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Total documents retrieved: 144 Results Generated From: Embase <1980 to 2026 Week 28> Embase Weekly Updates (updates since 2026-07-06) - (144 records) <1> Accession Number 2047027471 Title Safety and efficacy of transcatheter aortic valve replacement (TAVR) vs. surgical aortic valve replacement (SAVR) in patients with bicuspid aortic stenosis: A Systematic review and meta-analysis. Source Perfusion (United Kingdom). (no pagination), 2026. Date of Publication: 2026. Author Gadelmawla A.F.; Mansour A.; Elbataa A.; Asiri O.H.; Alharbi A.A.; Alquraish F.A.; Al-Ibrahim F.S.; AlHasani A.F.; Alharbi T.N.; Al Murayyi R.M.; Alotaibi A.G.; Abdul-Hafez H.A.; Suliman I. Institution (Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia, Egypt (Mansour, Elbataa) Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Asiri, Al Murayyi) College of Medicine, King Khalid University, Abha, Saudi Arabia (Alharbi) College of Medicine and Surgery, Taibah University, Medina, Saudi Arabia (Alquraish, Al-Ibrahim) College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia (AlHasani) College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia (Alharbi) College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia (Alotaibi) Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia (Abdul-Hafez) Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine (Suliman) King Abdulaziz Medical City, King Abdulaziz Cardiac Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia Publisher SAGE Publications Ltd Abstract Background: Bicuspid aortic valve (BAV) disease is a leading cause of aortic stenosis (AS). Surgical aortic valve replacement (SAVR) has traditionally been regarded as the best therapeutic option for bicuspid AS. However, the distinctive anatomical characteristics of BAV make the treatment with transcatheter aortic valve replacement (TAVR) challenging, so this population was often excluded from the trials. We aimed to compare TAVR and SAVR in terms of safety and efficacy in the population with bicuspid AS. Method(s): We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies, searched from PubMed, Cochrane, Scopus, and Web of Science (from inception until September 2025). Dichotomous outcomes were pooled as risk ratios (RRs), and continuous outcomes as mean differences (MDs), each with 95% confidence intervals (CIs). Result(s): A total of 78,677 patients were included in one RCT, 12 retrospective cohort studies, and one prospective cohort study. TAVR, compared to SAVR, was associated with significantly higher rates of permanent pacemaker implantation (PPI) (O.R. = 2.29, 95% C.I. [1.51, 3.47], P < 0.01) and shorter length of hospital stay (M.D. = -2.24, 95% C.I. [-3.96, -0.52], P = 0.01) and lower bleeding rates (O.R. = 0.31, 95% C.I. [0.14, 0.69], P < 0.01). However, there were no significant differences in all-cause mortality (ACM) (P = 0.948), acute kidney injury (AKI) (P = 0.28), stroke incidence (P = 0.475), and vascular complications (P = 0.31). The PPI and stroke rate results were consistent during in-hospital and short-term follow-ups. However, subgroup analysis by follow-up duration revealed that long-term stroke incidence was significantly higher in the TAVI group. Conclusion(s): TAVR offers benefit by minimizing significant bleeding and hospital length of stay. However, the benefits should be balanced against the considerably increased risk of PPI and PVL. Further RCTs are needed to confirm these findings. Copyright © The Author(s) 2026 <2> Accession Number 2046895961 Title Robotic versus traditional coronary artery bypass grafting (CABG): A dual-phase meta-analysis comparing human and AI-derived evidence. Source American Journal of Surgery. 260 (no pagination), 2026. Article Number: 117072. Date of Publication: 01 Oct 2026. Author Georginian N.; Wijeewera C.; Tran H.T.; Wilson H.; Carney T.; Wilson M.K.; Preda V.A. Institution (Georginian, Wilson, Preda) Macquarie University Hospital, 2 Technology Place Macquarie Park, Sydney, Australia (Wilson, Carney, Wilson) SurgicalXR, Suite 203, 2 Technology Place Macquarie Park, Sydney, NSW, Australia (Wijeewera) Bairnsdale Regional Health Service, East Gippsland, Victoria, NSW, Australia (Tran) Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia (Preda) Faculty of Medicine Health and Human Sciences, Macquarie University, Suite 407, 2 Technology Place, Sydney, NSW, Australia Publisher Elsevier Inc. Abstract Background: Robotic-assisted coronary artery bypass grafting (CABG) is gaining attention as a viable alternative to traditional CABG with reported benefits secondary to reduced invasiveness of procedure. Despite this, advantages, the impact of robotic-assisted CABG on critical outcomes such as graft patency, mortality, and need for reintervention remains incompletely defined. The emergence of artificial intelligence (AI) based large language models (LLMs) promise the ability to rapidly deliver robust secondarily derived data, like that obtained from gold standard human meta-analyses. However, there is a lack of direct comparison between these modalities, preventing adoption of these tools in clinical practice. Method(s): We conduct a dual-phase study, by first performing a rigorous, traditional human-led systematic review and meta-analysis comparing robotic-assisted CABG with traditional CABG with respect to graft patency, mortality, reintervention rates, and operative time. In the second phase, we compare outputs of flagship multimodal LLMs from five major vendors-OpenAI (GPT-4o), Anthropic (Claude Sonnet 4), xAI (Grok 3), Google (Gemini 2.5 Pro), and High-Flyer (DeepSeek-R1)-to the same clinical question, called via public, and domain specific API. Sensitivity analyses were performed excluding studies comparing robotic-assisted CABG with conventional minimally invasive direct CABG (MIDCAB) to address procedural heterogeneity. Result(s): Meta-analysis of 27 studies found no significant differences between robotic and conventional CABG in reintervention (OR 0.92, 95% CI 0.61-1.38), mortality (OR 0.65, 95% CI 0.38-1.13), or graft patency (P = 0.29). Sensitivity analysis excluding MIDCAB comparator studies did not materially alter these findings. Operative time analyses showed heterogeneous results: pooled estimates suggested shorter times with robotic CABG, but subgroup analyses revealed longer durations for multi-vessel procedures and shorter harvest times for single ITA grafts. Overall, robotic CABG demonstrated comparable outcomes to conventional surgery. Conclusion(s): Operative time findings were heterogeneous, with shorter durations observed in single-vessel procedures and longer operative times in multivessel robotic CABG. Domain-specific orchestration-such as that employed by CardioCanon-can substantially improve the clinical fidelity and interpretive quality of AI-generated evidence synthesis in cardiovascular surgery. Human oversight remains essential for robust use of AI and LLM in clinical research. Copyright © 2026 The Author(s) <3> Accession Number 2044368887 Title Saphenous vein graft longevity: Novel approaches. Source Cardiovascular Revascularization Medicine. 88 (pp 84-91), 2026. Date of Publication: 01 Jul 2026. Author Abusnina W.; Al Qaraghuli A.K.; Chitturi K.R.; Chaturvedi A.; Verma B.R.; Galo J.; Case B.C.; Ben-Dor I.; Hashim H.D.; Mintz G.S.; Waksman R. Institution (Abusnina, Chitturi, Chaturvedi, Verma, Galo, Case, Ben-Dor, Hashim, Mintz, Waksman) Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States (Al Qaraghuli) MedStar Washington Hospital Center, Washington, DC, United States Publisher Elsevier Inc. Abstract The saphenous vein remains the most commonly used conduit for coronary artery bypass grafting despite its low long-term patency rate. This has prompted extensive research focused on understanding the pathophysiology of graft failure and improving both short- and long-term patency. Several mechanisms of venous graft failure have been discussed in the literature, and different methods have been proposed to prevent and slow this pathological process, with the goal of improving the longevity of grafts. This review aims to provide a comprehensive overview of the novel therapies, techniques, and strategies to improve saphenous vein graft longevity after coronary artery bypass grafting. Copyright © 2026. Published by Elsevier Inc. <4> Accession Number 2045963493 Title Coronary artery disease: stable angina. Source Medicine (United Kingdom). 54(7) (pp 475-482), 2026. Date of Publication: 01 Jul 2026. Author Naderi Z.; Al-Lamee R. Institution (Naderi, Al-Lamee) Imperial College London, United Kingdom (Naderi, Al-Lamee) Imperial College Healthcare NHS Trust, United Kingdom Publisher Elsevier Ltd Abstract A global public health issue, coronary artery disease (CAD) is recognized as the leading cause of morbidity and mortality worldwide. Stable angina, a symptom of CAD, is defined as chest pain typically triggered by exertion or emotional distress and relieved by rest. Effective history-taking, assessing the nature and frequency of symptoms, a good physical examination and identifying key risk factors is vital in the initial care of patients with stable angina, allowing clinicians to opt for the most suitable test to investigate further. Over the last three decades, research has explored the most effective treatment modalities for the management of stable angina, in the form of percutaneous coronary intervention, coronary artery bypass graft surgery and medical therapy. Furthermore, understanding the definition of stable angina, its pathophysiology and patient symptomatology is key to developing trials to address some of the remaining unanswered questions. This chapter outlines some of the most important randomized controlled trials that have played a key role in developing our understanding of the complex aetiology of symptom management, most effective treatments and long-term outcomes of patients with stable angina. Copyright © 2026 Published by Elsevier Ltd. <5> Accession Number 2044357089 Title Angio-Seal plug-based versus dual ProGlide for transfemoral hemostasis in transcatheter aortic valve replacement: a systematic review and meta-analysis. Source Journal of Thrombosis and Thrombolysis. 59(5) (pp 1167-1178), 2026. Date of Publication: 01 Jun 2026. Author Alnomani Y.R.; Algazar M.; Omar M.M.; Aldemerdash M.A.; Henes K.; Arafa A.; Rageh B.M.; Abdelaziz A. Institution (Alnomani) Faculty of Medicine, Benha University, Benha, Egypt (Algazar) Faculty of Medicine, Al-Azhar University, Asyut, Egypt (Omar) Faculty of Medicine, Cairo University, Cairo, Egypt (Aldemerdash) Faculty of Medicine, Sohag university, Sohag, Egypt (Henes) Department of Cardiology, El-Mabarra Health Insurance Hospital, Asyut, Egypt (Arafa) Department of Nephrology, Alexandria University, Alexandria, Egypt (Rageh) Department of Physiology, Sana'a University, Sana'a, Yemen (Abdelaziz) Division of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Bronx, NY, United States (Algazar, Omar, Aldemerdash, Henes, Rageh, Abdelaziz) Medical Research group of Egypt (MRGE), Cairo, Egypt Publisher Springer Abstract Transcatheter aortic valve replacement (TAVR) carries risks of vascular and bleeding complications. We aimed to study the effectiveness of Angio-Seal combined with Perclose ProGlide versus dual Perclose ProGlide following transfemoral TAVR. We searched PubMed, Cochrane Library, Scopus, and WOS from inception until November 2024 for studies comparing Parclose ProGlide with Angio-Seal versus dual Parclose ProGlide in transfemoral TAVR. The primary outcome was major vascular complications, while other secondary outcomes were bleeding complications, the need for additional vascular closure device (VCD), minor vascular complications, unplanned surgical intervention, mortality, hematoma, pseudoaneurysm, and dissection. Dichotomous outcomes were pooled and analyzed using odds ratio (OR) with 95% confidence interval (CI) via the DerSimonian-Laird random-effect model. Seven studies (two RCTs and five observational studies) comprising 1,766 patients were included. In RCT-only analyses, single Perclose ProGlide combined with Angio-Seal showed no significant difference compared with dual Perclose ProGlide in major vascular complications (OR = 0.54, 95% CI [0.28-1.04], P = 0.07) or major/life-threatening bleeding (OR = 0.66, 95% CI [0.25-1.74], P = 0.40). However, it significantly reduced the need for additional vascular closure devices (OR = 0.11, 95% CI [0.05-0.24], P < 0.01) and minor vascular complications (OR = 0.52, 95% CI [0.38-0.72], P < 0.01). For dual Perclose ProGlide combined with Angio-Seal, no RCTs were available; observational evidence suggested a reduction in major/life-threatening bleeding compared to dual Perclose ProGlide (OR = 0.43, 95% CI [0.21 to0.92], p = 0.03), while there was no significant difference between the two groups upon excluding Costa et al. (EuroIntervention, 17:728-735, 2021) (OR = 0.56, 95% CI [0.26 to 1.21], p = 0.14). Based on the available RCTs, the combination of single Perclose ProGlide with Angio-Seal during transfemoral TAVR significantly reduces the need for additional vascular closure devices. It may also reduce minor vascular complications, but this effect is not consistently robust. The pooled analysis of observational studies suggests a potential benefit of dual Perclose ProGlide combined with Angio-Seal for major/life-threatening bleeding. However, this finding was not robust in sensitivity analyses and no RCTs have evaluated this strategy. Copyright © The Author(s) 2026. <6> Accession Number 2047007220 Title The endocarditis team: a review. Source Expert Review of Anti-Infective Therapy. (no pagination), 2026. Date of Publication: 2026. Author Maher A.; Baddour L.M.; El Dalati S.; Miro J.M.; DeSimone D.C.; Marti-Carvajal A.J.; Thornhill M.H.; Dayer M.J. Institution (Maher, Dayer) Department of Cardiology, Mater Private Hospital, Dublin, Ireland (Maher) Department of Cardiology, Beaumont Hospital, Dublin, Ireland (Maher, Dayer) Royal College of Surgeons, Dublin, Ireland (Baddour) Division of Public Health, Infectious Diseases, and Occupational Medicine, Departments of Medicine and Cardiovascular Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN, United States (El Dalati) Division of Infectious Diseases, University of Kentucky Medical Center, Lexington, KY, United States (Miro) Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain (Miro) CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain (Miro) Reial Academia de Medicina de Catalunya (RAMC), Barcelona, Spain (DeSimone) Departments of Medicine and Cardiovascular Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN, United States (Marti-Carvajal) Catedra Rectoral de Medicina Basada en la Evidencia, Universidad de Carabobo, Naguanagua, Venezuela (Marti-Carvajal) Facultad de Medicina, Universidad Francisco de Vitoria, Madrid, Spain (Thornhill) Unit of Oral and Maxillofacial Medicine, Surgery and Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom Publisher Taylor and Francis Ltd. Abstract Introduction: Infective endocarditis (IE) is a complex infection of the endocardium, associated with significant morbidity and mortality. Diagnosing IE can be challenging, as shown by the evolution of original diagnostic criteria. Managing IE is difficult, involving decisions about diagnosis, antibiotic therapy, and surgery. Given these challenges, the 2015 European Society of Cardiology (ESC) IE Guidelines recommended establishing an endocarditis team (ET) in centers managing IE. This review evaluates the evidence supporting ETs. Areas covered: We identified 19 before-and-after studies including 5,327 patients (3,069 before and 2,258 after ET introduction) that examined the impact of implementing an ET on the quality of care for patients with IE. No RCTs were found. The studies were reviewed and revealed a significant reduction in in-hospital mortality (20.9-16.3% [RR 0.71, CI 0.54 to 0.93], p = 0.0154)) and the proportion of endocarditis cases in which an organism was not identified (23.8-9.8%; [RR 0.50, 0.39 to 0.64, p < 0.0001]) following ET introduction. Expert opinion: This review provides consistent observational evidence that ETs are effective in saving lives. Despite limitations, the consistency of effect across multiple studies, biological plausibility, and alignment with successful multidisciplinary models in other diseases support the widespread implementation of ETs. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <7> Accession Number 2046626562 Title Inequalities in Access to and Outcomes of Cardiac Surgery Among Patients with Mental Health Disorders. Source Medical sciences. 14(2) (no pagination), 2026. Article Number: 277. Date of Publication: 01 Jun 2026. Author Leivaditis V.; Mitsos S.; Mulita F.; Maniatopoulos A.; Baikoussis N.G.; Shaska E.; Andrikopoulou C.; Liolis E.; Skoura T.; Antzoulas A.; Boucharas I.; Sepetis A.; Tomos P.; Dahm M. Institution (Leivaditis, Dahm) Department of Cardiothoracic and Vascular Surgery, Westpfalz Klinikum, Kaiserslautern, Germany (Mitsos, Tomos) Department of Thoracic Surgery, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece (Mulita, Andrikopoulou, Boucharas) Department of General Surgery, General Hospital of Eastern Achaia-Unit of Aigio, Aigio, Greece (Maniatopoulos) Department of Electrical and Computer Engineering, Democritus University of Thrace, Xanthi, Greece (Baikoussis) Department of Cardiac Surgery, Ippokrateio General Hospital of Athens, Athens, Greece (Shaska) Department of Psychiatry, "Ali Mihali" Psychiatric Hospital, Vlora, Albania (Liolis) Department of Oncology, General University Hospital of Patras, Patras, Greece (Skoura) Medical School, National and Kapodistrian University of Athens, NKUA, Aretaeion Hospital, Athens, Greece (Antzoulas) Department of Surgery, General University Hospital of Patras, Patras, Greece (Sepetis) Postgraduate Health and Social Care Management Program, Department of Business Administration, University of West Attica, Athens, Greece Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Cardiovascular disease remains the leading global cause of morbidity and mortality. Mental health disorders are common comorbidities that significantly influence how patients access and navigate specialist care. Increasingly, mental illness is recognized not merely as a comorbidity but as a potential driver of inequities in cardiovascular care, affecting diagnosis, referral, procedural management, and long-term secondary prevention. These concerns are particularly relevant in cardiac surgery, where care pathways are complex and resource-intensive. Aims and Objectives: This narrative review examines recent evidence on inequalities in access to cardiac surgery and postoperative outcomes among patients with mental health disorders. Particular emphasis is placed on severe mental illness, mood disorders, anxiety-related conditions, and mixed psychiatric cohorts. Material(s) and Method(s): A structured narrative review approach was employed. PubMed and ScienceDirect were systematically searched for peer-reviewed studies published between 2020 and 2025, including cohort studies, registry analyses, systematic reviews, and meta-analyses. The evidence was synthesized thematically, focusing on access to care, perioperative management, clinical outcomes, underlying mechanisms, ethical considerations, policy implications, and future research directions. Result(s): Evidence suggests that patients with mental health disorders are more likely to undergo cardiac surgery via emergency pathways, experience longer hospital stays, and have higher rates of readmission. Individuals with severe mental illness are less likely to receive invasive coronary procedures compared to the general population and exhibit higher short- and long-term mortality following acute coronary syndromes. Among psychiatric subgroups, psychosis-spectrum disorders appear to be associated with the greatest excess risk of morbidity, mortality, and adverse long-term surgical outcomes. Conclusion(s): Patients with mental health disorders face inequities across the entire surgical pathway, including preoperative, perioperative, and postoperative phases. Key contributing factors include stigma, diagnostic overshadowing, fragmented healthcare systems, socioeconomic disadvantage, and insufficiently developed models of integrated care. Addressing these disparities requires redesigned referral pathways, strengthened multidisciplinary collaboration (including cardiology, cardiac surgery, psychiatry, and primary care), and a shift toward interventional research aimed at reducing inequities rather than solely documenting them. Copyright © 2026 by the authors. <8> Accession Number 2044893954 Title Comparative Outcomes of Transcatheter Edge-to-Edge Repair and Surgical Mitral Valve Repair or Replacement for Degenerative Mitral Regurgitation: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis. Source Catheterization and Cardiovascular Interventions. 108(1) (pp 52-66), 2026. Date of Publication: 01 Jul 2026. Author Kurmasha Y.H.; Hamzah K.A.; Aljubori E.; Mohammed G.; Khan M.; Shweliya M.A.; Eladl H.H.; Al-Dhayani K.M.; Al-Waeli A.R.A.; Zainy H.J.; Al-Shammari A.S.; Sattar Y. Institution (Kurmasha, Aljubori, Mohammed, Zainy) Department of Internal Medicine, College of Medicine, University of Kufa, Najaf, Iraq (Hamzah) Department of Internal Medicine, Al-kindy College of Medicine University of Baghdad, Baghdad, Iraq (Khan) Department of Medicine and Surgery, Liaquat National Hospital and Medical College, Karachi, Pakistan (Shweliya, Al-Shammari) Department of Internal Medicine, College of Medicine, University of Baghdad, Baghdad, Iraq (Eladl) Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt (Al-Dhayani) Department of Internal Medicine, Faculty of Medicine, Amran University, Amran, Yemen (Al-Waeli) Department of Internal Medicine, Internal Medicine Department, Al-Karkh General Hospital, Baghdad, Iraq (Sattar) Camden Clark Medical Center, West Virginia University, Morgantown, WV, United States Publisher John Wiley and Sons Inc Abstract Traditionally, surgical mitral valve repair or replacement (SMVR) has been the mainstay of treatment for mitral regurgitation (MR), providing a long-lasting way to restore valve competence. On the other hand, transcatheter edge-to-edge repair (TEER) has emerged as an option, especially for high surgical risk patients, demonstrating favorable results from short-term to intermediate-term follow-up. This study aims to evaluate and compare the clinical outcomes of TEER versus SMVR in patients with degenerative mitral regurgitation (DMR). This systematic review was conducted in accordance with the PRISMA guidelines. A comprehensive literature search was conducted until February 2, 2025. Relevant randomized controlled trials (RCTs) and cohort studies were included in the analysis. The data were extracted, and analysis was conducted using Review Manager (RevMan) version 5.3. Eight studies involving a total of 13,308 patients were included in the analysis. TEER showed a statistically significantly higher risk of 1-year mortality (RR 1.82, 95% CI: 1.04-3.19) and mitral reintervention at >= 1-year follow-up (RR 4.52, 95% CI: 3.46-5.91). However showing lower risk of new-onset AF (0.21, 95% CI: 0.07-0.67), blood transfusion (RR 0.21, 95% CI, 0.13-0.34), septicemia (RR 0.13, 95% CI: 0.02-0.70), AKI (RR 0.45, 95% CI: 0.24-0.86), shorter hospital stay (MD -4.44 days, 95% CI: -6.60 to -2.27), and ICU stay (MD -1.00 days, 95% CI: -1.13 to -0.88), when compared to the SMVR group. Survival at >= 2-year follow-up was significantly favored in the surgery group (RR 0.72, 95% CI: 0.56-0.93). No significant differences were observed regarding 30-day mortality (RR 0.99, 95% CI: 0.77-1.27), MR grade 1 (RR 1.16, 95% CI: 0.60-2.21), stroke (RR 1.06, 95% CI: 0.37-3.03), HF rehospitalization (RR 2.36, 95% CI: 0.82-6.81), and wound infection (RR, 0.45, 95% CI: 0.05-4.27). TEER was associated with a significantly lower rate of postoperative MR grade 0 (RR 0.20, 95% CI: 0.08-0.49), and significantly higher rates of MR grades 2 (RR 4.82, 95% CI: 1.87-12.40), 3 (RR 8.39, 95% CI: 3.69-19.09), and 4 (RR 4.20, 95% CI: 1.45-12.18), indicating inferior MR resolution. Although TEER is associated with a lower risk of septicemia and may reduce the risk of new-onset AF, hospital stay, and ICU stay, current evidence doesn't support the use of TEER as a substitute for surgery in patients with SMVR, as TEER may be associated with higher 1-year mortality and reduced long-term survival. Further controlled trials are needed to validate these findings and identify patient subgroups that may derive the greatest benefit from TEER. Copyright © 2026 Wiley Periodicals LLC. <9> [Use Link to view the full text] Accession Number 650830397 Title Association Between Acute Gastrointestinal Injury and Mortality Risk in Critically Ill Patients: A Systematic Review and Meta-Analysis. Source Clinical and translational gastroenterology. 17(6) (pp e01028), 2026. Date of Publication: 01 Jun 2026. Author Gao T.; Liu J.; Du Y.; Yang J.; Sheng G.; Zhou L.; Qiu Y.; Zhang Q.; Duan M. Institution (Gao, Duan) Department of Anesthesiology, Jinling Hospital, Nanjing University of Chinese Medicine, Nanjing, China (Liu) Endocrinology Department, Liuzhou Traditional Chinese Medical Hospital, China (Liu, Du, Yang, Sheng, Zhou) Department of Intensive Care Medicine, Liuzhou Traditional Chinese Medical Hospital, China (Du, Yang) Department of Critical Care Medicine, Liuzhou Traditional Chinese Medical Hospital, China (Sheng) Liuzhou Traditional Chinese Medical Hospital, China (Zhou) Rehabilitation Department, Liuzhou Traditional Chinese Medical Hospital, China (Qiu) Guangxi University of Chinese Medicine, China (Zhang) Endocrinology Department, People's Hospital of Chongqing, Chongqing, China Abstract INTRODUCTION: To systematically evaluate the association between severe acute gastrointestinal injury (AGI)/gastrointestinal dysfunction score (GIDS) and mortality risk in adult intensive care unit (ICU) patients. METHOD(S): We conducted a systematic review and meta-analysis. We searched the MEDLINE, Embase, Web of Science, and Cochrane Central Register of Controlled Trials databases for articles published between January 2016 and January 2025. Observational cohort studies reporting mortality outcomes in ICU patients with AGI (grades III-IV vs 0-II) or GIDS (scores 2-4 vs 0-1) were included. Studies focusing on specific subpopulations such as patients after cardiac surgery or with COVID-19 were excluded to maintain population homogeneity. The primary outcome was short-term all-cause mortality. Random-effects meta-analysis using inverse-variance weighting was performed using odds ratios (ORs) with 95% confidence intervals (CIs). RESULT(S): Eight studies involving 2,786 critically ill patients were included. The pooled analysis demonstrated that severe GI dysfunction (AGI III-IV or GIDS 2-4) was significantly associated with increased mortality risk (OR 2.78, 95% CI 2.19-3.52, I 2 = 42.5%). Subgroup analyses by outcome type (28-day/ICU mortality: OR 2.70, 95% CI 2.04-3.58; in-hospital mortality: OR 4.27, 95% CI 1.63-11.18) and scoring system (AGI: OR 2.75, 95% CI 2.07-3.67; GIDS: OR 3.18, 95% CI 1.43-7.07) showed consistent results. The addition of a large-scale prospective Chinese study (n = 1,102) and a multicenter European cohort (n = 540) strengthened the findings and broadened generalizability. DISCUSSION(S): Severe AGI is strongly associated with increased mortality in critically ill patients. Early recognition and assessment of GI dysfunction using standardized grading systems may facilitate risk stratification and guide clinical management. Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology. <10> Accession Number 2043717355 Title Consensus Document on the Multidisciplinary Management of Advanced-Stage Respiratory Diseases. Source Archivos de Bronconeumologia. 62(7) (pp 481-498), 2026. Date of Publication: 01 Jul 2026. Author de Miguel-Diez J.; Castillo-Padros M.; Figueira-Goncalves J.M.; Torres-Castro R.; Gainza-Miranda D.; Golpe R.; Cuervo-Pinna M.A.; Perez-Rojo R.; Gonzalez-Barboteo J.; Callejas-Gonzalez F.J.; Calvo-Espinos C.; Rio-Ramirez M.T.; Olalla-Gallo M.A.; Salinas-Lasa M.B.; Salcedo-Peris T. Institution (de Miguel-Diez) Servicio de Neumologia, Hospital General Universitario Gregorio Maranon, Instituto de Investigacion Sanitaria Gregorio Maranon (IiSGM), Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain (Castillo-Padros) Unidad de Cuidados Paliativos, Complejo Hospitalario Universitario Nuestra Senora de Candelaria, Tenerife, Spain (Figueira-Goncalves) Servicio de Neumologia, Complejo Hospitalario Universitario Nuestra Senora de Candelaria, Tenerife, Spain (Torres-Castro) Departamento de Kinesiologia, Facultad de Medicina, Universidad de Chile, Santiago, Chile (Gainza-Miranda) Unidad de Cuidados Paliativos, Hospital Universitario Principe de Asturias, Madrid, Spain (Golpe) Servicio de Neumologia, Hospital Universitario Lucus Augusti, Lugo, Spain (Cuervo-Pinna) Equipo de Cuidados Paliativos, Hospital Universitario de Badajoz, Badajoz, Spain (Perez-Rojo) Servicio de Neumologia, Hospital Universitario 12 de Octubre, Madrid, Spain (Gonzalez-Barboteo) Servicio de Cuidados Paliativos, Grupo de Investigacion y Conocimiento en Cuidados Paliativos (GRICOPAL), Instituto Catalan de Oncologia-L'Hospitalet, Barcelona, Spain (Callejas-Gonzalez) Servicio de Neumologia, Complejo Hospitalario Universitario de Albacete, Albacete, Spain (Calvo-Espinos) Unidad de Cuidados Paliativos, Fundacion Rioja Salud, La Rioja, Spain (Rio-Ramirez) Servicio de Neumologia, Hospital Universitario de Getafe, Universidad Europea de Madrid, Madrid, Spain (Olalla-Gallo) Equipo de Soporte de Atencion Domiciliaria, Gerencia de Atencion Primaria de Burgos, SACYL, Burgos, Spain (Salinas-Lasa) Servicio de Neumologia, Hospital Universitario Galdakao-Usansolo, Galdakao, Spain (Salcedo-Peris) Unidad de Cuidados Paliativos, Hospital General Universitario Ciudad Real, Ciudad Real, Spain Publisher Sociedad Espanola de Neumologia y Cirugia Toracica (SEPAR) Abstract Advanced respiratory diseases, particularly chronic obstructive pulmonary disease (COPD) and interstitial lung diseases (ILD), constitute an increasing challenge for healthcare systems due to their high prevalence, substantial symptom burden, and significant resource use. This consensus document, developed jointly by the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) and the Spanish Society of Palliative Care (SECPAL), provides recommendations for a multidisciplinary, integrated model of care. Using the SIGN methodology and a systematic literature review, a multidisciplinary panel developed 70 evidence-based recommendations addressing key domains: identification of patients with palliative care needs; management of respiratory symptoms; strategies to improve quality of life; communication and shared decision-making; caregiver support; and coordination across care settings. A needs-based approach, rather than reliance on prognosis alone, is recommended to facilitate earlier recognition of patients with advanced COPD and ILD and to enable the timely integration of palliative care alongside disease-directed therapies. Adoption of these recommendations is expected to improve quality of life, reduce symptom burden and suffering, and optimize care for patients with advanced respiratory diseases. Copyright © 2026 SEPAR <11> Accession Number 2041351853 Title Quality indicators in pediatric cardiopulmonary bypass: Current perspectives and future directions. Source Perfusion (United Kingdom). 41(5) (pp 519-534), 2026. Date of Publication: 01 Jul 2026. Author Yoneyama F.; Van Dyke T.R.; Brenes J. Institution (Yoneyama, Brenes) Department of Congenital Heart Surgery, Baylor College of Medicine, Texas Children's Hospital, Austin, TX, United States (Van Dyke) Department of Perfusion, Texas Children's Hospital, Austin, TX, United States Publisher SAGE Publications Ltd Abstract Introduction: Cardiopulmonary bypass (CPB) plays a central role in pediatric cardiac surgery, yet standardized quality indicators (QIs) specific to pediatric practice remain underutilized across institutions. Method(s): A comprehensive review of literature from 2010 to 2025 was conducted using PubMed, Embase, and the Cochrane Library. Eligible studies included randomized trials, observational research, and meta-analyses. Result(s): DO<inf>2</inf>i > 340 mL/min/m2 in neonates and >400 mL/min/m2 in infants was associated with a lower risk of acute kidney injury (AKI). Lactate >3 mmol/L predicted major morbidity, while MAP >40-45 mmHg correlated with adequate perfusion. Maintaining Hct >=25% and a fluid balance within +/-5% of baseline also supported improved postoperative outcomes. The integration of real-time multimodal monitoring, including NIRS and venous oxygen metrics, enhances individualized perfusion management. Conclusion(s): Adopting and standardizing QIs in pediatric CPB supports early detection of inadequate perfusion and enhances surgical safety. A structured, multimodal QI framework can facilitate institutional benchmarking, improve patient outcomes, and guide future innovation in pediatric perfusion practices. Copyright © The Author(s) 2025 <12> Accession Number 2041273518 Title Comparative efficacy and safety of prothrombin complex concentrate versus fresh frozen plasma in cardiac surgery: A meta-analysis of randomized controlled trials. Source Perfusion (United Kingdom). 41(5) (pp 616-623), 2026. Date of Publication: 01 Jul 2026. Author Khan T.M.; Khan G.T.; Ahmed M.; Uddin M.S.; Ali D. Institution (Khan, Khan, Ahmed, Uddin, Ali) Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan Publisher SAGE Publications Ltd Abstract Background: Postoperative bleeding due to acquired coagulopathy is a common and serious complication following cardiac surgery. Fresh frozen plasma (FFP) and prothrombin complex concentrate (PCC) are the principal therapies used to correct coagulopathy in this setting. However, their comparative effectiveness and safety remain uncertain. Method(s): MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were systematically searched through March 2025 to identify randomized controlled trials (RCTs) comparing PCC and FFP in adult cardiac surgery patients with postoperative coagulopathy. All analyses were performed using Review Manager (Version 5.4; Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2020). Result(s): Four RCTs including a total of 671 patients were eligible for inclusion. Compared to FFP, PCC was associated with significantly lower chest tube drainage volume (mean difference [MD], -162.14; 95% CI: -264.47 to -59.81 mL; P = 0.002; I2 = 49%), reduced RBC transfusion rate (risk ratio [RR], 0.77; 95% CI: 0.65 to 0.91; P = 0.002; I2 = 27%), and fewer mean RBC units administered (MD, -0.86 units; 95% CI: -1.23 to -0.49 units; P < 0.001; I2 = 0%). No significant differences were found between groups in the rates of reoperation for bleeding, thromboembolic events, stroke or transient ischemic attack, acute kidney injury, or mortality. Length of stay in the intensive care unit and hospital were also comparable between groups. Conclusion(s): PCC demonstrates superior hemostatic efficacy compared to FFP in adult cardiac surgery patients, while maintaining a comparable safety profile. These findings support its use as a more effective and practical alternative for managing postoperative coagulopathy in this population. Copyright © The Author(s) 2025 <13> Accession Number 2041697709 Title The internal mammary artery - use as a free graft in coronary artery bypass grafting - evidence, technical considerations and controversies. Source Perfusion (United Kingdom). 41(5) (pp 535-546), 2026. Date of Publication: 01 Jul 2026. Author Navaratnarajah M.; Al-Zubaidi F.I.; Raja S.G. Institution (Navaratnarajah) Department of Cardiac Surgery, St Thomas Hospital, London, United Kingdom (Al-Zubaidi) Department of Cardiac Surgery, John Radcliffe Hospital, Oxford, United Kingdom (Raja) Department of Cardiac Surgery, Harefield Hospital, Middlesex, United Kingdom Publisher SAGE Publications Ltd Abstract Background: In-situ internal mammary artery (IMA) grafting remains the gold standard in coronary artery bypass grafting (CABG), particularly for left anterior descending artery revascularisation. However, the role of free-IMA grafts-especially free right IMA (RIMA) and select cases of free left IMA (LIMA)-has expanded in response to anatomical and technical constraints. This narrative review synthesises current evidence on free-IMA use during CABG. Method(s): A structured literature search was conducted using PubMed (1946-2025) and Embase (1974-2025), supplemented by Web of Science, Google Scholar, and thesis repositories. Studies were included if they reported outcomes related to free-IMA grafting, regardless of pump status or harvesting technique. Of 74 eligible studies, 9 chosen studies specifically reported free-RIMA outcomes and were analysed in detail. Result(s): Free-RIMA grafting demonstrated excellent long-term patency (up to 96%) and favourable survival outcomes when used as composite or direct aorto-coronary grafts. Multi-arterial grafting (MAG) and total arterial grafting (TAG) strategies incorporating free-IMA conduits were associated with reduced major adverse cardiac events (MACE) and improved freedom from repeat revascularisation. Despite these benefits, uptake of free-IMA techniques remains low in Europe and North America, often limited by institutional preferences and operator experience. Conclusion(s): Current evidence supports the selective use of free-IMA grafts in CABG, particularly when in-situ deployment is not feasible. Prospective studies are needed to validate long-term outcomes beyond 10 years, compare free-IMA with radial artery grafts, and define optimal arterial configurations for durable revascularisation. Copyright © The Author(s) 2025. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). <14> Accession Number 2041175215 Title Comparison of post-operative inflammatory biomarkers between minimal invasive extracorporeal circulation and conventional extracorporeal circulation in cardiac surgery. A meta-analysis of 15 randomized control trials. Source Perfusion (United Kingdom). 41(5) (pp 624-638), 2026. Date of Publication: 01 Jul 2026. Author Motawea K.R.; Ibrahim M.; Amer A.E.; Kandil O.; Abourady Y.; Pelletier M.; Abu-Omar Y.; El-Diasty M. Institution (Motawea, Abourady, Abu-Omar, El-Diasty) Division of Cardiac Surgery, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Centre, Cleveland, OH, United States (Ibrahim) Banner University Medical Center, Phoenix, AZ, United States (Amer, Kandil) Faculty of Medicine, Alexandria University, Alexandria, Egypt (Pelletier) Division of Cardiac Surgery, Yale School of Medicine, New Haven, CT, United States Publisher SAGE Publications Ltd Abstract Background/Aim: Recent literature suggested that the use of Minimal Invasive Extracorporeal Circulation (MIECC) may mitigate the inflammatory response in patients undergoing cardiac surgery. We aimed to perform a meta-analysis to compare post-operative inflammatory biomarkers between MIECC and conventional cardiopulmonary bypass in cardiac surgery. Method(s): We searched PubMed, Web of Science, Scopus, and Cochrane Library for randomized control trials (RCTs) that quantified systemic inflammatory mediators after the use of MIECC compared to conventional extracorporeal circulation (CECC). Result(s): Fifteen RCTs with a total of 1189 patients were identified. The inflammatory markers that were investigated included Tumor Necrosis Factor alpha (TNF-alpha), Interleukin 6 (IL-6), Interleukin 8 (IL-8), Interleukin 10 (IL-10), Elastase, C-Reactive protein (CRP) in addition to leucocyte count. No significant difference between both groups was detected for TNF-alpha and IL-6 at (30 minutes, 1 to 2 hours, 6 hours, 24 hours, and 48 hours), IL-8 at (30 minutes and 48 hours), Interleukin 10 at 6 hours, Elastase at (30 minutes to 1 hour, and 24 hours), CRP at 48 hours, and leucocytic count at (2 hours, 6 hours, 24 hours, and 48 hours). Pooled analysis showed a significant association between MIECC group and lower levels of TNF-alpha at 6 hours (p-value <.0001), IL-8 at 6 hours (p-value = .0005) and 24 hours (p-value = .005), IL-10 at 24 hours (p-value <.00,001), and Elastase at 6 hours (p-value = .04). However, CRP was lower, at 24 hours, in the CECC group (MD = 1.42, 95% CI = 0.13 to 2.71, p-value = .03). Conclusion(s): Our findings suggest that MIECC may be associated with lower levels of systemic inflammatory mediators early after cardiac surgery. However, the impact of this reduction on clinical outcomes needs to be defined to justify the use of MIECC in the routine clinical practice. Copyright © The Author(s) 2025 <15> Accession Number 2040418748 Title Delivery of oxygen during cardiopulmonary bypass and associated clinical outcomes among adult cardiac surgery patients: A systematic review. Source Perfusion (United Kingdom). 41(5) (pp 509-518), 2026. Date of Publication: 01 Jul 2026. Author Dias R.D.; Borges P.; Rance G.; Srey R.; Kennedy Metz L.R.; Martinez-Rioux A.; Arney D.; Paladugu P.; Gikandi A.; Miccile C.; Harari R.; Iwai K.; Fitzgerald J.; O'Gara P.; Shann K.; Gombolay M.; Zenati M.A. Institution (Dias, Borges, Paladugu, Miccile, Harari) Medical AI & Cognitive Engineering (MAICE) Lab, Department of Emergency Medicine, Mass General Brigham, Boston, MA, United States (Dias, Borges, Arney, Gikandi, Harari, Zenati) Harvard Medical School, Boston, MA, United States (Rance) Cape Cod Healthcare, Hyannis, MA, United States (Srey) InvoCirc, Inc, Sudbury, MA, United States (Kennedy Metz) Psychology Department, Roanoke College, Salem, VA, United States (Martinez-Rioux, Fitzgerald, O'Gara, Zenati) Division of Cardiac Surgery, Veterans Healthcare System, Boston, MA, United States (Paladugu, Gombolay) Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States (Harari) Department of Radiology, Mass General Brigham, Boston, MA, United States (Iwai, Shann, Zenati) Division of Cardiac Surgery, Mass General Brigham, Boston, MA, United States Publisher SAGE Publications Ltd Abstract Purpose: Oxygen delivery (DO<inf>2</inf>) during cardiopulmonary bypass (CPB) is critical in preventing postoperative complications in adult cardiac surgery. This systematic review aimed to assess the relationship between intraoperative DO<inf>2</inf> during CPB, particularly within Goal-directed Perfusion (GDP) strategies, and associated clinical outcomes. Method(s): A systematic search of MEDLINE, Embase, Web of Science, PsycINFO, CINAHL, PROSPERO, and Cochrane was conducted from database inception through December 2024, adhering to PRISMA 2020 guidelines. Studies reported intraoperative DO<inf>2</inf> measurements and their relationship with clinical outcomes among adults undergoing cardiac surgery with CPB. Data extraction and quality assessment were performed independently by two reviewers. Result(s): Thirty-nine studies (71,050 patients) were included, with acute kidney injury (AKI) being the most frequently studied outcome (84.6% of studies). A consistent association was found between lower intraoperative DO<inf>2</inf> and increased risk of AKI, intraoperative lactate elevations, and prolonged mechanical ventilation. Five randomized controlled trials (RCTs) demonstrated that maintaining DO<inf>2</inf> levels, indexed to body surface area (iDO<inf>2</inf>), above a threshold of 270-300 mL/min/m2 significantly reduced the risk of postoperative AKI. However, evidence linking DO<inf>2</inf> management directly to reductions in mortality or neurologic complications remains limited, as well as studies reporting compliance with GDP strategies. Conclusion(s): Maintaining adequate iDO<inf>2</inf> during CPB significantly reduces postoperative complications, especially AKI. These findings underscore the clinical relevance of GDP strategies, highlighting the importance of individualized perfusion management to optimize outcomes. Further large-scale RCTs are needed to confirm these benefits, standardize specific iDO<inf>2</inf> threshold levels that are beneficial, and to explore strategies that impact mortality and neurologic outcomes, as well as investigate the role that temperature management plays in DO<inf>2</inf> threshold determination. Copyright © The Author(s) 2025 <16> Accession Number 2040841775 Title Entropy-guided sevoflurane administration during cardiopulmonary bypass surgery in the paediatric population. Source Perfusion (United Kingdom). 41(5) (pp 731-739), 2026. Date of Publication: 01 Jul 2026. Author Ankur A.; Kumar A.; Paret M.L.; Joshi S.; Parikh B. Institution (Ankur, Kumar, Joshi) Department of Anaesthesia & Critical Care, Armed Forces Medical College, Pune, India (Paret) Department of Anaesthesia & Critical Care, Institute of Naval Medicine, INHS Asvini, Mumbai, India (Parikh) Department of Anaesthesia & Critical Care, Command Hospital (CC), Lucknow, India Publisher SAGE Publications Ltd Abstract Background: Maintaining optimal anesthetic depth during cardiopulmonary bypass (CPB) in pediatric patients is challenging due to altered physiology and unreliable conventional monitoring. Entropy, a processed electroencephalogram metric, offers a potential solution. This study aimed to evaluate the relationship between end oxygenator sevoflurane concentration and entropy values during pediatric CPB using fixed-dose versus entropy-guided sevoflurane administration. Methodology: A prospective, randomized study was conducted on 62 pediatric patients undergoing congenital heart surgery with CPB. Patients were allocated into two groups: Group A received fixed-dose sevoflurane (1% v/v), and Group B received sevoflurane titrated to maintain entropy values between 40 and 60. Parameters such as end oxygenator sevoflurane concentration, entropy (Response and State entropy, RE and SE), and sevoflurane consumption were recorded intraoperatively. Postoperative hemodynamic data, length of stay, and complication rates were assessed. Result(s): Entropy-guided patients showed significantly higher end oxygenator sevoflurane concentrations [1.64 (1.51-1.85)% versus 1.0%, p = .001] and sevoflurane consumption (1.26 +/- 0.12 vs 0.645 +/- 0.03 mL/min, p = .001). RE and SE values were significantly lower in the entropy group (p = .001), indicating better anesthetic depth control. A negative correlation was found between entropy and sevoflurane concentration (r = -0.6987, p = .02). Despite higher postoperative inotropic scores in the entropy group (p = .001), no significant differences were found in length of stay, mechanical ventilation duration, or morbidity and mortality rates between groups. Conclusion(s): Entropy-guided sevoflurane administration during pediatric CPB provides improved anesthetic depth control at the cost of higher anesthetic and inotropic requirements. However, it does not adversely affect clinical outcomes, supporting its safety and potential utility in refining pediatric anesthesia practices. Copyright © The Author(s) 2025 <17> Accession Number 2041157397 Title Veno-pulmonary extracorporeal membrane oxygenation for concomitant right ventricular and respiratory support: A systematic review of utilization patterns and outcomes. Source Perfusion (United Kingdom). 41(5) (pp 559-567), 2026. Date of Publication: 01 Jul 2026. Author Nasher N.; Mounzer M.; Mallur K.; Fayek F.B.; Rahimov D.; Rame J.E.; Alvarez R.J.; Entwistle J.W.; Rajagopal K.; Hoopes C.W.; Tchantchaleishvili V. Institution (Nasher, Rahimov, Entwistle, Rajagopal, Hoopes, Tchantchaleishvili) Department of Cardiac Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, United States (Mounzer, Mallur, Fayek) Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States (Rame, Alvarez) Division of Cardiology, Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, United States Publisher SAGE Publications Ltd Abstract Background: Veno-pulmonary artery extracorporeal membrane oxygenation (V-P ECMO) is a configuration of extracorporeal life support (ECLS) for patients with isolated or predominantly right ventricular (RV) failure and inadequate gas exchange due to severe respiratory failure. We aimed to systematically review the existing literature to better understand its utilization patterns and associated outcomes. Method(s): The electronic search identified all studies reporting the characteristics and outcomes of V-P ECMO use in adult patients. Patient-level data for 110 patients from 60 case reports and case series were extracted and analyzed. Result(s): The median patient age was 45 [IQR, 32-56] years, and 63% were male. Patients most commonly presented with moderate to severe RV dysfunction (90%), along with acute hypoxic respiratory failure (64%) and severe pulmonary hypertension (23%). On presentation, 85% of patients were placed on ventilatory support for a median duration of 13 [5-32] days. V-P ECMO was initiated in the setting of a primary cardiorespiratory pathology in 75% of cases, and major chest surgery in 25% of cases. A percutaneous dual-lumen cannula was used in 64% of cases, of which 29% required an additional cannula. The median duration of V-P ECMO support was 12 [7-31] days. Overall, 42% of patients recovered, 26% underwent lung transplantation, and 9% underwent heart transplantation. In-hospital mortality was 22%. At a median follow-up time of 81 [44-181] days, overall survival was 75%. Conclusion(s): V-P ECMO can be utilized in place of traditional ECLS strategies with favorable outcomes across various settings. Copyright © The Author(s) 2025 <18> Accession Number 2046598163 Title Inhaled nitric oxide for reducing major adverse events requiring intensive life support in adults undergoing cardiac surgery with cardiopulmonary bypass: protocol for a phase III, double-blind, multicenter randomized controlled trial (NORISC Trial). Source Nitric Oxide - Biology and Chemistry. 164 (pp 19-28), 2026. Date of Publication: 01 Oct 2026. Author Wang L.; Kamenshchikov N.O.; Zhang H.; Huang M.; Tyo M.A.; Koyanidi A.Y.; Shi J.; Evgeny G.; Sergey P.; Zhang Z.; Yang X.; Gao B.; Boboshko V.; Moroz G.; Vasilev M.; Zhai W.; Min J.; Liu Z.; Wang J.; Miao Z.H.; Wu Q.; Song Z.; Berra L.; Lei C. Institution (Wang, Zhang, Huang, Zhang, Yang, Gao, Lei) Department of Anesthesiology and Perioperative Medicine, Key Laboratory of Anesthesiology (The Fourth Military Medical University), Ministry of Education of China, Anesthesia Clinical Research Center, Xijing Hospital, The Fourth Military Medical University, Xi'an, China (Kamenshchikov, Tyo, Koyanidi) Laboratory of Critical Care Medicine, Department of Anesthesiology and Intensive Care Medicine, Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, 111a Kievskaya St., Tomsk, Russian Federation (Shi) Department of Anesthesiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China (Evgeny, Sergey) Scientific Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russian Federation (Boboshko, Moroz, Vasilev) Department of Anesthesiology and Intensive Care, Meshalkin National Medical Research Center, Federal State Budgetary Institution National Medical Research Center Named After Academician E.N. Meshalkin of the Ministry of Health of the Russian Federation, Novosibirsk, Russian Federation (Zhai) Tianjin University Chest Hospital, Tianjin Key Laboratory of Cardiovascular Emergency and Critical Care, Tianjin Municipal Science and Technology Bureau, Tianjin, China (Min, Liu) Department of Anesthesiology, The First Affiliated Hospital of Nanchang University, Nanchang, China (Wang, Miao) Anesthesia & Operation Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China (Wu) Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Song) Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, China (Berra) Department of Anesthesia, Mass General Brigham, Anesthesia Center for Critical Care Research, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States Publisher Academic Press Inc. Abstract Introduction Cardiac surgery remains a high-risk intervention, with postoperative complications, including ischemic events (myocardial infarction and stroke), acute kidney injury, respiratory failure, and neurocognitive dysfunction, affecting up to 30% of patients and resulting in increased mortality. While inhaled nitric oxide (NO) is traditionally used for pulmonary hypertension and right ventricular dysfunction, recent experimental and clinical studies suggest its organ-protective potential may mitigate ischemia-reperfusion injury and hemolysis induced toxicity. However, whether these physiological and mechanistic effects translate into improved patient-centered outcomes remains unproven in a large-scale setting. The NORISC trial aims to determine whether perioperative NO administration reduces major complications requiring intensive life support following cardiac surgery. Method and analysis This is an international, multicenter, double-blind, randomized (1:1), parallel-arm superiority trial. We will enroll 3650 patients undergoing elective cardiac surgery with cardiopulmonary bypass (CPB). The intervention group will receive NO at 80 parts per million (ppm) via the oxygenator sweep gas during CPB, followed by inhaled NO at 40-80 ppm via mechanical ventilation for up to 6 h postoperatively or until extubation, whichever occurs first. The control group will receive standard care with placebo gas. The primary outcome is a 30-d composite of all-cause mortality and major adverse events (MAEs) necessitating intensive life support (e.g., stage 3 AKI, mechanical circulatory support, or prolonged ventilation, etc). Based on a hypothesized 20% relative risk reduction (from 20% to 16%), a sample size of 3650 provides 80% power at a one-sided alpha of 0.025. Conclusion/Expected Impact: The NORISC trial will provide high-quality, definitive evidence on the clinical efficacy of NO in cardiac surgery. By targeting hemolysis-mediated organ injury through a standardized delivery strategy, this study has the potential to redefine perioperative management and reduce the global burden of postoperative morbidity. Ethics and dissemination The protocol has received Institutional Review Board approval at all participating centers. Recruitment commenced in May 2025. Results will be disseminated through peer-reviewed publications and international scientific congresses. Trial registration number ClinicalTrials.gov NCT06702553 . Copyright © 2026 Elsevier Inc. <19> Accession Number 2046101340 Title Systematic review of culture-confirmed septic pericarditis in systemic lupus erythematosus with an index case. Source Lupus Science and Medicine. 13(1) (no pagination), 2026. Date of Publication: 27 Apr 2026. Author Alamlih L.; Neiroukh H.; Qawasmeh N.; Rayyan M.A.; Alamlih H.; Doudin K.; Amro T.; Abumounshar J.; Henahen H. Institution (Alamlih, Alamlih) Internal Medicine, Al-Quds University, Jerusalem, Palestine (Alamlih, Qawasmeh, Rayyan, Alamlih, Doudin, Amro, Abumounshar, Henahen) Internal Medicine Department, Al-Mezan Specialty Hospital, Hebron, Palestine (Neiroukh) Al-Quds University, Jerusalem, Palestine Publisher BMJ Publishing Group Abstract Objective: Pericardial involvement is common in systemic lupus erythematosus (SLE), but distinguishing sterile immune-mediated pericarditis from septic pericarditis is difficult because clinical features overlap with sepsis, immunosuppressive effects and nonspecific serologic abnormalities. Septic pericarditis in SLE is rare yet potentially fatal and existing evidence is limited to isolated case reports. Case presentation: We describe a fatal case of a patient in the fourth decade of life with newly diagnosed SLE who developed methicillin-resistant Staphylococcus aureus (MRSA) purulent pericarditis. Despite broad-spectrum antibiotics and immunosuppressive therapy for multisystem lupus activity, the patient deteriorated rapidly due to MRSA-positive pericarditis. Method(s): In parallel with this index case, we systematically searched PubMed/MEDLINE, Google Scholar and ResearchGate for case reports and series of microbiologically confirmed septic or purulent pericarditis in SLE, from inception to March 2025 and updated through November 2025. Two reviewers independently screened studies; extracted relevant clinical, microbiologic, immunologic and outcome data; and synthesised findings descriptively. Result(s): Fifteen published culture-confirmed cases plus our index case were identified (total n=16). Most patients were female (93.8%), with a mean age of 34.1 years. Staphylococcus aureus (including MRSA) and Salmonella species predominated. Dyspnoea (68.8%) was more frequent than fever (31.3%) and nearly all patients progressed to cardiac tamponade requiring urgent drainage. Survival was 93.8% when timely pericardial drainage and pathogen-directed antimicrobial therapy were achieved, while routine serological markers failed to distinguish infection from lupus flare. Conclusion(s): Septic pericarditis in SLE is uncommon but rapidly progressive. Early echocardiography and a low threshold for diagnostic pericardiocentesis are essential to prevent fatal delay. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/. <20> Accession Number 2047031859 Title HLA selected red cell transfusions to prevent HLA sensitisation: a prospective, double-blinded, randomised controlled trial. Source Transplant Immunology. 97 (no pagination), 2026. Article Number: 102412. Date of Publication: 01 Aug 2026. Author McComish J.S.; Brewster J.; Brizard C.P.; Carreiro E.; Hogan C.; Hu R.; Ng I.; Paul S.; Williams D.; Zantomio D.; Daly J. Institution (McComish, Brewster, Carreiro, Daly) Australian Red Cross Lifeblood, Melbourne, Australia (Brizard) Cardiac Surgery Unit, Royal Children's Hospital, Melbourne, Australia (Hogan, Zantomio) Austin Health, Melbourne, Australia (Hu, Ng) Department of Critical Care, The University of Melbourne, Melbourne, Australia (Hu) Department of Anaesthesia, Austin Health, Melbourne, Australia (Ng, Williams) Department of Anaesthesia & Pain Management, Royal Melbourne Hospital, Melbourne, Australia (Paul) College of Life Sciences, University of Leicester, Leicester, United Kingdom (Williams) Department of Medicine, University of Melbourne, Melbourne, Australia Publisher Elsevier B.V. Abstract Human Leucocyte Antigen (HLA) sensitisation following red cell transfusion can disrupt planned transplantation and impair outcomes. We conducted a prospective, randomised controlled, double blinded, parallel arm study to evaluate the efficacy of HLA selected red cell transfusions in preventing blood donor specific HLA antibodies (bDSA). Participants were recruited to two groups: adults requiring transfusion or surgery, and paediatric cardiac surgery patients; and randomised to receive red cells selected for HLA compatibility from HLA-typed blood donors, or unselected red cells. Exclusion criteria included recent transfusions, immunoglobulin or B cell depleting treatments, and requirement for additional blood products. The primary outcome was cumulative incidence of de novo bDSA, by HLA antibody testing pre- and post-transfusion. 73 adult participants and 68 paediatric participants were randomised, with 26 and 52 respectively completing the study. Many randomised participants (40% and 59% in adult and paediatric groups respectively) received non-trial products, and there was no significant difference between treatment groups in the intention-to-treat analyses. No de novo bDSA were detected in participants who had received trial products only, while de novo bDSA were detected in participants who received unselected red cell products. Larger studies could confirm the potential to avoid HLA sensitisation by blood donor selection. Copyright © 2026 Published by Elsevier B.V. <21> Accession Number 2007551380 Title Dexmedetomidine improves early postoperative neurocognitive disorder in elderly male patients undergoing thoracoscopic lobectomy. Source Experimental and Therapeutic Medicine. 20(4) (pp 3867-3876), 2020. Date of Publication: 01 Oct 2020. Author Shi H.; Du X.; Wu F.; Hu Y.; Xv Z.; Mi W. Institution (Shi, Xv, Mi) Anesthesia and Operation Center, Chinese PLA General Hospital, Beijing, China (Shi, Du, Wu, Hu) Department of Anesthesiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China Publisher Spandidos Publications Abstract Perioperative neurocognitive disorder (PND) is a common complication following thoracic surgery that frequently occurs in patients >=65 years. PND includes postoperative cognitive dysfunction (POCD) and postoperative delirium (POD). To investigate whether intravenous dexmedetomidine (DEX) is able to improve neurocognitive function in elderly male patients following thoracoscopic lobectomy, a randomized, double-blinded, placebo-controlled trial was performed at the Affiliated Hospital of Inner Mongolia Medical University (Hohhot, China). Patients aged >=65 years were enrolled and were subjected to thoracic surgery under general anesthesia. A computer-generated randomization sequence was used to randomly assign patients (at a 1:1 ratio) to receive either intravenous DEX (0.5 microg/kg per h, from induction until chest closure) or placebo (intravenous normal saline).TheprimaryendpointwastheresultoftheMini-Mental State Examination (MMSE). The secondary endpoints were the results of the Montreal Cognitive Assessment (MoCA) and those obtained with the Confusion Assessment Method (CAM), as well as the incidence of POCD and POD during the first 7 postoperative days. Other observational indexes included sleep quality at night, self-anxiety scale prior to the operation and 7 days following the operation and the visual analogue scale (VAS) score at rest and during movement on the first and third day following the operation. Furthermore, at 6 h following surgery, the MMSE score in the DEX group was significantly higher than that in the saline group. At 6 h and on the first day postoperatively, the MoCA score in the DEX group was significantly higher than that in the saline group. The incidence of POCD and POD in the DEX group was 13.2 and 7.5%, respectively, while that in the saline group was 35.8 and 11.3%, respectively. There was a significant difference in the incidence of POCD between the two groups (P<0.01). In the DEX group, mean sleep quality was increased, whereas the mean VAS was decreased compared with the corresponding values in the saline group. In conclusion, elderly male patients who underwent thoracoscopic lobectomy under continuous infusion of DEX (0.5 microg/kg/h) exhibited a reduced incidence of POCD during the first 7 postoperative days as compared with the placebo group. Furthermore, DEX improved the subjective sleep quality in the first postoperative night, reduced anxiety and alleviated postoperative pain. In addition, it increased the incidence of bradycardia. The present study was registered in the Chinese Clinical Trial Registry (www.chictr.org.cn; registration no. ChiCTR-IPR-17010958). Copyright © This work is licensed under a Creative Commons Attribution 4.0 International (CC BY 4.0) License <22> Accession Number 2046873996 Title Left atrial appendage closure in patients with non-valvular atrial fibrillation and end stage chronic KIDNEY disease: Rationale and design of the prospective randomized LAA-KIDNEY trial. Source American Heart Journal. 300 (no pagination), 2026. Article Number: 107474. Date of Publication: 01 Oct 2026. Author Saraei R.; Heine G.H.; Osmancik P.; Schewel J.; Sandri M.; Landmesser U.; Schwenger V.; Latus J.; Bekeredjian R.; Chun J.; Haeusler K.G.; Paitazoglou C.; Sigusch H.; Thiele H.; Skurk C.; Rychlik I.; Schmidt B.; Stiermaier T.; Schneider S.; Eitel I. Institution (Saraei, Paitazoglou, Stiermaier, Eitel) Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Heart Center Lubeck, Lubeck, Germany (Saraei, Paitazoglou, Stiermaier, Eitel) German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lubeck, Lubeck, Germany (Heine) Internal Medicine IV, Department of Nephrology and Hypertension, Saarland University Medical Center, Homburg, Germany (Heine) Medical Clinic II, Department of Nephrology and Hypertension, Agaplesion Markus Hospital, Frankfurt am Main, Germany (Osmancik) Department of Cardiology, Charles University of Prague, Prague, Czechia (Schewel) Department of Cardiology, Marienkrankenhaus Hamburg, Hamburg, Germany (Sandri, Thiele) Department of Internal Medicine/Cardiology, Heart Center Leipzig - University Hospital, Leipzig, Germany (Landmesser, Skurk) Department of Cardiology, Charite-University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany (Landmesser, Skurk) German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany (Schwenger) Department of Nephrology, Klinikum Stuttgart, Stuttgart, Germany (Latus) Department of Internal Medicine and Nephrology, Robert-Bosch-Krankenhaus, Stuttgart, Germany (Bekeredjian) Department of Cardiology and Angiology, Bosch Health Campus, Robert Bosch Hospital, Stuttgart, Germany (Chun, Schmidt) Cardioangiologisches Centrum Bethanien, Agaplesion Markus Krankenhaus, Frankfurt am Main, Germany (Haeusler) Department of Neurology, Universitatsklinikum Ulm, Ulm, Germany (Sigusch) Department of Cardiology, Heinrich-Braun-Hospital, Zwickau, Germany (Rychlik) First Department of Internal Medicine, Third Faculty of Medicine, Charles University, Faculty Hospital Kralovske Vinohrady, Prague, Czechia (Schneider) Institut fur Herzinfarktforschung, Ludwigshafen, Germany Publisher Elsevier Inc. Abstract Background Patients with atrial fibrillation (AF) and kidney failure are at particularly high risk of both thromboembolic and bleeding complications. The safety and efficacy of oral anticoagulation in this population remain uncertain, as pivotal direct oral anticoagulant (DOAC) trials excluded patients with kidney failure and warfarin has been associated with excess bleeding risk. Left atrial appendage (LAA) closure may provide an alternative strategy in stroke prevention, but has not been tested in randomized trials in dialysis-dependent patients. Methods/Design The LAA-KIDNEY trial is a prospective, multicenter, randomized controlled clinical trial comparing percutaneous LAA closure with best medical care (including DOAC therapy whenever considered feasable) in patients with non-valvular AF and kidney failure at high risk of both, ischemic stroke and bleeding. A total of 272 patients will be randomized 1:1 across ~35 centers in Germany, Belgium and the Czech Republic. The primary efficacy endpoint is net clinical benefit defined as time to a composite of first stroke (including ischemic or hemorrhagic strokes), systemic embolism, cardiovascular or unexplained death or major bleeding (BARC 3-5). Secondary endpoints include individual components of the composite outcome, myocardial infarction, cardiovascular hospitalization, cognitive function, quality of life, and device-related complications. Analysis will be performed in the intention-to-treat population. Conclusion LAA-KIDNEY is the first randomized trial to evaluate LAA closure versus best medical care in AF patients with kidney failure. This trial will address a major evidence gap and is expected to inform clinical practice and guideline recommendations for stroke prevention in this high risk population. Trial Registration clinicaltrials.gov Identifier: NCT05204212. Copyright © 2026 The Author(s). <23> Accession Number 50730489 Title A New Plasma-Adapted Hydroxyethyl Starch Preparation: In Vitro Coagulation Studies. Source Journal of Cardiothoracic and Vascular Anesthesia. 24(3) (pp 394-398), 2010. Date of Publication: 2010. Author Boldt J.; Mengistu A. Institution (Boldt, Mengistu) Department of Anesthesiology and Intensive Care Medicine, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany Publisher W.B. Saunders Abstract Objective: Preparing hydroxyethyl starch (HES) in a plasma-adapted solution is supposed to improve safety with regard to coagulation. The influence of a new plasma-adapted HES preparation on coagulation was studied. Design(s): Operator-blinded, randomized study. Setting(s): Laboratory in vitro study. Participant(s): Fifteen healthy young men scheduled for blood donation. Intervention(s): Blood was diluted by 10%, 30%, and 50% using either a plasma-adapted or nonplasma-adapted (prepared in saline solution) potato-derived 6% HES 130/0.42. Only the composition of the solvent of the 2 HES preparations was different. Measurements and Main Results: Rotation thromboelastometry (ROTEM; Pentapharm, Munich, Germany) was used to assess changes in coagulation; whole blood aggregometry with 3 inducers was used to assess effects of dilution with HES on platelet function. Clotting time (CT) and clot formation time were significantly prolonged by 30% and 50% dilution, showing significantly longer times in the non-plasma-adapted than in the plasma-adapted HES group (eg, intrinsic CT at the 30% dilution level: plasma-adapted HES 228 +/- 26 seconds [within normal range] v 269 +/- 29 seconds in the nonplasma-adapted HES group). Clot strengthening and clot firmness were significantly reduced by the non-plasma-adapted HES at the 30% dilution level. Platelet aggregation was significantly more reduced by the non-plasma-adapted HES at the 30% and 50% dilution levels. Conclusion(s): Dilution with the nonplasma-adapted HES 130/0.42 was associated with more negative effects on thromboelastometry and platelet aggregation than the same HES 130/0.4 dissolved in a plasma-adapted solution. The benefits of using a plasma-adapted modern HES preparation on blood loss and use of blood/blood products in cardiac surgery need to be studied. © 2010 Elsevier Inc. All rights reserved. <24> Accession Number 2046987101 Title Robot-Assisted Coronary Artery Bypass Versus Percutaneous Coronary Intervention in Patients With Coronary Artery Disease: A Meta-Analysis. Source Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery. (no pagination), 2026. Date of Publication: 2026. Author Doma M.; Bertoli E.D.; Rovari G.; Ramadan A.; Seferasi L.; Kritya M.; Sanadgol G.; Kamel I.; Lingamsetty S.S.P.; Karara Y.; Bendaham L.C.A.R.; Hosseini M.; Geirsson A.; Brown C.R.; Goldsweig A.M. Institution (Doma, Ramadan, Sanadgol) Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States (Bertoli) Department of Internal Medicine, Marieta Konder Bornhausen Hospital and Maternity, Itajai, Brazil (Rovari) Hospital Universitario Antonio Pedro/Federal Fluminense University, Niteroi, Brazil (Ramadan, Kamel) Department of Internal Medicine, Boston Medical Center, MA, United States (Seferasi) Faculty of Medicine, University of Tirana, Albania (Kritya) DeBakey Heart and Vascular Institute, Houston Methodist, TX, United States (Sanadgol) General Surgery Department, Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States (Lingamsetty) Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States (Karara) Division of Cardiovascular Medicine, Alexandria Faculty of Medicine, Egypt (Bendaham) Faculty of Medicine, Federal University of Roraima, Boa Vista, Brazil (Hosseini) Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States (Geirsson) Division of Cardiothoracic and Vascular Surgery, Department of Surgery, Columbia University, New York, NY, United States (Brown) Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, United States (Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center and Division of Cardiovascular Medicine, University of Massachusetts-Baystate, Springfield, MA, United States Publisher SAGE Publications Ltd Abstract Objective: As alternatives to conventional coronary artery bypass grafting (CABG), robot-assisted CABG (R-CABG) and percutaneous coronary intervention (PCI) offer less invasive treatments for coronary artery disease (CAD). However, data comparing outcomes of R-CABG versus PCI are limited. Method(s): Databases were systematically searched for studies comparing R-CABG versus PCI. Random-effects models were used to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs), both overall and stratified by left main or multivessel (LM+MV) or isolated left anterior descending artery (LAD) disease. Kaplan-Meier curves were digitally extracted to reconstruct individual participant data (IPD), from which hazard ratios (HRs) were estimated for survival analyses. Result(s): Six retrospective studies, including 1,896 patients (R-CABG: 894, 47.1%), were analyzed. The mean age was 63.8 +/- 11.3 years, and 78.7% were male patients. Follow-up ranged from 2 to 8 years. Overall, R-CABG was associated with a lower odds of target vessel revascularization (TVR; OR = 0.50, 95% CI: 0.27 to 0.93, P = 0.03) and myocardial infarction (MI; OR = 0.44, 95% CI: 0.26 to 0.76, P < 0.01), with no significant difference in all-cause mortality. Among patients with LM+MV disease, R-CABG reduced TVR and MI. In LAD lesions, R-CABG significantly lowered the likelihood of MI (OR = 0.18, 95% CI: 0.04 to 0.71) as well as major adverse cardiovascular events (MACE; OR = 0.51, 95% CI: 0.28 to 0.93). Time-to-event analysis from reconstructed IPD demonstrated significantly improved freedom from reintervention (HR = 0.31, 95% CI: 0.16 to 0.60) and MACE (HR = 0.24, 95% CI: 0.15 to 0.60) with R-CABG, whereas no significant difference was found for all-cause mortality. Conclusion(s): R-CABG was associated with less TVR and MI compared with PCI in CAD patients, with no difference in all-cause mortality. Copyright © The Author(s) 2026 <25> Accession Number 2046251528 Title Risk prediction models for postoperative delirium in adult patients undergoing cardiac surgery: a systematic review and meta-analysis. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 489. Date of Publication: 01 Dec 2026. Author Wang B.; Du W.; Shen H.; Sun J.; Cao H.; Huang Z.; Wang X. Institution (Wang, Huang, Wang) Interventional Radiology and Vascular Surgery Department, Zhongda Hospital, School of Medicine, Southeast University, Jiangsu, Nanjing, China (Wang, Wang) Nursing Department, Zhongda Hospital, School of Medicine, Southeast University, Jiangsu, Nanjing, China (Du, Shen, Sun) Anesthesiology, Surgery and Pain Management Department, Zhongda Hospital, School of Medicine, Southeast University, Jiangsu, Nanjing, China (Cao) Cardiovascular Surgery Department, Zhongda Hospital, School of Medicine, Southeast University, Jiangsu, Nanjing, China Publisher BioMed Central Ltd Abstract Background: Postoperative delirium (POD), a frequent complication following cardiac surgery, is associated with adverse clinical outcomes. Despite the development of numerous prediction models for estimating the risk of POD, the overall performance and methodological quality of these models are not well understood. Objective(s): To systematically review and meta-analyze the performance of prediction models for postoperative delirium in adult patients undergoing cardiac surgery, with a particular emphasis on model discrimination and the identification of key predictors. Method(s): This study included studies that developed or validated multivariable prediction models for POD in adults undergoing cardiac surgery. Ten databases were searched from inception to July 10, 2025. Data extraction followed a standardized form based on the Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies (CHARMS) checklist. Risk of bias and applicability were assessed using the Prediction Model Risk of Bias Assessment Tool (PROBAST). Meta-analysis was performed using R software. Result(s): A total of 22 studies comprising 27 prediction models were included. All studies were rated as having a high risk of bias. The pooled area under the curve for modeling cohorts was 0.821 (95% CI: 0.778-0.858; 95%PI: 0.562-0.943), indicating a robust discrimination despite substantial heterogeneity (I2=96.7%, tau2 = 0.3692). Seven significant predictors were identified, including age, history of cerebrovascular disease, cardiopulmonary bypass time, mechanical ventilation time, American Society of Anesthesiologists classification, operative time, and Acute Physiology and Chronic Health Evaluation II (APACHE II) score. Conclusion(s): Although, existing prediction models for POD in patients undergoing cardiac surgery demonstrate promising performance, the evidence is limited by high risk of bias and heterogeneity across studies. There remains a need to improve methodological rigor, such as multicenter prospective studies and external validation. Relevance to clinical practice: This systematically review provides a reference for the development and validation of subsequent models for adults undergoing cardiac surgery. Although with modest discrimination, future models should focus on the construction of the preoperative models, which provide more opportunities for early prevention. Clinical trial number: PROSPERO: CRD420251081560. Copyright © The Author(s) 2026. <26> Accession Number 2046250095 Title Perioperative pulmonary infection prevention and management in adult patients after coronary artery bypass grafting: a summary of best evidence. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 488. Date of Publication: 01 Dec 2026. Author Peng Y.; Chen Y.; Hu Q.; Guo B.; Chen N.; Xu D.; Gao C.; Hu F. Institution (Peng, Chen, Hu, Guo, Gao) Department of Cardiovascular Surgery, Zhongnan Hospital of Wuhan University, #169 East Lake Road, Wuchang Distr, Hubei, Wuhan, China (Peng) Hubei Provincial Engineering Research Center of Minimally Invasive Cardiovascular Surgery, Hubei, Wuhan, China (Chen) Wuhan Clinical Research Center for Minimally Invasive Treatment of Structural Heart Disease, Hubei, Wuhan, China (Gao) State Key Laboratory of Metabolism and Regulation in Complex Organisms, Hubei, Wuhan, China (Chen, Xu) Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Hubei, Wuhan, China (Hu) Department of Nursing, Zhongnan Hospital of Wuhan University, #169 East Lake Road, Wuchang Distr, Hubei, Wuhan, China (Hu) Center for Critical Care and Anesthesia Nursing Research, Wuhan University, Hubei, Wuhan, China Publisher BioMed Central Ltd Abstract Background: Coronary artery bypass grafting is an important surgical treatment for coronary heart disease. As an open thoracic procedure, pulmonary infection is a common and potentially serious complication of coronary artery bypass grafting. Its occurrence may prolong mechanical ventilation, increase hospital length of stay, and raise mortality risk. This study therefore aims to evaluate and summarise the evidence for the prevention and management of perioperative pulmonary infection in patients undergoing coronary artery bypass grafting to inform clinical practice. Method(s): This evidence summary adheres to the standardised reporting framework of the Fudan University Centre for Evidence-Based Nursing (Registration No: ES20246831). The process encompassed clinical question identification, evidence retrieval, literature screening, methodological quality assessment, and evidence synthesis and grading. A systematic search was conducted from January 1, 2015, to December 31, 2025, across the following databases: UpToDate; BMJ Best Practice; the UK National Institute for Health and Care Excellence; the Registered Nurses' Association of Ontario; the National Guideline Clearinghouse; the Scottish Intercollegiate Guidelines Network; the Guidelines International Network; the Cochrane Library; the JBI Evidence Synthesis Database; PubMed; Web of Science; the China National Knowledge Infrastructure; Wanfang Data; and the Medlive Guidelines Network. Literature types included clinical decisions, guidelines, expert consensuses, systematic reviews, and evidence summaries. Result(s): This study included 19 publications comprising 2 clinical decisions, 2 guidelines, 2 expert consensuses, 6 systematic reviews, and 7 evidence summaries. It synthesised 4 themes and 23 best practice recommendations covering four critical phases: risk assessment and optimisation; preoperative early exercise and prehabilitation; intraoperative safety strategies and anaesthetic management; and postoperative respiratory exercise and rehabilitation. Conclusion(s): This study systematically synthesised 23 evidence-based measures for preventing and managing pulmonary infection in coronary artery bypass grafting patients. Collectively, these measures form a systematic approach to pulmonary infection prevention and management. Implementation of these recommendations may enable healthcare providers globally to enhance the quality and standardization of perioperative coronary artery bypass grafting care, while reducing the incidence of perioperative pulmonary infections and associated prognostic burden. Copyright © The Author(s) 2026. <27> Accession Number 629785128 Title Bronchial blocker versus double-lumen endobronchial tube in minimally invasive cardiac surgery. Source BMC Pulmonary Medicine. 19(1) (no pagination), 2019. Article Number: 207. Date of Publication: 09 Nov 2019. Author Zhang C.; Yue J.; Li M.; Jiang W.; Pan Y.; Song Z.; Shi C.; Fan W.; Pan Z. Institution (Zhang, Yue, Li, Jiang, Song, Shi, Pan) Department of Anesthesiology, Second Hospital of Jilin University, No.218 Ziqiang Street, Nanguan District, Changchun,Jilin province, China (Pan) Yanbian University, Yanbian,Jilin province, China (Fan) Department of Intensive Care Unit, Second Hospital of Jilin University, Changchun,Jilin province, China Publisher BioMed Central Ltd Abstract Background: To compare the therapeutic value of a bronchial blocker (BB) with a double-lumen tube (DLT) in minimally invasive cardiac surgery (MICS). Method(s): Sixty patients who underwent MICS were randomized to use either a DLT (Group D, n = 30) or a BB (Group B, n = 29; one failed was omitted). The following data were collected: Time of intubation and tube localization; incidence of tube displacement; postoperative sore throat and hoarseness; time of cardiopulmonary bypass; maintenance time for SpO<inf>2</inf> < 90% (PaCO<inf>2</inf> < 60 mmHg); mean arterial pressure and heart rate; SpO<inf>2</inf>, PaO<inf>2</inf>, PaCO<inf>2</inf>, EtCO<inf>2</inf>, mean airway pressure, and airway peak pressure; surgeons' satisfaction with anesthesia; and short-term complications. Result(s): The times of intubation and tube localization were significantly longer in Group B than in Group D (P < 0.05). Patients in Group B exhibited significantly lower incidence of tube displacement, postoperative sore throat, and hoarseness when compared with patients in Group D (P < 0.05). Mean arterial pressure and heart rate were significantly lower in Group B than in Group D after tracheal intubation (P < 0.05). The mean airway pressure and airway peak pressure were significantly lower in Group B than in Group D after one-lung ventilation (P < 0.05). SpO<inf>2</inf> and PaO<inf>2</inf> in Group B were significantly higher than in group D after cardiopulmonary bypass (P < 0.05). No short-term postoperative complications were observed in patients of Groups B and D during 3 month follow-up. Conclusion(s): BB can be a potential alternative to the conventional DLT for lung isolation in MICS. Trial registration: ChiCTR1900024250, July 2, 2019. Copyright © 2019 The Author(s). <28> Accession Number 2046820500 Title An updated systematic review of the impact of volume of surgery and specialization in Norwood procedure. Source BMC Pediatrics. 26(1) (no pagination), 2026. Article Number: 588. Date of Publication: 01 Dec 2026. Author Pachanov A.; Zhang Z.; Munschek S.; Asfour B.; Mathes T.; Pieper D. Institution (Pachanov, Munschek, Pieper) Faculty of Health Sciences Brandenburg, Institute for Health Services and Health System Research, Brandenburg Medical School (Theodor Fontane), Seebad 82/83, Rudersdorf bei Berlin, Germany (Pachanov, Munschek, Pieper) Center for Health Services Research, Brandenburg Medical School (Theodor Fontane), Rudersdorf, Germany (Zhang, Mathes) Department of Medical Statistics, University Medical Center Gottingen, Gottingen, Germany (Asfour) The German Paediatric Heart Centre, University Hospital Bonn, Bonn, Germany Publisher BioMed Central Ltd Abstract Background: Volume-outcome relationship proposed to exist for high-risk, low-volume procedures, such as the Norwood procedure. A systematic review published in 2014 examined impacts of hospital and surgeon volume, specialization, regionalization and teaching status on the patient-related outcomes of the Norwood procedure. The aim of this systematic review was to update the 2014 work by synthesizing current evidence alongside the original review. Method(s): We searched PubMed, Embase (Elsevier), and the Cochrane Library for peer-reviewed comparative studies published from 1 March 2013 to 30 December 2024 (date of last search) to update the original review covering database inception to March 2013. Citation chasing of relevant reports was performed on 20 March 2025. Mortality-related outcomes were defined as primary and all others as secondary. In studies on the volume-outcome relationship with categorical volume definitions, effect estimates were compared between the highest and lowest categories, as defined in each study. Risk of bias and certainty of evidence were assessed using ROBINS-E and GRADE, respectively. Data were presented in tables and synthesized narratively. Result(s): Eight additional studies reported in 13 publications were identified, resulting in a total of 18 studies (24 reports). Of these, 15 studies (20 reports), comprising 47 analyses, were included in the final synthesis. The reports were published between 2002 and 2025 and predominantly relied on routinely collected data from North America. Irrespective of statistical significance, 14 of 15 short-term and 4 of 5 long-term hospital-volume analyses, and 3 of 5 short-term and 3 of 3 long-term surgeon-volume analyses of mortality-related outcomes favored higher volume. Among 17 secondary outcome analyses, 14 favored higher hospital or surgeon volume. Evidence on hospital teaching status was limited to two older studies, which reported lower mortality in teaching hospitals. Overall, the certainty of evidence was rated as very low, reflecting heterogeneity in exposure definitions, reliance on routinely collected data, and limited use of analytical approaches that support causal interpretation. Conclusion(s): Although most analyses favored higher hospital or surgeon volume and teaching hospital status, the very low certainty of evidence limits its ability to inform clinical practice or policy, underscoring the need for stronger methodological approaches in future research. Registration: PROSPERO CRD42022385160. Copyright © The Author(s) 2026. <29> Accession Number 2046882066 Title Chair-based aerobic exercise versus slow breathing intervention during phase I cardiac rehabilitation after coronary artery bypass graft surgery: a randomized controlled trial. Source Journal of Bodywork and Movement Therapies. 48 (pp 358-366), 2026. Date of Publication: 01 Oct 2026. Author Ashok A.; Dhanesh Kumar K.U.; Gopalakrishnan M. Institution (Ashok, Dhanesh Kumar) Nitte (Deemed to be University), Nitte Institute of Physiotherapy (NIPT), Karnataka, Mangalore, India (Gopalakrishnan) Sree Mookambika Institute of Medical Sciences, Kulasekharam, Kanyakumari District, Tamil Nadu, India Publisher Churchill Livingstone Abstract Background Anxiety and diminished exercise tolerance are key challenges following Coronary Artery Bypass Grafting (CABG), adversely influencing postoperative recovery and prognosis. These symptoms are particularly prominent during the inpatient phase of rehabilitation. Although chair aerobics and nadishodhana pranayama are simple, low-cost, and safe therapeutic options suitable for hospital settings, there is limited evidence comparing their effects among CABG patients during Phase I cardiac rehabilitation. Objectives To compare the effectiveness of chair aerobics and nadishodhana pranayama on anxiety and exercise tolerance in post-CABG patients. Study design Outcome-assessor-blinded randomized clinical trial. Methods One hundred and twenty CABG patients were screened, consented, and randomly allocated into two groups using the Sequentially Numbered Opaque Sealed Envelope (SNOSE) method. Group A received chair aerobics and Group B performed nadishodhana pranayama, both in addition to standard Phase I cardiac rehabilitation. Each intervention lasted 15 min daily for five consecutive days (postoperative days 3-7). Anxiety and exercise tolerance were assessed at baseline and on day 7 using the Hospital Anxiety and Depression Scale (HADS) and the 6-Minute Walk Test (6MWD), respectively. Assessments were conducted by a blinded evaluator. Results Both groups demonstrated significant reductions in anxiety and significant improvements in 6-min walk distance (6MWD) following the intervention (p < 0.001) within the group. Chair aerobics showed large effect sizes for anxiety (r = 1.00) and exercise tolerance (r = -0.62), while nadishodhana pranayama demonstrated comparable effects for anxiety (r = 0.99) and exercise tolerance (r = 0.39). However, no statistically significant between-group differences were observed for any outcome (p > 0.05). Conclusions The chair aerobics and nadishodhana pranayama were safe, feasible, and associated with significant improvements in anxiety and exercise tolerance among CABG patients during Phase I cardiac rehabilitation. No statistically significant differences were observed between the interventions. These findings support their incorporation as adjuncts to standard inpatient cardiac rehabilitation programs. Copyright © 2026. Published by Elsevier Ltd. <30> Accession Number 2046758532 Title Intraoperative Methadone in Adult and Pediatric Cardiac Surgery: A Narrative Review. Source Hearts. 7(2) (no pagination), 2026. Article Number: 15. Date of Publication: 01 Jun 2026. Author Pontes J.P.J.; Reis I.R.; Pereira A.J.; Pacheco N.A.M.; Borges C.E.R.; Junior A.P.G.; Silva F.C.D.P. Institution (Pontes, Reis, Pereira, Borges, Junior, Silva) CET Integrado de Uberlandia, MG, Uberlandia, Brazil (Pacheco) Department of Anesthesiology, Universidade Federal de Uberlandia, MG, Uberlandia, Brazil Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Intraoperative methadone has emerged as a significant pharmacological strategy in cardiac surgery to improve postoperative analgesic outcomes and reduce the reliance on rescue short-action opioids. This review aims to synthesize evidence regarding the safety and efficacy of intravenous methadone compared to other strategies for postoperative pain control in adult and pediatric cardiac surgeries. Method(s): This narrative review relied on electronic searches in PubMed, Web of Science, Cochrane Library, and EMBASE up to January 2026. From 199 articles retrieved, 41 were included, focusing on analgesic efficacy, safety, pharmacokinetic variations during cardiopulmonary bypass (CPB), and cost-effectiveness. Result(s): The implementation of methadone results in up to 70% reduction in postoperative opioid requirements. Patients experience significantly lower pain scores from 24 to 72 h and improvement in satisfaction regarding pain management. In pediatric populations (neonates and children), the use of methadone leads to a significant reduction in opioid needs and a high rate of extubation in the operating room. Pharmacokinetically, a 48% drop in methadone concentration occurs during CPB due to hemodilution and sequestration. Safety data confirms that intraoperative use does not prolong mechanical ventilation; however, doses exceeding 0.25 mg/kg are linked to an increased incidence of delirium. Economically, methadone can be cost-effective, resulting in savings of up to $6355 per patient. Conclusion(s): Intraoperative methadone improves postoperative analgesia, opioid consumption, patient satisfaction, and costs after cardiac surgery. Its opioid-sparing effects make it particularly attractive for ERAS protocols, although vigilance against dose-related delirium and QT prolongation remains essential. Further research, especially in pediatrics, is needed to refine dosages and safety protocols. Copyright © 2026 by the authors. <31> Accession Number 2046061430 Title Efficacy and Safety of No-Touch versus Conventional Saphenous Vein Harvesting in Coronary Artery Bypass Grafting: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Source Cardiology (Switzerland). (pp 1-15), 2026. Date of Publication: 27 Feb 2026. Author Chen X.; Zhang X.; Xiang X.; Fang X.; Wei F.; Liu Y.; Feng S. Institution (Chen, Fang, Wei, Feng) Department of Cardiology, Dazhou Second People's Hospital, Dazhou, China (Zhang) Department of Otorhinolaryngology Head and Neck Surgery, Dazhou Second People's Hospital, Dazhou, China (Xiang) Department of Critical Care Medicine, Chengdu Fifth People's Hospital, Chengdu, China (Liu) Department of Thoracic, Cardiovascular and Breast Surgery, Dazhou Second People's Hospital, Dazhou, China Publisher S. Karger AG Abstract Abstract - Introduction: Saphenous vein graft (SVG) failure is a key determinant of long-term outcomes after coronary artery bypass grafting (CABG), particularly in individuals with multivessel disease or diabetes. This meta-analysis aimed to evaluate whether the no-touch SVG harvesting technique reduces graft occlusion and improves cardiovascular outcomes compared with the conventional approach. Method(s): A comprehensive literature search of PubMed, Embase, Web of Science, and the Cochrane Library was conducted up to May 2025 to identify randomized controlled trials (RCTs) comparing the no-touch and conventional saphenous vein harvesting techniques in CABG. A random-effects model was used for meta-analysis, and the certainty of evidence was evaluated using the GRADE framework. Result(s): Eight RCTs involving 4, 258 CABG patients (no-touch: 2, 144; conventional: 2, 114) were included. The no-touch technique significantly reduced the risk of vein graft occlusion (risk ratio, 0.59; 95% CI: 0.47-0.73; p < 0.00001; I2 = 31%). Subgroup analyses confirmed the consistency of this effect across regions and follow-up durations. Although differences in secondary outcomes - including all-cause and cardiovascular mortality, myocardial infarction, stroke, and repeat revascularization - were not statistically significant, most effect estimates favored the no-touch approach. The certainty of evidence was rated as moderate for the primary and several secondary outcomes according to the GRADE assessment. Conclusion(s): This meta-analysis shows that no-touch saphenous vein harvesting is associated with a lower risk of graft occlusion compared with conventional harvesting in CABG. However, current randomized evidence does not demonstrate a definitive improvement in major cardiovascular outcomes. These findings highlight the need to balance angiographic benefits against potential trade-offs and underscore the need for large-scale, event-driven randomized trials to clarify the net clinical benefit of this technique. Copyright © 2026 S. Karger AG, Basel <32> Accession Number 2044447014 Title Randomized, sham-controlled trial of intraoperative ticagrelor removal to reduce perioperative bleeding. Source Journal of Thoracic and Cardiovascular Surgery. 172(1) (pp 128-137.e4), 2026. Date of Publication: 01 Jul 2026. Author Mack M.J.; Whitlock R.; Chu M.W.A.; Taylor B.; Zias E.A.; Liu D.; Protos A.N.; Rokkas C.; Pelletier M.; Choi C.W.; Saha T.; Sellke F.W.; Schneider D.J.; Thourani V.H.; Douketis J.; Mazer C.D.; Fan W.; Deliargyris E.N.; Gibson C.M. Institution (Mack) Cardiovascular Surgery, Baylor Scott & White Health, Dallas, Tex, United States (Whitlock) Cardiovascular Surgery, Population Health Research Institute, Hamilton, Canada (Chu) Division of Cardiac Surgery, Western University, London Health Sciences Centre, London, Canada (Taylor) Division of Cardiac Surgery, University of Maryland Medical Center, Baltimore, Md, United States (Zias) Department of Cardiothoracic Surgery, NYU Langone School of Medicine, New York, NY, United States (Liu) Department of Cardiac Surgery, Beth Israel Deaconess Medical Center, Boston, Mass, United States (Protos) Division of Cardiac Surgery, University of Mississippi Medical Center, Jackson, Miss, United States (Rokkas) Division of Cardiac Surgery, University of Wisconsin, Madison, Wis, United States (Pelletier) Division of Cardiac Surgery, Yale School of Medicine, New Haven, Conn, United States (Choi) Division of Cardiothoracic Surgery, Virtua Health, Cherry Hill, NJ, United States (Saha) Division of Cardiac Anesthesia, Kingston General Hospital, Kingston, Canada (Sellke) Division of Cardiothoracic Surgery, Rhode Island Hospital, Providence, RI, United States (Schneider) Department of Medicine, Cardiovascular Research Institute, University of Vermont, Burlington, VT, United States (Thourani) Department of Cardiovascular Surgery, Piedmont Heart Institute, Atlanta, GA, United States (Douketis) Department of Medicine, Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, Canada (Mazer) Department of Anesthesia, St. Michael's Hospital, University of Toronto, Toronto, Canada (Fan, Deliargyris) CytoSorbents Corporation, Princeton, NJ, United States (Gibson) Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Mass, United States (Gibson) Baim Institute for Clinical Research, Boston, Mass, United States Publisher Elsevier Inc. Abstract Objective: Patients on ticagrelor who are undergoing cardiac surgery before completing guideline-recommended washout are at high risk for severe bleeding. This study evaluated whether a novel drug removal device reduces bleeding in patients operated within 2 days from ticagrelor discontinuation. Method(s): Eligible patients were randomized 1:1 to intraoperative DrugSorb-ATR or sham control. Primary safety end point was adverse events at 30 days. Efficacy was assessed by composite end points comprising bleeding events using Universal Definition of Perioperative Bleeding (UDPB) and 24-hour chest tube drainage (CTD) in the overall and isolated coronary artery bypass grafting (CABG) populations with a hierarchical win ratio (WR) method. Result(s): In total, 140 patients were randomized; 132 had surgery and received a study device; and 92% were isolated CABG. Mean age was 65 +/- 5 years, and 15% were female. The primary safety end point was met, with similar adverse events reported between groups. The primary efficacy end point was not met in the overall or CABG populations (Win ratio [WR], 1.07; 95% CI, 0.72-1.58; P = .748 and WR, 1.33; 95% CI, 0.86-2.04; P = .202 respectively). The supplementary efficacy end point was met in the CABG population (WR, 1.59; 95% CI, 1.02-2.46, P = .041) with significant reductions also shown in large CTD bleeding events (P = .016) and major bleeding, a composite of severe bleeding events or 24-hour CTD >=1 L (P = .041). The number needed to treat to prevent a major bleed was 6. Conclusion(s): Intraoperative use of DrugSorb-ATR is safe in patients operated within 2 days of ticagrelor discontinuation. Although the primary end point was not met in the overall population, there were significant reductions in severe bleeding events in the prespecified CABG population. Copyright © 2026 The Authors <33> Accession Number 2046979960 Title Relationship between anatomical variations in the aortic arch and risk of aneurysm formation - a systematic review. Source European Journal of Clinical and Experimental Medicine. 24(2) (pp 406-416), 2026. Date of Publication: 2026. Author Jain S.K.; Sharma S. Institution (Jain, Sharma) Department of Anatomy, Teerthanker Mahaveer Medical College and Research Center, Teerthanker Mahaveer University, Uttar Pradesh, Moradabad, India Publisher Rzeszow University Press Abstract Introduction and aim. Anatomical variation in the aortic arch has been proposed as an aneurysm risk factor based on changed hemodynamic forces and structural stress in arterial walls. Knowledge of these variations will be valuable in optimizing surgical planning and management of risks for patients to undergo cardiovascular and thoracic procedures. This systematic review summarized existing literature to assess the relation of different variations in the aortic arch with the risk of aneurysm formation by consolidating evidence of clinical relevance and predictive markers of risk. Material and methods. We conducted our searches in seven databases: PubMed, Embase, Scopus, Web of Science, Cochrane Library, CINAHL, and ProQuest, using Boolean operators and MeSH terms. The ROBINS-I tool was used to assess the risk of bias in studies, including confounding, participant selection, and outcome reporting. GRADE was used to evaluate global certainty of evidence, which also considered consistency, directness, and precision of evidence. Studies were eligible based on strict eligibility criteria and reported findings on specific aortic arch and their potential association with aneurysm formation. Results. The review included 12 studies that varied in terms of sample size and used a mostly retrospective design. According to the findings evaluated, certain forms of the aortic arch, for example, the bovine arch and aberrant right subclavian artery, posed an increased risk of developing proximal versus distal aneurysms. Advanced imaging studies, such as 4D flow MRI and enhanced CT, aided in the selection of at-risk patients, as they described the flow pressure dynamics with detailed assessments. While several authors reported consistent associations of anatomical variation with risk, other authors found no significant correlation and thus suggested variability in clinical relevance. The general review showed both converging and divergent findings of the review about the predictive value of certain types of arch for aneurysm risk. Conclusion. This systematic review highlights the incorporation of knowledge on aortic arch variation as part of the detailed risk assessment required in aneurysmal formation among patients. Although some forms, such as the bovine arch and the aberrant right subclavian artery, did indeed demonstrate the potential to be predictive of complications, study inconsistencies provide reason for continuing research on the topic. Advanced imaging may improve medical decision-making, as patient risk stratification would be feasible with greater information on anatomical variation. Copyright © 2026 Rzeszow University Press. All rights reserved. <34> Accession Number 2038188063 Title Optical coherence tomography versus angiographic guidance in true unprotected left main bifurcation disease: an OCTOBER substudy. Source EuroIntervention. 22(10) (pp 566-574), 2026. Date of Publication: 2026. Author Holck E.N.; Andreasen L.D.; Neghabat O.; Laanmets P.; Mogensen L.J.H.; Spratt J.C.; Bennett J.; Calic S.; Walsh S.; O'kane P.; Cockburn J.; Henerah L.; Chowdhary S.; Grikis K.; Lonborg J.; Heighert M.; Kische S.; Christiansen E.H. Institution (Holck, Andreasen, Neghabat, Mogensen, Christiansen) Department of Cardiology, Aarhus University Hospital, Aarhus N, Denmark (Laanmets) North Estonia Medical Centre, Tallinn, Estonia (Spratt) St George's University, London, United Kingdom (Bennett) Department of Cardiovascular Medicine, University Hospitals Leuven, Leuven, Belgium (Calic) Department of Cardiology, Sorlandet Sykehus Arendal, Arendal, Norway (Walsh) Department of Cardiology, Belfast Health and Social Care Trust, Belfast, United Kingdom (O'kane) Department of Cardiology, Royal Bournemouth Hospital, Bournemouth, United Kingdom (Cockburn) Department of Cardiology, Sussex Cardiac Centre, Brighton, United Kingdom (Henerah) Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden (Chowdhary) Manchester Academic Health Science Centre, Wythenshawe Hospital, Manchester, United Kingdom (Grikis) Pauls Stradins Clinical University Hospital, Riga, Latvia (Lonborg) Department of Cardiology, Copenhagen, Denmark (Heighert) Department of Cardiology, Trondheim University Hospital, Trondheim, Norway (Kische) Vivantes Klinikum im Friedrichshain, Berlin, Germany Publisher Europa Group Abstract BACKGROUND: Dedicated randomised studies on intravascular imaging guidance in unprotected left main coronary artery (LMCA) disease are lacking. AIMS: We aimed to investigate the clinical feasibility of optical coherence tomography (OCT) guidance in percutaneous coronary intervention (PCI) of true LMCA bifurcation lesions and to evaluate its prognostic impact compared with angiographic guidance. METHOD(S): Patients with true LMCA bifurcation lesions who were randomised to either OCT or angiographic guidance in the OCTOBER Trial were included. The feasibility of OCT guidance was assessed as the proportion of patients with successful and analysable OCT pullbacks before, during, and after stenting. Clinical outcomes between the two groups were compared based on the incidence of a composite of major adverse cardiac events (MACE), comprising cardiac death, any myocardial infarction, or target lesion revascularisation. RESULT(S): In total, 227 patients were included (OCT: 111, angiography: 116). OCT guidance was successful, with 98% of cases having a pre-stenting pullback performed and 96% a final pullback, as per protocol. The proximal LMCA stent edge was analysable in 43% of patients, and in the remaining 57%, only 5% were limited by insufficient image quality. No statistically significant difference in MACE was observed between the two groups (OCT: 14.4% vs angiography: 18.4%, hazard ratio 0.78, 95% confidence interval: 0.39-1.51). CONCLUSION(S): OCT-guided PCI in true LMCA bifurcation lesions was clinically feasible, but visibility of the LMCA ostium was limited by short pullbacks, insufficient clearance, or guide catheter shadowing. OCT guidance was associated with a non-significant reduction in MACE, consistent with the effect estimate in the main trial. Copyright © 2026, Europa Group. All rights reserved. <35> Accession Number 2041658013 Title Effects of intraoperative higher versus lower positive end-expiratory pressure during one-lung ventilation for thoracic surgery on postoperative pulmonary complications (PROTHOR): a multicentre, international, randomised, controlled, phase 3 trial. Source The Lancet Respiratory Medicine. 14(1) (pp 17-28), 2025. Date of Publication: 01 Jan 2025. Author Senturk M.; Kiss T.; de Abreu M.G.; Cinnella G.; Edmond C.; El Tahan M.R.; dos Reis Falcao L.F.; Gil M.G.; Gregoretti C.; Hachenberg T.; Hollmann M.W.; Jankovic R.J.; Waheedullah K.; Krassler J.; Licker M.; Loop T.; Nandor M.; Mills G.H.; Murrell M.T.; Neskovic V.; Neto A.S.; Nisnevitch-Savarese Z.; Rossaint R.; Schultz M.J.; Senturk N.M.; Severgnini P.; Szegedi L.L.; de Anda G.F.V.; Tamas V.; Voyagis G.; Wittenstein J.; Zhong J.; Abbenhuis J.; Abdulmomen A.; Abdyli A.; Abu Elyazed M.M.; Puig P.A.; Akbudak I.H.; Aksu C.; Alagoz A.; Alhamdi M.; Almadhati S.; Altorki N.K.; Alvarez S.A.; Arun O.; Azizoglu M.; Baar W.; Balde D.; Balla B.; Seker M.B.; Basheer M.; Bauer W.O.; Bence J.; Bernardi M.H.; Bigatello L.M.; Bignami E.; Bluth T.; Bonney I.; Bouhemad B.; Bradic N.; Brescianini L.; Bruthans J.; Bulte C.S.E.; Cadar G.; Cakmak G.; Cali P.; Cantatore L.P.; Chai X.; Chang Y.-T.; Chen J.; Christofaki M.; Sanches L.C.; Constantin A.; Contreras V.; Corsi L.; da Silva E.; Defosse J.; Deluca R.; Diaper J.; Didden L.; Dimitriou E.; do Nascimento P.; Domi R.; Dorfinger L.; Douradinho C.; Globokar M.D.; Duran F.M.; Eldawlatly A.; El-Gendy H.M.; Elmazny M.I.; Elsherif S.E.I.; Emara M.M.; de los Santos S.T.E.; Farnell-Ward S.; Ferrufino R.; Gao L.; Geyik D.; Gnezda D.; Goeden S.; Gorjup K.; Guerra R.E.G.; de Castro Pereira M.G.; Guinot P.G.; Guven A.; Hager H.; Han L.; Hatipoglu Z.; Hayashi M.; Hell J.; Hofland J.; Hu J.; Hudacek K.; Huti G.; Ilic M.; Jegarl A.; Andujar M.-J.J.; Jin D.; Kammerer T.; Karadza V.; Kawagoe I.; Paudel S.I.K.; Koch T.; Kolaric N.; Koning N.J.; Kostopanagiotou K.; Kostroglou A.; Kovac P.; Kramer T.; Kreft T.; Kumrular Y.; Kuut M.; Lan L.; Li P.-C.; Li X.-F.; Li L.-T.; Liu Y.; Longo F.; Lopez-Baamonde M.; Luise S.; Luo W.; Lv H.; de los Angeles Macias Jimenez M.; Magalhaes D.D.; Martuscelli M.; Mavko A.; Meco B.C.; Mermer H.A.; Miao C.; Michalek P.; Aragon E.M.; Mirabella L.; Molyneux M.; Montrano L.; Mosqueira L.; Mourisse J.; Navarro-Ripoll R.; Negru F.; Nikolic M.; de la Vega J.A.N.; Noto A.; Nyktari V.; Sungur M.O.; Ozdemir L.; Ozolina A.; Ozturk T.; Pace M.C.; Neto E.P.; Paloczi B.; Papaioannou A.; Papamichail K.; Patroniti N.; Pektas Y.; Matalobos D.P.; Persec J.; Petrovic S.; Pirc D.; Plismanis G.; Amendola C.P.; Prazetina M.; Radovic N.; Rauseo M.; Richter T.; Vallejo L.R.; Ruiz J.J.R.; Rondovic G.; Rosser J.; Sanchez Garcia F.J.; Sansone P.; Saracoglu A.; Saracoglu K.T.; Sazak H.; Scharffenberg M.; Schiavoni L.; Schilling T.; Sediq A.; Semmelmann A.; Bingul E.S.; Sertcakacilar G.; Sfika E.; Shelley B.; Shin S.H.; Sidiropoulou T.; Silva J.M.; Socci L.; Socorro T.; Soulioti E.; Spadaro S.; Spicek-Macan J.; Spray D.; Stamenkovic D.; Stefanakis G.; Stoica R.; Stojanovic M.; Stopora P.; Sungur Z.; Svareniece-Karjaka E.; Szamos K.; Tanase N.-V.; Tanriverdi C.; Tempel F.; Terwindt L.E.; Theilen R.; Tipura D.; Tire Y.; Tomaselli E.; Onari N.T.; Tunc M.; Turhan O.; Turktan M.; Ugliola D.; Ulugol H.; Vegh T.; Vetrugno L.; Vitali C.; Volta C.A.; von Dossow V.; Vukovic R.; Vukovic A.Z.; Waeschle R.M.; Wall D.; Wang H.; Wang D.; Winroth D.; Wu Q.; Xu P.; Yaldir O.; Sirzai E.Y.; Yang X.; Yapici D.; Yildirim O.; Guclu C.Y.; Yu H.; Tanriverdi S.Y.; Zarbock A.; Zeba S.; Zhang Y.; Zhang X.; Zhang Z.; Zhang J.; Zhang G.-W.; Ziemann S. Institution (Cinnella, Cantatore, Mirabella, Montrano, Rauseo, Ugliola) University of Foggia, Foggia, Italy (Edmond) Department of Anesthesiology, The Mount Sinai Hospital, New York, United States (El Tahan) Mansoura University, Mansoura, Egypt (dos Reis Falcao, Brescianini, Douradinho, Shin) Federal University of Sao Paulo, Brazil (Kiss, de Abreu) Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine, University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstrase 74, Dresden, Germany (Gil) Valencia University, Spain (Gregoretti) Intensive Care Unit and Anesthesiology Service, G Giglio Foundation Cefalu (PA), MED41 Unicamillus University, Rome, Italy (Hachenberg, Schilling) Department of Anesthesiology and Intensive Care, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany (Hollmann, Bauer, Terwindt) Department of Anesthesiology, Amsterdam UMC, Location AMC, Amsterdam, Netherlands (Jankovic) Clinic for Anesthesiology, Reanimathology and Intensive Therapy, University Clinical Center Nis, Serbia (Kiss) Department of Anaesthesiology, Intensive-, Pain- and Palliative Care Medicine, Radebeul Hospital, Academic Hospital of the Technische Universitat Dresden, Radebeul, Germany (Krasler, Stopora) Lung centre Coswig, Lung centre Coswig Centre for pneumology, allergology, respiratory medicine and thoracic surgery, Coswig, Saxony, Germany (Licker) Department of Cardiothoracic Anesthesia & Critical Care, University Hospital of Martinique, Fort de France, Martinique (Loop) Department of Anesthesiology and Critical Care, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany (Nandor) Division of Anaesthesia, Pain Medicine and Intensive Care, Imperial College London, Royal Brompton & Harefield Hospitals, Guy's & St. Thomas' NHS, London, United Kingdom (Zhong, Jin, Liu, Luo, Miao, Wu, Xu, Zhang) Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, China (Mills, Rosser) Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom (Murrell, Jegarl) Department of Anesthesiology, Weill Cornell Medicine, New York, NY, United States (Neskovic, Radovic, Rondovic, Vukovic, Zeba) Clinic for Anesthesia and Critical Care, Military Medical Academy, Belgrade, Serbia (Neto) Monash University, Data Analytics Research and Evaluation Centre, University of Melbourne, Austin Hospital, Australia (Nisnevitch-Savarese) Penn State Hershey Anesthesiology & Perioperative Medicine, Hershey, United States (Rossaint) Klinik fur Anasthesiologie, Uniklinik RWTH Aachen, Germany (Schultz) Department of Intensive Care, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands (Senturk, Senturk) Department of Anesthesiology, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey (Severgnini) Department Biotechnology and Sciences of Life, Azienda Ospedaliera Fondazione Macchi, University of Insubria, Varese, Italy (Szegedi) Department of Anesthesiology, Universite Libre de Bruxelles, H.U.B Hopital Erasme, Bruxelles, Belgium (de Anda) School of Medicine, State of Mexico Autonomous University, Mexico (Tamas, Balla, Paloczi, Szamos, Vegh) Department of Anesthesiology and Intensive Care, University of Debrecen, Debrecen, Hungary (Voyagis) Department of Anesthesiology, Sotiria Chest Hospital, Athens, Greece (Kiss, de Abreu, Wittenstein, Bluth, Dorfinger, Koch, Kramer, Richter, Scharffenberg, Tempel, Theilen) Department of Anesthesiology and Intensive Care Medicine, Pulmonary Engineering Group, Faculty of Medicine, University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstrase 74, Dresden, Germany (Senturk) Acibadem University, School of Medicine, Turkey (Nandor) Department of Anesthesia and Intensive Care, Semmelweis University, Budapest, Hungary (Abdulmomen, Alhamdi, Eldawlatly) College of Medicine, King Saud University, Riyadh, Saudi Arabia (Abdyli) American Hospital 3, Tirana, Albania (Abu Elyazed, El-Gendy, Elmazny, Elsherif) Department of anesthesia and surgical ICU, Faculty of medicine, Tanta university, Tanta, Egypt (Puig, Matalobos) Hospital Alvaro Cunqueiro, Complejo Hospitalario Universitario de Vigo, Vigo, Spain (Akbudak, Tanriverdi, Tanriverdi) Department of Anesthesiology and Reanimation, Pamukkale University, Faculty of Medicine, Denizli, Pamukkale, Turkey (Aksu) Department of Anesthesiology and Reanimation, Kocaeli University School of Medicine, Kocaeli, Izmit, Turkey (Alagoz, Sazak, Tunc) Department of Anesthesiology, University of Health Sciences, Ataturk Sanatorium Training and Research Hospital, Ankara, Turkey (Tanase) Department of Anesthesiology and Intensive Care Medicine, Central University and Emergency Military Hospital Dr. Carol Davila, Bucharest, Romania (Almadhati, Sediq) Azadi heart center, Iraq (Altorki) Department of Cardiothoracic Surgery, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, NY, United States (Alvarez, Aragon, Sanchez Garcia) Department of Anesthesiology, La Ribera University Hospital, Alcira, Valencia, Spain (Arun) Selcuk University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Konya, Turkey (Azizoglu, Ozdemir, Yapici) Mersin University School of Medicine, Turkey (Loop, Baar, Hell, Semmelmann, Winroth) Department of Anesthesiology and Critical Care, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany (Balde, Contreras, Mosqueira) Division Anestesiologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile (El Tahan) Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia (Seker) City Hospital Antalya, Turkey (Basheer) King Abdullah Medical City, Makkah, Saudi Arabia (Waeschle) DZHK (German Centre for Cardiovascular Research), Partner site Gottingen, Gottingen, Germany (Bence) Department of Anaesthesia and Intensive Care, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom (Bernardi, Hager, Wall) Medical University of Vienna, Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Division of Cardiac Thoracic Vascular Anaesthesia and Intensive Care Medicine, Vienna, Austria (Bigatello) Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, United States (Bignami) Anesthesiology, Critical Care and Pain Medicine Division, Department of Medicine and Surgery, University of Parma, Parma, Italy (Papamichail, Sfika) "Sotiria"Athens Chest Hospital, Greece (Bonney, Ferrufino) Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, Boston, MA, United States (Bouhemad, Guinot) Departement d'Anesthesie-Reanimation, Centre Hospitalier Universitaire de Dijon, Universite de Bourgogne Franche-Comte, Dijon, France (Bradic, Ilic, Nikolic, Persec, Prazetina, Tipura) Clinical Department of Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, Zagreb, Croatia (Voyagis) University of Patras, Patras, Greece (Bruthans, Michalek) Department of Anesthesiology, Intensive Care and Resuscitation, General University Hospital, Prague, Czechia (Abbenhuis, Bulte) Department of Anesthesiology, Amsterdam University Medical Center, Amsterdam, Netherlands (Cadar) Department of Anesthesia and Intensive Care, Institute of Pneumoftiziology Marius Nasta, Bucharest, Romania (Cakmak, Saracoglu, Sirzai) Marmara University School of Medicine, Istanbul, Turkey (Cali, Deluca) AOU G. Martino Messina, Italy (Papaioannou) Anaesthesiology Department, University Hospital of Heraklion, Crete, Greece (Chai, Chen, Hu, Wang, Yang) Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (USTC), Hefei, China (Chang) Department of Anesthesiology, Taichung Veterans General Hospital, Taiwan (Republic of China) (Tanriverdi, Tanriverdi) Department of Anesthesiology and Reanimation, Denizli State Hospital, Denizli, Merkezefendi, Turkey (Christofaki, Stefanakis) University Hospital of Heraklion, Crete, Greece (Stoica) Faculty of Medicine "Titu Maiorescu", Bucharest, Romania (Sanches, de Castro Pereira, Amendola, Onari) Hospital de Amor de Barretos, SP, Barretos, Brazil (Constantin) Department of Pulmonology, Institute of Pneumoftiziology Marius Nasta, Bucharest, Romania (Socci) Bristol Royal Infirmary (BRI), University Hospitals Bristol and Weston, United Kingdom (Corsi) IRCCS San Martino Policlinico Hospital, Genoa, Italy (da Silva, Magalhaes, Neto) Hospital Sao Vicente de Paulo, Passo Fundo city, Brazil (Defosse) Klinik fur Anasthesiologie und operative Intensivmedizin, Kliniken Koln, Klinikum der Universitat Witten, Herdecke, Koln, Germany (Senturk) Acibadem University, School of Medicine, Department of Anesthesiology and Reanimation, Istanbul, Turkey (Diaper, Luise) Department of Anesthesia, University of Geneva, Switzerland (Didden) Department of Intensive Care, Bernhoven Ziekenhuis, Uden, Netherlands (Dimitriou) University Hospital of Patras, Greece (do Nascimento) Department of Surgical Specialties and Anesthesiology, Clinics Hospital, Botucatu Medical School, University of Sao Paulo State, UNESP, Botucatu, Sao Paulo, Brazil (Domi) Faculty of Medicine, University of Medicine, Tirana, Albania (Persec) University North Department of Biomedical Sciences Croatia, Croatia (Persec) University of Zagreb School of Dental Medicine Croatia, Croatia (Patroniti) IRCCS Ospedale Policlinico San Martino, Genoa, Italy (Globokar, Gnezda, Gorjup, Kovac, Pirc) Clinical Department of Anesthesiology and Intensive Care, University Medical Center, Ljubljana, Slovenia (Duran) Department of Thoracic Surgery, Konya City Hospital, University of Health Sciences, Konya, Turkey (Meco) Ankara University, Brain Research Center (BAUM), Ankara, Turkey (Noto) Division of Anesthesia and Critical Care, Department of Human Pathology of the adult and evolutive age "Gaetano Barresi", University of Messina, Messina, Italy (Pace, Sansone) Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli ", Naples, Italy (Andujar, Lopez-Baamonde, Navarro-Ripoll, Vallejo) Institut d'Investigacions Biomediques Agusti Pi i Sunyer (IDIBAPS), Barcelona, Spain (Emara) Department of Anesthesiology and Intensive Care and Pain Medicine, Mansoura University Hospitals, Mansoura University, Faculty of Medicine, Mansoura, Egypt (de los Santos) Anesthesia Department, National Institute for Respiratory Diseases, Ismael Cosio Villegas, Mexico City, Mexico (Farnell-Ward, Spray) Department of Cardiothoracic Anaesthesia and Critical Care, St George's University Hospitals NHS Trust, London, United Kingdom (Huti) American Hospital, Tirana, Albania (Gil) Consorcio Hospital General Universitario of Valencia, Spain (Gao, Lv, Wang, Zhang) Department of Anesthesiology, Fudan University, Shanghai Cancer Center, Shanghai, China (Geyik, Saracoglu) Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey (Contreras) Departamento de Salud del Adulto y Senescente, Escuela de Enfermeria, Pontificia Universidad Catolica de Chile, Santiago, Chile (Goeden, Koning) Department of Anesthesiology and Pain Medicine, Rijnstate Hospital, Arnhem, Netherlands (Bradic) Department of Biomedical Sciences, University North, Varazdin, Croatia (Neskovic, Rondovic, Stamenkovic, Zeba) Faculty of Medicine, MMA, Belgrade, Serbia (Guerra, de los Angeles Macias Jimenez, de la Vega) Anesthesia Department, National Institute for Respiratory Diseases, Ismael Cosio Villegas, Mexico City, Mexico (Mills) University of Sheffield, Sheffield, United Kingdom (Licker) Faculty of Medicine, University of Geneva, Geneva, Switzerland (Guven, Meco, Guclu) Department of Anesthesiology and ICU, Ankara University, Faculty of Medicine, Ankara, Turkey (Nyktari) School of Medicine, University of Crete, University Hospital of Heraklion, Crete, Greece (Han) Department of Anesthesiology, Shanghai Tongren Hospital, Tongren Hospital Shanghai, Jiao Tong University School Of Medicine, Shanghai, China (Hatipoglu, Turktan) Cukurova University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Adana, Turkey (Hayashi, Kawagoe) Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan (de Abreu) Outcomes Research Consortium, Department of Anesthesiology, Integrated Health Care Institute, Cleveland Clinic, Cleveland, OH, United States (Hofland) Department of Anesthesiology, Pain- and Palliative Care Medicine, Radboud University Medical Centre, Nijmegen, Netherlands (de Abreu) Division of Intensive Care and Resuscitation, Department of Anesthesiology, Integrated Health Care Institute, Cleveland Clinic, Cleveland, OH, United States (Waheedullah) JenaGermany (Hudacek) Department of Anaesthesia, Resuscitation and Intensive Care Medicine, Faculty of Medicine, University Hospital Brno, Brno, Czechia (Huti) University of Medicine, Tirana, Albania (Ziemann) Department of Anaesthesiology, Medical Faculty, RWTH Aachen University, Aachen, Germany (Jankovic, Stojanovic, Vukovic) Clinic for Anesthesiology, Reanimatology and Intensive Therapy, University Clinical Center Nis, Serbia (Andujar, Lopez-Baamonde, Navarro-Ripoll, Vallejo) Anaesthesiology and Intensive Care Department, Hospital Clinic de Barcelona, University of Barcelona, Spain (Zhang) Department of Anesthesiology, West China (Airport) Hospital, Sichuan university, Chengdu, China (Zhang) Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital Affiliated to Tongji University, School of Medicine, Shanghai, China (Kammerer) Klinik fur Anasthesiologie und Operative Intensivmedizin, Universitatsklinikum Koln (AoR), Koln, Germany (Karadza, Kolaric, Spicek-Macan) Department of Anesthesiology and ICU, University Hospital Centre Zagreb, Zagreb, Croatia (Zhang) Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai Geriatric Medical Center, Shanghai, China (Paudel, Ulugol) Acibadem Mehmet Ali Aydinlar University, School of Medicine, Department of Anesthesiology and Reanimation, Istanbul, Turkey (Zarbock) Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Munster, Germany (Waeschle) Department of Anaesthesiology, University Medical Centre Gottingen, Gottingen, Germany (Molyneux) University Hospitals Bristol and Weston NHSFT, Department of Anaesthesia, Bristol, United Kingdom (von Dossow) Institut fur Anasthesiologie und Schmerztherapie, Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitatsklinik der Ruhr, Universitat Bochum, Med. Fakultat OWL, Universitat Bielefeld, Bad Oeynhausen, Germany (Kostopanagiotou) Department of Thoracic Surgery, Attikon University Hospital, Athens, Greece (Kostroglou, Sidiropoulou, Soulioti) Department of Anesthesiology, Attikon University Hospital, Athens, Greece (Vetrugno) Department of Medicine, University of Udine, Udine, Italy (Tanase) University of Medicine and Pharmacy Carol Davila, Bucharest, Romania (Negru) Department of Anesthesiology, Institute of Pneumoftiziology Marius Nasta, Bucharest, Romania (Kreft) Universitatsklinikum Magdeburg A. o. R., Medizinische Fakultat, Otto-von-Guericke Universitat Magdeburg, Magdeburg, Germany (Kumrular, Ozturk, Yaldir, Yildirim) Manisa Celal Bayar University, Faculty of Medicine, Department of Anaesthesiology and Reanimation, Manisa, Turkey (Kuut, Mourisse) Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, Nijmegen, Netherlands (Lan) The first affiliated hospital of Guangzhou Medical University, Guangzhou, China (Li) Department of Anesthesiology, Chang Gung Memorial Hospital, Chiayi, Taiwan (Republic of China) (Li, Yu) Department of Anesthesiology, West China Hospital, Sichuan university, Chengdu, China (Li) Department of Anesthesiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China (Stoica) Department of Anesthesiology Sanador Clinical Hospital, Bucharest, Romania (Stamenkovic) Military Medical Academy, Belgrade, Serbia (Longo, Martuscelli, Schiavoni, Tomaselli) Department of Anesthesia, Intensive Care Medicine and Pain Therapy, Fondazione Policlinico Universitario, Campus Bio-Medico, Rome, Italy (Spadaro, Vitali, Volta) Department of Translational Medicine, University of Ferrara, Azienda Ospedaliera Universitaria di Ferrara, Ferrara, Italy (Socci) Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom (Silva) Instituto de Assistencia Medica ao Servidor Publico Estadual de S. Paulo, SP, Sao Paulo, Brazil (Shelley) Golden Jubilee National Hospital, West of Scotland Heart and Lung Centre, University of Glasgow, Academic Unit of Anaesthesia, Pain and Critical Care, Scotland, Clydebank, United Kingdom (Sertcakacilar) Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Health Sciences University, Istanbul, Turkey (Bingul, Sungur, Turhan) Istanbul University, Istanbul Faculty of Medicine, Department of Anesthesiology and Reanimation, Istanbul, Turkey (Sungur) Department of Anesthesiology and Reanimation, Istanbul University, Istanbul Faculty of Medicine, Turkey (Ozolina) Department of Anesthesiology, Riga East University Hospital, Riga Stradins University, Riga, Latvia (Mavko) Clinical Department of Thoracic Surgery, University Medical Center Ljubljana, Slovenia (Ruiz, Socorro) Insular Hospital, Gran Canaria, Spain (Mermer, Tire) Department of Anesthesiology and Reanimation, Konya City Hospital, University of Health Sciences, Konya, Turkey (Plismanis, Svareniece-Karjaka) Department of Anesthesiology, Riga East University Hospital, Riga, Latvia (Petrovic) Institute For Pulmonary Diseases of Vojvodina, Thoracic Surgery Clinic, Anaesthetic Department, University of Novi Sad, Serbia (Pektas) Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Health Sciences University, Istanbul, Turkey (Patroniti) Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Italy Publisher Elsevier Ltd Abstract Background: The effect of higher positive end-expiratory pressure (PEEP) and recruitment manoeuvres aimed at lung expansion as compared with lower PEEP without recruitment manoeuvres aimed at permissive atelectasis on postoperative pulmonary complications (PPCs) in patients undergoing one-lung ventilation (OLV) during thoracic surgery is unclear. We aimed to determine the contribution of an intraoperative lung expansion strategy to preventing PPCs. Method(s): In this multicentre, randomised, controlled, international phase 3 trial (PROTHOR) conducted at 74 sites in 28 countries, we enrolled adult patients (aged >=18 years) with a BMI of less than 35 kg/m2 who were scheduled for open thoracic or video-assisted thoracoscopic surgery under general anaesthesia requiring one-lung ventilation with a double-lumen tube, with a planned operative time of more than 60 min, and an expected duration of one-lung ventilation longer than that of two-lung ventilation. Patients were randomly assigned (1:1), using permuted blocks of random size (4, 6, and 8) and stratified by study site, to receive one-lung ventilation with either a higher PEEP of 10 cm H<inf>2</inf>O and periodic lung recruitment manoeuvres (high PEEP group) or a lower PEEP of 5 cm H<inf>2</inf>O without routine recruitment manoeuvres (low PEEP group). All patients received protective tidal volumes of 5 mL/kg predicted body weight during one-lung ventilation and 7 mL/kg predicted body weight during two-lung ventilation. Postoperative assessors were masked to treatment allocation. The primary outcome was a composite of PPCs during the first 5 postoperative days, including aspiration pneumonia, moderate or severe respiratory failure, acute respiratory distress syndrome (ARDS), pulmonary infection, atelectasis, cardiopulmonary oedema, pleural effusion, non-operative pneumothorax, pulmonary infiltrates, prolonged air leak, purulent pleuritis, pulmonary embolism, and pulmonary haemorrhage. A modified intention-to-treat analysis was performed, with patients analysed according to their assigned treatment group, except in cases of withdrawal of informed consent, cancellation of surgery, and or loss to follow-up. This trial is registered with ClinicalTrials.gov (NCT02963025) and is completed. Finding(s): Between Jan 3, 2017, and Feb 12, 2024, 2200 patients were randomly allocated: 1099 to the high PEEP group and 1101 to the low PEEP group. 43 patients in the high PEEP group and 33 in the low PEEP group were excluded from the modified intention-to-treat analysis after randomisation. The primary outcome occurred in 555 (53.6%) of 1036 patients in the high PEEP group and 592 (56.4%) of 1049 patients in the low PEEP group (absolute risk difference -2.68 percentage points [95% CI -6.36 to 1.01]; p=0.155). Intraoperative complications occurred in 484 (49.8%) of 972 patients in the high PEEP group and in 305 (31.3%) of 974 patients in the low PEEP group (absolute risk difference 18.09 percentage points [95% CI 14.41-21.77]), among which hypotension (360 [37.3%] of 966 patients in the high PEEP group vs 140 [14.3%] of 978 in the low PEEP group) and new arrhythmias (89 [9.9%] of 899 vs 37 [3.9%] of 956) were more frequent in the high PEEP group, while hypoxaemia rescue manoeuvres were more frequent in the low PEEP group (29 [3.3%] of 888 vs 86 [8.8%] of 982). The proportions of patients with extrapulmonary postoperative complications (110 [10.6%] of 1036 vs 107 [10.2%] of 1049 patients), and the numbers of adverse events (209 vs 204 events), did not differ between groups. Interpretation(s): In patients with a BMI of less than 35 kg/m2 undergoing thoracic surgery, one-lung ventilation using higher PEEP with recruitment manoeuvres, compared with lower PEEP without recruitment manoeuvres, did not reduce PPCs. The choice for intraoperative lung expansion or permissive atelectasis should take the individual gas-exchange and haemodynamic conditions into account, which might vary during the intraoperative period. Funding(s): Clinical Trials Network of the European Society of Anaesthesiology and Intensive Care; Department of Anaesthesiology and Intensive Care, University Hospital Carl Gustav Carus, Technische Universitat Dresden (Dresden, Germany); Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (Brasilia, Brazil); and the Association of Anaesthetists of GB and Ireland. Copyright © 2025 Elsevier Ltd <36> Accession Number 651558606 Title Interventions for Silent Brain Infarction and Perioperative Neurocognitive Disorders in Cardiovascular Surgery (INSPIRE): study protocol for a multicentre randomised controlled trial. Source BMJ open. 16(6) (pp e116246), 2026. Date of Publication: 19 Jun 2026. Author Wang L.; Li S.; Devereaux P.J.; Lv H.; Li T.; Zhang L.; An Y.; Chen J.; Wei C.; Zhao L.; Peng Y.; Shi J. Institution (Wang, Lv, Li, Zhang) Department of Anaesthesiology, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Li) Department of Anaesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (Li, Peng) Outcomes Research Consortium, Houston, TX, United States (Devereaux) World Health Research, Population Health Research Institute, Departments of Health Research Methods, Evidence and Impact, and Medicine, McMaster University, Hamilton, Ontario, Canada (An) Department of Anaesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, China (Chen) Department of Anaesthesiology, Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Wei) Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (Zhao) Department of Anaesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, China (Peng) Department of Anaesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (Shi) Department of Anaesthesiology, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China Abstract INTRODUCTION: The incidence of silent brain infarction (SBI) and perioperative neurocognitive disorders (PND) is higher in cardiac surgery. However, standard preventive strategies remain unknown due to limited evidence. METHODS AND ANALYSIS: This multicentre, prospective, randomised controlled clinical trial with a 1-year follow-up includes patients undergoing elective cardiac surgery with cardiopulmonary bypass (CPB). 912 participants are randomly assigned 1:1 into either the intervention group with neuroprotective anaesthesia targets (mean arterial pressure 65-90 mm Hg, bispectral index 40-60, bilateral regional cerebral oxygen saturation >=60%, arterial inflow temperature <37 and rewarming rate <0.5/min after exceeding 30 during CPB) or the control group maintained by anaesthetists according to routine care. The primary outcome is the 7-day incidence of new-onset SBI. The key secondary outcome is the 30-day incidence of PND. The secondary outcomes include the 5-day incidence of postoperative delirium, the 30-day incidence of new-onset overt stroke, the 1-year incidence of new-onset overt stroke, the 30-day incidence of transient ischaemic attack (TIA), the 1-year incidence of TIA, the 1-year incidence of PND, the 30-day and 1-year composite incidence of major adverse events (renal insufficiency, myocardial infarction, pulmonary embolism, seizure, all-cause mortality), length of stay (LOS) in intensive care unit, LOS in hospital and hospitalisation cost. ETHICS AND DISSEMINATION: The trial was approved by the Institutional Review Board/Independent Ethics Committee of Fuwai Hospital (Approval No. 2024-2445) and all participating centres. We will disseminate the trial findings in peer-reviewed journals and present the results at national or international conferences. TRIAL REGISTRATION NUMBER: NCT07048002. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. <37> Accession Number 2045819235 Title Right internal thoracic artery versus radial artery as the second-best arterial conduit in multi-arterial coronary artery bypass grafting. Source Asian Cardiovascular and Thoracic Annals. 34(6) (pp 515-522), 2026. Date of Publication: 01 Jul 2026. Author Asai T. Institution (Asai) Department of Cardiovascular Surgery, Hayama Heart Center, Kanagawa Prefecture, Japan Publisher SAGE Publications Inc. Abstract Background: Multi-arterial coronary artery bypass grafting (maCABG) improves long-term outcomes compared to single internal thoracic artery grafting. Choosing the second arterial conduit-the right internal thoracic artery (RITA) or the radial artery (RA)-is critical. RITA offers superior biological integrity but raises deep sternal wound infection (DSWI) concerns; RA provides ease of harvest but is susceptible to vasospasm and patency issues. Method(s): This narrative review synthesizes recent high-quality clinical investigations, including propensity-matched cohort studies and meta-analyses, comparing RITA and RA as the second conduit in left internal thoracic artery-based CABG. We analyzed comparative long-term survival, graft patency, and complication rates. Finding(s): Multiple propensity score-matched studies demonstrate the superiority of RITA/bilateral internal thoracic artery (BITA) use, reporting significantly improved long-term survival and major adverse cardiac event-free survival compared to RA. BITA use was associated with a 35% reduction in the long-term hazard of death. Conversely, recent large-scale registries and randomized trials increasingly support the use of RA. The risk of DSWI with BITA use can be mitigated through skeletonized harvesting; however, this technique requires significant expertise to ensure graft patency. Conclusion(s): The second arterial graft selection must be individualized, balancing patient-specific risks-such as diabetes and obesity-against the surgeon's proficiency in multi-arterial revascularization. Copyright © The Author(s) 2026 <38> Accession Number 2043689916 Title Prognostic impact of myocardial bridge on long-term mortality and morbidity: A meta-analysis and systematic review. Source International Journal of Cardiovascular Imaging. 42(6) (pp 1125-1135), 2026. Date of Publication: 01 Jun 2026. Author Alam Y.S.; Nafakhi H.; Mahdi L.; Jumaah A.S.; Abdulzahra M.S.; Al-Aquli H.A.; Yasseen A.A. Institution (Alam, Nafakhi, Abdulzahra) Department of Internal medicine, Faculty of Medicine, University of Kufa, P.O. Box 21, Kufa, Iraq (Mahdi, Jumaah, Yasseen) Department of Pathology and Forensic Medicine, Faculty of Medicine, University of Kufa, P.O. Box 21, Kufa, Iraq (Al-Aquli) Department of general surgery, Faculty of Medicine, University of Kufa, P.O. Box 21, Kufa, Iraq (Nafakhi) Internal medicine department, Medicine College, university of Kufa, P.O. 21, Kufa, Najaf, Iraq Publisher Springer Science and Business Media B.V. Abstract Background: The clinical relevance of myocardial bridge (MB) remains uncertain and inconsistently reported across studies. This study aimed to assess the relationship between MB and long-term mortality and morbidity, while accounting for the influence of varying patient populations and diagnostic methods used to detect MB. Method(s): A comprehensive literature search was conducted to identify studies published up to December 2024 that examined the association between MB and adverse outcomes, including all-cause death (ACD), cardiovascular death (CVD), and major adverse cardiac events (MACE). Result(s): A total of 22 studies involving 37,940 participants were included in the analysis. MB was not significantly associated with an increased risk of ACD or CVD. However, MB showed a significant association with MACE, with a pooled hazard ratio (HR) of 1.958 (95% CI: 1.490-2.572; P < 0.001) across 19 studies. Subgroup analysis indicated that MB identified through conventional coronary angiography was significantly linked to a higher risk of MACE (pooled HR: 1.992; 95% CI: 1.432-2.772; P < 0.001), whereas MB detected using multi-detector computed tomography did not show a statistically significant association with MACE. Among high-risk groups, such as patients with hypertrophic cardiomyopathy and those with high-risk coronary artery disease, MB was associated with a notably increased risk of MACE, with pooled HRs of 2.174 (95% CI: 1.067-4.426; P = 0.032) and 3.435 (95% CI: 1.732-6.810; P < 0.001), respectively. Conclusion(s): MB was associated with an increased relative risk of MACE in pooled analyses but showed no significant association with isolated ACD or CVD. Copyright © The Author(s), under exclusive licence to Springer Nature B.V. 2026. <39> Accession Number 2047083403 Title From evidence to practice: Identifying candidates for semaglutide in chronic atherosclerotic disease. Source International Journal of Cardiology. 461 (no pagination), 2026. Article Number: 134646. Date of Publication: 15 Oct 2026. Author Maggioni A.P.; Orso F.; Lucci D.; De Luca L.; Colivicchi F. Institution (Maggioni, Orso, Lucci) ANMCO Research Center, HCF Fondazione ANMCO per il Tuo cuore ETS, Firenze, Italy (De Luca) Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy (Colivicchi) Clinical and Rehabilitation Cardiology Department, San Filippo Neri Hospital, ASL Roma 1, Roma, Italy Publisher Elsevier Ireland Ltd Abstract Background and aim: Randomised clinical trials (SELECT and SOUL) demonstrated that semaglutide, a GLP-1 receptor agonist, reduces the combined outcome measure of atherothrombotic events or cardiovascular mortality in patients with coronary artery disease, both with and without diabetes. Because real-world populations may differ from trial cohorts, we assessed the proportion of patients potentially eligible for semaglutide using the criteria set out by the regulatory authorities based on the SELECT and SOUL results. Methods and Results: Patients whose clinical characteristics were comparable to those of patients enrolled in the SELECT and SOUL trials were identified within the START and BRING-UP prevention registries. Among 12,430 patients, 623 were excluded because of severe renal impairment or ongoing GLP-1 receptor agonist therapy. The final population included 11,807 patients: 8682 without diabetes and 3125 with diabetes. Among non-diabetic patients, 3689 (42.5%) were SELECT-like, defined as overweight or obese individuals with established coronary disease. Among diabetic patients, 3059 (97.9%) were SOUL-like, defined as individuals aged >=50 years with cardiovascular disease. Overall, 6748 of 12,430 patients (54.3%) theoretically fulfilled eligibility criteria for semaglutide treatment in real-world cardiology practice. Conclusion(s): According to the criteria set out by the regulatory authorities based on the SELECT and SOUL trial results, a large proportion of patients with coronary artery disease managed by cardiologists may be potentially eligible for semaglutide therapy. Identifying the target population for this therapeutic strategy may help clinicians and healthcare authorities estimate unmet clinical needs and evaluate the sustainability of innovative approaches for secondary cardiovascular prevention. Copyright © 2026 Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <40> Accession Number 2042956900 Title Combined assessment of pulmonary artery pulsatility index and pulmonary arterial capacitance for risk stratification following transcatheter aortic valve implantation. Source Acta Cardiologica. 81(4) (pp 438-444), 2026. Date of Publication: 2026. Author Ozaki Y.; Uemura Y.; Kondo T.; Kazama S.; Yamaguchi S.; Okajima T.; Mitsuda T.; Ishikawa S.; Takemoto K.; Okumura T.; Murohara T.; Watarai M. Institution (Ozaki, Uemura, Yamaguchi, Okajima, Mitsuda, Ishikawa, Takemoto, Watarai) Cardiovascular Center, Anjo Kosei Hospital, Anjo, Japan (Kondo, Kazama, Okumura, Murohara) Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan Publisher Taylor and Francis Ltd. Abstract Background: Right heart haemodynamics, including right ventricular function and pulmonary arterial capacitance (PAC), are important prognostic determinants in cardiovascular disease. However, their combined role in patients undergoing transcatheter aortic valve implantation (TAVI) remains unclear. This study aimed to determine whether the combined assessment using pulmonary artery pulsatility index (PAPi) and PAC can stratify clinical outcomes in patients with aortic stenosis (AS) undergoing TAVI. Method(s): This retrospective single-centre study included 77 patients with severe AS who underwent right heart catheterisation within 3 months before TAVI. Patients were stratified into four groups based on the median values of PAPi and PAC. The primary endpoint was a composite of all-cause death or heart failure-related hospitalisation. Result(s): During a median follow-up of 3.60 years (interquartile range: 1.89-4.62), 15 patients experienced the primary endpoint. Kaplan-Meier's analysis showed significant stratification by PAPi-PAC groups (log-rank p = 0.040). In Cox regression models, the low PAPi/low PAC group was independently associated with adverse outcomes compared with the other groups (hazard ratio (HR): 3.65, 95% confidence interval (CI): 1.28-10.40, p = 0.015 adjusted for age and sex; HR: 3.61, 95% CI: 1.27-10.26, p = 0.016 adjusted for natriuretic peptide levels; HR: 3.07, 95% CI: 1.07-8.81, p = 0.038 adjusted for the Meta-analysis Global Group in Chronic Heart Failure score). Conclusion(s): Combined PAPi-PAC assessment identified distinct haemodynamic phenotypes with prognostic significance following TAVI. This approach offers a simple, physiologically grounded framework for postprocedural risk stratification and individualised management. Copyright © 2026 Belgian Society of Cardiology. <41> Accession Number 2046489432 Title Baseline Ejection Fraction as a Modifier of Beta-Blocker Therapeutic Effects in Post-Acute Coronary Syndrome Patients With Non-Reduced Ejection Fraction: A Systematic Review and Meta-Analysis. Source Cardiovascular Therapeutics. 2026(1) (no pagination), 2026. Article Number: 2988999. Date of Publication: 2026. Author Mirhosseini S.A.; Sadrzadeh S.A.; Semirani-Nezhad D.; Rajabi E.; Mohammadi H.; Shaabanpoor Haghighi A.; Jamali M.A.; Moshfeghinia R.; Ranjbar M.; Azami P.; Gupta R.; Aronow W.S.; Attar A. Institution (Mirhosseini, Azami) Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of (Mirhosseini, Azami, Attar) Department of Cardiovascular Medicine, TAHA Clinical Trial Group, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of (Sadrzadeh, Mohammadi, Shaabanpoor Haghighi, Jamali, Moshfeghinia) Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of (Semirani-Nezhad) Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Rajabi) Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Ranjbar) MD-MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of (Gupta) Department of Cardiology, St. Luke's University Health Network, Bethlehem, PA, United States (Aronow) Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, United States Publisher John Wiley and Sons Inc Abstract Background: Beta-blockers are regarded as one of the primary treatment options for acute coronary syndrome (ACS) patients with reduced left ventricular ejection fraction (LVEF). However, there is ongoing debate about their therapeutic efficacy in patients with non-reduced LVEF (>= 40%). Objective(s): To determine the impact of long-term beta-blocker administration on major adverse cardiovascular events (MACE) in ACS patients with LVEF >= 40%. Method(s): A thorough literature search across four databases was conducted to identify eligible studies comparing beta-blocker therapy with placebo or no medication in addition to standard ACS pharmacotherapy. The outcomes of interest included all-cause mortality and MACE (comprising cardiovascular mortality, recurrent myocardial infarction [Re-MI], stroke, rehospitalization for heart failure, and revascularization). Based on LVEF values, patients were divided into three groups: (1) LVEF > 40%, (2) 40% < LVEF < 50%, and (3) LVEF >= 50%, and the random-effects meta-analysis estimated the risk ratios (RRs), hazard ratios (HRs), and 95% confidence intervals (CIs). Result(s): Five randomized controlled trials (RCTs) and 19 observational studies met the inclusion criteria. Within the RCTs, beta-blocker use was associated with a non-significant 6% reduction in MACE (RR = 0.94, 95%CI = 0.87-1.02, I2 = 19.1%). The pooled analyses of observational studies showed no significant overall impact of beta-blocker use on endpoint outcomes. Subgroup analyses revealed a reduction in MACE (HR = 0.75, 95%CI = 0.59-0.95, I2 = 0%) and Re-MI (HR = 0.45, 95%CI = 0.23-0.89) in patients with LVEF 40%-49%; however, these findings were derived primarily from observational data. Patients with LVEF >= 50% did not appear to benefit from long-term beta-blocker use. Conclusion(s): Long-term beta-blocker use did not show a significant benefit in patients with preserved ejection fraction (LVEF >= 50%). Observational data suggested a possible reduction in MACE and Re-MI in the LVEF 40%-49% subgroup; however, this finding requires confirmation in dedicated RCTs. Future larger RCTs are needed to clarify the role of beta-blockers in this borderline population. Copyright © 2026 Seyed Alireza Mirhosseini et al. Cardiovascular Therapeutics published by John Wiley & Sons Ltd. <42> Accession Number 2046534417 Title Robot-Assisted Thoracic Surgery Versus Video-Assisted Thoracic Surgery for Lung Resection: A Systematic Review and Meta-Analysis. Source International Journal of Medical Robotics and Computer Assisted Surgery. 22(3) (no pagination), 2026. Article Number: e70191. Date of Publication: 01 Jun 2026. Author Maghrabi A.; Altoukhi S.M.; Alghamidi F.A.S.; Alshammari M.M.; Alharbi W.M.; Hanbazazah M.A.; Almasoudi M.M.; Jamjoum G. Institution (Maghrabi) Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia (Maghrabi) Thoracic Surgery Division, Department of Surgery, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia (Altoukhi, Alharbi) College of Medicine, University of Jeddah, Jeddah, Saudi Arabia (Alghamidi) College of Medicine, King Khalid University, Abha, Saudi Arabia (Alshammari) College of Medicine, University of Hail, Hail, Saudi Arabia (Hanbazazah) College of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia (Almasoudi) College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia (Jamjoum) Department of Surgery, King Abdulaziz University Hospital, Jeddah, Saudi Arabia (Jamjoum) Gastrointestinal Oncology Unit, King Abdulaziz University Hospital, Jeddah, Saudi Arabia Publisher John Wiley and Sons Ltd Abstract Background: Lung resection is a standard treatment for lung cancer. Video-assisted thoracoscopic surgery (VATS) is widely used as a minimally invasive approach. Recent advancements in robotic technology enhances the safety and efficacy of robot-assisted thoracic surgery (RATS). This systematic review and meta-analysis compared the clinical outcomes of RATS and VATS in lung resection. Method(s): PubMed, ClinicalTrials.gov, and the Cochrane Library were searched from inception to June 2025. Primary outcomes were lymph node yield and operative time. Secondary outcomes included R0 resection, postoperative complications, and recurrence. Data were analysed using Review Manager v5.4.1 with random-effects models. Result(s): Twenty-nine studies involving 66,406 patients were included. RATS significantly improved lymph node yield (MD 4.54; 95% CI 2.91-6.17) and showed shorter operative time (MD -6.09; 95% CI -13.20-1.03). RATS was associated with higher R0 resection rates, fewer complications, and lower recurrence. Conclusion(s): The findings support the safety and oncologic effectiveness of RATS. Copyright © 2026 John Wiley & Sons Ltd. <43> Accession Number 2045782145 Title Prehabilitation Before Cardiac Surgery and Structural Heart Interventions: An Umbrella Review of Pooled Evidence. Source Journal of Clinical Medicine. 15(10) (no pagination), 2026. Article Number: 3821. Date of Publication: 01 May 2026. Author Hughes E.H.; Lotto R.; Dawson E.A.; Saber M.; Richards E.; Morris A.; Mayhew D.; Faraz F.; Ashrafi R.; Jones J.D. Institution (Hughes, Saber, Morris, Mayhew, Faraz, Ashrafi, Jones) Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, United Kingdom (Hughes, Dawson) Research Institute for Sport and Exercise Science, Faculty of Health, Innovation, Technology & Science, Liverpool John Moores University, Liverpool, United Kingdom (Hughes, Lotto, Dawson, Mayhew, Faraz, Ashrafi, Jones) Liverpool Centre for Cardiovascular Science, Liverpool, United Kingdom (Lotto) School of Nursing, Public and Allied Health, Faculty of Health, Innovation, Technology & Science, Liverpool John Moores University, Liverpool, United Kingdom (Richards) School of Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Prehabilitation aims to optimise patients before cardiac procedures through interventions including exercise training, respiratory conditioning, nutritional support, psychological preparation and multimodal lifestyle programmes. Evidence from systematic reviews and meta-analyses is increasing but remains heterogeneous due to variation in intervention design, patient populations and overlap of primary studies. Method(s): We conducted an umbrella review of 17 systematic reviews and meta-analyses evaluating prehabilitation prior to cardiac surgery and structural heart interventions in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Methodological quality of included reviews was assessed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2). Outcomes of interest were postoperative pneumonia, hospital length of stay (LOS), and mortality. Result(s): Across pooled analyses, the most consistent finding was a reduction in postoperative pneumonia, particularly in studies incorporating inspiratory muscle training (IMT), with relative risk reductions of approximately 55-62%, corresponding to a modest absolute risk reduction. Reductions in hospital LOS were also reported, although effect sizes were smaller and more variable. In contrast, no consistent reduction in short-term mortality was demonstrated, likely reflecting low event rates. The evidence base was limited by substantial overlap between reviews and predominantly low or critically low methodological quality. Conclusion(s): Prehabilitation, particularly when incorporating IMT, is consistently associated with a reduction in postoperative pneumonia and may contribute to modest reductions in hospital LOS. However, the evidence base is constrained by heterogeneity, study overlap and low methodological quality. Further high-quality, adequately powered randomised trials are required to define the role of prehabilitation in contemporary cardiac surgical and structural intervention practice. Copyright © 2026 by the authors. <44> Accession Number 2044945185 Title Impact of SGLT2 Inhibitors on Clinical Outcomes in Patients with Diabetes Mellitus Following Heart Transplantation: A Meta-analysis. Source Diabetes Therapy. 17(6) (pp 839-852), 2026. Date of Publication: 01 Jun 2026. Author Wang H.; Xie X.; Gong G.; Huang L.; Tang Z. Institution (Wang) Department of Cardiology, The Peoples Hospital of Guangxi Zhuang Autonomous Region, Guangxi, Nanning, China (Xie) Macau University of Science and Technology, Macao (Gong) Department of Cardiology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi, Nanning, China (Huang) Wuming Hospital of Guangxi Medical University, Guangxi, Nanning, China (Tang) Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China Publisher Adis Abstract Introduction: In this new era, heart transplantation (HT) is rapidly gaining popularity worldwide. Patients with end-stage heart disease are often candidates for HT. However, studies have shown that more than 30% of patients who undergo HT have pre-existing diabetes mellitus (DM), which is associated with a higher risk of graft failure and death. In this analysis, we aimed to assess the impact of sodium-glucose co-transporter 2 (SGLT2) inhibitors on clinical outcomes in patients with DM following HT. Method(s): Online databases were searched for relevant publications. The statistical analysis was performed using the RevMan software version 5.4. The clinical outcomes included rejection post-HT, mortality, sepsis, weight reduction, change in body mass index (BMI), change in serum creatinine level, glomerular filtration rate (eGFR), and improvement in glycated hemoglobin (HbA1c). For dichotomous data, risk ratios (RR) with 95% confidence intervals (CI) were used to summarize the analysis. However, for continuous data, weight mean difference (WMD) with 95% CI was used. Result(s): Eight studies with a total number of 2755 participants were included in this analysis. Our current results showed that rejection risk post HT was significantly lower in the SGLT2 inhibitor group (RR: 0.85, 95% CI: 0.78-0.93; P = 0.0001). The mortality risk was not significantly different (RR: 0.64, 95% CI: 0.32-1.29; P = 0.21). Similarly, sepsis following HT was similar in both groups (RR: 1.62, 95% CI: 0.13-20.11; P = 0.71). No significant differences were observed in weight reduction, BMI, change in serum creatinine level, change in eGFR, or improvement in HbA1c following HT. Conclusion(s): In participants with DM following HT, SGLT2 inhibitors significantly reduced rejection post transplantation. However, its impact on other important clinical outcomes, including mortality, should be further assessed with more data in future studies. Copyright © The Author(s) 2026. <45> Accession Number 2046476007 Title Beta-Blockers After Myocardial Infarction With Preserved and Mildly Reduced Ejection Fraction: A Meta-Analysis With Trial Sequential Analysis. Source European Journal of Clinical Investigation. 56(6) (no pagination), 2026. Article Number: e70238. Date of Publication: 01 Jun 2026. Author Maremmani M.; Gianfico P.; Templin C.; Montecucco F.; Liberale L.; Kraler S.; Schweiger V.; Berti S.; Emdin M.; Di Vece D. Institution (Maremmani) Department of Cardiology, Sant'Andrea Hospital, La Spezia, Italy (Gianfico) Department of Cardiology, Vita-Salute San Raffaele University, Milan, Italy (Templin, Di Vece) Department of Internal Medicine B, University of Medicine Greifswald, Greifswald, Germany (Templin, Kraler) Center for Molecular Cardiology, Schlieren Campus, University of Zurich, Zurich, Switzerland (Montecucco, Liberale, Di Vece) Department of Internal Medicine, University of Genoa, Genoa, Italy (Montecucco, Liberale) IRCCS Ospedale Policlinico San Martino Genoa - Italian Cardiovascular Network, Genoa, Italy (Schweiger) Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Berlin, Germany (Berti, Emdin) Fondazione Toscana Gabriele Monasterio, Pisa, Italy (Emdin) Health Science Interdisciplinary Center, Scuola Superiore Sant'anna, Pisa, Italy Publisher John Wiley and Sons Inc Abstract Aims: We aimed to evaluate the efficacy of beta-blockers after myocardial infarction (MI) across left ventricular ejection fraction (LVEF) strata and to assess the conclusiveness of the available evidence using trial sequential analysis (TSA). Method(s): PubMed, Embase and ClinicalTrials.gov were searched for randomized controlled trials (RCTs) evaluating beta-blockers in post-MI patients with LVEF >= 40%. A time-to-event meta-analysis was performed for the primary composite (as defined by each trial) and for individual endpoints. The Mantel-Haenszel method was used to pool risk ratios (RR) for major adverse cardiovascular events (MACE; death, MI or heart failure), including LVEF-stratified analyses. TSA estimated the required information size (RIS) and generated adjusted significance and futility boundaries, assuming a 5% type I error and 90% power. Result(s): Across 19,826 post-MI patients (17,941 with LVEF >= 50% and 1885 with LVEF 40%-49%), beta-blockers did not reduce time to the primary endpoint (HR 0.92, 95% CI 0.85-1.01; p = 0.08; I2 = 35%) or mortality. In patients with preserved LVEF (>= 50%), beta-blocker therapy did not reduce the risk of death or MACE (RR 0.96, 95% CI 0.87-1.05; I2 = 42%), with TSA confirming futility. Among those with mildly reduced LVEF (40%-49%), beta-blockers reduced MACE (RR 0.74, 95% CI 0.58-0.94; I2 = 0%), although TSA failed to establish conclusiveness (RIS of 5717 [14.4%]). A significant interaction by LVEF subgroup was observed for cardiac death (p = 0.03). Conclusion(s): beta-blockers conferred no benefit in post-MI patients with preserved LVEF, with conclusive evidence of futility, whereas therapy was associated with reduced MACE in those with mildly reduced LVEF, pending confirmation in further adequately powered randomized trials. Copyright © 2026 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd. <46> Accession Number 2046520452 Title A Systematic Review of Modeling Platforms for Atrioventricular Valves in Atrioventricular Septal Defects. Source Journal of Cardiovascular Translational Research. 19(1) (no pagination), 2026. Article Number: 73. Date of Publication: 01 Dec 2026. Author Wang C.C.; Marx M.; Barth E.; D'Amore A.; Luo H.; Coyan G. Institution (Wang, Marx, Coyan) Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, TN, United States (Barth, Luo) Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, United States (D'Amore) Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States (D'Amore) Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States (Coyan) Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, United States (Coyan) Division of Pediatric Cardiac Surgery, Vanderbilt University Medical Center, Nashville, TN, United States Publisher Springer Abstract Given the high rate of re-intervention in patients with atrioventricular septal defects (AVSD), there is a continuing need to accurately model the complex valve anatomy and surgical repair strategies. This systematic review examined the current scientific landscape for modeling platforms designed to study abnormal congenital heart valves that are used or could be used for AVSD investigation. Of 1,050 sources screened, 47 were included (14 in silico; 26 in vitro; 7 in vivo). In silico models studying valve pathologies have advanced in recent years, but few targeted AVSD valves. In vitro platforms allow comparisons of repair techniques, but have yet to be applied for AVSD valve repair. In vivo studies could offer physiologically accurate platforms, but face challenges such as replicating AVSD pathologies. Multidisciplinary approaches to creating high-fidelity, reproducible, physiologically accurate AVSD valve models can transform the understanding of AVSD valve properties and repair strategies. Copyright © The Author(s) 2026. <47> Accession Number 2046388478 Title Antiplatelet therapy on top of anticoagulation in atrial fibrillation: when less may be more. Source IJC Heart and Vasculature. 65 (no pagination), 2026. Article Number: 101948. Date of Publication: 01 Aug 2026. Author Renda G.; Sorella A. Institution (Renda, Sorella) Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy Publisher Elsevier Ireland Ltd <48> Accession Number 2037935254 Title Ultrasound-guided in-plane and Out-of-plane Techniques Versus Landmark Technique for Internal Jugular Vein Catheterization in Adult Cardiac Surgery Patients. Source Kathmandu University Medical Journal. 23(4) (pp 458-463), 2025. Date of Publication: 01 Oct 2025. Author Amatya A.; Pudasaini A.; Bhusal S.; Bajracharya S.M.; Shrestha B.K.; Pandey P.; Shrestha B.M. Institution (Amatya, Pudasaini, Bhusal, Bajracharya, Shrestha, Pandey, Shrestha) Department of Anesthesia, Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Nepal Publisher Kathmandu University Abstract Background Internal jugular vein (IJV) catheterization is routinely performed in cardiac surgical patients. Ultrasound (US) guidance has been shown to increase success rates and reduce complications compared to landmark (LM) techniques; however, access to ultrasound machines and operator skill remain limitations in several centers. Objective To compare two different real-time 2-dimensional ultrasound-guided short axis/out-off-plane (SAX OOP) and long axis/in-plane (LAX IP) approaches and to determine whether ultrasound guidance could improve the success rate and decrease the complication rate of internal jugular vein catheterization compared with the landmark approach (LM). Method This Prospective, randomized comparative study evaluated three techniques for internal jugular vein cannulation in adult elective cardiac surgery patients (n=90): (1) real-time short-axis/out-of-plane ultrasound guidance (SAX-OOP), (2) real-time long-axis/in-plane ultrasound guidance (LAX-IP), and (3) landmark technique (LM). Primary outcomes included number of attempts and procedure duration. Secondary outcomes included mechanical complications. Chi-square for categorical variables and one-way ANOVA for continuous variables were applied to find out the associations. Result First-attempt success was highest in LAX-IP (100%), followed by SAX-OOP (96.7%) and LM (83.3%) (p=0.024). All complications (n=7) occurred in the LM group (p=0.001). Mean cannulation time was significantly longer in the LM group (90.83+/-13.23 seconds) versus SAX-OOP (60.47+/-10.96 seconds) and LAX-IP (70.47+/-23.10 seconds) (p<0.001). Conclusion Real-time ultrasound guidance, particularly the in-plane technique, significantly improves success rates, reduces complications, and shortens cannulation time compared with the landmark technique. Ultrasound guidance should be preferred for internal jugular vein cannulation in cardiac anesthesia settings. Copyright © 2025, Kathmandu University. All rights reserved. <49> Accession Number 2046551784 Title Mitral annular disjunction and high-risk profiles: a conceptual approach to risk stratification and surgical implications. Source General Thoracic and Cardiovascular Surgery. (no pagination), 2026. Date of Publication: 2026. Author Furukawa K.; Ishii H.; Sakaguchi S.; Mori K.; Iwasaki A.; Meiri R. Institution (Furukawa, Ishii, Sakaguchi, Mori, Iwasaki, Meiri) Division of Cardiovascular Surgery, Department of Surgery, Faculty of Medicine, University of Miyazaki, 5200 Kiyotakecho Kihara, Miyazaki, Miyazaki-City, Japan Publisher Springer Abstract Objective: Mitral annular disjunction (MAD), frequently associated with Barlow's disease, links degenerative mitral regurgitation to postoperative ventricular arrhythmias and sudden cardiac death, even after technically successful valve repair. However, despite advances in mitral repair, the arrhythmic substrate associated with MAD remains insufficiently addressed in current surgical paradigms. Method(s): A systematic search of PubMed and Google Scholar (2000-2025) was conducted using keywords including "mitral annular disjunction," "mitral regurgitation," "arrhythmic mitral valve prolapse," and "mitral valve surgery." Of 264 records screened, 41 peer-reviewed articles, prioritizing high-impact registries and surgical cohorts, were selected for synthesis. Result(s): MAD is associated with paradoxical annular curling and traction-related myocardial remodeling, which may contribute to fibrosis through pathological stretch. Observational studies suggest that higher-risk features-such as extensive MAD (>= 5 mm, particularly >= 8.5 mm), late gadolinium enhancement, or syncope-are linked to increased arrhythmic vulnerability. Although modern repair techniques can eliminate anatomical MAD, pre-existing substrate abnormalities may persist, and ventricular arrhythmias can still occur after technically successful repair. Conclusion(s): The extent of disjunction and the presence of associated substrate abnormalities appear to influence long-term rhythm stability. A conceptual, hypothesis-generating framework that integrates structural, electrical, imaging, and clinical information may help inform risk stratification. Prospective studies are needed to determine whether a risk-stratified approach or optimized intervention timing can modify arrhythmic risk or potentially affect long-term outcomes. Copyright © The Author(s) 2026. <50> Accession Number 2046195456 Title Conventional cardiac resynchronization therapy upgrading and its effect on functional mitral regurgitation in patients with pacing-induced cardiomyopathy. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1758374. Date of Publication: 19 May 2026. Author Adukauskaite A.; Adukauskiene D.; Senoner T.; Bilgeri V.; Spitaler P.; Rubatscher A.; Schgor W.; Stuhlinger M.; Pfeifer B.E.; Hintringer F.; Dichtl W.; Barbieri F. Institution (Adukauskaite, Senoner, Bilgeri, Spitaler, Rubatscher, Schgor, Stuhlinger, Hintringer, Dichtl) University Hospital for Internal Medicine III (Cardiology and Angiology), Medical University Innsbruck, Innsbruck, Austria (Adukauskiene) University Hospital of Lithuanian Health Sciences University, Kaunas, Lithuania (Pfeifer) Institute of Clinical Epidemiology, Tirol Kliniken, Innsbruck, Austria (Pfeifer) Institute of Electrical and Biomedical Engineering, University for Health Sciences, Medical Informatics and Technology (UMIT), Hall in Tirol, Austria (Barbieri) Department of Cardiology, Angiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Campus Benjamin Franklin, Berlin, Germany (Barbieri) Department of Cardiology, Angiology and Intensive Care Medicine, Charite - Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany (Barbieri) Institute of Active Polymers and Berlin-Brandenburg Center for Regenerative Therapies, Helmholtz-Zentrum Hereon, Teltow, Germany Publisher Frontiers Media SA Abstract Background - Data on the effects of conventional cardiac resynchronization therapy (CRT) upgrading by implantation of a left ventricular lead via the coronary sinus on functional mitral regurgitation (MR) in patients with pacing-induced cardiomyopathy are scarce. Methods - This analysis of the UPGRADE study, an investigator-initiated randomized controlled trial to evaluate the effect of conventional CRT on central sleep apnea, evaluated the significance of CRT on MR in all included patients. Differences in all-cause mortality were assessed in patients with significant MR during long-term follow-up. Results - Overall, 54 patients were included in the trial. MR was found in the majority of patients [mild: n = 30 (55.6%), moderate: n = 15 (27.8%), severe: n = 6 (11.1%)], while "none/trace" MR was observed in only three (5.6%) patients. CRT was associated with a significant reduction in MR ["none/trace": n = 5 (9.6%), mild: n = 37 (71.2%), moderate: n = 6 (11.5%), severe: n = 4 (7.7%); p = 0.035)] after 3-5 months, with all patients either having an improvement in MR grading or it remaining unchanged. Notably, only two patients with severe MR improved to either a mild or moderate level. CRT upgrading was linked to a significant amelioration of vena contracta width [2 mm (1.0-4.3) at baseline versus 2 mm (1.0-3.0) post-CRT; r = 0.73, 95% CI 0.53-0.85, p < 0.001]. The presence of significant MR at baseline was associated with impaired survival during long-term follow-up [MR < 2: n = 14 (42.4%), MR >= 2: n = 19 (90.5%); hazard ratio 0.25 (95% CI 0.12-0.54); log rank p < 0.001]. Conclusion - Conventional CRT upgrading in patients with pacing-induced cardiomyopathy was associated with significant improvement in MR grading. The presence of moderate or severe MR at baseline was associated with impaired outcomes during long-term follow-up, suggesting that these patients represent a high-risk cohort. Copyright © 2026 Adukauskaite, Adukauskiene, Senoner, Bilgeri, Spitaler, Rubatscher, Schgor, Stuhlinger, Pfeifer, Hintringer, Dichtl and Barbieri. <51> Accession Number 2046762209 Title CPR-induced vertebral fractures: a case report and systematic review of literature. Source Journal of Forensic and Legal Medicine. 121 (no pagination), 2026. Article Number: 103192. Date of Publication: 01 Jul 2026. Author Gozzelino C.; Pigaiani N.; Sanna J.; Chighine A. Institution (Gozzelino, Sanna, Chighine) Department of Medical Sciences and Public Health, Section of Legal Medicine, University of Cagliari, Cagliari, Italy (Pigaiani) Department of Diagnostics and Public Health, Section of Legal Medicine, University of Verona, Verona, Italy Publisher Churchill Livingstone Abstract Background: Cardiopulmonary resuscitation is a critical intervention for cardiac arrest, but its forceful chest compressions can lead to skeletal injuries, including rare vertebral fractures Case presentation: This case report details a 78-year-old woman with a history of cardiac surgery and obesity who suffered a fatal cardiac arrest due to a DeBakey type II aortic dissection. Despite 30 minutes of advanced manual CPR, she succumbed to cardiogenic shock. Autopsy revealed an incidental transvertebral fracture of the 8th thoracic vertebra alongside multiple bilateral rib fractures, with no evidence of pre-existing trauma Literature review: A systematic literature search was conducted in three major scientific databases and reported according to PRISMA 2020, with structured eligibility criteria and methodological quality appraisal of included reports. Results were evaluated by two independent reviewers. Data on demographics, anatomy, bone comorbidities, and CPR were extracted independently and reviewed collectively Conclusion(s): A systematic literature review of 16 studies identified 23 cases of CPR-related vertebral fractures, predominantly in the mid-to-lower thoracic spine, with Th10 being the most affected level. Pre-existing conditions such as osteopenia, osteoporosis, and kyphosis increase susceptibility to these injuries by compromising spinal integrity. The biomechanical forces of CPR, combined with structural vulnerabilities, contribute to this rare complication. This case underscores the importance of post-mortem examinations in distinguishing CPR-related injuries from traumatic causes, aiding forensic investigations. Clinicians and forensic pathologists should remain vigilant for vertebral fractures as a potential CPR complication, particularly in elderly patients with predisposing bone conditions, to ensure accurate diagnosis and avoid medico-legal issues. Copyright © 2026 Published by Elsevier Ltd. <52> Accession Number 2045389883 Title Impact of pre-operative factors on post-operative atrial fibrillation outcomes after cardiac surgery: systematic review with meta-analysis, trial sequential analysis, and meta-regression. Source Acta Cardiologica. 81(4) (pp 505-519), 2026. Date of Publication: 2026. Author Khalil I.; Hrebat M.; Abuawwad T.; Zetawi M.; Yassin B.M.; Amayre S.I.; Amarin H.; Gouda A.G.; Khazbak M.A.; Khatib S.; Mohammed M.H.H.; Okasha A.A.; Hassan Ali A.O.; Tntoush T.; Laouadi N. Institution (Khalil) Faculty of Medicine, Alexandria University, Alexandria, Egypt (Hrebat) Faculty of Medicine, Tanta University, Tanta, Egypt (Abuawwad) Fujian Medical University, Fuzhou, China (Zetawi, Khatib) Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine (Yassin) Faculty of Medicine, Kuwait University, Kuwait City, Kuwait (Amayre, Amarin) Faculty of Medicine, Al-Quds University, Jerusalem, Palestine (Gouda) Ministry of Health, Kuwait City, Kuwait (Khazbak) Ministry of Health, Muscat, Oman (Mohammed) Faculty of Medicine, University of Khartoum, Khartoum, Sudan (Okasha) Faculty of Medicine, University of Jordan, Amman, Jordan (Hassan Ali) Critical Care Department, Dr. Soliman Fakeeh Hospital, Riyadh, Saudi Arabia (Tntoush) Sidra Medicine, Doha, Qatar (Laouadi) Heart Center, King Abdulaziz Specialized Hospital, Al Jouf, Saudi Arabia Publisher Taylor and Francis Ltd. Abstract Objectives: Post-operative atrial fibrillation (POAF) is the most common arrhythmia following cardiac surgery. We conducted a systematic review and meta-analysis to quantify the association between POAF and adverse outcomes. Method(s): We searched PubMed, Embase, CENTRAL, and Web of Science through December 2024. Studies comparing outcomes between POAF and non-POAF patients after cardiac surgery were included. Random-effects meta-analysis was performed. Trial sequential analysis, Bayesian analysis, subgroup analyses, and meta-regression were conducted. Evidence certainty was assessed using the GRADE framework. Result(s): Fifty-four studies (623,962 patients) were included. POAF was associated with significantly increased risks of early mortality (RR 1.94; 95% CI 1.89-2.00; I2=0%), late mortality (RR 1.59; 95% CI 1.50-1.69; I2=30%), stroke (RR 1.39; 95% CI 1.34-1.44; I2=12%), and acute kidney injury (RR 1.53; 95% CI 1.49-1.57; I2=0%). Trial sequential analysis confirmed conclusive evidence for all outcomes. Bayesian posterior probability was 100% for all outcomes. GRADE certainty was moderate for early mortality, late mortality, and AKI; low for stroke. Meta-regression identified prior stroke prevalence and chronic kidney disease as significant effect modifiers. Conclusion(s): POAF is associated with substantially increased risks of mortality, stroke, and acute kidney injury following cardiac surgery. These findings support evidence-based prevention strategies and comprehensive management of POAF. Copyright © 2026 Belgian Society of Cardiology. <53> Accession Number 2046550893 Title Machine learning vs. traditional methods for predicting postoperative cardiac complications after non-cardiac surgery: a systematic review and Bayesian network meta-analysis. Source Anaesthesia. (no pagination), 2026. Date of Publication: 2026. Author Dhaliwal S.; Chen S.; Papas C.; Hughes I.; Cavalucci D.; O'Rourke N. Institution (Dhaliwal, Hughes) Gold Coast Hospital and Health Service, Southport, QLD, Australia (Chen, Papas) Goulburn Valley Health, Shepparton, VIC, Australia (Cavalucci, O'Rourke) The Wesley Hospital, Auchenflower, QLD, Australia Publisher John Wiley and Sons Inc Abstract Introduction: Accurate prediction of peri-operative cardiac complications is critical to optimise pre-operative decision-making. Traditional risk prediction scores, such as the Revised Cardiac Risk Index, show only modest discrimination. Machine learning can model complex, non-linear relationships but their predictive performance compared with traditional scores remains unclear. Method(s): We performed a systematic review and Bayesian network meta-analysis. The primary outcome was postoperative adverse cardiac events following non-cardiac surgery. Prediction models were assessed relative to the Revised Cardiac Risk Index. As many studies evaluated multiple versions of each model type, the highest performing ('best version') and lowest performing ('worst version') results were analysed. Models were ranked using the surface under the cumulative ranking curve (SUCRA). Result(s): Thirteen studies evaluating 54 models and 927,113 patients were included. Machine learning approaches generally outperformed traditional risk scores. Automated machine learning ranked highest (SUCRA 96.6) showed the greatest improvement in the best version analysis (mean difference (MD) 0.28 (95%CrI 0.16-0.40)) and remained superior in the sensitivity analysis (MD 0.30 (95%CrI 0.14-0.45)). Gradient boosting models showed superior performance over the Revised Cardiac Risk Index across analysis (best version: MD 0.20 (95%CrI 0.14-0.26), worst version: MD 0.18 (95%CrI 0.12-0.25), SUCRA 82.4). The Gupta Perioperative Risk for Myocardial Infarction or Cardiac Arrest score outperformed the Revised Cardiac Risk Index in the best version analysis (MD 0.16 (95%CrI 0.01-0.32)). Between-study heterogeneity was low. None of the included studies externally validated their machine learning models and only six were judged to be at low risk of bias. Discussion(s): Most machine learning models showed better discrimination than traditional risk scores, with automated machine learning and gradient boosting models ranking highest. However, study quality, calibration reporting and absence of external validation limit immediate clinical adoption. Prospective, multicentre evaluation is required before integration of these models into peri-operative practice. Copyright © 2026 Association of Anaesthetists. <54> Accession Number 2046873894 Title Coagulopathy in Cardiac Surgery: A Scoping Review of Prothrombin Complex Concentrate. Source Heart Lung and Circulation. (no pagination), 2026. Date of Publication: 2026. Author Vander Zwaag S.; Kukel I.; Fassl J. Institution (Vander Zwaag, Kukel, Fassl) Institute of Cardiac Anaesthesiology, Heart Centre and Medical Faculty, TUD Dresden University of Technology, Dresden, Germany Publisher Elsevier Ltd Abstract Background: Coagulopathy after cardiopulmonary bypass substantially contributes to postoperative bleeding, transfusion requirements, morbidity, and mortality. The traditional treatment option is fresh frozen plasma (FFP), but prothrombin complex concentrate (PCC) has become an alternative in the past years. Aim(s): This study aimed to systematically map the current evidence and identify critical knowledge gaps regarding the efficacy, optimal timing, dosing regimens, point-of-care testing guidance, administration order, cost-effectiveness, and safety of 4-factor PCC in adult patients undergoing on-pump cardiac surgery, thereby informing future research priorities. Method(s): A scoping review was conducted following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. A search of several databases was conducted on 8 April 2025 without restrictions on the language or date of the publications. Study selection, data extraction, and charting were performed independently by two mutually blinded reviewers. Result(s): A total of 57 primary studies (seven randomised controlled trials, 36 retrospective cohorts, five prospective cohorts, and nine experimental investigations) and 15 reviews with or without meta-analyses were identified. Evidence consistently indicates that PCC reduces postoperative chest tube output and transfusion requirements compared with FFP, although the effect sizes vary. Reported dosing ranged from fixed 500-4000 IU to weight-based 15-30 IU kg-1. Viscoelastic testing guides PCC administration; however, standardised thresholds are lacking. Limited data suggest that PCC may be more cost-effective than FFP, and serious adverse events appear to be rare. No study has directly compared different PCC dosing regimens or prophylactic use in high-risk patients. Conclusion(s): Substantial evidence gaps remain concerning the optimal dose, timing, viscoelastic targets, sequencing with fibrinogen concentrate, and health economic analyses of PCC use in cardiac surgery. High-quality randomised trials addressing these unanswered questions are warranted to refine the clinical guidelines. Copyright © 2026 The Author(s) <55> Accession Number 2038281813 Title Perioperative albumin versus other fluids to prevent cardiac surgery-associated kidney injury: a systematic review and meta-analysis of randomized trials. Source Critical Care Science. 38 (no pagination), 2026. Article Number: e20260353. Date of Publication: 2026. Author Darlison P.R.; Shehabi Y.; Walker H.G.M.; Neto A.S.; Motorniak D.C.; Pakavakis A.; Balachandran M.; Wigmore G.J.; Bellomo R.; Brown A.J.W. Institution (Darlison) Department of Anaesthesia, Perioperative Medicine, and Pain Medicine, Peter MacCallum Cancer Centre-Melbourne, VIC, Australia (Darlison, Walker, Motorniak, Brown) Department of Critical Care Medicine, St Vincent's Hospital Melbourne-Fitzroy, VIC, Australia (Darlison) Sir Peter MacCallum, Department of Oncology, The University of Melbourne-Melbourne, VIC, Australia (Shehabi, Pakavakis) School of Clinical Sciences at Monash Health, Monash University-Clayton, VIC, Australia (Shehabi, Pakavakis, Balachandran) Department of Intensive Care, Monash Medical Centre-Clayton, VIC, Australia (Shehabi, Pakavakis, Balachandran) Department of Intensive Care, The Victorian Heart Hospital-Clayton, VIC, Australia (Shehabi) Prince of Wales Clinical School of Medicine, University of New South Wales-Randwick, NSW, Australia (Walker, Neto, Wigmore, Bellomo, Brown) Department of Critical Care, University of Melbourne-Melbourne, VIC, Australia (Neto, Bellomo, Brown) Australia and New Zealand Intensive Care Research Centre, Monash University-Clayton, VIC, Australia (Neto, Bellomo, Brown) Intensive Care Unit, Austin Health-Heidelberg, VIC, Australia (Neto) Department of Critical Care Medicine, Hospital Israelita Albert Einstein, SP, Sao Paulo, Brazil (Motorniak, Wigmore) Faculty of Medicine, Nursing and Health Sciences, Monash University-Clayton, VIC, Australia Publisher Associacao de Medicina Intensiva Brasileira - AMIB Abstract Objective: Cardiac surgery-associated acute kidney injury is a common and serious complication of cardiac surgery. Albumin solution is a commonly administered fluid in cardiac surgery patients; the role of albumin in preventing cardiac surgery-associated acute kidney injury is unclear. The objective of this systematic review and meta-analysis was to evaluate the impact of perioperative albumin compared with other fluid regimens on the risk of acute kidney injury in cardiac surgical patients undergoing cardiopulmonary bypass. Method(s): A systematic search was performed of MEDLINE, Embase, CINAHL, and Cochrane Central Register of Controlled Trials databases, and the Australian New Zealand Clinical Trials Registry, ClinicalTrials.gov, World Health Organization International Clinical Trials Registry Platform, and ISRCTN registries. Randomized trials of adult patients undergoing on-bypass cardiac surgery comparing albumin-containing solutions with any other fluid regimen given perioperatively were included. Trials comparing fluids used only for bypass priming were excluded. Data extraction, risk of bias, and certainty of evidence were assessed in duplicate by independent reviewers. A Bayesian framework was the primary statistical approach, with a secondary frequentist approach. The primary outcome was perioperative acute kidney injury, defined as the period from surgery until hospital discharge. Secondary outcomes were all-cause mortality at longest follow-up, intensive care unit length of stay, hospital length of stay, proportion of patients requiring renal replacement therapy postoperatively, duration of mechanical ventilation postoperatively, and duration of vasopressor support postoperatively. Result(s): Fourteen randomized trials, including 3,304 adults, were included in the analysis. Seven trials contributed data to the primary outcome. Four trials had an overall low risk of bias across all domains and outcomes. The pooled estimated risk ratio for acute kidney injury with albumin solutions was 1.09 (95% credible interval 0.86-1.34, tau = 0.12; I2 = 31.5%), with a 18.3% posterior probability of reduced acute kidney injury. There were no significant subgroup effects or differences in secondary outcomes. Conclusion(s): Among patients undergoing on-bypass cardiac surgery, the use of albumin solutions is unlikely to reduce the risk of acute kidney injury. Other interventions need to be considered for this condition. Copyright © 2026, Associacao de Medicina Intensiva Brasileira - AMIB. All rights reserved. <56> Accession Number 2046515544 Title Echocardiography before non-cardiac surgery: current knowledge, guideline recommendations, and clinical evidence - a narrative review. Source Journal of Clinical Monitoring and Computing. (no pagination), 2026. Date of Publication: 2026. Author Mertin V.; Stroda A.; Bruns T.; Lurati Buse G. Institution (Mertin, Stroda, Bruns, Lurati Buse) Department of Anesthesiology, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany Publisher Springer Science and Business Media B.V. Abstract This narrative review provides an overview of the evidence on transthoracic echocardiography (TTE) at rest in patients undergoing non-cardiac surgery with regard to detection of new diagnoses, TTE-driven management changes, and outcome impact of preoperative TTE. It summarizes the evidence on preoperative TTE and reviews the current recommendations by professional societies from both Europe and Northern America. TTE is a very important non-invasive diagnostic tool to obtain information on cardiac function before surgery. While studies on the effectiveness of preoperative TTE are limited, there is evidence that TTE before non-cardiac surgeries can detect new diagnoses in a relevant proportion of patients. Also, data on changes in management based on TTE findings is scarce. Both the American Heart Association and the American College of Cardiologists and the European Society of Cardiology have recently published updated recommendations regarding the use of TTE before non-cardiac surgery. While both societies are in favour of TTE in symptomatic patients and do not recommend TTE to be performed routinely, several differences remain. Information on outcome benefits in patients having received TTE prior to surgery is not conclusive. In this review we could detect several knowledge gaps concerning the yield and impact on management and outcome of preoperative TTE in non-cardiac surgery patients. Copyright © The Author(s) 2026. <57> Accession Number 2046588993 Title Cardiorenal Outcomes With Tirzepatide Compared With Dulaglutide in Patients With Diabetes and Cardiovascular Disease: A Post Hoc Analysis of the SURPASS-CVOT Randomized Clinical Trial. Source JAMA Cardiology. 11(6) (pp 544-552), 2026. Date of Publication: 10 Jun 2026. Author Nissen S.E.; Wolski K.; D'Alessio D.; Weerakkody G.; Kiljanski J.; Wiese R.J.; Pavo I.; Cariou B.; Nicholls S.J. Institution (Nissen, Wolski) Cleveland Clinic Coordinating Center for Clinical Research (C5 Research), Cleveland Clinic, Cleveland, OH, United States (Nissen, Wolski) Department of Medicine, Cleveland Clinic, Cleveland, OH, United States (D'Alessio) Duke University Medical Center, Durham, NC, United States (Weerakkody, Kiljanski, Wiese, Pavo) Eli Lilly and Company, Indianapolis, IN, United States (Cariou) l'Institut du Thorax, Nantes Universite, CHU Nantes, CNRS, INSERM, Nantes, France (Nicholls) Victorian Heart Institute, Monash University, Melbourne, VIC, Australia Publisher American Medical Association Abstract Importance The dual glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) agonist tirzepatide was noninferior to a GLP-1 agonist, dulaglutide, for effects on the composite outcome of cardiovascular death, myocardial infarction (MI), or stroke. However, comparison for a comprehensive range of major adverse cardiovascular and kidney outcomes has not been reported. Objective To perform a post hoc analysis for an expanded range of adverse outcomes in a completed randomized clinical trial comparing the effects of tirzepatide and dulaglutide in patients with type 2 diabetes and cardiovascular disease. Design, Setting, and Participants This parallel-design double-blind trial enrolled patients with diabetes and preexisting cardiovascular disease (from May 29, 2020, to June 27, 2022) at 640 centers in North and South America, Europe, Asia, and Oceania. Data were analyzed from July 2025 to February 2026. Interventions Participants were randomized to receive subcutaneous tirzepatide up to 15 mg (n = 6586) or a fixed dose of dulaglutide, 1.5 mg (n = 6579), administered weekly. Main Outcomes and Measures The primary efficacy measure was time from randomization to first occurrence of a 6-component composite of cardiorenal adverse outcomes, including all-cause mortality, MI, stroke, coronary revascularization, hospitalization for heart failure, and a composite of adverse kidney outcomes. Results Among the 13 165 patients enrolled, the mean (SD) age was 64 (8.8) years; 9348 patients (71.0%) were male and 3817 were female (29.0%). The mean (SD) hemoglobin A<inf>1c</inf> was 8.4% (0.93). After a median (IQR) treatment duration of 46.9 (34.6-50.6) months, the primary cardiorenal end point occurred in 1559 tirzepatide-treated patients (23.7%) and 1803 dulaglutide-treated patients (27.4%; hazard ratio [HR], 0.84; 95% CI, 0.79-0.90; P <.001). Sensitivity analyses showed similar hazard ratios for a narrower 5-component end point (without the kidney composite outcomes: HR, 0.86; 95% CI, 0.80-0.93) and the 4-component composite (without either kidney or heart failure end points: HR, 0.86; 95% CI, 0.80-0.93). Gastrointestinal adverse events were more common with tirzepatide (2827 patients [42.5%]) than dulaglutide (2387 patients [35.9%]) treatment. Other adverse events were similar. Conclusions In this post hoc analysis, the dual GLP-1 and GIP agonist tirzepatide, compared with the GLP-1 agonist dulaglutide, was associated with a lower incidence of a broad 6-component composite cardiovascular and kidney end point in patients with diabetes and established cardiovascular disease. Copyright © 2026 Nissen SE et al. <58> Accession Number 2046536844 Title Effect of HA380 hemoperfusion on cardiac valve surgery and systemic inflammation at high altitude. Source Current Problems in Surgery. 81 (no pagination), 2026. Article Number: 102073. Date of Publication: 01 Aug 2026. Author Zhang W.; Yuan L.; Zeng F.; Xiao Y.; Li X.; Wei L. Institution (Li, Zhang, Yuan, Zeng, Xiao, Li) Department of Anesthesiology, People's Hospital of Qinghai Province, Qinghai Province, Xining City, China (Wei) Department of Anesthesiology, Qinghai Provincial Hospital of Traditional Chinese Medicine, Qinghai Province, Xining City, China Publisher Elsevier Inc. <59> [Use Link to view the full text] Accession Number 2046665710 Title Pulsed Field Ablation Versus Sham to Treat Atrial Fibrillation: The PFA-SHAM Randomized Clinical Trial. Source Circulation. 153(25) (pp 1984-1998), 2026. Date of Publication: 23 Jun 2026. Author Osmancik P.; Neuzil P.; Hozmanova J.; Petru J.; Herman D.; Kralovec S.; Hozman M.; Tichy M.; Waldauf P.; Karel T.; Sediva L.; Fischer J.; Stepanek L.; Mala I.; Lekesova V.; Hala P.; Funasako M.; Vesela J.; Filipcova V.; Karch J.; Whang W.; Reddy V.Y. Institution (Osmancik, Hozmanova, Herman, Hozman, Vesela, Filipcova, Karch) Cardiocenter, Third Faculty of Medicine (P.O., J.H., D.H., M.H., J.V., V.F., J.K.), Charles University Prague and University Hospital Kralovske Vinohrady, Czechia (Waldauf) Department of Anesthesiology (P.W.), Charles University Prague and University Hospital Kralovske Vinohrady, Czechia (Neuzil, Petru, Kralovec, Tichy, Sediva, Lekesova, Hala, Funasako, Reddy) Department of Cardiology, 1st Faculty of Medicine, harles University and Faculty Hospitals Motol and Homolka, Prague, Czechia (Karel, Fischer, Stepanek, Mala) Department of Statistical Analyses, Prague University of Economics and Business, Czechia (Whang) Helmsley Electrophysiology Center, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, United States Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - Catheter ablation for atrial fibrillation (AF) is one of the most common cardiovascular procedures being performed worldwide. Despite the large body of evidence of its effectiveness, with a single exception, prior ablation studies were largely unblinded trials. Accordingly, residual concerns remained about placebo effects, both for AF recurrence and, in particular, on subjective outcomes such as quality of life or anxiety. Here, we compared pulsed field ablation (PFA) with a sham procedure to treat patients with symptomatic AF. METHOD(S): - This prospective, sham-controlled, single-blind, randomized clinical trial with blinded end-point assessment enrolled patients with AF that was highly symptomatic (Atrial Fibrillation Effect on Quality-of-Life score <50). Patients were assigned 1:1 to PFA or a sham procedure. All participants received implantable cardiac monitors for continuous rhythm monitoring during follow-up. The 6-month co-primary outcomes were (1) time to first recurrence of atrial tachyarrhythmia and (2) changes from baseline in Atrial Fibrillation Effect on Quality-of-Life scores compared between groups. Secondary outcomes were AF burden and psychological distress (assessed by the Hospital Anxiety and Depression Scale [HADS]). RESULT(S): - Patients (n=60) were randomized to PFA or sham. At 6 months, the first co-primary end point of AF recurrence was met in 2 patients (6.7%) who underwent PFA and 25 patients (83.3%) who underwent sham (posterior hazard ratio, 19.6 [95% bayesian credible intervals, 6.7-76.9]; posterior probability of superiority >0.99). For the second co-primary end point, Atrial Fibrillation Effect on Quality-of-Life scores showed greater improvement from baseline with PFA than sham (improved by 43.9+18.1 points versus 11.3+27.9 points; posterior median difference, 32.6 [95% bayesian credible interval, 20.2-44.9]; posterior probability of superiority >0.99). AF burden at 6 months was significantly lower in the PFA than the sham group (0 [0-0] versus 0.43 [0.04-3.47]; between group median difference, -0.39 [95% credible interval, -2.5 to -0.1], posterior probability of superiority >0.99). The Hospital Anxiety and Depression Scale score changed by -4 points (-7.8 to -2.0) with PFA and by -0.5 (-4.5 to 1.0) with sham (group median difference, -3.5 [95% credible interval, -6.0 to -1.0]; posterior probability of superiority >0.99). CONCLUSION(S): - In patients with AF, PFA was superior to sham in reducing arrhythmia recurrences and burden and improving quality of life and AF-associated psychological distress. REGISTRATION: - URL: https://www.clinicaltrials.gov; Unique identifier: NCT05717725. Copyright © 2026 American Heart Association, Inc. <60> Accession Number 2046812787 Title Comparison of oxycodone hydrochloride injection versus sufentanil for postoperative analgesia in patients undergoing minimally invasive cardiac valve replacement: study protocol for a single-centre, randomised, double-blind non-inferiority trial. Source BMJ Open. 16(6) (no pagination), 2026. Article Number: e113082. Date of Publication: 01 Jun 2026. Author Chen X.; Shi Y.; Jin J.; Bao X.; Li Y.; Du H.; Pei L.; Song P.; Zhu Y. Institution (Chen, Shi, Jin, Bao, Li, Du, Song, Zhu) Department of Anesthesiology and Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi, Xi'an, China (Pei) Department of Epidemiology and Health Statistics, Xi'an Jiaotong University Health Science Center, Shaanxi, Xi'an, China Publisher BMJ Publishing Group Abstract Introduction: With the advancement of the ERAS (Enhanced Recovery After Surgery) concept, minimally invasive heart valve replacement surgery has become widely performed due to its advantages of smaller trauma and fewer adverse reactions. However, postoperative pain management remains complex and traditional opioid analgesia is often associated with adverse side effects. Oxycodone, an opioid agonist, has strong analgesic effects with relatively few side effects. This study aims to explore the efficacy and safety of oxycodone hydrochloride injection in multimodal pain management following minimally invasive heart valve replacement surgery. Methods and analysis: This is a prospective, double-blind, randomised controlled clinical trial designed as a non-inferiority study. The schedule of enrolment, interventions and outcome assessments is summarised in figure 2. The study period is from October 2024 to September 2027, and between 30 April 2026 and 31 October 2026, a total of 130 patients undergoing minimally invasive heart valve replacement surgery will be planned to recruit and randomly assign in a 1:1 ratio to receive either oxycodone hydrochloride injection or sufentanil for postoperative patient-controlled analgesia. The primary outcome is the Numerical Rating Scale pain score during coughing at 24 hours postoperatively. Secondary outcomes include measures of postoperative pain control, analgesic consumption, adverse events and recovery-related indicators. To address the risk of type I error due to multiple secondary outcomes, secondary endpoints are prespecified and categorised into key secondary outcomes and exploratory outcomes with corresponding statistical analysis strategies planned. This protocol is V.2.0, dated 29 December 2025. Ethics and dissemination: Ethical approval has been obtained from the Ethics Committee of the First Affiliated Hospital of Xi'an Jiaotong University (XJTU1AF2024LSYY-389-04). The study will be conducted in accordance with the Declaration of Helsinki, and informed consent will be obtained from all participants. Study results will be disseminated through peer-reviewed journals, scientific conferences and appropriate public channels. Trial registration: ChiCTR2400094930. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/. <61> Accession Number 2046476428 Title Prophylactic closed-incision negative pressure wound therapy after median sternotomy: a scoping review of surgical site infection prevention bundle reporting and implication for interpretation. Source Journal of Hospital Infection. 173 (pp 230-239), 2026. Date of Publication: 01 Jul 2026. Author Yoshida S.; Ishida O.; Tsutsumi K. Institution (Yoshida, Ishida, Tsutsumi) Department of Cardiovascular Surgery, National Defense Medical College, Tokorozawa, Japan Publisher W.B. Saunders Ltd Abstract Background: Closed-incision negative pressure wound therapy (ciNPT) is increasingly used to reduce surgical site infection (SSI) after median sternotomy, yet its true preventive effect remains uncertain. Published studies rarely specify which infection prevention measures were used alongside the therapy, making interpretation difficult. Aim(s): In this scoping review, we examined the completeness of reporting of infection prevention practices in studies evaluating ciNPT after cardiac surgery. Method(s): A systematic search of PubMed, Scopus, and the Cochrane Library identified studies of adult cardiac surgery in which negative pressure therapy was applied prophylactically to the closed sternal incision. Information on study design, patient characteristics, therapy protocols, clinical outcomes, and reporting of infection prevention elements was extracted. Reporting was classified as complete, partial, or absent according to 13 components derived from major clinical guidelines. Finding(s): Twenty-five studies met the inclusion criteria. Most studies reported fewer SSIs in patients receiving negative pressure therapy, but none described a complete set of infection prevention measures. Eighty-seven percent of recommended elements were not reported, and selective use of the therapy introduced additional bias. Conclusion(s): The substantial absence of infection prevention reporting limits the interpretability and reproducibility of current evidence. Standardized and transparent documentation is required to better define the preventive value of ciNPT. Copyright © 2026 The Author(s) <62> Accession Number 2044993305 Title Randomized, Placebo-Controlled Trial of Chronic Total Occlusion Percutaneous Coronary Intervention in Stable Angina. Source Journal of the American College of Cardiology. 88(1) (pp 4-18), 2026. Date of Publication: 07 Jul 2026. Author Mohdnazri S.R.; Cook C.M.; Demir O.M.; Spratt J.C.; Brilakis E.S.; Khan S.; Fawaz S.; Simpson R.; Sajjad U.; Ibrahim A.; Butt H.; Konstantinou K.; Al-Janabi F.; Kelly P.; Gamma R.; Jagethesan R.; Kabir A.; King S.; Sevant D.; Robertson C.; Karamasis G.V.; Mohdnazri S.; Tang K.; Keeble T.R.; Davies J.R.; Shun-Shin M.; Al-Lamee R.; O'Kane P.; Kadoth V.; Hinton J.; Spratt J.; Wilson S.; Marciniak M. Institution (Khan, Sajjad, Fawaz, Butt, Simpson, Ibrahim, Robertson, Kelly, Mohdnazri, Tang, Cook, Demir, Keeble, Davies, Khan, Fawaz, Simpson, Sajjad, Ibrahim, Butt, Konstantinou, Al-Janabi, Kelly, Gamma, Jagethesan, Kabir, King, Sevant, Robertson, Karamasis, Mohdnazri, Tang, Keeble, Davies, Shun-Shin, Al-Lamee, O'Kane, Kadoth, Hinton, Spratt, Wilson, Marciniak) Department of Interventional Cardiology, Essex Cardiothoracic Centre, Mid and South Essex NHS Foundation Trust, Essex, United Kingdom (Khan, Sajjad, Butt, Simpson, Ibrahim, Cook, Demir, Keeble, Davies, Khan, Fawaz, Simpson, Sajjad, Ibrahim, Butt, Konstantinou, Al-Janabi, Kelly, Gamma, Jagethesan, Kabir, King, Sevant, Robertson, Karamasis, Mohdnazri, Tang, Keeble, Davies, Shun-Shin, Al-Lamee, O'Kane, Kadoth, Hinton, Spratt, Wilson, Marciniak) Anglia Ruskin University School of Medicine and MTRC, Chelmsford, Essex, United Kingdom (O'Kane, Khan, Fawaz, Simpson, Sajjad, Ibrahim, Butt, Konstantinou, Al-Janabi, Kelly, Gamma, Jagethesan, Kabir, King, Sevant, Robertson, Karamasis, Mohdnazri, Tang, Keeble, Davies, Shun-Shin, Al-Lamee, O'Kane, Kadoth, Hinton, Spratt, Wilson, Marciniak) Department of Interventional Cardiology, Royal Bournemouth Hospital, Bournemouth, United Kingdom (Spratt, Khan, Fawaz, Simpson, Sajjad, Ibrahim, Butt, Konstantinou, Al-Janabi, Kelly, Gamma, Jagethesan, Kabir, King, Sevant, Robertson, Karamasis, Mohdnazri, Tang, Keeble, Davies, Shun-Shin, Al-Lamee, O'Kane, Kadoth, Hinton, Spratt, Wilson, Marciniak) Department of Interventional Cardiology, St George's Hospital, London, United Kingdom (Brilakis, Khan, Fawaz, Simpson, Sajjad, Ibrahim, Butt, Konstantinou, Al-Janabi, Kelly, Gamma, Jagethesan, Kabir, King, Sevant, Robertson, Karamasis, Mohdnazri, Tang, Keeble, Davies, Shun-Shin, Al-Lamee, O'Kane, Kadoth, Hinton, Spratt, Wilson, Marciniak) Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, United States (Karamasis, Khan, Fawaz, Simpson, Sajjad, Ibrahim, Butt, Konstantinou, Al-Janabi, Kelly, Gamma, Jagethesan, Kabir, King, Sevant, Robertson, Karamasis, Mohdnazri, Tang, Keeble, Davies, Shun-Shin, Al-Lamee, O'Kane, Kadoth, Hinton, Spratt, Wilson, Marciniak) School of Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece (Shun-Shin, Al-Lamee, Khan, Fawaz, Simpson, Sajjad, Ibrahim, Butt, Konstantinou, Al-Janabi, Kelly, Gamma, Jagethesan, Kabir, King, Sevant, Robertson, Karamasis, Mohdnazri, Tang, Keeble, Davies, Shun-Shin, Al-Lamee, O'Kane, Kadoth, Hinton, Spratt, Wilson, Marciniak) National Heart and Lung Institute, Imperial College London, London, United Kingdom Publisher Elsevier Inc. Abstract Background: Percutaneous coronary intervention for coronary chronic total occlusion (CTO PCI) is offered for symptom and quality of life improvement, despite the absence of blinded randomized evidence. Objective(s): The aim of this study was to assess the efficacy of CTO PCI in the first randomized, placebo-controlled trial of CTO PCI. Method(s): ORBITA-CTO is a multicenter, randomized, blinded trial comparing CTO PCI with a placebo procedure. Patients had angina attributable to a single-vessel CTO, without bystander coronary disease. Angina symptoms were recorded daily using the ORBITA app. After dual-injection coronary angiography, patients were randomized to either CTO PCI or placebo. Blinding was maintained using auditory isolation and deep conscious sedation. Antianginal medications were stopped at randomization and reintroduced on a patient-initiated protocol. At the 6-month follow-up, assessments were repeated. The primary efficacy outcome was the angina symptom score, an ordinal scale combining the daily symptom burden assessed by the ORBITA app, antianginal use, and over-ride events. Secondary outcomes were symptom and quality of life questionnaires and blinding fidelity. Result(s): Between October 19, 2021 and October 21, 2025, 50 patients were randomly assigned to CTO PCI (n = 25) or placebo (n = 25). One patient randomized to PCI was withdrawn during the procedure because of a complication. All 50 patients were included in the primary analysis. Compared with placebo, CTO PCI resulted in an immediate and sustained improvement in the angina symptom score (OR: 4.38; 95% credible interval [CrI]: 1.57-12.69; probability of benefit [Pr{Benefit}] = 0.996), arising from a clear reduction in the number of episodes of angina (OR: 4.38; 95% CrI: 1.55-11.78; Pr[Benefit] = 0.997). This resulted in an additional 30.6 days free of angina (95% CrI: 11.1-50.7; Pr[Benefit] >0.999). Improvements were also observed with the Seattle Angina Questionnaire in angina frequency (+10.7; 95% CrI: 1.4-20.2; Pr[Benefit] = 0.988), physical limitation, quality of life, and summary score and Canadian Cardiovascular Society class. Blinding of patients, staff, and researchers was maintained. Conclusion(s): In patients with symptomatic single-vessel CTO, CTO PCI improves angina beyond placebo. (A Placebo-controlled Trial of Chronic Total Occlusion Percutaneous Coronary Intervention for the Relief of Stable Angina [ORBITA-CTO]; NCT05142215) Copyright © 2026 by the American College of Cardiology Foundation. Published by Elsevier. <63> Accession Number 2046605961 Title Comparison Between Artificial Intelligence-Based Models and Traditional Risk Scores for Predicting Risks in Adult Cardiothoracic Surgery: A Systematic Review. Source Journal of Surgical Research. 325 (pp 64-72), 2026. Date of Publication: 01 Sep 2026. Author Fuchs T.K.; Jones C.; Breiner M. Institution (Fuchs, Jones) Edward Via College of Osteopathic Medicine (VCOM), Clinical Sciences, Blacksburg, VA, United States (Breiner) Department of Surgery, Edward Via College of Osteopathic Medicine (VCOM), Blacksburg, VA, United States Publisher Academic Press Inc. Abstract Introduction: Conventional risk scores like EuroSCORE II and Society of Thoracic Surgeons models, derived from logistic regression, may not fully represent complex interactions within cardiac surgery cohorts. Using nonlinear modeling, machine learning (ML) may improve risk prediction by capturing complex relationships. Objective(s): To conduct a systematic review of studies (2020-2026) that compare ML models with traditional risk scores for predicting perioperative mortality or significant adverse events in adult cardiac surgery. Method(s): Following the PRISMA 2020 guidelines, PubMed, Google Scholar, and Cochrane were searched from January 2020 to January 2026. The protocol was registered in PROSPERO (CRD420261295268; registered January 28, 2026). Inclusion necessitated direct comparisons between ML and traditional scoring methodologies with reported performance metrics, such as the area under the curve (AUC). Prediction model Risk Of Bias ASsessment Tool+ artificial intelligence was utilized for bias risk assessment. Result(s): Thirteen studies were included (N = 308-647,726). Studies originated from China (n = 5), United States (n = 3), United Kingdom (n = 2), Colombia, Saudi Arabia, and Turkey (n = 1 each). Algorithms included extreme gradient boosting, random forest, and ensembles. ML models showed improved or comparable performance, with AUC differences of 0.006-0.42, improved calibration, and reclassification (net reclassification improvement 0.550). Extreme gradient boosting AUC was 0.96 for postoperative infection, and random forest AUC was 0.975 for major adverse events in type A dissection. Prediction model Risk Of Bias ASsessment Tool+ artificial intelligence indicated low risk of bias; external validation was limited, and some analyses raised concerns regarding overfitting. Key methodological limitations included data leakage, overfitting risk, and limited temporal and external validation. Conclusion(s): ML models may improve risk prediction in cardiac surgery relative to traditional scores, especially through ensembles and advanced validation techniques. Prospective multicenter validation and evaluation of clinical integration and algorithmic fairness are needed before widespread implementation, with attention to data leakage prevention, overfitting mitigation, temporal drift, and calibration on independent validation sets. Copyright © 2026 Elsevier Inc. <64> Accession Number 2045941370 Title Coronary slow flow phenomenon: a meta-analysis of clinical risk predictors. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1656151. Date of Publication: 01 Jan 2026. Author Wang D.; Li Y.; Hu J.; Zhang K. Institution (Wang, Li) Department of Cardiology, The Second Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China (Hu) Department of Cardiology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China (Zhang) Department of Cardiology, Pengzhou Traditional Chinese Medicine Hospital, Pengzhou, China Publisher Frontiers Media SA Abstract Background - As coronary angiography becomes more common, more cases of coronary slow flow phenomenon (CSFP) are detected. To identify key clinical predictors of CSFP, we conducted a meta-analysis. This aims to improve treatment decisions for affected patients. Methods - We searched multiple databases (Embase, Web of Science, PubMed) up to May 2025 for studies on the association between clinical risk factors and CSFP. Study heterogeneity was assessed using Cochran's Q test and I2 statistics, followed by meta-analysis to pool effect estimates. Publication bias was evaluated with funnel plots and Egger's test. All analyses were conducted using R. Results - We identified 23 eligible studies, comprising a total of 2, 309 patients with CSFP and 3, 377 controls. The pooled analysis identified several clinically independent risk factors for CSFP: Triglycerides (TG)[odds ratio (OR) = 1.01, 95% confidence interval (CI): 1.01-1.02)], Totol cholesterol (TC)[OR = 1.008, CI: 1.001-1.015], White blood cell (WBC) counts[OR = 1.07, CI: 1.04-1.10], Platelets/lymphocytes ratio (PLR)[OR = 1.01, CI: 1.01-1.02], Body mass index (BMI)[OR = 1.09, CI: 1.05-1.13], and platelet count (PC) [OR = 1.009, CI: 1.006-1.011], Current smoke (OR = 1.09, 95% CI = 1.07-1.10) were significantly associated with an increased risk of CSFP. Conclusion - This comprehensive meta-analysis identifies seven key modifiable risk factors for CSFP. These findings not only enhance risk prediction models but also suggest potential therapeutic targets through lipid optimization, anti-inflammatory, antiplatelet strategies, weight control and smoking cessation interventions in CSFP management. Systematic Review Registration - PROSPERO CRD420251057679. Copyright © 2026 Wang, Li, Hu and Zhang. <65> Accession Number 2046872605 Title Stellate Ganglion Block for the Treatment of Refractory Ventricular Tachycardia and Electrical Storm: A Narrative Review. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Smith S.E.; Walker J.W.; D'Alonzo N.J.; Cios T.J. Institution (Smith, Walker, Cios) Department of Anesthesiology, Penn State Milton S. Hershey Medical Center, Hershey, PA, United States (D'Alonzo) Department of Surgery, Penn State Milton S. Hershey Medical Center, Hershey, PA, United States Publisher W.B. Saunders Abstract Contemporary management of refractory ventricular arrhythmias and electrical storm (ES) emphasizes antiarrhythmic therapy, autonomic modulation, sedation, catheter ablation, mechanical circulatory support, and heart transplantation. The stellate ganglion block (SGB) has been used for decades to treat refractory ventricular tachycardia (VT) and ventricular fibrillation (VF), and has gained more traction in the literature in recent years. The authors summarize the anatomy of the stellate ganglion, the mechanism of action of an SGB, and the physiology of VT, VF and ES. They then review current practices for the treatment of VT and VF and review the current literature supporting the use of SGB as treatment for refractory VT and VF. Finally, they describe practical considerations for the use of SGB for the treatment of VT and VF. Multiple observational studies, case series, retrospective studies, and meta-analyses in recent years have shown that SGB can be effective at reducing arrhythmia episodes in patients with refractory VT or VF; however, the quality of the available literature is weak because of the lack of randomized controlled trials. Despite this, the SGB may play a role as a bridge therapy in patients with refractory VT between initial stabilization and further long-term management. Copyright © 2026 Elsevier Inc. <66> Accession Number 2041244942 Title Sex differences among elderly ACS patients undergoing percutaneous coronary intervention receiving Ticagrelor 60 mg vs. 90 mg. Source Journal of Thrombosis and Thrombolysis. 59(3) (pp 551-563), 2026. Date of Publication: 01 Mar 2026. Author Piccolo R.; Laino A.; Vitale A.P.; Canonico M.E.; Avvedimento M.; Simonetti F.; Paolillo R.; Piaz F.D.; Charlier B.; Spinelli A.; Cristiano S.; Serafino L.D.; Cirillo P.; Gargiulo G.; Franzone A.; Filippelli A.; Conti V.; Esposito G. Institution (Piccolo, Laino, Vitale, Canonico, Avvedimento, Simonetti, Paolillo, Spinelli, Cristiano, Serafino, Cirillo, Gargiulo, Franzone, Esposito) Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy (Piaz, Charlier, Filippelli, Conti) Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, SA, Baronissi, Italy (Piaz, Charlier, Filippelli, Conti) Clinical Pharmacology Unit, University Hospital San Giovanni di Dio e Ruggi d Aragona, Salerno, Italy Publisher Springer Abstract No sex-based data are available on the pharmacodynamic and pharmacokinetic profile of ticagrelor 60 mg twice daily as alternative to its standard dose during the early phase after acute coronary syndrome (ACS). This post-hoc study is a sex-based secondary analysis of the PLINY THE ELDER randomized, crossover trial (NCT04739384), which compared ticagrelor 60 vs. 90 mg in elderly patients with ACS undergoing percutaneous coronary intervention (PCI). The primary endpoint was the pre-dose P2Y<inf>12</inf> reaction units (PRU) using the VerifyNow-P2Y<inf>12</inf> (Accumetrics, San Diego, CA, USA) at 14 days after treatment with ticagrelor 60 or 90 mg twice daily. A total of 50 elderly patients with ACS was included in the study. Of these patients, 28 (56%) were males and 22 (44%) females. The two doses of ticagrelor had a comparable PRU in both males (pre-dose: LSM difference<inf>60 vs. 90</inf> -7.00, 95%CI -25.3 to 11.3, p = 0.44; post-dose: LSM difference<inf>60 vs. 90</inf> 3.90, 95%CI -10.6 to 18.5, p = 0.59) and females (pre-dose: LSM difference<inf>60 vs. 90</inf> -0.89, 95%CI -20.3 to 18.5, p = 0.93; post-dose: LSM difference<inf>60 vs. 90</inf> -1.10, 95%CI -16.6 to 14.3, p = 0.88), with no evidence of sex-based interaction (pre-dose: p for interaction = 0.88; post-dose: p for interaction = 0.65). Consistently, transmittance aggregometry and multiple electrode aggregometry showed a similar pharmacodynamic profile between the two doses of ticagrelor in both male and female patients. Plasma levels of ticagrelor were significantly lower using the reduced dose of ticagrelor as compared with the standard dose in both males (pre-dose: LSM difference<inf>60 vs. 90</inf> -212, 95%CI -391 to -33.0, p < 0.002; post-dose: LSM difference<inf>60 vs. 90</inf> -308, 95%CI -510 to -105, p = 0.004) and females (pre-dose: LSM difference<inf>60 vs. 90</inf> -131, 95%CI -332 to 69.1, p = 0.19; post-dose: LSM difference<inf>60 vs. 90</inf> -670, 95%CI -898 to -442, p < 0.001). Ticagrelor 60 mg and ticagrelor 90 twice daily yielded the same magnitude of platelet inhibition among elderly patients with ACS irrespective of sex. Copyright © The Author(s) 2025. <67> Accession Number 2046898265 Title Prevalence of Cerebral Abnormalities in Children With Congenital Heart Disease: A Systematic Review and Meta-Analysis. Source Pediatrics. 157(6) (no pagination), 2026. Article Number: e2025071101. Date of Publication: 01 Jun 2026. Author Dagur G.; Ortinau C.M.; Chin T.I.; Morris G.; Kleinmahon J.A.; Gurvitz M.Z.; Bora S. Institution (Dagur, Bora) Health Services Research Center, University Hospitals Research & Education Institute; Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine, 11100 Euclid Ave, Cleveland, OH, United States (Dagur, Morris) Mater Research Institute, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia (Dagur) Ochsner Clinical School, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, New Orleans, LA, United States (Ortinau) Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, MO, United States (Chin) Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, United States (Kleinmahon) Cohen Children's Heart Center, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, United States (Gurvitz) Department of Pediatrics, Harvard Medical School, Boston, MA, United States (Gurvitz) Department of Cardiology, Boston Children's Hospital, Boston, MA, United States Publisher American Academy of Pediatrics Abstract CONTEXT: Children with congenital heart disease (CHD) are at risk of cerebral abnormalities. Current evidence is limited by small sample sizes, single-center cohorts, and single time points. OBJECTIVE(S): Conduct a systematic review and meta-analysis to determine the prevalence of structural cerebral abnormalities on magnetic resonance imaging (MRI) in children with CHD during prenatal, postnatal-preoperative, and postoperative periods. DATA SOURCES: Five electronic databases from inception to August 4, 2025. STUDY SELECTION: Studies published in English in peer-reviewed journals that met the following criteria: 1) samples comprised fetuses from 24 weeks gestation to birth or children from birth to 21 years, with 2) isolated (nonsyndromic) CHD with or without surgical intervention within the first year of life, and 3) reported structural cerebral abnormalities on MRI, during 4) prenatal, postnatal-preoperative, or postoperative period. DATA EXTRACTION: Data were extracted independently by 2 authors. Data were synthesized using random-effects modeling to determine pooled estimates. RESULT(S): Overall, 125 studies met the inclusion criteria. Sample size included 521, 1895, and 2443 fetuses and children with CHD for prenatal, postnatal-preoperative, and postoperative analyses, respectively, ensuring sample independence. The pooled overall prevalence of structural cerebral abnormalities was 23.1%, 36.7%, and 50.3% for prenatal, postnatal-preoperative, and postoperative periods, respectively. LIMITATIONS: Variations in MRI strength, postnatal vs fetal MRI detection capacity, and the underlying rationale for neuroimaging. CONCLUSION(S): Structural cerebral abnormalities are prevalent in a considerable number of fetuses and children with CHD. A further increase is evident postoperatively, indicating the potential adverse impact of surgical intervention and postoperative care on brain outcomes. Copyright © 2026 by the American Academy of Pediatrics <68> Accession Number 651599936 Title Ivabradine in Heart Transplant Recipients With Sinus Tachycardia: A Systematic Review and Meta-Analysis. Source Journal of cardiovascular pharmacology. (no pagination), 2026. Date of Publication: 04 Jun 2026. Author Hamzah K.A.; Kurmasha Y.H.; Rasheed W.M.; Al-Shammari A.S.; Shahzaib M.; Akoum A.; Shweliya M.A.; Ramadan A.; Al-Taii H.; Refaat M.M. Institution (Hamzah) Department of Internal Medicine, Alkindy College of Medicine, University of Baghdad, Baghdad, Iraq (Kurmasha) Department of Internal Medicine, College of Medicine, University of Kufa, Najaf, Iraq (Rasheed) Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan (Al-Shammari, Shweliya) Department of Internal Medicine, University of Baghdad College of Medicine, Baghdad, Iraq (Shahzaib) Department of Internal Medicine, King Edward Medical University, Lahore, Pakistan (Akoum) Department of Internal Medicine, Hennepin Healthcare, Minneapolis, MN, United States (Ramadan) Department of Internal Medicine, Faculty of Medicine, South Valley University, Qena, Egypt (Al-Taii) Department of Cardiology, Aultman Hospital, Canton, OH, United States (Refaat) Department of Cardiology, American University of Beirut Medical Center, Beirut, Lebanon Abstract Sinus tachycardia is common after heart transplantation (HTx) and may worsen graft function via increased oxygen demand and remodeling. Ivabradine, a selective If channel inhibitor, lowers heart rate independently of sympathetic activity. This meta-analysis evaluates its efficacy and safety versus standard care in HTx recipients. A comprehensive search of PubMed, Embase, WoS, Scopus, and Cochrane was conducted through September 2025. Eligible studies included randomized and non-randomized comparative trials. Data were pooled with a random-effects model to estimate mean differences (MD) for continuous outcomes and risk ratios (RR) for dichotomous outcomes. Six studies, including 852 adult HTx recipients, were included. Ivabradine consistently reduced HR across all time points. Statistical significance was reached at 24 months (MD -16.82 bpm; P=0.04) and 36 months (MD -12.94 bpm; P=0.04). A significant reduction was observed in LVMI (MD -11.10 g/m2; 95% CI -17.15 to -5.06; P<0.05; I^2=0%). While LVM and LVEF showed trends toward improvement at final follow-up (MD = -11.23 for LVM and +2.94% for LVEF), neither reached statistical significance (P = 0.06 and P = 0.48, respectively). No significant differences were found between the ivabradine and control groups regarding all-cause mortality (RR 1.16 at final follow-up; P=0.90), graft rejection (RR 1.14; P=0.87), or systolic blood pressure (MD 0.50 mmHg; P=0.83). Ivabradine lowers heart rate after heart transplantation but shows no clear benefit on mortality, rejection, or ejection fraction. It does not significantly affect blood pressure, supporting its tolerability, particularly when beta-blockers are not tolerated. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <69> Accession Number 651598243 Title Remote ECG monitoring as a diagnostic tool for therapeutic strategies after transcatheter aortic valve replacement: rationale and design of the DRAGON-TAVI randomized trial. Source Cardiology journal. 33 (pp e00226061), 2026. Date of Publication: 2026. Author Lis P.; Kozlik M.; Chamera M.; Kulach A.; Smolka G.; Smolarek M.; Orszulak M.; Mizia-Stec K.; Szydlo K.; Golba K.; Gladysz-Wanha S.; Kuzma L.; Morkisz L.; Gocol R.; Hudziak D.; D'Ascenzo F.; de Ferrari G.M.; Lip G.Y.H.; Wojakowski W.; Wita K.; Wanha W. Institution (Lis, Kozlik, Chamera, Wojakowski, Wanha) Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland (Kulach, Smolka, Smolarek) Department of Cardiology, SHS, Medical University of Silesia, Katowice, Poland (Orszulak, Mizia-Stec, Szydlo, Wita) First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland (Golba, Gladysz-Wanha) Department of Electrocardiology and Heart Failure, Medical University of Silesia in Katowice, Katowice, Poland (Kuzma) Department of Invasive Cardiology, Medical University of Bialystok, Bialystok, Poland (Morkisz, Gocol, Hudziak) Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland (D'Ascenzo, de Ferrari) Division of Cardiology, Cardiovascular and Thoracic Department, A.O.U. Citta della Salute e della Scienza, Turin, Italy (Lip) Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (Lip) Department of Clinical Medicine, Aalborg University, Aalborg, Denmark (Lip) Department of Cardiology, Lipidology and Internal Medicine with Intensive Coronary Care Unit, Medical University of Bialystok, Bialystok, Poland (Wanha) Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland <70> Accession Number 2047152262 Title Topography and functional connectivity analysis of heart surgery-associated brain lesions: a literature review. Source Neurological Sciences. 47(8) (no pagination), 2026. Article Number: 611. Date of Publication: 01 Aug 2026. Author Marcolongo F.; Guariglia C.; Tessari G.; Tropea A.; Volterrani M.; Alves P.N. Institution (Marcolongo, Guariglia, Tessari, Tropea) Psychology Department, Sapienza University of Rome, Rome, Italy (Marcolongo, Volterrani) Cardiopulmonary Department, IRCCS San Raffaele, Rome, Italy (Volterrani) Department of Human Sciences and Promotion of Quality of Life, San Raffaele Open University, Rome, Italy (Alves) Laboratorio de Estudos de Linguagem, Centro de Estudos Egas Moniz, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal (Alves) Servico de Neurologia, Departamento de Neurociencias E Saude Mental, Hospital de Santa Maria, ULSSM, Lisboa, Portugal Publisher Springer-Verlag Italia s.r.l. Abstract Background: Cardiac surgery is a major therapeutic advancement but remains associated with neurological complications, including ischemic stroke and postoperative cognitive decline. Compared with stroke of other etiologies, ischemic brain injury following cardiac surgery may involve distinct vascular territories and functional networks, potentially influencing its characteristic cognitive profile. Method(s): We performed a systematic review of case reports describing ischemic brain lesions occurring after cardiac surgery in adults with available neuroimaging data. Lesions were manually traced onto a standard brain atlas and compared with ischemic stroke lesions from the ATLAS database, matched for hemispheric involvement. Lesion topography was analyzed at the arterial territory and voxel levels. Lesion network mapping was conducted using normative resting-state functional connectivity data to identify patterns of functional disconnection. Permutation-based statistical analyses were applied, with correction for multiple comparisons and lesion volume included as a covariate. Result(s): Nineteen articles met the inclusion criteria, yielding 20 cases of post-cardiac surgery ischemic lesions. Compared with stroke controls, these lesions more frequently involved posterior arterial territories, particularly the occipital branches of the posterior cerebral arteries and posterior thalamic regions. Lesion network mapping revealed a distinct pattern of functional disconnection in the occipital lobes, posterior thalamus (including the pulvinar), and medial frontal cortex. Conclusion(s): Our results suggest that ischemia associated with cardiac surgery may preferentially involve posterior arterial territories and be associated with distinct patterns of functional disconnection involving the occipital lobe, the pulvinar, and the medial frontal cortex. Copyright © Fondazione Societa Italiana di Neurologia 2026. <71> Accession Number 651597810 Title Practice Changing Updates in Perioperative Medicine Literature 2025. A Systematic Review. Source The American journal of medicine. (no pagination), 2026. Date of Publication: 24 Jun 2026. Author Silbert R.E.; Bartlett M.A.; Devalapalli A.P.; Dinh C.A.; Mauck K.F.; Regan D.W.; Sanchez J.J.; Stephenson C.R.; Khambaty M. Institution (Silbert, Bartlett, Mauck, Stephenson) Division of General Internal Medicine, Department of Medicine, Mayo Clinic and Mayo Clinic College of Medicine, Rochester, MN, United States (Devalapalli, Dinh, Regan, Sanchez, Khambaty) Division of Hospital Internal Medicine, Department of Medicine, Mayo Clinic and Mayo Clinic College of Medicine, Rochester, MN, United States Abstract A wealth of new literature is published annually in the growing field of perioperative medicine. The most noteworthy publications are often hard to find as they are spread over a variety of journals. We have undertaken a multi-database literature search from January to December of 2025 to identify the most impactful perioperative articles from the past year. We included original research articles, systematic reviews, meta-analyses, and guidelines. We excluded abstracts, case reports, letters, or literature pertaining to cardiovascular surgery, pediatrics, and obstetrics. Two authors reviewed each reference using the Distiller SR systematic review software (Evidence Partners Inc., Ottawa, Ontario, Canada). A modified Delphi technique was used to narrow down to seven of the most impactful publications and another eight tabular summaries. The purpose of this review is to highlight new literature to improve perioperative outcomes for patients. Copyright © 2026 Elsevier Inc. All rights reserved. <72> Accession Number 2047204612 Title Seven-Year Valve Durability With Transcatheter or Surgical Aortic Valve Replacement: An Ad Hoc Analysis of the PARTNER 3 Randomized Clinical Trial. Source JAMA Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Ternacle J.; Hahn R.T.; Silva I.; Alperi A.; Giuliani C.; Zanuttini A.; Theron A.; Dahou A.; Cristell N.; Woods T.; Guzzetti E.; Turgeon P.Y.; Bernier M.; Mahjoub H.; Paquin A.; Skaf S.; Beaudoin J.; Kodali S.K.; Russo M.; Kapadia S.R.; Malaisrie S.C.; Cohen D.J.; Leipsic J.; Blanke P.; Williams M.R.; Mccabe J.M.; Brown D.L.; Babaliaros V.; Goldman S.; Szeto W.Y.; Genereux P.; Pershad A.; Nazif T.M.; Zhang Y.; Gunnarsson M.; Webb J.G.; Makkar R.R.; Thourani V.H.; Mack M.J.; Leon M.B.; Pibarot P.; El-Hajjar M.; Bailey S.; Brown J.; Kipperman R.; Webster M.; Zidar F.; Kerendi F.; Eng M.; Fang K.; Paulus B.; Shah P.; Kaneko T.; Chehab B.; Grizzell B.; Rinaldi M.; Skipper E.; Makkar R.; Trento A.; Eisenhauer A.; Kodali S.; George I.; Nazif T.; Bergman G.; Chiu Wong S.; Salemi A.; Mick S.; DeVries J.; DeSimone J.; Thourani V.; Guyton R.; Grubb K.; Accola K.; McKay R.; Hagberg R.; O'Neill W.; Paone G.; Apostolou D.; Engel P.; Castellanos J.; Caffarelli A.; Yazdani S.; Sarin E.; Whisenant B.; Jones K.; Nores M.; Rothenberg M.; McNulty E.; Richter R.; Hayashida K.; Coady P.; Gnall E.; Holmes D.; Alkhouli M.; Greason K.; Bowers B.; Dewey T.; Daniels D.; Vial C.; Jones N.; Wells P.; Xydas S.; Beohar N.; Wu W.; Anderson C.; Nass O.; Martin S.; Williams M.; Waxman S.; Haik B.; Levisay J.; Russell H.; Malaisrie C.; Davidson C.; Ramee S.; Tafur J.; Parrino P.; Ghani M.; Bodenhamer M.; Sakata Y.; Christy J.; Goldstein J.; Badr S.; Korngold E.; Swanson J.; Vincent L.; Montarello J.; Collado F.; Chhatriwalla A.; Rodriguez E.; Morse A.; Mahoney P.; Newton J.; Kemp C.; Webb J.; Fischebin M.; Yeung A.; Ingram M.; Huang P.-H.; Kozuma K.; Kereiakes D.; Answini G.; Kapadia S.; Unai S.; Mack M.; Szerlip M.; Spies C.; Plank B.; Lau J.; Smalling R.; Nguyen T.; Oldemeyer B.; Guadagnoli M.; Iyer V.; Grosner G.; Davies J.; Shemin R.; Suh W.; Beaver T.; Anderson D.; Horwitz P.; Helmer G.; John R.; Bavaria J.; Desai N.; Herrmann H.; Ailawadi G.; Yount K.; Kern J.; McCabe J.; Chung C.; Aldea G.; Gimelli G.; Lozonschi L.; Osaki S.; Zajarias A.; Maniar H.; Abbas A.; Schwartz R.; Tolerico P.; Burlingame M. Institution (Ternacle) Haut-Leveque Cardiology Hospital, Bordeaux University, Pessac, France (Hahn, Cristell, Kodali, Cohen, Leon) Cardiovascular Research Foundation, New York, NY, United States (Hahn, Nazif, Leon) Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, NY, United States (Silva, Alperi) Department of Cardiology, Hospital Universitario Central de Asturias, Oviedo, Spain (Silva, Alperi, Giuliani, Zanuttini, Theron, Woods, Guzzetti, Turgeon, Bernier, Paquin, Beaudoin, Pibarot) Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Quebec, QC, Canada (Theron) Department of Cardiology, Assistance Publique, Hopitaux de Marseille, France (Dahou) Department of Cardiology, Geisinger Medical Center, Geisinger College of Health Sciences, Wilkes-Barre, PA, United States (Guzzetti) Department of Cardiology, Centre hospitalier affilie universitaire regional, Trois-Rivieres, QC, Canada (Mahjoub) Service de cardiologie, Centre Medical Farfalla, Tunis, Tunisia (Skaf, Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United States (Russo) Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States (Kapadia) Cleveland Clinic, Cleveland, OH, United States (Malaisrie) Feinberg School of Medicine, Northwestern University, Chicago, IL, United States (Cohen) St Francis Hospital, Roslyn, NY, United States (Leipsic, Blanke, Webb) St Paul's Hospital, Vancouver, BC, Canada (Williams) New York University-Langone Medical Center, New York, NY, United States (Mccabe) Beth Israel Deaconess Medical Center, Boston, MA, United States (Brown, Mack) Baylor Scott & White Healthcare, Plano, TX, United States (Babaliaros) Emory University School of Medicine, Atlanta, GA, United States (Goldman) Lankenau Medical Center, Wynnewood, PA, United States (Szeto) Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, United States (Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ, United States (Pershad) Chandler Regional and Mercy Gilbert Medical Center, Chandler, AZ, United States (Zhang, Gunnarsson) Edwards Lifesciences, Irvine, CA, United States (Thourani) Department of Cardiovascular Surgery, Piedmont Heart Institute, Atlanta, GA, United States (El-Hajjar) Albany Medical College, Albany, NY, United States (Bailey) Allegheny - Singer Research Institute, Pittsburgh, PA, United States (Brown, Kipperman) Atlantic Health System Hospital Corp, Morristown, NJ, United States (Tolerico, Burlingame) York Hospital, York, PA, United States (Webster) Auckland City Hospital, Auckland, New Zealand (Zidar, Kerendi) Austin Heart, PLLC, Austin, TX, United States (Levisay, Russell) NorthShore University, HealthSystem Research Institute Evanston, Evanston, IL, United States (Eng, Fang) Banner University Medical Center Phoenix, Phoenix, AZ, United States (Schwartz) Winthrop-University Hospital Mineola, Mineola, NY, United States (Paulus) Baptist Memorial Hospital Memphis, Memphis, TN, United States (Shah, Kaneko) Brigham and Women's Hospital, Boston, MA, United States (Abbas) William Beaumont Hospital Royal Oak, Royal Oak, MI, United States (Chehab, Grizzell) Ascension Via Christi St. Francis, Kansas City, KS, United States (Zajarias, Maniar) Washington University in St. Louis, Barnes- Jewish Hospital, Saint Louis, MO, United States (Rinaldi, Skipper) Carolina's Health System, Charlotte, NC, United States (Gimelli, Lozonschi, Osaki) University of Wisconsin - Madison, Madison, WI, United States (Makkar, Trento) Cedars-Sinai Medical Center, Los Angeles, CA, United States (McCabe, Chung, Aldea) University of Washington, Seattle, WA, United States (Eisenhauer) Central Maine Medical Center, Lewiston, ME, United States (Kodali, George, Nazif) Columbia University Irving Medical Center, New York, NY, United States (Ailawadi, Yount, Kern) University of Virginia, Charlottesville, VA, United States (Bavaria, Desai, Herrmann) University of Pennsylvania, Philadelphia, PA, United States (Bergman, Chiu Wong, Salemi, Mick) Weill Cornell Medical Center, New York, NY, United States (Helmer, John) University of Minnesota Medical Center, Minneapolis, MN, United States (Horwitz) University of Iowa Hospitals and Clinics Iowa City, Iowa City, IA, United States (Beaver, Anderson) University of Florida Gainesville, Gainesville, FL, United States (DeVries, DeSimone) Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States (Shemin, Suh) University of California Los Angeles, Los Angeles, CA, United States (Babaliaros, Thourani, Guyton, Grubb) Emory University, Atlanta, GA, United States (Davies) University of Alabama at Birmingham, Birmingham, AL, United States (Iyer, Grosner) University at Buffalo, Kaleida Health, Buffalo, NY, United States (Oldemeyer, Guadagnoli) UC Health Northern Colorado, Medical Center of the Rockies, Loveland, CO, United States (Accola) Florida Hospital, Orlando, FL, United States (McKay, Hagberg) Hartford Hospital, Hartford, CT, United States (Smalling, Nguyen) The University of Texas Health Science Center at Houston, Houston, TX, United States (O'Neill, Paone, Apostolou, Engel) Henry Ford Hospital Detroit, Detroit, MI, United States (Spies, Plank, Lau) The Queen's Medical Center, Honolulu, HI, United States (Mack, Szerlip) The Heart Hospital Baylor Plano, Plano, TX, United States (Kapadia, Unai) The Cleveland Clinic Foundation, Cleveland, OH, United States (Castellanos, Caffarelli) Hoag Memorial Hospital Presbyterian, Newport Beach, CA, United States (Kereiakes, Answini) The Christ Hospital Cincinnati, Cincinnati, OH, United States (Yazdani, Sarin) Inova Heart and Vascular Institute, Fairfax, VA, United States (Kozuma) Teikyo University, Tokyo, Japan (Whisenant, Jones) Intermountain Medical Center Salt Lake City, Salt Lake City, UT, United States (Ingram, Huang) Sutter Medical Center, Sacramento, Sacramento, CA, United States (Nores, Rothenberg) JFK Medical Center, Atlantis, FL, United States (Daniels) Sutter, Bay Area, San Francisco, CA, United States (McNulty, Richter) Kaiser San Francisco Medical Center, San Francisco, CA, United States (Fischebin, Yeung) Stanford University Medical Center, Stanford, CA, United States (Hayashida) Keio University, Tokyo, Japan (Goldman, Coady, Gnall) Lankenau Medical Center, Wynnewood, PA, United States (Webb) St. Paul's Hospital Vancouver, Vancouver, BC, Canada (Mahoney, Newton, Kemp) Sentara Cardiovascular Research Institute, Norfolk, VA, United States (Holmes, Alkhouli, Greason) Mayo Clinic, Rochester, MN, United States (Rodriguez, Morse) Saint Thomas Health, Nashville, TN, United States (Chhatriwalla) Saint Luke's Hospital Mid America Heart Institute, Kansas City, MO, United States (Bowers, Dewey) Medical City Dallas Hospital, Dallas, TX, United States (Collado) Rush University Medical Center, Chicago, IL, United States (Daniels, Vial) Mills Peninsula Health Services, Burlingame, CA, United States (Montarello) Royal Adelaide Hospital, Adelaide, Australia (Jones, Wells) Mount Carmel Health System, Columbus, OH, United States (Korngold, Swanson, Vincent) Providence Heart & Vascular Institute, Portland, OR, United States (Xydas, Beohar) Mount Sinai Medical Center, Miami Beach, FL, United States (Christy, Goldstein, Badr) Prairie Education and Research Cooperative, Springfield, IL, United States (Wu, Anderson) NC Heart and Vascular (Rex Hospital), Raleigh, NC, United States (Sakata) Osaka University, Suita, Japan (Nass, Martin) Nebraska Heart Institute Lincoln, Lincoln, NE, United States (Ghani, Bodenhamer) Oklahoma Cardiovascular Research Group, Oklahoma City, OK, United States (Williams) New York University Langone Medical Center, New York, NY, United States (Russo, Waxman, Haik) Newark Beth Israel Medical Center, Newark, NJ, United States (Ramee, Tafur, Parrino) Ochsner Clinic Foundation, New Orleans, LA, United States (Malaisrie, Davidson) Northwestern University, Chicago, IL, United States Publisher American Medical Association Abstract Importance: As transcatheter aortic valve replacement (TAVR) is considered for younger and lower-risk populations, the durability of bioprosthetic valves is increasingly important. Limited data exist on long-term (7 years and beyond) valve durability. Objective(s): To report 7-year valve durability outcomes for low-risk patients with symptomatic severe aortic stenosis treated with TAVR vs surgery. Design, Setting, and Participant(s): Between March 2016 and October 2017, a total of 1000 patients were enrolled at 71 centers in the US and Canada and randomized to undergo TAVR vs surgery. The patient population for the present analysis consisted of all patients who underwent valve implantation (495 with TAVR and 453 with surgery). The last 7-year follow-up occurred in March 2025. Intervention(s): Patients were randomized to balloon-expandable TAVR with the SAPIEN 3 valve or surgery with any commercially available valve. Main Outcomes and Measures: The main outcomes of this analysis were stage 2 or 3 bioprosthetic valve dysfunction (BVD) related to structural valve deterioration (SVD), thrombosis, or endocarditis; all-cause bioprosthetic valve failure (BVF); BVF related to SVD; and aortic valve reintervention at 7 years. Analyses are presented as cumulative incidence rates with death as a competing risk. Result(s): The mean (SD) age of the study population was 73.5 (6.0) years, and 657 participants (69.3%) were male. Of 671 patients who were still alive and enrolled in the study at 7-year follow-up, 537 (80.0%) were available for echocardiographic analysis. Cumulative incidence rates of stage 2 or 3 SVD-related BVD (7.3% vs 7.6%; hazard ratio [HR], 0.96; 95% CI, 0.59-1.57; P =.88), all-cause BVF (6.9% vs 7.5%; HR, 0.91; 95% CI, 0.55-1.49; P =.69), SVD-related BVF (3.9% vs 5.3%; HR, 0.72; 95% CI, 0.39-1.36; P =.31), and valve reintervention (6.0% vs 5.5%; HR, 1.09; 95% CI, 0.62-1.90; P =.77) were low and similar for TAVR and surgery, respectively. Stage 2 or 3 thrombosis-related BVD (subclinical and clinical) occurred more frequently with TAVR (5.2% vs 0.9%; HR, 5.52; 95% CI, 1.92-15.85; P <.001), although most events occurred within 3 years and few progressed to BVF. Rates of stage 2 or 3 endocarditis-related BVD were also low and similar (0.4% in the TAVR group vs 0.5% in the surgery group; HR, 0.85; 95% CI, 0.12-6.07; P =.87). The proportion of patients alive and free of all-cause BVF was 73.4% (331/451) with TAVR vs 74.8% (288/385) with surgery (P =.69). Conclusions and Relevance: In this ad hoc analysis of a randomized clinical trial among low-risk patients with symptomatic severe aortic stenosis randomized to TAVR or surgery, both TAVR and surgery demonstrated comparable and sustained valve durability, with low and similar rates of SVD, all-cause BVF, and reintervention through 7 years. These findings may inform discussions of valve replacement strategies. Copyright © 2026 Ternacle J et al. <73> Accession Number 651589095 Title Impact of continuous serratus plane analgesia on quality of recovery after video-assisted thoracic surgery: a prospective double-blind, randomized, placebo-controlled trial. Source Regional anesthesia and pain medicine. (no pagination), 2026. Date of Publication: 23 Jun 2026. Author Biswas A.; Zidan H.; Kolodzey L.; Kumar K.; Nagappa M.; Fochesato L.-A.; Fortin D.; Inculet R.; Lin C.; Misurati M.; Nicolaou G.; Gomez Tamayo J.C.; Qiabi M.; Nayak R.; Van Doormaal C.J.; Malthaner R. Institution (Biswas, Zidan, Kolodzey, Kumar, Nagappa, Fochesato, Lin, Misurati, Nicolaou, Gomez Tamayo, Van Doormaal) Department of Anesthesia and Perioperative Medicine, Schuilch School of Medicine and Dentistry, Western University, London, ON, Canada (Fortin, Inculet, Qiabi, Nayak, Malthaner) Division of Thoracic Surgery, Department of Surgery, Schulich school of Medicine and Dentistry, Western Univeristy, London, ON, Canada Abstract BACKGROUND: Video-assisted thoracoscopic surgery (VATS) offers numerous advantages over open surgery; nevertheless, it remains associated with significant postoperative pain. Multiple regional anesthesia techniques have been explored, and the serratus anterior plane block (SAPB) has emerged as a promising option; however, evidence on the use of continuous SAPB infusion for quality of recovery (QoR-40) remains limited. We hypothesized that continuous SAPB infusion, combined with multimodal analgesia, could improve QoR-40 after VATS. METHOD(S): In this prospective, double-blind, randomized controlled trial, adults undergoing elective VATS received an infusion of either 0.2% ropivacaine or saline via a SAPB catheter, in addition to standardized multimodal analgesia. The primary outcome was the QoR-40 score on postoperative day (POD) 1. Secondary outcomes included QoR-40 scores on POD 2-4, pain scores, opioid consumption in intravenous morphine milligram equivalents (IV MME), length of hospital stay (LOS), complications, and 30-day readmission. RESULT(S): A total of 173 patients were analyzed (SAPB: n=88; control: n=85). Median QoR-40 scores on POD 1 were higher in the SAPB group (176 (166-184) vs 172 (159-183); p=0.1036), and remained higher across POD 2 to 4, although not statistically significant. SAPB significantly reduced opioid consumption in recovery (8.0+/-7.4 vs 10.6+/-9.3 IV MME; p=0.0388) and on POD 1 (12.73+/-10.75 vs 16.45+/-12.17 IV MME; p=0.0349). LOS was also lower but not statistically significant by 0.8 days (2.69+/-1.76 vs 3.50+/-4.01; p=0.0872). Pain scores, complications, and 30-day readmissions were similar between groups. CONCLUSION(S): In this prospective, double-blind, randomized, placebo-controlled trial, continuous SAPB catheter infusion did not improve the primary outcome (QoR-40), and the observed differences in secondary outcomes should be interpreted as exploratory. Larger studies are needed to confirm effects on patient-reported recovery. Copyright © American Society of Regional Anesthesia & Pain Medicine 2026. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ Group. <74> Accession Number 651594585 Title Depth and Procedure Specific Effects of Antimicrobial Versus Conventional Sutures on Surgical Site Infection: A Systematic Review and Meta-Analysis. Source ANZ journal of surgery. (no pagination), 2026. Date of Publication: 25 Jun 2026. Author Muakkassa R.; Roach A.; Elsayed A.A.R.; Basson M.D. Institution (Muakkassa, Roach, Elsayed, Basson) College of Medicine, Northeast Ohio Medical University, OH, United States (Elsayed, Basson) Department of Surgery, Northeast Ohio Medical University, OH, United States (Elsayed, Basson) Department of Biomedical Sciences, Northeast Ohio Medical University, OH, United States Abstract BACKGROUND: Surgical site infections (SSIs) are common postoperative complications that delay wound healing and increase morbidity and healthcare costs. Conventional sutures lack antimicrobial properties and may act as a nidus for infection. Antimicrobial-coated sutures have been proposed to reduce SSI rates. This systematic review synthesizes literature comparing traditional and antimicrobial sutures regarding SSIs and wound healing to inform clinical guidelines and future research. METHOD(S): A systematic review was conducted according to PRISMA guidelines. PubMed, Cochrane Library, Web of Science, and VHL were searched on March 25, 2025, using terms related to antimicrobial sutures, traditional sutures, and surgical site infection. Two independent reviewers screened studies by title and abstract, followed by full-text review using predefined eligibility criteria. Included studies were original investigations in English involving live human subjects. RESULT(S): Included studies primarily evaluated absorbable sutures, most commonly polyglactin 910 and polydioxanone, with antimicrobial variants incorporating triclosan or chlorhexidine. Antimicrobial sutures did not significantly reduce superficial SSI (OR 0.92, 95% CI 0.69-1.24, p = 0.59) but were associated with a 36% reduction in deep SSI (OR 0.64, 95% CI 0.44-0.93, p = 0.02). Significant reductions were observed in abdominal (OR 0.61, 95% CI 0.39-0.97, p = 0.04) and colorectal procedures (OR 0.60, 95% CI 0.45-0.80, p = 0.0004), but not in vascular or cardiothoracic surgery. In procedures demonstrating significant benefit, the incremental cost of antimicrobial sutures was lower than the estimated cost of treating SSI. CONCLUSION(S): Antimicrobial sutures reduce deep, but not superficial, SSIs, with most benefit in abdominal and colorectal procedures. This supports selective, risk-stratified implementation of antimicrobial sutures. Copyright © 2026 The Author(s). ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons. <75> Accession Number 651595010 Title Effect of Albumin Concentration and Timing on Acute Kidney Injury After Adult Cardiac Surgery: A Systematic Review and Meta-analysis. Source Annals of cardiac anaesthesia. (no pagination), 2026. Date of Publication: 29 Apr 2026. Author Abo T.; Umibe T.; Nakano K.; Tongu Y.; Oya K. Institution (Abo, Umibe, Oya) Department of Surgery, National Center for Global Health and Medicine/Japan Institute for Global Health and Medicine, Tokyo, Japan (Nakano, Tongu) Department of Internal Medicine, National Center for Global Health and Medicine/Japan Institute for Global Health and Medicine, Tokyo, Japan Abstract ABSTRACT: The effect of hyperoncotic (20%-25%) human albumin on cardiac-surgery-associated acute kidney injury (CS-AKI) is uncertain. This study evaluated whether intraoperative or postoperative administration of 20%-25% albumin influences the risk of CS-AKI compared with crystalloids or iso-oncotic (4%-5%) albumin. Systematic review and meta-analysis of randomized controlled trials (RCTs) and risk-adjusted cohort studies were conducted. Risk ratios (RRs) were pooled using random-effects models. Literature search of PubMed, Embase (Ovid), and Cochrane CENTRAL was carried out from January 1, 1995, to July 17, 2025. Adults undergoing on-pump CS. Four eligible studies-two RCTs and two cohort studies, encompassing 6651 patients-were included. About 20%-25% of human albumin was administered either intraoperatively or within 24 h postoperatively. Comparators were crystalloids or 4%-5% albumin. The primary outcome was the incidence of any-stage AKI within 7 days of surgery. Pooled analysis showed 20%-25% albumin increased the risk of CS-AKI (RR 1.10, 95% confidence interval [CI] 1.05-1.16; I2 =0%). Restriction to RCTs yielded a similar result (RR 1.12, 95% CI 1.04-1.20). The increased risk was consistent for both intraoperative (RR 1.09) and postoperative (RR 1.12) administration, but the interaction between infusion timing was non-significant (P = 0.59). Infusion of 20%-25% albumin is associated with a modest but consistent increase in postoperative AKI, independent of infusion timing from intraoperative to postoperative within 24 h. Until adequately powered trials resolve the remaining imprecision, routine perioperative administration of hyperoncotic albumin should be approached with caution. Copyright © 2026 Annals of Cardiac Anaesthesia. <76> Accession Number 2047265858 Title Mexican consensus statement on fasting before cardiovascular diagnostic and therapeutic interventions. Source Cardiovascular and Metabolic Science. 37(2) (pp 94-102), 2026. Date of Publication: 01 Apr 2026. Author Moguel-Ancheita R.; Olvera-Ruiz R.; Jimenez-Carbajal M.G.; Lozoya-Morales J.J.F.C.; Gonzalez-Ramirez N.; Ponte-Gonzalez G.; Garcia Y.; Cabrera-Arroyo C.; Rodriguez-Diez G.; Felix-Tellez F.A.; Estrada-Jaime M.A.; Rodriguez-Herrera C.I.; Garcia-Arvizu G.A.; Narvaez-Oriani C.A.; Najar-Guerrero M.S.; Lopez-Madrigal F.; Berni-Betancourt A.; Gutierrez-Garcia A.; Colin-Alvarez E.I.; Molina-Mendez F.J.; Lendewig-Barrera M.V.; Rivera-Rodriguez F.M. Institution (Moguel-Ancheita) FSCAI, Colegio Mexicano de Cardiologia Intervencionista y Terapia Endovascular (COMECITE), Mexico (Olvera-Ruiz, Lozoya-Morales) FSCAI, COMECITE, Mexico (Jimenez-Carbajal, Ponte-Gonzalez, Garcia, Cabrera-Arroyo) COMECITE (Gonzalez-Ramirez) Asociacion Nacional de Cardiologos de Mexico (ANCAM), Mexico (Rodriguez-Diez) Sociedad Mexicana de Electrofisiologia y Estimulacion Cardiaca (SOMEEC), Mexico (Felix-Tellez) Universidad Autonoma de Baja California, Mexico (Estrada-Jaime) Asociacion Nacional de Cardiologos al Servicio de los Trabajadores del Estado (ANCISSSTE), Mexico (Rodriguez-Herrera) Colegio Mexicano de Anestesiologia (COMEXANE), Mexico (Garcia-Arvizu, Narvaez-Oriani, Najar-Guerrero, Colin-Alvarez) ANCISSSTE, Mexico (Lopez-Madrigal) ANCAM, Mexico (Berni-Betancourt, Molina-Mendez) SOMEEC (Gutierrez-Garcia) COMEXANE (Lendewig-Barrera) Universidad Anahuac Cancun, Mexico (Rivera-Rodriguez) Universidad Autonoma de Zacatecas, Mexico Publisher Asociacion Nacional de Cardiologos de Mexico Abstract Introduction: prolonged fasting before cardiac catheterization remains a routine practice in almost all institutions, despite the lack of solid evidence of its benefits. Objective(s): to analyze and issue recommendations based on evidence and international consensus on preoperative fasting in elective cardiac catheterization procedures in adult and pediatric populations. Material(s) and Method(s): this national consensus used the nominal group technique and Delphi methodology, with participation from organizations such as COMECITE, ANCAM, SOMEEC, and COMEXANE, and a systematic review of the literature in medical databases, including randomized controlled trials and meta-analyses. Result(s): the consensus established recommendations for adult and pediatric populations, based on current evidence. Conclusion(s): short or liberalized fasting is safe before cardiac catheterization procedures and is associated with superior patient satisfaction compared with prolonged fasting, without an increase in broncho aspiration-related complications. Copyright © 2026 Asociacion Nacional de Cardiologos de Mexico. All rights reserved. <77> Accession Number 651594623 Title Efficacy of Preincisional Ultrasound Guided Pecto-intercostal Fascial Plane Block with Ropivacaine and Fentanyl in Patients Undergoing Open Heart Surgery by Median Sternotomy - A Prospective Single Blinded Randomized Controlled Study. Source Annals of cardiac anaesthesia. (no pagination), 2026. Date of Publication: 29 Apr 2026. Author Malik I.; Ahlawat G.; Budhwar D.; Singh S.; Dalai M.; Kumar V.; Gupta D.; Malhotra N. Institution (Malik, Ahlawat, Budhwar, Dalai, Malhotra) Department of Cardiac Anaesthesia, Pt BD Sharma PGIMS, Rohtak, Haryana, India (Singh) Department of Cardiothoracic Surgery, Pt BD Sharma PGIMS, Rohtak, Haryana, India (Kumar) Department of Anaesthesiology and Critical Care, Pt BD Sharma PGIMS, Rohtak, Haryana, India (Gupta) Department of Cardiac Anaesthesia, Medanta - The Medicity, Gurgaon, Haryana, India Abstract AIM: To evaluate the role of ultrasound (USG) guided Superficial Parasternal intercostal plane block (SPIP)/Pecto-Intercostal Fascial Plane Block (PIFB) on post sternotomy pain and postoperative outcomes in patients undergoing cardiac surgery. METHOD(S): This prospective single-blinded, randomized controlled study was conducted in 75 adult patients of age 18-75 years of ASA II-III undergoing cardiac surgery by median sternotomy. Patients were randomized into three groups with 25 patients in each group. Group I patients did not receive any block. Group II patients received USG guided PIFB with 0.4% ropivacaine+ 25 mug fentanyl on each side. Group III patients received USG guided PIFB with 0.4% ropivacaine+ 50 mug fentanyl. Numeric rating scale (NRS) for pain, Time to extubation, hemodynamic parameters (heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure) and SpO2 at various time points (T0: at extubation, T1: 2 h, T2: 4 h, T3: 8 h, T4: 16 h, T5: 24 h, T6: 48 h post extubation), cumulative fentanyl consumption and rescue analgesia, post operative nausea vomiting (PONV), time to drain removal, catheter removal, ambulation, length of intensive care unit (ICU), and hospital stay were noted. RESULT(S): Group II and III patients as compared to group I showed lower NRS values, shorter time to extubation, drain and catheter removal, early ambulation, stable hemodynamics, less fentanyl consumption and rescue analgesia requirement, less incidence of PONV, early ICU and hospital discharge. Group II and III had comparable results with no significant difference. CONCLUSION(S): USG guided SPIP/PIFB provides improved postoperative pain control, reduces the need for perioperative opioids, faster extubation, early ICU and hospital discharge. Copyright © 2026 Annals of Cardiac Anaesthesia. <78> Accession Number 2047012736 Title Does gabapentin add value to multimodal analgesia in thoracic surgery? A procedure-specific meta-analysis. Source Pain Management. (no pagination), 2026. Date of Publication: 2026. Author Lemos Gonzalez G.; Felippe V.A.; Wegner B.F.M.; Minetto Wegner G.R.; Lopes de Mattos I.L.; Souza do Nascimento T.; Area Leao Barreto L.; Alves Bersot C.D.; Nhuch F.; Lessa M.A. Institution (Lemos Gonzalez, Lopes de Mattos) Department of Anesthesia, Federal University of the State of Rio de Janeiro - UNIRIO, Rio de Janeiro, Brazil (Felippe) Department of Anesthesia, National Cancer Institute - INCA, Rio de Janeiro, Brazil (Wegner) College of Medicine, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil (Minetto Wegner) College of Medicine, Federal University of Fronteira Sul, Rio Grande do Sul, Brazil (Souza do Nascimento, Lessa) Department of Anesthesia, University of Iowa Carver College of Medicine, University of Iowa, Iowa City, IA, United States (Area Leao Barreto) College of Medicine, Federal University of Ceara, Ceara, Brazil (Alves Bersot) Paulista School of Medicine, EPM-UNIFESP, Sao Paulo, Brazil (Nhuch) Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, United States Publisher Taylor and Francis Ltd. Abstract Aims: Thoracic surgery is associated with severe acute and chronic pain, high opioid use, and other adverse outcomes. Gabapentin is commonly used perioperatively, but its effectiveness remains uncertain. This systematic review and meta-analysis evaluated the efficacy and safety of perioperative gabapentin versus placebo after thoracic surgery. Patients and Methods: Cochrane, Embase, PubMed, and Web of Science were searched through 29 August 2025 for randomized controlled trials comparing gabapentin with placebo in adults undergoing thoracic surgery. The primary outcome was pain at 24 hours. Secondary outcomes included pain at other time points, opioid consumption, chronic pain, and adverse events. Data were pooled using random-effects models. Result(s) and Conclusion(s): Six trials including 748 patients were analyzed. Gabapentin had no significant effect on rest pain at 24 hours (MD -0.13; 95% CI -1.17 to 0.91). A non-significant trend toward worse cough-evoked pain at 24 hours was observed with gabapentin (MD 0.53; 95% CI 0.00 to 1.07). Gabapentin also did not significantly affect opioid consumption, pain chronification, or adverse events such as nausea, sedation, or delirium. Based on low-certainty evidence, perioperative gabapentin does not appear to provide meaningful benefit after thoracic surgery. Protocol Registration: The www.crd.york.ac.uk/prospero identifier is CRD420251136259. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <79> Accession Number 651589079 Title Effect of the orexin receptor antagonist, suvorexant, on sleep architecture in the early postoperative period following cardiac surgery: a randomized controlled trial. Source Critical care (London, England). (no pagination), 2026. Date of Publication: 23 Jun 2026. Author Wongtangman K.; Reddy Janga S.; Azimaraghi O.; Khandaker R.; Khera T.; Leff J.; Forest S.J.; Suleiman A.; Tam C.; Spindel S.; DeYoung P.N.; Malhotra A.; Subramaniam B.; Eikermann M. Institution (Wongtangman, Azimaraghi, Khandaker, Leff, Suleiman, Tam, Eikermann) Department of Anesthesiology, Montefiore Medical Center and Albert Einstein College of Medicine, 111 East 210th St, Bronx, 10467, NY, USA (Wongtangman) Department of Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand (Reddy Janga, Khera) Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, Israel (Forest, Spindel) Department of Cardiothoracic and Vascular Surgery, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, United States (DeYoung, Malhotra) Division of Pulmonary, Critical Care, Sleep Medicine, Physiology, University of California San Diego, La Jolla, CA, United States (Subramaniam) Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, Israel (Eikermann) Klinik fur Anasthesiologie und Intensivmedizin, Universitat Duisburg- Essen, Essen, Germany Abstract BACKGROUND: Patients recovering from cardiac surgery in the intensive care unit (ICU) do not sleep well. Commonly used sedative-hypnotic medications can disrupt sleep architecture and increase the risk of delirium in critically ill patients after surgery. The orexin receptor antagonist suvorexant, improves sleep onset and duration in patients with chronic insomnia. We hypothesized that suvorexant improves sleep onset and duration while also reducing the incidence of delirium after cardiac surgery. METHOD(S): This multicentric, double-blind, randomized controlled trial was conducted at two university-based cardiac ICUs. One hundred adult patients were enrolled after admission to the ICU following cardiac surgery. Enrollment occurred between March 2020 and February 2025. Participants were randomized to receive either a once daily oral dose of suvorexant 20 mg or placebo. Treatment began on the first night after extubation and continued until hospital discharge or for a maximum of seven days, whichever occurred first. Sleep was recorded using an electroencephalography (EEG) monitor (SedLine, Masimo Corp., California, USA) on the first night after extubation and was scored blindly by an experienced registered polysomnographic technologist. The primary outcome was wakefulness after persistent sleep onset (WASO). Sleep onset was defined as the first 30-second epoch classified by rapid eye movement (REM) or non-REM stages 1, 2, 3 after lights off. Wakefulness was defined as an awake period of 30s or longer. Sleep questionnaires were administered and delirium screenings were conducted every morning until hospital discharge. RESULT(S): One hundred patients were randomized to receive suvorexant (n = 49) or placebo (n = 51). EEG analysis indicated that neither the median [inter-quartile range] nighttime WASO (200.7 [112.1, 328.4] minutes vs. 184.2 [80.4, 304.2] minutes; p = 0.33) nor total sleep time (224.0 [112.0, 379.0] minutes vs. 253.0 [68.0, 420.0] minutes; p = 0.92) differed significantly between the groups. There was no significant difference in rescue medication (melatonin, dexmedetomidine, benzodiazepine) utilization between the groups. Subjective sleep quality, incidence of delirium, and delirium-free days did not differ between the two groups. TRIAL REGISTRATION NUMBER: Clinical Trials Registry no. NCT04092894, Registration Date 09/17/2019. CONCLUSION(S): Among patients recovering in the ICU who underwent cardiac surgery with cardiopulmonary bypass, the suvorexant treatment did not affect wakefulness after sleep onset or post-operative delirium. Copyright © 2026. The Author(s). <80> Accession Number 651596430 Title A Systematic Review on the Impact of Postoperative Rehabilitation Programs in Thoracic Surgery Patients. Source Seminars in thoracic and cardiovascular surgery. (no pagination), 2026. Date of Publication: 24 Jun 2026. Author Wang N.; Luan K. Institution (Wang) Department of thoracic surgery,The Second Affiliated Hospital of Harbin Medical University, Harbin, China (Luan) Department of Medical oncology,The Second Affiliated Hospital of Harbin Medical University, Harbin, China Abstract BACKGROUND: Post-operative challenges, including reduced respiratory function and slower overall recovery, are often associated with thoracic surgeries. Rehabilitation strategies have been important over the years for their potential to support patient recovery and improve post-surgical outcomes. METHOD(S): Studies published up to March 2025 across the databases, including Google Scholar, PubMed, and ProQuest, were retrieved and analyzed for this systematic review. RESULT(S): Out of the initially selected 29 studies systematically reviewed, 8 fulfilled the final inclusion criteria and were included in the analysis. Postoperative rehabilitation strategies such as physiotherapy-based programs, nurse-led initiatives, and technology-assisted interventions have been included in the systematic review and found to influence the recovery following thoracic surgery. Interventions like these improve pulmonary function, better pain management, enhanced functional capacity, reduced complication rates, and shorter recovery periods. CONCLUSION(S): The findings suggest that rehabilitative approaches may contribute to better postoperative outcomes. However, further clinical research is still needed to develop more standardized rehabilitation protocols. Copyright © 2026 Elsevier Inc. All rights reserved. <81> Accession Number 2047037128 Title The Evolution of Minimally Invasive Cardiac Surgery Literature: A 50-Year North American Bibliometric Review and Future Trends. Source Journal of Cardiac Surgery. 2026(1) (no pagination), 2026. Article Number: 2938936. Date of Publication: 2026. Author Samir Cubas W.; Alfabeto A.; Kawaguchi Y.; Guo L.-R.; Chu M.W.A. Institution (Samir Cubas, Alfabeto, Kawaguchi, Guo, Chu) Division of Cardiac Surgery, London Health Sciences Centre, Western University, London, ON, Canada Publisher John Wiley and Sons Inc Abstract Objective: This study provides the first bibliometric analysis of minimally invasive cardiac surgery (MICS) in North America, mapping its evolution, collaboration networks, and research trends while forecasting future scientific trajectories through 2050. Method(s): We performed a bibliometric analysis of North American MICS literature (1975-2025) using Scopus and PubMed. Data processed using R (bibliometrix and biblioshiny) enabled network mapping, keyword analysis, and predictive modeling. Metrics included publication growth, document types, authorship, collaboration, citations, h-index, journals, and research topics. Collaboration networks and thematic evolution were visualized. Future MICS output (2030-2050) was forecasted using linear extrapolation with 95% confidence intervals. Result(s): We analyzed 1433 publications (United States: 76.3%; Canada: 23.7%). Original articles comprised 48.7%, and case reports comprised 28.7%, with an 8.51% annual growth rate. Among 4800 authors, 89.9% were male, averaging 5.65 coauthors per paper and 22.2% international collaborations. First authors were mainly faculty-surgeons (67.5%) and fellows (15.3%). Top topics are mitral valve (41.7%) and CABG (28.7%). Leading journals are Innovations (16.0%), Annals of Thoracic Surgery (12.6%), Journal of Cardiac Surgery (5.7%), and JTCVS (5.0%). Key affiliations are Cleveland Clinic (13.8%) and Western University (12.5%). Collaborations were strongest with Italy (43.5%) and Germany (32.8%). Forecasting models predicted an annual output of 79 publications by 2030, 93 by 2040, and 107 by 2050 (95% CI 58-146). Conclusion(s): This inaugural bibliometric analysis of North American MICS outlines five decades of growth, projects continued expansion to 2050, and offers a strategic foundation for future research, funding, and collaboration. Copyright © 2026 Samir Cubas W. et al. Journal of Cardiac Surgery published by John Wiley & Sons Ltd. <82> Accession Number 2047105843 Title Contemporary approach and key considerations to asymptomatic aortic stenosis treatment. Source Expert Review of Cardiovascular Therapy. (no pagination), 2026. Date of Publication: 2026. Author Banovic M.; Iung B. Institution (Banovic) Belgrade Medical School, University of Belgrade, Belgrade, Serbia (Banovic) Cardiology Department, University Clinical Center of Serbia, Belgrade, Serbia (Iung) Cardiology Department, Bichat Hospital, APHP, INSERM LVTS1148, Universite Paris-Cite, Paris, France Publisher Taylor and Francis Ltd. Abstract Introduction: Aortic stenosis (AS) is the most common and the deadliest valvular disease. The treatment of asymptomatic patients with severe AS remains a subject of investigation. Recently, ESC/EACTS guidelines for valvular diseases introduced a new indication for the treatment of asymptomatic low-risk patients with isolated high-gradient severe AS, as an alternative to clinical surveillance Area covered: This paper attempts to provide a rational, clinically oriented and evidence-based approach to the treatment of asymptomatic patients with high-gradient severe AS without additional adverse factors such as decrease in left ventricular systolic function or increase in natriuretic peptides. We searched for original and review papers through the PubMed database using the keywords: aortic stenosis, asymptomatic, risk stratification and intervention, without limiting the time period of the analyzed papers Expert opinion: The latest ESC/EACTS recommendations for the treatment of asymptomatic AS should be considered adequate. Considering differences in patient characteristics and heterogeneous treatment modalities, as well as differences in institutional-level outcomes, the optimal intervention strategy still needs clarification. Ongoing trials in asymptomatic patients with severe AS should provide significant new evidence. The diverse array of therapeutic options emphasizes the need for TAVI vs. SAVR randomized trial in middle-aged asymptomatic patients. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <83> Accession Number 2047131423 Title Descending Necrotizing Mediastinitis Across Age and Host-Status Groups: Diagnosis, Treatment Phases, and Outcomes in the Literature, with an Illustrative Case. Source Infectious Diseases and Therapy. (no pagination), 2026. Date of Publication: 2026. Author Ionescu C.; Cambrea C.S.; Bulbuc I.; Neagu E.; Caraban B.M. Institution (Ionescu, Cambrea, Bulbuc, Neagu, Caraban) Faculty of Medicine, Ovidius University, Constanta, Romania (Ionescu, Neagu, Caraban) Sf. Apostol Andrei Clinical Emergency County Hospital, Constanta, Romania Publisher Adis Abstract Introduction: Descending necrotizing mediastinitis (DNM) is a rare but life-threatening infection originating from odontogenic, tonsillopharyngeal, or deep cervical sources, and propagating through the cervical fascial planes into the mediastinum. Despite advances in cross-sectional imaging, thoracic surgery, intensive care medicine, and antimicrobial therapy, DNM remains associated with mortality ranging from 11 to 40% across contemporary series. The evidence base is fragmented and lacks a unified framework integrating anatomical, physiological, microbiological, and critical care dimensions. The aims of this study are to map the DNM literature across five predefined age and host-status subgroups, to synthesize differences in source infection, diagnostic pathway, mediastinal extent, treatment phases, ICU burden, microbiological evolution, and outcomes, to appraise methodological quality, and to identify future research priorities. Method(s): A scoping review was conducted in accordance with PRISMA-ScR, with incorporation of a prespecified illustrative institutional case for contextual comparison and pregnancy subgroup representation. Structured searches of PubMed/MEDLINE, Scopus, and Web of Science were supplemented by systematic citation chaining and revised eligibility criteria, allowing the inclusion of mixed infectious mediastinitis studies when the DNM subgroup could be clearly distinguished, yielding 18 studies (881 patients) in the final synthesis. A prospectively documented institutional case of DNM in pregnancy was analyzed separately from the PRISMA-tracked literature and used only to contextualize the pregnancy subgroup and to compare the proposed phase-based framework with a high-complexity observed clinical course. Result(s): The methodological quality of the PRISMA-tracked studies was predominantly Fair to Good; the illustrative institutional case was appraised separately as Fair. The reviewed literature suggested a hypothesis-generating, generally recurrent, phase-based clinical trajectory across subgroups. The institutional case was broadly consistent with the literature-derived pattern in seven of eight phases and differed mostly in the degree of multidrug-resistant microbiological complexity during Phase 7, an exploratory finding that may extend, rather than contradict, the proposed framework. Six recurrent adverse inflection points were identified, while evidence density varied across phases. Conclusion(s): DNM may be more usefully interpreted as a staged infectious syndrome rather than as an exclusively anatomical or surgical entity. The proposed phase-based framework, derived from structured synthesis of heterogeneous literature and contextualized by a prospectively documented severe case, should be interpreted as a conceptual, hypothesis-generating complement to existing anatomical staging systems rather than as a validated clinical model. Prospective multicenter registries, standardized reporting frameworks, and reproducibility testing should be regarded as the highest-priority research needs. Copyright © The Author(s) 2026. <84> Accession Number 651587904 Title The effect of remote ischemic preconditioning on cardiac injury in adults undergoing cardiac surgery: a systematic review with quantitative synthesis. Source Journal of cardiothoracic surgery. (no pagination), 2026. Date of Publication: 23 Jun 2026. Author Chen Z.; Dong W.; Zhang Q.; Wang Y. Institution (Chen, Dong, Zhang) Peoples Hospital of Yuhuan, China (Wang) Peoples Hospital of Yuhuan, China Abstract BACKGROUND: To evaluate the association between remote ischemic preconditioning and postoperative hs-TnT levels in patients undergoing cardiac surgery. METHOD(S): We systematically searched PubMed, Cochrane Central, Scopus, Embase, and Web of Science library databases for original RCTs (randomized controlled trials) articles that looked at the effect of RIPC on cardioprotection undergoing Cardiovascular Surgery. The outcome assessed was high-sensitivity troponin T (hs-TnT). Random-effects-analyses were conducted using standardized mean differences (SMDs) or mean differences (MDs) with 95% confidence intervals, applying the Hartung-Knapp-Sidik-Jonkman (HKSJ) method with restricted maximum likelihood estimation (REML). Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool, certainty of evidence was graded using GRADE. RESULT(S): Four randomized controlled trials were included in the quantitative synthesis. Using a random-effects model with restricted maximum likelihood estimation (REML) and HKSJ, the pooled analysis showed no significant difference in hs-TnT levels between the RIPC and control groups (Hedges' g = - 0.13, 95% CI - 0.83 to 0.56; p = 0.59). Substantial heterogeneity was observed among studies (I2 = 84.6%, tau2 = 0.16). Leave-one-out sensitivity analyses demonstrated that the pooled estimate was highly sensitive to the inclusion of individual studies, indicating limited robustness of the available evidence. Exploratory subgroup analyses suggested that effect estimates varied according to postoperative hs-TnT measurement timing; however, these findings were based on very small numbers of studies and should be interpreted cautiously. CONCLUSION(S): Remote ischemic preconditioning was not associated with a significant overall reduction in postoperative hs-TnT levels in adult cardiac surgery. The available evidence is limited by the small number of trials, substantial heterogeneity, and reliance on a surrogate biomarker outcome. Consequently, current evidence is insufficient to support or refute a clinically meaningful cardioprotective effect of RIPC in this setting. Copyright © 2026. The Author(s). <85> Accession Number 2047113398 Title Long-Term Clinical and Angiographic Outcomes With Transcatheter Versus Surgical Aortic Valve Replacement in the Low- and Intermediate-Risk Population: An Updated Meta-Analysis of Randomized Controlled Trials. Source Journal of Interventional Cardiology. 2026(1) (no pagination), 2026. Article Number: 3341689. Date of Publication: 2026. Author Saleem M.M.; Tariq M.H.; Brar A.; Usman A.; Upadhyay M.; Mudassar M.; Ibrahim S.; Bajwa M.S. Institution (Saleem, Upadhyay) Internal Medicine, Michigan State University, Flint, MI, United States (Tariq) Internal Medicine, Northwest Medical Center, Tucson, AZ, United States (Brar, Usman) Internal Medicine, Hurley Medical Center, Flint, MI, United States (Mudassar) Internal Medicine, King Edward Medical College, Lahore, Pakistan (Ibrahim) Internal Medicine, King Edward Medical University, Lahore, Pakistan (Bajwa) Neurology, JFK University Medical Center, Edison, NJ, United States Publisher John Wiley and Sons Inc Abstract Background: Transcatheter aortic valve replacement (TAVR) is preferred over surgical aortic valve replacement (SAVR) in patients at high risk of morbidity or mortality from surgery. However, surgery is still preferred in younger and healthier patients with symptomatic severe aortic stenosis, although recent trials support comparable efficacy and safety of TAVR even in low-risk patients. Method(s): An intention-to-treat analysis was conducted to construct a forest plot. The primary clinical outcome was the relative risk (RR) of stroke, and the secondary outcomes included the RR of all-cause mortality, cardiovascular mortality, myocardial infarction, new-onset atrial fibrillation, aortic reinterventions, and new permanent pacemaker implantation at the longest available follow-up. Angiographic outcomes were measured in terms of the standardized mean difference (SMD) in effective orifice area (EOA) and the RR of paravalvular leakage (PVL). Subgroup analysis was performed for the clinical outcomes at a 5-year follow-up as well. Result(s): No difference was seen between the two groups in terms of the RR of mortality (RR: 0.92, 95% CI: 0.75, 1.12) as well as stroke (RR: 1.05, 95% CI: 0.81, 1.35) in both the low- and intermediate-risk patients and patients < 80 years old. The RR of cardiovascular mortality, disabling stroke, and myocardial infarction was also similar. Five-year follow-up did not show any significant difference in risk of mortality (RR: 0.97, 95% CI: 0.86, 1.11) or stroke (RR: 1.05, 95% CI: 0.89, 1.25). TAVR was associated with a lower risk of new-onset atrial fibrillation (RR: 0.35, 95% CI: 0.25, 0.49, p < 0.00001). TAVR was associated with an increased risk of PVL (RR: 5.21; 95% CI: 2.70-10.07; p < 0.00001), aortic reintervention (RR: 1.95, 95% CI: 1.38, 2.77, p = 0002), and permanent pacemaker implantation (RR: 2.04, 95% CI: 1.55, 2.69, p < 0.00001). No statistically significant difference was found in the EOA; however, sensitivity analysis showed improved EOA with TAVR (SMD: 0.24, 95% CI: 0.12, 0.35). Conclusion(s): TAVR is angiographically comparable and clinically as safe and effective as SAVR in low-risk patients, even at longer follow-up durations. Copyright © 2026 Muhammad M. Saleem et al. Journal of Interventional Cardiology published by John Wiley & Sons Ltd. <86> Accession Number 651597333 Title A comparative analysis of the effects of moderate vs mild hypothermia on serum neuron-specific enolase, S100beta, and near-infrared spectroscopy during cardiopulmonary bypass-assisted open-heart surgery: a single-centre study. Source Cardiovascular journal of Africa. 37(2) (pp 208-214), 2026. Date of Publication: 05 Jun 2026. Author Tulek F.; Oc B.; Arun O.; Unlu A.; Oc M.; Celik J.B.; Yildirim S.; Duman A. Institution (Tulek) Department of Anesthesiology, Ministry of Health Konya Numune Hospital, Konya, Turkey (Oc, Arun, Celik) Department of Anesthesiology, Selcuk University Faculty of Medicine, Konya, Turkey (Unlu) Department of Biochemistry, Selcuk University Faculty of Medicine, Konya, Turkey (Oc) Department of Cardiovascular Surgery, Selcuk University Faculty of Medicine, Konya, Turkey (Yildirim) Department of Cardiovascular Surgery, Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey (Duman) Department of Anesthesiology, Atlas University Faculty of Medicine, Istanbul, Turkey Abstract PURPOSE: Neurological injury remains a critical concern in cardiac surgery despite advancements in surgical and anaesthetic techniques. Hypothermia is commonly utilised for neuroprotection during cardiopulmonary bypass (CPB); however, the optimal temperature range remains undetermined. This study evaluates the neuroprotective effectiveness of mild versus moderate hypothermia by assessing neuron-specific enolase (NSE) and S100beta levels, near-infrared spectroscopy (NIRS) cerebral oxygenation, and cognitive function in patients undergoing CPB-assisted open-heart surgery. METHOD(S): Forty elective coronary artery bypass grafting (CABG) patients were randomised to mild (32-34degreeC, n = 20) or moderate (28-32degreeC, n = 20) hypothermia groups. Serum NSE and S100beta levels were measured preoperatively and at 0, 12, 24, and 48 hours postoperatively. Cerebral oxygenation via NIRS and Mini-Mental State Examination (MMSE) scores were evaluated preoperatively and at 24 and 48 hours postoperatively. This is a single-centre study. The primary outcome was the between-group difference in S100beta levels at 24 and 48 hours; all other variables were predefined secondary outcomes. RESULT(S): Postoperative NSE levels increased in both groups, with no significant intergroup differences (p > 0.05). However, S100beta levels were significantly lower in the moderate hypothermia group at 24 and 48 hours (p = 0.012, p = 0.004). NIRS values and MMSE scores remained comparable between groups (p > 0.05). CONCLUSION(S): Our findings suggest that moderate hypothermia may offer improved neuroprotection by attenuating S100beta release without adversely affecting cerebral oxygenation or cognitive outcomes. Although these results are encouraging, further validation through larger, multicentre studies is warranted before definitive conclusions can be drawn. <87> Accession Number 651594476 Title Incidence and Predictors of Postoperative Atrial Fibrillation Following Cardiac Surgery: A Systematic Review. Source Annals of cardiac anaesthesia. (no pagination), 2026. Date of Publication: 29 Apr 2026. Author Prasetyadhi J.; Adil A.; Hisbullah; Arif S.K. Institution (Prasetyadhi, Hisbullah, Arif) Department of Anesthesiology, Intensive Care, Pain Management, Kolaka Timur Regional Public Hospital, South Sulawesi, Indonesia (Adil) Department of Anesthesiology, Intensive Care, Pain Management, Faculty of Medicine, Hasanuddin University - Wahidin Sudirohusodo Hospital, Makassar, South Sulawesi, Indonesia Abstract ABSTRACT: Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery, with an incidence ranging from 10% to 65%, and is associated with increased risks of stroke, prolonged hospitalization, and mortality. This systematic review aimed to evaluate the incidence and identify predictors of POAF in adults undergoing cardiac procedures. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched PubMed, Europe PMC, and SAGE databases for English-language studies published between January 2020 and June 2025. Eligible studies included observational and experimental designs involving adults (>18 years) undergoing cardiac surgery. Two reviewers independently screened titles/abstracts, assessed full texts, extracted data, and evaluated quality using the Newcastle-Ottawa Scale and Joanna Briggs Institute tools. From 6598 initial records, 52 studies (32 prospective cohorts, 17 retrospective cohorts, and 3 cross-sectional) were included, encompassing diverse geographies, and surgical types (e.g., coronary artery bypass grafting, valve surgery). POAF incidence varied from 7.9% to 60.9%, highest in combined procedures (40%-50%), and valve surgery (30%-40%). Consistent predictors included advanced age (odds ratio 1.05-1.10/year), left atrial enlargement, valve surgery, comorbidities (hypertension, diabetes, renal dysfunction), prolonged cardiopulmonary bypass, inflammation (e.g. C-reactive protein, neutrophil-to-lymphocyte ratio), and oxidative stress markers (e.g. NOX2). Novel biomarkers like MR-proANP and gene panels showed potential. POAF remains multifactorial and burdensome; standardized monitoring and integrated risk models could enhance prediction and prevention, warranting further validation in multicenter trials. Copyright © 2026 Annals of Cardiac Anaesthesia. <88> Accession Number 2047158448 Title Protection against postoperative atrial fibrillation via antiplatelet aggregation induced by remote ischemic preconditioning during off-pump coronary artery bypass grafting. Source Basic Research in Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Jiang Q.; Zheng Y.; Huang K.; Du J.; Yang Z.; Hu S. Institution (Jiang, Huang) Department of Cardiac Surgery, Sichuan Provincial People's Hospital, Affiliated Hospital of University of Electronic Science and Technology, Chengdu, China (Jiang, Zheng) School of Medicine, University of Electronic Science and Technology, Chengdu, China (Jiang) Ultrasound Medicine and Computational Cardiology Key Laboratory of Sichuan Province, Chengdu, China (Du) Department of Operating Room, Sichuan Provincial People's Hospital, Affiliated Hospital of University of Electronic Science and Technology, Chengdu, China (Yang) The Key Laboratory for Human Disease Gene Study of Sichuan Province, Department of Laboratory Medicine, Sichuan Provincial People's Hospital, Chengdu, China (Hu) Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Jiang) No.32, West Second Section First Ring Road, Chengdu, China Publisher Springer Science and Business Media Deutschland GmbH Abstract Off-pump coronary artery bypass grafting (OPCABG) is associated with increased platelet aggregation and a higher incidence of postoperative atrial fibrillation (POAF). Remote ischemic preconditioning (RIPC) has been reported as a promising intervention to mitigate these adverse outcomes. Consecutive patients with cytochrome P450 family 2 subfamily C member 19 (CYP2C19) loss-of-function (LOF) genotype who underwent isolated OPCABG were randomly assigned to receive intermittent ischemia-reperfusion applied to the arm (RIPC group) or not intervention (control group). RIPC was performed after induction of anesthesia using three cycles of 5-min inflation separated by 5-min deflation. The primary outcome was the cumulative incidence of POAF within the first postoperative week, assessed by the intention-to-treat analysis. Secondary outcomes included POAF burden, biochemical indicators, and clinical trajectory. Among the 220 patients available for the primary endpoint analysis, POAF occurred in 27 of 109 patients (24.8%) in the RIPC group versus 46 of 111 patients (41.4%) in the control group (hazard ratio [HR]: 0.542, 95% confidence interval [CI]: 0.342 to 0.858; P = 0.01). The RIPC group also showed significantly lower values than the control group for AF burden (5.1% [IQR 2.3-11.3%] vs. 8.3% [IQR 4.1-19.1%]; P = 0.019), arachidonic acid- and adenosine diphosphate-stimulated platelet aggregation, inflammatory and prothrombotic index, and intensive care unit length of stay. In CYP2C19 LoF carriers, administration of RIPC favorably reduced the incidence and burden of POAF within 1 week after OPCABG, attenuated platelet aggregation and systemic inflammation, and shortened the duration of intensive care unit stay. Copyright © Springer-Verlag GmbH Germany, part of Springer Nature 2026. <89> Accession Number 2047028080 Title Meta-analysis of perioperative amiodarone for prevention of postoperative atrial fibrillation (POAF) in cardiac surgery patients: update and reevaluation of timing, route, and dosage. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 547. Date of Publication: 01 Dec 2026. Author Li Z.; Wang S.; An L.; Chen C.; Zhang G.; Chen L.; Du J. Institution (Li, Wang, Chen, Du) Department of Surgical Intensive Care Unit, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China (An, Chen) Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Zhang) Department of Neurology, 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 Publisher BioMed Central Ltd Abstract Background: Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery, and perioperative amiodarone is recommended for POAF prophylaxis, while the optimal timing, route, and dosage remain unclear. The purpose of this study is to evaluate the efficacy of perioperative amiodarone for the prevention of POAF in patients undergoing cardiac surgery and to reevaluate the impact of its timing, route, and dosage. Method(s): Data were collected through searching PubMed, Embase, and the Cochrane Library from inception until September 30, 2025, for randomized controlled trials (RCTs). Data were pooled using a random-effects model. Result(s): Forty RCTs involving 6,166 patients were included. Amiodarone was associated with a substantial reduction in the incidence of POAF (odds ratio [OR] 0.39, 95% confidence interval [CI] 0.31 to 0.49, P < 0.00001, I2 = 57%). The preventive efficacy may be primarily influenced by the combination of administration timing and route, rather than by the cumulative dose alone. Notably, a significant dose-response relationship was observed within the preoperative through postoperative oral strategy. Statistically significant differences were found in length of hospital stay (mean difference -1.33 days, P < 0.0001) and cerebrovascular accident (OR = 0.59, P = 0.04), and an increased risk of bradycardia (OR = 2.33, P < 0.00001). No statistically significant differences were found in mortality, heart block, or hypotension. Conclusion(s): Prophylactic perioperative amiodarone may be associated with a reduced incidence of POAF, consistent with current guideline recommendations, and the timing and route of administration appear to play a more important role than the dose alone. While an increased risk of bradycardia was observed, no clear association with major adverse outcomes was identified. These results should be interpreted cautiously and may help optimize prophylactic strategies in appropriate clinical contexts. Copyright © The Author(s) 2026. <90> Accession Number 2047237431 Title Meta-Analysis of Radial Artery Conduit Use after Transradial Catheterisation. Source Heart Lung and Circulation. Conference: Heart Lung and Circulation. Sydney Australia. 35(Supplement 1) (pp S1), 2026. Date of Publication: 01 Jun 2026. Author Sharma V.; Wang M.; Hamilton G.; Marasco S. Institution (Sharma) Monash Health, Melbourne, Vic, Australia (Wang, Marasco) Department of Surgery (Alfred), Monash University, Melbourne, Vic, Australia (Hamilton) Department of Cardiology, Austin Health, Melbourne, Vic, Australia (Marasco) Department of Cardiothoracic Surgery, Alfred Health, Melbourne, Vic, Australia Publisher Elsevier Ltd Abstract Purpose: Transradial catheterisation (TRC) is now the default approach for coronary angiography but is associated with endothelial damage and vasodilatory dysfunction of the radial artery (RA). To date, there is insufficient evidence regarding the impact of TRC on RA graft patency. We conducted a meta-analysis of studies comparing the patency of catheterised (CRA) to non-catheterised (NCRA) radial arteries as conduits in coronary artery bypass grafting (CABG). Methodology: Comprehensive Search was conducted on Embase and PubMed in accordance with PRISMA guidelines. Pre-operative demographic, time from catheterisation, follow-up imaging and patency data were collected. Pooled analysis was undertaken using fixed-effects modelling using risk rates (RR) for the outcome of patency. Heterogeneity was assessed using I2 statistics. Result(s): Systematic review yielded four comparative studies with a total of 554 patients, 175 previously catheterised (CRA) and 379 were not (NCRA). The mean age of intervention was 64.4 +/- 10.2 years; 407 (73.4%) were males, 222 (40.1%) had diabetes, 208 (73.6%) hypertension, 412 (74.4%) hypercholesterolaemia and 214 (38.6%) were smokers. The mean time from catheterisation to CABG was 27.4+/-16.0 days, and repeat imaging was undertaken at a mean of 2.06+/-1.88 years from CABG. CRA (n=128/175) had lower patency compared to NCRA (n=318/379) on repeat imaging (73.2 vs. 83.9%, 10.7% difference, p<0.01). In pooled weighted meta-analyses, CRA were at 1.82 times the odds of failure compared to non-cannulated radials (Odds ratio [OR] 1.82, 95% CI 1.26-2.61, p=0.001). Heterogeneity using I2 statistic was 33% (95% confidence interval [CI] 0%-76%). Influence assessment using jackknife, Egger's and Funnel Plot analysis did not yield any significant bias. Conclusion(s): CRA radials have a significantly lower rate of patency at a mean of 2 years follow-up, with a 1.8-fold increase in odds of occlusion. Copyright © 2026 <91> Accession Number 2047262037 Title The Plantaris Tendon in Surgery: A Scoping Review of Reconstructive Roles Beyond Orthopedics. Source Journal of Surgical Research. 325 (pp 668-675), 2026. Date of Publication: 01 Sep 2026. Author Davidson A.M.; Chi A.; Gonzalez G.; Papp D.F. Institution (Davidson, Chi, Gonzalez, Papp) Department of Orthopaedic Surgery, Florida International University, Baptist Health South Florida, Miami, Florida, United States Publisher Academic Press Inc. Abstract Introduction: The plantaris tendon, a slender and often vestigial structure of the posterior leg, has long been recognized in orthopedic surgery for its favorable properties as an autograft. However, its role beyond musculoskeletal applications remains under characterized. This scoping review synthesizes the existing literature on the surgical use of the plantaris tendon in nonorthopedic procedures, highlighting patterns, outcomes, and evidence gaps across clinical specialties. Method(s): Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, a systematic search of PubMed, Scopus, and Embase was conducted from inception through final search date. Studies were eligible if they described nonorthopedic surgical applications of the plantaris tendon or muscle and reported procedural detail or outcomes. Data were extracted using a standardized charting form and summarized narratively by surgical domain. Result(s): Ten studies met inclusion criteria, encompassing facial reanimation, ophthalmic surgery, hand reconstruction, cardiac valve repair, visceral grafting, and cadaveric feasibility assessments. The most common use was static suspension for facial paralysis, with 55 patients undergoing tendon sling procedures and reporting improved symmetry and oral competence. In comparative studies, plantaris tendon grafts showed superior lip excursion versus alternative techniques. Experimental data supported tendon viability for esophageal grafting and cardiac repair. Across studies, the plantaris was favored for its length, tensile strength, and low donor site morbidity. Outcome reporting varied and was most robust in facial applications. Conclusion(s): The plantaris tendon demonstrates promising versatility in reconstructive and experimental surgery beyond orthopedics. Despite encouraging results, the literature remains sparse and heterogeneous. Broader adoption may benefit from greater anatomical familiarity, standardized outcomes, and further comparative studies. Copyright © 2026 Elsevier Inc. <92> Accession Number 2047237102 Title Impact of Transcatheter Aortic Valve Implantation on the Practice of Surgical Aortic Valve Replacement. Source Heart Lung and Circulation. Conference: Heart Lung and Circulation. Sydney Australia. 35(Supplement 1) (pp S14-S15), 2026. Date of Publication: 01 Jun 2026. Author Jacoub M.; Kejriwal N. Institution (Jacoub, Kejriwal) Waikato Terteriary Hospital, Waikato, Hamilton, New Zealand Publisher Elsevier Ltd Abstract Background & Purpose: Transcatheter aortic valve implantation (TAVI) has expanded rapidly for the treatment of aortic stenosis (AS) in patients who were deemed inoperable or high risk for surgical aortic valve replacement (sAVR). Multiple robust evidence based on randomised clinical trials have demonstrated TAVI as non-inferior to sAVR in intermediate and high-risk patients with severe symptomatic aortic stenosis. The Placement of Aortic Transcatheter Valves (PARTNER) 1A trial concluded that TAVI was non-inferior to SAVR in high-risk patients up to 5 years after valve implantation. The PARTNER 2A and SURTAVI trials concluded that TAVI is non-inferior to SAVR for death from any cause or disabling stroke at 2 years following treatment of severe aortic stenosis in intermediate-risk patients. In patients with severe aortic stenosis who were at low surgical risk, the PARTER 3 and EVOLUT trials reported that TAVI was associated with lower incidence of composite end- point of death, disabling stroke, rehospitalisation within 1 year, bleeding complications and acute kidney injury. However, the long-term impact of increased pacemaker use, paravalvular regurgitation, leaflet thickening and durability concerns associated with TAVI is still unknown. SAVR remains a vital treatment choice in patients with high anatomical risk for TAVI including bicuspid aortic valve, heavy annular calcification, and low coronary heights. Interestingly despite TAVI being utilised in an increasingly wide spectrum of patients with AS, globally the number of sAVR cases remain high. Aim & Conclusion(s): This suggests that an increased number of patients with severe aortic stenosis are receiving intervention and the introduction of TAVI in addition to sAVR is having a meaningful impact on the broader patient population. There is a lack of up-to-date local data involving sAVR cases in Waikato Hospital since the introduction of TAVI. The objective of this study is hence to examine if the introduction of TAVI at Waikato Hospital has influenced sAVR case numbers or the age and risk profile of patients receiving SAVR and review outcomes. Copyright © 2026 <93> Accession Number 2047234600 Title SGLT2 inhibitors after transcatheter aortic valve implantation: a systematic review and exploratory meta-analysis. Source IJC Heart and Vasculature. 65 (no pagination), 2026. Article Number: 101963. Date of Publication: 01 Aug 2026. Author Spadafora L.; Bernardi M.; Sarto G.; Frati G.; Valenti V.; Peruzzi M.; Galli M.; Tocci G.; Simeone B.; Nardoianni G.; Lodoli C.; Di Muro F.M.; Stefanini G.; Versaci F.; Biondi-Zoccai G.; Sciarretta S. Institution (Spadafora, Frati, Valenti, Galli, Simeone, Biondi-Zoccai, Sciarretta) Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (Spadafora, Bernardi, Versaci) UOC UTIC Emodinamica e Cardiologia, Santa Maria Goretti Hospital, Latina, Italy (Sarto) Cardiology Division, ICOT Istituto 'Marco Pasquali' University Hospital, Latina, Italy (Frati, Sciarretta) IRCCS NeuroMed, Pozzilli, Italy (Valenti, Peruzzi, Galli, Biondi-Zoccai) Maria Cecilia Hospital, GVM Care and Research, Cotignola, Italy (Peruzzi) Department of Medical and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy (Tocci, Nardoianni) Division of Cardiology, Department of Clinical and Molecular Medicine, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy (Lodoli) Department of Maternal and Child Health and Urological Sciences - Policlinico Umberto I, Rome, Italy (Di Muro) Cardiology Unit, Cardiovascular and Thoracic Department, University Hospital "San Giovanni Di Dio E Ruggi d'Aragona" Largo Citta Di Ippocrate, Salerno, Italy (Di Muro) Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno, Italy (Stefanini) Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy Publisher Elsevier Ireland Ltd <94> Accession Number 2047238253 Title Comparative Short-Term and Matched Survival Outcomes of CUSA-Assisted Mitral Valve Replacement Versus Transcatheter Valve Techniques in Severe Mitral Annular Calcification: A Meta-Analysis and Propensity-Matched Analysis. Source Heart Lung and Circulation. Conference: Heart Lung and Circulation. Sydney Australia. 35(Supplement 1) (pp S2-S3), 2026. Date of Publication: 01 Jun 2026. Author Singh B.; Singh T.; Mejia R.; Nazefati P.; Gupta A.; Seah P.; Saxena P.; Nandapurkar M.; Singh G.; Kaur M. Institution (Singh, Singh, Mejia, Nazefati, Gupta, Seah, Saxena, Nandapurkar, Singh, Kaur) John Hunter Hospital, Rankin Park, NSW, Australia Publisher Elsevier Ltd Abstract Background: Severe mitral annular calcification (MAC) poses significant challenges during mitral valve replacement due to annular rigidity, anatomic distortion, and high perioperative risk. Traditional surgical approaches using Cavitron Ultrasonic Surgical Aspirator (CUSA)-assisted surgical mitral valve replacement (SMVR) carry risks like atrioventricular (AV) groove rupture. Alternatively, transcatheter techniques, including surgically implanted transcatheter aortic valves in the mitral position (ViMAC) and purely percutaneous transcatheter mitral valve replacement (TMVR), have emerged as potential solutions, particularly in high-risk patients. These techniques present unique complications, including left ventricular outflow tract (LVOT) obstruction, paravalvular leak (PVL), and device malposition, underscoring the need for precise procedural planning and patient selection. Method(s): We performed a systematic review and meta-analysis of 15 single-arm studies involving a total of 560 patients with severe MAC undergoing SMVR, ViMAC, or TMVR. Data on demographics, perioperative risk profiles, and short-term outcomes were extracted. A meta-analysis of proportions was conducted for 30-day mortality, LVOT obstruction, AV groove rupture, moderate/severe PVL, and stroke rates. Additionally, a propensity-matched analysis was performed comparing SMVR and ViMAC patients to account for differences in baseline risk factors, including age, Society of Thoracic Surgeons (STS) risk score, diabetes mellitus, and chronic kidney disease. Kaplan-Meier curves were constructed to evaluate survival outcomes following matched analysis. No clinical trials registry was applicable. Result(s): Patients undergoing ViMAC and TMVR were significantly older (mean age 75-80 years) and exhibited higher surgical risk profiles with STS scores ranging from 9%-12%, compared to SMVR patients whose mean age ranged from 68-72 years and STS scores from 6%-9%. Pooled analysis revealed 30-day mortality was substantially lower for SMVR, with a median rate of 6.3% (range 0%-27%), whereas ViMAC exhibited a higher 30-day mortality of 21.8%. LVOT obstruction was observed in 10% of ViMAC cases, often associated with significant haemodynamic compromise. In contrast, AV groove rupture, a catastrophic complication specific to SMVR, was reported in up to 7% of surgical cases. Rates of moderate or severe PVL were low across both SMVR and ViMAC groups but occasionally required reintervention in ViMAC patients. Stroke rates were rare, occurring in fewer than 2% of cases across all interventions. Propensity-matched survival analysis demonstrated significantly improved outcomes for SMVR patients, with early divergence of Kaplan-Meier curves suggesting that perioperative complications, notably LVOT obstruction in ViMAC procedures, were key drivers of early mortality. Notably, recent technological advances have contributed to reductions in LVOT obstruction risk. The use of preoperative imaging software to simulate the neo-LVOT area and hybrid surgical techniques, such as anterior leaflet resection or prophylactic LVOT myectomy, have become increasingly incorporated into the surgical armamentarium. These innovations have reduced LVOT obstruction rates in contemporary ViMAC series to approximately 5%-6%, representing a significant improvement over earlier reports exceeding 10%. Conclusion(s): Despite technical advances, CUSA-assisted SMVR maintains a lower perioperative mortality and superior short-term survival compared to ViMAC, largely attributable to lower rates of perioperative complications like LVOT obstruction. However, AV groove rupture remains a unique risk associated with aggressive annular decalcification during SMVR. Emerging hybrid surgical-transcatheter strategies and refined preoperative planning tools hold promise for improving outcomes in patients with severe MAC. Our findings underscore the critical importance of individualised procedural planning and multidisciplinary evaluation when managing this complex patient cohort. Copyright © 2026 <95> Accession Number 2046953528 Title Effects of Inspired Oxygen Concentrations During Cardiopulmonary Bypass on the Pulmonary Function of Patients Undergoing a Modified Morrow Procedure via a Small Right Axillary Incision. Source Anesthesiology Research and Practice. 2026(1) (no pagination), 2026. Article Number: 9078621. Date of Publication: 2026. Author Xu L.; Wang L.; Yan M.; Wei H.; Jiang T.; Wang H.; Guo J.; Cui Y. Institution (Xu, Yan, Wei, Jiang, Wang, Guo) Center for Rehabilitation Medicine, Department of Anesthesiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Zhejiang, Hangzhou, China (Wang) Department of Anesthesiology, The First Affiliated Hospital of Shantou University Medical College, Guangdong, Shantou, China (Cui) Heart Center, Department of Cardiovascular Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Zhejiang, Hangzhou, China Publisher John Wiley and Sons Ltd Abstract Background: Patients with hypertrophic obstructive cardiomyopathy (HOCM) undergoing minimally invasive modified Morrow procedure may be vulnerable to postoperative pulmonary dysfunction. During cardiopulmonary bypass (CPB), lung-protective ventilation has been proposed, but the optimal inspired oxygen concentration under this strategy remains unclear. This study aimed to compare different inspired oxygen concentrations under a fixed lung-protective ventilation strategy during CPB. Method(s): This was a prospective clinical observation study involving 97 patients scheduled for modified Morrow procedures via a small right axillary incision between January 2023 and November 2023 at a single center. Patients were randomized to receive CPB ventilation with FiO<inf>2</inf> of 30%, 50%, or 100% under a standardized ultra-low-tidal-volumelung-protective strategy. The primary outcomes included the Horowitz Index (HI = PaO<inf>2</inf>/FiO<inf>2</inf>), respiratory index (RI = P(A-a)O<inf>2</inf>/PaO<inf>2</inf>), and alveolar-arterial oxygen pressure difference [P(A-a)O<inf>2</inf>] at six different time points within the first 24 h postoperatively, as well as postoperative pulmonary complications. Secondary outcomes included plasma levels of inflammatory cytokines, endothelial glycocalyx (eGC) components, and measures of postoperative rehabilitation and other complications. Result(s): There were no significant differences in terms of postoperative complications and rehabilitation among the three groups with different inspired oxygen concentrations under a fixed lung-protective ventilation strategy during CPB. Compared with the 100% FiO<inf>2</inf> group, the 30% FiO<inf>2</inf> group exhibited higher HI at 6 h and 24 h postoperatively with lower P(A-a)O<inf>2</inf> at 18 h and 24 h postoperatively and a lower RI at 24 h postoperatively. In addition, the 30% FiO<inf>2</inf> group showed lower plasma levels of inflammatory cytokines and eGC. Conclusion(s): These findings indicate that the use of 30% 100% FiO<inf>2</inf> group with ultra-low tidal volume ventilation during CPB in patients undergoing a modified Morrow procedure via a small right axillary incision was safe and associated with improved early postoperative oxygenation and attenuated inflammatory response. Trial Registration: Chinese Clinical Trial Registry: ChiCTR2400084443. Copyright © 2026 Linting Xu et al. Anesthesiology Research and Practice published by John Wiley & Sons Ltd. <96> Accession Number 2047287633 Title Effect of the ligament of Marshall excision during minimally invasive cardiac surgery-coronary artery bypass grafting (MICS-CABG) on the prevention of postoperative new-onset atrial fibrillation (LOMEX-AF): study protocol for a randomised controlled trial. Source BMJ Open. 16(7) (no pagination), 2026. Date of Publication: 01 Jul 2026. Author Song J.; Wang J.; Wang X.; Fu Y.; Yang W.; Yang H.; Gong Y.; Meng L.; Ding T.; Rui L.; Feng H.; Zhao J.; Zheng H.; Zhan S.; Ling Y. Institution (Song, Fu, Yang, Yang, Gong, Meng, Ding, Rui, Zhao, Zheng, Ling) Department of Cardiac Surgery, Peking University Third Hospital, Beijing, China (Wang) Department of Epidemiology, Chinese Academy of Medical Sciences Fuwai Hospital, Beijing, China (Wang, Zhan) Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China (Feng, Zheng) Cardiac Intensive Care Unit, Peking University Third Hospital, Beijing, China Publisher BMJ Publishing Group Abstract Introduction: Postoperative atrial fibrillation (POAF) remains one of the most common complications following coronary artery bypass grafting (CABG), including minimally invasive cardiac surgery-CABG (MICS-CABG). The ligament of Marshall (LOM), containing myocardial fibres and rich autonomic innervation, has been implicated in atrial arrhythmogenesis. Despite evidence that catheter ablation targeting the LOM or surgical interruption during conventional CABG can be effective, prophylactic surgical excision of the LOM during MICS-CABG has not been evaluated in randomised controlled trials (RCTs). Methods and analysis: The Ligament of Marshall Excision for the Prevention of Postoperative New-Onset Atrial Fibrillation (LOMEX-AF) trial is a single-centre, prospective, triple-blind (participants, outcome assessors, statisticians) RCT. Adults 30-80 years scheduled for elective MICS-CABG who meet inclusion/exclusion criteria will be randomised to Standard MICS-CABG with posterior left pericardiotomy (control) or the same procedure plus excision of a segment of the LOM (intervention). Resected tissue will be fixed for histopathology. Primary Outcome: new-onset POAF during index hospitalisation defined as atrial fibrillation or atrial flutter lasting >=30 s detected by ECG/telemetry. Secondary outcomes include frequency and duration of episodes, need for Class I/III antiarrhythmics or electrical cardioversion, intensive care unit and hospital length of stay, mechanical ventilation time and reoperation for bleeding. Sample size: 340 per arm (n=680 total) to detect a 50% relative reduction from an estimated 17% control event rate with 90% power, two-sided alpha=0.05, allowing 5% attrition. Primary analysis: intention-to-treat; categorical comparisons by chi2 or Fisher exact test; continuous variables by t-test or Mann-Whitney U as appropriate; analyses performed in R. Ethics and dissemination: The study has been approved by the institutional ethics committee of Peking University Third Hospital, Beijing, China (IRB00006761-M20250847. 11 October 2025). Written informed consent will be obtained from all participants before enrolment. The trial will be conducted in accordance with the Declaration of Helsinki, Good Clinical Practice principles and applicable national regulations. The findings will be disseminated through publication in peer-reviewed journals and presentation at academic conferences. Trial registration number: ChiCTR2500110913. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/. <97> Accession Number 2047143991 Title Comment on "Sex-related differences in long-term mortality after coronary artery bypass graft surgery: a systematic review and meta-analysis". Source International Journal of Cardiology: Cardiovascular Risk and Prevention. 30 (no pagination), 2026. Article Number: 200673. Date of Publication: 01 Sep 2026. Author Yashinova D.Z.; Yuldashev S.; Khodjaniyazov A.; Murodovna A.G. Institution (Yashinova) Department of Obstetrics and Gynecology in Family Medicine, Bukhara State Medical Institute Named After Abu Ali ibn Sino, Bukhara, Uzbekistan (Yuldashev) Republican Specialized Scientific and Practical Medical Centre for Maternal and Child Health, Department of Surgical Gynecology, Uzbekistan (Khodjaniyazov) Department of Surgical Diseases and Transplantology, Urgench State Medical Institute, Uzbekistan (Murodovna) Department of Obstetrics and Gynecology No. 2, Andijan State Medical Institute, Andijan, Uzbekistan Publisher Elsevier B.V. <98> Accession Number 2047245663 Title Physiology vs angiography-guided percutaneous coronary intervention in transcatheter aortic valve implantation: the FAITAVI trial. Source European Heart Journal. 47(25) (pp 3257-3266), 2026. Date of Publication: 01 Jul 2026. Author Ribichini F.L.; Gregori D.; Lorenzoni G.; Gallo F.; Baccani B.; Petronio A.S.; Ribichini F.; Pesarini G.; Pighi M.; Scarsini R.; Lunardi M.; Fezzi S.; Del Sole P.A.; Iossa L.; Mammone C.; Rubino F.; Cesar Vigo F.; Rojas J.D.C.; Esposito G.; Franzone A.; Castiello D.S.; D'ascenzo F.; Bruno F.; Conrotto F.; Tarantini G.; Fabris T.; Napodano M.; Nai Fovino L.; Fraccaro C.; Masiero G.; Zanchettin C.; Bedogni F.; Caprioglio F.; Drago A.; Cabianca E.; Piva T.; Nicolini E.; Fineschi M.; Bccani B.; Barbierato M.; D'Amico G.; Saia F.; Orzalkiewicz M.; Berti S.; Sclafani R.; Cavallini C.; Gandolfo C.; La Spina K.; Sonia Petronio A.; De Carlo M.; Di Mario C. Institution (Ribichini, Scarsini, Pesarini) Division of Cardiology, Department of Medicine, University of Verona, Piazzale Aristide Stefani, 1, Verona, Italy (Fabris, Zanchettin, Gregori, Lorenzoni, Tarantini) Department of Cardiac, Thoracic and Vascular Science, University of Padua, Padua, Italy (Barbierato, D'Amico, Zanchettin, Gallo) Division of Cardiology, Ospedale dell'Angelo, Venice, Mestre, Italy (Piva, Nicolini) Division of Cardiology, Azienda Ospedaliero Universitaria delle Marche, Ancona, Italy (Gandolfo, La Spina) Division of Cardiology, ISMETT di Palermo, Palermo, Italy (Fineschi, Baccani) Division of Cardiology, Azienda Ospedaliera Universitaria Senese, Siena, Italy (Petronio, De Carlo) Division of Cardiology, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy (Berti) Division of Cardiology, Ospedale del Cuore-Fondazione Monasterio, Massa, Italy (Drago) Division of Cardiology, Ospedale San Bortolo di Vicenza, Vicenza, Italy (Saia) Division of Cardiology, Policlinico S. Orsola-Malpighi, Bologna, Italy (Sclafani) Division of Cardiology, Azienda Ospedaliera di Perugia-Ospedale S. Maria della Misericordia, Perugia, Italy (Esposito) Division of Cardiology, Policlinico Universitario Federico II di Napoli, Naples, Italy (D'Ascenzo) Division of Cardiology, Department of Medical Sciences, Citta della Salute e della Scienza, Hospital University of Turin, Turin, Italy Publisher Oxford University Press Abstract Background and Aims: The optimal approach to coronary revascularization in patients undergoing transcatheter aortic valve implantation (TAVI) remains debated. Fractional flow reserve (FFR) may improve the identification of ischaemia-producing lesions compared to angiographic assessment alone, but data in the TAVI population are lacking. Method(s): In this multicentric, open-label, randomized, superiority trial with blind adjudication of adverse events, patients with aortic stenosis and intermediate coronary lesions undergoing TAVI were randomized 1:1 to FFR-guided or angiography-guided percutaneous coronary intervention (PCI). The trial was registered at ClinicalTrials.gov (NCT03360591). All randomized patients were included in the primary analysis according to the intention-to-treat principle. The primary endpoint was a major adverse cardiac and cerebrovascular event (MACCE) at 12 months of follow-up, defined as a composite of all-cause death, myocardial infarction, ischaemia-driven target vessel revascularization, disabling stroke, or major bleeding. Result(s): A total of 320 patients were enrolled across 15 Italian centres. The median age of the patients was 86 years [interquartile range (IQR) 83-90], and the median STS score was 3% (IQR 2-5). The median SYNTAX score was 7 (IQR 5-11). FFR-guided PCI was associated with a significantly lower rate of MACCE at 12 months compared with angiography-guided PCI (8.5% vs 16.0%; hazard ratio .52; 95% confidence interval .27-.99; P = .047). The difference in the primary endpoint was primarily driven by a reduction in all-cause mortality (hazard ratio .31; 95% confidence interval .10-.96). Other components of the composite were numerically lower but not statistically significant. Conclusion(s): In patients undergoing TAVI with intermediate coronary lesions, FFR-guided PCI was associated with a reduced risk of MACCE at 12 months. These findings support a physiology-based revascularization strategy in this frail, elderly population. Copyright © The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights) <99> Accession Number 2047063373 Title Intracardiac Echocardiography Versus Transesophageal Echocardiography for Guidance of Atrial Fibrillation Ablation: A Systematic Review and Meta-Analysis of Procedural Safety and Efficacy. Source Echocardiography. 43(7) (no pagination), 2026. Article Number: e70543. Date of Publication: 01 Jul 2026. Author Kanniyan A.S.; Mohammed O.; Wadhwa A.; Koduri S.S.P.; Fatima N.; Gowda D.S.; Romero-Acero L.M.; Nanna M.; Kutty S. Institution (Kanniyan, Mohammed) Government Medical College, Kerala, Kozhikode, India (Wadhwa) Shri Atal Bihari Vajpayee Medical College and Research Institute, Bangalore, India (Koduri) JSS Medical College, Mysore, India (Fatima) Ayaan Institute of Medical Sciences, Telangana, Hyderabad, India (Gowda) Hassan Institute of Medical Sciences, Karnataka, Hassan, India (Romero-Acero, Nanna) Cardiac Care and Vascular Medicine, Albert Einstein College of Medicine, New York City, NY, United States (Kutty) BayCare Health System, Clearwater, FL, United States Publisher John Wiley and Sons Inc Abstract Purpose: Transesophageal echocardiography (TEE) is the standard periprocedural imaging modality for atrial fibrillation (AF) catheter ablation but carries the burden of esophageal instrumentation, frequent deep sedation, and logistical constraints. Intracardiac echocardiography (ICE) is a growing alternative, yet comparative evidence had not been systematically synthesized. This systematic review and meta-analysis compared ICE and TEE as periprocedural imaging strategies in adults undergoing AF catheter ablation, focusing on safety and procedural efficiency. Method(s): A search of PubMed, Embase, CENTRAL, and Web of Science identified six eligible studies (five cohort studies and one multicenter randomized controlled trial) enrolling 4760 participants (ICE n = 2616; TEE n = 2144). Peto odds ratios (OR) were used for dichotomous safety outcomes and mean differences (MD) with random-effects models for continuous outcomes; certainty of evidence was graded using GRADE. Result(s): ICE was not associated with significant differences in periprocedural complications, including cardiac tamponade (Peto OR 0.67, 95% CI 0.33-1.36), stroke/TIA/thromboembolism (0.81, 0.36-1.78), vascular complications (1.22, 0.70-2.13), or bleeding (0.50, 0.22-1.12). Total procedure duration did not differ (MD -7.11 min, 95% CI -18.82 to 4.61). ICE was associated with shorter fluoroscopy time (MD -4.17 min, -6.07 to -2.26), though this was attenuated after excluding studies with combined left atrial appendage occlusion. Certainty of evidence was low to very low; the absence of significant differences reflects imprecision rather than demonstrated equivalence and should be regarded as hypothesis-generating. Conclusion(s): Within these limitations, ICE may be a reasonable alternative to TEE in appropriately selected patients at centers with established ICE expertise. PROSPERO: CRD420251239269. Copyright © 2026 Wiley Periodicals LLC. <100> Accession Number 2046481731 Title Uniportal versus multiportal video-assisted thoracic surgery (VATS) in esophageal cancer: A systematic review and meta-analysis. Source Journal of Clinical Oncology. Conference: ASCO Gastrointestinal Cancers Symposium. San Francisco United States. 44(16_suppl) (pp e16114-e16114), 2026. Date of Publication: 01 Jun 2026. Author Fatima R.; Ali S.; Amin F.; Htun S.H.; Raza A.; Ahmed N.; Saif L.; Abid A.; Musleh Ud Din S. Institution (Fatima) King Edward Medical Univeristy, Lahore, Pakistan (Ali) Memorial Healthcare System, Hollywood, FL, United States (Amin, Saif, Abid) King Edward Medical University, Lahore, Pakistan (Htun) International School of Medicine, Zhejiang University, Hangzhou, China (Raza) Akhtar Saeed Medical and Dental College, Lahore, Pakistan (Ahmed) Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan (Musleh Ud Din) Department of Hematology - Oncology, Memorial Cancer Institute, Pembroke Pines, FL, United States Publisher Lippincott Williams and Wilkins Abstract Background: Minimally invasive approaches are increasingly used in esophageal cancer surgery, but the relative benefits of uniportal versus multiportal video-assisted thoracic surgery (VATS) remain unclear. This study aimed to compare perioperative outcomes, complications, and survival between the two approaches.To compare the perioperative outcomes, postoperative complications, and survival of uniportal versus multiportal VATS in patients undergoing esophagectomy for esophageal cancer.To evaluate whether uniportal VATS offers clinical advantages in pain reduction, hospital stay, and complication rates. Method(s): A systematic review and meta-analysis was performed including studies comparing uniportal and multiportal VATS in patients undergoing esophagectomy. Primary outcomes were postoperative pain (POD1, VAS), overall postoperative complications (Clavien-Dindo grade I-II), length of hospital stay, mortality, and overall survival. Secondary outcomes included postoperative pneumonia, anastomotic leakage, and operative time. Effect sizes were pooled using a random-effects model and reported as mean difference (MD), odds ratio (OR), or hazard ratio (HR) with 95% confidence intervals (CI). Heterogeneity was assessed using I2. Result(s): Uniportal VATS was associated with significantly lower postoperative pain on POD1 compared with multiportal VATS (MD -1.89, 95% CI -3.47 to -0.31, p = 0.019; I2 = 99.1%). A trend toward fewer overall postoperative complications was observed (OR 0.51, 95% CI 0.24-1.10, p = 0.088; I2 = 54.6%), while length of hospital stay was significantly shorter in the uniportal group (MD -1.22 days, 95% CI -2.15 to -0.29, p = 0.010; I2 = 96.3%). No significant differences were found in mortality (OR 1.63, 95% CI 0.20-13.34, p = 0.65; I2 = 0%) or overall survival (HR 1.07, 95% CI 0.51-2.24, p = 0.87; I2 = 0%). Among secondary outcomes, uniportal VATS significantly reduced postoperative pneumonia (OR 0.48, 95% CI 0.26-0.88, p = 0.017; I2 = 35.4%), while anastomotic leakage rates were comparable (OR 0.56, 95% CI 0.22-1.40, p = 0.21; I2 = 0%). Conclusion(s): Uniportal VATS for esophageal cancer is associated with lower early postoperative pain, reduced length of hospital stay, and fewer postoperative pneumonias, with comparable mortality, anastomotic leakage, and long-term survival relative to multiportal VATS. These findings support the safety and potential perioperative benefits of the uniportal approach. Copyright © 2026 by American Society of Clinical Oncology <101> Accession Number 2046969659 Title Outcomes of donation after circulatory death heart transplant using normothermic regional perfusion: a systematic review and meta-analysis. Source Journal of Artificial Organs. 29(3) (no pagination), 2026. Article Number: 41. Date of Publication: 01 Sep 2026. Author He M.; Zhang X.; Li H.; Zhang Y.; Zhao Q.; Wu X.; Li Y.; Pei W. Institution (He, Zhang, Li, Zhang, Zhao, Wu, Li, Pei) Lanzhou University, Lanzhou, China (He, Zhang, Li, Zhang, Zhao, Wu, Li, Pei) Department of Cardiac Surgery, Lanzhou University Second Hospital, Lanzhou University, No. 80 Cuiyingmen, Chengguan District, Lanzhou, China Publisher Springer Abstract This systematic review and meta-analysis aim to synthesize evidence comparing normothermic regional perfusion (NRP) and direct procurement and perfusion (DPP) in donation after circulatory death (DCD) heart transplantation, providing evidence-based guidance for optimizing donor heart procurement and transplantation protocols. A systematic literature review was conducted following PRISMA guidelines. PubMed, Embase, the Cochrane Library, and the International Clinical Trials Registry Platform were systematically searched. Two reviewers independently applied eligibility criteria, evaluated quality, and extracted data. The primary outcome was the 30-day survival rate. The 30-day survival rates for NRP and DPP patients were 96.58% and 94.79%, respectively (odds ratio [OR]: 1.52, 95% confidence interval [CI] 1.06-2.17, P = 0.02). Severe primary graft dysfunction (PGD) rates for NRP and DPP patients were 7.90% and 14.03%, respectively (P = 0.002), while the combined rate of none/mild PGD was 86.36% and 85.84% for each group. The cumulative postoperative extracorporeal membrane oxygenation rate for NRP patients was 6.54%, compared to 17.18% for DPP patients (P = 0.0001). The postoperative intra-aortic balloon pump rate for NRP patients was 9.09%, compared to 17.78% for DPP patients (P = 0.35). NRP patients had a higher likelihood of being discharged home than DPP patients (P = 0.36), while NRP patients had a lower likelihood of being discharged from the intensive care unit than DPP patients (P = 0.71). NRP was associated with higher 30-day survival, which is a promising clinical approach in the application of DCD donor hearts. Copyright © The Author(s), under exclusive licence to the Japanese Society for Artificial Organs 2026. <102> Accession Number 2046955596 Title Perioperative Transfusion Trigger Score Versus Restrictive Transfusion in Older Non-Cardiac Surgery Patients: A Multicenter Randomized Controlled Trial. Source Journal of the American Geriatrics Society. (no pagination), 2026. Date of Publication: 2026. Author Liang S.; Bai L.; Yang G.; Chen Z.; Wei Y.; Lv Y.; Huang Z.; Huang Y.; Lu K. Institution (Liang, Bai, Yang, Chen, Wei, Wei, Lv, Huang, Lu) Department of Anesthesiology, The Third Affiliated Hospital of Guangxi Medical University, Guangxi, Nanning, China (Liang, Bai, Yang, Chen, Wei, Wei, Lv, Huang, Lu) Department of Anesthesiology, The Second Naning People's Hospital, Guangxi, Nanning, China (Huang) Department of Anesthesiology, Affiliated Hospital of Youjiang Medical University for Nationalities, Guangxi, Baise, China Publisher John Wiley and Sons Inc Abstract Background: Restrictive transfusion (Hb < 7 g/dL) is recommended for most perioperative patients, but the optimal threshold for those with cardiovascular disease or Hb 7-10 g/dL remains uncertain. The Perioperative Transfusion Trigger Score (POTTS), which integrates adrenaline requirement, FiO<inf>2</inf>, temperature, and angina history, may standardize decisions and safely reduce transfusions in older non-cardiac surgery patients. Method(s): This multicenter RCT in two Chinese hospitals randomized patients >= 60 years undergoing non-cardiac surgery 1:1 to POTTS or control. POTTS = 6 plus points for adrenaline, FiO<inf>2</inf> (to maintain SpO<inf>2</inf> >= 95%), core temperature, and angina; transfusion when Hb < POTTS. Control followed 2012 AABB guideline (Hb < 7 always transfuse; > 10 not; 7-10 physician discretion). Primary Outcome: proportion receiving allogeneic RBC transfusion during perioperative period (ITT population). Result(s): 253 patients (mean age 72.3 years; 67.6% women) were randomized (May 2023-Sept 2025). Baseline Hb similar (median 9.60 vs. 9.50 g/dL). In ITT, transfusion required in 24.00% (30/125) of POTTS vs. 35.94% (46/128) of control (p = 0.038). Transfusion volume did not differ significantly (median 2.50 vs. 3.00 units, p = 0.520). Overall complication rates: 12.80% vs. 8.59% (p = 0.279); one death in control group (0.85%). No significant differences in specific complications. Conclusion(s): In patients >= 60 years undergoing non-cardiac surgery, POTTS-guided transfusion significantly reduced the proportion of patients transfused without increasing complications. Trial Registration: This study was registered at http://www.chictr.org.cn (#ChiCTR2300071739). Copyright © 2026 The Author(s). Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society. <103> Accession Number 651576381 Title Chronic kidney disease following pediatric cardiac surgery: a systematic review and meta-analysis. Source BMC pediatrics. (no pagination), 2026. Date of Publication: 22 Jun 2026. Author Badeli H.; Motiei M.; Nejad A.T.; Hassanzadeh-Rad A. Institution (Badeli, Motiei, Hassanzadeh-Rad) Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran, Islamic Republic of (Nejad) Inflammatory Lung Diseases Research Center, Department of Internal Medicine, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran, Islamic Republic of Abstract BACKGROUND: Chronic kidney disease (CKD) is a potential long-term complication in children undergoing cardiac surgery. With improved survival rates in this population, attention has shifted toward long-term outcomes, yet the true burden of CKD remains unclear due to limited data. OBJECTIVE(S): To determine the pooled prevalence of chronic kidney disease among pediatric patients with a history of cardiac surgery. MATERIALS AND METHODS: A systematic literature search was conducted in PubMed, Scopus, and Web of Science from inception to March 1, 2025. Eligible studies included those reporting CKD prevalence in patients under 18 years of age who had undergone any type of cardiac surgery. We performed this systematic review and meta-analysis following PRISMA guidelines and Cochrane Collaboration recommendations using a random-effects model. Pooled prevalence estimates were calculated with 95% confidence intervals (95% CI). RESULT(S): Data from five prospective studies involving 1002 pediatric patients were included. The studies were published between 2016 and 2022 and conducted in Canada, France, the United States, and Belgium. The pooled prevalence of CKD was 16% (95% CI: 9.0-26.0%), with moderate heterogeneity across studies (I2 = 49.5%, p = 0.09). Sensitivity analysis confirmed the stability of the pooled estimate. CONCLUSION(S): The findings of this analysis highlight the need for long-term renal monitoring in this population, although further high-quality studies with standardized definitions and extended follow-up are warranted to confirm and refine these estimates. Copyright © 2026. The Author(s). <104> Accession Number 2047173446 Title Association between preoperative atherogenic index of plasma and postoperative pneumonia in patients undergoing off-pump coronary artery bypass grafting. Source Chinese Journal of Anesthesiology. 46(5) (pp 538-543), 2026. Date of Publication: 20 May 2026. Author Zhang Z.; Zhai W.; Er J.; Yuan B.; Ren M.; Chen Q.; Guo Z.; Han J. Institution (Zhang, Zhai, Er, Yuan, Han) Department of Anesthesiology, Chest Hospital, Tianjin University, Tianjin, China (Zhang, Zhai, Er, Yuan, Chen, Guo, Han) Tianjin Key Laboratory of Cardiovascular Emergency and Critical Care, Tianjin, China (Ren) Tianjin Cardiovascular Institute, Tianjin, China (Chen, Guo) Department of Cardiovascular Surgery, Chest Hospital, Tianjin University, Tianjin, China Publisher Chinese Medical Journals Publishing House Co.Ltd Abstract Objective To evaluate the association between preoperative atherogenic index of plasma (AIP) and postoperative pneumonia in patients undergoing off-pump coronary artery bypass grafting (OPCABG). Methods This study was a secondary analysis of data from a randomized controlled trial "perioperative management guided by multisite tissue oxygenation and hemodynamic monitoring in OPCABG". Medical records of patients, aged 60-80 yr, of American Society of Anesthesiologists Physical Status classification III or IV, with a body mass index of 18-30 kg/m2, who underwent elective OPCABG from June 2021 to December 2023 at Tianjin Chest Hospital, were collected. AIP before surgery was calculated as log10(preoperative triglyceride concentration/preoperative high-density lipoprotein cholesterol concentration in serum). Patients were divided into low AIP, intermediate AIP and high AIP groups based on the tertiles of AIP. The primary outcome was postoperative pneumonia within 30 days after surgery. The association between AIP and postoperative pneumonia was evaluated using multivariable logistic regression, restricted cubic spline analysis, and subgroup analyses. Results A total of 1 920 patients were included, with 638 cases in low AIP group (AIP < -0.11), 641 cases in intermediate AIP group (AIP -0.11 to 0.24), and 641 cases in high AIP group (AIP > 0.24). There was significant difference in the incidence of postoperative pneumonia within 30 days after surgery among the three groups (P=0.001), with the highest incidence in high AIP group (14.2%). Multivariable logistic regression analysis showed that, in the fully adjusted model, higher AIP was associated with an increased risk of postoperative pneumonia when AIP was included as a continuous variable (OR=1.73, 95% confidence interval 1.03-2.90, P=0.038). When AIP was included as a categorical variable, compared with low-AIP group, the risk of postoperative pneumonia was increased in high AIP group (OR=1.58, 95% confidence interval 1.05-2.38, P=0.027), and no statistically significant change was observed in the risk of postoperative pneumonia in intermediate AIP group (P>0.05). Restricted cubic spline analysis showed a linear positive association between AIP and the risk of postoperative pneumonia (P for overall association=0.004, P for nonlinearity=0.337). Subgroup analyses showed that age, sex, body mass index, smoking history, and comorbid hypertension and diabetes did not interact with the association between AIP and the risk of postoperative pneumonia (P for interaction>0.05). Conclusions Preoperative AIP is associated with the risk of postoperative pneumonia in patients undergoing OPCABG. Copyright 2026, Chinese Medical Association <105> Accession Number 2047178379 Title Neoadjuvant chemoimmunotherapy in resected stage III non-small-cell lung cancer: real-world data from a nationwide registry. Source Translational Lung Cancer Research. 15(6) (no pagination), 2026. Article Number: 164. Date of Publication: 30 Jun 2026. Author Vaillo X.; Galvez C.; Bolufer S.; Lirio F.; Call S.; Jimenez U.; Zabaleta J.; Gomez M.T.; Sanchez L.; Cerezal L.J. Institution (Vaillo, Galvez, Bolufer, Lirio, Cerezal) Department of Thoracic Surgery, Dr. Balmis University General Hospital, Alicante, Spain (Call) Department of Thoracic Surgery, MutuaTerrassa University Hospital, Terrassa, Spain (Jimenez) Department of Thoracic Surgery, Cruces University Hospital, Baracaldo, Spain (Zabaleta) Department of Thoracic Surgery, Donostia University Hospital, San Sebastian, Spain (Gomez) Department of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain (Sanchez) Department of Thoracic Surgery, Marques de Valdecilla University Hospital, Santander, Spain Publisher AME Publishing Company Abstract Background: Neoadjuvant chemoimmunotherapy is increasingly used in resectable stage III non-small-cell lung cancer. The objective was to compare oncological effectiveness, surgical complexity and perioperative safety of neoadjuvant chemoimmunotherapy compared to chemotherapy. Method(s): A multicentre cohort study was performed within the Registry of the Spanish Society of Thoracic Surgery. Consecutive patients with stage III non-small-cell lung cancer treated with chemoimmunotherapy or chemotherapy followed by anatomical resection (January 2023-April 2025) were analysed (114 patients: chemoimmunotherapy 77; chemotherapy 37). Oncological variables were pathological complete response, downstaging and complete resection (International Association for the Study of Lung Cancer criteria). Surgical and perioperative outcomes were compared, including complications and mortality. Propensity-score matching was used to reduce confounding and outcomes were compared using paired tests. Result(s): After matching, 68 patients remained (34 pairs). Chemoimmunotherapy yielded higher pathological complete response [38% vs. 12%; relative risk (RR) 3.3, 95% confidence interval (CI): 1.2-9.0; P=0.02], downstaging (79% vs. 56%; RR 1.4, 95% CI: 1.0-2.0; P=0.057) and complete resection (74% vs. 41%; RR 1.8, 95% CI: 1.1-3.1; P=0.049). Median operative time was longer (240 vs. 180 minutes; P=0.048). Overall postoperative complications were higher (41% vs. 21%; RR 2.0, 95% CI: 0.9-4.3; P=0.12), whereas major morbidity, reoperations and in-hospital, 30-day and 90-day mortality were low and comparable. Conclusion(s): Neoadjuvant chemoimmunotherapy for resected stage III non-small-cell lung cancer improved pathological complete response, downstaging and complete resection versus chemotherapy, at the expense of longer operations and higher morbidity, without an increase in severe complications or early mortality. Copyright © AME Publishing Company. This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/. <106> Accession Number 2038318256 Title EFFECT OF LOW TIDAL VOLUME VENTILATION VERSUS NO VENTILATION DURING CARDIOPULMONARY BYPASS IN ADULT CARDIAC SURGICAL PATIENTS ON POST-OPERATIVE RESPIRATORY OUTCOMES. Source International Journal of Medicine and Public Health. 16(2) (pp 3602-3607), 2026. Date of Publication: 01 Apr 2026. Author Patel K.; Goklani A.; Patel B. Institution (Patel) Department of Anesthesia, Gmers Medical College, Dharpur, Patan, India (Goklani) Department of Anesthesia, Gmers Medical College, Vadanagar, India (Patel) K.B Hospital Chanasma, Patan, India Publisher Pink Petals Publications Pvt Ltd Abstract Background: Postoperative pulmonary dysfunction is a common complication following cardiac surgery with cardiopulmonary bypass (CPB), often leading to impaired gas exchange, atelectasis, and reduced lung compliance. Various ventilation strategies, including continuous positive airway pressure (CPAP) and high-frequency ventilation, have been investigated to minimize these adverse effects, but their clinical benefits remain uncertain. Atelectasis during CPB is considered a major factor contributing to postoperative pulmonary impairment and intrapulmonary shunting. Continuous low tidal volume ventilation during CPB may help maintain alveolar recruitment and preserve lung function. Therefore, this study aimed to evaluate the effect of continuous low tidal volume ventilation during CPB on postoperative pulmonary function, gas exchange, and lung mechanics in patients undergoing cardiac surgery. The aim is to evaluate and compare the effect of LTVV techniques versus no ventilation during CPB on post operative respiratory outcomes. Material(s) and Method(s): This prospective single-blind randomized controlled clinical study was conducted in the Department of Anaesthesiology, Geetanjali Medical College & Hospital, Udaipur over 24 months from September 2022 to June 2024 after institutional ethical committee approval. 80 patients were enrolled after accounting for a 10% dropout rate and were randomly allocated into two groups: a ventilation group (n = 36) and a non-ventilation group (n = 36). During cardiopulmonary bypass (CPB), Group A received low tidal volume ventilation (3 mL/kg, respiratory rate 12/min, PEEP 5 cm H2O), while ventilation was discontinued in Group B until aortic cross-clamp removal. Arterial blood gases, SpO2, chest radiographs, extubation time, ICU stay, and hospital stay were recorded and compared between the groups. Result(s): The demographic characteristics were comparable between the two groups, with most patients belonging to the 51-60 years age group and a similar gender distribution. Oxygen saturation (SpO2) values were similar preoperatively and intraoperatively; however, postoperative SpO2 was significantly higher in the LTVV group compared to the No Ventilation group (96.78 +/- 1.12% vs. 93.13 +/- 1.9%, p < 0.0001). No statistically significant differences were observed between the groups in arterial blood gas parameters (PaO2 and PaCO2) at any measured time point (p > 0.05). Although the LTVV group showed shorter extubation times and ICU stays than the No Ventilation group, these differences were not statistically significant. The duration of hospital stay was significantly shorter in the LTVV group (8.6 +/- 1.86 days) compared to the No Ventilation group (10.38 +/- 2.02 days, p = 0.0001). Furthermore, postoperative pulmonary complications, including basal atelectasis (10% vs. 25%) and pneumonia (5% vs. 12.5%), were less frequent in the LTVV group, suggesting a beneficial effect of low tidal volume ventilation during cardiopulmonary bypass. Discussion is Despite these encouraging findings, this study has certain limitations, including its single-center design and relatively small sample size, which may limit the generalizability of the results. Additionally, only short-term postoperative outcomes were assessed, and long-term respiratory outcomes were not evaluated. Further large-scale multicenter studies are needed to confirm these findings and determine the optimal ventilation strategy during cardiopulmonary bypass. Conclusion(s): This study demonstrates that low tidal volume ventilation (LTVV) during cardiopulmonary bypass improves postoperative respiratory outcomes in adult cardiac surgical patients, including better oxygen saturation, reduced extubation time, and fewer pulmonary complications. It is also associated with shorter ICU and hospital stays, indicating faster overall recovery, although no significant differences were observed in PaO2 and PaCO2 levels. These findings support the use of LTVV during CPB, with further large-scale studies needed to confirm long-term benefits. Copyright © 2026, Pink Petals Publications Pvt Ltd. All rights reserved. <107> Accession Number 2046821355 Title Clinical Impact of MeltDose Technology Extended-Release Tacrolimus (LCPT) in Solid Organ Transplantation: A Systematic Review. Source Drug Design, Development and Therapy. 20 (no pagination), 2026. Article Number: 613201. Date of Publication: 2026. Author Almalki B.A. Institution (Almalki) Department of Pharmacy Practice, College of Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia Publisher Dove Medical Press Ltd Abstract Tacrolimus is a narrow-therapeutic-index immunosuppressant whose clinical performance is XREnvarsus XR), an extended-release tacrolimus formulation, was developed to enhance dissolution, improve bioavailability, and reduce pharmacokinetic variability. This systematic review evaluated the clinical and translational impact of LCPT compared with immediate-release tacrolimus (IR-Tac) across solid-organ transplantation. A systematic search of PubMed/MEDLINE and Google Scholar was conducted from database inception through October 2025. Owing to heterogeneity in study populations, designs, and outcome reporting, a quantitative meta-analysis was not performed, and findings were synthesized qualitatively. Of 351 identified records, 326 underwent screening, and six studies met inclusion criteria. The primary outcome was biopsy-proven acute rejection (BPAR); secondary outcomes included graft survival, mortality, renal function, metabolic complications, adverse events, and tacrolimus trough concentrations. Across studies, LCPT demonstrated clinical efficacy comparable to IR-Tac. In de novo kidney transplantation, BPAR rates were similar (13.1% vs 13.5%), with comparable graft survival and mortality. In heart transplantation, LCPT maintained noninferior outcomes (BPAR 15% vs 10%). In conversion settings, rejection rates remained comparable. LCPT consistently achieved therapeutic trough concentrations with approximately 20-30% lower total daily doses, reflecting enhanced bioavailability attributable to MeltDose technology. These findings support LCPT as a formulation-driven optimization of tacrolimus delivery. While pharmacokinetic advantages are evident, their translation into superior long-term clinical outcomes remains to be fully established. Copyright © 2026 Almalki. <108> Accession Number 2047287983 Title Effects of integrated inspiratory-expiratory muscle training within hybrid cardiac rehabilitation following cardiac surgery: A randomized controlled study. Source Respiratory Medicine. 261 (no pagination), 2026. Article Number: 109018. Date of Publication: 01 Sep 2026. Author Eksi B.U.; Cilbir C.E.; Ucgun H.; Ertan Harputlu O.; Aslan G.K.; Ezelsoy M.; Ugurlucan M.; Sagbas L.E.; Akinci B. Institution (Eksi) Biruni University, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Istanbul, Turkey (Cilbir) Health Institutes of Turkey, Institute of Public Health and Chronic Diseases, Ankara, Turkey (Ucgun) Istanbul Atlas University, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Istanbul, Turkey (Ertan Harputlu) Istanbul Kent University, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation (English), Istanbul, Turkey (Aslan) Istanbul University-Cerrahpasa, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Istanbul, Turkey (Ezelsoy) Koc University Hospital, Division of Cardiovascular Surgery, Istanbul, Turkey (Ugurlucan) Liv Hospital, Division of Cardiovascular Surgery, Istanbul, Turkey (Sagbas) Florence Nightingale Hospital, Division of Cardiovascular Surgery, Istanbul, Turkey (Akinci) Biruni University, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation (English), Istanbul, Turkey Publisher W.B. Saunders Ltd Abstract Background: Cardiac surgery may reduce pulmonary function, respiratory muscle strength, and functional capacity after surgery. Respiratory muscle training (RMT) is recommended in cardiac rehabilitation; however, evidence regarding RMT within HCR remains limited. Objective(s): To evaluate the effects of adding RMT to an HCR program following cardiac surgery in a randomized controlled trial. Method(s): In this randomized controlled trial, 20 patients were randomized to HCR (n = 10) or HCR + RMT (n = 10). Rehabilitation started in postoperative week 1 and continued for 8 weeks. Both groups received HCR, while the HCR + RMT group performed combined inspiratory and expiratory muscle training. Primary outcomes were pulmonary function, respiratory muscle strength, and 6-min walk distance. Secondary outcomes included quality of life, physical activity, usability, feasibility, and satisfaction. Result(s): Twenty participants completed the study, with 100% retention and attendance in both groups and no adverse events. At postoperative week 1, respiratory and functional parameters declined in both groups. By week 8, 6-min walk distance increased by 49.5 m in the HCR group and 55.5 m in the HCR + RMT group. Duke Activity Status Index scores improved by 5.25 and 4.95 points, respectively, while Minnesota Living with Heart Failure Questionnaire scores decreased by 7-9 points. No significant between-group differences were found for any outcome (all p > 0.05). Conclusion(s): Adding RMT to HCR is feasible, safe, and well accepted. Both interventions improved respiratory function, respiratory muscle strength, functional capacity, physical activity, and quality of life. Although no additional short-term benefit was observed with RMT, it may be considered complementary to HCR programs. Clinical trial registration number: NCT06258681. Copyright © 2026 Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <109> Accession Number 651558354 Title Functional mitral valve regurgitation outcomes by treatment modality: a systematic review and meta-analysis of reconstructed survival data. Source BMC cardiovascular disorders. (no pagination), 2026. Date of Publication: 19 Jun 2026. Author Dastjerdi P.; Tavakoli K.; Narimani-Javid R.; Anaraki N.; Shayesteh H.; Hosseini Mohammadi N.S.; Momeni S.; Nikfar R.; Rahmati S.; Mohsen A.; Hosseini K.; Soleimani H. Institution (Dastjerdi, Tavakoli, Anaraki, Shayesteh, Hosseini Mohammadi, Momeni, Nikfar, Rahmati, Soleimani) Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Narimani-Javid) Research Center for Advanced Technologies in Cardiovascular Medicine, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Mohsen) Division of Cardiology, Loma Linda University Medical Center, Loma Linda, CA, United States (Hosseini) Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Hosseini) Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark (Hosseini) Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Abstract BACKGROUND: Functional mitral regurgitation (FMR) carries poor prognosis, and optimal management remains debated. Mitral Transcatheter Edge-to-Edge Repair (MTEER) is an alternative to surgical repair (SMVR) or optimized medical therapy (OMT), but long-term outcomes are uncertain. METHOD(S): PubMed, Embase, Scopus, and the Cochrane Library were searched for studies reporting Kaplan-Meier curves of MTEER, SMVR, or OMT in FMR. Individual patient data (IPD) were reconstructed using the Liu method with accuracy checks. Pooled IPD were analyzed with Cox and time-varying Cox models, landmark, time-restricted, and restricted mean survival time analyses. RESULT(S): Sixteen studies (n = 4,570) were included. Patients undergoing MTEER were older and higher risk, with greater prevalence of atrial fibrillation, prior myocardial infarction, chronic kidney disease, higher EuroSCORE, and more frequent NYHA class >= III compared with SMVR. Over up to 60 months, both MTEER (HR: 0.65; 95% CI: 0.57-0.75; p < 0.001) and SMVR (HR: 0.39; 95% CI: 0.33-0.46; p < 0.001) significantly reduced all-cause mortality versus OMT, whereas MTEER carried higher mortality risk than SMVR (HR: 1.68; 95% CI: 1.43-1.97; p < 0.001). MTEER was less effective than SMVR in reducing recurrent MR > 2 (HR: 3.31; 95% CI: 1.62-6.75; p < 0.001) and reoperation (HR: 4.62; 95% CI: 2.22-9.61; p < 0.001). In contrast, MTEER reduced hospitalization risk by 30% compared to OMT (HR: 0.70; 95% CI: 0.64-0.77; p < 0.001) and decreased MACE by 21% (HR: 0.79; 95% CI: 0.73-0.84; p < 0.001). CONCLUSION(S): MTEER improves survival and reduces hospitalization and MACE compared with OMT but is less durable than SMVR, with higher risks of recurrent MR, reoperation, and late mortality. Copyright © 2026. The Author(s). <110> Accession Number 651550024 Title Effect of the active cycle breathing technique on pain, anxiety and arterial blood oxygen saturation in patients undergoing coronary artery bypass grafting. Source BMC anesthesiology. (no pagination), 2026. Date of Publication: 17 Jun 2026. Author Solati Kooshkqazi M.; Rakhshan M.; Roosta H.; Shirazi F. Institution (Solati Kooshkqazi) School of Nursing and Midwifery, Shiraz University of Medical Sciences, Namazi Square, Shiraz, Iran, Islamic Republic of (Rakhshan) Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of (Roosta) Al-Zahra Heart and Martyr Hejazi Hospital, Shiraz, Iran, Islamic Republic of (Shirazi) Community Based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of Abstract PURPOSE: Addressing pain and anxiety after coronary artery bypass grafting (CABG) is essential. This research evaluates the associations between the Active Cycle of Breathing Technique (ACBT) and pain levels, anxiety, and blood oxygen saturation in patients recovering from CABG surgery. METHOD(S): Seventy-six patients undergoing CABG surgery were randomly assigned using permuted block randomization (19 blocks of 4 participants) to either the intervention group (n = 38) or the control group (n = 38). After exclusions (2 reoperations in control, 1 withdrawal in intervention), 73 patients completed the study (intervention: n = 37; control: n = 36). The intervention group received ACBT alongside standard respiratory care, consisting of four sessions (two sessions daily at 10:00 AM and 5:00 PM on postoperative days 2 and 3), with each session lasting 10 min and including three phases: breathing control, thoracic expansion exercises, and coughing technique. The control group received standard respiratory care with incentive spirometry (10-20 deep breaths per session) over the same schedule. Outcome measures pain (Visual Analog Scale), anxiety (State-Trait Anxiety Inventory), and arterial oxygen saturation (pulse oximetry) were assessed before intervention and after each of the four sessions by a blinded research assistant. Data were analyzed using repeated measures ANOVA. RESULT(S): Baseline pain levels differed significantly between groups (p = 0.005), with the intervention group reporting higher pain. After adjusting for baseline differences, the ACBT group demonstrated significantly lower pain scores after the second (p < 0.001), third (p = 0.007), and fourth (p < 0.001) sessions compared to the control group. Anxiety levels were significantly lower in the ACBT group after all four sessions (p = 0.005, p = 0.019, p = 0.010, p = 0.004, respectively). Arterial oxygen saturation was significantly higher in the ACBT group after all four sessions (p < 0.001). Repeated measures ANOVA revealed significant group effects for pain (p < 0.001), anxiety (p = 0.006), and oxygen saturation (p < 0.001). Time effects were significant for anxiety (p < 0.001) and oxygen saturation (p < 0.001), but not for pain (p = 0.491). The group x time interaction was significant only for oxygen saturation (p < 0.001). CONCLUSION(S): ACBT was associated with lower pain and anxiety and higher arterial oxygen saturation in patients after CABG surgery. These findings suggest that ACBT may warrant consideration for integration into postoperative respiratory care protocols, pending further research with stronger methodological controls. However, the absence of participant blinding and potential attention bias limit causal inference, and future studies with sham controls are needed. Copyright © 2026. The Author(s). <111> Accession Number 651570888 Title Hemodynamic effects of dexmedetomidine versus propofol in cardiac surgery: a systematic review and meta-analysis. Source BMC anesthesiology. (no pagination), 2026. Date of Publication: 20 Jun 2026. Author Montaseri M.; Saberian M.; Jackson A.C.; Bahramnejad F.; Bahramnezhad F. Institution (Montaseri) Critical Care Nursing Department, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Saberian) Department of Epidemiology & Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Jackson) Centre on Behavioral Health, University of Hong Kong, Hong Kong SAR, Pokfulam, China (Bahramnejad) Department of Health Information Technology, Sirjan School of Medical Sciences, Sirjan, Iran, Islamic Republic of (Bahramnezhad) Department of Critical Care Nursing, Nursing and Midwifery Care Research Center, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of Abstract BACKGROUND: Cardiac surgery, particularly open-heart procedures such as coronary artery bypass grafting and valve surgery, is one of the most common curative options for ischemic heart disease, congenital heart defects, and valvular disease but is also associated with severe hemodynamic hazards. Intravenous anesthetic agents such as propofol and dexmedetomidine are employed to sedate such patients in routine clinical practice. There is, however, conflicting and sporadic evidence in the literature regarding the relative effects of these two agents on hemodynamic parameters. This review systematically analyzed and contrasted the hemodynamic effects of dexmedetomidine and propofol in patients undergoing cardiac surgery. METHOD(S): Systematic searches in the PubMed, Scopus, Embase, Web of Science, CINAHL, Cochrane Library, and Google Scholar databases were performed for randomized controlled trials published between December 2000 and 18 January 2025. Studies in which adult patients underwent cardiac surgery (e.g., coronary artery bypass grafting or valve surgery) and received dexmedetomidine or propofol for intraoperative or immediate postoperative intensive care unit (ICU) sedation were included. This was a PRISMA-guided review, and the extracted data were meta-analyzed and descriptively analyzed. The primary outcomes were hypotension and bradycardia. Secondary outcomes included vasopressor requirements, tachycardia, heart rate, atrial fibrillation (AF), ventricular tachycardia, and bleeding. Odds ratios (ORs) or mean differences (MDs) with 95% confidence intervals (CIs) were pooled via random-effects models. Sensitivity analysis and assessment of publication bias were performed as needed. RESULT(S): Compared with propofol, dexmedetomidine significantly increased the risk for hypotension (OR = 1.76; 95% CI: 1.25-2.48; p < 0.001) and bradycardia (OR = 2.89; 95% CI: 1.28-6.49; p = 0.01). Alternatively, dexmedetomidine significantly reduced vasopressor requirements (OR = 0.52; 95% CI: 0.32-0.84; p = 0.007) and lowered the heart rate (MD = - 4.78 beats/min; 95% CI: - 7.47 to - 2.26; p < 0.001). No considerable differences were observed in tachycardia, ventricular tachycardia, AF, or bleeding. Sensitivity analysis was employed to check for the stability of the findings, and no publication bias was detected. CONCLUSION(S): This meta-analysis revealed that, compared with propofol, dexmedetomidine is associated with a greater incidence of hypotension and bradycardia but lower vasopressor requirements. No considerable differences were observed in ventricular tachycardia, AF, bleeding or any other hemodynamic parameters. Evidence for several secondary outcomes remains limited; therefore, findings for less frequently reported endpoints should be interpreted cautiously. CLINICAL TRIAL NUMBER: Not applicable. Copyright © 2026. The Author(s). <112> Accession Number 651559947 Title A pilot study of the impact of enhanced cardiac index coupled with pulsatile flow on goal direct perfusion during cardiopulmonary bypass. Source The journal of extra-corporeal technology. 58(2) (pp 110-116), 2026. Date of Publication: 01 Jun 2026. Author Bagherinasab M.; Rezaei S.; Moradi A.R.; Aghal B.; Steele-Pruett J.; Darban N.H. Institution (Bagherinasab) Baqiyatallah University of Medical Sciences, Tehran, Iran, Islamic Republic of (Rezaei) Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Moradi, Aghal) Baqiyatallah University of Medical Sciences, Tehran, Iran, Islamic Republic of (Steele-Pruett, Darban) Midwestern University, College of Health Sciences, Cardiovascular Science Program, 19555 N. 59TH Avenue Glendale Abstract INTRODUCTION: Providing sufficient organ perfusion during cardiopulmonary bypass (CPB) is a common research topic among extracorporeal technology researchers. The application of an elevated cardiac index (CI) to enhance CPB flow, coupled with the adoption of pulsatile flow, constitutes a novel approach designed to improve organ perfusion and oxygen delivery (DO2). this study aims to assess the effects of increased CI and pulsatile flow on organ perfusion during CPB. MATERIAL AND METHODS: In this pilot study, thirty patients scheduled for on-pump coronary artery bypass graft (CABG) surgery with an estimated prolonged CPB time were enrolled. Patients were randomly divided into two study groups. Patients in the control group were managed with a CI of 2.4 L/min/m2, while patients in the study group received a CI equal to 2.6 to 3 L/min/m2 with pulsatile flow (PF) throughout the bypass run. Lactate fluctuations, creatinine variation, inotrope needs, blood transfusion requirements, ICU and hospital length of stay were assessed and noted. RESULT(S): Participants in the study group exhibited lower creatinine levels throughout the assessment period; however, this difference did not reach statistical significance (P > 0.05). Participants in the study group consistently exhibited significantly lower lactate concentrations over the course of the investigation (P < 0.05). Patients in the study groups experienced a reduced duration of both ICU and hospital lengths of stay; however, this difference did not reach statistical significance (P > 0.05). CONCLUSION(S): This prospective study concludes that an increased CI in conjunction with PF during CPB can markedly enhance organ perfusion, as evidenced by a statistically significant reduction in lactate production observed throughout the duration of the bypass. Copyright © The Author(s), published by EDP Sciences, 2026. <113> Accession Number 651562343 Title Methylprednisolone for heart surgery in pediatric patients: a meta-analysis of randomized trials. Source Scientific reports. (no pagination), 2026. Date of Publication: 19 Jun 2026. Author Barboza J.J.; Rivera-Lozada O.; Bonilla-Asalde C.; Morales-Olivera J.A.; Alvarez J.F.; Flores-Palacios R. Institution (Barboza) Vicerrectorado de Investigacion, Universidad Senor de Sipan, Chiclayo, Peru (Rivera-Lozada, Bonilla-Asalde) Vicerrectorado de Investigacion, Universidad Senor de Sipan, Chiclayo, Peru (Morales-Olivera) Facultad de Medicina, Doctorado en Ciencias Clinicas, Universidad de La Sabana, Chia, Colombia (Alvarez) NeumoVigo I+i Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), Vigo, Spain (Flores-Palacios) Universidad Nacional Jorge Basadre Grohmann, Tacna, Peru Abstract Perioperative corticosteroids, particularly methylprednisolone, have been used for decades in pediatric cardiac surgery to attenuate the systemic inflammatory response associated with cardiopulmonary bypass. This systematic review and meta-analysis evaluated the efficacy and safety of perioperative methylprednisolone in pediatric patients undergoing cardiac surgery with cardiopulmonary bypass. This systematic review and meta-analysis followed PRISMA 2020 guidelines (PROSPERO CRD420251231338). We searched PubMed/MEDLINE, Embase, Scopus, Web of Science, and CENTRAL from inception to November 2025 for randomized controlled trials comparing perioperative intravenous methylprednisolone with placebo or standard care in patients aged < 18 years undergoing cardiac surgery with cardiopulmonary bypass. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. The primary outcome was all-cause in-hospital or 30-day mortality. Secondary outcomes included mechanical ventilation duration, cardiac intensive care unit length of stay, postoperative infections, and hyperglycemia. Random-effects models with Paule-Mandel estimator and Hartung-Knapp confidence intervals were used to pool risk ratios and mean differences. We included eight randomized controlled trials (1,735 pediatric patients; 867 on methylprednisolone, 868 controls). Overall, methylprednisolone was not associated with reduced mortality compared with control (RR 0.66, 95% CI 0.35-1.25; I2 = 0%; 6 trials, 1,586 patients). However, methylprednisolone reduced the duration of mechanical ventilation (MD - 0.27 days, 95% CI - 0.46 to - 0.09; I2=0%; 5 trials) but significantly increased the risk of hyperglycemia (RR 2.28, 95% CI 1.38-3.78; I2=45.0%; 6 trials). No differences were observed in infection rates (RR 1.06, 95% CI 0.68-1.66; I2=0%; 5 trials) or ICU length of stay (MD - 0.13 days, 95% CI - 0.51 to 0.25; I2=0%; 5 trials). Perioperative methylprednisolone was not associated with reduced overall mortality in pediatric cardiac surgery. Among secondary outcomes, methylprednisolone was associated with a modest reduction in mechanical ventilation duration but with a significantly increased risk of postoperative hyperglycemia. These findings indicate that any potential benefit in ventilatory outcomes should be weighed against the higher metabolic risk. Further research is required to determine whether any patient subgroups may derive net clinical benefit from its use. Copyright © 2026. The Author(s). <114> Accession Number 651561599 Title Evaluation of accuracy of platelet rich plasma preparation devices for cardiac surgery: A prospective, randomized, single blinded study. Source The journal of extra-corporeal technology. 58(2) (pp 124-127), 2026. Date of Publication: 01 Jun 2026. Author Garrison L.; Nicks D.; Nicks S.; Green J.; Pham H.; Wysocki S. Institution (Garrison, Nicks, Nicks, Green, Pham, Wysocki) Franciscan Health Indianapolis, Indianapolis, IN, United States Abstract BACKGROUND: Applying platelet rich plasma (PRP) to the sternum immediately prior to approximation has been shown to enhance wound healing, lower the incidence of sternal wound infections, reduce costs associated with treating these infections and decrease post-operative pain scores. Multiple investigations have reported device specific outcomes regarding PRP preparation yields from healthy volunteer blood donors, all with initial platelet counts in the normal range. What is missing from the literature is how accurately PRP preparations reflect device-specific yield target values, particularly under the clinical conditions encountered routinely in the cardiac surgery arena. METHOD(S): The Magellan group (30 cases) and the Angel group (30 cases) comprised the two study groups (2 groups, 60 total cases, 120 samples total). Pre and post processing blood samples from each group were analyzed for platelet counts. Platelet count increases were assessed for accuracy when compared to a specific target. RESULT(S): Individual yields from each tested device demonstrated some degree of limited variability. However, both groups mean values achieved and slightly exceeded the target value of a six-fold increase; Magellan group (M = 6.58, SD = 1.33), Angel group (M = 6.31, SD = 0.93). CONCLUSION(S): Both devices, on average, appear capable of accurately preparing PRP to meet the specific target value of a six-fold increase over baseline under conditions routinely encountered in cardiac surgery. Copyright © The Author(s), published by EDP Sciences, 2026. <115> Accession Number 651569439 Title Lessons Learned from the Feasibility Phase of the REvascularization CHoices Among Under-Represented Groups Evaluation (RECHARGE) Trial Program. Source American heart journal. (pp 107515), 2026. Date of Publication: 20 Jun 2026. Author Gaudino M.; Stone G.W.; Puskas J.; Krieger K.; Redfors B.; Bagiella E.; Gelijns A.; Bhatt D.L.; Sandner S.; Barman N.; Bozinovski J.; Gee P.; Haider A.; Hafiz A.M.; Jolly S.S.; Li D.; Mack C.; Madani M.M.; Mahmud E.; Pineda A.M.; Masoudi F.A.; Mazzaferri E.; Monroe R.; Nicholson W.; Pocock S.J.; Sachdeva R.; Yong C.; Zwischenberger B.A.; Yancy C.; Creber R.M.; Spertus J. Institution (Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine, NY, United States (Stone) Icahn School of Medicine at Mount Sinai, NY, United States (Puskas) Division of Cardiac Surgery, Emory University, Atlanta, GA, United States (Krieger) Department of Cardiothoracic Surgery, Weill Cornell Medicine, NY, United States (Redfors) Division of Biostatistics, Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA; Department of Molecular and Clinical Medicine, Institute of Medicine, Gothenburg University, Gothenburg, Sweden; Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden (Bagiella, Gelijns, Li) Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA (Bhatt) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, NY, United States (Sandner) Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria (Barman) Division of Cardiology, Mount Sinai Morningside, NY, United States (Bozinovski, Mazzaferri) Ohio State University Wexner Medical Center, Columbus, OH, United States (Gee) Healthcare Consultant/Patient Advocate, North Chesterfield, VA, United States (Haider, Mack) NewYork-Presbyterian Queens, NY, United States (Hafiz) Division of Cardiology, Southern Illinois University School of Medicine, IL, United States (Jolly) Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (Madani, Mahmud) Sulpizio Cardiovascular Center, UC San Diego, San Diego, CA, United States (Pineda, Zwischenberger) Duke University Medical Center, Durham, NC, United States (Masoudi) Ascension Clinical Research Institute, St Louis, MO, United States (Monroe) BOOST - Better Outcomes Optimal Scientific Therapies, Washington, DC, USA; Heart Failure Society of America Advocacy Committee, Charlotte, North Carolina, USA (Nicholson) Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States (Pocock) Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom (Sachdeva) Division of Cardiology, Atlanta VA Medical Center, Decatur, GA, United States (Yong) Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA; Department of Medicine, Stanford University School of Medicine, Stanford, California, USA (Yancy) Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States (Creber) Columbia University School of Nursing, NY, United States (Spertus) University of Missouri - Kansas City's Healthcare Institute for Innovations in Quality and Saint Luke's Mid America Heart Institute, Saint Luke's Hospital, Kansas City, MO, United States Abstract The REvascularization CHoices Among Under-Represented Groups Evaluation (RECHARGE) program is enrolling 1200 women, Black, and Hispanic patients in two parallel randomized trials of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG). Funded by a phased Patient-Centered Outcomes Research Institute award, the pilot phase was designed to assess the feasibility of enrolling groups historically under-represented and challenging to enroll in prior revascularization trials, evaluate willingness of patients to accept randomization, refine patient and stakeholder engagement, and scale site infrastructure and data collection across diverse centers. We report key insights from the pilot phase. Physician and patient treatment preferences, often shaped by prior experience and evidence not directly applicable to these cohorts, were the main reasons eligible patients were not randomized. Many sites also lacked consistent multidisciplinary Heart Team processes for coronary disease, requiring new workflows to establish equipoise between PCI and CABG. Successful recruitment required intentional trust-building and tailored patient-facing materials, while engagement of non-academic centers demanded added financial, educational, and start-up support. During the 2-year pilot phase, 91 U.S. and 17 Canadian sites were selected, and 65 were activated. Median activation time was 10.8 months (IQR 9.1-13.6). The pilot enrollment goal of 60 participants was exceeded, with 141 patients randomized within 13 months at a mean rate of 0.27 patients/site/month, prompting expansion to up to 150 sites for the full program. The lessons learned from the pilot phase of the RECHARGE program can inform the design and implementation of future randomized trials seeking to enroll traditionally under-represented populations. Copyright © 2026. Published by Elsevier Inc. <116> Accession Number 651556655 Title Leadless Pacemaker in Bradyarrhythmia After Transcatheter Aortic Valve Replacement: A Meta-Analysis. Source Cardiology in review. (no pagination), 2026. Date of Publication: 19 Jun 2026. Author Pajareya P.; Chuanchai W.; Laohasurayotin K.; Siranart N.; Phutinart S.; Tokavanich N.; Prasitlumkum N.; Chokesuwattanaskul R. Institution (Pajareya, Chuanchai, Laohasurayotin, Siranart, Phutinart, Chokesuwattanaskul) From the Division of Cardiovascular Medicine, Center of Excellence in Arrhythmia Research, Cardiac Center, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand (Tokavanich) Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL, Puerto Rico (Prasitlumkum) Department of Cardiology, Electrophysiology Section, Pali Momi, Hawaii Pacific Health, Hawaii, HI Abstract Leadless pacemaker (LPM) offers a favorable safety profile for bradyarrhythmia, especially in patients at high risk for infection from transvenous pacemaker (TPM). However, its use for bradyarrhythmia after transcatheter aortic valve replacement (TAVR) remains unexplored. We conducted a systematic search from the inception of PubMed to November 2025. Eligible studies included adults who received a pacemaker after TAVR. Primary endpoints were overall complications and device-related complications. Secondary endpoints included all-cause mortality, device-related mortality, hospitalization for heart failure, procedure time, fluoroscopy time, and length of stay after pacemaker implantation. We included a total of 11 studies involving 11,750 patients who underwent TAVR (1243 with LPM and 10,507 with TPM). None of the patients in the LPM group experienced device-related complications, with significantly lower rates compared to the TPM group [adjusted hazard ratio (aHR) 0.35, 95% confidence interval (CI): 0.13-0.97; I2 = 0%]. Similarly, no device-related mortality was observed in the LPM group. All-cause mortality and hospitalization for heart failure were comparable between the LPM and TPM groups (aHR 1.02, 95% CI, 0.05-20.68; I2 = 25% and aHR 0.87, 95% CI, 0.24-3.17; I2 = 0%, respectively). The feasibility of LPM was also similar to TPM in terms of procedural time (MD -28.66 minutes, 95% CI, -92.36 to 35.03; I2 = 11%), fluoroscopy time (MD -1.36 minutes, 95% CI, -6.30 to 3.59; I2 = 0%), and length of stay (MD -0.53 days, 95% CI, -1.33 to 0.27; I2 = 6%). In conclusion, LPM could serve as a first-line pacing strategy in bradyarrhythmia post-TAVR due to its safer profile with comparable efficacy and feasibility to TPM. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <117> Accession Number 651569037 Title Fractional Flow Reserve-Guided Versus Coronary Angiography Alone for Guiding Coronary Artery Bypass Grafting: A Meta-Analysis of Randomized Trials. Source The American journal of cardiology. (no pagination), 2026. Date of Publication: 21 Jun 2026. Author Abbas O.F.; Emara A.; Almarfadi A.; Haddad R.; Atta K.; Elbenawi H.; Zordok M.; Elgendy I.Y. Institution (Abbas, Emara) Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Almarfadi) Ferhat Abbas University of Setif, Department of Medicine, Setif, Algeria (Haddad) Faculty of Medicine, October 6 University, Giza, Egypt (Atta) Institute of Medicine, National Research Mordovia State University, Saransk, Russian Federation (Elbenawi) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Zordok) Department of Cardiovascular Medicine, Baylor Scott & White, Heart Hospital Plano, Plano, TX, United States (Elgendy) Department of Cardiovascular Medicine, Gill Heart and Vascular Institute, University of Kentucky, Lexington, KY, United States Abstract Coronary artery bypass grafting (CABG) is traditionally guided by coronary angiography, although angiographic severity may not accurately reflect the physiological significance of coronary lesions. Fractional flow reserve (FFR) improves outcomes in percutaneous coronary intervention, but its role in guiding CABG remains uncertain. We conducted a meta-analysis of randomized controlled trials (RCTs) comparing FFR-guided versus angiography-guided CABG. Electronic databases were systematically searched from inception to April 2026. Outcomes included all-cause death, myocardial infarction (MI), and stroke. Random-effects models were used to calculate pooled risk ratios (RRs) with 95% confidence intervals (CIs). Three RCTs including 1,061 patients were analyzed, with 533 patients assigned to FFR-guided CABG. During a mean follow-up of 15 months, FFR-guided CABG was associated with a significantly lower risk of MI compared with angiography-guided CABG (RR 0.48, 95% CI 0.26-0.89; P=0.01; I2=0%). There were no statistically significant differences in all-cause death (RR 0.74, 95% CI 0.52-1.07; P=0.10; I2=0%) or stroke (RR 1.60, 95% CI 0.94-2.74; P=0.08; I2=0%). Risk of bias was low across all included trials. In conclusion, FFR-guided CABG was associated with a reduced incidence of MI compared with angiography-guided CABG, without significant differences in all-cause death or stroke. Larger trials with longer follow-up are needed to further define the role of physiology-guided surgical revascularization. Copyright © 2026. Published by Elsevier Inc. <118> Accession Number 2046591502 Title A virtual reality-based multicomponent intervention program for preventing postoperative delirium in the intensive care unit for cardiac surgery patients: from evidence-based design to a pilot trial. Source Frontiers in Medicine. 13 (no pagination), 2026. Article Number: 1815659. Date of Publication: 2026. Author Dong J.; Ni Q.; Gong X.; Sui W.; Wang L.; Huang Z.; Yi J.; Yan R.; Jiang W.; Zhou H.; Zhang J.; Zhuang Y. Institution (Dong, Ni, Gong, Sui, Wang, Huang, Yi, Yan, Jiang, Zhou, Zhang, Zhuang) Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (Dong, Ni, Huang, Yi, Yan, Jiang, Zhou, Zhuang) Zhejiang University School of Medicine, Hangzhou, China Publisher Frontiers Media SA Abstract Background - Postoperative delirium (POD) after cardiac surgery in the intensive care unit (ICU) has a high incidence and poor outcomes. Virtual reality (VR) is a non-pharmacological intervention of growing interest, but its effects in cardiac surgery patients remain underexplored. Aim - To evaluate the feasibility of a perioperative VR-based intervention program and to explore its preliminary clinical effects on POD, anxiety, depression, cognition, sleep, and mobility in cardiac surgery patients. Study design - A randomized controlled trial was conducted from February to March 2025 in a tertiary hospital in China. Forty participants undergoing elective cardiac surgery were assigned to usual care (control group) or usual care plus daily VR sessions from preoperative preparation until ICU discharge (intervention group) (n = 20 each). Outcomes included delirium incidence, severity, duration, onset time, and changes in stress, cognition, sleep, and mobility with time perioperatively. Results - In this pilot trial, the intervention group had a lower incidence of delirium than the control group (5% vs. 35%, p = 0.048). However, the study was not powered to detect differences in delirium incidence, and the limited number of events (n = 8) makes this estimate unstable. Therefore, this finding should be interpreted as a hypothesis-generating signal only, not as evidence of clinical efficacy. The intervention group also had lower delirium severity, higher Barthel Index scores, and shorter ICU length of stay (all p < 0.05). In addition, patients in the intervention group had lower stress levels at multiple perioperative time points, better sleep on the first and last ICU nights, and higher cognitive scores at ICU discharge than those in the control group. Repeated-measures analyses suggested favorable changes over time in anxiety, depression, and sleep in the intervention group. Conclusion - Perioperative VR-based multicomponent intervention was feasible and well accepted in this pilot study, and may indicate potential benefit in reducing POD and improving selected psychological and functional outcomes in cardiac surgery patients. These findings are preliminary and require confirmation in larger, adequately powered multicenter trials. Copyright © 2026 Dong, Ni, Gong, Sui, Wang, Huang, Yi, Yan, Jiang, Zhou, Zhang and Zhuang. <119> Accession Number 2046743989 Title Enterococcal Infections in Left Ventricular Assist Device Recipients: Two Clinical Cases and Systematic Review. Source Pathogens. 15(6) (no pagination), 2026. Article Number: 626. Date of Publication: 01 Jun 2026. Author Gay C.; Ramos-Merino L.; Sandoval E.; Couto-Mallon D.; Perissinotti A.; Garcia-Vieites M.; Barge-Caballero E.; Farrero M.; Hernandez-Meneses M.; Crespo-Lerio M.G. Institution (Gay, Hernandez-Meneses) Department of Infectious Diseases, Hospital Clinic de Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain (Ramos-Merino) Department of Infectious Diseases, Hospital Universitario A Coruna, A Coruna, Spain (Sandoval) Department of Cardiovascular Surgery, Hospital Clinic de Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain (Couto-Mallon, Barge-Caballero, Crespo-Lerio) Cardiology Department, Hospital Universitario A Coruna, CIBERCV, A Coruna, Spain (Perissinotti) Department of Nuclear Medicine, Hospital Clinic de Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain (Perissinotti) Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain (Garcia-Vieites) Department of Cardiovascular Surgery, Hospital Universitario A Coruna, A Coruna, Spain (Farrero) Heart Failure Unit, Cardiology Department, Hospital Clinic de Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Infections remain a major complication in patients with left ventricular assist devices (LVADs). Enterococcal infections are increasingly recognized and are therapeutically challenging because of antimicrobial tolerance, biofilm formation on prosthetic material, and the frequent impossibility of device removal. Objective and method: We report two clinical cases of Enterococcus faecalis LVAD infection and a PRISMA-based systematic review of cases published between 1996 and 2025 that were identified through PubMed/MEDLINE. Primary outcomes were clinical cure, relapse or recurrence, mortality, and device removal. Results were synthesized descriptively. Result(s): Seventeen cases were analyzed, including 15 previously reported cases and two new cases. E. faecalis accounted for 47% of infections, Enterococcus faecium for 29%, and Enterococcus spp. without species identification for 24%. Bacteremia was the most common presentation, occurring in 76%, whereas LVAD-associated endocarditis occurred in 18%. Driveline or pocket involvement was reported in 41%. Suppressive antimicrobial therapy (SAT) was used in 29%, often as a bridge to heart transplantation. Cultures from explanted LVAD components were positive in 47% of cases despite prolonged antimicrobial therapy. Recurrence or relapse and overall mortality each occurred in 18% of patients. Conclusion(s): Enterococcal LVAD infections may be associated with microbiological persistence despite prolonged therapy. SAT may help control infection in selected patients and bridge to heart transplantation when device removal is not feasible. Copyright © 2026 by the authors. <120> Accession Number 2047089660 Title Optimal coronary flow rates for preservation of function during normothermic ex situ heart perfusion. Source Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2026. Date of Publication: 2026. Author Alexander W.D.; Nakashima T.; Chakrabortty V.; Urrea K.A.; King S.D.; Raza S.S.; Daman M.G.; Ling C.; Bergin I.L.; Niman J.B.; Rojas-Pena A.; Drake D.H. Institution (Alexander, Nakashima, Chakrabortty, Urrea, King, Raza, Daman, Niman, Rojas-Pena) Department of Surgery, University of Michigan, Ann Arbor, Mich, United States (Alexander) Department of Surgery, University of California, San Diego, San Diego, Calif, United States (Raza, Ling, Drake) Department of Cardiac Surgery, University of Michigan, Ann Arbor, Mich, United States (Bergin) Unit for Laboratory Animal Medicine, University of Michigan, Ann Arbor, Mich, United States Publisher Elsevier Inc. Abstract Objective: Current clinical normothermic ex situ heart perfusion (NEHP) flow rates, approximately 1.5 cc/g cardiac tissue per minute, are based on lactate level trends. Lactate level alone may not be sufficient for optimizing flow. We sought to identify optimal coronary flow using multiple assays of myocardial preservation. Method(s): Consecutive porcine donor hearts were maintained in our 24-hour NEHP model. Hearts were randomized to 1 of 3 perfusion rates: high flow (HF) 1.5 cc/g/minute, medium flow (MF) 0.75 cc/g/minute, and low flow (LF) 0.25 cc/g/minute (n = 5 each). Data collection included biomarkers, immunohistochemistry, and echocardiography. Result(s): MF had the least secondary aortic regurgitation (LF 14.0% +/- 16.3% vs MF 7.9% +/- 3.4% [P < .001] and MF vs HF 14.0% +/- 16.3% [P = .023]). HF interventricular septal dimension in diastole increased due to edema (LF 91% +/- 8% vs HF 129% +/- 11% [P = .024] and MF 84% +/- 9% vs HF [P = .013]). HF fatty acid binding proteins and soluble suppression of tumorigenicity-2 levels increased, indicating myocardial injury (LF 0.426 +/- 0.13 ng/mL vs HF 1.41 +/- 0.70 ng/mL [P = .016], MF 0.021 +/- 0.03 ng/mL vs HF [P < .001], and MF 1.06 +/- 0.10 ng/mL vs HF 9.53 +/- 7.8 ng/mL [P = .013]). Initial LF von Willebrand factor increases indicated endothelial ischemia (LF 11.2 +/- 0.9 ng/mL, MF 6.2 +/- 1.3 ng/mL, and HF 6.9 +/- 0.6 ng/mL; LF vs MF P = .013, LF vs HF P = .026). Histopathology demonstrated autolysis and myofiber degeneration in LF, focal hemorrhage in MF, and extensive hemorrhage, myofiber degeneration, and endothelial damage in HF. Troponin-I immunohistochemistry staining was preserved in MF and markedly diminished in LF and HF. Conclusion(s): NEHP coronary flow rates of 0.75 cc/g/minute optimized donor heart function while minimizing injury. This coronary flow rate is substantially less than current clinical practice. Reducing coronary flow during NEHP may improve donor heart preservation and function following transplantation. Copyright © 2026 The American Association for Thoracic Surgery <121> [Use Link to view the full text] Accession Number 2046586492 Title Leadless Pacemakers in the Setting of Surgical and Transcatheter Tricuspid Valve Procedures. Source Circulation: Arrhythmia and Electrophysiology. 19(6) (no pagination), 2026. Article Number: e015000. Date of Publication: 01 Jun 2026. Author Abou Deb G.; Abou Deb F.; Kozhuharov N.; Albouaini K. Institution (Abou Deb, Albouaini) Royal Liverpool University Hospital, United Kingdom (Abou Deb) University of Chester, United Kingdom (Kozhuharov) Inselspital, Bern University Hospital, University of Bern, Switzerland Publisher Lippincott Williams and Wilkins Abstract Transvenous pacing is increasingly recognized as problematic in patients with prior or concomitant tricuspid valve intervention, owing to risks of leaflet interference, prosthetic dysfunction, and progression of tricuspid regurgitation. Leadless pacemakers offer a valve-sparing alternative; however, their safety and performance in structurally altered right heart anatomy remain incompletely defined. We conducted a systematic review to evaluate procedural feasibility, electrical performance, device-valve interaction, and clinical outcomes of leadless pacemaker implantation in patients undergoing surgical or transcatheter tricuspid valve interventions. Thirty-four studies comprising 272 patients were included, encompassing surgical repair, bioprosthetic replacement, valve-in-valve procedures, transcatheter edge-to-edge repair, and transcatheter tricuspid valve replacement. Leadless pacemakers were implanted via transfemoral, transjugular, or direct surgical approaches, achieving a procedural success rate of 99.3%. Electrical performance was consistently favorable, with stable capture thresholds, sensing amplitudes, and impedance during follow-up. Device-valve interaction was infrequent and generally manageable. Leadless pacemaker-related complications were rare (1.1%), with no device-related mortality. Within the included studies of patients undergoing surgical or transcatheter tricuspid valve interventions, no study demonstrated worsening tricuspid regurgitation attributable to the leadless pacemaker or its delivery system. Across a broad spectrum of complex tricuspid anatomies, leadless pacemakers demonstrated excellent feasibility, durable electrical performance, and a low complication profile, supporting their role as a valve-sparing pacing strategy in this population. These findings support leadless pacing in patients with prior tricuspid intervention, although prospective comparative data are required to define its role relative to alternative pacing modalities. Copyright © 2026 American Heart Association, Inc. <122> Accession Number 2047210374 Title Comment: Topical Use of Tranexamic Acid in Cardiac Surgery: A Meta-Analysis. Source Thoracic and Cardiovascular Surgeon. (no pagination), 2026. Date of Publication: 2026. Author Umair Shah S.; Akbar H.; Hatim Hussain S.; Muhammad Momin S. Institution (Umair Shah, Akbar, Hatim Hussain, Muhammad Momin) Department of Medicine, Nowshera Medical College, Khyber Pakhtunkhwa, Nowshera, Pakistan Publisher Georg Thieme Verlag <123> Accession Number 2046881207 Title Comparative outcomes of balloon-expandable and self-expanding valves in transcatheter aortic valve replacement: A systematic review and meta-analysis. Source Journal of Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Hafez A.; Sobhy A.; Elshahat A.; Bruce D.; Saad O.A.; Ashour M.; Ali K.; Shebl M.A.; Bolla A.K.; Usmani R.; Aboudabash M.; Arafa A.; Shehata S.A.; Abdellatif N.; Alagab A.; Eldessouki A.; Riccelli R.; Gir D.; Elzewiei G.Y.A.; Toraih E.A.; Aiash H. Institution (Hafez) Cardiovascular Medicine Department, Mayo Clinic, Phoenix, AZ, United States (Sobhy) Faculty of Medicine, Kafr Elsheikh University, Kafr Elsheikh, Egypt (Elshahat, Saad) Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Bruce) Tulane University School of Medicine, New Orleans, LA, United States (Ashour) College of Human Medicine, Banha University, Banha, Egypt (Ali) Department of Internal Medicine, Hennepin County Medical Center, Minneapolis, MN, United States (Shebl) Faculty of Medicine, Cairo University, Cairo, Egypt (Bolla) Meinig School of Biomedical Engineering, Cornell University, NY, United States (Usmani) Syracuse University, College of Arts and Sciences, NY, United States (Aboudabash) School of Medicine, New Giza University, Giza, Egypt (Arafa) Faculty of Medicine, Alexandria University, Alexendria, Egypt (Shehata, Eldessouki, Aiash) Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt (Abdellatif) Gulf Medical University, Ajman, United Arab Emirates (Alagab) Faculty of Medicine, Tripoli University, Tripoli, Libyan Arab Jamahiriya (Riccelli) Christain Brothers Academy, NY, United States (Gir) St. Joseph's Medical Center, CA, United States (Elzewiei) Department of Medicine, Tobruk University, Tobruk, Libyan Arab Jamahiriya (Toraih, Aiash) Cardiovascular Perfusion Department, SUNY Upstate Medical University, Syracuse, NY, United States (Toraih) Genetics Unit, Faculty of Medicine, Suez Canal University, Ismailia, Egypt Publisher Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai) Abstract Background Balloon-expandable valves (BEVs) and self-expanding valves (SEVs) are the two primary platforms for transcatheter aortic valve replacement (TAVR), differing in design, deployment, and hemodynamic performance. Comparative evidence on their clinical and procedural outcomes remains limited and inconsistent. Methods A systematic review and meta-analysis were conducted, searching PubMed, Scopus, Web of Science, and Cochrane Library up to July 2025 for studies comparing BEVs and SEVs in adults with severe aortic stenosis undergoing transfemoral TAVR. Outcomes included all-cause mortality, cardiovascular mortality, stroke, permanent pacemaker implantation, hemodynamic parameters, device success, and safety endpoints. Dichotomous and continuous outcomes were pooled as risk ratios (RR) and mean differences (MD) with corresponding 95% confidence intervals (CI) using a random-effects model. Results Fifty-three studies ( n = 157,921) were included (6 randomized controlled trials, 12 prospective, and 35 retrospective cohorts). BEVs showed significant early survival benefits at 1 month (RR = 0.75, 95% CI 0.57-0.97, p = 0.03) and 6 months (RR = 0.33, 95%CI0.18-0.60, p < 0.001), with reduced cardiovascular mortality at 12 months (RR = 0.88, 95% CI 0.79-0.99, p = 0.03). Permanent pacemaker implantation rates were consistently lower with BEVs (e.g. RR = 0.75, 95% CI 0.64-0.88, p < 0.001 at 1 month). SEVs exhibited superior hemodynamics, with lower mean gradients (MD = -3.16 to -7.77 mmHg) and larger aortic valve areas (MD = +0.11 to +0.13 cm2). Long-term mortality and safety outcomes, including major bleeding, vascular complications, and myocardial infarction, were comparable. Conclusion BEVs offer early survival and conduction preservation advantages, while SEVs provide superior hemodynamic performance. These findings highlight the importance of individualized valve selection based on patient-specific factors. Further randomized trials with extended follow-up are needed to evaluate long-term durability and outcomes in diverse patient populations. Copyright © 2026 Elsevier Ltd. <124> Accession Number 2046743993 Title Prosthetic Valve Endocarditis by Acinetobacter baumannii: Case Report and Systematic Descriptive Review. Source Pathogens. 15(6) (no pagination), 2026. Article Number: 581. Date of Publication: 01 Jun 2026. Author Salvati A.; Alessio L.; Trombaccia G.; Cimmino G.; De Feo M.; Ferraro F.; De Pascalis S.; Coppola N. Institution (Salvati, Alessio, De Pascalis, Coppola) Infectious Diseases Unit, Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Naples, Italy (Trombaccia) Internal Medicine Unit, "Sacro Cuore"-Fatebenefratelli Hospital, Benevento, Italy (Cimmino) Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, Napoli, Italy (De Feo) Department of Women, Child and General and Specialized Surgery, Section of Anesthesiology, University of Campania Luigi Vanvitelli, Naples, Italy (Ferraro) Department of Translational Medical Sciences, Section of Cardiac Surgery and Heart Transplant, University of Campania Luigi Vanvitelli, Naples, Italy Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract A 61-year-old woman developed prosthetic valve infective endocarditis after osteomyelitis caused by extensively drug-resistant (XDR) Acinetobacter baumannii. Moreover, a systematic descriptive review of published case reports was performed to describe the main features, treatment, and outcomes of this condition. Method(s): Apart from the description of our case, a PubMed and Embase literature review was conducted up to January 2026 using the terms "A. baumannii" AND ("infective endocarditis" OR "endocarditis" OR "valvular infection"). We included clinical cases of IE caused by A. baumannii published as full-text articles in English. Result(s): After orthopedic osteosynthesis surgery following a femur fracture, our patient developed osteomyelitis by XDR A. baumannii and was treated for a short period of time. Later, prosthetic aortic valve endocarditis was diagnosed. Despite treatment with cefiderocol and eravacycline, she died. An additional 18 clinical cases of IE by A. baumannii were identified from the literature, bringing the total to 19 cases. IE affected prosthetic valves in nine cases, native valves in nine and involved a right atrial mass in one. Twelve cases were caused by MDR or XDR A. baumannii. Mortality occurred more frequently in cases not treated with surgery (9/13, 69%) compared to those treated with surgery (1/6, 16.7%). However, given the very small sample size, these data should be interpreted with caution. Conclusion(s): This case, together with previously reported observations, highlights the severity of EI by A. baumannii and the need of multidisciplinary management. Copyright © 2026 by the authors. <125> Accession Number 2047145592 Title A bibliometric analysis of lung cancer and atrial fibrillation [1991-2026]: research hotspots, thematic evolution, and translational landscape in cardio-oncology. Source Journal of Thoracic Disease. 18(6) (no pagination), 2026. Article Number: 624. Date of Publication: 30 Jun 2026. Author Lin Z.; Chen S.; Liu Y.; Chen H.; Dai Y.; Xie H.; Wang W.; Huang D.; Fu Z. Institution (Lin, Liu, Xie, Fu) Department of Cardiology, The First Affiliated Hospital of Guangdong Pharmaceutical University, The First Clinical Medical School of Guangdong Pharmaceutical University, Guangdong Pharmaceutical University, Guangzhou, China (Chen, Wang) Department of Cardiovascular Disease, Shantou Hospital of Traditional Chinese Medicine, Shantou, China (Chen) Department of Gastroenterology, Central People's Hospital of Zhanjiang, Zhanjiang, China (Dai) Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China (Huang) Department of Thoracic Surgery, Central People's Hospital of Zhanjiang, Zhanjiang, China Publisher AME Publishing Company Abstract Background: The intersection of lung cancer (LC) and atrial fibrillation (AF) is common in thoracic surgery, systemic cancer therapies, and cardio-oncology, yet the research landscape remains inadequately characterized. To understand the progression of LC-AF research, a detailed overview is necessary to identify its main research focuses and highlight the most pertinent knowledge gaps for upcoming clinical and translational research. The present study aimed to systematically clarify the global research landscape, translational priorities, and key molecular signatures relevant to contemporary clinical and scientific focus in LC-AF comorbidity via a multi-perspective approach. Method(s): We conducted a bibliometric study on LC-AF literature sourced from the SCI-Expanded database in the Web of Science Core Collection (WoSCC), updated to April 2026, including original articles and reviews after a predefined screening process. Clinical trial records indexed in PubMed were analyzed as an additional module to explore trends in trial-oriented clinical trends. Additionally, a transcriptomic analysis that integrates AF and LC datasets was carried out to give molecular context to repeated bibliometric themes. Result(s): The LC-AF field experienced steady publication growth, which became more pronounced post-2015. The primary contributors were the United States and China, with productive institutions clustered in several renowned global academic centers. Research hotspots were mainly centered on perioperative AF, thoracic surgery, cardiovascular complications, and risk-factor assessment, with thematic evolution toward cardio-oncology, treatment-related toxicity, immunotherapy, and precision-oriented research. Supplementary analysis of trials pointed to a need for greater emphasis on precision therapy, age-specific management, and more rigorous study designs. The transcriptomic exploratory study pinpointed shared genes with differential expression, including S100A8, S100A9, and IGFBP2, and underscored inflammatory and metabolic pathways as potential molecular connections to frequent bibliometric topics. Conclusion(s): The field of LC-AF research is expanding from a focus on perioperative and descriptive aspects to include a wider cardio-oncology orientation. Future work should prioritize long-term follow-up in comorbid populations, clearer distinction between perioperative and chronic AF scenarios, prospective multicenter validation of risk models, and translational studies linking molecular signals to perioperative surveillance and treatment decision-making. Copyright © AME Publishing Company. This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/. <126> Accession Number 2046714386 Title The impact of inspiratory muscle training on pulmonary function recovery and pulmonary complications in patients undergoing cardiothoracic surgery: a systematic review and meta-analysis. Source Frontiers in Physiology. 17 (no pagination), 2026. Article Number: 1761926. Date of Publication: 01 Jun 2026. Author Ge Y.; Zhang M.; Gan Y. Institution (Ge) Department of Thoracic Surgery, Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China (Zhang) Department of Neurosurgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Gan) Department of Infection Control, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China Publisher Frontiers Media SA Abstract Objective - To quantify the effects of inspiratory muscle training (IMT) on pulmonary function (PF) recovery and postoperative pulmonary complications (PPCs) including pneumonia and atelectasis in patients undergoing cardiothoracic surgery through systematic evaluation and meta-analysis, providing an evidence-based basis for perioperative respiratory management. Methods - PubMed, Embase, Cochrane Library, and Web of Science were systematically searched until May 2025, with 7 randomized controlled trials (RCTs) involving 507 adult patients who underwent cardiothoracic surgery retrieved (the study of transcatheter aortic-valve replacement was excluded due to heterogeneous surgical characteristics). The quality of the literature was evaluated using the Cochrane Risk-of-Bias Tool (RoB 2.0). A meta-analysis was conducted using RevMan 5.4 software to compare the differences in predefined outcome measures: forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and the pneumonia incidence between the IMT and control groups. Results - The meta-analysis showed that the IMT group had a higher FEV1 than the control group [mean difference (MD)=0.80 L, 95% confidence interval (CI): 0.09-1.52, P = 0.03], with clinically relevant improvements. Similarly, FVC was better in the IMT group (MD = 0.64 L, 95% CI: 0.11-1.17, P = 0.03), also representing a clinically meaningful benefit. However, there was no difference in FEV1/FVC ratio between the two groups (P = 0.15). The IMT group performed better in the 6-minute walk test (6MWT) (MD = 47.89 m, 95% CI: 1.28-94.51, P = 0.04), indicating improved functional capacity. Regarding PPCs, the incidence of postoperative pneumonia [odds ratio (OR)=0.18, 95% CI: 0.06-0.57, P = 0.004] and atelectasis (OR = 0.37, 95% CI: 0.17-0.81, P = 0.01) in the IMT group were lower than those in the control group. Conclusion - IMT can effectively improve PF and reduce the risk of PPCs in patients undergoing cardiothoracic surgery by enhancing the strength and endurance of inspiratory muscles. Copyright © 2026 Ge, Zhang and Gan. <127> Accession Number 651559465 Title Direct oral anticoagulants versus vitamin K antagonists after left atrial appendage occlusion: a systematic review and meta-analysis. Source BMC cardiovascular disorders. (no pagination), 2026. Date of Publication: 19 Jun 2026. Author Dai Y.; Chang J.; Guo J. Institution (Dai, Chang) International Medical Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China (Guo) Department of Nursing, Guang'anmen Hospital, Academy of Chinese Medical Sciences, No. 5 Beixiange, Xicheng District, Beijing, China Abstract BACKGROUND: Non-valvular atrial fibrillation (NVAF) elevates the risk of stroke owing to thrombus development, especially in the left atrial appendage (LAA). Left atrial appendage occlusion (LAAO) provides stroke prophylaxis for those unable to tolerate prolonged anticoagulant therapy. This meta-analysis evaluates the effectiveness and safety of direct oral anticoagulants (DOACs) in comparison to vitamin K antagonists (VKAs) following LAAO, concentrating on ischemic stroke, systemic embolism (SE), severe bleeding, and device-related thrombosis. METHOD(S): A comprehensive literature search was conducted in Web of Science, Cochrane Library, Embase, and PubMed for studies published between 2017 and 2025. The inclusion criteria were trials involving patients undergoing LAAO who were treated with either DOAC or VKA regimens. The primary outcomes included transient ischemic attack (TIA), SE, ischemic stroke, and major hemorrhage. Any major adverse event was defined as a composite of major bleeding, stroke, SE, device-related thrombosis, and all-cause mortality, and analyzed as a secondary/exploratory outcome due to heterogeneity in component reporting across studies. Meta-analysis was performed using random-effects models for all pooled analyses, given the anticipated clinical and methodological heterogeneity across studies. Subgroup and sensitivity analyses were conducted to further assess the robustness of the findings. RESULT(S): Twenty-one studies were included. DOACs had a considerably reduced incidence of serious bleeding (OR = 0.88, 95% CI: 0.80-0.98) and any major adverse event (OR = 0.88, 95% CI: 0.82-0.95) than VKAs, but there was no discernible difference in stroke or SE rates (OR = 0.86, 95% CI: 0.69-1.05). Exploratory subgroup analyses suggested potential differences in certain groups (e.g., North America, longer follow-up), but these should be interpreted as exploratory. Secondary outcomes, including peri-device leaks and device-related thrombosis, did not differ significantly between groups. CONCLUSION(S): DOACs may provide comparable thromboembolic protection with a lower risk of major bleeding than VKAs after LAAO. However, most available evidence is derived from non-randomized studies and remains subject to residual confounding, selection bias, and moderate-to-low certainty of evidence. Therefore, the observed benefits of DOACs should be interpreted cautiously. Further large-scale prospective studies and randomized controlled trials are needed to confirm these findings and inform optimal post-LAAO anticoagulation strategies. Copyright © 2026. The Author(s). <128> Accession Number 651551090 Title Computed tomography-derived low muscle status and clinical outcomes after isolated coronary artery bypass grafting: A systematic review and meta-analysis with implications for perioperative nutrition risk stratification. Source Nutrition and health. (pp 2601060261461906), 2026. Date of Publication: 17 Jun 2026. Author Zhou Z.; Sun T.; Zhao J.; Wang Y.; Wu W. Institution (Zhou, Sun, Zhao, Wang, Wu) Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China Abstract Background and aimsComputed tomography (CT)-derived measures of low muscle quantity and quality may indicate reduced physiologic reserve, but their prognostic value after isolated coronary artery bypass grafting (CABG) is uncertain. We conducted a PRISMA-guided systematic review and conservative meta-analysis of adjusted estimates to examine associations between preoperative CT-derived low muscle status and outcomes after isolated CABG.MethodsWe searched PubMed, Embase, Web of Science, Cochrane CENTRAL, and ClinicalTrials.gov from inception to December 23, 2025. Cohort studies of adults undergoing isolated CABG were eligible if they assessed preoperative low muscle status using CT (dual-energy X-ray absorptiometry eligible) and reported mortality and/or postoperative complications. Overlapping cohorts were excluded. Adjusted hazard ratios (HRs) were pooled using random-effects meta-analysis (restricted maximum likelihood) with the Hartung-Knapp-Sidik-Jonkman adjustment.ResultsFour independent cohorts (n = 3931) met inclusion criteria and used CT-based definitions spanning lumbar and thoracic muscle quantity/quality measures. Three cohorts (n = 3452) contributed adjusted estimates for long-term mortality. Across studies, the direction of association was unfavorable, but quantitative synthesis was exploratory and highly uncertain (pooled HR 2.71, 95% confidence interval 0.38-19.40; I2 = 92.3%; approximate 95% prediction interval 0.47-15.6). Secondary outcomes were too heterogeneous for pooling and were summarized narratively.ConclusionsPreoperative CT-derived low muscle status may serve as a pragmatic vulnerability flag in isolated CABG when CT is already available, but current pooled evidence for long-term mortality remains exploratory, highly heterogeneous, and statistically imprecise. Standardized measurement, more comparable adjustment strategies, and harmonized outcome reporting are needed before broader clinical translation. <129> Accession Number 651553884 Title Effects of Cycle Ergometer Exercise on Functional Capacity and Hospitalization Time of Patients After Open-Heart Surgery: A Systematic Review and Meta-Analysis. Source Brazilian journal of cardiovascular surgery. 41(3) (no pagination), 2026. Date of Publication: 01 May 2026. Author Simas M.; Gulart A.A.; Souza Filho V.P.P.; Cani K.C.; Campos M.L.; Matte D.L. Institution (Simas, Gulart, Matte) Universidade do Estado de Santa Catarina, Universidade do Estado de Santa Catarina Florianopolis Santa Catarina Brazil Postgraduate Program in Physiotherapy, Florianopolis, Santa Catarina, Brazil (Gulart, Matte) Universidade do Estado de Santa Catarina, Universidade do Estado de Santa Catarina Physical Therapy Department Florianopolis Santa Catarina Brazil Physical Therapy Department, Florianopolis, Santa Catarina, Brazil (Souza Filho, Matte) Universidade do Estado de Santa Catarina, Universidade do Estado de Santa Catarina Florianopolis Santa Catarina Brazil Postgraduate Program in Human Movement Sciences, Florianopolis, Santa Catarina, Brazil (Cani, Campos) Universidade Federal de Santa Catarina Hospital Universitario Multiprofessional Unit Florianopolis Santa Catarina Brazil Multiprofessional Unit, Hospital Universitario da Universidade Federal de Santa Catarina, Florianopolis, Santa Catarina, Brazil Abstract INTRODUCTION: Cycle ergometer in the postoperative period of open-heart surgery is a safe and economical exercise option. However, its specific effects, whether or not associated with conventional physiotherapy, are not well established in current literature. The objective of this study was to evaluate the effects of cycle ergometer exercise associated or not with conventional physical therapy, compared with only conventional physical therapy, on functional capacity, hospitalization time, peripheral muscle strength, and pulmonary complications of patients after open-heart surgery. METHOD(S): MEDLINE, Cumulative Index to Nursing & Allied Health Literature, Latin American and Caribbean Health Sciences Literature, Web of Science, Scopus, Embase, Physiotherapy Evidence Database, and Cochrane Library were searched; manual searches were also conducted in the references of the included studies. Randomized controlled trials that analyzed the effects of cycle ergometer exercise associated or not with conventional physical therapy compared with only conventional physical therapy in adult patients after an open-heart surgery were included. Methodological quality was assessed by Cochrane risk-of-bias tool, and the meta-analysis was undertaken using RevMan 5.3. RESULT(S): Mean difference in the six-minute walk test (31 meters, 95% confidence interval [CI]: 1.59 to 60.3 meters, P = 0.04) was higher and in intensive care unit stay was lower (-0.5 days, 95% CI: -0.86 to -0.14 days, P = 0.007) in the intervention group. The total hospitalization time (-0.18 days, 95% CI: -0.73 to 0.38 days, P = 0.53) didn't change between groups. CONCLUSION(S): Cycle ergometer exercises improved functional capacity but with no clinically relevant effects on hospitalization time after open-heart surgeries. <130> Accession Number 651556755 Title Repeat revascularization: a reflection of durability, not a trivial endpoint. Source Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese. (no pagination), 2026. Date of Publication: 18 Jun 2026. Author Angouras D.C. Institution (Angouras) Professor of Cardiac Surgery, National and Kapodistrian University of Athens, School of Medicine, Head, Department of Cardiac Surgery, Attikon University Hospital, 1 Rimini Street, Athens, Greece <131> Accession Number 651572146 Title Precision neuroprotection in cardiac surgery: a structured narrative review of multimodal, data-driven perioperative care. Source Journal of cardiothoracic surgery. (no pagination), 2026. Date of Publication: 21 Jun 2026. Author Hamza M.; Zafarullah M.; Mujtaba M.; Javaid M.H.; Butt A.I.; Mahato R.K.; Chaudhry I.U.H. Institution (Hamza, Chaudhry) Muzaffarabad General Hospital, AJK, Muzaffarabad, Pakistan (Zafarullah, Mujtaba, Javaid) Shifa College of Medicine, Islamabad, Pakistan (Butt) Allama Iqbal Medical College, Lahore, Pakistan (Mahato) Gandaki Medical College Teaching Hospital and Research Center, Pokhara, Nepal Abstract Neurological injury remains a major contributor to morbidity, mortality, and long-term cognitive decline in patients undergoing cardiac surgery, despite significant advancements in surgical techniques and cardiopulmonary bypass (CPB) technology. These injuries arise from a complex interplay of embolic load, hypoperfusion, impaired cerebral autoregulation, inflammatory responses, and patient-specific vulnerabilities, underscoring the need for a precision-based approach rather than generalized neuroprotective strategies. This narrative review synthesizes current evidence across the perioperative continuum to propose an integrated, data-driven framework for precision neuroprotection. This structured narrative review was conducted according to the SANRA framework. Literature was retrieved from PubMed and Scopus databases covering publications from January 2005 to October 2025.Preoperative risk assessment is enhanced by multimodal imaging, frailty evaluation, neurocognitive screening, metabolic and inflammatory biomarkers, and emerging machine learning models capable of predicting postoperative delirium and cognitive dysfunction. Intraoperatively, precision neuroprotection centers on autoregulation-guided blood pressure management, individualized perfusion targets during CPB, optimized temperature and glucose control, and multimodal neuromonitoring, including transcranial Doppler (TCD), near-infrared spectroscopy (NIRS), processed EEG/BIS, and embolic load characterization, to identify and mitigate cerebral insults in real time. Postoperative precision strategies incorporate biomarker-based surveillance, delirium screening, early mobilization, cognitive rehabilitation, and digital monitoring through wearable devices and remote platforms to detect delayed neurological decline. Although these modalities demonstrate clear potential, major research gaps persist, including variability in device accuracy, limited ability to differentiate embolic subtypes, inconsistent biomarker performance and insufficient integration of AI-driven analytics with clinical workflows. Collectively, available evidence supports the transition from fragmented, organ-focused neuroprotection to a unified, multimodal continuum that leverages data integration, personalized thresholds, and predictive analytics. Future large-scale, human-centered clinical trials are essential to validate this approach and operationalize precision neuroprotection across cardiac surgical practice. Copyright © 2026. The Author(s). <132> Accession Number 651556363 Title Comparison of clinical outcomes between pulsatile and non-pulsatile perfusion during cardiopulmonary bypass: A prospective randomized study. Source The journal of extra-corporeal technology. 58(2) (pp 117-123), 2026. Date of Publication: 01 Jun 2026. Author Sharma A.; Luitel P.; Khakural P.; Sapkota R. Institution (Sharma, Khakural, Sapkota) Department of Cardiothoracic and Vascular Surgery, Manmohan Cardiothoracic Vascular and Transplant Center, Kathmandu, Nepal (Luitel) Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal Abstract BACKGROUND: The clinical benefits of pulsatile perfusion during cardiopulmonary bypass (CPB) remain a subject of debate. This study aimed to compare clinical outcomes between pulsatile and non-pulsatile perfusion during CPB in patients undergoing elective cardiac surgery. MATERIALS AND METHODS: Eighty patients undergoing elective atrial septal defect (ASD) closure or mitral valve replacement (MVR) between July 2019 and July 2020 were randomized to two groups: pulsatile perfusion (PP) group and non-pulsatile perfusion (NP) group. All surgeries were performed by a single surgical team. In the PP group, pulsatile flow was maintained at 60-80 per minute for adults and 80-120 per minute for pediatric patients, pulse pressure was maintained higher than 15 mm Hg, while all other intraoperative management and perioperative protocols were kept consistent between groups. The two groups were compared in terms of length of ICU stay, hospital stay, renal function test, liver function test, and complications. RESULT(S): 77 patients with a mean age of 33.8 +/- 15.9 were included in the final analysis. The groups were similar in demographics, clinical and intra-operative variables, except body surface area and baseline creatinine, which were higher in the pulsatile group. Length of ICU stay, hospital stay, liver function tests, renal function tests, and complications were similar across both groups, except for higher urea (p-value 0.049) in the pulsatile group. CONCLUSION(S): This study did not demonstrate significant differences in clinical outcomes between pulsatile and non-pulsatile flow during CPB in elective cardiac surgery. Routine use of pulsatile flow cannot be recommended based on current findings. The study was limited by its restriction to patients undergoing ASD closure or MVR surgery and the dominance of younger patients without major comorbidities. Copyright © The Author(s), published by EDP Sciences, 2026. <133> Accession Number 651550700 Title Endoscopic Versus Open Radial Artery Harvesting in Coronary Artery Bypass Grafting: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Source Cardiology in review. (no pagination), 2026. Date of Publication: 18 Jun 2026. Author Balach R.; Khalid A.; Qadri F.H.; Zafar A.; Ahmed M.; Rahman M.F.; Daniyal S.M.; Ahmad A.; Musani M.H. Institution (Balach, Rahman) From the Ziauddin University, Karachi, Pakistan (Khalid, Daniyal) Dow University of Health Sciences, Karachi, Pakistan (Qadri) Foundation University Medical College, Islamabad, Pakistan (Zafar) Department of Medicine, POF Hospital, Wah Medical College, Pakistan (Ahmed) Rawalpindi Medical University, Rawalpindi, Pakistan (Ahmad) Hameed Latif Teaching Hospital, Lahore, Pakistan (Musani) Indiana University School of Medicine, Fort Wayne, IN, United States (Musani) Director, Advanced Cardiac Imaging, Lutheran Hospital, Fort Wayne, IN, United States Abstract The radial artery is a commonly used conduit in coronary artery bypass grafting (CABG) due to its favorable long-term patency. However, conventional open radial artery harvesting (ORAH) is associated with wound and neurological morbidity. Endoscopic radial artery harvesting (ERAH) has emerged as a minimally invasive alternative, but its comparative safety and efficacy remain uncertain. PubMed, ScienceDirect, and the Cochrane Library were systematically searched from inception to January 2026 for randomized controlled trials comparing ERAH with ORAH in patients undergoing CABG. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using random-effects models. Primary outcomes included wound infection, overall wound complications, and neurological complications. Secondary outcomes included graft patency, hematoma, neurological deficit, stenosis, occlusion, and mortality. Eight randomized controlled trials involving 914 patients were included. ERAH was associated with a significantly lower risk of overall wound complications (RR: 0.51; 95% CI, 0.32-0.79; P = 0.003), hematoma (RR: 0.24; 95% CI, 0.07-0.78; P = 0.02), and neurological deficits (RR: 0.47; 95% CI, 0.36-0.62; P < 0.0001) compared with ORAH. No significant differences were observed in wound infection, overall neurological complications, graft patency, stenosis, occlusion, or mortality. ERAH reduces wound complications, hematoma, and neurological deficits without compromising graft patency or increasing mortality, supporting its use as a safe minimally invasive alternative to ORAH in CABG. Registration: PROSPERO (CRD420261333569). Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <134> Accession Number 2038188062 Title Comparison of self-expanding transcatheter heart valves for aortic stenosis: the multicentre, randomised, controlled, non-inferiority DOUBLE-CHOICE trial. Source EuroIntervention. 22(10) (pp 555-565), 2026. Date of Publication: 2026. Author Feistritzer H.-J.; Lauten P.; Rudolph T.K.; Rudolph V.; Geisler T.; Massberg S.; Adam M.; Baldus S.; Sossalla S.; Joner M.; Moellmann H.; Wolf A.; Kim W.-K.; Borger M.A.; Noack T.; Boening A.; Bleiziffer S.; Hohenstein S.; Hoesler N.; Buske M.; Majunke N.; Lankisch N.; Roeder M.V.; Desch S.; Thiele H.; Abdel-Wahab M. Institution (Feistritzer, Borger, Noack, Buske, Majunke, Lankisch, Roeder, Desch, Thiele, Abdel-Wahab) Heart Center Leipzig, Leipzig University, Leipzig, Germany (Lauten, Bleiziffer) Zentralklinik Bad Berka, Bad Berka, Germany (Rudolph, Rudolph, Bleiziffer) Heart and Diabetes Center NRW, Oeynhausen, Germany (Geisler) University Hospital Tubingen, Tubingen, Germany (Massberg) Department of Medicine I, Ludwig Maximilian University Munich, Munich, Germany (Adam, Baldus) Heart Center, University of Cologne, Cologne, Germany (Sossalla, Kim, Boening) University Hospital Giesen, Giesen, Germany (Joner) Department of Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany (Moellmann) Department of Cardiology, St. Johannes Hospital Dortmund, Dortmund, Germany (Wolf) Heart Center Wuppertal, Witten-Herdecke University, Wuppertal, Germany (Hohenstein) Helios Health Institute, Leipzig, Germany (Hoesler) Leipzig Heart Science, Leipzig, Germany Publisher Europa Group Abstract BACKGROUND: Although with drawn from the market, the specific design of the ACURATE neo2 valve might nfluence the design of future transcatheter aortic valve platforms. AIMS: We aimed to evaluate the safety and efficacy of transcatheter aortic valve implantation (TAVI) using the ACURATE neo2 valve compared with the Evolut platform in selected anatomies. METHOD(S): In this investigator-initiated, 2x2 factorial, open-label, randomised, multicentre, non-inferiority trial, patients with symptomatic, severe aortic stenosis were randomised to the ACURATE neo2 or an Evolut PRO/ PRO+/FX valve. The primary endpoint was a composite of all-cause mortality, stroke, moderate/severe prosthetic valve regurgitation, and permanent pacemaker implantation at 30 days. Non-inferiority of the ACURATE neo2 to an Evolut valve was tested in the intention-to-treat population (absolute non-inferiority margin of -6%, alpha of 0.05). RESULT(S): At 10 sites in Germany, 835 patients were randomised. Within 30 days, the primary endpoint occurred in 60/389 patients (15.4%) in the ACURATE neo2 group and in 120/395 patients (30.4%) in the Evolut group (rate difference 15.0%, lower boundary of the 1-sided 95% confidence interval [CI]: 10.1%; p for non-inferiority<0.001, 2-sided 95% CI: 9.1-20.7; p for difference<0.001). A permanent pacemaker was implanted in 42/374 patients (11.2%) in the ACURATE neo2 group and in 101/381 patients (26.5%) in the Evolut group (p for difference <0.001). Rates of moderate/severe prosthetic valve regurgitation were low for both valves (1.3% vs 1.7%; p for difference=0.6). CONCLUSION(S): In selected anatomies, TAVI with the ACURATE neo2 was non-inferior to TAVI with an Evolut valve, with significantly lower rates of the primary endpoint, driven by lower permanent pacemaker implantation at 30 days. Copyright © 2026, Europa Group. All rights reserved. <135> Accession Number 651557740 Title The Impact of Massage on Pain and Vital Signs Following Cardiovascular Surgery in Pediatric Patients. Source The Journal of cardiovascular nursing. (no pagination), 2026. Date of Publication: 22 Jun 2026. Author Turan E.; Turan M.; Manav G.; Kangin M. Institution (Turan) Engin Turan, Department of Nursing, Sirnak University, Department of Child Health and Diseases Nursing, Faculty of Health Sciences, Mugla Sitki Kocman University, Department of Pediatrics, Faculty of Medicine, Istanbul Medipol University, RN, MD, Turkey Abstract BACKGROUND: The management of postoperative pain in children represents a complex and crucial aspect of their care. OBJECTIVE(S): This study was conducted to determine the effect of massage on pain and vital signs in children receiving postoperative care following cardiovascular surgery. METHOD(S): The study was conducted in accordance with a randomized controlled experimental design, with 86 children undergoing cardiovascular surgery in the postoperative period. Patients in the experimental group received classical massage. Pain and vital signs were evaluated in the experimental and control groups. RESULT(S): The mean scores of the children in the experimental and control groups were found to be statistically similar at the pretest measurement. A statistically significant difference was identified between the groups in the mean scores of pain, heart rate, and oxygen saturation at the posttest measurement. CONCLUSION(S): The massage therapy group exhibited reduced postoperative pain compared with the control group, and demonstrated favorable effects on oxygen saturation, respiratory rate, heart rate, and systolic blood pressure. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <136> Accession Number 651569289 Title Intracardiac bone cement embolism and cardiac injury: a systematic review of 116 reported cases. Source Journal of cardiothoracic surgery. (no pagination), 2026. Date of Publication: 20 Jun 2026. Author Shim H.; Jeon C.; Lee S.S.; Cho Y.; Kim S.W.; Chung J.W.; Baek J. Institution (Shim) Division of Cardiac Surgery, University of Rochester Medical Center, Rochester, NY, United States (Jeon) Department of Thoracic and Cardiovascular Surgery, Incheon Sejong Hospital, Incheon, South Korea (Lee) Department of Thoracic and Cardiovascular Surgery, Hanyang University College of Medicine, Changwon Hanmaeum Hospital, Changwon, South Korea (Cho) Medical library, College of Medicine, Yeungnam University, Daegu, South Korea (Kim) Medical Research Center, College of Medicine, Yeungnam University, Daegu, South Korea (Chung) Division of Cardiovascular and Thoracic Surgery, College of Medicine, University of Kentucky, Lexington, KY, United States (Baek) Department of Thoracic and Cardiovascular Surgery, Yeungnam University Medical Center, Yeungnam University College of Medicine, 170 Hyeonchung-ro ,Nam-gu, Daegu, South Korea Abstract BACKGROUND: Intracardiac bone cement embolism (BCE) is a rare but potentially serious complication of spinal augmentation. Clinical awareness remains limited because these events occur at the interface of spine and cardiothoracic specialties. This study synthesizes a collection of strictly intracardiac BCE cases to describe reported clinical features, injury patterns, and management strategies. METHOD(S): A systematic search of PubMed, Embase, and Cochrane (from inception through 2025) identified 116 unique cases after a two-tier adjudication process to eliminate duplicates. Reporting quality was assessed using a modified Joanna Briggs Institute checklist. RESULT(S): The median patient age was 69 years, and 75.9% were female. Most embolic events followed vertebroplasty (67.2%) or kyphoplasty (26.7%). Chest pain (59.5%) and dyspnea (54.3%) were the most common symptoms. Diagnostic yield was high for echocardiography (96.0%) and computed tomography (CT) (93.8%) but lower for chest X-ray (63.4%). Linear cement fragments were frequently associated with perforation (46.6%), most often involving the right ventricle (70.9%). Surgical retrieval was reported in 65.5% of cases, with concomitant structural repair in 19.2%. No deaths were attributable to surgical retrieval, whereas delayed diagnosis or treatment refusal led to fatal outcomes. CONCLUSION(S): Published reports suggest that intracardiac BCE may behave as a mechanically hazardous condition with a substantial risk of perforation. The recurring patterns observed across studies highlight the importance of timely recognition and careful management. These descriptive findings may help inform clinical awareness and generate hypotheses for future investigation. Copyright © 2026. The Author(s). <137> Accession Number 2046592674 Title Risk prediction models for postoperative atrial fibrillation in patients with lung cancer: a systematic review and meta-analysis. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1779009. Date of Publication: 2026. Author Yang F.; Sun T.; Shang Y.; Chen Y.; Wu J.; Shang X. Institution (Yang, Sun) Medicine School of Lishui University, Zhejiang, Lishui, China (Shang) Changchun Humanities and Sciences College, Changchun, China (Chen) Department of Otorhinolaryngology, Lishui Hospital of Wenzhou Medical University, The First Affiliated Hospital of Lishui University, Lishui People's Hospital, Zhejiang, Lishui, China (Wu) Department of Hepatology and Infectious Diseases, Lishui Hospital of Wenzhou Medical University, The First Affiliated Hospital of Lishui University, Lishui People's Hospital, Zhejiang, Lishui, China (Shang) Department of Nursing, Lishui Hospital of Wenzhou Medical University, The First Affiliated Hospital of Lishui University, Lishui People's Hospital, Zhejiang, Lishui, China Publisher Frontiers Media SA Abstract Background - Postoperative atrial fibrillation (POAF) is a common and clinically significant complication following lung cancer surgery, associated with increased morbidity and mortality. Although numerous prediction models have been developed to estimate POAF risk, their overall performance and methodological quality remain unclear. Methods - A systematic review and meta-analysis were conducted in accordance with the PRISMA 2020 guidelines, and the protocol was registered with PROSPERO (CRD42025115874). Chinese and English databases were searched from their inception until 30 May 2024. Studies that developed or validated prediction models for postoperative atrial fibrillation (POAF) in patients with surgically treated lung cancer were included. Data were extracted using the CHARMS checklist and the risk of bias was assessed using PROBAST. A random-effects meta-analysis was performed to pool the discriminative performance of the eligible models, using the area under the curve (AUC). Results - Six studies were included. Most models were developed using logistic regression, with age, sex, cardiovascular comorbidities and surgical factors being the most common predictors. Reported area under the curve (AUC) values ranged from 0.72 to 0.89. The pooled AUC was 0.79 (95% CI: 0.71-0.87), which indicates good overall discrimination. However, substantial heterogeneity was observed (I 2 = 98.7%). Subgroup analysis with consistent outcome definitions showed reduced heterogeneity. All studies were judged to have a high overall risk of bias. Conclusions - Current POAF prediction models for lung cancer patients show acceptable discriminative ability but are limited by methodological weaknesses and lack of external validation, restricting their clinical applicability. Systematic Review Registration - https://www.crd.york.ac.uk/PROSPERO/view/CRD420251158742, identifier CRD420251158742. Copyright © 2026 Yang, Sun, Shang, Chen, Wu and Shang. <138> Accession Number 2046895250 Title Total intravenous anesthesia on the quality of early recovery in patients with pulmonary tuberculosis undergoing argon plasma coagulation. Source Chinese Journal of Clinical Research. 38(12) (pp 1852-1857), 2025. Date of Publication: 01 Dec 2025. Author Li Y.; Wang J.; Zhang W.; Leng W.; Zhang C. Institution (Li, Wang, Zhang, Leng, Zhang) Department of Anesthesia, Second Hospital of Nanjing, Nanjing Hospital Affil ated to Nanjing University of Chinese Medicine, Jiangsu, Nanjing, China Publisher Editorial Department of Chinese Journal of Clinical Research Abstract Objective To compare the effects of total intravenous anesthesia (TIVA) and inhalation anesthesia on early postoperative recovery quality, adverse events and postoperative deliriurn in patients with pulmonary tuberculosis undergoing argon plasma coagulation (APC). Methods A total of 90 pulmonary tuberculosis patients who underwent APC at Second Hospital of Nanjing from September 1st, 2022, to September 30th, 2024, were prospectively selected. The patients were randomly divided into Group T and Group I, with 45 patients in each group. In the Group T, propofol-based TIVA and routine medications were used for anesthesia induction, while in the Group I, sevoflurane- based inhalation anesthesia and routine medications were used. The following parameters were recorded: general data, surgery duration, anesthesia duration, extubation time, time to leave the operating room, fluid replacement volume, (vital signs, intraoperative adverse events, and cough intensity during extubation. Postoperative recovery was assessed over the first 7 days, including pain [using the Visual Analog Scale (VAS)], nausea and vomiting, dizziness, recovery quality [using the 15-item Quality of Recovery (QoR-15) scale], and the occurrence of delirium [using the Confusion Assessment Method for the Intensive Care Unit, (CAM- ICU)]. Results There was a significant time effect on mean arterial pressure (MAP), heart rate, and saturation of peripheral oxygen (SpO2) in both groups (P<0.05), but no significant group effect or interaction effect was observed (Q0.05). Pairwise comparisons showed that MAP decreased after induction in both groups (P<0.05). Heart rate was lower in Group T than in Group I when leaving the operating room, Heart rate decreased intraoperatively in both groups (P<0.05), but Heart rate in Group I before anesthesia exceeded that when leaving the operating room ((P<0.05); SpO2 increased after induction but was lower before anesthesia than that when leaving the operating room (P<0.05). There was no significant differences in the incidence of hypotension, hypertension, hypoxemia, or bradycardia between the two groups (p>0.05), but the incidence rates of tachycardia was lower in Group T than that in Group I (15.56% vs 62.22%, chi2 =20.618, P<0.01). There was no significant difference in cough intensity at extubation between the two groups (2=1.567, P=0.117). There was no significant difference in VAS and QoR-15 scores between the two groups (p>0.05). Compared with preoperative day 1, (both groups had decreased QoR-15 scores on postoperative day 1 and day 2 (P<0.05). There was no significant difference in the incidence of delirium on postoperative day 1 between Groups I and (11.11% vs 8.89%, chi =0.123, P=0.725). The incidence of dizziness in Group T was significantly lower than that in Group I at 4 hours postoperatively (P<0.05). Similarly, the incidences of nausea and vomiting were significantly lower in Group T compared to Group I at 2, 4, and 6 hours postoperatively (P<0.05). Conclusion In pulmonary tuberculosis patients undergoing APC, total intravenous anesthesia showed more stable blood pressure and heart rate control compared to inhalation anesthesia, as well as a lower incidence of nausea, vomiting, and dizziness. Copyright © (2025), (Editorial Department of Chinese Journal of Clinical Research), All Rights Reserved. <139> Accession Number 2047133538 Title Impact of Social Support on Patient-Reported Outcomes in Cardiothoracic Surgery: A Systematic Review. Source Journal of Surgical Research. 325 (pp 576-586), 2026. Date of Publication: 01 Sep 2026. Author Adebayo O.W.; Ansari M.; Naeem W.; Brooks C.; D'Alise L.; Khan A.A.; Westrick J.C.; Juarez L.; Casanova T.; Alex G.C.; Geissen N.M.; Liptay M.J.; Seder C.W. Institution (Adebayo, Ansari, Naeem, D'Alise, Casanova, Alex, Geissen, Liptay, Seder) Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, Illinois, United States (Brooks) College of Medicine, University of Illinois Chicago, Chicago, Illinois, United States (Khan) Washington University, Department of General Surgery, St. Louis, Missouri, United States (Westrick, Juarez) Rush University Medical Center Library, Chicago, Illinois, United States Publisher Academic Press Inc. Abstract Introduction: Disparities in cardiothoracic surgery recovery outcomes highlight the need to understand the impact of social determinants, such as social support, on patient-reported outcomes (PROs). This systematic review synthesizes evidence on the relationship between social support and PROs following cardiothoracic surgery. Method(s): Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched PubMed/MEDLINE, Embase, CINAHL, and Cochrane CENTRAL. Three reviewers screened studies independently, with a fourth resolving conflicts. Included studies examined adult cardiothoracic surgery patients and assessed the association between social support and at least one PRO domain: physical functioning, mental health, symptom burden, or health-related quality of life. Result(s): Thirty-one studies (N = 10,920) met the inclusion criteria. Only 26.1% of participants were women, and 10.5% were racial minorities. Most studies found that emotional, informational, tangible, and physical support were positively associated with improved PROs, including better mental health, physical recovery, and lower symptom burden. However, women received less support and reported greater anxiety, fatigue, and depression. Racial and ethnic minorities were underrepresented, and no studies directly compared outcomes across racial/ethnic subgroups. Conclusion(s): Social support is associated with improved PROs following cardiothoracic surgery, yet key disparities persist. Women and racial minorities remain underrepresented in this literature, and their outcomes are poorly characterized. Future research should focus on inclusive study designs and targeted interventions to enhance support and improve outcomes for underserved populations. Copyright © 2026 Elsevier Inc. <140> Accession Number 2046749463 Title Management of Persistent Air Leak. Source Journal of Respiration. 6(2) (no pagination), 2026. Article Number: 8. Date of Publication: 01 Jun 2026. Author Serna S.; Khan M.; Shingada K.; Podder S.; Singh H.; Benn B.S.; Verga S.; Malsin E.; Kurman J.S. Institution (Serna, Khan, Shingada, Podder, Singh, Verga, Malsin, Kurman) Division of Pulmonary & Critical Care, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI, United States (Benn) Pulmonary Department, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, OH, United States Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Alveolar-pleural or broncho-pleural fistulas, leading to persistent air leaks (PALs), are associated with prolonged hospitalization and substantial morbidity. While guidelines advocate surgical repair as the primary treatment, its efficacy is limited. For patients recently subjected to thoracic surgery or those for whom surgery is contraindicated due to severe illness, viable treatment alternatives have been lacking. This article reviews the newer and less invasive treatment options for PALs. Further research is crucial, including randomized controlled trials comparing these options, and long-term monitoring of intervention outcomes is warranted. Copyright © 2026 by the authors. <141> Accession Number 2046682929 Title Preoperative neutrophil-to-lymphocyte ratio and systemic immune-inflammation index as prognostic biomarkers for postoperative pneumonia and pulmonary complications after thoracic surgery: a systematic review and meta-analysis. Source Frontiers in Medicine. 13 (no pagination), 2026. Date of Publication: 05 Jun 2026. Author Yin X.; Du S. Institution (Yin) Department of Anesthesiology, Aerospace Center Hospital, Beijing, China (Du) Department of VIP Dental Service, Peking University Stomatological Hospital, Beijing, China Publisher Frontiers Media SA Abstract Background - Postoperative pneumonia and pulmonary complications are major adverse events following thoracic surgery. The neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII), two circulating immune-inflammatory biomarkers derived from routine complete blood counts, have been individually associated with postoperative outcomes, but no quantitative synthesis has specifically evaluated their prognostic value for pulmonary outcomes after lung resection or esophagectomy. Methods - A systematic search of PubMed, Embase, Web of Science, Scopus, CENTRAL, CNKI, and Wanfang Data was conducted from inception to 11 April 2026. Observational studies reporting associations between preoperative NLR and/or SII and postoperative pneumonia or pulmonary complications in adults undergoing lung resection or esophagectomy were eligible. A hierarchical framework prioritized continuous associations as the primary synthesis, with categorical high-versus-low comparisons as secondary. Random-effects models with restricted maximum likelihood estimation and the Hartung-Knapp adjustment were used, and certainty of evidence was assessed using GRADE. Results - Eight retrospective cohort studies comprising 3, 936 patients were included. Higher preoperative NLR and SII showed directionally consistent associations with increased postoperative pulmonary risk across all analyses. For NLR, continuous analyses suggested an approximately twofold increase in the odds of postoperative pneumonia per one-unit increment, and categorical analyses an approximately fourfold increase above study-specific thresholds. For SII, the continuous association was more modest, while categorical analyses indicated more than twice the odds above study-specific cut-offs. However, Hartung-Knapp confidence intervals crossed unity in three of the four pooled analyses, reflecting the very small number of contributing studies (k = 2-3 per analysis), and the overall certainty of evidence was low to very low. Conclusion - Higher preoperative NLR and SII may be associated with an increased risk of postoperative pneumonia and related pulmonary complications after thoracic surgery, but the evidence base remains small, exclusively retrospective, and geographically concentrated. These low-cost immune-inflammatory indices should be regarded as promising, hypothesis-generating prognostic markers that require confirmation in larger, prospective, and methodologically standardized studies before they can be considered for routine perioperative risk stratification. Systematic review registration - https://www.crd.york.ac.uk/PROSPERO/view/CRD420261329394, identifier PROSPERO (CRD420261329394). Copyright © 2026 Yin and Du. <142> Accession Number 2046687355 Title Computational modelling for personalized transcatheter aortic valve replacement planning: a systematic review of complications and decision support. Source Frontiers in Digital Health. 8 (no pagination), 2026. Article Number: 1832926. Date of Publication: 04 Jun 2026. Author Rauseo E.; Bevis L.; Chen X.; Petersen S.E.; Mathur A.; Slabaugh G.G.; Roney C.H. Institution (Rauseo, Petersen, Slabaugh) William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom (Rauseo, Petersen, Mathur) Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom (Rauseo, Bevis, Chen, Slabaugh, Roney) Digital Environment Research Institute, Queen Mary University of London, London, United Kingdom (Bevis, Slabaugh, Roney) School of Engineering and Materials Science, Queen Mary University of London, London, United Kingdom (Chen) Department of Medicine, University of Cambridge, Cambridge, United Kingdom (Petersen, Mathur) NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom (Mathur) Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom (Slabaugh) The British Library, John Dodson House, Alan Turing Institute, London, United Kingdom Publisher Frontiers Media SA Abstract Patient-specific digital simulation is emerging as a tool to support personalized planning of transcatheter aortic valve replacement (TAVR), particularly as the procedure expands to younger, lower-risk patients, and more complex anatomies. Despite procedural advances, complications such as paravalvular leak, conduction disturbances, coronary obstruction, and aortic injury remain important determinants of outcome. Current pre-procedural planning relies heavily on computed tomography-based anatomical assessment, which is indispensable but largely static and cannot fully capture dynamic device-tissue interactions, and haemodynamic mechanisms underlying many procedural events. Computational modelling derived from patient-specific imaging can extend this assessment by simulating valve deployment, device-tissue contact, and flow, offering mechanistic insight and potential support for individualized procedural decision-making. This systematic review evaluates modelling approaches addressing TAVR complications and procedural planning, including high-risk scenarios such as bicuspid valves and valve-in-valve procedures. Across the literature, modelling enables patient-specific simulations and exploration of procedural strategies that may reduce complication risk. However, clinical translation remains limited by small study populations, heterogeneous methodologies, limited patient-specific validation, and lack of integration into routine workflows. Future progress will require validation against clinically meaningful endpoints, scalable digital infrastructure, and close collaboration between clinicians and engineers to incorporate simulation outputs into routine Heart Team decision-making. Copyright © 2026 Rauseo, Bevis, Chen, Petersen, Mathur, Slabaugh and Roney. <143> Accession Number 651547832 Title Evaluation of Antithrombin III Utilization in Cardiovascular Surgery Requiring Cardiopulmonary Bypass-A Retrospective Review of Institutional Practice. Source American Journal of Hematology. Conference: Thrombosis and Hemostasis Summit of North America, THSNA 2026. Portland United States. 101(Supplement 2) (pp 129), 2026. Date of Publication: 01 Jun 2026. Author Pechenko E.; Osborn J.; Breeding J.; Pachpande V. Institution (Pechenko, Osborn, Pachpande) M Health Fairview University, Minnesota Medical Center, Minneapolis, MN, United States (Breeding) M Health Fairview Southdale Hospital, Edina, MN, United States Publisher John Wiley and Sons Inc Abstract Background: Antithrombin III (AT) is a critical serine protease inhibitor that enhances heparin-mediated anticoagulation during cardiopulmonary bypass (CPB). Acquired AT deficiency during CPB-due to hemodilution, consumption, and circuit adsorption-can lead to heparin resistance, defined as failure to achieve an activated clotting time (ACT) >= 480 s despite > 500 units/kg of unfractionated heparin. AT concentrate (ATc) is FDA-approved for managing heparin resistance in cardiac surgery; however, recent evidence questions its routine use. While AT supplementation improves laboratory markers (AT activity, heparin sensitivity), randomized trials and meta-analyses have shown no reduction in bleeding or transfusion requirements and have raised safety concerns, including increased acute kidney injury (AKI) and mortality. Objective(s): to evaluate the utilization, efficacy, and safety of ATc in cardiovascular surgeries requiring CPB by examining dosing strategies and criteria for use, assessing ATc impact on achieving target ACT (>= 480 s), and analyzing safety outcomes. Method(s): This retrospective cohort study will include adult patients >= 18 years who underwent cardiac surgery requiring CPB and received ATc between January 1, 2022, and October 31, 2025, at M Health Fairview hospitals. Data collected will include demographics (age, sex, weight, and BMI), comorbidities (hypertension, diabetes, liver disease, prior thromboembolism), surgical type and urgency, baseline laboratory parameters (INR, PTT, anti-Xa, platelet count, AT activity, hemoglobin, serum creatinine), and preoperative anticoagulation. Perioperative details will include heparin dosing in units/kg, dose of ATc administered, ACT measurements before and after ATc administration, and timing of CPB initiation. The primary outcome is resolution of heparin resistance, defined as achieving ACT >= 480 s after ATc administration. Secondary outcomes include in-hospital mortality, ICU length of stay, acute kidney injury (AKI), and incidence of bleeding events-measured by postoperative chest tube output in the first 12 h, the number of packed red blood cell (pRBC) units transfused within 24 h, and whether surgical re-exploration for bleeding occurred during hospitalization-as well as overall transfusion requirements (fresh frozen plasma [FFP], pRBC, platelets, 4-factor prothrombin complex concentrate, fibrinogen concentrate) and thromboembolic events (stroke, venous thromboembolism [VTE], myocardial infarction). Result(s): research in progress Conclusion(s): research in progress <144> Accession Number 651546534 Title Evaluation of Updated Protocol for Intraoperative Antithrombin-III and Unfractionated Heparin Administration During Cardiac Surgery. Source American Journal of Hematology. Conference: Thrombosis and Hemostasis Summit of North America, THSNA 2026. Portland United States. 101(Supplement 2) (pp 49), 2026. Date of Publication: 01 Jun 2026. Author Fannoun R.; Davis S.; Dane K.; Lindsley J.; Buck M.; Crow J.; Ariyo P. Institution (Davis, Dane, Lindsley, Buck, Crow, Ariyo) The Johns Hopkins Hospital, Baltimore, MD, United States Publisher John Wiley and Sons Inc Abstract Background: Cardiac surgery with cardiopulmonary bypass (CPB) necessitates systemic anticoagulation to prevent thrombosis in the extracorporeal circuit. Weight-based unfractionated heparin (UFH), typically 300-400 units/kg, is administered to achieve activated clotting times (ACT) above 400-480 s before CPB initiation. Heparin resistance, defined as failure to achieve target ACT despite standard UFH dosing, affects up to 20% of cardiac surgery patients. Contributing factors include antithrombin III (ATIII) deficiency, elevated fibrinogen, paraprotein, or heparin neutralization by platelet factor 4 and other heparin-binding proteins. Current blood conservation guidelines support ATIII concentrate administration for heparin resistance. Although ATIII administration improves heparin responsiveness, randomized controlled trials have failed to demonstrate improvements in clinical outcomes in adults, and a meta-analysis has raised concern for a potential signal of harm. Given the multifactorial nature of heparin resistance, high ATIII cost, and emerging safety concerns, a revised intraoperative anticoagulation protocol for CPB was implemented at a large academic medical center. Key changes included increasing initial UFH bolus, administration of two to three units of fresh frozen plasma (FFP) before ATIII consideration, and restricted ATIII use to cases with persistent ACT < 480 s despite cumulative administration of UFH boluses of > 650 units/kg. Objective(s): To determine whether the updated intraoperative anticoagulation protocol for CPB altered UFH dosing patterns, ATIII utilization, ACT response, and transfusion-related outcomes in patients undergoing CPB. Method(s): This IRB-approved retrospective cohort study will include adults undergoing cardiac surgery with CPB between September 2022 and February 2023 (preimplementation) and April 2023 and September 2023 (post-implementation). Data will be obtained from the Society of Thoracic Surgeons registry and electronic medical records. Primary outcomes include UFH dosing prior to CPB initiation, UFH dosing prior to FFP or ATIII administration, the number of ATIII administrations, and the proportion of cases requiring ATIII. Secondary outcomes include ACT at the time of CPB initiation, maximum ACT, time from UFH bolus to CPB, intraoperative blood loss, red blood cell transfusion, prothrombin complex concentrate use, and the frequency of ACT values exceeding the assay's upper limit. Continuous variables will be analyzed using independent t-tests or Wilcoxon rank-sum tests, and categorical variables will be analyzed using chi-square testing. Result(s): Data retrieval and cohort construction will begin following completion of the approved data pull. Conclusion(s): This study will evaluate the clinical and stewardship impact of a revised anticoagulation strategy incorporating higher initial UFH dosing, FFP administration before ATIII, and conditional ATIII supplementation. Findings will help guide evidence-based, cost-conscious anticoagulation practices for CPB.

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