27.5% were female, 92.0% had
hypertension, 65.7% had diabetes, and 41.3% had heart failure. At
baseline, the mean estimated glomerular filtration rate (eGFR) was
44.5mL/min/1.73 m2, mean low-density lipoprotein cholesterol
level was 77.7 mg/dL, median hsCRP level was 4.5 mg/L, and median IL-6
level was 4.9 pg/mL. At enrollment, sodium-glucose cotransporter-2
inhibitors and glucagon-like peptide-1 receptor agonists were being used
by 36.8% and 11.3% of the cohort, respectively. The primary outcome is
3-point major adverse cardiovascular events. Secondary cardiovascular
outcomes include (1) an expanded major adverse cardiovascular event
outcome including hospitalization for unstable angina requiring urgent
coronary revascularization, (2) hospitalizations for heart failure
orurgent heart failure visits or cardiovascular death, and (3) all-cause
mortality. The secondary kidney outcome is a composite of greater than 40%
decline in eGFR, eGFR less than 15mL/min/1.73 m2, dialysis,
kidney transplant, death from kidney disease, or cardiovascular death.
CONCLUSIONS AND RELEVANCE The ZEUS randomized clinical trial will formally
test the hypothesis that IL-6 inhibition with ziltivekimab will lower
incident cardiovascular event rates and potentially slow kidney decline
among participants with known ASCVD, CKD, and elevated hsCRP. If
successful, the ZEUS trial would provide a fully novel approach for
prevention of myocardial infarction, stroke, cardiovascular death, and
kidney function decline among high-risk patients with CKD. Copyright
© 2025 American Medical Association. All rights reserved, including
those for text and data mining, AI training, and similar technologies.

<57>
Accession Number
2041907894
Title
Clinical outcomes of transcatheter pulmonary valve replacement versus
surgical pulmonary valve replacement: A meta-analysis.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Ahmed H.; Ismayl M.; El-Shaer A.; Aboeata A.; Goldsweig A.M.
Institution
(Ahmed, El-Shaer) Department of Medicine, Division of Internal Medicine,
Creighton University School of Medicine, Omaha, NE, United States
(Ismayl) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Aboeata) Department of Medicine, Division of Cardiovascular Disease,
Creighton University School of Medicine, Omaha, NE, United States
(Goldsweig) Department of Cardiovascular Medicine, Baystate Medical
Center, Springfield, MA, United States
Publisher
Elsevier Inc.

<58>
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. (no pagination), 2025.
Date of Publication: 2025.
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.

<59>
Accession Number
649550771
Title
Deferoxamine for the Prevention of Cardiac Surgery-Associated Acute Kidney
Injury: The DEFEAT-AKI Randomized Clinical Trial.
Source
American Journal of Hematology. Conference: 10th Congress of the BioIron
Society. Montreal, QC Canada. 100(Supplement 6) (pp 52-53), 2025. Date of
Publication: 01 Nov 2025.
Author
Leaf D.; Krajewski M.; Kim E.; Muehlschlegel J.; Bagchi A.; Shaefi S.
Institution
(Leaf, Kim) Brigham and Women's Hospital, United States
(Leaf, Krajewski, Kim, Bagchi, Shaefi) Harvard Medical School, United
States
(Krajewski, Shaefi) Beth Israel Deaconess Medical Center, United States
(Muehlschlegel) Johns Hopkins University Medical Center, United States
(Bagchi) Massachusetts General Hospital, United States
Publisher
John Wiley and Sons Inc
Abstract
Introduction and Objective: Multiple lines of evidence support a key role
of labile iron in the pathogenesis of acute organ injury, including acute
kidney injury (AKI). Patients undergoing cardiac surgery may be
particularly susceptible to iron-mediated AKI due to the profound
hemolysis that occurs from cardiopulmonary bypass and intraoperative
transfusion of red blood cells. Method(s): In an NIH-funded, phase 2,
multicenter, double-blind clinical trial, we randomly assigned adult
patients undergoing coronary artery bypass graft and/or valve surgery with
cardiopulmonary bypass considered to be at high-risk of AKI to receive a
12-h IV infusion of deferoxamine (30 mg/kg) or an equal volume of saline
placebo beginning immediately after induction of anesthesia. The primary
outcome was the occurrence of AKI within 7 days, defined according to the
KDIGO consensus criteria, incorporating changes in serum creatinine, urine
output, and kidney replacement therapy. Secondary outcomes included AKI
stage, receipt of kidney replacement therapy, atrial fibrillation,
prolonged receipt of invasive mechanical ventilation, sepsis, and time to
liberation from IV vasoactive medications. Result(s): We enrolled 301
patients from 3 large academic medical centers in Boston, MA and assigned
151 to deferoxamine and 150 to placebo. AKI occurred in 99 patients
(65.6%) in the deferoxamine group and in 108 (72.0%) in the placebo group
(relative risk, 0.91; 95% CI, 0.78-1.06). Rates of secondary outcomes were
similar between groups (Table), as were rates of adverse events.
 Conclusion(s): Among adult patients undergoing cardiac surgery,
prophylactic administration of IV deferoxamine did not reduce the
occurrence of AKI.

<60>
Accession Number
2039208346
Title
Baseline right ventricular-to-pulmonary artery coupling and outcomes after
transcatheter aortic valve replacement: a systematic review and
meta-analysis.
Source
Hellenic Journal of Cardiology. 86 (pp 148-151), 2025. Date of
Publication: 01 Nov 2025.
Author
Theofilis P.; Sakalidis A.; Vlachakis P.K.; Mantzouranis E.; Karakasis P.;
Pamporis K.; Dardas S.; Oikonomou E.; Drakopoulou M.; Dimitriadis K.;
Aggeli K.; Tsioufis K.; Tousoulis D.
Institution
(Theofilis, Sakalidis, Vlachakis, Mantzouranis, Pamporis, Drakopoulou,
Dimitriadis, Aggeli, Tsioufis, Tousoulis) Department of Cardiology,
"Hippokration" General Hospital of Athens, Athens, Greece
(Karakasis) Department of Cardiology, Ippokrateio General Hospital of
Thessaloniki, Thessaloniki, Greece
(Dardas) London Health Sciences Center, ON, Canada
(Oikonomou) Department of Cardiology, Sotiria General Hospital, Athens,
Greece
Publisher
Hellenic Cardiological Society

<61>
Accession Number
2041858807
Title
Effects of perioperative dexmedetomidine on renal vascular function and
renovascular histopathology in ovine cardiopulmonary bypass.
Source
Intensive Care Medicine Experimental. 13(1) (no pagination), 2025. Article
Number: 128. Date of Publication: 01 Dec 2025.
Author
Betrie A.H.; Jufar A.H.; Evans R.G.; Cochrane A.D.; Marino B.; Birchall
I.; Hood S.G.; McCall P.R.; Ayton S.; Miles L.F.; May C.N.; Lankadeva Y.R.
Institution
(Betrie, Jufar, Evans, Cochrane, Birchall, Hood, Miles, May, Lankadeva)
Florey Institute of Neuroscience and Mental Health, The University of
Melbourne, VIC, Australia
(Betrie, Ayton) Florey Department of Neuroscience and Mental Health, The
University of Melbourne, VIC, Australia
(Evans) Biomedicine Discovery Institute and Department of Physiology,
Monash University, Melbourne, VIC, Australia
(Cochrane) Department of Cardiothoracic Surgery, Monash Health and
Department of Surgery, Monash University, Melbourne, VIC, Australia
(Marino) Cellsaving and Perfusion Resources, Melbourne, VIC, Australia
(Birchall) Department of Surgery, The University of Melbourne, VIC,
Australia
(McCall, Miles, Lankadeva) Department of Anaesthesia, Austin Hospital,
Melbourne, Australia
(Miles, May, Lankadeva) Department of Critical Care, Melbourne Medical
School, The University of Melbourne, VIC, Australia
(Lankadeva) Translational Cardiovascular and Renal Research Group, The
Florey Institute of Neuroscience and Mental Health, 30 Royal Parade,
Parkville, VIC, Australia
Publisher
Springer Nature
Abstract
Background: Cardiopulmonary bypass (CPB) is integral to the conduct of
cardiac surgery but is associated with postoperative acute kidney injury
(AKI). Dexmedetomidine, an alpha2-adrenoceptor agonist with
anti-inflammatory and sympatholytic properties, has putative
renoprotective effects. In a recent meta-analysis, dexmedetomidine during
CPB reduced AKI; conversely, a large, randomised trial reported an
increase in postoperative AKI. Further, we found increased renal tubular
injury in sheep receiving dexmedetomidine during CPB. Here, we aimed to
determine whether dexmedetomidine during CPB induces changes in renal
vascular reactivity or endothelial integrity that could explain focal
renal tubular injury. Method(s): Fourteen instrumented Merino ewes
underwent 2 h of non-pulsatile CPB (flow 70 mL/kg/min; MAP 65-75 mmHg;
cooled by 3 degreeC) under standardised propofol-fentanyl-sevoflurane
anaesthesia. Animals were randomly allocated to dexmedetomidine (0.4-0.8
microg/kg/h, n = 7) or fluid-matched saline (n = 7) from induction of
anesthesia to end-CPB. Arterial pressure, renal blood flow, cortical and
medullary perfusion and PO2 were measured in vivo (n = 7/group). Post-CPB,
renal interlobar arteries were isolated for wire myography. Due to
standardisation failures, in vitro analyses of dose-response curves for
phenylephrine were performed in n = 6 per group, while
endothelial-dependent and independent relaxation responses were performed
in n = 7 per group. Endothelial histology of CPB arteries was compared
with arteries from a separate cohort of healthy Merino ewes (n = 7).
 Result(s): In vitro functional investigations demonstrated that
interlobar arteries from dexmedetomidine-treated sheep exhibited a
2.3-fold increase in phenylephrine sensitivity (pEC50 5.82 +/- 0.27 vs.
5.45 +/- 0.23; p = 0.034), with unchanged maximal contraction.
Endothelium-dependent and independent relaxations were similar between
groups, though inhibitor studies indicated a shift towards
cyclooxygenase-mediated dilation under dexmedetomidine. Histology revealed
intact endothelial architecture and no damage to endothelial integrity in
all groups. Conclusion(s): Perioperative dexmedetomidine during CPB
enhanced alpha1-adrenergic vasoconstrictor sensitivity in renal interlobar
arteries without disrupting endothelial integrity or compromising renal
blood flow or intrarenal perfusion. The enhanced vasoreactivity may
contribute to focal renal ischaemia and tubular injury during CPB, which
cannot be detected by in vivo measurements of global and regional kidney
perfusion and oxygenation. Further investigation is warranted to elucidate
the pathways through which dexmedetomidine contributes to renal tubular
injury during CPB. Copyright © The Author(s) 2025.

<62>
Accession Number
649550608
Title
Myocardial Hepcidin Predicts Long-Term Outcomes following Myocardial
Infarction.
Source
American Journal of Hematology. Conference: 10th Congress of the BioIron
Society. Montreal, QC Canada. 100(Supplement 6) (pp 65), 2025. Date of
Publication: 01 Nov 2025.
Author
Kabir S.N.; Vera-Aviles M.; Mohamad G.; Duncker D.; Hekkert M.;
Lakhal-Littleton S.
Institution
(Kabir, Vera-Aviles, Mohamad, Lakhal-Littleton) Physiology, Anatomy and
Genetics, University of Oxford, United Kingdom
(Duncker, Hekkert) Erasmus University Medical Center, Netherlands
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Myocardial infarction (MI) is an acute inflammatory state.
The iron homeostatic hormone hepcidin is expressed in the heart and
regulated by inflammation. The impact of MI on hepcidin and iron
homeostasis, and the role of hepcidin in outcomes of MI remain unknown.
This study aims to characterise changes in hepcidin after MI, in patients
and preclinical models, and to explore the impact of such changes on
outcomes. Methodology: We conducted sub-studies of two cohorts of patients
admitted to hospital for Percutaneous Coronary Intervention (PCI)
following ST elevation MI (STEMI). The first cohort, ASSessing the Effect
of Anti-IL-6 Treatment in Myocardial Infarction (ASSAIL-MI), was a
randomised clinical trial where patients were administered with either a
placebo or IL-6 receptor antagonist, Tocilizumab on admission. The second
cohort was an observational cohort from the Oxford Acute Myocardial
Infarction (OXAMI) study. In both cohorts, cardiac function was assessed
by MRI, and hepcidin, serum iron markers and inflammatory markers were
assessed in plasma. In mice, MI was induced surgically and heart function
analysed by MRI, and myocardial labile iron assessed by
bioluminescent-iron-caged luciferin. In porcine model of MI, hepcidin
expression was examined in infarct and remote areas of the myocardium.
 Result(s): In ASSAIL-MI patients receiving placebo (n = 100),
hepcidin rose acutely within 24 h (p = 0.0003) while serum iron markers
dropped (p = 0.014). The opposite occurred in the Tocilizumab group (n =
101). Hepcidin levels at 24 h post-MI correlated with the size of the area
at risk (p = 0.032) and predicted adverse cardiac remodelling at 6 months:
NTproBNP (p = 0.007), infarct size (p = 0.001), and LVEF % (p = 0.029),
after correcting for confounders. In the OXAMI cohort, hepcidin levels in
the acute stage were positively correlated with IL-6 and intramyocardial
haemorrhage (IMH). Post-MI in mice, hepcidin levels were also raised
acutely compared to SHAM controls, accompanied by increased myocardial
labile iron pool (LIP) in the area at risk. In porcine model of MI,
hepcidin expression rose acutely in the infarcted area of the heart.
 Conclusion(s): Following an MI, plasma hepcidin rises rapidly,
deriving from the myocardium under the influence of IL-6. This elevation
corresponds with a reduction in serum iron and predicts adverse cardiac
remodelling. Mechanistically, preclinical data suggests that hepcidin's
effect on cardiac remodelling may be linked to excess LIP, and LIP-related
injury in the infarcted myocardium.

<63>
[Use Link to view the full text]
Accession Number
649546141
Title
Artificial intelligence in cardiothoracic monitoring and echocardiography.
Source
Current opinion in anaesthesiology. (no pagination), 2025. Date of
Publication: 03 Dec 2025.
Author
Bryant J.M.; Jelly C.A.; Kertai M.D.
Institution
(Bryant) Department of Anesthesiology, Vanderbilt University Medical
Center, Nashville, TN, United States
Abstract
PURPOSE OF REVIEW: This review describes the recent advancements of
artificial intelligence (AI) in cardiothoracic anesthesia monitoring.
RECENT FINDINGS: The application of AI in cardiothoracic anesthesia
monitoring has potential to affect all phases of perioperative care - from
preoperative testing and risk stratification to postoperative evaluation
and advances in echocardiography image acquisition and interpretation.
While these developments are promising, they remain in the early stages of
clinical integration and validation. SUMMARY: Advances in machine learning
and natural language processing are expected to play an increasingly
significant role in the monitoring and management of cardiothoracic
surgery patients. As these technologies evolve, they hold the potential to
enhance the precision, efficiency, and personalization of care. However,
as AI becomes more integrated into clinical decision-making, it is
imperative that care models remain grounded in the core principles of
patient-centeredness and safety. Copyright © 2025 Wolters Kluwer
Health, Inc. All rights reserved.

<64>
Accession Number
649543487
Title
Impact of hemadsorption technique connected to extracorporeal circulation
during cardiac surgery on antibiotic concentrations: a randomised
controlled clinical trial.
Source
Intensive Care Medicine Experimental. Conference: ESICM LIVES 2024.
Barcelona Spain. 12(Supplement 1) (no pagination), 2024. Date of
Publication: 01 Oct 2024.
Author
Di Paolo F.; Ramirez V.H.; Riera J.S.; Sanguino V.D.G.; Ulsamer A.; Molina
E.; Larraz A.; Rigo R.; Fernandez X.P.
Institution
(Di Paolo, Sanguino) Bellvitge Hospital, Intensive Care Medicine,
Hospitalet De Llobregat, Spain
(Ramirez) Facultat De Medicina-Universitat De Barcelona, Facultat De
Medicina, Barcelona, Spain
(Riera) Bellvitge, L'Hospitalet De Llobregat, Spain
(Ulsamer) IDIBELL Institut d'Investigacio Biomedica De Bellvitge,
L'Hospitalet De Llobregat, Spain
(Molina) Bellvitge University Hospital, Intensive Care Department,
L'Hospitalet De Llobregat, Spain
(Larraz, Fernandez) Hospital Universitari De Bellvitge, Intensive Care
Department, L'Hospitalet De Llobregat, Spain
(Rigo) Hospital Clinic De Barcelona, Centre Diagnostic Biomedic.,
Barcelona, Spain
Publisher
Springer Nature
Abstract
Introduction: At present, the use of adsorption membranes during
cardiopulmonary bypass (CPB) could reduce cardiac surgery-associated acute
kidney injury (CSA-AKI) in patients with an expected extracorporeal
circulation time of more than 90 min. Furthermore, the risk of
postoperative infection is high, so effective antimicrobial prophylaxis is
crucial. Currently, cefuroxime is a second-generation cephalosporin
administrated as antimicrobial therapy in these patients.
 Objective(s): To assess the impact of adsorption membranes connected
to the cardiopulmonary bypass (CPB) circuit on plasma concentrations of
cefuroxime, in the context of a randomised controlled trial (SIRAKI-02).
 Method(s): We performed a retrospective analysis of a randomised and
completed clinical trial comparing the CPB connected to the oXiris
membrane vs. standard CPB therapy during non-emergent cardiac surgery. For
this study we selected eighteen patients that had not received any kind of
ultrafiltration during cardiac surgery. The intervention group (n = 9)
received Prismaflex eXeed IITM system with a high-adsorbent oXirisR
membrane (Baxter International Inc.). Control group (n = 9) was subjected
to the conventional procedure, which did not involve any adsorption
membrane. In the intervention group, blood flow was maintained at 200-300
mL/min while the mean CPB pump flow was 4.3 L in both groups. Mean CPB
time was 127 min in the intervention group and 132 min in the control
group. All patients were treated with cefuroxime in prophylaxis doses
according to institutional standards. Blood samples were collected after
unclamping the CPB circuit and cefuroxime concentrations in plasma were
measured using ultra-high-performance liquid chromatography coupled to
tandem mass spectrometry (UHPLC-MS/MS) technique. Cut-off values of 8 mg/L
from EUCAST were used as the target minimum inhibitory concentration (MIC)
of cefuroxime for the most common microorganisms causing
community-acquired sepsis in our hospital: E. coli and S. aureus.
Therefore, the target clinical cefuroxime concentration was four times the
MIC: 32 mg/L. Comparison between groups was assessed using the
Mann-Whitney U test in the statistical package SPSS v25 (IBM Corp.
Endicott, NY, USA). Result(s): In both groups, cefuroxime
concentrations remained above 90% of the dosing interval. Cefuroxime
medians (interquartile ranges) were 42.5 (34.9-54.9) mg/L and 44.6
(32.3-57.3) mg/L for the oXiris and control groups, respectively. No
statistical differences were observed between them (p = 0.5364).
 Conclusion(s): According to the results obtained, the use of oXirisR
membrane does not alter the cefuroxime concentrations in comparison with
the conventional procedure. Thus, this technique could not have potential
drawbacks in the context of cefuroxime administration.

<65>
Accession Number
649543811
Title
Prophylactic use of methylene blue (MB) in patients at high risk of
vasoplegic syndrome after cardiopulmonary bypass.
Source
Intensive Care Medicine Experimental. Conference: ESICM LIVES 2024.
Barcelona Spain. 12(Supplement 1) (no pagination), 2024. Date of
Publication: 01 Oct 2024.
Author
Torrez J.P.; Otsuki D.; Pontes A.E.L.; Sanchez A.F.; Zeferino S.P.; Auler
J.O.
Institution
(Torrez, Pontes, Sanchez, Zeferino, Auler) Heart Institute of the Hospital
das Clinicas of FMUSP, Sao Paulo, Brazil
(Otsuki) Clinical Hospital FMUSP, Sao Paulo, Brazil
Publisher
Springer Nature
Abstract
Introduction: Vasoplegic or vasogenic shock syndrome is a common event
after cardiopulmonary bypass surgery, characterized by low arterial
pressure, unresponsive vascular collapse to high doses of vasopressors,
and biochemical signals of cellular oxygen debt. Pathophysiology is
related to the dysfunction of vascular smooth muscle cell contraction,
activation of the complement cascaDe and the expression of
pro-inflammatory mediators, adrenoreceptor desensitization, nitric oxiDe
(NO) synthesis increase, cellular membrane hyperpolarization, dysfunction
of the renin-angiotensin system, endothelial glycocalyx lesion and
possible vasopressin synthesis decrease. Methylene blue (MB) actively
inhibits NO synthase and the enzyme guanylate cyclase, preventing the
accumulation of cGMP, and thus decreasing the vessels' sensitivity to
cGMP-dependent vasodilators and restoring normal vascular tone. Most
reports state that the MB is given after the vasoplegic syndrome is
installed. We hypothesize that the prophylactic use of MB at the start of
the bypass could decrease the number of vasopressor drugs, length of ICU
stays, and secondary outcomes in patients with higher Euro scores and
susceptibility to vasoplegia. Objective(s): We aimed to conduct a
randomized, controlled clinical trial (110 patients) of high-risk for
developing vasoplegic syndrome after bypass undergoing cardiac during
routine valvar surgery. Method(s): The patients were randomized to
control (normal saline) or MB (1 mg/kg/hour starting at the beginning of
bypass lasting seven consecutive hours, totaling seven mg/k). The size
sample was calculated to reduce by 25% the vasopressors consumption over
time at the p level (5%) and statistical power of 80% (total number 110
patients). To this point, we have randomized 52 patients (26 control group
and 26 MB group. Patients were selected from the routine valvar procedure
surgeries with bypass. The inclusion criteria were EURO scores between 4
and 18. Exclusion criteria were patients chronically taking SSRIs,
serotonin-norepinephrine reuptake inhibitors, or clomipramine, a tricyclic
antidepressant. We followed the patients in the ICU for seven days,
recording information about the average daily doses of vasoactive agents,
renal function, ICU length of stay, extubating time, and hospital death.
 Result(s): We selected norepinephrine as a principal vasopressor
agent to keep mean arterial pressure > 65 mmHg. The interim results
indicated a reduction in the average dosage of norepinephrine on the 4th
postoperative day in the MB group (0.083 +/- 0.080 vs. 0.483 +/- 0.438
mcg/kg/min, P = 0.022), which is consistent with a lower level of
consumption of this drug. In Fig. 1 and 2, it is possible to see the
percentage of patients over time and a reduction of vasopressors in the
days following the surgery. Conclusion(s): The preliminary results
show early MB in cardiac surgery patients decreased vasopressor
requirements.

<66>
Accession Number
649543311
Title
Effects of balanced versus saline-based solutions on acute kidney injury
in off-pump coronary artery bypass surgery: A randomised controlled trial.
Source
Intensive Care Medicine Experimental. Conference: ESICM LIVES 2024.
Barcelona Spain. 12(Supplement 1) (no pagination), 2024. Date of
Publication: 01 Oct 2024.
Author
Nam J.S.; Kim W.J.; Seo W.W.; Lee S.W.; Joung K.W.; Chin J.H.; Choi D.K.;
Choi I.C.; Choi S.
Institution
(Nam, Kim, Seo, Lee, Joung, Chin, Choi, Choi, Choi) Anesthesiology, Seoul
Asan Medical Center, Seoul, South Korea
Publisher
Springer Nature
Abstract
Introduction: Although it has been suggested that hyperchloremic acidosis
induced by 0.9% sodium chloriDe solution (saline) can adversely affect the
kidney, whether chloride-restrictive fluid strategies can reduce the
incidence of acute kidney injury after off-pump coronary artery bypass
surgery remains unclear. Method(s): A total of 360 adults undergoing
coronary artery bypass surgery were randomly assigned to receive balanced
solution-based chloride-restrictive intravenous fluid (balanced group) or
saline-based chloride-liberal intravenous fluid (saline group). The
primary outcome was acute kidney injury within 7 postoperative days, as
defined by the 2012 Kidney Disease: Improving Global Outcomes Clinical
Practice Guideline. Result(s): The incidence of acute kidney injury
was 4.4% (8/180) in the balanced group and 7.3% (13/178) in the saline
group. The difference was not statistically significant (risk difference,
2.86%, 95% confidence interval [CI], 7.72% to 2.01%; risk ratio, 0.61, 95%
CI, 0.26 to 1.43, P = 0.35). Compared to the balanced group, the saline
group had higher levels of intraoperative serum chloriDe and lower base
excess, which resulted in lower pH. Conclusion(s): In patients
undergoing off-pump bypass surgery with normal estimated glomerular
filtration rate, the intraoperative balanced solution-based
chloride-restrictive intravenous fluid administration strategy did not
reduce the rate of postoperative acute kidney injury compared to the
saline-based chloride-liberal intravenous fluid administration strategy.

<67>
Accession Number
649543763
Title
First-attempt success of endotracheal intubation using hyper-angulated
videolaryngoscopy versus conventional direct laryngoscopy: a randomized
multiple cross-over cluster trial.
Source
Intensive Care Medicine Experimental. Conference: ESICM LIVES 2024.
Barcelona Spain. 12(Supplement 1) (no pagination), 2024. Date of
Publication: 01 Oct 2024.
Author
Schmidt M.; Ott S.; Muller-Wirtz L.M.; Turan A.; Ruetzler K.
Institution
(Schmidt, Ott, Muller-Wirtz, Turan, Ruetzler) Department of OUTCOMES
RESEARCH, Cleveland Clinic, Cleveland, United States
Publisher
Springer Nature
Abstract
Introduction: Endotracheal tubes are usually inserted with direct
laryngoscopy, but patients sometimes require multiple attempts which can
provoke morbidity.1 Videolaryngoscopy improves airway visualization, but
endotracheal tubes are nonetheless sometimes difficult to pass through the
vocal cords. 2 Whether improved glottis visualization facilitates
intubation and reduces intubation attempts remains unclear.
 Objective(s): We therefore tested the primary hypothesis that fewer
intubation attempts are required when initial laryngoscopy is performed
with videolaryngoscopy than with direct laryngoscopy in surgical patients.
 Method(s): We conducted a cluster-randomized multiple crossover trial
in patients having cardiothoracic or vascular surgery at the Cleveland
Clinic Main Campus, Cleveland, OH. Patients were randomized to either
hyperangulated videolaryngoscopy or direct laryngoscopy for the initial
intubation attempt. The primary outcome was number of intubation attempts.
Secondary outcomes were intubation failure and a composite of airway and
dental injuries. The trial was registered with clinicaltrials.gov
(identifier NCT04701762), current trial status closed for enrollment.
 Result(s): We enrolled 8,429 surgeries from March 2021 to December
2022. 4,413 (52%) surgeries were randomized to videolaryngoscopy, and
4,016 (48%) to direct laryngoscopy. About 70% of initial intubations were
performed by nurse anesthetists or residents, supervised by attending
anesthesiologists. Videolaryngoscopy reduced the need for multiple
intubations by about a factor-of-four from 7.6 to 1.7% and reduced the
number of intubation attempts compared to direct laryngoscopy [(OR 0.19
(95% CI 0.13, 0.28; P < 0.001)] (Fig. 1). Intubation failed in 0.27% with
videolaryngoscopy vs. 4% with direct laryngoscopy [RR 0.05 (95% CI 0.02,
0.12; P < 0.001)] (Table 1). Airway and dental injuries did not differ
between videolaryngoscopy (41 injuries, 0.93%) vs. direct laryngoscopy (42
injuries, 1.1%), RR 0.85 (95% CI 0.53, 1.39; P = 0.376)].
 Conclusion(s): Videolaryngoscopy is a preferable initial approach for
intubating surgical patients.

<68>
Accession Number
649543567
Title
Dobutamine plus levosimendan as a protective factor for the development of
acute kidney injury in on-pump cardiac surgery.
Source
Intensive Care Medicine Experimental. Conference: ESICM LIVES 2024.
Barcelona Spain. 12(Supplement 1) (no pagination), 2024. Date of
Publication: 01 Oct 2024.
Author
Argueta C.D.D.A.; Olvera O.I.A.; Aguirre-gomez G.; Silva J.A.V.
Institution
(Argueta, Olvera, Aguirre-gomez, Silva) High Specialty Regional Hospital
of Ciudad Victoria, Ciudad Victoria, Mexico
Publisher
Springer Nature
Abstract
Introduction: Acute kidney injury has an incidence of up to 40% in cardiac
surgery, adding morbidity-mortality and increasing the days of hospital
stay. Levosimendan, a calcium-sensitizing inotrope that improves cardiac
contractility, has a vasodilatory effect and is cardioprotective against
ischemia due to reperfusion, among others. On the other hand, despite a
wiDe range of inotropic agents available, the most appropriate agent to
prevent postoperative complications such as acute kidney injury or low
output syndrome is still unknown. Method(s): Prospective cohort of
hospitalized patients from 2021 to 2023 in the HRAEV of Northeast Mexico.
91 post-cardiac surgery patients with extracorporeal circulation admitted
to the ICU were included, authorized by the ethics committee. The
objective was to evaluate the association of the use of dobutamine +
levosimendan vs dobutamine with the presence of acute kidney injury during
their stay, days of stay in the ICU and mortality. Continuous variables
are described as means and standard deviation, categorical variables as
frequencies and percentages. Relative risk was used and statistical
significance was taken with a p value < 0.05. A Kaplan-Meier survival
curve was obtained. Result(s): 91 patients were included and the
observation was divided into two groups, dobutamine + levosimendan (n =
25) and dobutamine (n = 66), with a greater frequency of men in both
groups, mean age (53 +/- 16) and (57 +/- 11), significant difference in
the presence of hypertension as comorbidity 23% vs 42.2% (p = 0.02) and
the presence of more patients in NYHA functional class II-III in the
dobutamine group (Table 1). The incidence of AKI was 15.4% in total, and
for the dobutamine + levosimendan group, it was 6.6% and for dobutamine
8.8% (p = 0.16), cardiovascular complications defined as arrhythmias 0% vs
8.7% (p = 0.23) and heart failure 2.1% vs 8.7% (P = 0.13). There was no
difference in mortality during the ICU stay between both groups (Graph 1).
Relative risk for acute kidney injury and use of dobutamine + levosimendan
was 2.28 (95% CI 0.7-7.4, p = 0.16). Conclusion(s): In our study, we
found no difference in the development of AKI in the intervention group vs
dobutamine. Perioperative dobutamina + levosimendan is not associated with
beneficial or harmful effects on days of stay in the ICU, mortality or
acute kidney injury (Graph 2). There is a lack of large, high-quality
randomized clinical trials that compare different therapeutic strategies
with inotropes on postoperative outcomes. There is not much literature on
the use of two inotropes in cardiac surgery.

<69>
Accession Number
2041839621
Title
Data-Driven Investigation of Traditional Chinese Medicine Approaches for
Optimizing Multiple Clinical Parameters in Esophageal Cancer Treatment.
Source
International Journal of Genomics. 2025(1) (no pagination), 2025. Article
Number: 6667025. Date of Publication: 2025.
Author
Fang Y.; Peng J.; Yang D.; Liu H.; Chen T.; Cao J.
Institution
(Fang, Peng, Yang, Liu, Chen, Cao) Department of Thoracic Surgery, The
First Affiliated Hospital With Nanjing Medical University, Nanjing, China
Publisher
John Wiley and Sons Ltd
Abstract
Background: The purpose of the study is to evaluate the comparative
effects of conventional perioperative care and conventional care plus
Traditional Chinese Medicine (TCM) appropriate technology on blood glucose
fluctuation, comfort level, and stress response in postoperative
esophageal cancer patients. Method(s): This study included 100
patients who underwent radical esophagectomy in our hospital's thoracic
surgery department from January 2023 to June 2024. Patients were randomly
divided into a study group and a control group, with 50 cases in each
group, using a computer-generated random number table (generated via SPSS
22.0 software) to ensure randomization integrity. The control group
received conventional perioperative care, while the study group received
TCM appropriate technology in addition to conventional care. Blood glucose
fluctuations were monitored 1 day before surgery, and on postoperative
Days 1, 3, 7, and 14. On the day before surgery and postoperative Day 14,
the General Comfort Questionnaire (GCQ) and Perceived Nursing Service
Quality (PNSQ) scale were used to evaluate patients' comfort levels and
perception of service quality. The Connor-Davidson Resilience Scale
(CD-RISC) was used to assess psychological stress state. Physiological
stress was evaluated by analyzing adrenocorticotropic hormone (ACTH) and
cortisol (Cor) levels. Result(s): Significant differences in blood
glucose fluctuation values were observed between the study group and
control group (between-group F = 9.457, p < 0.001). Significant
differences also existed across different time points (time point F =
6.542, p < 0.001), with a significant interaction effect between group and
time point (group*time point F = 10.055, p < 0.001). Although blood
glucose fluctuation levels in both groups showed a downward trend, the
study group demonstrated significantly lower blood glucose fluctuation
values than the control group at all time points: 1 day before surgery,
and on postoperative days 1, 3, 7, and 14 (p < 0.05). The study group's
total GCQ score on postoperative Day 14 (89.36 +/- 12.40) was higher than
the control group (73.07 +/- 10.14), with all intergroup differences in
scores across the four dimensions being statistically significant (p <
0.001). The study group's CD-RISC score on postoperative Day 14 (74.23 +/-
10.3) was higher than the control group (65.34 +/- 9.06), while ACTH
(12.23 +/- 1.68 ng/L) and Cor (9.46 +/- 1.29 ng/L) levels were lower than
the control group (14.41 +/- 1.98 and 10.22 +/- 1.41 ng/L, respectively).
All differences were statistically significant (p < 0.001).
 Conclusion(s): TCM appropriate technology significantly reduces blood
glucose fluctuations in patients undergoing radical esophagectomy,
improves patient comfort levels, and positively impacts psychological
stress (via higher Connor-Davidson Resilience Scale [CD-RISC] scores:
74.23 +/- 10.3 vs. 65.34 +/- 9.06) and physiological stress (via lower
adrenocorticotropic hormone [ACTH]: 12.23 +/- 1.68 vs. 14.41 +/- 1.98
ng/L; cortisol [Cor]: 9.46 +/- 1.29 vs. 10.22 +/- 1.41
ng/L). Copyright © 2025 Ying Fang et al. International Journal of
Genomics published by John Wiley & Sons Ltd.

<70>
Accession Number
649547570
Title
Mortality after urgent versus elective transcatheter aortic valve
replacement: a systematic review and meta-analysis using reconstructed
individual patient data from Kaplan-Meier curves.
Source
BMC cardiovascular disorders. (no pagination), 2025. Date of Publication:
13 Dec 2025.
Author
Babaei M.; Fallahtafti P.; Mohammadi N.S.H.; Azarboo A.; Habibzadeh A.;
Azizpour A.; Rashedi S.; Mattumpuram J.; Mohsen A.; Hosseini Z.; Soleimani
H.; Kolte D.
Institution
(Babaei) Vascular Disease and Thrombosis Research Center, Rajaei
Cardiovascular Institute, Tehran, Iran, Islamic Republic of
(Babaei, Hosseini) Cardiovascular Intervention Research Center, Rajaei
Cardiovascular Institute, Tehran, Iran, Islamic Republic of
(Fallahtafti, Mohammadi, Azarboo) Tehran Heart Center, Cardiovascular
Diseases Research Institute, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Habibzadeh, Azizpour) School of Medicine, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Rashedi) Thrombosis Research Group, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Rashedi) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, Harvard Medical School, Boston, United States
(Mattumpuram) Division of Cardiology, University of Louisville School of
Medicine, Louisville, KY, United States
(Mohsen) Division of Cardiology, Loma Linda University Medical Center,
Loma Linda, United States
(Soleimani) Department of Cardiology, Imam Khomeini Hospital Complex,
Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Kolte) Cardiology Division, Massachusetts General Hospital and Harvard
Medical School, Boston, MA, United States
Abstract
BACKGROUND: Urgent transcatheter aortic valve replacement (TAVR),
performed during unplanned hospitalizations, is linked to worse outcomes
compared with elective TAVR. However, temporal trends in mortality remains
poorly understood. This study aimed to compare survival after urgent
versus elective TAVR using a reconstructed individual patient data (IPD)
meta-analysis. METHOD(S): PubMed, Embase, and Scopus were searched
through August 2025. Studies reporting Kaplan-Meier (KM) survival curves
for urgent versus elective TAVR were included. Survival data were
digitally extracted from published KM curves, and IPD were reconstructed
algorithmically using a two-stage approach. Kaplan-Meier curves and Cox
frailty models estimated survival and hazard ratios (HRs). Landmark
analysis at one-year post-procedure and restricted mean survival time
(RMST) were also employed to compare survival. RESULT(S): Eleven
studies including 77,108 patients were identified. Kaplan-Meier curves
were available for 76,108 patients (urgent: 5,683; elective: 71,425) and
used for reconstructed IPD analysis. Urgent TAVR was associated with
higher early mortality (HR 1.83, 95% CI: 1.73-1.93; p < 0.001), with
convergence beyond one year (HR 1.01, 95% CI: 0.84-1.22; p = 0.83). RMST
analysis demonstrated a 6.5-month overall survival advantage in favor of
elective TAVR (p = 0.001). CONCLUSION(S): Urgent TAVR is associated
with significantly increased early mortality compared with elective TAVR.
These findings highlight the prognostic implications of procedural timing
and support early referral for elective intervention in patients with
severe AS. Copyright © 2025. The Author(s).

<71>
[Use Link to view the full text]
Accession Number
649548889
Title
Preoperative anemia in cardiac surgery patients: how to achieve clinical
optimization - a narrative review.
Source
Current opinion in anaesthesiology. (no pagination), 2025. Date of
Publication: 09 Dec 2025.
Author
Saal-Bauernschubert L.; Faske A.; Meybohm P.
Institution
(Saal-Bauernschubert) Department of Anaesthesiology, Intensive Care,
Emergency and Pain Medicine, University Hospital Wurzburg, Wurzburg,
Germany
Abstract
PURPOSE OF REVIEW: Anemia is a common comorbidity in patients with cardiac
disease, with iron deficiency accounting for approximately 80% of cases.
Preoperative anemia has consistently been associated with increased
morbidity and mortality in patients undergoing cardiac surgery. Moreover,
this population carries a markedly elevated risk of red blood cell
transfusion, which itself is linked to adverse clinical outcomes. RECENT
FINDINGS: Patient blood management (PBM) represents a multidisciplinary,
evidence-based strategy to address anemia, reduce unnecessary blood loss,
and optimize transfusion practices. In this context, intravenous iron
supplementation, with or without erythropoiesis-stimulating agents, has
emerged as a promising intervention for the correction of preoperative
anemia. Nevertheless, the establishment of local PBM programs and routine
evaluation of anemic or iron-deficient patients should be promoted.
SUMMARY: This narrative review provides a contemporary and clinically
relevant synthesis of the evidence on preoperative anemia optimization in
cardiac surgery. Particular emphasis is placed on key findings, existing
knowledge gaps, and practical strategies for the detection, prevention,
and treatment of preoperative anemia in this high-risk population. Further
high-quality studies are required to define optimal therapeutic regimens
and assess patient-centered outcomes. Copyright © 2025 Wolters
Kluwer Health, Inc. All rights reserved.

<72>
Accession Number
649543775
Title
Ivabradine use in critical care: a systematic review.
Source
Intensive Care Medicine Experimental. Conference: ESICM LIVES 2024.
Barcelona Spain. 12(Supplement 1) (no pagination), 2024. Date of
Publication: 01 Oct 2024.
Author
Pasetto M.; Calabro L.; Polato M.; Zorzi S.; Annoni F.; Zaccarelli M.;
Donadello K.; Taccone F.S.
Institution
(Pasetto, Calabro, Polato, Zorzi, Annoni, Zaccarelli, Taccone) Soins
intensifs, ULB Erasme, Brussels, Belgium
(Donadello) Anesthesia and intensive care b unit, University of Verona,
AOUI-University Hospital Integrated Trust of Verona, Verona, Italy
Publisher
Springer Nature
Abstract
Introduction: In patients with acute illness, compensatory tachycardia
initially serves to maintain adequate cardiac output, oxygen delivery, and
tissue oxygenation but may persist despite appropriate fluid and
vasopressor resuscitation or may be secondary to inotropic therapy.
Sustained tachycardia is a predictor of adverse outcomes in critical
illness. Ivabradine, a highly selective inhibitor of the sinoatrial node's
pacemaker current (If or "funny" current), mitigates heart rate by
modulating diastolic depolarization slope without affecting contractility.
 Objective(s): To report the existing evidence on the use of
ivabradine in critically ill patients. Method(s): A systematic
literature search was performed up to September 2023 in the
MEDLINE/PubMedR database. The search included only original human studies
published in English in peer-reviewed journals. The search was performed
using the following terms: ("ivabradine"[MeSH Terms] OR "ivabradine"[All
Fields]) AND (("critical care"[MeSH Terms] OR ("critical"[All Fields] AND
"care"[All Fields]) OR "critical care"[All Fields] OR ("intensive"[All
Fields] AND "care"[All Fields]) OR "intensive care"[All Fields])). The
trial protocol is registered in PROSPERO (CRD42023449267), in adherence
with to the Preferred Reporting Items for Systematic Reviews and
Meta-Analysis-Protocols (PRISMA-P) guidelines. Result(s): After the
first screening procedure, 39 studies were assessed for eligibility on a
total of 93 records identified after the initial research (Table 1). Among
these, 29 were excluded; 9 studies (4 randomized controlled trial, 5 case
report/series), including a total of 234 patients, were included in the
qualitative analysis. Ivabradine showed a potential role for improving
hemodynamics in patients with multiple organ failure [1 study] and
cardiogenic shock (e.g. due to myocardial infarction or myocarditis) [4
studies], in those with mechanical circulatory support, low cardiac output
syndrome [2 studies] following tachycardiomyopathy after heart transplant
or heart surgery, and septic shock [2 studies]. In addition, the
combination of dobutamine with ivabradine has been explored to capitalize
on dobutamine's positive inotropic action while mitigating its positive
chronotropic effects, resulting in a more efficient cardiac cycle and
improved hemodynamics. Conclusion(s): At present, the use of
ivabradine in critically ill patients has been poorly described. Future
studies dealing with potential advantages or adverse events related to
this drug use in these heterogeneous patients' populations are required.

<73>
Accession Number
649543197
Title
Mechanical left ventricular unloading in cardiogenic shock treated with
venoarterial extracorporeal membrane oxygenation: a systematic review and
meta-analysis.
Source
Intensive Care Medicine Experimental. Conference: ESICM LIVES 2024.
Barcelona Spain. 12(Supplement 1) (no pagination), 2024. Date of
Publication: 01 Oct 2024.
Author
Kotani Y.; Nardelli P.; Yamamoto T.; Koroki T.; Yaguchi T.; Nakamura Y.;
Tonai M.; Karumai T.; Landoni G.; Hayashi Y.
Institution
(Kotani, Yamamoto, Koroki, Yaguchi, Nakamura, Tonai, Karumai, Hayashi)
Department of Intensive Care Medicine, Kameda Medical Center, Kamogawa,
Japan
(Nardelli, Landoni) Department of Anesthesia and Intensive Care, San
Raffaele Hospital, Milan, Italy
Publisher
Springer Nature
Abstract
Introduction: Mechanical left ventricular unloading can prevent increased
left ventricular afterload induced by venoarterial extracorporeal membrane
oxygenation (VA-ECMO), thereby potentially improving clinical outcomes. A
previous meta-analysis of observational studies found an association
between the use of mechanical left ventricular unloading and improved
survival among patients with cardiogenic shock undergoing VA-ECMO
treatment. However, this result can be biased due to inherent limitations
of observational studies. The recent publications of randomized controlled
trials (RCTs) and propensity score-matched studies allowed for an updated
meta-analysis by overcoming challenges of the previous study.
 Objective(s): This systematic review and meta-analysis focusing on
RCTs and propensity score-matched studies aimed to evaluate if mechanical
left ventricular unloading could reduce mortality in patients with
cardiogenic shock undergoing VA-ECMO. Method(s): This study was
registered on PROSPERO International prospective register of systematic
review on January 15, 2024 (CRD42024498665). We searched MEDLINE, Embase,
and the Cochrane Library for RCTs and propensity score-matched studies
published from inception until December 20, 2023. The primary outcome was
mortality at the longest follow-up, and the secondary outcomes included
successful weaning from VA-ECMO, major bleeding, hemolysis, stroke, renal
replacement therapy, limb ischemia, and bridge to heart transplantation or
durable ventricular assist device. We used a Mantel-Haenszel random
effects meta-analysis and reported the pooled results with a risk ratio
(RR) and 95% confidence interval (CI). Result(s): We identified two
RCTs and eleven propensity-matched studies totaling 9858 patients.
Mechanical left ventricular unloading was significantly associated with
reduced mortality at the longest followup (RR, 0.89; 95% CI, 0.84 to 0.94;
P = 0.0001; moderate certainty of evidence). Among secondary outcomes,
successful VA-ECMO weaning was more frequent with mechanical LV unloading
(RR, 1.15; 95% CI, 1.02 to 1.29; P = 0.02; low certainty of evidence),
while major bleeding (RR, 1.27; 95% CI, 1.02 to 1.59; P = 0.03; low
certainty of evidence) and hemolysis (RR, 1.49; 95% CI, 1.10 to 2.02; P =
0.01; moderate certainty of evidence) were increased. Other secondary
outcomes were not significantly different. Conclusion(s): Among adult
patients with cardiogenic shock treated with VA-ECMO, mechanical left
ventricular unloading was significantly associated with reduced mortality.

<74>
Accession Number
649543715
Title
The impact of preoperative crystalloid administration on non-invasive
cardiac output measurements in patients undergoing general anaesthesia for
non-cardiac surgery-preliminary results of a secondary aim analysis.
Source
Intensive Care Medicine Experimental. Conference: ESICM LIVES 2024.
Barcelona Spain. 12(Supplement 1) (no pagination), 2024. Date of
Publication: 01 Oct 2024.
Author
Hoedl M.; Eichinger M.; Eichlseder M.; Pichler A.; Schreiber N.; Essber
H.; Wild G.; Bayer A.; Eckhardt A.
Institution
(Hoedl, Eichinger, Eichlseder, Pichler, Schreiber, Essber, Wild, Bayer,
Eckhardt) Divison of Anaesthesiology and Intensive Care Medicine 1,
Department of Anaesthesiology and Int, Medical University of Graz, Graz,
Austria
Publisher
Springer Nature
Abstract
Introduction: Perioperative haemodynamic management is critical to patient
care, especially during major non-cardiac surgery. Cardiac output (CO) is
a haemodynamic parameter that reflects the volume of blood pumped by the
heart per unit of time. Monitoring CO provides physicians with valuable
information for fluid management and optimising oxygen supply to vital
organs. Non-invasive methods for measuring CO are viable alternatives to
invasive monitoring methods such as pulse contour analysis. These
techniques are associated with fewer complications, making them suitable
for routine use in non-cardiac surgery. It might also be used to assess
the effect of a preoperative fluid bolus on post-induction blood pressure.
 Objective(s): This preliminary secondary aim analysis of a randomised
controlled interventional study entitled "Effect of Pre-operative
Intravenous Crystalloids on Post-Induction Blood Pressure"
(ClinicalTrials. govNCT05079269) aims to investigate the effects of
preoperative administration of crystalloid fluid on CO during the first 20
min after induction of anaesthesia or until the surgical incision,
whichever occurred first. Method(s): In the main study, patients were
randomly assigned to receive a weight-adjusted balanced, isotonic
crystalloid solution before induction of anaesthesia (intervention group)
or to standard of care (SOC group). The study was performed at the Medical
University Hospitals in Graz and Vienna, Austria. This analysis compares
the noninvasive CO measurements between the two groups. CO was measured
using the CNAP-Monitor (CNSystems, Graz, Austria). Data from the
electronic Medical records of patients enrolled in this prospective trial
were collected. Patients were categorised based on preoperative
crystalloid administration. Demographics, comorbidities, intraoperative
fluid management, and haemodynamic variables of available data were
analysed. Descriptive statistics summarised the data, comparing groups
using the Mann-Whitney U and Student's T tests. Result(s): For a
total of 72, each group included 36 patients. The preliminary results show
no statistically significant difference between mean CO between the groups
(5.01;4.98, p = 0.83). The majority of participants in both groups were
male. On average, patients in the intervention group required less
norepinephrine and phenylephrine (see Table). Conclusion(s): Although
our study did not proviDe statistically significant results, these
preliminary data revealed a trend towards increased CO in patients who
received the intervention. In addition, it showed that patients in the
intervention group had a lower average requirement for intraoperative
fluids and vasopressors compared to those who received standard care. In
conclusion, our results suggest that the intervention has the potential to
improve cardiac performance and reduce the need for vasopressors in
patients undergoing non-cardiac surgery. However, the main study is not
powered for this secondary analysis. Potential non-significant results
should be evaluated with a larger sample size to validate these
observations.

<75>
Accession Number
649550026
Title
Reconstructed Patient Level Meta-Analysis of Prophylactic Left Atrial
Appendage Closure during Cardiac Surgery.
Source
The Canadian journal of cardiology. (no pagination), 2025. Date of
Publication: 10 Dec 2025.
Author
Dong A.; Lee G.; Krishna V.; Whitlock R.; Kiankhooy A.; Bowdish M.; Chikwe
J.; Tam D.Y.
Institution
(Dong, Krishna, Kiankhooy, Bowdish, Chikwe) Department of Cardiac Surgery,
Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Lee) Temerty Faculty of Medicine, University of Toronto, Toronto, ON,
Canada
(Whitlock) Population Health Research Institute, Division of Cardiac
Surgery, McMaster University, Hamilton, ON, Canada
(Tam) Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai
Medical Center, Los Angeles, CA, USA; Temerty Faculty of Medicine,
University of Toronto, Toronto, ON, Canada
Abstract
BACKGROUND: The benefit of prophylactic concomitant left atrial appendage
closure (LAAC) in cardiac surgery patients without preoperative atrial
fibrillation is unclear. We aim to evaluate whether LAAC reduces the risk
of late stroke in patients without preoperative atrial fibrillation.
 METHOD(S): A systematic search was conducted through July 2025 for
studies investigating LAAC versus no LAAC in cardiac surgery patients
without atrial fibrillation. Random effects meta-analysis was performed
and Kaplan Meier curves were digitized to reconstruct individual patient
data. Primary outcome was stroke at 5 years. Median follow-up time was 3.8
years (IQR 2.1 to 4.6 years). RESULT(S): One randomized controlled
trial and six observational studies were included with 4,306 LAAC and
4,129 no LAAC patients. LAAC versus no LAAC patients were similar in
preoperative characteristics including age (66 vs 65 years, p=0.8), sex
(30 vs 29% female, p=0.8), and CHA2DS2-VASc scores (2.7 vs 2.6, p=0.9).
There was no difference in 30-day mortality (1.2% vs 1.1%, RR: 1.04,
95%CI: 0.64-1.69, p=0.42, I2=0%). Postoperative atrial fibrillation was
significantly higher after LAAC (31.1% vs 26.1%, RR: 1.20, 95%CI:
1.03-1.39, p<0.01, I2=72%). Using reconstructed patient level data, 5-year
freedom from stroke improved after prophylactic LAAC (95.9% vs 94.4%, HR:
0.66, 95%CI: 0.52-0.83, p=0.0004). The number needed to treat was 67 to
prevent one stroke. CONCLUSION(S): In patients without atrial
fibrillation undergoing cardiac surgery, prophylactic LAAC was associated
with a lower observed risk of stroke. These exploratory findings warrant
confirmation in ongoing large multicentred randomized clinical
trials. Copyright © 2025. Published by Elsevier Inc.

<76>
Accession Number
649547918
Title
Endoscopic versus open vein harvesting for coronary artery bypass: a
systematic review and meta-analysis.
Source
Journal of cardiothoracic surgery. (no pagination), 2025. Date of
Publication: 13 Dec 2025.
Author
Arnaout A.Y.; Aladna A.; Kozum R.; Makki R.; Sabouni A.; Antakli K.;
Raffoul L.; Shabouk M.B.; Nayal S.; Arnaout K.; Amino A.
Institution
(Arnaout) Faculty of Medicine, University of Aleppo, Aleppo University
Hospital, Aleppo, Syrian Arab Republic
(Aladna, Kozum, Makki, Sabouni, Antakli, Shabouk, Nayal, Arnaout, Amino)
Faculty of Medicine, University of Aleppo, Aleppo University Hospital,
Aleppo, Syrian Arab Republic
(Raffoul) Faculty of Medicine, Al Andalus University for Medical Sciences,
Syrian Arab Republic
Abstract
BACKGROUND: A common treatment for coronary artery disease is CABG, which
often involves the use of saphenous veins or internal mammary arteries as
grafts. The selected harvesting technique-open vein harvesting (OVH) or
endoscopic vein harvesting (EVH)-is pivotal for successful graft outcomes,
significantly influencing patient recovery and long-term graft patency
rates. This systematic review aims to analyze and compare these harvesting
methods to inform clinical decision-making. METHOD(S): Our systematic
review and meta-analysis were conducted in accordance with the PRISMA 2020
guidelines, following our registered protocol in PROSPERO (identifier
CRD42024511815). We included full-text studies, encompassing both RCTs and
observational studies, that evaluated the effectiveness of EVH versus OVH
for elective and urgent CABG procedures. A comprehensive literature search
was conducted in PubMed, Scopus, Cochrane Library, and Embase from
inception until December 28, 2023. We applied a Fixed Effect Model for the
meta-analysis, utilizing RR and SMD alongside the inverse variance method.
The I2 statistic assessed heterogeneity, supported by sensitivity analyses
for result robustness, while funnel plots evaluated publication bias. All
statistical analyses were performed using Pythmeta software.
 RESULT(S): From an initial 1,906 records, we removed 841 duplicates
and unrelated studies, resulting in 34 studies included in the review (21
RCTs and 13 observational studies). Quality assessment revealed a high
risk of bias in 11 of 19 RCTs, with multiple concerns across all studies
regarding reported outcomes. The review comprised 7,442 patients, with a
majority (53.05%) in the EVH group, and median ages of 64.09 (EVH) and
64.35 (OVH). EVH demonstrated significantly lower leg wound complications,
including reduced rates of infections (RR = 0.29 95% CI [0.19, 0.43], p <
0.001 (11 studies) and edema (RR = 0.38 95% CI [0.27, 0.55], p < 0.001).
However, graft patency favored OVH at both 6 months (92.9% vs. 80.4%, P =
0.04) and 2 years (90.8% vs. 73.9%, P = 0.01), with EVH showing heightened
acute endothelial damage (51% vs. 29%, P < 0.001). Pain levels were
substantially lower in the EVH group on postoperative day three, while
mortality rates remained comparable. CONCLUSION(S): This systematic
review indicates that while EVH presents significant advantages for
reducing leg wound complications, its efficacy in graft patency appears
less favorable than OVH. Further investigation is essential to explore the
long-term benefits and cost-effectiveness of these techniques, ensuring
optimal practices in vein harvesting for CABG. Copyright © 2025.
The Author(s).

<77>
Accession Number
649543288
Title
Dexmedetomidine is not associated with hyperthermia after cardiac surgery:
post hoc analysis of a randomized trial.
Source
Intensive Care Medicine Experimental. Conference: ESICM LIVES 2024.
Barcelona Spain. 12(Supplement 1) (no pagination), 2024. Date of
Publication: 01 Oct 2024.
Author
Muller-Wirtz L.M.; Ott S.; Patterson W.M.; Mohammad K.; Barband S.; Reuter
A.; Dussan C.; Li Y.; Ruetzler K.; Sessler D.; Turan A.
Institution
(Muller-Wirtz, Ott, Patterson, Mohammad, Barband, Reuter, Dussan, Li,
Ruetzler, Sessler, Turan) Outcomes Research Consortium, Department of
Anesthesiology, Cleveland Clinic, Cleveland, United States
Publisher
Springer Nature
Abstract
Introduction: Postoperative hyperthermia is common and associated with
neurocognitive impairment after cardiac surgery. Dexmedetomidine was
reported to be associated with hyperthermia and is frequently used during
and after cardiac surgery. A potential mechanism by which administration
of dexmedetomidine results in hyperthermia is sparing propofol which
impairs thermoregulation. We therefore performed a post hoc analysis of
the DECADE trial aiming to test the hypothesis that dexmedetomidine
administration increases the incidence of postoperative hyperthermia
during the initial 24 h after cardiac surgery, and whether this effect is
mediated by propofol dose. Method(s): We conducted a post hoc
analysis of the DECADE trial in which patients were randomized to placebo
or dexmedetomidine. Dexmedetomidine infusion was started before surgery at
a rate of 0.1, was increased to 0.2 at the end of bypass, and was
increased to 0.4g/ kg/h postoperatively which was maintained until 24 h
after the infusion started. DECADE tested the primary hypothesis that
dexmedetomidine reduces atrial fibrillation and delirium after cardiac
surgery (it did neither). For the current analysis, we primarily compared
the fraction of patients having a postoperative body temperature 38
degreeC during the first 24 h after surgery in patients given
dexmedetomidine or placebo using a generalized linear model for binomial
distribution to estimate the relative risk (RR). Secondarily, we performed
the same analysis restricted to patients with continued propofol
administration within the first 24 h after surgery and with a threshold in
postoperative body temperature of 37.5 degreeC, and planned to test for
effect mediation by propofol dose. We adjusted for confounding in all
analyses with inverse probability of treatment weighting for age, sex,
race, body mass index, ASA status, and type and duration of surgery.
 Result(s): We included 501 patients, 248 of whom were assigned to
dexmedetomidine. After inverse propensity weighting, standardized mean
differences were < 0.03 for all potential confounders. There was no
significant difference in the incidence of postoperative body temperature
38 degreeC during the first 24 h after surgery (dexmedetomidine: 27%,
placebo: 21%; RR: 1.2 [95%CI 0.9, 1.7], p = 0.25). Similarly, there was no
statistically significant difference in the incidence of postoperative
body temperature 37.5 degreeC during postoperative propofol infusion
(dexmedetomidine: 26%, placebo: 21%; RR: 1.2 [95%CI 0.8, 1.8], p = 0.32)
which precluded testing for mediation by propofol dose. Exploratory
analyses for different thresholds for postoperative hyperthermia did not
reveal any statistically significant difference (Table 1). A post hoc
power analysis revealed that our sample size would have enabled us to
detect a 52% increase in the risk for postoperative hyperthermia with a
power of 80% and a type I error of 0.05. Conclusion(s):
Dexmedetomidine administration in patients having cardiac surgery did not
significantly increase the incidence of postoperative hyperthermia. Our
study was powered to detect increases in relative risk for postoperative
hyperthermia exceeding 52%. Further studies are thus needed to excluDe
smaller effect sizes.

<78>
Accession Number
649542951
Title
Effects of closed-loop ventilation versus conventional ventilation on
alarms and interventions at the ventilator.
Source
Intensive Care Medicine Experimental. Conference: ESICM LIVES 2024.
Barcelona Spain. 12(Supplement 1) (no pagination), 2024. Date of
Publication: 01 Oct 2024.
Author
Van Haren L.M.A.A.; Nabben D.L.J.; Dekker M.A.C.; Bouwman R.A.; Schultz
M.J.; De Bie A.J.R.; Kloeze C.
Institution
(Van Haren, Kloeze) Clinical Physics, Catharina Ziekenhuis, Eindhoven,
Netherlands
(Nabben, Bouwman) Anesthesiology, Catharina Ziekenhuis, Eindhoven,
Netherlands
(Dekker, De Bie) Intensive care, Catharina Ziekenhuis, Eindhoven,
Netherlands
(Schultz) Intensive care, Amsterdam University Medical Centers, Amsterdam,
Netherlands
Publisher
Springer Nature
Abstract
Introduction: Mechanical ventilation is an essential intervention in the
intensive care unit (ICU). Closed-loop ventilation modes, like
INTELLiVENTR-Adaptive Support Ventilation (ASV), offer important
advantages by automatically adapting ventilator settings based on
real-time monitoring. Previous studies demonstrated its safety and
improved lung protectiveness in various patient groups [1], however
knowledge gaps remain regarding clinicians' workload and acceptance.
 Objective(s): To compare workload related to alarms and interventions
at the ventilator with INTELLiVENT-ASV versus conventional ventilation in
patients receiving postoperative ventilation after cardiac surgery. We
also determined the acceptance of the closed-loop moDe by ICU caregivers.
 Method(s): We conducted preplanned analysis of POSITiVE [2], a
randomized clinical trial comparing INTELLiVENT-ASV with conventional
ventilation in patients after cardiac surgery. The primary outcome was a
combination of the number of alarms, and the number of manual
interventions at the ventilator. Manual interventions included those
related to changing ventilation and alarm settings. The primary outcome
was calculated over the first three hours of ventilation or until
extubation. Caregivers' acceptance was determined using a questionnaire
based on the Technology Acceptance Model 2 [3], and a user acceptance
score ranging from 1 to 10. Result(s): POSITiVE included 210 patients
(104 automated and 106 conventional). The automated moDe generated a
comparable number of alarms at a similar frequency as the conventional
group (2.00 [1.33- 3.57] vs 2.24 [1.33-4.01] alarms per hour; P = 0.65),
less ventilation control interventions per hour (0.33 [0.33-1.00] vs 1.00
[0.33-2.00]; P < 0.001), but significantly more alarm management
interventions per hour (12.50 [9.13-24.00] vs 2.11 [1.33-3.65]; P <
0.001), compared to the conventional group. Respectively, 99 ( 1 for 95%
of patients) and 103 ( 1 for 97% of patients) surveys were completed for
the automated and conventional group. Perceived ease of use did not differ
between the two modes. The automated moDe scored higher in perceived
usefulness (2.61 [2.25-2.84] vs 2.11 [1.82-2.35]; P < 0.001) and had
higher user acceptance (7.98 [7.75-8.20] vs 7.01 [6.67-7.35]; P < 0.001)
compared to the conventional group. Conclusion(s): Automated
ventilation for post-cardiac surgical patients reduces the number of
interventions related to ventilation management and shows higher
clinicians' acceptance, indicating its potential to optimize patient care
and reduce bedsiDe nurses' workload. However, while alarm frequencies were
similar, interventions related to alarm management increased. the x-axis
the ventilation time. Patients following a black box represent the
automated group and patients following a gray box represent the
conventional group. Green represents zero alarms/interventions during that
period, orange 1-3 alarms/interventions and red 4 or more
alarms/interventions.

<79>
Accession Number
649543465
Title
Randomized Embedded Multifactorial Adaptive Platform in ExtraCorporeal
Membrane Oxygenation (REMAP ECMO)-rationale and design of the left
ventricular unloading trial.
Source
Intensive Care Medicine Experimental. Conference: ESICM LIVES 2024.
Barcelona Spain. 12(Supplement 1) (no pagination), 2024. Date of
Publication: 01 Oct 2024.
Author
Van Steenwijk M.P.J.; Van Rosmalen J.; Elzo Kraemer C.V.; Donker D.;
Hermens J.; Kraaijeveld A.O.; Maas J.J.; Akin S.; Montenij L.; Vlaar
A.P.J.; Van den Bergh W.M.; OuDe Lansink-Hartgring A.; De Metz J.; Voesten
N.; Boersma E.; Scholten E.; Beishuizen A.; Lexis C.; Peperstraete H.;
Schiettekatte S.; Lorusso R.; Gommers D.; Tibboel D.; Boer R.A.; Van
Mieghem N.M.D.A.; Meuwese C.
Institution
(Van Steenwijk) Intensive care, Erasmus University Medical Center,
Rotterdam, Netherlands
(Van Rosmalen) Department of biostatistics, Erasmus University Medical
Center, Rotterdam, Netherlands
(Elzo Kraemer, Maas) Intensive care, Leiden University Medical Center
(LUMC), Leiden, Netherlands
(Donker, Hermens) Intensive care, UMC Utrecht, Utrecht, Netherlands
(Kraaijeveld) Cardiology, UMC Utrecht, Utrecht, Netherlands
(Akin) Intensive care, Haga Hospital, Den Haag, Netherlands
(Montenij) Intensive care, Catharina Ziekenhuis, Eindhoven, Netherlands
(Vlaar) Intensive care, Amsterdam UMC, Amsterdam, Netherlands
(Van den Bergh, OuDe Lansink-Hartgring) Intensive care, University Medical
Center Groningen, Groningen, Netherlands
(De Metz) Intensive care, OLVG, Amsterdam, Netherlands
(Voesten) Intensive care, Amphia Hospital, Breda, Netherlands
(Boersma, Boer, Van Mieghem) Cardiology, Erasmus University Medical
Center, Rotterdam, Netherlands
(Scholten) Intensive care, St. Antonius Hospital, Nieuwegein, Netherlands
(Beishuizen) MST, Enschede, Netherlands
(Lexis) Maastricht UMC +, Maastricht, Netherlands
(Peperstraete) Ghent University Hospital, Gent, Belgium
(Schiettekatte) Ziekenhuis Oost-Limburg, Genk, Belgium
(Lorusso) Cardiothoracic surgery, heart and vascular center, Mumc +,
Maastricht, Netherlands
(Gommers, Tibboel) Intensive care and department of pediatric surgery,
Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam,
Netherlands
(Meuwese) Intensive Care Medicine and Cardiology, Erasmus University
Medical Center, Rotterdam, Netherlands
Publisher
Springer Nature
Abstract
Introduction: The use of Extracorporeal Membrane Oxygenation (ECMO)
remains associated with high rates of complications, weaning failure, and
mortality in part due to a knowledge gap on how to properly manage
patients on ECMO support. To address relevant patient management issues,
we designed a "Randomized Embedded Multifactorial Adaptive Platform
(REMAP)" in the setting of ECMO (REMAP ECMO) and a first embedded trial
domain investigating the effects of routine early left ventricular (LV)
unloading through intra-aortic balloon pumping (IABP) (Figure 1).
 Method(s): REMAP ECMO describes a registry-based platform allowing
for the embedding of multiple response adaptive randomized controlled
trials (RCTs) (trial domains) which can perpetually address the effect of
relevant patient management issues on ECMO weaning success. A first trial
domain studies the effects of LV unloading by means of an IABP as an
adjunct to veno-arterial (V-A) ECMO versus V-A ECMO alone on ECMO weaning
success at 30 days in adult cardiogenic shock patients admitted to the
Intensive Care Unit (ICU) (Figure 2). Result(s): The primary outcome
of this trial is "successful weaning from ECMO" being defined as a
composite of survival without the need for mechanical circulatory support,
heart transplantation, or left ventricular assist device (LVAD) at 30 days
after initiation of ECMO. Secondary outcomes incluDe the need for
interventional escalation of LV unloading strategy, mechanistic endpoints,
and quality of life. Trial data will be analyzed using a Bayesian
statistical framework. The adaptive design allows for a high degree of
flexibility, such as response adaptive randomization and early stopping of
the trial for efficacy or futility (Figure 3). Conclusion(s): The
REMAP ECMO trial platform enables the efficient roll-out of multiple RCTs
on relevant patient management issues. A first embedded trial domain will
compare routine LV unloading by means of an IABP as an adjunct to V-A ECMO
versus V-A ECMO alone.

<80>
Accession Number
649543235
Title
Does the use of focused echocardiography affect the management impact of
pulmonary embolism in the intensive care setting?.
Source
Intensive Care Medicine Experimental. Conference: ESICM LIVES 2024.
Barcelona Spain. 12(Supplement 1) (no pagination), 2024. Date of
Publication: 01 Oct 2024.
Author
Strong K.
Institution
(Strong) Bristol Medical School, University of Bristol, Bristol, United
Kingdom
Publisher
Springer Nature
Abstract
Introduction: The use of echocardiography in the intensive care setting is
becoming a more utilised imaging modality. It provides information to
guiDe therapeutic interventions and prognosticate pulmonary embolism (PE)
allowing consideration of specialist referral for cardiac/surgical
intervention [1]. Objective(s): This literature review analyses
primary research and explores the impact echocardiography has when
assessing and treating the critically unwell patient. It aims to explore
the PICO question 'Does the use of focused echocardiography affect the
management impact of pulmonary embolism in the intensive care setting-'.
 Method(s): Systemic searches of the electronic database PubMed were
conducted in July 2022, where articles were manually screened by the
author according to the selection criteria. Main reasons for exclusion
were the extensive use of transoesophageal echocardiography or the use of
echocardiography in cardiology which were not included as part of this
review. Assessment of the included studies were stratified against a
critical appraisal checklist. From a total of 47 identified articles, 15
were included. All the studies included data that was statistically
significant for the parameters (PE and haemodynamic instability). However,
it must be noted that the follow up duration on some studies was limited
and there were some confounding factors that might have altered the
results included. Result(s): The use of echocardiography in the
haemodynamically stable patient cannot directly excluDe the diagnosis of
PE alone, it is used however to risk stratify PE patients to moderate or
high risk groups depending on the presence or absence of right ventricular
dysfunction [2]. In patients with a high clinical suspicion of PE, studies
have shown a consistently high specificity (approx. 90%) and low
sensitivity (56-70%) for echocardiography making it a useful rule-in test
[3]. In high-risk patients with massive PE, echocardiography is widely
embraced and confirms aetiology of haemodynamic compromise however in
low-risk patients echocardiography rarely yields findings and does not
change prognostication. 4 New pathways have now been developed to
synchronise management of acute PE utilising the advantages of
echocardiography. Conclusion(s): With the current evidence, the use
of echocardiography can be favoured (when used alongsiDe other modalities)
in the diagnosis and management of PE in the intensive care environment.
However, further high-quality randomised control trials with a longer
follow up time are needed to make this suggestion more substantial. It is
highlighted that the focused echocardiogram performed in the intensive
care setting does not replace a comprehensive exam and its use is
primarily around point of care ultrasound to identify life threatening PE.
There is no doubt that with little complication rate the use of
echocardiography to aid diagnosis and management in the intensive care
setting is a rapidly evolving field and using it alongsiDe other imaging
modalities in the assessment of a patient is likely to lead to a
gold-standard approach.

<81>
Accession Number
649545875
Title
Prioritizing surgical ablation for atrial fibrillation during coronary
artery bypass grafting: new evidence, old debate.
Source
Expert review of cardiovascular therapy. (no pagination), 2025. Date of
Publication: 13 Dec 2025.
Author
Erez E.; Squiers J.J.; Dorton C.W.; Banwait J.; Gasparini A.; Mack M.;
DiMai J.M.; Schaffer J.M.
Institution
(Erez, Dorton, Banwait, Mack, DiMai) Baylor Scott & White Research
Institute, Dallas, TX, United States
(Squiers, DiMai, Schaffer) Department of Cardiothoracic Surgery, Baylor
Scott & White the Heart Hospital, Plano, TX, United States
(Gasparini) StockholmSweden
Abstract
INTRODUCTION: Atrial fibrillation (AF) affects 10-20% of patients
undergoing coronary artery bypass grafting (CABG) and is associated with
increased postoperative morbidity and mortality. Although studies support
the safety and effectiveness of surgical ablation (SA), and guidelines
recommend its use during CABG for patients with preexisting AF, clinical
adoption remains limited. AREAS COVERED: In this review, we outline
current guideline recommendations, evaluate the evidence base, highlight
recent analyses, and examine persistent barriers to the adoption of SA
during CABG, informed by studies identified through searches of PubMed and
Google Scholar. EXPERT OPINION: Small randomized studies demonstrate that
SA restores sinus rhythm following CABG, while observational studies
suggest rhythm restoration improves survival and reduces thromboembolic
events. Recent national database analyses have lent further support,
finding an association between SA and long-term survival. Analytic
approaches included analysis by treatment type using propensity-score risk
adjustment and, more recently, using surgeon frequency of SA as an
instrumental variable. However, concerns about unmeasured confounding,
sparse rhythm follow-up, and limited lesion-set granularity, undermine
confidence and contribute to underuse. A randomized trial comparing
long-term outcomes between pulmonary vein isolation, left atrial, and
bi-atrial lesion sets is critically needed to guide optimal implementation
of SA during CABG.

<82>
[Use Link to view the full text]
Accession Number
649546626
Title
Will prothrombin complex concentrate replace plasma in cardiac surgical
bleeding in North America?.
Source
Current opinion in anaesthesiology. (no pagination), 2025. Date of
Publication: 04 Dec 2025.
Author
Bartoszko J.; Gabarin N.; Tanaka K.; Callum J.
Institution
(Bartoszko) Department of Anesthesia and Pain Management, Sinai Health,
Women's College Hospital, University of Toronto, University Health Network
(Bartoszko) Peter Munk Cardiac Centre and Toronto General Hospital
Research Institute, University Health Network
(Bartoszko) Departments of Anesthesiology and Pain Medicine
(Gabarin) Laboratory Medicine and Pathobiology, University of Toronto,
Toronto, ON, Canada
(Tanaka) Department of Anesthesiology, University of Oklahoma Health,
Oklahoma City, OK, United States
(Callum) Department of Pathology and Molecular Medicine, Kingston Health
Sciences Centre and Queen's University, Kingston, Ontario, Canada
Abstract
PURPOSE OF REVIEW: There is increasing interest in four-factor prothrombin
complex concentrate (4F-PCC) for treatment of acquired coagulopathic
bleeding in cardiac surgery. Plasma, traditionally the treatment of
choice, has a different composition compared with 4F-PCC. This review
summarizes the current evidence. RECENT FINDINGS: Because of its rapid
reconstitution at the bedside and small administration volume, the use of
4F-PCC over plasma is rising - particularly with new clinical trial
evidence suggesting 4F-PCC has efficacy and safety advantages. This is
reinforced by mechanistic evidence supporting the role of 4F-PCC in
normalizing or improving thrombin generation, an important aspect of
secondary hemostasis often impacted in cardiac surgery. Four randomized
controlled trials contribute to the human evidence base for the use of
4F-PCC in cardiac surgery. FARES-II, the largest study to date,
demonstrated that 4F-PCC has improved hemostatic efficacy and a superior
safety profile compared with plasma. Three additional studies are underway
to confirm these findings. SUMMARY: The use of 4F-PCC for the treatment of
coagulopathic bleeding in cardiac surgery is supported by high-quality
clinical evidence. Several unanswered questions remain regarding sex- and
race-specific efficacy, the mechanism through which 4F-PCC may reduce
serious adverse events, and its use in procedures that were
under-represented in existing clinical trials. Copyright © 2025
Wolters Kluwer Health, Inc. All rights reserved.

<83>
Accession Number
649543238
Title
Patients experiences after heart transplantation: systematic review of
qualitative studies.
Source
Intensive Care Medicine Experimental. Conference: ESICM LIVES 2024.
Barcelona Spain. 12(Supplement 1) (no pagination), 2024. Date of
Publication: 01 Oct 2024.
Author
Danielis M.; Zanotti R.; NourElHadi S.
Institution
(Danielis, Zanotti, NourElHadi) Department of Cardiac, Thoracic, Vascular
Sciences and Public Health, University of Padua, Padua, Italy
Publisher
Springer Nature
Abstract
Introduction: After heart transplantation, patients' health is affected by
a multituDe of factors, many of which may be unfamiliar to the healthcare
professionals. The process surrounding heart transplantation, both during
and after the procedure, is highly complex, highlighting the need for
studies that delve into patient experiences. Heart transplantation
significantly disrupts recipients' daily activities and exposes them to
various challenges that may compromise adherence to their care plan and
jeopardize the success of the transplant. Given the wealth of research
documenting its impact on quality of life and lifestyle adjustments, we
recognized the need to synthesize these findings. Objective(s): To
investigate the post-heart transplantation experiences of patients, this
study conducted an in-depth analysis of existing qualitative research,
aiming to gain a comprehensive understanding of the diverse facets of
their post-transplantation journey, with a particular focus on their
quality of life. Method(s): We conducted a systematic search across
Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase
(Ovid), MEDLINE (Ovid), Social Science Citation Index (Web of Science),
and Scopus databases up to September 30, 2023. We included primary studies
focusing on qualitative data, encompassing designs, such as phenomenology,
grounded theory, ethnography, and descriptive research. Following
Sandelowsky and Barroso guidelines, our analysis involved: (a) extracting
findings, (b) editing for accessibility, (c) grouping into topical
domains, and (d) abstracting findings. The Critical Assessment Skills
Programme checklist was used for the quality assessment of studies.
 Result(s): A total of 13 studies with 176 patients were included.
Figure 1 summarizes the themes and categories that emerged as affecting
patients' reports of their experiences post-transplant. The 28 codes that
emerged from the abstraction process were grouped into seven categories
and three themes. In the theme of 'Undergoing an emotionally charged
journey,' heart transplant patients described post-transplant
psychological challenges, including coping with emotional optimism.
Transitioning to 'Balancing personal health and social dynamics,' they
navigated transformative adjustments and perceptions, managed medications
and a lifelong care plan, and confronted social challenges. In the final
theme, 'Fostering existential reflection,' patients explored revised life
goals and navigated interpersonal dynamics. Conclusion(s): Patients
undergoing heart transplantation navigated a spectrum of emotions, faced
challenges such as adjusting habits, and often embraced new opportunities
for the future. Nurses and doctors should enhance the post-heart
transplant experience for patients by implementing small changes, such as
prioritizing effective communication, ongoing education, and fostering
collaboration among multidisciplinary teams. These initiatives were
essential for ensuring the delivery of high-quality care.

<84>
Accession Number
2042296983
Title
Towards a More Standardized Bicuspid Aortic Valve Repair: Rationale and
Design of the CONTOUR Trial.
Source
European Journal of Cardio-thoracic Surgery. 67(12) (no pagination), 2025.
Article Number: ezaf360. Date of Publication: 01 Dec 2025.
Author
Girdauskas E.; Stock S.; Hofbauer D.; Petersen J.; Reichenspurner H.;
Holubec T.; Walther T.; Vogl T.; Borger M.; Gutberlet M.; Kroncke T.;
Decker J.; Zapf A.; Lezius S.; Lenz A.; Lansac E.; Bannas P.
Institution
(Girdauskas, Stock, Hofbauer) Department of Cardiovascular and Thoracic
Surgery, University Hospital Augsburg, Augsburg, Germany
(Girdauskas, Petersen, Reichenspurner) Department of Cardiovascular
Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany
(Holubec, Walther) Department of Cardiovascular Surgery, University
Hospital, Frankfurt, Germany
(Vogl) Department of Diagnostic and Interventional Radiology, University
Hospital, Frankfurt, Germany
(Borger) Department Cardiac Surgery, Leipzig Heart Center, Leipzig,
Germany
(Gutberlet) Department of Diagnostic and Interventional Radiology, Leipzig
Heart Center, Leipzig, Germany
(Kroncke, Decker) Department of Diagnostic and Interventional Radiology,
University Hospital Augsburg, Augsburg, Germany
(Zapf, Lezius) Institute of Medical Biometry and Epidemiology, University
Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Lenz, Bannas) Department of Diagnostic and Interventional Radiology and
Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg,
Germany
(Lansac) Department of Cardiothoracic Surgery, Hopital de La
Pitie-Salpetriere, AP-HP, Sorbonne Universite, Paris, France
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Objectives Aortic valve repair is an evolving and still underused strategy
in young bicuspid aortic valve (BAV) patients with aortic regurgitation
(AR). The lack of standardization remains the main limitation of current
repair techniques, resulting in an increased risk of AR recurrence and
reoperation. The most controversial issue is the stabilization of the BAV
annulus. Methods The CONTOUR trial is a multicentre RCT designed to
compare 2 aortic valve annuloplasty concepts in 100 consecutive BAV
patients. BAV AR patients with an asymmetric configuration and without
aortopathy will be randomized 1:1 to undergo aortic valve repair using an
internal HAART 200 annuloplasty device (INTERNAL group) or double external
annuloplasty using Extra Aortic ring (EXTERNAL group). 4 D flow magnetic
resonance imaging (MRI) will be performed preoperatively (t1),
postoperatively at discharge (t2), and at 1-year follow-up (t3) for
rater-blinded assessment of haemodynamic profiles (ie, flow eccentricity)
and regurgitation fraction at the MRI core-lab. Two hierarchically ordered
primary end-points will be considered: (1) postoperative reduction of flow
eccentricity at hospital discharge and (2) regurgitation fraction (%) at
1-year follow-up. Results The CONTOUR trial is the first RCT designed to
compare 2 different annuloplasty techniques in their effectivity to create
a completely symmetric post-repair BAV geometry and to achieve superior
aortic valve repair outcomes. Conclusions The study findings are expected
to significantly influence aortic valve repair practice and contribute to
the refinement of guideline recommendations in the management of BAV
patients with AR. Copyright © The Author(s) 2025. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. All rights reserved.

<85>
Accession Number
649538449
Title
Transcatheter aortic valve replacement for severe asymptomatic aortic
stenosis - A systemic review and Bayesian meta-analysis.
Source
The Canadian journal of cardiology. (no pagination), 2025. Date of
Publication: 09 Dec 2025.
Author
Brophy J.M.
Abstract
BACKGROUND: Previous meta-analyses have concluded that early aortic valve
replacement (AVR) is associated with reduced cardiovascular events
compared to clinical surveillance (CS) for severe asymptomatic aortic
stenosis (AS). However, individual patient data (IPD) was not used and the
possibility of biases not considered. METHOD(S): A systematic review
of randomized clinical trials (RCTs) whose primary outcome was mortality
and unplanned cardiac hospitalization. IPD data was reconstructed,
permitting calculation of time varying risks. Bayesian analyses, with
vague priors, were performed for each trial and combined in a
meta-analysis. RESULT(S): Four RCTs were identified. The pooled
average long-term primary outcome was hazard ratio (HR) 0.52 (95% credible
interval (CrI) 0.25 - 0.93) and the predicted HR for the next study was HR
0.52 (95% CrI 0.13 - 1.87) with increased uncertainty from between study
heterogeneity. Only the EARLY_TAVR trial showed improved outcomes in year
one (HR 0.33, 95% CrI 0.24 - 0.46), driven by a 142% increase in the
crossover rate compared to previous trials. A one-year landmark analysis,
that eliminates possible early unblinding bias, showed no long term AVR
benefit for any individual study or for the pooled result (RR 0.59, 95% CI
0.20 - 1.40). CONCLUSION(S): One-year landmark analysis showed no
definitive longer-term benefit for early AVR compared to CS in
asymptomatic AS. The early TAVR benefit is possibly the result of
performance bias. Further research is required before early AVR for
asymptomatic AS can become the new standard of care. Copyright ©
2025. Published by Elsevier Inc.

<86>
Accession Number
649535359
Title
Coronary artery bypass grafting versus percutaneous coronary intervention
outcomes among patients with acute coronary syndrome and unprotected left
main coronary artery disease: a meta-analysis with a reconstructed
time-to-event analysis.
Source
Expert review of cardiovascular therapy. (no pagination), 2025. Date of
Publication: 11 Dec 2025.
Author
Elbahloul M.A.; Gadelmawla A.F.; Ali A.H.G.; Awad A.K.; Elazab A.; Mansour
A.; Mohamed A.N.; Sarhan H.; Elgendy I.Y.
Institution
(Elbahloul) Faculty of Medicine, Kafr El-Shaikh University, Egypt
(Gadelmawla) Faculty of Medicine, Menoufia University, Egypt
(Ali) Institute of Medicine, National Research Mordovia State University,
Saransk, Russian Federation
(Awad) Department of Cardiothoracic Surgery, Ain-Shams University, Cairo,
Egypt
(Elazab) Faculty of Medicine, South Valley University, Qena, Egypt
(Mansour) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Mohamed) Department of Internal Medicine, Cleveland Clinic, Cleveland,
Oh, United States
(Mohamed) Department of Internal Medicine, Charleston Area Medical Center
(CAMC), Charleston, WV, United States
(Sarhan) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, Oh, United States
(Elgendy) Division of Cardiovascular Medicine, Gill Heart and Vascular
Institute, University of Kentucky, Lexington, KY, United States
Abstract
INTRODUCTION: Patients with an unprotected left main coronary artery
(ULMCA) presenting with acute coronary syndrome (ACS) were
underrepresented in randomized trials. We aimed to compare the outcomes of
coronary artery bypass grafting (CABG) and percutaneous coronary
intervention (PCI) in these patients. METHOD(S): Electronic databases
were searched for studies comparing CABG vs PCI for patients with ULMCA
presenting with ACS. The primary outcome was all-cause mortality. The
outcomes were reported using a risk ratio (RR) and 95% confidence interval
(CI) using random-effect model. RESULT(S): A total of 7 studies with
4033 patients were included. There was no difference in the incidence of
all-cause mortality between CABG and PCI. CABG was associated with a trend
toward a higher incidence of stroke in short-term, but with lower rates of
lower target vessel revascularization, and target lesion revascularization
during long-term follow-up. CONCLUSION(S): CABG and PCI were
associated with comparable long-term mortality among patients with ULMCA
who presented with ACS. However, CABG was associated with a lower
incidence of MI and revascularization but a trend toward a higher
incidence of stroke. These findings could help with informed
decision-making among patients with ULMCA presenting with ACS.
REGISTRATION: The protocol was registered on PROSPERO (CRD420251034578).

<87>
Accession Number
649539412
Title
To estimate the trend and rise or fall of the intracuff pressure using
continuous intracuff pressure monitoring in children less than 7 years of
age undergoing anesthesia with microcuff endotracheal tube-A single arm
prospective observational study.
Source
Paediatric Anaesthesia. Conference: Asian Society of Paediatric
Anaesthesiologists (ASPA) Conference. Kuching Malaysia. 34(Supplement 1)
(pp 8), 2024. Date of Publication: 01 Nov 2024.
Author
Doctor J.; Bichewar M.
Institution
(Doctor, Bichewar) Department of Anesthesiology, Tata Memorial Hospital,
Mumbai, India
Publisher
John Wiley and Sons Inc
Abstract
Background: The use of microcuff endotracheal tubes in pediatric
anesthesia has been widely advocated. High intracuff pressures may affect
tracheal mucosal perfusion. Objective(s): (1) To measure cuff
pressure after intubation and to identify patients requiring cuff
deflation. (2)To observe the continu- ous trend of intracuff pressure. (3)
To determine the frequency of inflation/deflation required during the
course of surgery. Methodology: After obtaining institutional ethics
committee ap- proval, we conducted this study on 49 pediatric patients
undergo- ing abdominal and thoracic surgeries with parental consent. Air
was used to inflate the microcuff after intubation. A 3way connector was
used to connect a pressure transducer and tuberculin syringe to the pilot
balloon. Initial cuff pressure measurement was recorded immediately after
cuff inflation. The tuberculin syringe was used to inflate/deflate the
cuff in aliquots of 0.1 mL to maintain intracuff pressure below 15mmhg.
The intracuff pressure and the number of inflation/deflations was measured
every 15 min. Result(s): After initial cuff inflation 8.2% patients
required inflations due to a ventilator leak and 24.5% patient required
cuff deflation as intracuff pressure was higher than 15 mmHg. During the
course of surgery 18.4% patients required cuff inflation due to inadequate
ventilation and 51% patients required cuff deflation to keep intra- cuff
pressure below 15 mmHg. On subgroup analysis in the O2 + N2O group, 57%
require cuff deflation and 20% patients required cuff in- flation. In the
O2 + Air group, 35% patient required cuff deflation and 14.2% patients
required cuff inflation. We also noted the number of inflation/deflation
of the cuff for each patient. Conclusion(s): We noted a significant
variation in the intracuff pres- sure after initial inflation of the cuff.
It also varied considerably throughout the duration of surgery, requiring
multiple inflations and deflations. We conclude that routine continuous
monitoring of in- tracuff pressure is recommended in children undergoing
procedures under general anesthesia with microcuff tubes.

<88>
Accession Number
2041838799
Title
Conventional hybrid coronary vs. robot-assisted minimally invasive direct
revascularization: a meta-analysis and systematic review.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1650138. Date of Publication: 2025.
Author
Schuering C.L.; Zwaans V.I.T.; Huang A.; Kohler-Seuster M.; von Mackensen
J.K.R.; Iske J.; Stein J.; Kaemmel J.; Heck R.; Starck C.T.; Kempfert J.;
Jacobs S.; Falk V.; Wert L.
Institution
(Schuering, Zwaans, Huang, Kohler-Seuster, von Mackensen, Iske, Stein,
Kaemmel, Heck, Starck, Kempfert, Jacobs, Falk, Wert) Department of
Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charite
(DHZC), Berlin, Germany
(Kaemmel, Starck, Kempfert, Jacobs, Falk) DZHK (German Center for
Cardiovascular Research), Berlin, Germany
(Falk) Department of Cardiothoracic Surgery, Charite-Universitatsmedizin
Berlin, Corporate Member of Freie Universitat Berlin and
Humboldt-Universitat zu Berlin, Berlin, Germany
(Falk) Department of Health Sciences and Technology, ETH Zurich, Zurich,
Switzerland
Publisher
Frontiers Media SA
Abstract
Objectives: Hybrid coronary revascularization (HCR), a revascularization
strategy that amalgamates the minimally invasive direct coronary artery
bypass (MIDCAB) procedure and percutaneous coronary intervention (PCI),
represents a significant advancement in coronary artery disease treatment.
This study compares conventional and robotic approaches in HCR.
 Method(s): A systematic literature review and individual patient data
analysis was conducted via PubMed following PRISMA guidelines, including
original works published until 28 February 2025. Result(s): 32
publications met the inclusion criteria, providing individual data from
2,048 patients. All patients underwent MIDCAB for LAD lesions and
perioperative PCI for non-LAD lesions. 903 patients (670 male, 233 female;
mean age 51.69 +/- 7.77 years; BMI 34.66 +/- 13.13) were treated with
robot-assisted HCR, whilst 1,145 patients (890 male, 255 female; mean age
69.62 +/- 8.42 years; BMI 26.62 +/- 1.30) underwent conventional HCR. The
robot-assisted group showed significantly higher rates of right coronary
artery (RCA) stenosis (18.60% vs. 16.07%, p = 0.004) and drug-eluting
stent use (62.68% vs. 5.42%, p = 0.027), along with significantly shorter
hospital stays (4.27 +/- 1.34 vs. 10.27 +/- 7.34 days, p = 0.001).
Although not statistically significant, wound complications were more
frequent in the robot-assisted cohort (0.66% vs. 0.09%), whereas pleural
effusion (10.74% vs. 0.00%), pericardial effusion (0.61% vs. 0.11%), and
pneumothorax (1.83% vs. 0.11%) were more frequent in the conventional
group. Mortality was low in both cohorts (robotic vs. conventional):
intra-operative (0% vs. 0.09%, p = 0.73), 30-day (0.44% vs. 0.70%, p =
0.82), follow-up (2.66% vs. 4.72%, p = 0.41). Conclusion(s): Hybrid
coronary revascularization offers a less invasive alternative with
potential benefits. Robotic assistance may enhance outcomes, but limited
adoption and heterogeneous data underscore the need for further
investigation and validation. Copyright 2025 Schuering, Zwaans, Huang,
Kohler-Seuster, von Mackensen, Iske, Stein, Kaemmel, Heck, Starck,
Kempfert, Jacobs, Falk and Wert.

<89>
Accession Number
2042230635
Title
Sex does not influence outcomes in valvular heart surgery due to infective
endocarditis: A systematic review and meta-analysis.
Source
Asian Cardiovascular and Thoracic Annals. (no pagination), 2025. Date of
Publication: 2025.
Author
Zeb R.; Sharma S.; Abdullah R.; Patel M.; Nallamotu S.; Veintemilla-Burgos
F.; Kovil Thangam B.M.; Sai B.A.; Kaur G.
Institution
(Zeb) Army Medical College, Rawalpindi, Pakistan
(Sharma) Riga Stradins University, Riga, Latvia
(Abdullah) Foundation University Medical College, Islamabad, Pakistan
(Patel) NHL Municipal Medical College, Gujarat, Ahmedabad, India
(Nallamotu) Kasturba Medical College, Manipal, Karnataka, India
(Veintemilla-Burgos) Universidad Catolica de Santiago de Guayaquil,
Guayaquil, Ecuador
(Kovil Thangam) Spartan Health Sciences University, Saint Lucia, Vieux
Fort
(Sai) Kamineni Academy of Medical Sciences and Research, Telangana,
Hyderabad, India
(Kaur) American University of Antigua School of Medicine, Osbourn, Antigua
and Barbuda
Publisher
SAGE Publications Inc.
Abstract
This systematic review and meta-analysis aimed to evaluate sex-based
differences in surgical outcomes among patients with infective
endocarditis (IE). A comprehensive search of three major medical databases
identified ten studies encompassing 16,763 patients who underwent valvular
surgery for IE. Of these, 70.8% were male (n = 11,873), and 29.2% were
female (n = 4890). Female patients were generally older at the time of
surgery. The most common causative pathogen was Staphylococcus aureus
(28.4%), followed by Streptococcus (22.5%) and Enterococcus (4.1%).
Females demonstrated lower aortic valve involvement (risk ratio [RR]:
0.80, 95% confidence interval [CI]: 0.67-0.96) but higher mitral valve
involvement (RR: 1.30, 95% CI: 1.17-1.45, p < 0.001). They also had a
reduced prevalence of Streptococcus (RR: 0.89, 95% CI: 0.81-0.98, p =
0.02) and Enterococcus (RR: 0.71, 95% CI: 0.62-0.82, p = 0.03) infections
and a lower risk of abscess formation (RR: 0.87, 95% CI: 0.76-0.99, p =
0.03) compared to males. There was a significant difference in the
in-hospital mortality between female and male patients (RR: 1.30, 95% CI:
1.04-1.61, p = 0.02). No significant sex-related differences were observed
in the duration of hospitalization. However, significant sex-related
differences were observed in the incidence of postoperative stroke (RR:
1.10, 95% CI: 1.02-1.20, p = 0.02). In summary, female patients undergoing
surgery for IE face a higher risk of both in-hospital mortality and
postoperative stroke compared to males, underscoring clinically meaningful
sex-based disparities in short-term surgical outcomes. These findings
emphasize the need for further studies to clarify these observations.
(PROSPERO Registration: CRD42024602013). Copyright © The
Author(s) 2025

<90>
Accession Number
649539742
Title
Comparative study between ultrasound-guided serratus anterior and erector
spinae block for perioperative analgesia in children undergoing upper
thoracic surgeries.
Source
Paediatric Anaesthesia. Conference: Asian Society of Paediatric
Anaesthesiologists (ASPA) Conference. Kuching Malaysia. 34(Supplement 1)
(pp 16), 2024. Date of Publication: 01 Nov 2024.
Author
Amrita R.; Khyati A.
Institution
(Amrita, Khyati) Department of Anesthesiology and Critical Care, Institute
of Medical Sciences, BHU, U.P., Varanasi, India
Publisher
John Wiley and Sons Inc
Abstract
Background: Pain control is very important in children as they have a more
profound inflammatory response and lack a central inhibi- tory response.
Inadequate control of post thoracotomy pain can contribute to
deterioration of respiratory function and development of chronic pain. we
hypothesize that ultrasound guided Erector spi- nae block (ESPB) is better
compared to Serratus anterior plane block (SAPB) for perioperative
analgesia in upper thoracic surgeries under general anesthesia in this
study. Objective(s): 1. To compare intraoperative, postoperative and
cumulative opioid consumption between the two groups. 2. To determine time
of chest physiotherapy initiation, postopera- tive hospital stay,
associated complications and postoperative pain scores between the two
groups. Method(s): After ethical committee clearance No.
Dean/EC/2503, a prospective, randomized study was conducted in patients of
age group 5 to 14 years undergoing open thoracotomy under general an-
esthesia. Seventy patients were allocated randomly into two equal groups
of 35 each: Group 1 received SAPB, while Group 2 received ESPB,
respectively. Each group received 0.5 mL/kg of 0.25% bupi- vacaine with 2
mug/mL of fentanyl. Baseline changes in heart rate and blood pressure of
more than 20% were supplemented with 0.25-1 mug/kg of fentanyl. The rescue
analgesia was given if patients had a pain score >=4 in the post-operative
period. Cumulative opioid consumption and time to start chest
physiotherapy, hospital stay, and associated complications were noted.
 Result(s): Mean opioid requirement during intraoperative, postopera-
tive period and cumulative was more in Group 1 than Group 2 with p-values
of 0.0002, 0.0032 and 0.0024 respectively. The mean Time to start chest
physiotherapy & mean postoperative hospital stay values was higher in
Group1 than Group2 (p value 0.002 & 0.046 respectively).
 Conclusion(s): Ultrasound guided ESPB is superior to SAPB in chil-
dren undergoing thoracic surgery with decreased perioperative opi- oid
analgesia with early initiation of chest physiotherapy and lesser hospital
stay.

<91>
Accession Number
649540125
Title
Asian Society of Paediatric Anaesthesiologists (ASPA) Conference.
Source
Paediatric Anaesthesia. Conference: Asian Society of Paediatric
Anaesthesiologists (ASPA) Conference. Kuching Malaysia. 34(Supplement 1)
(no pagination), 2024. Date of Publication: 01 Nov 2024.
Author
Anonymous
Publisher
John Wiley and Sons Inc
Abstract
The proceedings contain 93 papers. The topics discussed include:
predictors of perioperative respiratory events (PRAE) in children
undergoing surgery for oropharyngeal cleft deformity; pediatric difficult
airway management simulation course: initiation to pediatric difficult
airway response team program; a comparison between palonosetron and
ondansetron as prophylaxis against postoperative nausea and vomiting in
adolescent idiopathic scoliosis surgery: a randomized trial; effects of
head and neck rotation on internal carotid artery blood flow velocity in
infants undergoing general anesthesia: assessment by transfontanelle
ultrasonography; effect of preoperative oral carbohydrate-electrolyte
drink on HOMA-IR, IL-6 levels and length of stay in pediatric patients;
the use of ketamine on emergence agitation in children: a systematic
review and meta-analysis of randomized control trials; and the nonlinear
relationship between preoperative serum total bilirubin levels and
outcomes after pediatric cardiac surgery.

<92>
Accession Number
649539909
Title
Optimization of intraoperative myocardial protection during cardiac
surgery in young children.
Source
Paediatric Anaesthesia. Conference: Asian Society of Paediatric
Anaesthesiologists (ASPA) Conference. Kuching Malaysia. 34(Supplement 1)
(pp 40), 2024. Date of Publication: 01 Nov 2024.
Author
Khodjiev B.F.; Satvaldieva E.A.; Kuralov E.T.; Abdukadirov A.A.
Institution
(Khodjiev, Satvaldieva, Kuralov, Abdukadirov) National Children's Medical
Center, Uzbekistan
(Khodjiev, Satvaldieva) Tashkent Pediatric Medical Institute, Tashkent,
Uzbekistan
Publisher
John Wiley and Sons Inc
Abstract
Background: This article provides a brief overview of the current problem
of modern pediatric cardiac anesthesiology - intraoperative cardioplegic
protection of the myocardium during open heart sur- gery. The combination
of hypothermia and potassium cardioplegic arrest has become the most
common method of myocardial protec- tion in the evolution of myocardial
protection. The review touched upon the classification and types of
cardioplegic solutions, their ad- vantages and disadvantages based on
meta-analyses. The current state of the problem is highlighted.
 Objective(s): To improve intraoperative myocardial protection through
a localized modification of the original Del Nido formulation for cardiac
surgical correction of congenital heart defects in young children.
 Material(s) and Method(s): The study included 76 young children with
septal congenital heart defects (ASD, VSD), who underwent elective cardiac
surgery with CPB at the National Children's Medical Center for the period
2021-2023. Group 1 consisted of 37 children who un- derwent crystalloid
cardioplegia (CC), Group 2 included 39 children using a localized
modification of the del Nido cardioplegic solution. In the first group,
children diagnosed with ASD 33% and VSD 67%, in the second group 27% and
73%, respectively. Result(s): Cardiopulmonary bypass and aortic
cross-clamp time, return of spontaneous cardiac activity following the
aortic cross-clamp release, incidence of ventricular fibrillation,
frequency and duration of action of cardioplegic solutions, duration of
inotropic support and mechanical ventilation, left ventricular ejection
fraction, statement in intensive care unit were comparable between two
groups. In the del Nido group, the aortic cross-clamping time (42.8 +/- 12
vs. 38.6 +/- 11 min in the CC group, p = 0.02). The rates of spontaneous
restoration of normal rhythm after removal of the aortic cross-clamp (92
versus 85%), development of ventricular fibrillation (9.2 versus 14.6%)
and intraoperative defibrillation (8.4 versus 13.4%) were also slightly
better in the del Nido group. Conclusion(s): The localized
modification of del Nido cardioplegic solution has proven to be a reliable
and affordable means of protecting the myocardium during cardiac surgery
in young children, with a long-term (at least 60 min) protective effect
after a single administration. Further research is needed to resolve the
issue of widespread implementation of the technique in domestic clinical
practice.

<93>
Accession Number
649517221
Title
Mind over cervix: Research protocol proposing use of virtual reality
headsets to reduce patient anxiety during outpatient colposcopy.
Source
BJOG: An International Journal of Obstetrics and Gynaecology. Conference:
BGCS ASM 2024. Liverpool United Kingdom. 131(Supplement 4) (pp 16), 2024.
Date of Publication: 01 Oct 2024.
Author
Braden V.; McFeeters C.; Ratnavelu N.
Institution
(Braden, McFeeters, Ratnavelu) Northern Gynaecological Oncology Centre
Gateshead, Gateshead, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Aims: To investigate whether the addition of virtual reality (VR) headsets
provides a reduction in anxiety levels in women attending for outpatient
colposcopy. Background(s): Colposcopy is a time of high stress for
women due to the risk of cancer and the inimate nature of examination.
Previous studies have shown that women feel a higher level of anxiety when
attending for colposcopy than they do when they attend of cardiac surgery,
so it is an area that we need to improve. Previous Cochrane studies have
shown that playing music as a form of distraction therapy has some benefit
for women in colposcopy, so our aim is to investigate if VR provides an
immersive form of distraction therapy. Method(s): We will perform a
single centre, non-blinded, randomised control trial to measure the
reduction in state trait anxiety (STAI) scores and numerical rating scores
(NRS) for pain in women allocated to the intervention arm (addition of VR
headsets during their colposcopy appointment) compared to the control arm
(standard colposcopy care). All women attending the department for their
colposcopy appointment will be offered enrolment to the trial dependant on
inclusion/exclusion criteria. Result(s): Primary outcome measure will
be reduction in anxiety experienced by women attending for outpatient
colposcopy as measured by STAI. Secondary outcome measures will include
reduction in pain experienced by women attending for outpatient colposcopy
as measured by NRS and acceptability of women to use the headset in the
future. 141 women will need enrolled to provide statistical significance.
 Conclusion(s): The study is awaiting IRAS approval and will aim to be
published in 2025. We anticipate that this form of distraction therapy
will provide a meaningful reduction in STAI scores.

<94>
Accession Number
2041770098
Title
Evaluating Surgical Approaches in Early NSCLC: A Meta-Analysis of
Robot-Assisted and Video-Assisted Techniques.
Source
Annals of Surgical Oncology. (no pagination), 2025. Date of Publication:
2025.
Author
Khan W.; Ali T.; Bilal M.; Ahmad W.; Ali S.A.; Hashim A.; Khan A.Z.; Kumar
A.; Abdullah M.; Khan S.; Ahmed A.; Jawad M.
Institution
(Khan, Abdullah, Jawad) Dow Medical College, Dow University of Health
Sciences, Karachi, Pakistan
(Ali) Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi,
Pakistan
(Bilal) Peshawar Medical College, Peshawar, Pakistan
(Ahmad) King Edward Medical University, Lahore, Pakistan
(Ali) Bahria Medical College, Karachi, Pakistan
(Hashim, Khan) Al-Aleem Medical College, Lahore, Pakistan
(Kumar, Ahmed) Ziauddin Medical College, Ziauddin University, Karachi,
Pakistan
(Khan) Nishtar Medical College, Multan, Pakistan
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Lung cancer, especially non-small cell lung cancer (NSCLC), is
a leading cause of cancer death. Surgical resection is the primary
treatment for early-stage NSCLC. Video-assisted thoracoscopic surgery
(VATS) and robot-assisted thoracic surgery (RATS) are minimally invasive
options, with RATS offering better precision at higher costs. This
meta-analysis compared the perioperative outcomes of both techniques in
NSCLC. Method(s): A systematic search in PubMed, Web of Science, NLM,
CNKI, and Wanfang was conducted for RCTs published between 31 July 2021
and 31 December 2024. Primary outcomes included operation time, blood
loss, lymph node dissection, conversion to thoracotomy, chest drainage
time, and hospital stay. Statistical analyses were performed using RevMan
5.3, with heterogeneity assessed using the I2 statistic. A p
value lower than 0.05 was considered significant. Result(s): Three
RCTs were analyzed. Blood loss showed no significant difference between
VATs and RATs (mean difference [MD], -33.00; 95% CI, -85.51 to 22.89; p =
0.07). Conversion to thoracotomy was comparable (MD, 0.69; 95% CI, 0.37 to
1.28; p = 0.24). Hospital stay did not differ significantly (MD, 0.13; 95%
CI, -0.58 to 0.84; p = 0.74). Operation time remained similar (MD, -4.63;
95% CI, -10.93 to 1.67; p = 0.15). The VATS procedure enabled
significantly greater lymph node dissection (MD, 1.83; 95% CI, 0.16 to
3.49; p = 0.03). Chest drainage duration showed no difference (MD, 0.00;
95% CI, -0.27 to 0.27; p = 1.00). Conclusion(s): In NSCLC, RATS and
VATS yield comparable outcomes, with RATS potentially reducing blood loss
and VATS allowing more lymph node dissection. Further high-quality RCTs
are needed to clarify the optimal approach for NSCLC. Copyright ©
Society of Surgical Oncology 2025.

<95>
Accession Number
649513719
Title
Perioperative Antibiotic Prophylaxis in Paediatric Cardiac Surgery - Is
One Day Sufficient to Prevent Surgical Site Infections?.
Source
Clinical Pharmacology in Drug Development. Conference: 2024 American
College of Clinical Pharmacology Annual Meeting. Bethesda, MD United
States. 13(Supplement 1) (pp 53-54), 2024. Date of Publication: 01 Sep
2024.
Author
Zuern C.; Paul L.; Beckschulte K.; Hoehn R.; Kroll J.; Grieshaber P.;
Loukanov T.; Stiller B.; Gorenflo M.; Ziesenitz V.
Institution
(Zuern, Beckschulte, Hoehn, Kroll, Stiller) Freiburg Univ Hosp,
Baden-Wurttemberg, Germany
(Paul, Grieshaber, Loukanov, Gorenflo) Heidelberg Univ Hosp,
Baden-Wurttemberg, Germany
(Ziesenitz) Ctr for Child and Adolescent Health, Heidelberg,
Baden-Wurttemberg, Germany
Publisher
John Wiley and Sons Inc
Abstract
Statement of Purpose, Innovation or Hypothesis: Perioperative antibiotic
prophylaxis (PAbP) is a standard practice in paediatric cardiac surgery to
prevent surgical site infections (SSI). Current prophylactic regimens in
Germany include cefuroxime (second-generation cephalosporin). The duration
of its administration is debated, due to the lack of randomised controlled
trials. The target of antibiotic stewardship is to effectively treat
infections, prevent antibiotic resistance and to protect patients from
unnecessary harm. This study aims at comparing the efficacy of PAbP with
cefuroxime during one vs five days perioperatively in children undergoing
congenital heart surgery.Description of Methods and Materials: This
retrospective, bi-centre study included patients <18 yrs of age undergoing
congenital cardiac surgery with cardiopulmonary bypass (CBP) and primary
chest closure from 2015 to 2019. Patients with preoperative antibiotic
treatment or signs of infection and cases of prior surgeries with CBP
during the same admission were excluded. PAbP consisted of cefuroxime,
which was administered according to two different regimens based on local
guidelines: one day (centre 1) vs five days (centre 2). Patients were
stratified according to age and procedural risk (STAT score). The
endpoints were the duration of invasive ventilation and the duration of
postoperative hospitalisation.Data and Results: A total number of 305
patients could be included in this analysis so far. Bodyweight (mean 14,0
vs 16,7 kg, p = 0.074) and STAT score (median 2 vs 2, p = 0.14) were
similar, but the patients were older in centre 2 (median 1,3 vs 2,5 yrs, p
= 0.04) and mechanical ventilation was longer in center 1 (mean 1,8 vs 1,7
days, p <0,01). Mean duration of cefuroxime administration was 3,1 days in
centre 1 and 6,3 days in centre 2 (p <0.01). These results show that the
shorter use of cefuroxime is non-inferior and does not cause a significant
difference in the duration of postoperative hospitalisation (median 10 vs
10 days, p = 0.1414).Interpretation, Conclusion or Significance: According
to this retrospective bi-centre study, a one-day PAbP regimen is
sufficient to prevent SSI around congenital cardiac surgical procedures.
Prospective data should be obtained in a multicentre study to confirm
these results.

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