EPICORE Embase Updates

Total documents retrieved: 125 Results Generated From: Embase <1980 to 2026 Week 43> Embase Weekly Updates (updates since 2026-10-19) - (125 records) <1> Accession Number 2045729304 Title Time- and risk-dependent effects of dual antiplatelet therapy targeting the P2Y12 receptor after CABG: A network meta-analysis of graft permeability and clinical outcomes. Source Journal of Thrombosis and Thrombolysis. 59(7) (pp 1711-1727), 2026. Date of Publication: 01 Oct 2026. Author Zhou Y.; Zhang X.; Gui W.; Xie J.; Chen J.; Song Y.; Ma R. Institution (Zhou, Zhang, Xie, Chen, Ma) Department of Cardiac Surgery, Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical University, Yunnan Province, Kunming, China (Gui, Song) Department of Cardiacpulmonary Bypass, Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences/Affiliated Cardiovascular Hospital of Kunming Medical University, Yunnan Province, Kunming, China Publisher Springer Abstract The optimal anticoagulation strategy following Coronary artery bypass grafting remains undetermined, particularly regarding the balance between graft patency, ischemic events, and bleeding across different follow-up periods and risk profiles. A systematic search was conducted in PubMed, Embase, Web of Science, and the Cochrane Database to identify randomized controlled trials comparing regimens of aspirin, DAPT (clopidogrel or ticagrelor), and rivaroxaban. The primary angiographic endpoints were saphenous vein graft(SVG) patency and the left internal mammary artery(LIMA) occlusion; clinical endpoints included myocardial infarction, major adverse cardiovascular events(MACE), major bleeding, and all-cause mortality. A random-effects network meta-analysis was conducted, reporting odds ratios (OR) and 95% CIs, with pre-specified 1-year follow-up stratification and multiple subgroup analyses.The primary analysis included 17 RCTs with 1-year follow-up (9,831 patients). SVG occlusion: Aspirin plus ticagrelor (OR = 0.41,95% CI:0.30-0.56) and aspirin plus clopidogrel (OR = 0.59, 95% CI: 0.44-0.78) were both significantly superior to aspirin monotherapy. MACE: Compared with aspirin monotherapy, no anticoagulation strategy showed a statistically significant difference. Major bleeding: Aspirin plus ticagrelor (OR = 2.53,95% CI:1.59-4.04) and rivaroxaban monotherapy (OR = 2.33, 95% CI: 1.01-5.37) significantly increased the risk. No strategy showed statistically significant differences in myocardial infarction or all-cause mortality. No clear conclusions could be drawn regarding LIMA occlusion due to the rarity of events. Subgroup analysis: In the subgroups of off-pump CABG (OR = 0.42, 95% CI: 0.19-0.90) and early initiation <= 48 h (OR = 0.47, 95% CI: 0.29-0.75), the combination of aspirin and ticagrelor significantly reduced MACE; however, the risk of bleeding increased with this regimen when initiation was delayed (> 48 h) (OR = 2.51, 95% CI: 1.52-4.16). Sensitivity analyses showed that the conclusions regarding SVG occlusion and major bleeding were highly robust (the direction and significance of ORs remained consistent across all sensitivity scenarios), whereas estimates for MACE and all-cause mortality were sensitive to specific studies. The net benefit of post-CABG antithrombotic therapy is time- and patient-specific. DAPT (particularly aspirin plus clopidogrel) offers the optimal balance between revascularization protection and bleeding risk; the ticagrelor regimen provides stronger ischemic protection but comes at a higher cost of bleeding; the rivaroxaban regimen is not suitable for routine use. An individualized antithrombotic strategy based on risk stratification is recommended. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <2> Accession Number 2044511199 Title Multicentre, adaptive, double-blind, three-arm, placebo-controlled, non-inferiority trial examining antimicrobial prophylaxis duration in cardiac surgery (CALIPSO): trial protocol. Source BMJ Open. 16(3) (no pagination), 2026. Date of Publication: 01 Mar 2026. Author Stewardson A.J.; Peleg A.Y.; Forster S.; Berkovic D.; Myles P.S.; Peel T.; Stewardson A.; Myles P.; McGiffin D.; Smith J.; Marasco S.; Pilcher D.; Peleg A.; Forbes A.; Petrie D.; Wisniewski J.; Roney J.; Druce P.; Astbury S.; McCracken P. Institution (Peel) Infectious Diseases, Monash University, Melbourne, VIC, Australia (Peel, Stewardson, Roney) Infectious Diseases, Alfred Hospital, Melbourne, VIC, Australia (McGiffin) Cardiothoracic Surgery, Monash University Faculty of Medicine Nursing and Health Sciences, Melbourne, VIC, Australia (McGiffin, Wisniewski) Alfred Hospital, Melbourne, VIC, Australia (Smith) Cardiothoracic Surgery, Monash Medical Centre Clayton, Clayton, VIC, Australia (Smith) Department of Surgery, School of Clinical Sciences, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, VIC, Australia (Forbes) School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, Australia (Marasco) Cardiothoracic Surgery, Alfred Hospital, Melbourne, VIC, Australia (Pilcher) Australian and New Zealand Intensive Care Society Centre for Outcomes and Resource Evaluation, Melbourne, VIC, Australia (Stewardson, Peleg) Centre to Impact AMR, Monash University, Melbourne, VIC, Australia (Petrie) Centre for Health Economics, Monash University, Melbourne, VIC, Australia (Peleg, Astbury) Department of Infectious Diseases, Monash University, Clayton, VIC, Australia (Peleg) Monash University Monash Biomedicine Discovery Institute, Clayton, VIC, Australia (Forster) Hudson Institute of Medical Research, Clayton, VIC, Australia (Druce, Myles) Anaesthesiology and Perioperative Medicine, Monash University, Melbourne, VIC, Australia (Druce) Anaesthesiology and Perioperative Medicine, Alfred Health, Melbourne, VIC, Australia (Berkovic) Monash University, Clayton, VIC, Australia (Mccracken) Bayside Health, Melbourne, VIC, Australia (Mccracken) Monash University, Melbourne, VIC, Australia (Myles) Anaesthesiology and Perioperative Medicine, Alfred Hospital, Melbourne, VIC, Australia Publisher BMJ Publishing Group Abstract IntroductionAdministration of antibiotics before incising the skin ('surgical antimicrobial prophylaxis') is a critical infection prevention strategy in surgery. Extending doses of prophylaxis into the postoperative period is a common practice in cardiac surgery; however, the benefit has not been clearly established and may lead to emergence of antimicrobial resistance and patient harm. We present the protocol for a large international multicentre, adaptive, pragmatic, double-blind, three-arm, placebo-controlled, randomised, non-inferiority clinical trial to compare the incidence of surgical site infection after three different durations of postoperative surgical antimicrobial prophylaxis in patients undergoing cardiac surgery.Methods and analysisThis adaptive, multi-arm multistage non-inferiority trial will compare intraoperative only (Arm A), to intraoperative and 24 hours (Arm B) and, to intraoperative and 48 hours (Arm C) of intravenous cefazolin and placebo as surgical antimicrobial prophylaxis in 9180 patients undergoing cardiac surgery. The adaptive design allows for potential dropping of any of the three arms if clear inferiority is indicated at any of the scheduled interim analyses. The trial will evaluate the clinical and cost-effectiveness of the three different antibiotic prophylaxis durations.Ethics and disseminationEthics approval will be obtained at all participating sites. Results of the study will be submitted for publication in peer-reviewed journals and the key findings presented at national and international conferences. Patients and members of the public will also be involved in the dissemination and translation of the trial results.Trial registration numberNCT05447559. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. <3> Accession Number 2042256297 Title Prognostic Value of the Systemic Immune-Inflammation Index in Patients With Acute Myocardial Infarction: A Systematic Review and Meta-Analysis. Source Angiology. 77(10) (pp 1219-1234), 2026. Date of Publication: 01 Nov 2026. Author Du Y.; Deng X.; Song Y.; Yan J. Institution (Du, Deng, Song, Yan) Department of General Medicine, The People's Hospital of Leshan, Sichuan, China Publisher SAGE Publications Inc. Abstract The present review and meta-analysis evaluated the prognostic value of the Systemic Immune-Inflammation Index (SII) for patients with acute myocardial infarction (AMI) based on a search of PubMed, Embase, Cochrane Library, and Web of Science up to May 2024. Predefined inclusion and exclusion criteria were applied, with sensitivity and subgroup analyses performed to evaluate heterogeneity and assess the robustness of the findings. A total of 21 studies, including 13 771 patients with either ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI), were analyzed. Higher SII levels were consistently associated with an increased risk of major adverse cardiovascular events (MACE) in AMI patients (odds ratio [OR]: 1.09; 95% confidence interval [CI]: 1.04-1.13; P < .0001) across various study designs, regions, and sample sizes. Elevated SII was significantly linked to MACE in STEMI patients, though not in NSTEMI patients. Additionally, high SII levels correlated AMI is divided into high SII group and low SII group. There is a significant correlation between the incidence of no-reflow in the high SII group with increased risks of no-reflow post-percutaneous coronary intervention (PCI), left ventricular adverse remodeling, and all-cause mortality, regardless of study factors (ie, research type, population characteristics, region, and sample size). Elevated SII is a significant predictor of adverse outcomes in AMI patients, especially for forecasting MACE in STEMI cases. Copyright © The Author(s) 2025 <4> Accession Number 2049592248 Title Preoperative and postoperative ultrasound guided intercostal nerve blockade on postoperative analgesia in patients undergoing video assisted thoracic surgery (VATS): a prospective randomized comparative study. Source Frontiers in Medicine. 13 (no pagination), 2026. Article Number: 1825123. Date of Publication: 2026. Author Xie N.; Luo L.; Zhu Y.; Zhu M.; Wang X. Institution (Xie, Zhu, Zhu, Wang) Fudan University Shanghai Cancer Center, Shanghai, China (Luo) Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China Publisher Frontiers Media SA Abstract Objectives - Ultrasound-guided intercostal nerve block (ICNB) is an effective modality for alleviating pain after video-assisted thoracic surgery (VATS). However, the optimal timing for its administration remains controversial. This study aimed to compare the analgesic efficacy of preoperative versus postoperative ICNB in patients undergoing VATS. Methods - A total of 172 adult patients undergoing VATS were randomized into two parallel groups: the pre-ICNB group (preoperative ultrasound-guided ICNB, n = 88) and the post-ICNB group (postoperative ultrasound-guided ICNB, n = 84). The primary outcome was the incidence of at least one episode of moderate-to-severe pain at rest (Numeric Rating Scale [NRS] score > 4) during the first 24 h postoperatively. Secondary outcomes included NRS scores during coughing, perioperative opioid consumption, sleep quality, and the incidence of postoperative complications. Results - The incidence of moderate-to-severe resting pain during the first 24 h postoperatively was significantly lower in the post-ICNB group than in the pre-ICNB group (11.9% vs. 28.4%, P < 0.05). Both static (at rest) and dynamic (during coughing) NRS scores were significantly lower in the post-ICNB group at 4, 6 and 8 h postoperatively (P < 0.05); however, comparable pain scores were observed upon admission to the post-anesthesia care unit (PACU) and at 2, 24, and 48 h postoperatively (P > 0.05). Cumulative postoperative opioid consumption at 24 and 48 h was significantly lower in the post-ICNB group (P < 0.01). Furthermore, patients in the post-ICNB group exhibited superior sleep quality during the first two postoperative nights (P < 0.01). No significant differences were observed in total (intraoperative + postoperative) opioid consumption, overall recovery quality, or surgical/anesthetic complications. Conclusion - Postoperative ICNB provides superior early postoperative analgesia, reduces postoperative opioid requirements, and improves sleep quality compared with preoperative ICNB. These findings suggest that postoperative administration is a more effective strategy for acute pain management following VATS. Clinical trial registration - https://www.chictr.org.cn/showproj.aspx?proj=183278, identifier ChiCTR2300079183. Copyright © 2026 Xie, Luo, Zhu, Zhu and Wang. <5> Accession Number 2049239224 Title Computational modeling of thrombosis after transcatheter aortic valve implantation: A systematic review of hemodynamic and mechanical risk metrics. Source Computer Methods and Programs in Biomedicine. 287 (no pagination), 2026. Article Number: 109644. Date of Publication: 01 Dec 2026. Author Erina Y.; Kuchumov A.G. Institution (Erina, Kuchumov) Scientific Center of Genetics and Life Sciences, Sirius University of Science and Technology, Olympic Avenue 1, Sirius, Russian Federation (Kuchumov) Biofluids Laboratory, Perm National Research Polytechnic University, Professor Pozdeev Street 11, Perm, Russian Federation Publisher Elsevier Ireland Ltd Abstract Background and objective Although transcatheter aortic valve implantation (TAVI) generally provides favorable procedural outcomes, thrombotic complications remain an important concern for the long-term performance and durability of transcatheter heart valves. A subset of patients develops hypo-attenuated leaflet thickening (HALT), reduced leaflet mobility, or late thrombotic complications, often in the absence of overt clinical manifestations. This has motivated the use of computational modeling to investigate post-TAVI hemodynamics and valve mechanics and to identify flow- and device-related factors associated with thrombus formation. Methods In this review, we systematically analyze 68 computational studies focused on post-TAVI hemodynamics and thrombosis. The literature is organized into three categories based on their relevance to thrombogenic risk modeling: Peripheral (31 studies), Intermediate (21 studies), and Core (16 studies). This classification reflects the presence of hemodynamic modeling, the use of dedicated proxy metrics of thrombogenicity, and the extent to which thrombosis constitutes the primary focus of the investigation. We further examine the methodological spectrum of existing approaches, including computational fluid dynamics, fluid-structure interaction, and finite element analysis; the use of patient-specific versus idealized geometries; and the application of thrombogenicity-related metrics, such as residence time and washout indices, wall shear stress-based measures, and stress-history-based indicators of mechanical platelet activation. Results Our study shows that while direct simulation of thrombus formation is still mostly lacking, most published studies use indirect hemodynamic and mechanical proxies to evaluate thrombogenic risk. The existence and geometry of paravalvular leaks, valve implantation depth, asymmetric stent expansion, and patient-specific characteristics of aortic root architecture are the risk factors that are most frequently reported across studies. Notably, research in the Core category shows a distinct move away from descriptive flow analyzes and toward a more mechanistic understanding of thrombogenic risk, connecting the cumulative mechanical exposure of blood constituents, unstable neo-sinus hemodynamics, and implantation parameters. Conclusions Overall, this analysis shows that modern in silico methods already make it possible to compare implantation techniques and valve design elements quantitatively in terms of thrombogenic risk. Simultaneously, a shift from exclusively proxy-based evaluations to hybrid and multiscale modeling frameworks that incorporate geometry, hemodynamics, and a minimally adequate description of the biological mechanisms behind thrombus formation will be necessary for future advancements in the field. Copyright © 2026 Elsevier B.V. <6> Accession Number 2050187123 Title Effects of postoperative educational interventions on psychological, self-management, and quality-of-life outcomes after coronary artery bypass grafting: a systematic review and meta-analysis. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1866764. Date of Publication: 01 Oct 2026. Author Si S.; Li C.; Qi M.; Ge J. Institution (Si, Li, Qi) Department of Nursing, The Fourth Affiliated Hospital of School of Medicine and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, China (Ge) Department of Cardiology, The Fourth Affiliated Hospital of School of Medicine and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, China Publisher Frontiers Media SA Abstract Background - Postoperative education is an important component of recovery after coronary artery bypass grafting (CABG), but its overall effects on psychological, self-management, and quality-of-life outcomes remain unclear. This systematic review and meta-analysis aimed to evaluate the effects of postoperative educational interventions in patients undergoing CABG. Methods - PubMed, Web of Science, Embase, Cochrane Library, Scopus, and CINAHL were searched from inception to March 2026. Randomized controlled trials (RCTs) enrolling adult patients undergoing CABG were included if they compared postoperative educational interventions with routine care. Meta-analysis was conducted using Stata/MP 18.0. Pooled effects were calculated as standardized mean differences (SMDs) with 95% confidence intervals (CIs). A random-effects model was used when substantial heterogeneity was present; otherwise, a fixed-effect model was applied. Leave-one-out sensitivity analyses were performed when appropriate. Results - Fourteen studies involving 1, 669 participants were included. Postoperative educational interventions significantly reduced anxiety (SMD = -0.48, 95% CI: -0.87 to -0.08) and depression (SMD = -0.42, 95% CI: -0.71 to -0.14), and significantly improved physical functioning (SMD = 0.30, 95% CI: 0.08 to 0.52). Mental functioning showed a favorable but non-significant trend (SMD = 0.26, 95% CI: -0.01 to 0.53). The pooled effect on self-efficacy was not statistically significant (SMD = 1.08, 95% CI: -1.12 to 3.29), with substantial heterogeneity. Self-power improved significantly (SMD = 0.54, 95% CI: 0.19 to 0.89), but this finding was based on only two studies. Subgroup analyses suggested that intervention effects varied according to the dominant intervention format. Conclusions - Postoperative educational interventions appear to reduce anxiety and depression and improve physical functioning in patients after CABG. However, the current evidence does not support significant improvements in mental functioning or self-efficacy. Given the limited number of included studies, the finding for self-power should be interpreted cautiously. Copyright © 2026 Si, Li, Qi and Ge. <7> Accession Number 2050387019 Title Repurposing landscape of N-acetylcysteine: A scoping review of reviews toward clinical translation. Source PLOS One. 21(10 October) (no pagination), 2026. Article Number: e0360434. Date of Publication: 01 Oct 2026. Author Al Alaili M.K. Institution (Al Alaili) Clinical Pharmacy, Saida, Lebanon Publisher Public Library of Science Abstract Background: Growing interest in drug repurposing and oxidative stress has heightened attention on N-acetylcysteine (NAC). Despite the abundance of reviews across diverse clinical domains, clinical translation remains limited. This review seeks to map the existing evidence, identify critical gaps, and outline priorities for future research. Method(s): Five databases were systematically searched to identify relevant reviews based on predetermined inclusion and exclusion criteria. Comprehensive data extraction enabled meaningful evidence mapping. To enhance rigor, critical appraisal was conducted using two validated tools assessing methodological quality and risk of bias, thereby allowing stratification of evidence. Additionally, the corrected covered area (CCA) was calculated to detect potential evidence inflation or redundancy. Result(s): Among the 140 retrieved reviews spanning 17 clinical domains, only 63 were systematic reviews with meta-analysis, representing the highest level of evidence included in this study. Approximately half of these supported NAC repurposing. Beyond its antioxidant, anti-inflammatory, and glutamatergic modulatory roles, which were most frequently reported, several additional mechanisms have been proposed. The number of NAC reviews has increased over time, with most originating from China and the United States. Appraisals revealed a high prevalence of critically low-quality systematic reviews, alongside a notable proportion of reviews with low risk of bias. Finally, CCA analysis demonstrated substantial overlap and redundancy across domains, particularly within subdomains. Conclusion(s): This novel overview mapped the extensive NAC evidence landscape, highlighting its pleiotropic roles and repurposing potential while revealing possible research waste and critical gaps across domains and evidence levels. Psychiatry, reproductive medicine, nephrology, pulmonology, and toxicology emerged as priority clinical domains for future exploration. However, the overall inconsistency in review certainty remains a barrier to the integration of NAC into clinical guidelines. By delineating research priorities and highlighting new avenues, this review underscores the need for precision medicine approaches to guide future NAC clinical implementation and research. Copyright © 2026, Mohammed Khaled Al Alaili. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. http://creativecommons.org/licenses/by/4.0/ <8> Accession Number 2038669030 Title Guarding the Threshold: Depth-of-Anesthesia Monitoring and its Impact on the Neuroendocrine-Inflammatory Stress Response: A Systematic Review. Source Natural Resources for Human Health. 6(12S) (pp 39-47), 2026. Date of Publication: 08 Sep 2026. Author Hemaidah E.G.S.; Omar A. Institution (Hemaidah) Department of Anesthesia, Intensive Care, and Pain Management, Faculty of Medicine For girls, Al-Azhar University, Cairo, Egypt (Omar) Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt Publisher Visagaa Publishing House Abstract Background: Intraoperative depth-of-anesthesia (DoA) monitoring using processed-EEG indices (Bispectral Index [BIS], Entropy, Narcotrend) was developed to prevent intraoperative awareness, but a growing body of evidence suggests it may also modulate the neuroendocrine-inflammatory response to surgical stress. This review frames the anesthetic titration strategy itself as the primary exposure and neuroendocrine/inflammatory biomarkers as the outcome, a pairing not addressed by prior reviews in this space. Method(s): MEDLINE/PubMed and general web search (search-engine mediated; institutional access to Embase, Scopus, Web of Science, and Cochrane CENTRAL was not available for this review) were searched for randomized controlled trials and comparative cohort studies evaluating processed-EEG-guided anesthesia against standard or alternative-depth anesthesia, reporting at least one neuroendocrine (cortisol, ACTH, glucose) or inflammatory (IL-6, TNF-alpha, CRP, IL-1beta, IL-10) biomarker. Reference lists of included studies were hand-searched. One identified study was excluded after discovery that it had been formally retracted. Given cross-study heterogeneity, findings were synthesized by vote-counting direction of effect rather than pooled meta-analysis. Result(s): Seven studies (plus one retrospective cohort retained for mechanistic context only) met inclusion criteria, spanning cardiac (CABG/OPCAB), thoracic (VATS lobectomy), and abdominal/gastrointestinal surgery in adult and elderly populations. Monitoring modalities included BIS, Spectral/State Entropy, and Narcotrend. Deeper or monitor-titrated anesthesia favored attenuated TNF-alpha in 3 of 4 studies, lower CRP in 2 of 2 studies, lower IL-1beta in 2 of 2 studies, and lower IL-6 in 2 of 3 studies reporting each marker; no study reported a biomarker moving in the direction of harm under monitor-guided titration for these markers. Conclusion(s): Across a modest but consistent evidence base, anesthetic depth-titration strategy shows a directionally consistent association with attenuated postoperative inflammatory cytokine release, without evidence of harm. The evidence base remains limited in size and heterogeneous in monitoring modality and biomarker timing; a fully resourced multi-database systematic search with formal meta-analysis is needed before these findings can inform practice guidance. Copyright © 2026, Visagaa Publishing House. All rights reserved. <9> Accession Number 2047972551 Title Safety of Flecainide and Propafenone in Patients With Atrial Fibrillation and Structural Heart Disease. Source Journal of Cardiovascular Electrophysiology. 37(10) (pp 2251-2260), 2026. Date of Publication: 01 Oct 2026. Author Singireddy S.; Shoura S.; Venugopal D.; Saravanabavanandan R.; Coombes K.; Baman T.; Shah S. Institution (Singireddy, Shoura, Venugopal, Saravanabavanandan, Coombes, Baman, Shah) Department of Cardiovascular Medicine, University of Illinois College of Medicine, Peoria, IL, United States Publisher John Wiley and Sons Inc Abstract Background: Class Ic antiarrhythmic drugs (AADs) have been contraindicated in patients with structural heart disease since the 1991 Cardiac Arrhythmia Suppression Trial (CAST), which demonstrated increased mortality in post-myocardial infarction patients with ventricular ectopy and reduced ejection fraction. Contemporary guidelines extend this prohibition broadly to coronary artery disease (CAD), heart failure, and other structural heart disease, yet CAST enrolled a narrow population, and the totality of post-CAST evidence across structural heart disease has never been comprehensively synthesized. Objective(s): To systematically evaluate the safety of class Ic AADs (flecainide and propafenone) compared with alternative antiarrhythmic strategies in patients with atrial fibrillation (AF) and structural heart disease, with CAD as the principal prespecified subgroup. Method(s): We searched PubMed, Embase, Cochrane Library, and Web of Science from inception through May 2026 for studies comparing class Ic AAD use with class III AADs, amiodarone, or no antiarrhythmic therapy in patients with AF and structural heart disease (CAD, heart failure, or left ventricular hypertrophy). The primary endpoint was ventricular arrhythmia (VA); secondary endpoints were all-cause mortality and major adverse cardiovascular events (MACE). The primary analysis pooled all structural heart disease populations; CAD was the principal prespecified subgroup, and a test for subgroup differences (CAD vs. non-CAD) was performed. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using restricted maximum likelihood (REML) random-effects models with the Hartung-Knapp adjustment. Heterogeneity was assessed with I2 and Cochran Q statistics. Result(s): Seven studies (N = 35 886) met inclusion criteria; six contributed to quantitative pooling. In the primary analysis across all structural heart disease populations, class Ic AAD use was not associated with increased ventricular arrhythmia risk (pooled HR 0.73; 95% CI 0.51-1.03; p = 0.065; I2 = 88.6%; k = 5), and no individual study reported a statistically significant increase in VA risk. All-cause mortality was numerically lower but did not reach significance after the Hartung-Knapp adjustment (HR 0.47; 95% CI 0.21-1.01; k = 5); MACE was significantly lower with class Ic use (HR 0.54; 95% CI 0.39-0.75; p = 0.010; k = 4). The CAD subgroup was directionally concordant and showed no harm (VA HR 0.80 [95% CI 0.54-1.17]; mortality HR 0.65 [95% CI 0.22-1.91]; MACE HR 0.54 [95% CI 0.29-0.99]). Tests for subgroup differences between CAD and non-CAD populations were nominally significant for VA (p = 0.009) and mortality (p = 0.037) but not MACE (p = 0.92). Substantial heterogeneity was observed across all endpoints. Conclusion(s): Across structural heart disease populations, including a well-powered CAD subgroup, class Ic antiarrhythmic therapy for AF was not associated with excess ventricular arrhythmia risk, and no subgroup demonstrated harm. The absence of a proarrhythmic signal across diverse study designs and substrates provides supportive, though not definitive, hypothesis-generating evidence regarding the safety of these agents in carefully selected patients with stable disease and preserved ventricular function. Prospective randomized trials are needed to confirm these findings. PROSPERO Registration: CRD420261411804. Copyright © 2026 Wiley Periodicals LLC. <10> Accession Number 2049571910 Title Efficacy of serratus anterior plane block on postoperative nausea and vomiting: a meta-analysis of randomized controlled trial. Source Frontiers in Medicine. 13 (no pagination), 2026. Date of Publication: 12 Aug 2026. Author Zeng J.; Li Z.; Gao H.; Ye Y.; Hua J.; Huang D. Institution (Zeng, Li, Gao, Ye, Hua, Huang) Department of Anaesthesiology and Pain Medicine, Jiangnan University Medical Center, No. 2 People's Hospital, Wuxi, China (Zeng, Li, Gao, Hua, Huang) Jiangsu Province Key Laboratory of Anesthesiology and Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, Jiangsu, China (Ye) Wuxi School of Medicine, Jiangnan University, Wuxi, China Publisher Frontiers Media SA Abstract Background - Postoperative nausea and vomiting (PONV) still often occurs after surgery, which adversely affects recovery and patient satisfaction. Serratus anterior plane block (SAPB) has been proposed as a regional anesthesia technique that may reduce PONV indirectly by improving postoperative analgesia and decreasing perioperative opioid requirements. Methods - A systematic review and meta-analysis of the randomized controlled trial (RCT) was conducted to evaluate the impact of SAPB on PONV. From its establishment to April 20, 2026, the central register of PubMed, Embase, CNKI and Cochrane controlled trials was searched. Eligible studies include adults who underwent surgery under general anesthesia with a control group (placebo or no intervention). The main results are the incidence of postoperative nausea and vomiting; the secondary results include postoperative opioid consumption, pain score (visual analog scale, VAS), hospitalization time, the time of first rescue analgesia, and the incidence of headache or hypotension. Random effect element analysis was carried out to gather risk differences (RD) and standardized mean differences (SMD) with 95% confidence intervals (CI). Use GRADE to evaluate the certainty of evidence and apply test sequence analysis (TSA) to evaluate robustness. Results - Twenty RCTs involving 1, 651 patients were included. Compared with control treatment, SAPB was associated with a reduced incidence of postoperative nausea (RD = -0.17; 95% CI: -0.23 to -0.11; I2 = 67%; moderate-certainty evidence). SAPB may also reduce postoperative vomiting, although this finding was borderline and should be interpreted cautiously (RD = -0.13; 95% CI: -0.25 to -0.00; I2 = 79%; moderate-certainty evidence). SAPB reduced fentanyl consumption (SMD = -1.08; 95% CI: -1.86 to -0.31) and remifentanil consumption (SMD = -2.14; 95% CI: -3.25 to -1.03), whereas sufentanil consumption was not significantly reduced. SAPB also improved postoperative pain scores, shortened hospital stay, prolonged the time to first rescue analgesia, and reduced headache incidence. Funnel plot inspection and Egger's and Begg's tests did not suggest significant small-study effects for postoperative nausea. Risk-of-bias concerns were mainly related to insufficient reporting of allocation concealment and blinding procedures. Conclusion - SAPB appears to reduce postoperative opioid requirements and improve analgesia in patients undergoing breast and thoracic surgery. These benefits are associated with a reduced incidence of postoperative nausea and may contribute to enhanced recovery. However, the current evidence does not establish an independent direct antiemetic effect of SAPB, and the effect on postoperative vomiting should be interpreted cautiously. Further high-quality RCTs with standardized opioid and antiemetic protocols are needed to clarify the causal pathway between SAPB, opioid reduction, and PONV. Systematic review registration - https://www.crd.york.ac.uk/prospero/CRD420261373467, identifier CRD420261373467. Copyright © 2026 Zeng, Li, Gao, Ye, Hua and Huang. <11> Accession Number 2047679317 Title Practice-changing updates in the perioperative medicine literature of 2025. Source American Journal of Medicine. 139(12) (pp 1610-1618.e2), 2026. Date of Publication: 01 Dec 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 Publisher Elsevier Inc. 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. <12> Accession Number 2038742773 Title Infective endocarditis following transcatheter valvular interventions (transcatheter aortic valve implantation and transcatheter edge-to-edge repair). Expert opinion of the Association of Valvular Heart Disease and of the Association of Cardiovascular Intervention of the Polish Cardiac Society. Source Kardiologia Polska. 84(9) (pp 1082-1098), 2026. Date of Publication: 30 Sep 2026. Author Plonska-Gosciniak E.; Wojakowski W.; Deja M.; Gosciniak P.; Zatorska K.; Huczek Z.; Tomkiewicz-Pajak L.; Komar M.; Kukulski T.; Mizia-Stec K.; Szachowicz-Jaworska J.; Blach A.; Pacholewicz J.; Kasprzak J.D.; Gasior Z.; Scislo P.; Nowak J.; Hryniewiecki T.; Grygier M.; Ciurzynski M. Institution (Plonska-Gosciniak) Department of Cardiology, Pomeranian Medical University, Szczecin, Poland (Wojakowski) Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland (Deja) Department of Cardiac Surgery, Medical University of Bialystok, Bialystok, Poland (Gosciniak) Independent Unit of Cardiometabolism and Cardio-Oncology, Department of Endocrinology, Metabolic Diseases, and Internal Medicine, Pomeranian Medical University, Szczecin, Poland (Zatorska, Hryniewiecki) Department of Valvular Heart Disease, Cardinal Stefan Wyszynski National Institute of Cardiology, Warszawa, Poland (Huczek) 1st Department of Cardiology, Medical University of Warsaw, Warszawa, Poland (Tomkiewicz-Pajak) The Adult Congenital Heart Diseases, Institute of Cardiology, Jagiellonian University Medical College, St. John Paul II Hospital, Krakow, Poland (Tomkiewicz-Pajak, Komar) St. John Paul II Hospital, Krakow, Poland (Komar) Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland (Kukulski) Clinical Department of Cardiology, Medical University of Silesia in Katowice, Specialistic Hospital, Zabrze, Poland (Mizia-Stec, Gasior) Department of Cardiology, Medical University of Silesia, Katowice, Poland (Szachowicz-Jaworska) Department of Radiology and Diagnostic Imaging, St. John Paul II Hospital, Krakow, Poland (Blach) Medical Diagnostic Centre Voxel, Katowice, Poland (Pacholewicz) Department of Cardiac Surgery, Pomeranian Medical University, Szczecin, Poland (Kasprzak) 1stDepartment of Cardiology, Medical University of Lodz, Bieganski Hospital, Lodz, Poland (Scislo) Department of Cardiology, Medical University of Warsaw, Warszawa, Poland (Nowak) 3rdDepartment of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland (Grygier) 1stDepartment of Cardiology, Poznan University of Medical Sciences, Poznan, Poland (Ciurzynski) Department of Internal Medicine and Cardiology with Center for Diagnostics and Treatment of Venous Thromboembolism, Medical University of Warsaw, Warszawa, Poland Publisher Via Medica Abstract Infective endocarditis (IE) following transcatheter valvular interventions, including transcatheter aortic valve implantation and transcatheter edge-to-edge repair, is an uncommon but life-threat-ening complication associated with major diagnostic and therapeutic challenges. As indications for structural interventions continue to expand, the burden of device-related IE is expected to increase. This expert opinion, jointly developed by the Association of Valvular Heart Disease and the Association of Cardiovascular Intervention of the Polish Cardiac Society, summarizes contemporary evidence regarding the epidemiology, clinical presentation, diagnosis, treatment, and prevention of transcatheter valve-related IE. Transcatheter aortic valve implantation-related IE occurs at an estimated incidence of 0.3-2.0 per 100 person-years and is associated with high in-hospital and long-term mortality, whereas transcatheter edge-to-edge repair-related IE is less frequent but similarly associated with poor outcomes. Clinical presentation is frequently atypical, particularly in older patients and in those with multimorbidity, resulting in delayed diagnosis. Echocardiography remains the first-line imaging modality but is often limited by prosthesis-related artifacts. Multi-modality imaging, particularly electrocardiography-gated cardiac computed tomography and in selected cases positron emission tomography, substantially improves diagnostic accuracy, especially for the detection of perivalvular complications. Management relies on prolonged pathogen-directed intravenous antibiotic therapy, but surgical intervention should be considered in all patients, with a significant indication for surgery in patients with uncontrolled infection, heart failure, embolic complications, or extensive tissue destruction. Preventive measures, including maintaining strict periprocedural asepsis and targeted antibiotic prophylaxis, remain essential. IE after transcatheter valvular interventions therefore represents a rare but devastating complication requiring high clinical vigilance, multidisciplinary management, and individualized treatment strategies to im-prove outcomes. Copyright © by the Polish Cardiac Society, 2026. <13> Accession Number 2047816509 Title One-Year Outcomes of High-Risk Percutaneous Coronary Interventions With Versus Without Mechanical Circulatory Support: Propensity Score-Matched Analysis. Source Catheterization and Cardiovascular Interventions. 108(4) (pp 1268-1275), 2026. Date of Publication: 01 Oct 2026. Author Gasecka A.; Pietrasik A.; Pawlowski T.; Zimodro J.M.; Ciesla D.; Sacha J.; Grygier M.; Kochman J.; Tajstra M.; Dyrbus K.; Wojakowski W.; Mizia-Stec K.; Swiatkowski A.; Francuz P.; Kalarus Z.; Smolka G.; Gasior M. Institution (Gasecka, Pietrasik, Zimodro, Kochman) 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland (Pawlowski) National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland (Ciesla) Department of Science and New Technologies, Silesian Center for Heart Diseases, Zabrze, Poland (Sacha) Department of Cardiology, University Hospital in Opole, Opole, Poland (Sacha) Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland (Grygier) 1st Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland (Tajstra, Dyrbus, Gasior) 3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland (Wojakowski) Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland (Mizia-Stec) 1st Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland (Swiatkowski, Francuz, Kalarus) Department of Cardiology, Congenital Heart Disease and Electrotherapy, Silesian Center for Heart Diseases, Medical University of Silesia, Zabrze, Poland (Smolka) Department of Cardiology, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland Publisher John Wiley and Sons Inc Abstract Background: Impella is increasingly used as mechanical circulatory support (MCS) during high-risk percutaneous coronary interventions (HR-PCI). Registry-based data provide insights into the efficacy and safety of Impella-assisted HR-PCI. Aim(s): We aimed to evaluate 1-year outcomes of Impella-assisted HR-PCI compared to HR-PCI without MCS. Method(s): One hundred and thirty-eight patients undergoing Impella-assisted PCI, included in the IMPELLA-PL registry, were propensity score-matched with controls from the retrospective CardioSilesia registry who underwent HR-PCI without MCS. Study endpoints included 1-year post-discharge all-cause mortality, myocardial infarction (MI), stroke, rehospitalization for heart failure (HF), and repeat coronary revascularization. Result(s): Clinical and angiographic characteristics were comparable in both groups, with higher rates of dyslipidemia (78.3% vs. 37.7%, p < 0.001), chronic kidney disease (39.9% vs. 16.7%, p < 0.001), and peripheral artery disease (34.1% vs. 8.0%, p < 0.001) in the IMPELLA-PL cohort. Intravascular ultrasound was more frequently used in the Impella-supported patients (44.2% vs. 25.4%, p = 0.002), while staged revascularization was more common among controls (30.4% vs. 15.9%, p = 0.007). At 1 year, rates of post-discharge all-cause mortality, stroke, and repeat coronary revascularization were similar in both groups. MI was less frequent in the IMPELLA-PL cohort (1.4% vs. 10.9%, p = 0.003), alongside a trend toward lower incidence of rehospitalizations for HF (9.4% vs. 18.1%, p = 0.055). Conclusion(s): Despite an unfavorable cardiovascular risk profile, patients who underwent Impella-assisted HR-PCI had similar 1-year post-discharge survival, with a lower rate of MI, compared to propensity score-matched controls who underwent HR-PCI without MCS. Impella may improve HR-PCI outcomes in selected patients, but further randomized controlled trials are required to confirm this finding. Copyright © 2026 Wiley Periodicals LLC. <14> Accession Number 2050437035 Title Acute Kidney Injury After Cardiac Surgery: A Systematic Review of Pharmacological and Non-Pharmacological Interventions. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author D'Amico F.; Bonizzoni M.A.; Losiggio R.; Kaufman N.; Oliva F.M.; Vives M.; Bove T.; Redaelli M.B.; Stoppe C.; Zangrillo A.; Monti G.; Landoni G.; Ajello V.; Beretta L.; Chiodi B.; Crusco A.; De Piccoli N.; Facondo A.; Foggia G.D.; Fresilli S.; Fossati L.; Ghezzi M.; Giardina G.; Arina K.; Labanca R.; Lembo R.; Chirojit M.; Mure F.; Nakhnoukh C.; Notarianni L.; Paternoster G.; Pontillo D.; Silvetti S.; Alsa S.; Veneziano M. Institution (D'Amico, Bonizzoni, Losiggio, Kaufman, Oliva, Zangrillo, Monti, Landoni, Beretta) Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy (Vives) Department of Anaesthesia & Critical Care, Clinica Universidad de Navarra, Pamplona, Spain (Vives) IdiSNA, Instituto de Investigacion Sanitaria de Navarra, Pamplona, Spain (Bove) Department of Basic Biotechnological Sciences, Intensive Care Peri-Operative Clinics, Universita Cattolica del Sacro Cuore, Rome, Italy (Bove) Department of Emergency, Anesthesiological and Reanimation Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy (Redaelli) Department of Biotechnologies and Life Science, University of Insubria, Varese, Italy (Redaelli) Azienda Ospedaliera Ospedale di Circolo e Fondazione Macchi di Varese, Varese, Italy (Stoppe) Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wurzburg, Wurzburg, Germany (Stoppe) Department of Cardiac Anesthesiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Berlin, Germany (Zangrillo, Monti, Landoni, Beretta) School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (Ajello, Chiodi, Crusco, De Piccoli, Facondo, Foggia, Fresilli, Fossati, Ghezzi, Giardina, Arina, Labanca, Lembo, Mure, Nakhnoukh, Notarianni, Pontillo, Alsa, Veneziano) Cardiac Anesthesia Department, Tor Vergata University Hospital, Rome, Italy (Chirojit) Department of Anaesthesia, HELIOS Clinic for Cardiac Surgery Karlsruhe, Karlsruhe, Germany (Paternoster) Department of Health Sciences, University of Basilicata, Potenza, Italy (Paternoster) Anesthesia and ICU, San Carlo Hospital, Potenza, Italy (Silvetti) Department of Cardiac Anaesthesia and Intensive Care, Ospedale Policlinico San Martino IRCCS, IRCCS Publisher W.B. Saunders Abstract Objective: To identify and synthesize all randomized controlled trials (RCTs) evaluating pharmacological and non-pharmacological interventions for the prevention of cardiac surgery-associated acute kidney injury (CSA-AKI). Design(s): We performed a systematic review of RCTs evaluating pharmacological and non-pharmacological strategies. Interventions were qualitatively synthesized, and meta-analysis was performed when at least 4 RCTs were available. Setting(s): Hospitals. Participant(s): Adults undergoing cardiac surgery. Intervention(s): Pharmacological and non-pharmacological strategies to prevent CSA-AKI. Measurements and Main Results: A total of 207 RCTs, including 63,785 patients and evaluating 55 interventions, were identified. Most studies were small (median sample size 120) and single-center (76.7%) and reported neutral results (149/206), whereas 49 reported benefit and 8 reported harm. N-Acetylcysteine was the most frequently studied pharmacological intervention (19 RCTs), and remote ischemic preconditioning was the most frequently studied non-pharmacological intervention (34 RCTs). Among interventions evaluated in at least 4 RCTs were the use of dexmedetomidine (odds ratio [OR] 0.48, 95% confidence interval [CI] 0.29-0.80), fenoldopam (OR 0.57, 95% CI 0.33-0.98), nitric oxide (OR 0.61, 95% CI 0.43-0.88), and remote ischemic preconditioning (OR 0.78, 95% CI 0.67-0.90) were associated with lower odds of CSA-AKI. Among interventions evaluated in fewer than 4 RCTs were signals of benefit reported for amino acids, atrial natriuretic peptide, goal-directed perfusion, and KDIGO-based care bundles. Conclusion(s): Only a limited number of interventions were associated with lower odds of CSA-AKI; these findings require cautious interpretation and confirmation in adequately powered RCTs. Copyright © 2026 Elsevier Inc. <15> Accession Number 2044079947 Title Perioperative and Long-Term Cardiorenal Outcomes of SGLT2 Inhibitors in Cardiac Surgery Patients: A Systematic Review and Meta-Analysis. Source Cardiovascular Drugs and Therapy. 40(5) (pp 1781-1792), 2026. Date of Publication: 01 Oct 2026. Author Rajpar N.A.; Meghwar S.; Nabi R.; Khaskheli S.A.; Khan S.; Rehman A.; Fatima M.; Abbasi S.U.A.M.; Shaikh N.; Nabi Z.; Ahmed S.; Ahmed R. Institution (Rajpar) Bilawal Medical College, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan (Meghwar, Khaskheli, Shaikh) Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan (Nabi) Islamic International Medical College, Rawalpindi, Pakistan (Khan) Nishtar Medical University and Hospital, Multan, Pakistan (Rehman, Abbasi) Allama Iqbal Medical College, Lahore, Pakistan (Fatima) People's University of Medical and Health Sciences for Women-Nawabshah, Nawabshah, Pakistan (Nabi) KRL Hospital, Islamabad, Pakistan (Ahmed) Sunderland Royal Hospital, Sunderland, United Kingdom (Ahmed) Newcastle University Medical School, Newcastle, United Kingdom (Ahmed) The Medical School, Newcastle University, Framlington Place, Newcastle upon Tyne, Newcastle upon Tyne, United Kingdom Publisher Springer Abstract Background: Cardiac-surgery-associated acute kidney injury (CSA-AKI) occurs in 20-30% of patients undergoing valve surgery or CABG and is linked to prolonged ICU stay, increased costs, and higher mortality. Sodium-glucose cotransporter 2 inhibitors (SGLT2i), initially for diabetes, confer cardiovascular and renal protection. We conducted the first meta-analysis to evaluate perioperative SGLT2i use in cardiac surgery patients. Method(s): Randomized controlled trials and observational studies evaluating SGLT2i in cardiac surgery patients were identified through comprehensive database searches to July 2025. Risk of bias was assessed with RoB 2.0 and the Newcastle-Ottawa Scale. Pooled effect estimates were calculated as risk ratios (RR) with 95% confidence intervals using Mantel-Haenszel random-effects models. Heterogeneity was quantified with I2, with prespecified subgroup and sensitivity analyses performed. Result(s): Perioperative SGLT2i use significantly reduced acute kidney injury (RR 0.39, 95% CI 0.29-0.53; I2=1%). Secondary outcomes showed reduced heart failure hospitalization (RR 0.49, 95% CI 0.36-0.67; I2=0%) and major adverse cardiovascular events (RR 0.64, 95% CI 0.48-0.85; I2=50%). A reduction in mortality was observed (RR 0.51, 95% CI 0.30-0.86; I2=47%), although this effect was primarily driven by observational studies and not confirmed in randomized trials. No significant differences were observed for stroke, myocardial infarction, hypoglycaemia, or urinary tract infection. Conclusion(s): Perioperative SGLT2 inhibitor use was associated with improved renal and cardiovascular outcomes after cardiac surgery. While a mortality benefit was suggested, it was not confirmed in randomized trials. Larger, high-quality RCTs are required to establish definitive efficacy and guide perioperative use. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <16> Accession Number 2050285323 Title Incidence and Predictors of Complications After Transcatheter Aortic Valve Implantation According to VARC-3 Criteria: A Systematic Review and Meta-Analysis. Source Journal of the American Heart Association. 15(19) (no pagination), 2026. Article Number: e045455. Date of Publication: 2026. Author Giacobbe F.; Bruno F.; Brero M.; Meynet P.; Solano A.; Capoccia S.; Pilia R.; D'Ascenzo F.; Conrotto F.; Tarantini G.; la Torre M.; Kim W.-K.; Buono A.; Blumenstein J.; Polzin A.; Gennari M.; Gmeiner J.M.D.; Piperata A.; Ruge H.; Li J.; Mascherbauer J.; Waksman R.; Barbash I.; Tang G.; Gasior T.; Webb J.; Hioki H.; Obaid D.; Mangieri A.; Crimi G.; Joner M.; Toggweiler S.; Mauri V.; Lin M.-S.; Haussig S.; Avvedimento M.; Nanayakkara S.; Serruys P.W.; Landolff Q.; Latib A.; Rodes-Cabau J.; De Ferrari G.M.; de Filippo O. Institution (Giacobbe, Bruno, Brero, Meynet, Solano, Capoccia, Pilia, D'Ascenzo, Conrotto, De Ferrari, de Filippo) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Giacobbe, Brero, Meynet, Solano, Capoccia, Pilia, D'Ascenzo, De Ferrari) Division of Cardiology, Department of Medical Sciences, University of Turin, Italy (Giacobbe, Bruno) Royal Brompton and Harefield Hospitals Trust, Imperial College, London, United Kingdom (Tarantini) Cardiology Clinic, Department of Cardiac, Thoracic, and Vascular Sciences and Public Health Padova, University of Padua, Italy (la Torre) Division of Cardiac Surgery, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Kim) Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (Buono) Interventional Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza, Brescia, Italy (Blumenstein) Department of internal medicine, St. Johannes hospital Dortmund, Dortmund, Germany (Blumenstein) Department of cardiology, University Oldenburg, Oldenburg, Germany (Polzin) Department of Cardiology, Pulmonology, and Vascular Medicine, University Hospital Dusseldorf, Medical Faculty of the Heinrich Heine University Dusseldorf, Dusseldorf, Germany (Polzin) Cardiovascular Research Institute Dusseldorf (CARID), Dusseldorf, Germany (Gennari) IRCCS Centro Cardiologico Monzino, Valvular and Structural Invasive Cardiology Unit, Milan, Italy (Gmeiner) Medizinische Klinik und Poliklinik I, LMU Klinikum Munchen, Munich, Germany (Piperata) Division of Cardiac Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy (Ruge) Technical University of Munich, TUM School of Medicine and Health, Department of Cardiovascular Surgery, TUM University Hospital German Heart Center, Munich, Germany (Li) Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China (Mascherbauer) Universitatsklinikum St. Polten Karl Landsteiner Privatuniversitat fur Gesundheitswissenschaften Dunant-Platz St. Polten, Austria (Waksman) Cardiovascular Research and Advanced Education, MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, DC (Barbash) Interventional Cardiology Unit, Sheba Medical Center, Ramat Gan, Tel Aviv University, Israel (Tang) Division of Cardiology, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York, NY (Gasior) Collegium Medicum - Faculty of Medicine, WSB University, Dabrowa Gornicza, Poland (Webb) St. Paul's Hospital, University of British Columbia, Vancouver, Canada (Hioki) Department of Cardiology, Division of Minimal Invasive Treatment Center, IMS Tokyo Katsushika General Hospital, Katsushika City, Tokyo, Japan (Obaid) Morriston Regional Heart Centre, Swansea University Medical School, Swansea, United Kingdom (Mangieri) IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy (Crimi) Cardiology Unit, Cardiothoracic and Vascular Department (DICATOV) IRCCS, Ospedale Policlinico San Martino, Genoa, Italy (Joner) TUM University Hospital German Heart Center, Technical University of Munich, Germany (Joner) German Center for Cardiovascular Research (DZHK), Berlin, Germany (Toggweiler) Heart Center Lucerne, Luzerner Kantonsspital, Lucerne, Switzerland (Mauri) Faculty of Medicine and University Hospital Cologne, Clinic III for Internal Medicine, University of Cologne, Cologne, Germany (Lin) National Taiwan University Hospital, Taipei, Taiwan (Republic of China) (Haussig) Herzzentrum Dresden, University Clinic, Department of Internal Medicine and Cardiology, Technische Universitaet Dresden, Dresden, Germany (Avvedimento, Rodes-Cabau) Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada (Nanayakkara) Department of Cardiology, The Alfred, Melbourne, Australia (Nanayakkara) Monash Alfred Baker Centre for Cardiovascular Research, School of Translational Medicine, Monash University, Melbourne, Australia (Nanayakkara) Heart Failure Research Group, Baker Institute, Melbourne, Australia (Serruys) Department of Cardiology, School of Medicine, University of Galway, Ireland (Landolff) Department of Cardiology, Clinique Saint Hilaire, Rouen, France (Latib) Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical CenterAlbert Einstein College of Medicine, Bronx, NY Publisher American Heart Association Inc. Abstract BACKGROUND: Despite continuous advancements in devices and techniques, transcatheter aortic valve implantation remains associated with complications impacting outcomes. In 2021, the Valve Academic Research Consortium (VARC) introduced the VARC-3 criteria to better classify procedural complications. METHOD(S): We conducted a systematic review and meta-analysis of studies reporting transcatheter aortic valve implantation-related complications using VARC-3 definitions between 2021 and 2025. The primary end point was all-cause mortality at latest follow-up. Secondary end points included major VARC-3 complications and predictors of adverse events. RESULT(S): A total of 57 studies with 73588 patients were included. The cohort had a mean age of 81.7years, 51.7% were women, and most had preserved ejection fraction (55.5%) and low-to-moderate surgical risk (Society of Thoracic Surgeons [STS] predicted risk of mortality [PROM] 4.1%). Technical and 30-day device success rates were 95% and 90%, respectively; early safety rate at 30days was 66%. At average 12months follow-up, all-cause mortality was 10.2%. The most common complication was permanent pacemaker implantation (13%), followed by type 2 or greater bleeding (9.7%), acute kidney injury stage 3-4 (4.7%), major vascular events (4.3%), and stroke (3.0%). Moderate/severe paravalvular regurgitation and patient-prosthesis mismatch occurred in 4% and 8%, respectively. Study-level pooled predictor analyses showed that acute kidney injury, type 2 or greater bleeding, paravalvular regurgitation, non-structural valve dysfunction, and higher STS score were associated with higher mortality, while eccentric/severe aortic valve calcification was associated with significant paravalvular regurgitation. CONCLUSION(S): Transcatheter aortic valve implantation shows high procedural success but non-negligible complication rates under VARC-3 criteria. acute kidney injury, type 2 or greater bleeding, NSVD, periprocedural stroke and myocardial infarction after transcatheter aortic valve implantation were associated with higher mortality. Copyright © 2026 The Author(s). Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. <17> Accession Number 2046443191 Title A Systematic Review of the Clinical Impact of GLP-1 Receptor Agonists in Hidradenitis Suppurativa. Source American Journal of Clinical Dermatology. 27(5) (pp 909-923), 2026. Date of Publication: 01 Sep 2026. Author Visan M.-A.; Carroll E.; Ryan S.-L.; Pender E.; Costache D.-O.; Caruntu C.; Hughes R.; Kirby B. Institution (Visan, Carroll, Ryan, Pender, Hughes, Kirby) Dermatology Department, St. Vincent's University Hospital, Dublin, Ireland (Visan, Caruntu) Physiology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania (Visan, Costache) Dermatology Department, Carol Davila Central Military Emergency University Hospital, Bucharest, Romania (Carroll, Pender, Hughes, Kirby) School of Medicine, Charles Institute of Dermatology, University College Dublin, Dublin, Ireland (Costache) Dermatology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania (Caruntu) Prof. Dr. N. Paulescu National Institute of Diabetes, Nutrition, Metabolic Diseases, Bucharest, Romania Publisher Adis Abstract Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease which imposes a significant burden in terms of pain, disability, and comorbidities. Obesity and metabolic dysfunction are highly prevalent in HS, contributing to disease severity. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), widely used in type 2 diabetes and obesity, have shown additional anti-inflammatory properties that may be relevant in HS.However, data on their clinical benefit remain limited. Method(s): We performed a systematic review of PubMed/MEDLINE, Scopus, Web of Science, and Embase through June 2025, following PRISMA guidelines. Studies reporting outcomes in HS patients treated with GLP-1RAs were included. Information on clinical severity, quality of life, metabolism, inflammatory markers, and healthcare use were extracted. Findings were critically assessed and summarized descriptively, with pooled analysis applied where outcomes were consistently reported. This review was registered with PROSPERO (CRD420251110220). Result(s): Nineteen studies including 67,568 patients were identified. Pooled analysis showed that 60% of patients achieved clinical improvement in Hurley stage (95% CI 52-67). Dermatology Life Quality Index (DLQI) improved by a mean of -3.83 points (95% CI -5.14 to -2.51). Clinical benefit was observed despite modest weight reduction (mean BMI change -2.64 kg/m2). Inflammatory and metabolic markers improved, with significant reductions in mean C-reactive protein (-1.35 mg/L, 95% CI -2.33 to -0.36) and HbA1c (-0.39%, 95% CI -0.59 to -0.18). Large real-world cohorts showed decreased antibiotic and corticosteroid use and lower hospitalization rates, though results for biologic use, surgical procedures, and cardiovascular outcomes were mixed. Two studies reported reduced risk of major adverse cardiovascular events, while one HS-diabetes cohort suggested persistent excess cardiovascular risk compared with diabetes-only controls. Conclusion(s): This systematic review suggests that GLP-1RAs are associated with improvements in HS severity, quality of life, metabolic and inflammatory parameters, and may additionally reduce healthcare utilization and cardiometabolic risk, observed alongside weight loss. However, current evidence remains limited and heterogeneous, and the relative contribution of weight-dependent and weight-independent effects cannot be determined. Prospective studies and controlled trials are needed to clarify the role of GLP-1RAs in HS management. Copyright © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2026. <18> Accession Number 2049863651 Title Clinical Presentation, Diagnosis, Treatment, and Outcome of Heart Disease in Becker Muscular Dystrophy. Source Anatolian Journal of Cardiology. 30(10) (pp 631-643), 2026. Date of Publication: 01 Oct 2026. Author Finsterer J. Institution (Finsterer) Department of Neurology, Neurology & Neurophysiology Center, Vienna, Austria Publisher Turkish Society of Cardiology Abstract Becker muscular dystrophy (BMD) is a primary myopathy caused by mutations in the dystrophin gene on chromosome Xq21.2, which often affects the myocardium and cardiac conduction system. However, there is limited experience with cardiac disease in BMD. This review aims to summarize and discuss recent advances and future perspectives regarding the clinical presentation, diagnosis, treatment, and outcome of cardiac involvement in BMD. Data were retrieved by searching for relevant articles in the PubMed and Google Scholar databases. Cardiac disease in BMD is characterized by myocardial fibrosis, can be subclinical or clinical, and manifests as left or right ventricular systolic dysfunction with/without heart failure due to dilated or hypertrophic cardiomyopathy, diastolic dysfunction with preserved/decreased systolic function, conduction disturbances and supraventricular/ventricular arrhythmias, thrombus formation, arterial hypertension, pulmonary hypertension, left ventricular hyperrabeculation, coronary artery disease, and valve defects. Cardiac involvement in BMD must be detected and treated at an early stage, because it progresses over time and has a significant impact on the course of the disease. Established treatment methods include non-invasive therapies with small molecules and catheter-based invasive therapies (stent implantation, endocardial and epicardial ablation), device-related treatments (pacemaker, implantable cardioverter-defibrillator, cardiac resynchronization therapy, left ventricular assist device), and heart surgery. Cardiac involvement in BMD occurs in about two-thirds of patients, is subclinical in the early stages but becomes symptomatic as the heart disease progresses, requires early diagnosis, and can be treated with non-invasive and invasive therapies, with prognosis improving with early detection and adequate treatment. Copyright © Available online at anatoljcardiol.com. Content of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. <19> Accession Number 2047495298 Title Preoperative Resting Heart Rate and 30-Day Heart Failure After Off-Pump Coronary Artery Bypass Grafting. Source Annals of Thoracic Surgery. 122(4) (pp 1104-1113), 2026. Date of Publication: 01 Oct 2026. Author Zhang Z.; Zhai W.; Xu H.; Liu J.; Ren Y.; Zhao B.; Guo Z.; Liu Z.; Han J.; Meng L. Institution (Zhang, Zhai, Xu, Liu, Ren, Zhao, Han) Department of Anesthesiology, Tianjin Chest Hospital, Tianjin University, Tianjin, China (Guo) Department of Cardiovascular Surgery, Tianjin Chest Hospital, Tianjin University, Tianjin, China (Liu) Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indiana University, Indianapolis, IN, United States (Meng) Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN, United States Publisher Elsevier Inc. Abstract Background Postoperative heart failure complicates off-pump coronary artery bypass grafting. Whether preoperative resting heart rate (RHR) is associated with 30-day heart failure, as well as how intraoperative physiologic patterns relate to this association, remains unclear. Methods This secondary cohort analysis included adults aged 60 years or older who underwent elective off-pump coronary artery bypass grafting in a randomized trial. Preoperative RHR was the mean of 3 resting, supine measurements taken 24 to 48 hours preoperatively. The primary outcome was 30-day heart failure. The association between preoperative RHR and 30-day heart failure was assessed using Firth logistic regression, restricted cubic splines, and change-point models; exploratory, hypothesis-generating mediation analyses evaluated intraoperative physiologic patterns. Results Among 1952 patients, 69 (3.5%) experienced 30-day heart failure. Higher RHR was independently associated with heart failure (adjusted odds ratio, 1.47 per 10 beats/min; 95% confidence interval, 1.16-1.86; P = .002). The association was nonlinear, with the risk rising steeply beyond approximately 80 beats/min. Sensitivity analyses yielded consistent adjusted odds ratios ranging from 1.42 to 1.53. In exploratory mediation analyses, intraoperative heart rate metrics showed stronger indirect associations with the observed relationship between preoperative RHR and 30-day heart failure than hypotension metrics; other intraoperative variables were not statistically significant. Conclusions Preoperative RHR, particularly greater than 80 beats/min, may serve as a practical complementary marker for 30-day heart failure after off-pump coronary artery bypass grafting. Exploratory mediation analyses identified intraoperative heart rate and hypotension patterns that may warrant further study. Copyright © 2026 The Society of Thoracic Surgeons. <20> Accession Number 2049557268 Title Comparison of analgesic efficacy of dexamethasone and dexmedetomidine as an adjuvant to local anaesthetic in transversus thoracic muscle plane block in adult patients undergoing median sternotomy: A randomised controlled trial. Source Heart and Lung. 80 (no pagination), 2026. Article Number: 102955. Date of Publication: 01 Nov 2026. Author Kumari P.; Jha L.; Sinha C.; Kumar A.; Kumar S.; Kapoor P. Institution (Kumari, Kumar, Sinha, Kumar) Department of Anaesthesiology, All India Institute of Medical Sciences, Patna, India (Jha) Department of Anaesthesia & Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India (Kumar, Kapoor) Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Patna, India Publisher Elsevier Inc. Abstract Background: Post-sternotomy pain contributes significantly to delayed recovery following cardiac surgery. The transversus thoracic muscle plane block (TTPB) is a recently described regional anaesthetic technique that provides analgesia to the anterior chest wall. The addition of adjuvants such as dexamethasone and dexmedetomidine may enhance the analgesic efficacy of TTPB. Objective(s): This study compared the analgesic efficacy of dexamethasone and dexmedetomidine as adjuvants to bupivacaine for TTPB in patients undergoing median sternotomy. Method(s): 66 adult patients (ASA I-III) scheduled for cardiac surgery via median sternotomy were recruited for this randomised trial. Following induction of anaesthesia, all patients received bilateral TTPB and were allocated to three groups: dexamethasone (0.25 % bupivacaine + 8 mg dexamethasone), dexmedetomidine (0.25 % bupivacaine + 1 microg/kg dexmedetomidine), and a control group (0.25 % bupivacaine alone). The primary outcome was the time to first rescue analgesia following extubation. Secondary outcomes included 24-hour postoperative fentanyl consumption, intraoperative fentanyl requirement, pain scores, extubation time, patient satisfaction, and adverse events. Result(s): Time to first rescue analgesia was significantly longer in the dexmedetomidine group than in the dexamethasone and control groups (P 0.001). Twenty-four-hour postoperative fentanyl consumption was significantly lower in both adjuvant groups than in the control group (P < 0.001). Pain scores were consistently lower with dexmedetomidine and dexamethasone groups. Extubation time and intraoperative fentanyl consumption were comparable among the three groups (P > 0.05). Conclusion(s): Both dexamethasone and dexmedetomidine improved TTPB analgesia. Dexmedetomidine significantly prolonged the duration of analgesia, whereas 24-hour postoperative opioid consumption was comparable between the adjuvant groups. Copyright © 2026 Elsevier Inc. <21> Accession Number 2048445038 Title Intramyocardial injection of allogeneic human induced pluripotent stem cell-derived cardiomyocytes in advanced ischemic heart failure: an early-stage randomized trial. Source Nature Medicine. 32(9) (pp 3331-3338), 2026. Date of Publication: 01 Sep 2026. Author Zhang H.; Menasche P.; Fan J.; Gao L.; Luo H.; Xue Y.; Zhu X.; Wang Q.; Li C.; Xu Y.; Zhang A.; Wang J.; Wang D. Institution (Zhang, Luo, Xue, Zhu, Wang) Department of Cardiac Surgery, Nanjing Drum Tower Hospital Affiliated Hospital of Medical School, Nanjing University, Nanjing, China (Menasche) Department of Cardiovascular Surgery, University Paris-Cite, INSERM Unit 970, Paris Cardiovascular Research Center (PARCeC), Hopital Europeen Georges Pompidou, Paris, France (Fan, Wang, Li, Xu, Zhang, Wang) HELP Therapeutics, Nanjing, China (Gao) Institute for Regenerative Medicine, State Key Laboratory of Cardiology and Medical Innovation Center, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China Publisher Nature Research Abstract A treatment for heart failure that could promote myocardial regeneration has long been sought. Here we conduct the HEAL-CHF trial (n = 20; 18 male and 2 female), in which patients with advanced heart failure with reduced ejection fraction (left ventricular ejection fraction <=45%) were randomized to receive intramyocardial injections of allogeneic human induced pluripotent stem cell-derived cardiomyocytes or were uninjected. Both groups received concomitant coronary artery bypass grafting. The primary endpoint was safety, defined as the incidence of sustained ventricular tachycardia during the 1- to 6-month postoperative period and tumorigenicity at 12 months of follow-up. Neither sustained ventricular tachycardia nor tumorigenicity was observed in either patient group. Early post-transplantation ventricular arrhythmias occurred in patients in the cell therapy group during the first 4 weeks, as all 10 patients in this group developed accelerated idioventricular rhythm, typically emerging 5 to 7 days post-transplantation. Clinically significant ventricular tachycardia (>140 bpm), which occurred in 2 patients, peaked at 2 to 3 weeks post-procedure and resolved completely after cardioversion. Secondary efficacy analyses indicated that cell transplantation provided significantly greater improvements in 6-min walk distance, global myocardial perfusion (as assessed by the summed rest score on 99mTc single-photon emission computed tomography-computed tomography) and relative wall thickening, compared with coronary artery bypass grafting alone. No significant between-group differences were observed for left ventricular ejection fraction, left ventricular volumes, myocardial scar size, New York Heart Association functional class or Minnesota Living with Heart Failure Questionnaire scores at 12 months. In view of the arrhythmic events observed, future studies will need to determine the risk-to-benefit ratio associated with human induced pluripotent stem cell-derived cardiomyocyte therapy. ClinicalTrials.gov registration: NCT03763136. Copyright © The Author(s), under exclusive licence to Springer Nature America, Inc. 2026. <22> Accession Number 2049265518 Title Recurrent Stroke Following Left Atrial Appendage Closure in Patients with Breakthrough Stroke: A Systematic Review and Meta-Analysis. Source Journal of Clinical Medicine. 15(18) (no pagination), 2026. Article Number: 7320. Date of Publication: 01 Sep 2026. Author Bini T.; Gamardella M.; Gasys A.; Galea R.; Roten L.; Seiffge D.; Raber L.; Siontis G.C.M. Institution (Bini, Gamardella, Gasys, Galea, Roten, Raber, Siontis) Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (Bini, Gasys) Graduate School for Health Sciences, University of Bern, Bern, Switzerland (Galea) Department of Cardiology, Hospital Centre of Biel, Biel, Switzerland (Seiffge) Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (Siontis) Institute of Social and Preventive Medicine (ISPM, University of Bern, 3012 Bern, Switzerland Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Objective: To determine the incidence of recurrent ischemic stroke following percutaneous left atrial appendage closure in patients with previous thromboembolic events despite oral anticoagulation. Method(s): We conducted a systematic review and meta-analysis of studies of any design reporting ischemic stroke recurrence after left atrial appendage closure in patients with prior ischemic stroke despite oral anticoagulation therapy. The literature search was conducted in MEDLINE, Embase, and the Cochrane Library for studies published between 1 January 2010 and 31 December 2025. Data on study design, population characteristics, indexed intervention, and outcomes were extracted from each included report. The primary outcome was ischemic stroke occurring after left atrial appendage closure, as defined by each individual study. A pooled incidence rate was estimated using a random-effects model to account for anticipated between-study heterogeneity. The study is registered in Open Science Framework. The Risk of Bias in Non-randomized Studies of Interventions assessment tool was used to assess the risk of bias. Result(s): Overall, eight studies of a total of 1091 patients met the eligibility criteria. Patients were elderly (mean age range 71.8 to 78.1 years), 33% to 53% were women, and thromboembolic risk was consistently high (mean CHA<inf>2</inf>DS<inf>2</inf>-VASc scores >= 5.0). The risk of bias across the included studies was either moderate or serious. Antithrombotic therapy after left atrial appendage closure varied considerably across the included studies. In one study, all patients were discharged on dual antiplatelet therapy, whereas in five studies >70% received oral anticoagulation alone or in combination with antiplatelet therapy at discharge. In six studies, antithrombotic therapy at follow-up was reported, with the proportion of patients on oral anticoagulation alone or in combination with antiplatelet therapy at follow-up ranging from 8.1% to 100% in individual studies. Follow-up duration ranged from 1.0 to 3.1 years. At a mean follow-up of 17.7 months the pooled incidence of the ischemic stroke recurrence rate following left atrial appendage closure was 3.1% per year (95% confidence interval 2.35-4.20%). Conclusion(s): Among elderly patients with prior ischemic stroke despite oral anticoagulation, the recurrence rate of ischemic stroke following left atrial appendage closure was 3.1% per year. Given the residual risk of stroke recurrence and the substantial heterogeneity in post-procedural antithrombotic management observed across studies, prospective randomized trials are urgently needed to define both the protective impact of left atrial appendage closure and the optimal antithrombotic strategy in this high-risk population. Copyright © 2026 by the authors. <23> Accession Number 2049073443 Title A randomized controlled study on the effects of the T-REX Twente (Thoracic Surgical Rehabilitation Experts Twente) sternal precautions on quality of life and physical activity levels in cardiac surgery patients, compared to standard care in patients following a median sternotomy: the study protocol. Source Trials. 27(1) (no pagination), 2026. Article Number: 571. Date of Publication: 01 Dec 2026. Author Wielens N.; Roerdink K.; Lynch W.; Esau L.; van der Palen J.; Halfwerk F.R. Institution (Wielens, Roerdink, Lynch, Halfwerk) Thorax Centrum Twente, Medisch Spectrum Twente, Enschede, Netherlands (Esau) Department of Physiotherapy, Foothills Medical Centre, Alberta Health Services, Calgary, Canada (van der Palen) Department of Epidemiology, Medisch Spectrum Twente, Enschede, Netherlands (van der Palen) Section Cognition, Data and Education, Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands (Halfwerk) Cardiac Surgery Innovations Lab, Department of Biomechanical Engineering, University of Twente, Enschede, Netherlands Publisher BioMed Central Ltd Abstract Background: In 2023, a majority (86%) of open-heart surgeries was performed at Thorax Centrum Twente (TCT) via a full median sternotomy. Currently, there is no consensus on postoperative sternal precautions following full median sternotomy. Research from the USA and Canada suggests that existing restrictive sternal precautions may not be necessary. More lenient sternal precautions, such as the "Keep Your Move in the Tube" principle, have shown positive outcomes, with no significant complications. Patients following this approach experienced fewer mobility issues and reported improved quality of life and reduced anxiety. This study explores the potential benefits of fewer restrictions, which could reduce patient anxiety and lead to fewer follow-up visits. This study aims to determine whether the Thoracic Surgical Rehabilitation Experts Twente (T-REX Twente) sternal precautions have a small positive effect on the Modified MacNew Quality of Life after Myocardial Infarction questionnaire (QLMI-2), physical activity, and reduction of movement-related anxiety in patients after full median sternotomy, compared to standard restrictive sternal precautions. It also assesses whether the T-REX sternal precautions result in no negative effects on pain, wound healing, or postoperative complications. Method(s): This prospective, randomized, controlled, single-blind study will include adult patients undergoing full median sternotomy at TCT between June 2024 and June 2026, all participating in outpatient cardiac rehabilitation. Exclusion criteria include intensive care unit stays over 72 h, delirium, dementia, severe cognitive impairments, language barriers, or treatment by an external referring cardiologist. The control group will adhere to current restrictive sternal precautions, whereas those in the intervention group will follow the T-REX sternal precautions, which allow lifting, pushing, or pulling as long as arm movement remains within a defined "tube." The primary endpoint is the change in QLMI-2 from baseline (T<inf>0</inf>) to start of phase II cardiac rehabilitation (T<inf>4</inf>). Discussion(s): The T-REX Twente sternal precautions may improve quality of life, physical activity, and reduce movement-related anxiety, supporting the idea that less restrictive postoperative sternal precautions can enhance patient outcomes. Trial registration: CCMO Trial Register NL78107.100.23, registered on 29 February 2024. ClinicalTrials.gov: NCT06115759. Copyright © The Author(s) 2026. <24> Accession Number 2050283297 Title Clinical Outcomes of Left Atrial Appendage Occlusion During Cardiac Surgery in Patients Without Atrial Fibrillation: A Systematic Review and Meta-Analysis. Source Journal of the American Heart Association. 15(19) (no pagination), 2026. Article Number: e049033. Date of Publication: 2026. Author Song Q.; Tu X.; Zheng Z.; Song L.; Fan C. Institution (Song, Tu, Zheng, Song, Fan) Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Hunan, Changsha, China Publisher American Heart Association Inc. Abstract BACKGROUND: The left atrial appendage is the primary source of cardiac thrombi, and prophylactic exclusion during cardiac surgery may.educe thromboembolic risk. However, its benefit in patients without preoperative atrial fibrillation (AF) remains uncertain. METHOD(S): We searched PubMed, Web of Science, EMBASE, and the Cochrane Library for randomized controlled trials and observational studies comparing surgical left atrial appendage occlusion (LAAO) versus no LAAO in patients with sinus rhythm undergoing cardiac surgery. Primary outcomes were new-onset transient ischemic attack (TIA)/stroke, postoperative AF, and all-cause death. Dichotomous outcomes were pooled as odds ratios and continuous outcomes as mean differences, with 95% CIs. RESULT(S): Eleven studies involving 12 145 participants were included. Compared with no LAAO, surgical LAAO.educed newonset TIA/stroke (odds ratio, 0.75 [95% CI, 0.62-0.90]) and bleeding (odds ratio, 0.78 [95% CI, 0.60-1.00]) but increased postoperative AF (odds ratio, 1.27 [95% CI, 1.06-1.53]). No significant differences were detected between the 2 groups in all-cause death, 30-day death, and length of stay. Subgroup analyses showed some variation in effect estimates across study design, type of surgery, and LAAO technique. CONCLUSION(S): In patients with sinus rhythm undergoing cardiac surgery, surgical LAAO was associated with a lower risk of new-onset TIA/stroke and bleeding but a higher incidence of postoperative AF, with no significant differences in all-cause death, 30-day death, or length of hospital stay. Study design, type of cardiac surgery, and LAAO technique may influence these associations. These findings should be interpreted cautiously given low to moderate certainty of evidence. Copyright © 2026 The Author(s). Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made <25> Accession Number 2049104557 Title Impact of Cipepofol versus Propofol on Long-Term Cardiovascular Outcomes After TAVR: An Extended Follow-Up of a Randomized Trial. Source Drug Design, Development and Therapy. 20 (no pagination), 2026. Article Number: 621481. Date of Publication: 2026. Author Ni T.; Lv Y.; Zhou L.; Yu J.; Tao X.; Cao H.; Yao Y.; Yan M. Institution (Ni, Lv, Zhou, Yu, Tao, Cao, Yao, Yan) Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, Hangzhou, China Publisher Dove Medical Press Ltd Abstract Background: Patients undergoing transfemoral transcatheter aortic valve replacement (TAVR) under general anesthesia are particularly vulnerable to hemodynamic instability. General anesthesia remains a common approach and is necessary in selected patients, although conscious sedation is increasingly used. A previous randomized trial showed greater peri-induction hemodynamic stability with cipepofol than with propofol, but whether this translates into improved clinical outcomes is uncertain. Method(s): We conducted a post hoc, exploratory extended follow-up of a single-center randomized trial. Patients were randomly assigned to cipepofol or propofol. In-hospital analyses included 122 TAVR-treated participants (61 per group), whereas the 30-day and 1-year analyses included 118 participants with follow-up data in the full analysis set (59 per group). The primary endpoint was the 1-year composite of all-cause mortality, stroke, acute kidney injury, myocardial infarction, and new-onset atrial fibrillation (NOAF). For this exploratory analysis, the components were grouped based on their hypothesized association with periprocedural hemodynamic instability and were also reported separately. Result(s): At 1 year, the primary composite endpoint occurred in 13/59 (22.0%) patients in the cipepofol group and 22/59 (37.3%) patients in the propofol group (hazard ratio [HR] 0.56; 95% confidence interval [CI] 0.28 to 1.10; P = 0.093). NOAF, analyzed separately as an exploratory secondary endpoint, occurred less frequently with cipepofol than with propofol (7/59 [11.9%] vs 17/59 [28.8%]; HR 0.39; 95% CI 0.16 to 0.95; P = 0.037). At 30 days, the composite endpoint occurred in 9/59 (15.3%) and 14/59 (23.7%) patients, respectively (HR 0.63; 95% CI 0.27 to 1.45; P = 0.277). The in-hospital composite endpoints were 10/61 (16.4%) and 16/61 (26.2%), respectively (P = 0.185). Conclusion(s): In this exploratory extended follow-up, cipepofol did not significantly reduce the 1-year primary composite endpoint compared with propofol. The observed lower incidence of NOAF should be regarded as hypothesis-generating given the limited sample size, multiple comparisons, and intermittent rhythm surveillance. The applicability of these findings is limited to patients undergoing transfemoral TAVR under general anesthesia and does not extend to procedures performed under conscious sedation. Copyright © 2026 Ni et al. <26> Accession Number 2049265509 Title Balloon-Expandable Versus Self-Expandable Transcatheter Aortic Valve Implantation Devices: A Contemporary Systematic Review. Source Journal of Clinical Medicine. 15(18) (no pagination), 2026. Article Number: 7224. Date of Publication: 01 Sep 2026. Author Apergis I.; Georghiou G.P.; Georghiou P.; Chrisofos E.E.; Triposkiadis F.; Lampropoulos K. Institution (Apergis, Georghiou, Chrisofos, Triposkiadis, Lampropoulos) School of Medicine, European University Cyprus, Nicosia, Cyprus (Georghiou) Department of Surgery, Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel (Georghiou) Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Turner St, London, United Kingdom Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Transcatheter aortic valve implantation (TAVI) is an established treatment for severe aortic stenosis. Prosthesis selection is increasingly important because balloon-expandable valves (BEVs) and self-expandable valves (SEVs) differ in deployment, hemodynamics, and lifetime-management implications. This systematic review synthesized contemporary evidence comparing BEVs and SEVs, while platform-, generation-, and subgroup-specific studies provided contextual evidence. Method(s): A PubMed-only systematic search was performed on 25 January 2026 for studies published between 1 January 2020 and 31 December 2025. Eligible human studies evaluated contemporary balloon or self-expandable systems. Randomized and observational studies, including single-arm cohorts, were included. Risk of bias was assessed using the revised Cochrane Risk of Bias tool (RoB 2) and the Methodological Index for Non-Randomized Studies (MINORS). Because of heterogeneity, findings were synthesized narratively without meta-analysis. Direct randomized and adjusted comparative evidence received greatest weight, whereas single-arm and within-platform studies were not interpreted as establishing comparative superiority. Result(s): Fifty studies met the eligibility criteria. No consistent mortality advantage was identified for either expansion mechanism. The most reproducible differences concerned hemodynamics, paravalvular regurgitation, and conduction outcomes. Supra-annular SEVs were more consistently associated with lower residual gradients and less prosthesis-patient mismatch, whereas BEVs showed lower paravalvular regurgitation or permanent pacemaker implantation in selected comparative settings. These signals varied by valve generation, implantation technique, anatomy, and study design. Evidence on coronary reaccess, durability, thrombosis, and reintervention was less extensive. Conclusion(s): Contemporary evidence does not support a universal BEV-versus-SEV hierarchy. Prosthesis selection should be individualized according to anatomy, conduction risk, hemodynamic priorities, and lifetime-management considerations. Comparative conclusions should remain generation-specific and distinguish direct comparative evidence from single-arm or anatomically selected cohorts. The review was not prospectively registered and received no external funding. Copyright © 2026 by the authors. <27> Accession Number 2049401594 Title Efficacy and safety of preoperative intranasal dexmedetomidine in adults: a systematic review and meta-analysis of randomized controlled trials. Source Brazilian Journal of Anesthesiology (English Edition). 76(5) (no pagination), 2026. Article Number: 844820. Date of Publication: 01 Sep 2026. Author Voznyy V.; Elganga M.; Tawfik L.; Tan T.; Yu S.; Yan E.; Saripella A.; Englesakis M.F.; Chung F. Institution (Voznyy, Elganga, Tawfik, Tan, Yu, Chung) University of Toronto, Temerty Faculty of Medicine, Toronto, ON, Canada (Yan, Chung) University of Toronto, Temerty Faculty of Medicine, Institute of Medical Science, Toronto, ON, Canada (Yan, Saripella, Chung) University of Toronto, University Health Network, Toronto Western Hospital, Department of Anesthesia and Pain Management, Toronto, ON, Canada (Englesakis) University Health Network, Library & Information Services, Toronto, ON, Canada Publisher Elsevier Editora Ltda Abstract Background: Airway manipulation during General Anesthesia (GA) can produce sympathetic activation and hemodynamic instability. Intravenous (IV) dexmedetomidine attenuates these responses but may cause bradycardia or hypotension. Intranasal (IN) administration is a noninvasive alternative with uncertain evidence in adults. We evaluated preoperative IN dexmedetomidine in adult patients undergoing GA. Method(s): We performed a PROSPERO-registered (CRD420251250492) systematic review and meta-analysis of randomized trials. MEDLINE, Embase, CENTRAL, and CDSR were searched from inception to November 26, 2025. IN dexmedetomidine versus control and IN vs. IV dexmedetomidine were assessed separately. Random-effects models pooled continuous outcomes as MDs/SMDs and adverse events as RRs. Risk of bias was assessed using RoB2 and certainty of evidence using GRADE. Result(s): Across 25 trials including 1,968 patients, IN dexmedetomidine was associated with deeper sedation (SMD = 0.76; 95% CI: 0.18-1.34) and reduced heart rate and mean arterial pressure at induction, intubation, and during the early intraoperative period compared with control (MD range: -12.7 to -13.4 bpm and -7.8 to -10.7 mmHg, respectively). Rates of bradycardia and hypotension were similar between IN dexmedetomidine and control groups. Compared with IV dexmedetomidine, IN administration resulted in lighter sedation (SMD = -0.54; 95% CI: -1.08 to -0.01), with similar hemodynamic effects, while bradycardia and hypotension occurred less frequently. Conclusion(s): Preoperative IN dexmedetomidine may improve sedation and blunt peri-induction hemodynamic responses compared with controls, with broadly similar hemodynamic effects and fewer observed cardiovascular adverse events versus IV administration. However, certainty was low or very low for several efficacy outcomes, and larger well-designed trials are needed. Copyright © 2026 Sociedade Brasileira de Anestesiologia <28> Accession Number 2049951470 Title Left atrial appendage isolation and thrombotic and thromboembolic outcomes in atrial fibrillation: A systematic review and meta-analysis. Source Thrombosis Research. 266 (no pagination), 2026. Article Number: 109839. Date of Publication: 01 Oct 2026. Author Bai X.; Huang H.; Zhang Z.; Yuan J.; Yan S.; Xiang X. Institution (Bai, Huang, Zhang, Yuan, Yan, Xiang) Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China Publisher Elsevier Ltd Abstract Background: Electrical left atrial appendage isolation (LAAI) may be accompanied by impaired appendage function and thromboembolic complications. We evaluated the association between LAAI and clinical stroke or transient ischemic attack (TIA), while separately examining imaging-detected left atrial appendage (LAA) thrombus and related supportive outcomes. Method(s): PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception to December 6, 2024 for comparative clinical studies reporting thrombotic or thromboembolic outcomes after LAAI. Clinical stroke or TIA was the primary outcome. Risk ratios (RRs) were pooled using an inverse-variance random-effects model with restricted maximum-likelihood estimation and Hartung-Knapp-adjusted confidence intervals (CIs). The preferred primary analysis excluded the smaller Rillig cohort because of possible participant overlap with the Heeger cohort. Imaging-detected LAA thrombus, anticoagulation-at-event data, and LAA functional findings were evaluated separately. Result(s): Five comparative observational studies were included. The preferred primary analysis comprised four studies and 3876 patients, including 801 who underwent LAAI and 3075 controls. Clinical stroke or TIA occurred in 42 and 66 patients, respectively. LAAI was associated with a higher cumulative risk of clinical stroke or TIA (RR=4.96, 95% CI 1.10-22.42; P=0.043; I2=55.6%). The 95% prediction interval was 0.21-115.69. Inclusion of the potentially overlapping Rillig cohort yielded an RR of 5.26 (95% CI 1.80-15.36; P=0.013), but the prediction interval remained compatible with no association. Leave-one-out analyses were directionally consistent, although statistical significance was lost after omission of Kim, Heeger, or Romero. Comparative LAA thrombus estimates were available only from Rillig (RR=22.31, 95% CI 1.34-370.43) and Heeger (RR=10.31, 95% CI 2.50-42.56) and were not pooled because potential cohort overlap could not be excluded. Anticoagulation-at-event and LAA functional data were unsuitable for quantitative synthesis. Conclusion(s): The available evidence suggests that LAAI may be associated with a higher cumulative risk of clinical stroke or TIA. However, the extremely wide prediction interval crossing the null and the loss of statistical significance after omission of several individual studies indicate considerable uncertainty regarding the magnitude and consistency of this potential association across different practice settings. Comparative imaging findings also suggested a higher frequency of postprocedural LAA thrombus, although the available evidence was limited and potentially overlapping. Independent comparative studies with standardized TEE surveillance, clearly defined anticoagulation exposure, and complete clinical and imaging outcome reporting are required. Copyright © 2026 Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <29> Accession Number 2050284548 Title Minimally Invasive Versus Sternotomy in Redo Mitral Valve Surgery: Short-and Long-Term Outcomes with MetaRegression and Time-to-Event Analysis. Source Journal of the American Heart Association. 15(19) (no pagination), 2026. Article Number: e050284. Date of Publication: 2026. Author Santos K.; Kim Kim J.Y.B.; Patel N.; Sah H.; Koduru S.; Napoli F.; Brozzi N.A.; Navia J.L.; Polanco A.; Sa M.P. Institution (Santos, Patel) New Vision University School of Medicine, Tbilisi, Georgia (Kim Kim) Faculty of Medical Sciences, Universidad Nacional de Asuncion, Asuncion, Paraguay (Sah) Bahgesehir University, Istanbul, Turkey (Koduru) Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India (Napoli, Brozzi, Navia, Polanco, Sa) Department of Cardiovascular Surgery Heart, Thoracic & Vascular Institute; Cleveland Clinic Florida, Weston, FL, United States Publisher American Heart Association Inc. Abstract BACKGROUND: Redo mitral valve surgery carries substantial risk, and the relative benefits of minimally invasive (MI-MVS) versus sternotomy MVS, particularly regarding long-term survival, remain uncertain. METHOD(S): Electronic databases were searched for studies comparing MI-MVS with sternotomy MVS in adult redo MVS. Kaplan-Meier curves were digitized to reconstruct individual patient data for time-to-event analysis, with study-level hazard ratios (HR) generated using a Cox frailty model. Perioperative outcomes were pooled using random-effects models. Subgroup analyses evaluated propensity-matched cohorts, endoscopic/video-assisted minithoracotomy, and direct-vision minithoracotomy. Meta-regression explored the impact of study-level covariates on mortality. RESULT(S): Fifteen studies including 3457 patients were analyzed. MI-MVS was associated with lower perioperative mortality compared with sternotomy MVS (odds ratio [OR], 0.33 [95% CI, 0.23-0.48]; P<0.001), reduced incidence of reoperation (OR, 0.65 [95% CI, 0.44-0.98]; P=0.04), and acute kidney injury (OR, 0.58 [95% CI, 0.39-0.87]; P=0.008); rates of stroke and arrhythmia were similar. The direction and magnitude of the mortality effect consistently favored MI-MVS in the subgroup analyses. Time-to-event analysis demonstrated improved survival with MI-MVS (HR, 0.74 [95% CI, 0.62-0.89]; P=0.001), but this was attenuated in the propensity-matched analysis. Meta-regression showed that sex distribution, mean age, and baseline left ventricular ejection fraction did not significantly moderate mortality effects. CONCLUSION(S): In redo MVS, MI-MVS is associated with improved perioperative outcomes without compromising long-term survival; however, attenuation of the survival difference after propensity matching suggests that this long-term advantage may reflect baseline risk rather than procedural effect. Copyright © 2026 The Author(s). Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. <30> Accession Number 2048371898 Title Nurse-Led Algorithm-Based Early Mobilization Protocol for Reducing Post-Intensive Care Syndrome in Intensive Care Unit Patients: A Randomized Controlled Trial. Source Journal of Cardiovascular Nursing. 41(6) (pp E706-E714), 2026. Date of Publication: 01 Dec 2026. Author Jeong Y.; Lee H. Institution (Jeong) Cardiovascular Intensive Care Unit, Gil Medical Center, Gachon University, Incheon, South Korea (Lee) College of Nursing, Research Institute of AI and Nursing Science, Gachon University, Incheon, South Korea Publisher Lippincott Williams and Wilkins Abstract Background: - Post-intensive care syndrome (PICS) is a significant challenge for cardiac surgery survivors. While early mobilization (EM) is recommended, there is a lack of evidence regarding the effectiveness and safety of nurse-led, algorithm-based protocols in cardiovascular intensive care units (ICUs). Objective(s): - To evaluate the effects of a nurse-led algorithm-based EM protocol on PICS scores, psychological distress (anxiety and depression), sleep quality, and nursing satisfaction in patients following cardiac surgery. Method(s): - A randomized controlled pretest-posttest study was conducted with 38 adult patients at a Korean tertiary hospital. Participants were randomly assigned to a control (n = 19) or experimental (n = 19) group. The experimental group received the protocol from 12 hours post-intensive care admission until transfer. Outcomes were measured using the PICS Questionnaire, Hospital Anxiety and Depression Scale, Korean Modified Leeds Sleep Evaluation Questionnaire, and Nursing Service Satisfaction Tool. Data were analyzed using nonparametric tests. Result(s): - Significant improvements were observed in the experimental group compared with the control group in PICS scores (Z = -3.83, P <.001), anxiety and depression (Z = -3.52, P <.001), sleep quality (Z = -3.83, P <.001), and all subdomains of nursing satisfaction (Z = -3.58 to -3.83, P <.001). No mobilization-related adverse events occurred, indicating the safety of the protocol. Conclusion(s): - The application of a nurse-led algorithm-based EM protocol is a safe and effective strategy to reduce PICS, alleviate psychological distress, and enhance sleep and nursing satisfaction after cardiac surgery. This standardized nurse-driven approach should be integrated into routine cardiovascular ICU clinical practice. Trial Registration: - This study was registered with the Korean Clinical Research Information Service (CRIS) (identifier: KCT0010880, https://cris.nih.go.kr). Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <31> Accession Number 2045719054 Title Influence of Baseline Smoking Status on Intensive Blood Pressure Control: Results From the STEP Randomized Trial. Source Canadian Journal of Cardiology. 42(10) (pp 2464-2472), 2026. Date of Publication: 01 Oct 2026. Author Chen S.; Ji Y.; Yang R.; Peng X.; Bai J.; Fan X.; Song Q.; Cai J. Institution (Chen, Ji, Song) Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China (Yang, Peng, Bai, Cai) Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China (Fan) Cardiac Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China Publisher Elsevier Inc. Abstract Background The St rategy of Blood Pressure Intervention in the E lderly Hypertensive P atients (STEP) trial has proven that intensive systolic blood pressure (SBP) lowering reduces cardiovascular events. However, the cardiovascular risks posed by smoking have caused uncertainty regarding the effects of intensive SBP control in smokers. Methods In this secondary subgroup analysis of the STEP trial, the participants were categorized into nonsmokers and current smokers on the basis of their baseline smoking status. The primary outcome was a composite of cardiovascular outcomes, including stroke, acute coronary syndrome, acute decompensated heart failure, coronary revascularization, atrial fibrillation, and death from cardiovascular causes. Cox proportional hazards regression and interaction analysis were used to assess the effects of baseline smoking status on intensive SBP control. Results A total of 8489 patients were included in this analysis. The proportion of patients who reached the intensive SBP target was smaller in current smokers during the first 9 months. Compared with nonsmokers, current smokers had a higher adjusted risk of primary outcome (hazard ratio, 1.39; 95% confidence interval, 1.03-1.88; P = 0.03) and stroke (hazard ratio, 1.66; 95% confidence interval, 1.03-2.67; P = 0.04). The interactions between baseline smoking status and SBP treatment were not statistically significant for all outcomes. Findings were similar in sensitivity analyses using 4 smoking categories and in analyses including only never and often smokers. Conclusions Smoking was associated with a higher risk of primary outcome and stroke. We observed no statistical evidence of heterogeneity in the treatment effect of intensive SBP control according to smoking status. Clinical Trial Registration NCT03015311. Copyright © 2026 Canadian Cardiovascular Society. <32> Accession Number 2049977257 Title Effectiveness of elastic therapeutic taping in pain management after median sternotomy: A randomized controlled trial. Source PLOS One. 21(9 September) (no pagination), 2026. Article Number: e0359282. Date of Publication: 01 Sep 2026. Author Ozel A.; Ugras U.A.; Uysal M.F.; Ucaroglu E.R. Institution (Ozel, Uysal) Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bolu Abant Izzet Baysal University, Bolu, Turkey (Ugras, Ucaroglu) Department of Cardiovascular Surgery, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey Publisher Public Library of Science Abstract : To evaluate the effectiveness of elastic therapeutic taping on postoperative pain, functional mobility, sleep quality, analgesic consumption, and length of hospital stay in patients undergoing coronary artery bypass grafting (CABG) via median sternotomy. In this prospective, randomized, double-blind, placebo- and sham-controlled trial, 195 patients undergoing elective CABG were randomly assigned to elastic therapeutic taping (n = 65), placebo taping without tension (n = 65), or sham taping to a non-related region (n = 65). Elastic therapeutic taping was applied after patients were transferred from the intensive care unit to the cardiovascular surgery ward. Pain at rest and during coughing was assessed using the Visual Analog Scale (VAS) at baseline and 12, 24, and 48 hours. Secondary outcomes were Timed Up and Go (TUG), sleep quality, total analgesic use, and length of hospital stay. Data were analyzed using a prespecified two-way mixed ANOVA with Bonferroni-adjusted post hoc comparisons for the primary pain outcome. Nonparametric secondary outcomes were analyzed using Kruskal-Wallis or Friedman tests, as appropriate. At 48 hours, resting pain was lower in the elastic therapeutic taping group (19.0 +/- 10.2) than placebo taping without tension group (37.5 +/- 13.7) and sham taping group (41.2 +/- 16.2; p = 0.001). The observed between-group reduction in pain exceeded the reported minimal clinically important difference (MCID) of 9.9 mm for acute postoperative pain, indicating a clinically meaningful treatment effect. Coughing pain was also reduced (39.2 +/- 17.0 vs. 56.3 +/- 17.2 and 59.4 +/- 16.8; p = 0.001). Tramadol use was lower with elastic therapeutic taping (50 +/- 50 mg vs. 100 +/- 50 mg; p = 0.038). Elastic therapeutic taping was associated with a shorter length of hospital stay (4 [3-5] vs. 5 [4-7] days; p = 0.042). Functional mobility (TUG, p = 0.002) and sleep quality (p = 0.001) were also significantly improved in the elastic therapeutic taping group compared with the placebo and sham groups. Elastic therapeutic taping was associated with reduced pain, lower opioid use, improved early recovery, and a shorter length of hospital stay after median sternotomy. Trial registration: ClinicalTrials.gov NCT06910215 Copyright © 2026, Ozel et al. This is an open access article distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. <33> Accession Number 2048844328 Title Left Atrial Appendage Closure Versus Oral Anticoagulation in Atrial Fibrillation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Source Circulation: Arrhythmia and Electrophysiology. 19(9) (pp e015245), 2026. Date of Publication: 01 Sep 2026. Author Rao A.; Ravi V.; Murthi M.; Chikatimalla R.; Talla V.; Nagaraj N.; Dhar G.; Jolly N.; Vij A. Institution (Rao) Department of Internal Medicine, Guthrie Robert Packer Hospital, Sayre (Ravi) Division of Electrophysiology, Heart and Vascular Institute, Saint Francis Health System, Tulsa (Murthi, Vij) Division of Cardiology (Chikatimalla) Department of Internal Medicine, University of Texas Health Science Center at Tyler (R.C.). (Talla) Vydehi Institute of Medical Sciences and Research Centre, Bengaluru (Nagaraj) Jagadguru Jayadeva Murugarajendra Medical College, Davanagere (Dhar, Jolly, Vij) Division of Cardiology Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - Left atrial appendage closure (LAAC) is an alternative to oral anticoagulation (OAC) for stroke prevention in patients with atrial fibrillation, but randomized controlled trials have primarily focused on composite end points, potentially obscuring differences in individual clinical outcomes. We compared the efficacy and safety of LAAC versus OAC with an emphasis on individual clinical outcomes. METHOD(S): - A systematic review and meta-analysis of randomized controlled trials comparing LAAC with OAC in adults with atrial fibrillation was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Databases were searched from January 2000 to March 2026. The primary efficacy end point was any stroke, and the primary safety end point was major bleeding. Risk ratios (RRs) with 95% CIs were pooled using a random-effects model. RESULT(S): - Six randomized controlled trials comprising 7004 patients (3681 LAAC; 3323 OAC) were included. LAAC was associated with a higher risk of ischemic stroke (RR, 1.41 [95% CI, 1.04-1.91]; P=0.03; 3.2% versus 2.1%), without a significant difference in any stroke (RR, 1.08 [95% CI, 0.82-1.42]; P=0.60) or the composite of stroke, systemic embolism, or death (RR, 0.99 [95% CI, 0.77-1.29]; P=0.96). Cardiovascular mortality (RR, 0.88; P=0.40) and all-cause mortality (RR, 0.92; P=0.36) were similar between groups. Major bleeding, including procedural events, did not differ significantly (RR, 0.93; P=0.40), although LAAC was associated with a significantly lower risk of nonprocedural major bleeding (RR, 0.57 [95% CI, 0.43-0.77]; P<0.01; 6.2% versus 10.7%). CONCLUSION(S): - In patients with atrial fibrillation, LAAC is associated with a higher risk of ischemic stroke, but lower risk of nonprocedural major bleeding compared with OAC, with no significant differences in composite thromboembolic outcomes or mortality, underscoring the importance of individualized risk-benefit assessment in stroke prevention strategies. Copyright © 2026 American Heart Association, Inc. <34> Accession Number 2049551354 Title Erector spinae plane and superficial parasternal intercostal plane blocks vs. control for sternotomy in cardiac surgery: A prospective, randomized trial. Source Journal of Clinical Anesthesia. 115 (no pagination), 2026. Article Number: 112330. Date of Publication: 01 Nov 2026. Author Shariat A.; Egorova N.; Ouyang Y.; Fang S.; Koshchak E.; Qian D.; Armenta D.; Choi J.; Puskas J.; Bhatt H.V. Institution (Shariat, Koshchak, Armenta, Choi, Bhatt) Mount Sinai Morningside Hospital, New York, United States (Egorova, Ouyang) Department of Population Health Science and Policy at Mount Sinai, New York, NY, United States (Shariat, Egorova, Ouyang, Koshchak, Qian, Bhatt) Icahn School of Medicine at Mount Sinai, New York, NY, United States (Fang) Maimonides Medical Center, Brooklyn, NY, United States (Puskas) Emory University Hospital, Atlanta, GA, United States Publisher Elsevier Inc. Abstract Background Cardiac surgical pain is challenging to treat because of its multifactorial nature. Fascial plane blocks present an attractive alternative analgesic technique due to their favorable safety profile and relative technical simplicity. Methods This prospective, randomized controlled trial tested the hypothesis that fascial plane blocks added to a multimodal analgesic regimen in patients undergoing cardiac surgery will decrease opioid consumption and pain scores postoperatively. Participants included adults of all genders between the ages of 18-85 who were assigned to American Society of Anesthesiologists physical status II-IV and underwent elective sternotomy procedures at Mount Sinai Morningside Hospital Center. Patients were randomized 1:1:1 to standard therapy, erector spinae plane block, or superficial parasternal intercostal plane block. Outcomes included the use of postoperative opioid medications in morphine equivalents, numerical rating scale pain scores, intensive care unit length of stay, hospital length of stay and postoperative nausea. Results A total of 271 patients were enrolled into the trial between July 2022 and July 2024. There was no significant difference in opioid consumption during the surgery and on postoperative days 0, 1, and 2, although the median morphine milligram equivalents use on postoperative day 3 was significantly different among the three groups driven by lower consumption in the ESP group, ( p = 0.047). Maximum numerical pain rating scale was significantly lower in both regional block groups compared to control for postoperative day 0, 1, 2, and 3: POD 1 ( p < 0.001), POD 2 ( p < 0.001), and POD 3 ( p = 0.002). Conclusion Patients undergoing sternotomy procedures may benefit from the addition of erector spinae plane or superficial parasternal intercostal plane blocks to a postoperative multimodal analgesic regimen. Copyright © 2026 Elsevier Inc. <35> Accession Number 2049262968 Title Effects of Pulsatile and Non-Pulsatile Cardiopulmonary Bypass on Early Inflammatory Response After Cardiac Surgery: A Secondary Biomarker Analysis of a Multicentric Randomized Controlled Trial. Source Journal of Clinical Medicine. 15(18) (no pagination), 2026. Article Number: 7228. Date of Publication: 01 Sep 2026. Author Ljubacev A.; Grcic A.; Baticic L.; Jenko M.; Taleska Stupica G.; Curko-Cofek B.; Sestan M.; Laskarin G.; Knezevic D.; Damic M.; Vujnovic Dukic V.; Medved I.; Sostaric M.; Antonic M.; Zdravkovic M.; Sotosek V. Institution (Ljubacev, Medved) Department of Surgery, Faculty of Medicine, University of Rijeka, Brace Branchetta 20, Rijeka, Croatia (Grcic, Baticic) Department of Medical Chemistry, Biochemistry and Clinical Chemistry, Faculty of Medicine, University of Rijeka, Brace Branchetta 20, Rijeka, Croatia (Jenko, Taleska Stupica, Sostaric) Clinical Department of Anesthesiology and Surgical Intensive Care, University Medical Centre Ljubljana, Zaloska Cesta 7, Ljubljana, Slovenia (Jenko, Taleska Stupica, Sostaric, Zdravkovic) Department of Anesthesiology and Reanimatology, Faculty of Medicine, University of Ljubljana, Vrazov Trg 2, Ljubljana, Slovenia (Curko-Cofek, Laskarin) Department of Physiology, Immunology and Pathophysiology, Faculty of Medicine, University of Rijeka, Brace Branchetta 20, Rijeka, Croatia (Sestan, Knezevic, Damic, Vujnovic Dukic, Sotosek) Clinic of Anesthesiology, Intensive Medicine and Pain Management, Clinical Hospital Centre Rijeka, Kresimirova 42, Rijeka, Croatia (Laskarin) Hospital for Medical Rehabilitation of Hearth and Lung Diseases and Rheumatism "Thalassotherapia-Opatija", M. Tita 188, Opatija, Croatia (Knezevic, Sotosek) Department of Anesthesiology, Reanimatology, Emergency and Intensive Care Medicine, University of Rijeka, Brace Branchetta 20, Rijeka, Croatia (Antonic) Department for Cardiac Surgery, University Medical Centre Maribor, Ljubljanska Ulica 5, Maribor, Slovenia (Antonic, Zdravkovic) University of Maribor, Taborska 8, Maribor, Slovenia (Zdravkovic) Department of Anesthesiology, Intensive Care and Pain Management, University Medical Centre Maribor, Ljubljanska Ulica 5, Maribor, Slovenia (Sotosek) Department of Clinical Medical Sciences II, Faculty of Health Studies, University of Rijeka, Viktora Cara Emina 2, Rijeka, Croatia Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Cardiopulmonary bypass (CPB) induces a systemic inflammatory response that may contribute to postoperative organ dysfunction. However, the effects of pulsatile and non-pulsatile CPB on the inflammatory response remain incompletely understood. This study investigated the perioperative dynamics of interleukin (IL)-1beta, IL-18, and IL-18 binding protein (IL-18BP), as pre-specified secondary inflammatory biomarker analysis of a prospective, multicentric, randomized trial (ISRCTN11243508), in patients undergoing cardiac surgery with pulsatile or non-pulsatile CPB and evaluated their relationships with routine inflammatory and myocardial injury biomarkers. Method(s): In this study 142 patients undergoing elective cardiac surgery were randomized to pulsatile (Group P) or non-pulsatile (Group NP) CPB, and 129 were analyzed (pulsatile, n = 63; non-pulsatile, n = 66). Blood samples were collected before surgery and at five postoperative time points. Plasma concentrations of IL-1beta, IL-18, and IL-18BP were measured by ELISA. Leukocyte count, C-reactive protein (CRP), procalcitonin (PCT), high-sensitivity cardiac troponin I (hsTnI), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were also analyzed. The trial was powered for its primary outcome; for these secondary outcomes the achieved sample size had 80% power to detect between-group ratios of geometric means of approximately 1.27 (IL-18), 1.41 (IL-18BP) and 1.38 (IL-1beta). Result(s): Cardiac surgery with CPB induced a marked postoperative inflammatory response in both groups: leukocyte count, CRP, PCT, IL-18, IL-18BP, hsTnI and NT-proBNP increased significantly after surgery, whereas IL-1beta remained essentially unchanged. In the pre-specified confirmatory comparison of postoperative peak concentrations, no biomarker differed significantly between groups. The 95% confidence intervals of this comparison exclude a pulsatile-flow effect on peak IL-18 larger than a 15% reduction or 19% increase, and on peak IL-18BP larger than a 26% reduction or 20% increase. A supporting mixed model for repeated measures showed no differential trajectory over time for any biomarker; its confidence intervals for the average postoperative effect were narrower (approximately +/-10% for IL-18 and -9% to +15% for IL-18BP). The only exception was the leukocyte count, which was approximately 10% higher throughout the postoperative period in Group NP, without a differential trajectory shape. Conclusion(s): This pre-specified secondary analysis of a randomized trial found no evidence that pulsatile CPB reduces the early postoperative inflammatory or myocardial-injury response compared with non-pulsatile CPB for any of the eight biomarkers studied, apart from a modest difference in leukocyte count that did not survive correction for multiple comparisons. The confidence intervals obtained exclude only moderate-to-large between-group differences in IL-18 and IL-18BP; smaller true differences remain compatible with the data and cannot be ruled out at this sample size. These findings should not be interpreted as evidence of biochemical equivalence between pulsatile and non-pulsatile CPB, but they do not support a clinically important early anti-inflammatory advantage of pulsatile perfusion in this population. Copyright © 2026 by the authors. <36> Accession Number 2049300643 Title Progressive Spastic Paraparesis Caused by Thoracic Spinal Epidural Lipomatosis: A Case Report and Systematic Review. Source Medical sciences. 14(5) (no pagination), 2026. Article Number: 559. Date of Publication: 01 Sep 2026. Author Gawel W.S.; Fercho J.M.; Kaluzna O.; Krasula Z.; Tyburski M.; Nakoneczna J.; Kopec R.; Szypenbejl J.; Sobon J.; Birski M.; Furtak J.; Sieminski M. Institution (Gawel, Fercho, Kaluzna, Krasula, Tyburski, Nakoneczna, Kopec, Szypenbejl) Scientific Circle of Neurotraumatology, Department of Emergency Medicine, Medical University of Gdansk, Gdansk, Poland (Fercho, Szypenbejl, Sieminski) Department of Emergency Medicine, Medical University of Gdansk, Gdansk, Poland (Fercho, Sobon, Birski, Furtak) Neurosurgery Department, 10th Military Research Hospital and PolyClinic SPZOZ in Bydgoszcz, 85-681, Bydgoszcz, Poland (Furtak) Faculty of Medicine, Bydgoszcz University of Science and Technology, 85-796, Bydgoszcz, Poland Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Spinal epidural lipomatosis (SEL) is a rare disorder characterized by excessive epidural fat accumulation. Diagnosis may be challenging because imaging findings are frequently overlooked, and evidence-based management guidelines, particularly thoracic disease, remain limited. Case report: We present a case report of a 54-year-old male patient, who suffered from lower limb spastic paresis and associated muscle spasms (Nurick grade V). After a difficult diagnostic process, MRI of the thoracic spine confirmed dorsal/posterior spinal epidural lipomatosis (SEL; Manjila grade IIb-alpha) extending from Th2 to Th9, with moderate thecal sac compression. A small Th6-Th7 intervertebral disc prolapse was also present, without evidence of scoliosis, syrinx, spinal cord edema, or myelomalacia. Following bilateral thoracic decompression and complete resection of the SEL tissue, the patient's neurological function improved markedly, from Nurick grade V preoperatively to Nurick grade II at 11 months of follow-up. Consequently, bilateral laminectomy of the thoracic region was performed with total resection of the SEL tissue. Following surgery, the patient's neurological symptoms improved markedly (Nurick grade II; 11 months postoperatively), and histopathological examination confirmed the diagnosis of spinal epidural lipomatosis. Method(s): We performed a systematic review of case reports of SEL occurring, or co-occurring in the thoracic region based on the literature identified on PubMed, Scopus and Web of Science databases, after using search terms: "(thoracic) AND ("spinal" OR "epidural") AND (lipomatosis)" and filters: [English], [humans] and [year 2020-2026], with the accordance to the PRISMA guidelines. Result(s): We identified 21 cases of thoracic SEL from 19 articles. In 12 cases the patients were male, in 9 female. Reported etiological associations included type 1 diabetes mellitus, exogenous corticosteroid exposure, obesity/metabolic syndrome, Cushing syndrome, and CLOVES syndrome. Given the small, case-report-based sample, these findings should be considered reported associations rather than estimates of prevalence or independent risk factors. Surgical treatment of thoracic SEL can be accomplished by various techniques such as laminectomy (continuous or skip), laminoplasty, or minimally invasive procedures-including endoscopic spine surgery. Conclusion(s): Large-volume, multicenter studies with long-term clinico-radiological follow-up would be necessary to understand the natural history and treatment outcomes, and to form evidence-based guidelines for interventions. Our case report and findings highlight that thoracic SEL should be included in the differential diagnosis of unexplained compressive myelopathy, even when imaging studies are inconclusive. Rapid identification or possibly reversible causes of myelopathy and initiation of treatment can significantly relieve symptoms, so it is important to remember this disease in the diagnostic process. Copyright © 2026 by the authors. <37> Accession Number 2047865156 Title Changes in Free and Total Remimazolam Concentrations During Cardiopulmonary Bypass: A Randomized Dose-Comparison Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(11) (pp 3502-3512), 2026. Date of Publication: 01 Nov 2026. Author Ohno S.; Yoshikawa Y.; Kurihara D.; Sato Y.; Kunigo T.; Takahashi K.; Sato T.; Hirahata T.; Maeda M.; Negishi K.; Ikeshima Y.; Ishida M.; Shimizu H.; Hayashi M.; Takasaki Y.; Chaki T.; Aoyama T.; Toda T.; Yamakage M. Institution (Ohno, Yoshikawa, Sato, Kunigo, Takahashi, Sato, Hirahata, Maeda, Negishi, Ikeshima, Chaki, Yamakage) Department of Anesthesiology, Sapporo Medical University School of Medicine, Hokkaido, Sapporo, Japan (Kurihara, Ishida, Shimizu, Hayashi, Takasaki, Aoyama, Toda) Department of Clinical Pharmacology, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Hokkaido, Sapporo, Japan Publisher W.B. Saunders Abstract Objectives: Remimazolam is increasingly used in cardiac surgery for hemodynamic stability; however, during cardiopulmonary bypass (CPB), hemodilution and hypoalbuminemia may increase its pharmacologically active free fraction, raising concern about unrecognized overexposure under constant infusion. Yet, the temporal profile of free remimazolam during CPB has not been fully elucidated. We investigated whether a pragmatic dose adjustment could maintain free remimazolam concentrations within a stable range. Design(s): Randomized, controlled, parallel-group trial. Setting(s): A university hospital. Participant(s): Thirty-six adults undergoing cardiac surgery with CPB. Intervention(s): Patients were assigned to a normal-dose group (1 mg/kg/h) or a low-dose group in which the infusion rate of remimazolam was reduced to 70% at CPB initiation (0.7 mg/kg/h). Measurements and Main Results: The primary outcome was free remimazolam concentration. Secondary outcomes included total remimazolam concentration, protein binding, and associations between bispectral index values and drug concentrations. Baseline-adjusted analysis of free remimazolam concentrations showed a significant time-by-group interaction (p<inf>interaction</inf> = 0.001), increasing over time in the normal-dose group but remaining stable in the low-dose group. The largest adjusted between-group difference was observed 30 minutes after CPB termination (mean difference [95% CI], 89 [58-120] ng/mL; p < 0.001). No linear association was observed between bispectral index values and free or total remimazolam concentrations. Conclusion(s): During CPB, free remimazolam concentrations increased over time under constant infusion without corresponding changes in bispectral index values, whereas reducing the infusion rate to 70% at CPB initiation maintained free remimazolam concentrations within a stable range. Copyright © 2026 Elsevier Inc. <38> 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. 40(11) (pp 3817-3828), 2026. Date of Publication: 01 Nov 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. <39> Accession Number 2047312795 Title Intracardiac Echocardiography for Procedural Guidance of Left Atrial Appendage Occlusion From Right Atrium: A Subgroup From a Multicenter Randomized Controlled Trial With Two Intracardiac Echocardiography Imaging Systems. Source Journal of Cardiovascular Electrophysiology. 37(10) (pp 2203-2211), 2026. Date of Publication: 01 Oct 2026. Author Huang B.; Hao Z.; Kuang Y.; Wang J.; Chu H.; Ning Z.; Li H.; Ma W.; Zhang X.; He B.; Xu J.; Jiang L. Institution (Huang, Kuang, Wang, He, Xu, Jiang) Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China (Hao) Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (Chu) Department of Cardiology, The First Affiliated Hospital of Ningbo University, Zhejiang, Ningbo, China (Ning) Department of Cardiology, Shanghai Pudong New District Zhoupu Hospital, Shanghai, China (Li) Department of Cardiology, Shenzhen Hospital, The University of Hong Kong, Shenzhen, China (Ma) Department of Cardiology, Peking University First Hospital, Beijing, China (Zhang) Department of Cardiology, Huai'an First People's Hospital, Jiangsu, Huai'an, China Publisher John Wiley and Sons Inc Abstract Background: Intracardiac echocardiography (ICE)-guided left atrial appendage occlusion (LAAO) from left atrium under local anesthesia showed potential advantages over transesophageal echocardiography (TOE). This study sought to demonstrate the intraprocedural efficiency and safety of LAAO with ICE guidance in right atrium. Method(s): In a multicenter randomized controlled trial to assess whether the imaging quality of a novel DynaSight ICE system (SONOSEMI, Shenzhen, China) is noninferior to the SoundStar (Biosense Webster, USA), a sub-group analysis was performed in patients who underwent LAAO under local anesthesia with ICE guidance in right atrium. Result(s): Thirty-three of 66 in the DynaSight group and 30 of 67 in the SoundStar group were performed LAAO with ICE guidance in right atrium. There were no statistical differences between two groups in baseline characteristics including demographics, cardiovascular comorbidities, CHA2DS2-VASc score, and HAS-BLED score. Both ICE systems had similar clear image qualities according to multi-plane assessments for home view, atrial septum and left atrium, and judgments for occluders including displaying location and resolution. There was comparable procedural successful rate for device implantation (100% in the DynaSight group vs. 96.67% in the SoundStar group, p = 0.4762) and occurrence of major peri-procedural complications including tamponade, device embolism, death, major bleeding, and ischemic stroke/transient ischemic attack/systemic embolism (0 of 33 in the DynaSight group vs. 3 of 30 in the SoundStar group, p = 0.1022). Conclusion(s): The DynaSight ICE system has the same clear image quality as the SoundStar, which-guided LAAO with the catheter in right atrium is intraprocedural effective and safe for device implantation. Copyright © 2026 Wiley Periodicals LLC. <40> Accession Number 2047626279 Title Enhanced Recovery After Cardiac Surgery: A Bibliometric Analysis With Emphasis on Perioperative and Anesthetic Practice. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(11) (pp 3710-3726), 2026. Date of Publication: 01 Nov 2026. Author Huang S.; Chao M.; Zhao X.-S.; Liu K.-X.; Gao S.-S.; Yao Y.-T. Institution (Huang, Zhao, Liu, Gao, Yao) Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China (Huang, Zhao, Liu, Gao, Yao) The Evidence in Cardiovascular Anesthesia (EICA) Group, Beijing, China (Chao, Yao) Center of Outcomes Research, Department of Anesthesiology, Critical Care and Pain Medicine, University of Texas, Houston, TX, United States (Chao, Yao) Outcomes Research Consortium, Houston, TX, United States Publisher W.B. Saunders Abstract Objectives: To systematically characterize the global research landscape and emerging trends of enhanced recovery after cardiac surgery (ERACS). Design(s): Bibliometric analysis. Data Source: Publications were retrieved from the Web of Science Core Collection database, a comprehensive repository of peer-reviewed international literature. Study Selection: A total of 725 publications related to ERACS published between 1979 and 2026 were included. Intervention(s): Not applicable. Measurements and Main Results: Annual publication output increased markedly after 2015, indicating growing interest in ERACS. The United States and Canada were the leading contributors in both productivity and academic influence. Co-occurrence and clustering analyses identified major research themes, including minimally invasive cardiac surgery, multimodal analgesia, perioperative management, and postoperative complications. Temporal keyword analysis demonstrated a transition from early extubation strategies toward comprehensive perioperative care pathways. Despite this expansion, high-quality randomized evidence remains limited. Conclusion(s): This bibliometric analysis provides a comprehensive overview of the evolving research landscape of ERACS. The field is rapidly expanding and shifting toward integrated perioperative care models. However, further high-quality studies are required to strengthen the evidence base and support clinical implementation. Copyright © 2026 Elsevier Inc. <41> Accession Number 2047687886 Title Measuring patient disability in the peri-operative period using the WHODAS 2.0 questionnaire: a systematic review. Source Anaesthesia. 81(11) (pp 1569-1580), 2026. Date of Publication: 01 Nov 2026. Author Boerlage R.M.; van Dartel D.; Vernooij J.E.M.; Koning N.J.; Posthuma L.M.; Kalkman C.J.; Doggen C.J.M.; Preckel B. Institution (Boerlage, Vernooij, Koning) Department of Anaesthesiology and Pain Medicine, Rijnstate Hospital, Arnhem, Netherlands (Boerlage, Doggen) Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, Netherlands (Boerlage, Doggen) Clinical Research Center, Rijnstate Hospital, Arnhem, Netherlands (Boerlage, Preckel) Department of Anaesthesiology, Amsterdam UMC location AMC, Amsterdam, Netherlands (van Dartel) Department of Intensive Care, Gelre ziekenhuizen, Apeldoorn, Netherlands (Posthuma) Department of Intensive Care, Albert Schweitzer Hospital, Dordrecht, Netherlands (Kalkman) Department of Anaesthesiology, University Medical Centre Utrecht, Utrecht, Netherlands (Preckel) Amsterdam Public Health, Quality of Care Research Institute, Amsterdam, Netherlands (Preckel) Amsterdam Cardiovascular Science Research Institute, Amsterdam, Netherlands Publisher John Wiley and Sons Inc Abstract Introduction: The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is recommended by peri-operative core outcome sets as a measure of disability. Despite its growing use, the effect of different surgical procedures on disability measured by WHODAS 2.0 remains poorly understood and heterogeneous reporting across studies limits direct comparison. Method(s): We conducted a systematic review to assess the effect of different surgical procedures on disability measured by WHODAS 2.0, and the reporting of disability endpoints in peri-operative medicine. The primary outcome was the difference in WHODAS 2.0 summary score before and after surgery. Disability scores were calculated as a metric between 0% (no disability) and 100% (complete disability). Result(s): Thirty-nine studies were included. Pre-operative disability ranged from 2% to 61%. In 21 studies, disability increased by 1% to 17% within 3 months of surgery, with little change between 6 and 12 months (0% to -2%). Studies of orthopaedic surgery generally reported high pre-operative disability (> 35%) but also reductions in disability (10-37% reduction) within 3 months of surgery. In contrast, studies evaluating cancer surgery (n = 12) generally reported lower pre-operative disability (< 20%) but small increases (1-8%) within 3 months of surgery. Cardiovascular surgical studies displayed pre-operative disability between 4% and 17% with a difference in disability of -8% to +3% 3 months after surgery. Three different thresholds to define disability and 13 different WHODAS 2.0 endpoints were used, measured at eight different time-points after surgery. Discussion(s): The effect of surgical procedures on postoperative disability as measured by WHODAS 2.0 is influenced by the type of surgery. Orthopaedic surgery may decrease disability, whereas cancer surgery may be associated with persistent increases. Standardised reporting of disability endpoints is needed to enhance the quality and comparability of future studies using WHODAS 2.0. Copyright © 2026 The Author(s). Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists. <42> Accession Number 2048124175 Title Milrinone versus Dobutamine as Supportive Agent for Right Ventricular Dysfunction after Cardiopulmonary Bypass: A Randomized Comparative Study. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(11) (pp 3513-3522), 2026. Date of Publication: 01 Nov 2026. Author Hegazy M.A.; Abdelbaser I.; Abdellatif A.; Mamdouh M.; Atallah A.; Farid A.; Elsayed H.M.; Alseoudy M. Institution (Hegazy, Abdelbaser, Abdellatif, Mamdouh, Farid, Elsayed, Alseoudy) Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt (Hegazy) Department of Anesthesia and Intensive Care, Emirates Health Services, United Arab Emirates, Sharjah, United Arab Emirates (Atallah) Ministry of Health, Aga, Egypt Publisher W.B. Saunders Abstract Objectives: To compare milrinone versus dobutamine for right ventricular (RV) dysfunction after cardiopulmonary bypass (CPB). Design(s): Randomized, open-label, parallel-group controlled trial. Setting(s): A tertiary cardiac surgery center. Participant(s): Adults (N = 88) with new RV systolic dysfunction (tricuspid annular plane systolic excursion [TAPSE] <=17 mm) post-CPB. Intervention(s): Milrinone (loading 50 microg/kg over 10 minutes, then 0.3-0.8 microg/kg/min) or dobutamine (2-10 microg/kg/min). Measurements & Main Results: The co-primary outcomes were duration of mechanical ventilation (clinical) and change in TAPSE over 24 hours (echocardiographic). Secondary outcomes included RV fractional area change, pulmonary artery systolic pressure (PASP), left ventricular outflow tract velocity-time integral, intensive care unit stay, arrhythmias, hypotension, and vasopressor need. Both groups had similar baseline characteristics. TAPSE improved significantly over 24 hours in both groups (p < 0.001). After adjustment for baseline TAPSE and left ventricular ejection fraction, milrinone was associated with modestly higher TAPSE at 24 hours (adjusted difference 1.82 mm, 95% CI 0.72-2.92, p = 0.001), though the clinical significance of this difference is uncertain. Milrinone required more norepinephrine than dobutamine (93.2% v 72.7%, p = 0.021). Other clinical outcomes did not differ significantly. In an exploratory subgroup analysis of patients with baseline post-CPB PASP >40 mmHg (n = 30), milrinone produced greater TAPSE improvement at 1, 6, and 24 hours (p < 0.05 for each), with a statistically significant interaction (p = 0.010); norepinephrine use was similar between groups in this subgroup (93.8% v 85.7%, p = 0.586). In patients with PASP <=40 mmHg (n = 58), the drugs were equivalent. Conclusion(s): Milrinone and dobutamine provide comparable overall RV recovery, though milrinone was associated with modestly higher adjusted TAPSE at 24 hours of uncertain clinical significance and increased norepinephrine requirements. An exploratory subgroup analysis suggests milrinone may provide superior RV functional recovery in patients with elevated post-CPB PASP (>40 mmHg), though this hypothesis-generating finding requires prospective validation. Copyright © 2026 Elsevier Inc. <43> Accession Number 2045659247 Title Methemoglobin Formation Reflects Systemic Nitric Oxide Uptake: The Critical Role of Delivery Method-Results from Secondary Analysis of a Randomized Controlled Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(11) (pp 3693-3700), 2026. Date of Publication: 01 Nov 2026. Author Cenci S.; Gaonkar M.; Villalobos R.; Medeiros K.J.; Shetty N.; Nardini R.; Carroll R.W.; Bittner E.A.; Winkler T.; Yu B.; Lewandrowski K.B.; Ichinose F.; Arora P.; Berra L. Institution (Cenci, Villalobos, Medeiros, Shetty, Bittner, Winkler, Ichinose, Berra) Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, United States (Cenci, Medeiros, Shetty, Nardini, Yu, Ichinose, Berra) Anesthesia Center for Critical Care Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, United States (Gaonkar, Arora) Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, United States (Carroll) Division of Pediatric Critical Care, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States (Carroll, Bittner, Winkler, Yu, Lewandrowski, Ichinose, Berra) Harvard Medical School, Boston, MA, United States (Lewandrowski) Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States (Arora) Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL, United States (Berra) Respiratory Care Department, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States Publisher W.B. Saunders Abstract Objectives: Methemoglobin (metHb) is routinely monitored as a safety marker during inhaled nitric oxide (NO) therapy but may also reflect systemic NO uptake. This study aims to investigate how different NO delivery systems influence metHb formation rates and systemic NO uptake. Design(s): Retrospective analysis of a randomized controlled trial. Setting(s): Single-center study at an academic institution. Participant(s): Adults undergoing cardiac surgery with preoperative signs/symptoms suggestive of endothelial dysfunction. Intervention(s): Patients received 80 parts-per-million (ppm) of NO for 24 consecutive hours to prevent postoperative kidney injury. NO was subsequently administered via cardiopulmonary bypass (CPB), mechanical ventilation (MV), and nasal cannula (NC). Systemic metHb formation and NO uptake rates were assessed and compared across different NO delivery methods. Measurements and Main Results: Data on metHb from 105 patients were analyzed. Median metHb levels were 0.6% during CPB, 2.1% during ICU MV, and 0.8% during NC administration. Duration of NO exposure significantly affected metHb levels (p < 0.001). The slope of metHb increase was higher during MV than during CPB (beta = 8.354 * 10-3 v beta = 3.738 * 10-3, p < 0.001), whereas metHb levels declined during NC with a negative slope compared with CPB (beta = -5.352 * 10-3 v beta = 3.738 * 10-3, p < 0.001). Estimated NO delivery rates were greater with MV than with CPB (median 25.1 v 8.2 mumol/min, p < 0.001). Conclusion(s): NO delivery modalities significantly influence metHb formation and systemic NO uptake. Monitoring biomarkers of NO uptake, such as metHb, may help optimize NO therapy beyond delivered concentration, particularly when extrapulmonary effects are desired. Copyright © 2026 Elsevier Inc. <44> Accession Number 2047601085 Title Superiority of Fibrinogen Concentrate Versus Cryoprecipitate for Treatment of Bleeding in Cardiac Surgery Patients: A Secondary Analysis of the FIBRES Randomized Clinical Trial Stratified by Surgical Risk. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(11) (pp 3607-3615), 2026. Date of Publication: 01 Nov 2026. Author Bartoszko J.; Karkouti K.; Callum J.L. Institution (Bartoszko, Karkouti) Department of Anesthesia and Pain Management, University Health Network, Sinai Health, Women's College Hospital, University of Toronto, Toronto, ON, Canada (Bartoszko, Karkouti) Peter Munk Cardiac Centre and Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada (Bartoszko, Karkouti) Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada (Callum) Department of Pathology and Molecular Medicine, Kingston Health Sciences Centre and Queen's University, Kingston, ON, Canada Publisher W.B. Saunders Abstract Objectives: To explore the superiority of fibrinogen concentrate (FC) versus cryoprecipitate for bleeding after cardiac surgery. Design(s): Secondary analysis of the FIBRES randomized trial. Setting(s): Eleven Canadian hospitals, February 2017-November 2018. Participant(s): Adult cardiac surgery patients experiencing significant postbypass bleeding and acquired hypofibrinogenemia (fibrinogen <2.0 g/L or FIBTEM A10 <10 mm). Intervention(s): FC (4 g) or cryoprecipitate (10 units) dosed within 24 hours after cardiopulmonary bypass as needed. Measurements and Main Results: In total, 735 patients (372 FC, 363 cryoprecipitate) were included in the primary analysis (median age 64 years, 30% women). The primary endpoint was cumulative blood components (red cells, platelets, plasma) administered within 24 hours postbypass. Superiority was assessed using deviance-scaled Poisson regression. FC was superior to cryoprecipitate in the a priori-defined, well-balanced subgroups of non-critically ill patients (n = 634, 86% of population; mean 13.6 versus 16.2 units, mean ratio 0.84 [95% CI 0.73, 0.96]; p = 0.01) and elective surgery patients (n = 466, 63% of population; 11.7 versus 14.4 units, 0.81 [0.69, 0.96]; p = 0.02). In elective surgery patients, adverse events (relative risk 0.85 [0.75, 0.97]; p = 0.02) and serious adverse events (0.71 [0.52, 0.99]; p = 0.04) were less frequent with FC. Conclusion(s): FC showed superior hemostatic efficacy to cryoprecipitate in the prespecified subgroups of elective cardiac surgery patients and patients who were not in a critical state before surgery, representing the large majority of patients with bleeding postbypass. FC may also offer safety advantages over cryoprecipitate. Copyright © 2026 The Author(s) <45> Accession Number 2050354225 Title Home versus centre exercise-based cardiac rehabilitation after coronary artery bypass grafting: a systematic review and meta-analysis. Source Heart and Lung. 80 (no pagination), 2026. Article Number: 102975. Date of Publication: 01 Nov 2026. Author Zheng X.; Liu R.; Yu Z.; Lu F. Institution (Zheng, Liu, Yu, Lu) Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Zheng) Department of Nursing, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China Publisher Elsevier Inc. Abstract Background: Exercise-based home-based cardiac rehabilitation (HBCR) is an alternative to exercise-based centre-based cardiac rehabilitation (CBCR) following coronary artery bypass grafting (CABG); however, its effects on functional capacity, psychological outcomes, and health-related quality of life remain uncertain. Objective(s): To evaluate exercise-based HBCR compared with exercise-based CBCR or usual care (UC) after CABG. Method(s): The protocol was registered in PROSPERO (CRD420251238099) on 23 November 2025, followed by the formal systematic search on 25 November 2025 in PubMed (MEDLINE), Embase, Cochrane CENTRAL, Web of Science, and CINAHL. Randomized controlled trials comparing exercise-based HBCR with CBCR or UC were included. Outcomes included peak oxygen uptake (VO2), waist-hip ratio (WHR), health-related quality of life (HRQoL), anxiety, and depression. Mean differences (MDs) with 95% confidence intervals (CIs) were pooled. Result(s): Nine trials (n = 991) were included. No significant difference in peak VO2 was observed between HBCR and CBCR (MD = -0.22, 95% CI -1.24 to 0.80; I2 = 0%). Anxiety favored HBCR over UC (MD = -2.85, 95% CI -5.05 to -0.65), but heterogeneity was extreme (I2 = 90%). No significant difference in depression was observed (MD = -1.83, 95% CI -4.15 to 0.48; I2 = 95%). HRQoL and body composition were each reported by only two studies and were not meta-analyzed. Conclusion(s): Evidence suggests no significant difference in functional capacity between exercise-based HBCR and CBCR. Evidence for patient-reported and psychosocial outcomes remains limited and inconclusive, and no firm conclusions can be drawn. Findings should be interpreted cautiously given the small number of studies and substantial heterogeneity. Copyright © 2026 <46> Accession Number 2048961499 Title Should Left Atrial Appendage Occlusion Devices Be Routinely Used Instead of Oral Anticoagulants to Prevent Thromboembolic Events, Stroke, and Bleeding for Patients With Non-Valvular Atrial Fibrillation?. Source Journal of Cardiovascular Electrophysiology. 37(10) (pp 2403-2408), 2026. Date of Publication: 01 Oct 2026. Author Kantharia B.K.; Slee A.; Olshansky B. Institution (Kantharia) Cardiovascular and Heart Rhythm Consultants, Icahn School of Medicine at Mount Sinai, New York, NY, United States (Slee) New Arch Consulting LLC, Seattle, WA, United States (Olshansky) Francois M. Abboud Cardiovascular Research Center, University of Iowa, Iowa City, IA, United States Publisher John Wiley and Sons Inc Abstract Introduction: Oral anticoagulants (OACs), preferably direct (D)/non-vitamin K (N) dependent OACs [DOACs/NOACs] are recommended for the management of patients with non-valvular atrial fibrillation (AF) at risk for thromboembolic events, including stroke. Left atrial appendage occlusion (LAAO) device implantation has been considered for patients who are unsuitable for OACs or prefer not to take them. Herein, we discuss the clinical evidence for routine use of LAAO instead of OACs for patients with AF at risk of thromboembolic events, stroke, and bleeding. Method(s): From pertinent, recent, randomized clinical trials, the CHAMPION-AF (Watchman Flx vs. NOAC for Embolic Protection in the Management of Patients with Non-Valvular Atrial Fibrillation), and CLOSURE-AF (Catheter-Based Left Atrial Appendage Closure in Patients with Atrial Fibrillation at High Risk of Stroke and Bleeding as Compared with Best Medical Therapy) were selected for review. Result(s): As interpreted by the authors of the CHAMPION-AF trial, LAAOs were considered non-inferior to NOACs at 3 years. In the CLOSURE-AF trial, non-inferiority criteria were not met. For safety, that is, bleeding, LAAO was considered superior in CHAMPION-AF. We found several points related to both trials that are critical to interpret the results and clinical implications of these trials. These points are particularly related to the interpretation of non-inferiority trial design, selection bias, combined primary endpoint, bleeding and peri-procedural bleeding complications, serious adverse events, cross-over rates, sub-group analyses, conflicts of interest, and mechanism of stroke. Conclusion(s): Data from the CHAMPION-AF and CLOSURE trials do not favor routine and widespread use of LAAO devices in non-valvular AF patients over use of OACs. Copyright © 2026 Wiley Periodicals LLC. <47> Accession Number 2049631671 Title Long-term survival after multiple arterial coronary artery bypass grafting compared with percutaneous coronary intervention: a systematic review and meta-analysis. Source Surgery Today. (no pagination), 2026. Date of Publication: 2026. Author Nishida H.; Nakamura R.; Tamaki R.; Abe K.; Rahman M. Institution (Nishida, Rahman) Graduate School of Public Health, St. Luke's International University, Tokyo, Japan (Nishida, Nakamura, Tamaki, Abe) Department of Cardiovascular Surgery, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, Japan Publisher Springer Abstract Background: Multiple arterial coronary artery bypass grafting (CABG) has been associated with superior long-term outcomes compared with single arterial CABG. However, randomized trials comparing percutaneous coronary intervention (PCI) with CABG have largely evaluated single arterial grafting strategies, leaving evidence comparing multiple arterial CABG with PCI limited. Method(s): This systematic review and meta-analysis was registered prospectively in PROSPERO (CRD42025106759). MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched for studies published from inception through September 30, 2025, that compared outcomes between multiple arterial CABG and PCI in patients with multivessel coronary artery disease. Study-level meta-analyses and reconstructed individual patient data (IPD) meta-analyses were performed. The primary outcome was all-cause mortality, and the secondary outcome was major adverse cardiovascular and cerebrovascular events (MACCE). Result(s): Ten observational studies were included. Study-level meta-analysis showed higher all-cause mortality with PCI (hazard ratio [HR] 1.78, 95% confidence interval [CI] 1.51-2.09), consistent with reconstructed IPD analysis (HR 2.05, 95% CI 1.86-2.27). PCI was also associated with increased MACCE (study-level HR 2.48, 95% CI 1.91-3.21; IPD HR 2.94, 95% CI 2.56-3.39). Conclusion(s): In multivessel coronary artery disease, multiple arterial CABG was associated with significantly lower long-term mortality and MACCE than PCI, supporting its consideration in heart team decision-making. Copyright © The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd. 2026. <48> Accession Number 2049621689 Title Development in Left Ventricular Mass After Early and Late Conversion From Calcineurin Inhibitors to Everolimus in Heart Transplant Recipients-Results From Two Randomized Controlled Trials. Source Clinical Transplantation. 40(10) (no pagination), 2026. Article Number: e70705. Date of Publication: 01 Oct 2026. Author Murbraech K.; Tecklzig F.; Massey R.J.; Gude E.; Gustafsson F.; Eiskjaer H.; Karason K.; Radegran G.; Andreassen A.K.; Gullestad L.; Broch K. Institution (Murbraech, Massey, Gude, Andreassen, Gullestad, Broch) Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway (Tecklzig, Massey, Gullestad, Broch) Faculty of Medicine, University of Oslo, Oslo, Norway (Gude, Gullestad, Broch) KG Jebsen Center For Cardiac Research and Center for Heart Failure Research, University of Oslo, Oslo, Norway (Gustafsson) Department of Cardiology, Rigshospitalet, Copenhagen, Denmark (Eiskjaer) Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (Karason) Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden (Radegran) The Clinic for Heart Failure and Valvular Disease, Skane University Hospital, Lund, Sweden (Radegran) Lund University, Lund, Sweden Publisher John Wiley and Sons Inc Abstract Left ventricular hypertrophy in heart transplant recipients has been attributed to the use of calcineurin inhibitors. We assessed left ventricular mass across treatment arms in 83 heart transplant recipients in the Scandinavian heart transplant everolimus de novo study with early calcineurin inhibitors avoidance (SCHEDULE), and in 75 maintenance recipients in the Nordic Certican Trial in Heart and Lung Transplantation (NOCTET). In SCHEDULE, we randomized participants to treatment with calcineurin inhibitors or replacement with everolimus within 7-11 weeks after transplant. In NOCTET, participants were randomized to treatment with calcineurin inhibitors or a combination of low dose calcineurin inhibitors and everolimus. We followed patients with echocardiography for 3 years in the SCHEDULE trial and for 5 years in NOCTET. In SCHEDULE, left ventricular mass diminished with time, particularly across the first year of follow-up (everolimus arm: -10 +/- 18 g/m2, cyclosporine arm: -9 +/- 13 g/m2). However, there was no between-group difference in this development (p = 0.91). In NOCTET, there was no significant change in LVM over time and no between-group difference in the change (p = 0.27). In conclusion, the replacement of calcineurin inhibitors with everolimus or a reduction in the calcineurin inhibitor dose did not mitigate left ventricular hypertrophy after heart transplantation. Trial Registration: SCHEDULE-ClinicalTrials.gov Identifier: NCT01266148; NOCTET-ClinicalTrials.gov Identifier: NCT00377962. Copyright © 2026 The Author(s). Clinical Transplantation published by Wiley Periodicals LLC. <49> Accession Number 2049612393 Title Trial Of Pathogen-reduced Cryoprecipitate vs. cryoprecipitated AHF to Lower Operative Transfusions (TOP-CLOT): a single center, prospective, cluster randomized trial in cardiovascular surgery. Source Journal of Clinical Anesthesia. 116 (no pagination), 2027. Article Number: 112335. Date of Publication: 01 Jan 2027. Author Cushing M.M.; Cohen T.; Girardi N.I.; Jimenez A.; Andy C.; Milewski A.R.; Fitzgerald M.M.; Chen D.; Parra P.; Rand S.; Sinfort A.; Lau C.; Keltner N.; Corash L.; Mack C.; DeSimone R.A. Institution (Cushing, Cohen, Jimenez) Weill Cornell Medicine, Pathology and Laboratory Medicine, 1300 York Avenue, New York, NY, United States (Girardi, Fitzgerald) Weill Cornell Medicine, Clinical Anesthesiology, 1300 York Avenue, New York, NY, United States (Andy) Weill Cornell Medicine, Population Health Sciences, Division of Biostatistics, 1300 York Avenue, New York, NY, United States (Milewski) Weill Cornell Medicine, Anesthesiology, 1300 York Avenue, New York, NY, United States (Chen, Parra) NewYork-Presbyterian Hospital, Transfusion Medicine, 525 East 68th Street, New York, NY, United States (Rand) Weill Cornell Medicine, 1300 York Avenue, New York, NY, United States (Sinfort) Columbia University Vagelos College of Physicians and Surgeons, 630 W 168th St, New York, NY, United States (Lau, Mack) Weill Cornell Medicine, Cardiothoracic Surgery, 1300 York Avenue, New York, NY, United States (Keltner) Cerus Corporation, Clinical Strategy and Education, 1220 Concord Ave Suite 600, Concord, CA, United States (Corash) Cerus Corporation, 1220 Concord Ave Suite 600, Concord, CA, United States (DeSimone) Weill Cornell Medicine, Clinical Pathology and Laboratory Medicine, 1300 York Avenue, New York, NY, United States Publisher Elsevier Inc. Abstract Background Low perioperative fibrinogen levels potentiate hemorrhage and increase transfusions in cardiac surgery patients. Cryoprecipitated anti-hemophilic factor (Cryo) requires on-demand thawing, often delaying fibrinogen supplementation; its short post-thaw shelf life limits pre-emptive availability. In contrast, Pathogen Reduced Cryoprecipitated Fibrinogen Complex (PR CRYO) can be stored post-thaw at room temperature for up to five days, allowing immediate availability without the need for on-demand thawing. This single-center, randomized trial compared PR CRYO to Cryo in cardiac surgery patients with suspected hypofibrinogenemia to determine whether PR CRYO reduces transfusions. Methods Cryoprecipitate orders were cluster-randomized by month to PR CRYO or Cryo. Bleeding cardiac surgery patients receiving intraoperative cryoprecipitate were included. The primary outcome was number of allogeneic blood components transfused within 30 days. Multivariable mixed effects regression was used to evaluate outcomes. Results The trial stopped early for futility after 170 of 502 planned patients (84 PR CRYO, 86 Cryo; conditional power 8.2%). Baseline characteristics were similar; valve/CABG procedures were most common (51%), followed by aneurysm (38%), and aortic arch repair (11%). Total blood component utilization was identical (6 units, IQR 3-12, both groups; p > 0.9). PR CRYO was issued 19 min faster (12 vs. 31 min; p < 0.001) and transfusion began 16 min sooner (46 vs. 62 min; p = 0.008). Adverse events and 3-day transfusions were similar. Conclusions PR CRYO was available earlier for bleeding patients in this first clinical trial of the product. No reduction in 30 day transfusions was demonstrated in this underpowered, single-center superiority trial. Safety and efficacy outcomes were numerically similar between groups; however, the trial was not designed to assess noninferiority, and therefore equivalence cannot be formally concluded. Copyright © 2026. Published by Elsevier Inc. <50> Accession Number 2049621962 Title Generalizing Conditional Average Treatment Effects From Nested Randomized Trials to Trial-Eligible Individuals. Source Statistics in Medicine. 45(23-24) (no pagination), 2026. Article Number: e70767. Date of Publication: 01 Oct 2026. Author Wen L.; Dahabreh I.J.; Chiu Y.-H. Institution (Wen) Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, Canada (Dahabreh) Department of Epidemiology and Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States (Chiu) Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States (Chiu) Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, RI, United States Publisher John Wiley and Sons Ltd Abstract Randomized controlled trials often enroll participants whose characteristics differ from those of a target population. When the distribution of effect modifiers differs between trial participants and the target population, treatment effects estimated within the trial may not be directly applicable to all trial-eligible individuals. Although substantial progress has been made in generalizing average treatment effects from randomized trials to target populations, clinical and policy decisions are often informed by conditional average treatment effects (CATEs) that characterize heterogeneity across selected effect modifiers in the target population. In this work, we provide a unified approach for estimating CATEs in a target population of trial-eligible individuals under a nested trial design. Our approach first estimates nuisance functions using data-adaptive methods and constructs pseudo-outcomes from conditional influence functions. These pseudo-outcomes are subsequently regressed on pre-specified effect modifiers using local linear (kernel) regression to obtain a smoothed estimate of the CATE function. We establish asymptotic properties under sample splitting and cross-fitting, and provide conditions under which first-stage nuisance estimation has negligible impact on the final estimator. We assess the finite-sample performance of the proposed estimator via simulation studies, and illustrate its practical use through an application to the Coronary Artery Surgery Study (CASS). Copyright © 2026 The Author(s). Statistics in Medicine published by John Wiley & Sons Ltd. <51> Accession Number 2050180903 Title Efficacy of Oral Clonidine On Intraoperative Hemodynamics and Postoperative Analgesia in Patients Undergoing Lumbar Spine Surgeries. Source International Journal of Drug Delivery Technology. 16(80 Supplement) (pp 1230-1234), 2026. Date of Publication: 2026. Author Chaudhari A.V.; Vazhakalayil S.T.J. Institution (Chaudhari, Vazhakalayil) Department of Anaesthesiology, Dr.D.Y.Patil Medical College, Hospital and Research Centre, Pimpri, Pune, India Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background: Lumbar spine surgery is associated with significant perioperative sympathetic responses and postoperative pain. Clonidine, an alpha 2-adrenergic agonist, may attenuate hemodynamic responses while providing analgesic and anesthetic-sparing effects. This study evaluated the efficacy of oral clonidine as premedication in patients undergoing lumbar spine surgery. Method(s): This prospective, randomized, double-blinded comparative study included 64 ASA I-II patients aged 18-65 years undergoing lumbar spine surgery under general anesthesia. Patients were randomly allocated to receive oral clonidine 100 mug (Group S, n=32) or placebo (Group C, n=32) 45 minutes before surgery. Intraoperative heart rate (HR), systolic, diastolic and mean arterial pressure (MAP), fentanyl and propofol requirements were assessed. Postoperative pain, duration of analgesia, time to first rescue analgesia, rescue analgesic consumption, sedation, and adverse events were evaluated. Result(s): Baseline characteristics and hemodynamic parameters were comparable between groups. Intraoperatively, HR and MAP were significantly lower in the clonidine group at all assessed time points after baseline (p<0.001). Fentanyl consumption was significantly lower with clonidine (198.6 +/- 9.4 vs 268.3 +/- 10.6 mug; p<0.001), while additional propofol was required in 40.6 versus 100 of patients (p<0.001). Postoperative VAS scores were generally lower with clonidine, with significant differences from 60 minutes onward at most assessment points. Duration of analgesia and time to first rescue analgesia were significantly prolonged, while 24-hour rescue analgesic requirements were reduced (p<0.001). Early postoperative sedation was greater with clonidine but resolved by 2 hours. Adverse events were comparable between groups. Conclusion(s): Oral clonidine 100 mug administered 45 minutes preoperatively provided effective hemodynamic stabilization, reduced anesthetic and opioid requirements, and improved postoperative analgesia without significant additional adverse effects. Copyright © 2026, Dr. Yashwant Research Labs Pvt. Ltd. All rights reserved. <52> Accession Number 2050164181 Title Does a Simple Touch Make a Difference? The Effect of Acupressure on Pain Scores in Infants Undergoing Cardiac Catheterization: A Randomized, Placebo-Controlled Trial. Source Journal of Cardiovascular Nursing. 41(6) (pp E623-E632), 2026. Date of Publication: 01 Dec 2026. Author Ercan-Koyuncu I.; Gozen D. Institution (Ercan-Koyuncu) Department of Nursing, Faculty of Health Sciences, Baskent University, Ankara, Turkey (Gozen) Department of Child Health and Diseases Nursing Doctorate Programme, Institute of Graduate Studies, Istanbul University-Cerrahpasa, Istanbul, Turkey (Gozen) Department of Pediatric Nursing, Faculty of Nursing, Koc University, Istanbul, Turkey Publisher Lippincott Williams and Wilkins Abstract Background: - Infants with congenital heart disease frequently undergo cardiac catheterization, an invasive procedure associated with pain and physiological stress. Objective(s): - Our aim was to evaluate the effects of acupressure applied before and after cardiac catheterization on pain, heart rate, and oxygen saturation. Method(s): - This randomized placebo-controlled trial was conducted in the pediatric cardiac surgery unit of Baskent University Ankara Hospital, Turkiye, between November 2024 and October 2025. Sixty infants aged 1-12 months with congenital heart disease who were undergoing cardiac catheterization were randomly assigned to the acupressure, placebo, or control group, with 20 infants in each group. Acupressure was applied to the HT7, LI4, and PC6 points before and after the procedure. Pain was assessed using the Face, Legs, Activity, Cry, Consolability scale, while heart rate and oxygen saturation were measured from the preprocedural period to discharge. Data were analyzed using analysis of variance and chi-square tests. Result(s): - Infants in the acupressure group had significantly lower pain scores than those in the placebo and control groups at all postprocedural time points. Heart rate values were also significantly lower in the acupressure group during follow-up. Analgesic use was less frequent in the acupressure group than in the placebo and control groups. Oxygen saturation improved over time, with no significant between-group differences at individual time points. Conclusion(s): - Acupressure may be an effective, noninvasive, nurse-delivered complementary intervention for reducing procedural pain, supporting physiological stability, and decreasing analgesic requirements in infants with congenital heart disease undergoing cardiac catheterization. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <53> Accession Number 2047012736 Title Does gabapentin add value to multimodal analgesia in thoracic surgery? A procedure-specific meta-analysis. Source Pain Management. 16(10) (pp 1161-1169), 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. <54> 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. 41(6) (pp E578-E585), 2026. Date of Publication: 01 Nov 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, LLC. All rights reserved. <55> Accession Number 2049263378 Title Remimazolam Versus Dexmedetomidine for Monitored Anesthesia Care in Patients Undergoing Transfemoral Transcatheter Aortic Valve Implantation: A Randomized Clinical Trial. Source Journal of Clinical Medicine. 15(18) (no pagination), 2026. Article Number: 7182. Date of Publication: 01 Sep 2026. Author Hyung S.-W.; Choi M.; Chung M.Y.; Hwang W. Institution (Hyung, Chung) Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Department of Anesthesiology and Pain Medicine, Seoul, South Korea (Choi) Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Department of Anesthesiology and Pain Medicine, Bucheon, South Korea (Hwang) Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Monitored anesthesia care is increasingly used for transfemoral transcatheter aortic valve implantation (tf-TAVI), but the optimal sedative regimen remains uncertain. We compared remimazolam with dexmedetomidine during tf-TAVI. Method(s): In this single-center randomized trial, 34 patients were assigned 1:1 to remimazolam or dexmedetomidine. Primary outcomes were the number of intraoperative hypotensive episodes, defined as mean arterial pressure <65 mmHg requiring vasopressor treatment, and cumulative phenylephrine and norepinephrine doses. Secondary outcomes included hemodynamic and physiological variables, regional cerebral oxygen saturation (rSO<inf>2</inf>), arterial blood gases, recovery time, surgeon requests for deeper sedation, and procedural outcomes. Longitudinal variables were analyzed using generalized estimating equations with Holm adjustment for time-specific comparisons. Result(s): No significant between-group differences were detected in intraoperative hypotensive episodes or cumulative phenylephrine and norepinephrine doses, and no significant group-by-time interactions were observed for blood pressure. Both left and right rSO<inf>2</inf> showed significant group-by-time interactions, with higher remimazolam values at selected time points after Holm adjustment. Arterial carbon dioxide tension was higher and arterial pH lower with remimazolam immediately before rapid ventricular pacing and at procedure completion. Recovery was faster with remimazolam (mean +/- standard deviation, 13.5 +/- 7.2 vs. 32.4 +/- 12.5 min; p < 0.001), and surgeon requests for deeper sedation were less frequent (11.8% vs. 76.5%; p < 0.001). Conclusion(s): Remimazolam was associated with faster recovery and fewer surgeon requests for deeper sedation; however, the trial was not designed or powered to establish equivalence for hypotensive episodes, vasopressor requirements or hemodynamic outcomes. Copyright © 2026 by the authors. <56> Accession Number 2045111017 Title Research Trends on Deep Breathing Exercises in Perioperative Care: A Bibliometric and Topic Modeling Analysis. Source Journal of Perianesthesia Nursing. 41(5) (pp 1422-1433), 2026. Date of Publication: 01 Oct 2026. Author Yoltay H.E.; Yildirim Y.; Deveci Kocakoc I. Institution (Yoltay) Faculty of Nursing, Department of Surgery Nursing, Ege University, Izmir, Bornova, Turkey (Yildirim) Faculty of Nursing, Department of Internal Medicine Nursing, Ege University, Izmir, Bornova, Turkey (Deveci Kocakoc) Faculty of Economics and Administrative Sciences, Department of Econometrics, Dokuz Eylul University, Izmir, Buca, Turkey Publisher W.B. Saunders Abstract Purpose The purpose of this analysis was to systematically map the intellectual structure, thematic evolution, and collaborative patterns of research in the field of deep-breathing exercises (DBEs). Design A comprehensive bibliometric analysis combined with Latent Dirichlet Allocation-based topic modeling was conducted using publications retrieved from Web of Science, Scopus, and PubMed. Methods A total of 2,017 publications published between 1940 and 2024 were included. Bibliometric indicators were used to examine publication trends, leading journals, authors, countries, and collaboration networks, while Latent Dirichlet Allocation was applied to identify dominant research themes. Findings The annual number of publications increased steadily over time, with a marked rise after 2011 and a peak observed in 2020. The most productive countries were the United States, Italy, and Germany, while the leading journals included Chest and The Annals of Thoracic Surgery. Collaboration analyses revealed limited international and interinstitutional research networks. Topic modeling identified three major thematic clusters: (1) education and training-focused DBE interventions, (2) application of DBE following cardiac and thoracic surgery, and (3) postoperative complication prevention and rehabilitation. Conclusion This bibliometric and topic modeling analysis provides a structured overview of the intellectual organization and thematic evolution of DBE research in surgical and perioperative care. Rather than evaluating clinical effectiveness, the findings highlight prevailing research priorities, collaboration gaps, and underexplored areas. These insights may support perianesthesia nursing by informing future research agendas, encouraging interdisciplinary collaboration, and guiding the strategic development of DBE-related studies. Copyright © 2026. Published by Elsevier Inc. <57> Accession Number 2048164040 Title Coronary artery bypass grafting in women: optimizing operative outcomes. Source Current Opinion in Cardiology. 41(6) (pp 538-548), 2026. Date of Publication: 01 Nov 2026. Author Constantakis S.; Lamarche-Silmser K.; Reed E.; Clarizia N.A.; Ruel M.; Sozzi F.B. Institution (Constantakis) Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada (Constantakis, Lamarche-Silmser) Division of Cardiac Surgery, Ottawa Heart Institute Research Corporation, Ottawa, ON, Canada (Reed, Clarizia, Ruel) Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON, Canada (Sozzi) Department of Cardio-Thoracic-Vascular Diseases, IRCCS Ca 'Granda Foundation Maggiore Policlinico Hospital, Milan, Italy Publisher Lippincott Williams and Wilkins Abstract Purpose of review - Women undergoing coronary artery bypass grafting (CABG) continue to experience worse perioperative and long-term outcomes than men despite advances in surgical techniques and perioperative care. This review summarizes contemporary evidence on sex-related differences in coronary artery disease (CAD), surgical outcomes, and secondary prevention. Gaps in the current evidence are identified and priorities for optimizing outcomes and informing sex-specific clinical practice are highlighted. Recent findings - Women present with distinct patterns of CAD, including higher prevalence of microvascular dysfunction and nonobstructive disease, contributing to delayed diagnosis and referral for surgical revascularization. Women are less likely to receive guideline-recommended revascularization strategies, including multiple arterial grafting. Women also experience higher rates of graft failure, mortality, and stroke after CABG. Emerging observational evidence suggests that off-pump and minimally invasive CABG approaches may reduce the disparities in female patients, although randomized sex-specific data remains limited. Secondary prevention remains suboptimal, with persistent gaps in implementation of guideline-directed therapies. Summary - Significant disparities persist across the continuum of care for women undergoing CABG, from diagnosis through long-term secondary prevention. Improving equitable implementation of evidence-based surgical strategies, increasing representation of women in randomized clinical trials, and developing sex-specific evidence are essential to optimize outcomes and inform future clinical guidelines. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <58> Accession Number 2048819338 Title Comparing the Safety and Efficacy of Outpatient Parenteral Antibiotic Therapy Versus Hospital-Based Antibiotic Therapy in Patients with Infective Endocarditis: A Systematic Review and Meta-Analysis. Source American Journal of Therapeutics. 33(5) (pp e384-e394), 2026. Date of Publication: 01 Oct 2026. Author Alkuwaiti M.A.; Al-Harbi F.A.; Alkuwaiti F.A.; Alsaif A.K.; Ashraf H. Institution (Alkuwaiti) College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia (Al-Harbi) Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia (Alkuwaiti) Division of Cardiology, Department of Internal Medicine, King Fahad Hospital of the University, Academic Medical City, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia (Alsaif) College of Medicine, Al-Rayan Colleges, Al-Madinah, Saudi Arabia (Ashraf) Department of Medicine, Allama Iqbal Medical College, Lahore, Pakistan Publisher Lippincott Williams and Wilkins Abstract Introduction: - Infective endocarditis (IE) requires 4 to 6 weeks of intravenous antibiotics. Outpatient parenteral antibiotic therapy (OPAT) is increasingly used and guideline endorsed, but IE-specific comparative evidence is limited, as prior meta-analyses pooled single-arm data without an inpatient comparator. We compared the safety and efficacy of OPAT versus continued hospital-based antibiotic therapy. Method(s): - This systematic review and meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. PubMed/MEDLINE, Embase, Cochrane CENTRAL, and Web of Science were searched to 18 April 2026 for comparative studies of adults with IE. Two reviewers screened using Rayyan and extracted data, and risk of bias was assessed with Risk Of Bias In Non-randomized Studies of Interventions. Random-effects meta-analyses (DerSimonian-Laird) produced risk ratios with 95% confidence intervals (CIs) (RevMan 5.4). Result(s): - Five comparative studies (3497 adults) were included. OPAT was associated with lower all-cause mortality (risk ratio [RR]: 0.40, 95% CI: 0.18-0.90; I2 = 87%, P = 0.03) and with lower acute kidney failure (RR: 0.71, 95% CI: 0.59-0.86, P = 0.0004). No significant differences were seen for readmission (RR: 1.09), relapse (0.73), valve replacement (1.15), arrhythmia, sepsis, stroke, embolic complications, or heart failure. Conclusion(s): - In appropriately selected, stabilized patients, OPAT was associated with lower all-cause mortality and acute kidney failure, with no significant differences in major other adverse events. Protocol: CRD420261410723. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <59> Accession Number 2047562187 Title Safety and efficacy of magnetic-anchoring vs conventional video-assisted thoracoscopic surgery (VATS) lung resection: a randomized controlled trial. Source Surgical Endoscopy. 40(10) (pp 8544-8553), 2026. Date of Publication: 01 Oct 2026. Author Yu C.; Wang T.; Chen N.; Li X.; Lv X.; Xu H.; Liang R.; Li C.; Liu A.; Cui X.; You J.; Lv Y.; Zhang Y. Institution (Yu, Wang, Chen, Li, Xu, Liang, Li, Liu, Cui, You, Zhang) Department of Thoracic Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China (Lv) Department of Otorhinolaryngology-Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China (Lv) Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China (Zhang) Department of Thoracic Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China Publisher Springer Abstract Background: Video-assisted thoracic surgery (VATS) is the preferred approach for lung resection. Magnetic anchoring technology (MAT) utilizes magnetic forces for organ retraction and improves surgical field exposure. This trial aimed to evaluate the safety and efficacy of MAT-assisted VATS for lung resection. Method(s): This single-center randomized controlled trial (registered at the Chinese Clinical Trial Registry, ChiCTR2000029676) enrolled 40 patients scheduled for lung resection and randomly assigned them to MAT-assisted VATS (Group A, n = 20) or conventional VATS (Group B, n = 20). The primary outcomes included surgical field exposure efficacy, intraoperative collateral injuries, and operator-related adverse events. Secondary outcomes included surgeon satisfaction score, number of assistants, and perioperative recovery metrics with a 1-month postoperative follow-up. Result(s): Surgical field exposure efficacy (graded as Excellent, Satisfactory, Normal, and Poor) was as follows: Group A, 15, 4, 1, and 0 cases; and Group B, 17, 2, 1, and 0 cases (p = 0.115). Intraoperative collateral injuries (graded as None, Mild, Moderate, and Severe) were as follows: Group A, 13, 6, 1, and 0 cases; Group B, 9, 6, 3, and 2 cases (p = 0.304). No significant differences were observed in the operative time (p = 0.136), intraoperative blood loss (p = 0.380), postoperative drainage tube removal time (p = 0.180), time to extubation (p = 0.529), time to ambulation (p = 0.260), total hospitalization duration (p = 0.685), or postoperative hospitalization duration (p = 0.305). Surgeon satisfaction score was significantly higher in Group A (p = 0.003). Moreover, MAT use markedly reduced dependence on surgical assistants, with fewer cases requiring two assistants in Group A (p = 0.006). The magnetic anchoring devices demonstrated seamless operability, with no adverse events reported during postoperative follow-up. Conclusion(s): MAT-assisted VATS lung resection is as effective and safe as conventional VATS. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <60> Accession Number 2049740796 Title The association between body mass index and perioperative outcomes by ethnicity and socioeconomic status: a systematic review of systematic reviews. Source Ethnicity and Health. (no pagination), 2026. Date of Publication: 2026. Author Oyolola O.; Daley A.; McLaughlin J.; Murphy G.; Slade K.; Graham H.; Abbott T.; Issa A.; Madigan C. Institution (Oyolola, Daley, Slade, Graham, Madigan) Centre for Lifestyle Medicine and Behaviour (CLiMB), The School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom (McLaughlin) Centre for Public Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom (Murphy) Department of Cardiovascular Sciences, University of Leicester Glenfield Hospital, Leicester, United Kingdom (Abbott) Centre for Translational Medicine & Therapeutics, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom (Issa) The Research Institute of the McGill University Health Centre (RI-MUHC), Montreal, Canada Publisher Routledge Abstract Objectives: Body mass index (BMI) is associated with adverse perioperative outcomes. This study investigated the completeness of ethnicity and socioeconomic status (SES) reporting in perioperative research and the association between BMI and perioperative outcomes by ethnicity and SES. Design(s): We extended a previous systematic review of reviews that compared perioperative outcomes by BMI categories. For this review, we extracted primary studies published from 2004 onwards from included systematic reviews that focused on seven frequently performed surgeries with some evidence of ethnic disparities: total hip arthroplasty, total knee arthroplasty, coronary artery bypass grafting, caesarean section, prostatectomy, breast reconstruction postmastectomy, and gynaecological surgery. We calculated the number (%) of primary studies reporting ethnicity and/or SES and extracted data for perioperative outcomes up to 90 days postoperatively by ethnicity and SES. Outcomes were based on the Standardised Endpoints in Perioperative Medicine initiative. Effect measures and incidence (%) were qualitatively summarised due to heterogeneity in reporting. Result(s): From 49 systematic reviews, 332 primary studies investigated the seven surgical procedures and only 39 (11.7%) reported ethnicity (10.8%) or SES (2.4%) at baseline. Among these, only 10 studies (3%) stratified perioperative outcomes by ethnicity and/or SES, with most adjusting for BMI in regression models. Only one study clearly stratified outcomes across BMI categories within each ethnicity. There was some evidence of increasing risk of postoperative atrial fibrillation by ethnicity and BMI. Two studies found that Black patients had higher odds of pulmonary embolism than White patients after adjusting for BMI. Findings for other outcomes and SES were inconsistent. Conclusion(s): Poor reporting of ethnicity and SES data limits understanding of how these variables modify the association between BMI and perioperative outcomes. Deliberate inclusion of ethnicity and SES data in study design, analysis, and reporting is needed to address inequality in perioperative research. Copyright © 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. <61> Accession Number 2038768883 Title Ultrasound-Guided Erector Spinae Plane Block vs. Thoracic Paravertebral Block for Postoperative Analgesia in Single-Port Video Assisted Thoracoscopic Lung Wedge Resection for Postoperative Analgesia: A Randomized Controlled Trial. Source Anaesthesia, Pain and Intensive Care. 30(7) (no pagination), 2026. Date of Publication: 01 Jul 2026. Author Sharaf A.G.S.; Kamel A.T.H.; Bayoumy A.A.M.; Abugabal A.E.M.S.; Ahmed M.H.M. Institution (Sharaf) Anesthesia, Intensive Care, And Pain Management, Faculty of Medicine, Ain-Shams University Hospitals, Egypt (Kamel) Cardiothoracic Surgery, Ain-Shams University Hospitals, Egypt (Bayoumy) Anesthesia and Pain Management, Ain-Shams University Hospitals, Egypt (Abugabal) cardiothoracic surgery, Ain-Shams University, Egypt (Ahmed) Cardiothoracic Surgery, Ain Shams University Hospital, Egypt Publisher Faculty of Anaesthesia, Pain and Intensive Care, AFMS Abstract Objective(s): To compare the efficacy and safety of ultrasound-guided erector spinae plane block (ESPB) versus single-injection thoracic paravertebral block (TPVB) via intrathoracic approach for postoperative analgesia in patients undergoing single-port video-assisted thoracoscopic lung wedge resection. Design(s): Prospective, randomized, controlled clinical trial. Setting(s): Cardiothoracic and Vascular Academy, University Hospitals, Cairo, Egypt. Study period: February 2024 - August 2024. Participant(s): Forty-eight adult patients (age 18 65 years), ASA physical status I II, BMI < 35 kg/m2, scheduled for uniportal video-assisted thoracoscopic lung wedge resection for pneumothorax, bullae, or lung nodules (suspected carcinoma in situ). Intervention(s): Patients were randomized to one of two groups (n=24 each). Group P received a thoracic paravertebral block (TPVB) via intrathoracic approach; Group E received an ultrasound-guided erector spinae plane block (ESPB). Both blocks were administered preoperatively. Measurements & Main Results: * Primary outcome: cumulative morphine consumption in the first 24 postoperative hours. * Secondary outcomes: time to first rescue analgesic; serial Numeric Rating Scale (NRS) pain scores at rest and during cough at PACU, and at 2, 4, 6, 12, 18, 24 hours; hemodynamic parameters at same timepoints; incidence of bradycardia (>20% decrease in HR), hypotension (MAP < 50 mmHg), nausea, vomiting, pruritus; and pulmonary complications (atelectasis, respiratory depression). Result(s): There was no significant difference between groups for 24-hour morphine consumption, time to chest tube removal, or length of hospital stay. TPVB (Group P) showed significantly lower pain scores compared with ESPB at 6 hours (static NRS: P = 0.003), and at 24 hours for both dynamic (coughing) NRS (P = 0.005) and static rest NRS (P = 0.04). Incidents of bradycardia, hypotension, nausea, vomiting, pruritus, and pulmonary complications did not differ significantly between groups. Conclusion(s): In patients undergoing uniportal VATS lung wedge resection, both TPVB and ESPB provide adequate postoperative analgesia. TPVB confers superior pain control at selected early (6 h) and later (24 h) timepoints without increasing adverse events. These findings support consideration of TPVB for enhanced recovery protocols in thoracic surgery. Copyright © 2026, Faculty of Anaesthesia, Pain and Intensive Care, AFMS. All rights reserved. <62> Accession Number 2049722585 Title The impact of intraoperative hemoadsorption during cardiac surgery for infective endocarditis. Source Intensive Care Medicine Experimental. 14(1) (no pagination), 2026. Article Number: 137. Date of Publication: 01 Dec 2026. Author Serradj A.; Saiydoun G.; Radu C.; Bergoend E.; Fiore A.; Huguet R.; Lim P.; Moini C.; Folliguet T. Institution (Serradj, Saiydoun, Radu, Bergoend, Fiore, Folliguet) Chirurgie Cardiaque et Transplantation, Assistance-Publique Hopital Henri Mondor, Universite Paris 12 UPEC, Paris, France (Huguet, Lim) Service de Cardiologie, Assistance Publique Hopital Henri Mondor, Universite Paris 12 UPEC, Paris, France (Moini) Service de Cardiologie, Hopital de Melun, Melun, France (Serradj) Department of Thoracic and Cardiovascular Surgery, Henri Mondor University Hospital APHP, 1 rue Gustave Eiffel, Paris, Creteil, France Publisher Springer Nature Abstract Background: Postoperative sepsis and/or systemic inflammatory response syndrome caused by infective endocarditis (IE) can lead to significant postoperative mortality. Intraoperative hemoadsorption therapy has shown promising results in the treatment of sepsis and dysregulated inflammatory response during cardiac surgery. The aim of this study was to evaluate the effects of intraoperative hemoadsorption in high-risk patients with IE undergoing cardiac surgery. Method(s): A total of 176 high-risk patients with IE were enrolled from 10/2020 to 10/2024. Patients with intraoperative hemoadsorption (HA group, n = 93) were compared to patients without hemoadsorption (control, n = 83). The primary endpoint was a composite of 30-day mortality, incidence of vasoplegic syndrome within the first 24 h and 7 days postoperatively, and intensive care (ICU) stay, analyzed using an unmatched hierarchical win-ratio method. Result(s): There were no differences in baseline characteristics between the groups. The mean hemoadsorption time was 106 +/- 61 min in the HA group. Vasoplegic syndrome was more frequent in the control group (49.4% vs. 24.7%, p < 0.001). Importantly, 30-day mortality was also significantly lower with intraoperative hemoadsorption (7.5% vs. 20.5%, p = 0.003). The mean ICU stay was shorter in the HA group (7.8 +/- 4.6 vs. 11.5 +/- 4.2 days, p < 0.001). The analysis met the primary endpoint in favor of patients receiving intraoperative hemoadsorption (win ratio 3.83; 95% CI 2.55, 5.74; p < 0.001). Conclusion(s): In high-risk cardiac surgery patients with IE, the intraoperative use of hemoadsorption was associated with a significantly lower incidence of postoperative vasoplegic syndrome and lower overall 30-day mortality. These findings should be interpreted in the context of the study's methodological limitations and confirmed in future randomized controlled trials. Trial registration: This study was approved by the Institutional Review Board (IRB00012919) of the French Society of Thoracic and Cardiovascular Surgery (CERCSFCTCV20251021). Copyright © The Author(s) 2026. <63> Accession Number 2049709522 Title Machine Learning for Clinical Outcome Prediction After Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis of Predictive Performance, Validation, and Clinical Readiness. Source Journal of Clinical Medicine. 15(19) (no pagination), 2026. Article Number: 7692. Date of Publication: 01 Oct 2026. Author Alizadehasl A.; Abdi Bastami E.; Hosseini Jebelli S.F.; Narimani Davani D.; Bahramnejad A.; Yalameh Aliabadi A.; Moussavi S.M.; Ghaffari A.; Amani-Beni R.; Darouei B.; Amini-Salehi E.; Hashemi S.M.; Golkar S.; Hakimian H.; Najdaghi S. Institution (Alizadehasl, Hosseini Jebelli, Bahramnejad, Yalameh Aliabadi, Moussavi, Hakimian) Cardio-Oncology Research Center, Rajaie Cardiovascular Institute, Tehran, Iran, Islamic Republic of (Abdi Bastami) Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of (Narimani Davani, Najdaghi) School of Medicine and Dentistry, Griffith University, QLD, Australia (Ghaffari) Cardiovascular Research Center, Rajaie Cardiovascular Institute, Tehran, Iran, Islamic Republic of (Amani-Beni, Darouei) Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of (Amini-Salehi) Gastrointestinal and Liver Diseases Research Center, Guilan, University of Medical Sciences, Rasht, Iran, Islamic Republic of (Hashemi) Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran, Islamic Republic of (Golkar) Clinical Research Development Center, Najafabad Branch, Islamic Azad University, Najafabad, Iran, Islamic Republic of Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Machine learning (ML) models are increasingly used to predict adverse outcomes after transcatheter aortic valve replacement (TAVR), but their generalizability and clinical readiness remain uncertain. We evaluated predictive performance across post-TAVR outcomes, emphasizing validation quality, transportability, methodological bias, and clinical utility. Method(s): PubMed/MEDLINE, Embase, Scopus, and Web of Science were searched from inception through 6 August 2026 for supervised ML studies reporting out-of-sample performance for clinically relevant post-TAVR outcomes. Overlapping source populations were audited before synthesis. Areas under the receiver operating characteristic curve (AUCs) were pooled on the logit scale using restricted maximum likelihood (REML) random-effects models with modified Hartung-Knapp inference and prediction intervals. Prespecified analyses examined validation maturity, predictor timing, prediction horizon, data architecture, and risk of bias. Within-study dependence was addressed using multilevel meta-regression with bias-reduced cluster-robust variance estimation (CR2); Bayesian analyses complemented the primary synthesis. Result(s): Sixty-seven full-text reports were included. Twenty independent source/report families contributed to mortality meta-analysis, yielding a pooled AUC of 0.791 (95% confidence interval [CI], 0.732-0.840; I2 = 91.5%; prediction interval, 0.480-0.940). The high heterogeneity and wide prediction interval indicate that this pooled AUC is an average across heterogeneous settings rather than a transportable performance guarantee. Stronger external, temporal, geographic, or inter-centre evaluation showed lower discrimination than internal/resampled evaluation (0.754 vs. 0.814; p = 0.299), while preprocedural models yielded 0.767 versus 0.866 for peri-/postprocedural or mixed models (p = 0.083). High-risk studies showed higher apparent mortality discrimination than low/unclear-risk studies (0.895 vs. 0.747; p for interaction = 0.0009); this observational comparison involved only five high-risk mortality studies and should not be interpreted causally. The Bayesian-adjusted difference was +0.118 AUC units (95% credible interval [CrI], +0.037 to +0.179). Pooled AUCs were 0.760 for permanent pacemaker implantation (PPMI), 0.778 for broader conduction abnormalities, and 0.747 for paravalvular leak (PVL). No algorithm family showed reproducible superiority (p = 0.775). Stronger independent evaluation, calibration/Brier assessment, and decision-curve analysis were reported in only 18/67, 23/67, and 10/67 reports, respectively. Conclusion(s): ML shows promising post-TAVR discrimination, particularly for mortality, but substantial heterogeneity, limited independent validation, and sparse calibration and decision utility assessment constrain clinical translation. A high AUC alone should not be interpreted as evidence of transportability or clinical usefulness. Copyright © 2026 by the authors. <64> Accession Number 2049719705 Title Selective and non-selective carotid ultrasound screening and perioperative stroke incidence in the coronary artery bypass grafting population: a systematic review and meta-analysis. Source Journal of Cardiothoracic Surgery. 21(1) (no pagination), 2026. Article Number: 792. Date of Publication: 01 Dec 2026. Author King-O'Reilly B.; Graves D.L.; Sandrasekaran K.; Briffa N. Institution (King-O'Reilly, Graves, Sandrasekaran, Briffa) Cardiothoracic Department, The University of Sheffield Medical School, Sheffield, United Kingdom (Briffa) Sheffield Teaching Hospitals NHS Foundation Trust Cardiothoracic Centre: Northern General Hospital Cardiothoracic Centre, Sheffield, United Kingdom (King-O'Reilly) Sheffield Medical School, University of Sheffield, Beech Hill Road, Sheffield, United Kingdom Publisher BioMed Central Ltd Abstract Objectives: A systematic review and meta-analysis was performed to observe the incidence of perioperative stroke associated with selective and non-selective carotid ultrasound (CU) screening in the isolated coronary artery bypass grafting (CABG) population. Method(s): PubMed, Scopus and CENTRAL databases were searched for studies published between January 1995 and October 2025. Inclusion criteria for the review focused on studies reporting primary data related to perioperative stroke in adult patients scheduled to undergo non-emergency isolated CABG who underwent either selective or non-selective preoperative CU screening. The primary outcome was perioperative stroke. Study quality was assessed using the ROBINS-I tool. Data related to the primary outcome was synthesised using an exploratory random-effects model meta-analysis. This review was reported as per PRISMA guidelines. Result(s): 2398 studies were identified to undergo title and abstract screening; 63 studies were identified to undergo full-text screening of which 15 studies were eligible for inclusion within the review (Total N = 25,931). For the 13 studies utilising a non-selective screening strategy, the pooled perioperative stroke rate was 1.78% (95% CI: [1.28;2.48]). Independently, the two cohorts utilising a selective screening strategy reported perioperative stroke rates of 1.16% and 1.23%. Due to the structural limitations of the existing literature these findings are presented as independent descriptive cohorts. Conclusion(s): This review provides a descriptive synthesis of perioperative stroke rates across the two previously mentioned screening cohorts and does not establish comparative effectiveness. Although the low absolute event rates observed within the selective screening cohort align with current guideline recommendations, the structural limitations and high disproportion of the available evidence base prevent definitive comparison. Copyright © The Author(s) 2026. <65> Accession Number 2049709455 Title Transcatheter Aortic Valve Implantation in Complex Anatomy: An Anatomy-Driven Framework for Bicuspid Stenosis, Pure Aortic Regurgitation, and the Small Annulus in the Era of Lifetime Management. Source Journal of Clinical Medicine. 15(19) (no pagination), 2026. Article Number: 7452. Date of Publication: 01 Oct 2026. Author Brie D.M.; Mornos C.; Popescu R.; Brie A.D. Institution (Brie, Mornos) Cardiovascular Disease Institute Timisoara, Gheorghe Adam Street, No. 13A, Timisoara, Romania (Brie, Mornos) Research Center, Institute of Cardiovascular Diseases, Gheorghe Adam Street, No. 13A, Timisoara, Romania (Mornos) Department of Cardiology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square, No. 2, Timisoara, Romania (Popescu, Brie) Department of Cell and Molecular Biology, "Victor Babes" University of Medicine and Pharmacy, Tudor Vladimirescu Street, No. 14, Timisoara, Romania (Popescu, Brie) ANAPATMOL Research Center, "Victor Babes" University of Medicine and Pharmacy, Tudor Vladimirescu Street, No. 14, Timisoara, Romania (Brie) "Louis Turcanu" Emergency Children Hospital, Doctor Iosif Nemoianu Street, No. 2, Timisoara, Romania Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Transcatheter aortic valve implantation is established for severe calcific tricuspid aortic stenosis, but its application in bicuspid aortic valve (BAV) stenosis, pure native aortic regurgitation (AR), and small aortic annulus anatomy remains limited by heterogeneous morphology, device-specific constraints, and uncertain long-term outcomes. These settings require decisions that extend beyond immediate procedural success to encompass coronary access, reintervention, valve durability, and associated aortopathy. This review synthesizes current evidence and proposes an anatomy-driven framework integrating imaging, device selection, procedural planning, and lifetime management. Method(s): A structured narrative review was conducted in accordance with the Scale for the Assessment of Narrative Review Articles (SANRA) criteria. PubMed/MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched from 1 January 2010 to 31 March 2026 for studies addressing TAVI in BAV stenosis, pure native AR, and small aortic annulus anatomy. Randomized trials, meta-analyses, multicenter registries, pivotal device studies, and guideline or consensus documents were prioritized. After screening 2663 records and assessing 330 full-text reports, 101 records were retained for qualitative synthesis. Evidence was appraised by anatomical substrate, imaging phenotype, device strategy, procedural hazards, and implications for lifetime management. Result(s): In BAV stenosis, contemporary registry and prospective cohort data support high device success and acceptable early and mid-term outcomes in carefully selected patients; however, calcified raphe, bulky asymmetric leaflet or left ventricular outflow tract calcification, annular eccentricity, and concomitant aortopathy identify higher-risk phenotypes that often favor surgery. Randomized evidence in younger low-risk BAV patients remains limited and exploratory, with the NOTION-2 trial showing a numerically higher 3-year composite event rate after TAVI than surgical aortic valve replacement (20.4% vs. 7.8%; hazard ratio 2.9, 95% confidence interval 0.9-9.0) in the small bicuspid subgroup. In pure native AR, lack of annular calcification and frequent root dilatation impair anchoring of conventional transcatheter heart valves, increasing risks of migration, embolization, residual AR, and second-valve implantation. Dedicated leaflet-anchoring devices have improved outcomes: in ALIGN-AR, the JenaValve Trilogy system achieved procedural success above 95% in high-surgical-risk patients, although evidence remains single-arm and nonrandomized. In small annuli, the strongest comparative evidence comes from the SMART trial, in which supra-annular self-expanding valves were non-inferior to balloon-expandable valves for the 12-month clinical composite and reduced moderate/severe prosthesis-patient mismatch at 30 days (11.2% vs. 35.3%). Across all three phenotypes, electrocardiography-gated computed tomography is fundamental for defining anchoring, sizing, calcium distribution, root and coronary anatomy, anticipated coronary re-access, and the feasibility of redo-TAVI. Surgery remains particularly relevant when aortic repair, annular/root enlargement, or a more durable lifetime strategy is required. Conclusion(s): TAVI is feasible in selected patients with BAV stenosis, pure native AR, and small aortic annuli, but the evidentiary strength and optimal procedural strategy differ substantially across these anatomies. Treatment should be guided by an anatomy-driven, computed-tomography-based Heart Team assessment that integrates immediate procedural feasibility with age, surgical candidacy, aortopathy, prosthesis-patient mismatch risk, coronary access, durability, and future reintervention options. Surgery remains the more established strategy for many younger, operable patients with unfavorable BAV morphology or aortopathy, AR with root dilatation, or very small annuli amenable to enlargement. Dedicated randomized trials, standardized imaging criteria, and long-term durability data are needed to refine lifetime management in complex aortic valve anatomy. Copyright © 2026 by the authors. <66> Accession Number 2049690645 Title Considerations regarding a meta-analysis investigating the efficacy and safety of robotic-assisted thoracic surgery after neoadjuvant therapy in non-small cell lung cancer. Source Updates in Surgery. (no pagination), 2026. Date of Publication: 2026. Author Jiao B.; Wang L. Institution (Jiao, Wang) Department of Pulmonary and Critical Care Medicine, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, Hainan Province, Haikou, China Publisher Springer Science and Business Media Deutschland GmbH <67> Accession Number 652369509 Title Hybrid versus Norwood Surgery, The Quest for Improved Outcome: a meta analysis. Source Indonesian Journal of Cardiology. Conference: 12th Indonesian Society of Interventional Cardiology Annual Meeting (ISICAM) 2020. Jakarta Indonesia. 41(Supplement B) (no pagination), 2020. Date of Publication: 2020. Author Caesa P.; Prakoso R. Institution (Caesa) Universitas Gadjah Mada, Indonesia (Prakoso) Division of Pediatric Cardiology and Congenital Heart Disease, Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, National Cardiac Center of Harapan Kita, Indonesia Publisher Indonesian Heart Association Abstract Background: The resurgence of Hybrid approach as an alternative option for Hypoplastic Left Heart Syndrome (HLHS) has paved the way for high risk individual to be qualified for stage I surgery. Albeit the absence of Cardiopulmonary bypass in Hybrid arms, survival remains questionable. We sought to compare Inter-stage mortality rate among Hybrid and Norwood cohort with a systematic review and meta-analysis. Method(s): Electronic searches were carried out in PubMed and COCHRANE databases. Individual study quality was assessed using Newcastle-Ottawa Scale. The Cochrane Q test and I2 test statistic were used to test heterogeneity across studies. The pooled estimate of mortality rate was computed by a random or fixed effects model, depend on the heterogeneity. Forest plot was used to described quantitative result. Sensitivity analysis was performed by leave-one-out analysis. Result(s): The search yielded 368 citations, reduced to 30 full text screening of which 14 studies were suitable for inclusion criteria. Based on 14 studies, 468 patients underwent Norwood surgery with 136 mortality rate (29.05%), while Hybrid had 325 patients with 111 death in total (34.15%). Cumulative mortality (30 days after stage I and the interstage phase) was higher in Hybrid patients with (RR: 1.112 95% CI (0.897-1.379) p: 0.332). Similar result was found in early and inter-stage mortality (RR 1.140 95% CI (0.839-1.548); RR 1.324 95% CI (0.763-2.295). Overall survival was superior in the Norwood cohort, although this did not reach statistical significance. Conclusion(s): Hybrid procedure is associated with poor survival compared to the traditional Norwood surgery during the first stage of HLHS palliation. Nevertheless, due to the preferential selection of Hybrid among the high risk infants, the efficacy of the procedure remains inconclusive. The two cohorts are inequal in risk. <68> Accession Number 652369505 Title WHICH ANTITHROMBOTIC(S) SHOULD BE GIVEN TO PATIENT UNDERGOING TRANSCATHETER AORTIC VALVE REPLACEMENT? - A SYSTEMATIC REVIEW AND META-ANALYSIS. Source Indonesian Journal of Cardiology. Conference: 10th Indonesian Society of Interventional Cardiology Annual Meeting. Jakarta Indonesia. 39(Supplement B) (pp 134-136), 2018. Date of Publication: 2018. Author Pranata R.; Yonas E.; Pamungkas B.; Siswanto B.B.; Purwowiyoto B.S. Institution (Pranata) Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia (Yonas) Faculty of Medicine, Universitas YARSI, Jakarta, Indonesia (Pamungkas) Department of Cardiology and Vascular Medicine, Central Army Hospital Gatot Soebroto, Jakarta, Indonesia (Siswanto, Purwowiyoto) Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia Publisher Indonesian Heart Association Abstract Introduction Dual antiplatelet therapy (DAPT) has been used widely in patients undergoing transcatheter aortic valve replacement (TAVR) with uncertain clinical evidence. The aim of this study is to compare the efficacy and safety of DAPT, single antiplatelet therapy (SAPT) with or without oral anticoagulant (OAC). Methods Electronic search on PubMed (MEDLINE), EBSCO, EuropePMC, Cochrane Central Database, Clinicaltrials.gov, and Google Scholar was done. Studies comparing the use of DAPT or SAPT with/without OAC in patients undergoing TAVR was included. Meta-analysis directly compared the outcome of DAPT vs SAPT + OAC, DAPT vs SAPT, and indirectly compared SAPT vs SAPT + OAC. There were 13 studies included. Results A total of 4 studies (931 patients) that compared DAPT and SAPT + OAC were included. There was no significant difference in mortality, stroke/TIA, and bleeding rate between these groups. An analysis of 5-7 studies (752-1301 patients) comparing DAPT and SAPT yield a non-significant outcome in terms of 30-days all-cause mortality, all-cause mortality, stroke/TIA, and myocardial infarction. However, life-threatening/major bleeding was significantly higher in those who took DAPT [RR = 1.98, 95% CI 1.13-3.45, p=0.02 albeit high heterogeneity] number needed to harm for major/life-threatening bleeding was 12.5. On indirect analysis comparing SAPT vs SAPT + OAC, there was no significant difference in mortality, stroke/TIA, and major bleeding. Conclusion Mortality, stroke/TIA, and myocardial infarction were statistically not significant between groups. However, the number of major/life-threatening bleeding was highest in DAPT. Since DAPT or OAC did not have better efficacy and SAPT having an edge in safety, the latter may suffice in patients undergoing TAVR. (Figure presented). <69> Accession Number 2049630056 Title Left Atrial Appendage Occlusion vs Oral Anticoagulation for Stroke Prevention in Atrial Fibrillation: A Meta-Analysis. Source PACE - Pacing and Clinical Electrophysiology. (no pagination), 2026. Date of Publication: 2026. Author Nazmy A.; Abouelmagd A.A.; Sobhy A.; Ashour M.; El-shirbiny H.; Khalaph M.; Shaban A.Y.; Nazmy M.; Shabaan A.; Elbanna A.F.; Hafez A.; Gibson C.M. Institution (Nazmy, Sobhy, Nazmy) Faculty of Medicine, Kafr-Elsheikh University, Kafr-Elsheikh, Egypt (Abouelmagd, Shabaan) Faculty of Medicine, Qena University, Qena, Egypt (Ashour) College of Human Medicine, Banha University, Banha, Egypt (El-shirbiny) Cardiology Department, Faculty of Medicine, Kafr Elsheikh University, Kafr El Sheikh, Egypt (El-shirbiny, Khalaph) Department of Electrophysiology, Heart and Diabetes Center NRW, Ruhr University Bochum, Bad Oeynhausen, Germany (Shaban) Department of Hematology and Oncology, Mayo Clinic, Rochester, MN, United States (Elbanna) Department of Medicine, Division of Rheumatology, Vanderbilt University Medical Center, Nashville, TN, United States (Hafez) Department of Medicine, University of Arizona College of Medicine Phoenix, Phoenix, AZ, United States (Hafez) Department of Cardiovascular Medicine, Mayo Clinic, Phoenix and Scottsdale, AZ, United States (Gibson) Baim Institute for Clinical Research, Harvard Medical School, Harvard University, Boston, MA, United States Publisher John Wiley and Sons Inc Abstract Background: Left atrial appendage occlusion (LAAO) has emerged as a non-pharmacological alternative to oral anticoagulation (OAC) for stroke prevention in patients with atrial fibrillation (AF). Following the publication of recent CHAMPION-AF and CLOSURE-AF trials, an updated synthesis of evidence is warranted to clarify the long-term comparative efficacy and safety of LAAO versus OAC in patients with AF. Method(s): We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing LAAO with OAC in adults with AF. A comprehensive search of major databases was performed from inception to April 2026. The primary efficacy outcomes were major adverse cardiovascular events (MACE) and stroke. The primary safety outcome was non-procedure-related bleeding. Random-effects models were used to calculate pooled risk ratios (RRs) with 95% confidence intervals (CIs). Result(s): Six RCTs including 7,004 patients (3,681 LAAO; 3,323 OAC) were analyzed. No statistically significant difference was observed for MACE (7.5% vs 6.9%; RR 1.03, 95% CI 0.79-1.34) or stroke (3.7% vs 3.2%; RR 1.07, 95% CI 0.80-1.43). LAAO was associated with a significantly lower risk of non-procedure-related bleeding (9.8% vs 16.7%; RR 0.63, 95% CI 0.52-0.77), corresponding to an absolute risk reduction of 6.9% and an approximate number needed to treat of 15 based on crude pooled event rates over the observed trial follow-up. Trial sequential analysis indicated that the accumulated evidence for MACE and stroke remained inconclusive. Comparator-type subgroup analyses showed no significant interaction for MACE (p = 0.67) or stroke (p = 0.81) between contemporary predominantly-DOAC and VKA comparator trials. Conclusion(s): LAAO was associated with lower non-procedure-related bleeding, while no statistically significant differences were observed for MACE or stroke. The available efficacy evidence remains inconclusive regarding equivalence or non-inferiority, and larger trials are needed. These findings support individualized consideration of LAAO when the long-term bleeding burden of anticoagulation is clinically important. Copyright © 2026 The Author(s). Pacing and Clinical Electrophysiology published by Wiley Periodicals LLC. <70> Accession Number 2049784188 Title Management Strategies for Paediatric Pleural Empyema: A Systematic Review. Source Journal of Paediatrics and Child Health. (no pagination), 2026. Date of Publication: 2026. Author Shahar A.I.; Alghamdi M.M.; Athwani Z.A.; Ayoub L.H.; Mutahar A.H.; Alenazi A.M.; Alanazi A.S. Institution (Shahar, Alanazi) Pediatric Pulmonology Division, Department of Pediatrics, Security Forces Hospital, Riyadh, Saudi Arabia (Alghamdi, Alenazi) Pediatric Pulmonology Division, Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia (Athwani) Department of Pediatrics, Jazan General Hospital, Jazan, Saudi Arabia (Ayoub) Pediatric Allergy and Immunology Division, Department of Pediatrics, King Fahad Medical City, Riyadh, Saudi Arabia (Mutahar) Department of Pediatrics, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia Publisher John Wiley and Sons Inc Abstract Aim: To examine and compare management strategies for paediatric pleural empyema with respect to efficacy, safety, length of hospital stays, complications and long-term outcomes. Method(s): Database searches across PubMed, Web of Science, Cochrane Library and ScienceDirect (January 2005-May 2025) were conducted following PRISMA guidelines. After exclusions, 22 studies (RCTs and observational) were included. Quality was assessed using the Newcastle-Ottawa Scale and Cochrane Risk of Bias tool. Because studies defined success inconsistently, effectiveness was also expressed as single-procedure success: resolution without a further drainage procedure. Other outcomes included reintervention, hospital stay, complications and mortality. Result(s): Included were 18 cohort studies and 4 RCTs (3667 patients; empyema stages 1-3). Evaluated approaches included video-assisted thoracic surgery (VATS), intrapleural fibrinolysis, chest tube drainage and thoracotomy. Study-reported success ranged from 90%-96% with VATS and 70%-95% with fibrinolysis; expressed as single-procedure success, these fell to 67%-100% and 63%-98%, respectively, against 47% for drainage alone. Chest tube duration was often shorter after VATS, although the drain serves a different purpose in each pathway and is not a measure of efficacy. Overall complication rates were low; bronchopleural fistula was reported by only three studies. Conclusion(s): Both VATS and intrapleural fibrinolysis are safe and effective treatments for paediatric empyema. Both are superior to chest drainage alone. VATS more often achieves resolution with a single procedure, whereas fibrinolysis remains a viable, less-invasive first-line option. Simple parapneumonic effusion requires intravenous antibiotics and supportive care alone. Because allocation was not standardized, differences in reintervention should not be read causally. Copyright © 2026 Paediatrics and Child Health Division (The Royal Australasian College of Physicians). <71> Accession Number 652369479 Title DUCTAL STENT IMPLANTATION AS AN ADJUNCT THERAPY TO BALLOON PULMONARY VALVULOPLASTY IN CRITICAL PULMONARY STENOSIS: IS IT NECESSARY OR OPTIONAL ?. Source Indonesian Journal of Cardiology. Conference: 10th Indonesian Society of Interventional Cardiology Annual Meeting. Jakarta Indonesia. 39(Supplement B) (pp 124-125), 2018. Date of Publication: 2018. Author Caesa P.; Prakoso R. Institution (Caesa) Universitas Gadjah Mada, Indonesia (Prakoso) Division of Pediatric Cardiology and Congenital Heart Disease, Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, National Cardiac Center of Harapan Kita, Indonesia Publisher Indonesian Heart Association Abstract Introduction Balloon pulmonary valvuloplasty (BPV) has been the standard management of critical pulmonary stenosis (CPS). Despite the success of BPV, the need to augment pulmonary blood flow still prevailing. This is a systematic review to evaluate the benefit of ductal stent (DS) as an adjunct therapy to BPV in CPS Method Electronic search was carried out in PubMed and COCHRANE database to September 2018. The literature search followed the PRISMA guidelines. Individual study quality was assessed using Newcastle-Ottawa Scale. Primary outcomes observed were SaO2, reintervention, conversion to surgical shunt, RV to Aortic pressure gradient, and RV to PA pressure gradient. Result Two studies were included with a total of 128 subjects with CPS underwent BPV. Overall, preprocedural and post-procedural SaO2, RV to PA pressure gradient and RV systolic dysfunction were improved. Twenty two subjects required pulmonary blood flow augmentation after a successful BPV. Subjects with duct dependency persisted after a week's time were received DS. DS was performed in the same session in 16 subjects and in a subsequent session in six. Initial SaO2 was significantly lower in subjects that subjected to DS (78.1+/-8.26; 72+/-10.1; p<0.028). The median TV and PV diameter and Z score were statistically low in patients requiring pulmonary blood flow augmentation with DS (p = 0.002 for the TV annulus; p= 0.011 for the TV Z score; p= 0.009 for the PV annulus; p = 0.004 for the PV Z score). A TV and PV Z score less than -1.93 SD and -1.69 predicted the need for pulmonary blood flow augmentation with DS if ductal dependency persisted for a week's time following BPV. Conclusion The need for pulmonary blood flow augmentation in post-BPV CPS is frequent. Adjunct therapy with DS is safe and advisable in selected cases where RV compliance status is compromised. <72> Accession Number 2049709524 Title Clinical Outcomes of Combined TAVR-PCI Versus SAVR-CABG in Patients with Aortic Stenosis and Coronary Artery Disease: A Systematic Review and Meta-Analysis. Source Journal of Clinical Medicine. 15(19) (no pagination), 2026. Article Number: 7556. Date of Publication: 01 Oct 2026. Author Rodriguez Mejia R.A.; Aldaoud M.; Momodu I.; Dongol M.; Feyissa G.; Aruogu K.; Bhatti Z.M.; Riaz A.H.; Saleem N. Institution (Rodriguez Mejia, Momodu, Dongol, Feyissa, Aruogu, Bhatti, Riaz, Saleem) Cape Fear Valley Medical Center, Methodist University Cape Fear Valley Health School of Medicine, Fayetteville, NC, United States (Aldaoud) Department of Cardiology, Faculty of Medicine, University of Jordan, Amman, Jordan Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Coronary artery disease coexists with severe aortic stenosis in about half of patients. Surgical aortic valve replacement with coronary artery bypass grafting (SAVR+CABG) is guideline-recommended, but transcatheter aortic valve replacement with percutaneous coronary intervention (TAVR+PCI) is increasingly used. Prior meta-analyses double-counted overlapping populations and did not report randomized evidence separately; we re-examined the comparison after correcting both. Method(s): PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science and ClinicalTrials.gov were searched up to July 2026 for randomized and comparative observational studies, excluding reports with overlapping populations. Outcomes were pooled with random-effects models, stratified by study design, and re-analysed without administrative databases. Certainty was rated with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Result(s): Fourteen studies were included (two randomized trials, nine cohorts, three administrative databases), comprising 154,892 patients (28,569 TAVR+PCI; 126,323 SAVR+CABG). TAVR+PCI was associated with lower early mortality (odds ratio (OR) 0.60, 95% confidence interval (CI) 0.44-0.84) and less acute kidney injury (OR 0.34, 0.20-0.57), but greater pacemaker implantation (OR 2.18, 1.93-2.46) and major vascular complications (OR 3.38, 1.65-6.89). Stroke, myocardial infarction and one-year mortality (OR 0.80, 0.58-1.10) did not differ; bleeding results were inconsistent (I2 = 95%). Over 12-72 months, mortality was higher with TAVR+PCI (hazard ratio (HR) 1.38, 1.28-1.49; nine observational studies), unchanged without the largest cohort. Administrative databases drove heterogeneity but not the direction of any early outcome. Certainty was moderate for pacemaker implantation and low or very low otherwise; randomized data were too limited to confirm these findings. Conclusion(s): In predominantly observational evidence, TAVR+PCI was associated with lower early risk but higher mortality over longer follow-up. This trade-off supports individualized Heart Team decisions rather than the superiority of either strategy. Adequately powered randomized trials with long-term follow-up are needed. Copyright © 2026 by the authors. <73> Accession Number 2049707966 Title Short-Term Complications of Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis (PROLONG-TAVR). Source Catheterization and Cardiovascular Interventions. (no pagination), 2026. Date of Publication: 2026. Author Castillo-Perez M.; Leon-Gutierrez H.D.; Jerjes-Sanchez C.; Royzman-Rivera L.; Paredes-Vazquez J.G.; Jimenez-Franco V.; Gutierrez-Gallegos P.; Cabada-Garcia M.J.; Rodriguez-Rivera J.; Paredes-Gutierrez E.; Quevedo-Salazar R.; Sanchez-Avila J.F. Institution (Castillo-Perez, Leon-Gutierrez, Jerjes-Sanchez, Royzman-Rivera, Gutierrez-Gallegos, Cabada-Garcia, Rodriguez-Rivera, Paredes-Gutierrez, Quevedo-Salazar, Sanchez-Avila) Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Nuevo Leon, Monterrey, Mexico (Jerjes-Sanchez, Paredes-Vazquez, Jimenez-Franco) Instituto de Cardiologia y Medicina Vascular, TecSalud, Escuela de Medicina y Ciencias de la Salud, Tecnologico de Monterrey, Nuevo Leon, San Pedro Garza Garcia, Mexico (Sanchez-Avila) Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Mexico Publisher John Wiley and Sons Inc Abstract To estimate the cumulative incidence of short-term complications across different transcatheter heart valve (THV) prostheses used for transcatheter aortic valve replacement (TAVR). We performed a systematic review and meta-analysis in accordance with PRISMA and a prospectively registered PROSPERO protocol. Observational studies published from 2002 through May 2024 that included patients with severe aortic stenosis undergoing predominantly transfemoral TAVR and reported prosthesis-specific complications were eligible. Although the original protocol intended to evaluate both short- and long-term complications, long-term outcomes were too sparse and inconsistently reported for robust pooled analyses; therefore, the present analysis focuses on short-term complications. Pooled cumulative incidences were calculated using random-effects models. We included 242 studies comprising 181,187 patients. SAPIEN 3 had the lowest incidence of moderate-to-severe paravalvular leak (PVL) (1.04%, 95% CI 0.69-1.55) and stroke (1.87%, 95% CI 1.64-2.14), whereas ACURATE neo2 had the lowest incidence of permanent pacemaker implantation (PPI) (7.7%, 95% CI 5.82-10.11). Evolut PRO and SAPIEN 3 showed among the lowest rates of major vascular complications (3.56%, 95% CI 2.77-4.57 and 3.87%, 95% CI 3.22-4.66, respectively) and major or life-threatening bleeding (2.96%, 95% CI 2.09-4.17 and 4.8%, 95% CI 4.04-5.69, respectively). Short-term complications have decreased with newer-generation THV prostheses. PVL remains more frequent with self-expanding valves, whereas PPI is the most frequent complication and is generally less frequent with balloon-expandable valves and ACURATE neo2. Stroke rates have changed little across newer generations, and annular rupture, coronary artery obstruction, and valve embolization remain rare (< 1%). Copyright © 2026 Wiley Periodicals LLC. <74> Accession Number 652369487 Title BIFURCATION LESIONS ONE OR TWO STENT STRATEGY?. Source Indonesian Journal of Cardiology. Conference: 10th Indonesian Society of Interventional Cardiology Annual Meeting. Jakarta Indonesia. 39(Supplement B) (pp 26-27), 2018. Date of Publication: 2018. Author Kurniawan A.B.; Taufiq N. Institution (Kurniawan, Taufiq) Division of Interventional Cardiology, Departement of Cardiology & Vascular Medicine, Sardjito General Hospital, Indonesia Publisher Indonesian Heart Association Abstract Introduction: Coronary bifurcations lesion are frequent and account for approximately 20% of all percutaneus coronary interventions. Coronary bifurcation stenting is still a complex procedure and associated with lower procedural succes rate and also high risk of long term outcomes such as Major Cardiac Events (MACEs), Target Lesion Revascularizations (TLRs), stent thromboses and restenoses. Various techniques with usage of one or two stents have been developed to optimize treatments of this subset of lesions. One stent strategy with provisional side branch stenting should be the default approach in the majority of cases due to lower risk of failure and complications. Some studies reported that 5-20% of patients in which the provisional one stent strategy was performed requiring crossover of two stents strategy due to suboptimal result of side branch. In this case report, two cases were shown to be discussed of how to decide between interventional strategy of bifurcation lesions using one stent strategy, two stents strategy, and one stent strategy in which we encountered some problems that we resolved with crossing over to two stent strategy. Case Illustration: Case 1. A 56-year old male presented with typical angina with the history of acute myocardial infarction 2 days before admission. Electrocardiogram evaluation showed anterior old myocardial infarction with evolution of ST segment. He underwent coronary angiography with 80% stenoses (1-1-1 type) of Medina classification at Left Circumflex (LCx) and Obtus Marginal (OM) 1 bifurcation. Provisional stenting based on angiogram profile were used. Drug Eluting Stent (DES) with 3.0 on diameter and 24 mm on length of stent were deployed at the vascular lesion. Stent was displaced to distal side of the vessel when the stent was inflated and plaque at the lesion shifted to proximal part of bifurcation core and ostial of OM1. Crossover strategy with cullote technique were opted. Case 2. A 58-year old male were presented with acute myocardial infarction since 7 hours before admission. Electrocardiogram evaluation showed ST segmen elevation at inferior leads. Primary PCI was executed. Coronary angiogram showed long stenosis 60% at the proximal side of Left Anterior Descending (LAD), significant stenosis at OM2 bifurcation with 1-0-1 Medina classification, and nonsignificant stenosis at proximal Right Coronary Artery (RCA) with non dominant circulation. LCx was the infarct related artery and the bifurcation lesion at LCx and OM2 were planned to be intervened. Provisional stenting technique based on angiogram profile was used . Drug Eluting Stent (DES) with 2.4 on diameter and 24 mm on length of the stent were implanted at the lesion. Because of long lesion and slower flow of the side branch, crossover strategy with internal crush technique were chosen to overcome limitations of provisional stenting. These two case showed that two stent strategy was performed due to suboptimal result of provisional stenting. Some studies reported that this crossover usually occured due to suboptimal result in a side branch including side branch dissection, shifting plaque, slow flow, or FFR <0.75. The decision to use one stent strategy or two stent strategy is the most important thing for the management of bifurcation lesion. Main vessel stenting with provisional side branch treatment is recomended as the preferred technique for the majority of bifurcation lession due to no significant differences in outcome compare with two stent strategy and lower periprosedural duration. Two stent strategy must be planned in bifurcation lession with true bifurcation especially Medina Classification 1-1-1, large diameter of side branch (>2,5 mm) and long lesion of side branch beyond the ostium (>10-20 mm). Conclusion(s): Coronary bifurcation remains a challenging lesion subset of percutaneus coronary intervention. The provisional approach, with main branch stenting only, is the more preferred strategy for the bifurcation lession. However, there were a lot of incidences of crossing over to two stent strategy due to suboplimal side branch result. Initial two stent strategy was preferred in patients with true bifurcation, large side branch and non-focal ostial plaque disease of side branch. <75> Accession Number 2049692413 Title Biventricular Assist Devices Versus Total Artificial Heart as Bridge-to-Transplantation Strategies: A Systematic Review and Meta-analysis. Source Cardiovascular Engineering and Technology. (no pagination), 2026. Date of Publication: 2026. Author Ahmed O.J.I.; Ahmed M.J.I.; Aboutabl M.M.; Mohammed M.; Elserougi M.; Mohamed K.A.; Ghazy T.; Saeed D.; Abdelsamad A. Institution (Ahmed, Ahmed) Faculty of Medicine, Near East University, Nicosia, Cyprus (Aboutabl) Faculty of Medicine, Alexandria University, Alexandria, Egypt (Mohammed) Faculty of Medicine, New Giza University, Cairo, Egypt (Elserougi) Faculty of Medicine, Cairo University, Cairo, Egypt (Mohamed) Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, United States (Ghazy) Deputy Head of Cardiac Surgery, Philipps University Marburg, Marburg, Germany (Saeed) Department of Cardiovascular Surgery, Heart Center Niederrhein, Health and Medical University Krefeld, Krefeld, Germany (Abdelsamad) Surgery Department II, University of Witten/Herdecke, Witten, Germany (Abdelsamad) Chief, General and Gastrointestinal Surgery, Helios Klinik Cuxhaven, Cuxhaven, Germany (Ahmed) Near East University, Near East Boulevard, Mersin 10, Nicosia/TRNC, Turkey Publisher Springer Abstract Purpose: Biventricular assist devices (BiVADs) and total artificial heart (TAH) are the principal bridge-to-transplantation strategies for patients with advanced biventricular heart failure awaiting heart transplantation, but their comparative effectiveness and safety remain uncertain. This systematic review and meta-analysis compared pretransplant outcomes between the two approaches. Method(s): A systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Scopus, Web of Science, and Cochrane Library were searched from inception through January 2026 for studies comparing BiVADs and TAH as bridge-to-transplantation strategies. Study quality was assessed using the Newcastle-Ottawa Scale, and certainty of evidence was evaluated using the GRADE framework. Random-effects models were used to compare survival to transplantation, mortality during support, support-related complications, and duration of support. Result(s): Ten retrospective studies involving 2,242 patients met the inclusion criteria. The overall analysis showed no significant difference in survival to transplantation between patients supported with BiVADs and TAH (RR = 0.97, 95% CI (0.84, 1.13), P = 0.74). However, after excluding potentially overlapping cohorts, sensitivity analysis showed a higher rate of survival to transplantation in those supported with TAH (RR = 0.88, 95% CI (0.80, 0.97), P = 0.01). No significant difference was observed in mortality during support in the overall analysis (RR = 1.19, 95% CI (0.88, 1.61), P = 0.26) or after excluding potentially overlapping cohorts (RR = 0.98, 95% CI (0.79, 1.21), P = 0.84). BiVADs were associated with higher rates of bleeding and stroke (RR = 2.79, 95% CI (1.70, 4.59), P < 0.0001 and RR = 2.31, 95% CI (1.53, 3.50), P < 0.0001, respectively), whereas infection did not differ significantly between the two groups (RR = 1.18, 95% CI (0.50, 2.78), P = 0.70). Sensitivity analysis for stroke after excluding potentially overlapping cohorts showed a similarly higher rate in patients supported with BiVADs (RR = 2.39, 95% CI (1.46, 3.93), P = 0.0006). Duration of support did not differ significantly between both groups in the overall analysis (MD = 2.25 days, 95% CI (- 16.46, 20.96), P = 0.81) or after excluding potentially overlapping cohorts (MD = - 0.90 days, 95% CI (- 24.26, 22.46), P = 0.94). Conclusion(s): TAH may be associated with higher rates of survival to transplantation after excluding potentially overlapping cohorts, while BiVAD support may be associated with higher rates of bleeding and stroke. However, all included studies were retrospective, and the certainty of evidence was low for most outcomes. These findings should therefore be interpreted with caution and require confirmation in prospective multicenter studies. Copyright © The Author(s) under exclusive licence to Biomedical Engineering Society 2026. <76> Accession Number 652369544 Title Percutaneous Versus Surgical Pulmonary Valve Replacement in Patients with Right Ventricular Outflow Tract Dysfunction: A Systematic Review and Meta-Analysis. Source Indonesian Journal of Cardiology. Conference: 12th Indonesian Society of Interventional Cardiology Annual Meeting (ISICAM) 2020. Jakarta Indonesia. 41(Supplement B) (no pagination), 2020. Date of Publication: 2020. Author Ulfiarakhma D.; Ardining H.; Prakoso R. Institution (Ulfiarakhma, Ardining) Faculty of Medicine, Universitas Indonesia, Indonesia (Prakoso) Division of Pediatric Cardiology and Congenital Heart Disease, Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, National Cardiac Center of Harapan Kita, Indonesia Publisher Indonesian Heart Association Abstract Background: This study aimed to compare the clinical outcomes between percutaneous pulmonary valve implantation (PPVI) and surgical pulmonary valve replacement in patients with right ventricular outflow tract (RVOT) dysfunction. Method(s): A systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. We systematically searched the relevant studies from PubMed and Cochrane Library databases from date of inception to October 2020. Outcomes of interest were all-cause mortality, procedural complications, length of hospital stay, post-procedural infective endocarditis, reintervention, 30-day rehospitalization, significant pulmonary regurgitation, and total hospital costs. Result(s): Eighteen observational studies comprising 6854 patients (1854 with PPVI and 5000 with surgical procedure) were included. From our analysis, there were no differences between groups in terms of all-cause mortality (odds ratio 0.69; 95% CI 0.42-1.12, p=0.13), reintervention (odds ratio 0.74; 95% CI 0.48-1.14, p=0.17), and total hospital costs (mean difference US$2,505; 95% CI -2,632-7,643, p=0.34). PPVI was associated with a statistically significant decreased in procedural complications (odds ratio 0.32; 95% CI 0.15-0.69, p=0.003), 30-day rehospitalization (odds ratio 0.67; 95% CI 0.50-0.91, p=0.01), and rate of significant pulmonary regurgitation (odds ratio 0.10; 95% CI 0.04-0.25, p<0.00001) compared to surgical procedure. Length of hospital stay was shorter in PPVI than surgical group (mean difference -4.92; 95% CI -5.72--4.120). However, PPVI appears to be associated with more frequent post-procedural infective endocarditis compared to surgical procedure (odds ratio 3.26; 95% CI 2.15-4.93, p<0.00001). Conclusion(s): Our meta-analysis suggests that PPVI is a safe and efficacious alternative to surgical pulmonary valve replacement in patients with RVOT dysfunction, as it results in significantly fewer procedural complications, shorter length of hospital stay, lower rate of 30-days of rehospitalization and significant PR, although it was associated with higher risk of post-procedural IE compared to surgical procedure. <77> Accession Number 2050571621 Title Cannabinoids for Acute Pain Management: A Contemporary Scoping Review of Evidence, Mechanisms, and Clinical Implications. Source Current Pharmaceutical Design. (no pagination), 2026. Date of Publication: 2026. Author Akman C.; Ucar A.B.; Inci O.; Unaldi M.; Erdem B.; Ozkaya B.; Yilmaz G.; Karcioglu O. Institution (Akman) Department of Emergency Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey (Ucar) Department of Emergency Medicine, Marmara University School of Medicine, Pendik, Istanbul, Turkey (Inci) Department of Emergency Medicine, Faculty of Medicine, Ege University, Izmir, Turkey (Unaldi) Department of Emergency Medicine, Beykoz State Hospital, Istanbul, Beykoz, Turkey (Erdem) Department of Emergency Medicine, Sisli Hamidiye Etfal Education and Research Hospital, University of Health Sciences, Istanbul, Turkey (Ozkaya) Department of Emergency Medicine, Losante Children's and Adult Hospital, Ankara, Turkey (Yilmaz) Department of Emergency Medicine, Konya Beyhekim Education and Research Hospital, Konya, Turkey (Karcioglu) Department of Emergency Medicine, Istanbul Education and Research Hospital, University of Health Sciences, Istanbul, Turkey Publisher Bentham Science Publishers Abstract Background/Introduction: The global opioid crisis has intensified interest in non-opioid and opioid-sparing analgesic strategies, including cannabinoids. Despite the expanding legal landscape for cannabis and a rapidly growing cannabinoid market, the clinical evidence for cannabinoid use in acute pain management remains inconsistent and largely of low quality. Method(s): This contemporary scoping review was conducted and reported in accordance with the PRISMA extension for Scoping Reviews (PRISMA-ScR). A systematic search of six electronic databases (Cochrane Central Register of Controlled Trials (CENTRAL), PubMed/MEDLINE, ClinicalKey, EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and BIOSIS) was performed for literature published between 1 January 2016 and 5 April 2026, with the final database search executed on 5 April 2026, addressing the pharmacology, mechanisms of action, clinical efficacy, safety, and perioperative implications of cannabinoids in acute and postoperative pain. Two blinded reviewers independently screened records and charted data against predefined eligibility criteria; discrepancies were resolved by a third author. Findings are summarized narratively and in tabular format, and the study selection process is depicted in a PRISMA flow diagram. Result(s): Preclinical evidence supports robust antinociceptive effects of cannabinoids through multiple receptor pathways; however, these findings have not translated reliably into human acute pain models. Meta-analytic data demonstrate either no significant reduction in acute pain scores with cannabinoids versus placebo, or only small, clinically uncertain improvements. The opioid-sparing effect, while promising in preclinical and some chronic pain studies, has not been demonstrated for acute postoperative pain. A notable exception is a 2024 randomized trial showing a 40% reduction in opioid requirements with perioperative dronabinol after cardiac surgery. Safety data indicate that non-serious adverse events (dizziness, nausea, sedation) are consistently more frequent with cannabinoids than placebo. The 2023 American Society of Regional Anesthesia and Pain Medicine (ASRA) consensus guidelines now formalize 21 recommendations for perioperative cannabinoid management. Conclusion(s): While the biological rationale for cannabinoid analgesia is compelling, the clinical evidence base for acute pain remains insufficient to support routine use. Cannabinoids may serve as adjuncts in specific populations, but require careful patient selection, dose titration, and safety monitoring. Well-designed, large randomized controlled trials targeting defined acute pain populations are urgently needed. Copyright 2026, Bentham Science Publishers <78> Accession Number 2050575738 Title Di(2-ethylhexyl) phthalate (DEHP) exposure during cardiopulmonary bypass: A narrative review of human clinical evidence and future directions. Source Perfusion (United Kingdom). (no pagination), 2026. Date of Publication: 2026. Author Elgazzar S.H.; Ayoub Y.M.; Elkhouly A.G.; Arafat A.A. Institution (Elgazzar, Ayoub) Nursing Department, King Saud Medical City, Riyadh, Saudi Arabia (Elkhouly, Arafat) Cardiothoracic Surgery Department, Tanta University, Tanta, Egypt (Arafat) Cardiac Surgery Department, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia (Arafat) Research and Innovation Institute, Ministry of Defense Health Services, Riyadh, Saudi Arabia Publisher SAGE Publications Ltd Abstract Background: Di(2-ethylhexyl) phthalate (DEHP) is widely used as a plasticizer in polyvinyl chloride medical devices employed during cardiopulmonary bypass (CPB). Although migration from these devices and blood-storage systems has long been recognized, the human clinical evidence remains limited and methodologically heterogeneous. Method(s): This narrative review used a structured search of PubMed/MEDLINE, Scopus, and Google Scholar from database inception through 23 August 2026. Original peer-reviewed human clinical studies measuring parent DEHP or its metabolites in blood, plasma, or urine among patients undergoing CPB were eligible for the primary synthesis. Relevant mechanistic, biomaterial, transfusion-medicine, guideline, and regulatory sources were used for context. Result(s): The searches identified 237 database records; 33 duplicates were removed, and 204 unique records were screened. Thirteen full-text reports were assessed, and seven human clinical studies published between 1983 and 2025 were included. Across adult and pediatric settings, perioperative increases in parent DEHP and/or urinary or circulating metabolites were documented. The studies implicated multiple sources, including CPB components, blood-storage systems, and ancillary blood-contacting devices, but none provided complete patient-level source apportionment. DEHP-free tubing reduced, but did not eliminate, exposure. RBC washing reduced DEHP and MEHP in vitro, but a reduction in patient-level internal exposure has not been established. Conclusion(s): Human clinical evidence consistently demonstrates internal exposure to DEHP or its metabolites during cardiac surgery involving CPB. However, small heterogeneous cohorts, variable analytes and sampling schedules, and limited outcome follow-up preclude causal inference regarding clinical harm. Prospective multicenter studies using standardized biomonitoring and source-apportionment methods are required. Copyright © The Author(s) 2026 <79> Accession Number 652369500 Title Five Years Outcome of Percutaneous Coronary Intervention versus Coronary Artery Bypass Graft in Left Main Coronary Artery Disease: A Meta-Analysis. Source Indonesian Journal of Cardiology. Conference: 12th Indonesian Society of Interventional Cardiology Annual Meeting (ISICAM) 2020. Jakarta Indonesia. 41(Supplement B) (no pagination), 2020. Date of Publication: 2020. Author Putra H.B.P.; Ramli R.; Febrianto I.R.; Hartono F.; Jovie B. Institution (Putra) Emergency Department, Dr. Ramelan Naval Hospital, Surabaya, Indonesia (Ramli) Emergency Department, Dr. M. Haulussy General Hospital, Ambon, Indonesia (Febrianto) Emergency Department, Hasanah Islamic Hospital, Mojokerto, Indonesia (Hartono) Cardiology Department, Dr. Ramelan Naval Hospital, Surabaya, Indonesia (Jovie) Cardiology Department, Dr. Ramelan Naval Hospital, Surabaya, Indonesia Publisher Indonesian Heart Association Abstract Background: Short-term comparison of Percutaneous Coronary Intervention using Drug-Eluting Stent (PCI-DES) with Coronary Artery Bypass Grafting (CABG) to treat Left Main Coronary Artery Disease (LMCAD) had showed favorable outcomes. However, long-term outcomes of PCI-DES in LMCAD remain questionable. This meta-analysis aims to evaluate 5-year outcomes of PCI versus CABG in treating LMCAD. Method(s): A systematic literature search comparing PCI-DES and CABG in LMCAD was conducted on several electronic database. Inclusion criteria were randomized clinical trial (RCT) or non-RCT, patients with LMCAD, PCI versus CABG, and had completed 5 years of clinical follow-up. Selected studies were analyzed using a fixed or random-effect model. The primary endpoint was Major Adverse Cardiac and Cerebrovascular Events (MACCE), defined as composite of all-cause mortality, myocardial infarction (MI), target vessel revascularization (TVR), and stroke. Secondary endpoints included cardiac death, TVR, and stroke. Result(s): Total of 4 RCT and 1 non-RCT were selected, with 5.398 patients were pooled in our analysis. Comparing with CABG, PCI was associated with higher rates of MACCE (RR=1.43 [95% CI, 1.19-1.72], p=0.0001) and TVR (RR=2.00 [95% CI, 1.48-2.72], p<0.00001). However, incidence of cardiac death (RR=1.19 [95% CI, 0.84-1.67], p=0.33) and stroke (RR=0.95 [95% CI, 0.60-1.49], p=0.82) were not significantly different. Conclusion(s): In patients with LMCAD, PCI had similar outcomes in cardiac death and stroke during five years follow-up compared to CABG. However, MACCE and TVR remain drawbacks and a great challenge to PCI. <80> Accession Number 652369510 Title PERCUTANEOUS CORONARY INTERVENTION VS CORONARY ARTERY BYPASS GRAFTING IN UNPROTECTED LEFT MAIN ARTERY DISEASE - SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIAL. Source Indonesian Journal of Cardiology. Conference: 10th Indonesian Society of Interventional Cardiology Annual Meeting. Jakarta Indonesia. 39(Supplement B) (pp 137-138), 2018. Date of Publication: 2018. Author Pranata R.; Yonas E.; Pamungkas B.; Damay V. Institution (Pranata, Damay) Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia (Yonas) Faculty of Medicine, Universitas YARSI, Jakarta, Indonesia (Pamungkas) Department of Cardiology and Vascular Medicine, Central Army Hospital Gatot Soebroto, Jakarta, Indonesia (Damay) Department of Cardiology and Vascular Medicine, Siloam Hospitals Lippo Village, Tangerang, Indonesia Publisher Indonesian Heart Association Abstract Introduction Percutaneous coronary intervention (PCI) emerges as a less invasive alternative to the routinely done coronary artery bypass grafting (CABG) for management of unprotected left main coronary artery (ULMCA) disease. This meta-analysis aimed to compare the efficacy of PCI and CABG in the management of ULMCA disease. Methods Electronic search on PubMed (MEDLINE), EBSCO, EuropePMC, Cochrane Central Database, Clinicaltrials.gov, and Google Scholar was done. Randomized controlled trials comparing the use of PCI or CABG in patients with ULMCA stenosis were included. Meta-analysis was done to compare the outcome of PCI and CABG. There were 6 studies included. 5 studies exclusively used Drug-Eluting Stent (DES) and 1 study used both Bare Metal Stent (BMS) and DES. The primary outcome of interest was all-cause mortality and secondary was CV death, MACE, myocardial infarction (MI), stroke, and repeat revascularization. Results There were a total of 4688 participants from 6 studies. PCI of ULMCA was associated with similar all-cause mortality, CV death, 1-year MACE, MI, and stroke. However, PCI had a higher rate of repeat revascularization [OR 1.78; 95% CI 1.48-2.15; p<0.001] and 3-5-year MACE [OR 1.40; 95% CI 1.21-1.62; p<0.001]. After ousting 1 study that used a mixture of BMS and DES, the result is still significant for repeat revascularization [OR 1.85; 95% CI 1.53-2.23; p<0.001] and 3-5-year MACE [OR 1.40; 95% CI 1.21-1.62; p<0.001]. Conclusion Coronary artery bypass graft still upholds the advantage over PCI in ULMCA revascularization. However, PCI is non-inferior in terms of all-cause mortality, CV death, 1-year MACE, MI, and stroke. Percutaneous coronary intervention can be considered as an acceptable option in inoperable patients. (Figure presented). <81> Accession Number 2049741332 Title Leadless Pacemakers After Transcatheter Aortic Valve Replacement: A Meta-analysis With Time-to-Event Analysis. Source PACE - Pacing and Clinical Electrophysiology. (no pagination), 2026. Date of Publication: 2026. Author Wijayanto F.P.S.; Tristan C.D.; Aditya M.R.; Simanjuntak A.M.T.; Pranata R. Institution (Wijayanto, Simanjuntak) Department of Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia (Tristan) Department of Medicine, Faculty of Medicine, Universitas Sebelas Maret, Solo, Indonesia (Aditya) Department of Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia (Pranata) Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia (Pranata) Department of Cardiovascular Medicine, Siloam Hospitals Lippo Village, Tangerang, Indonesia Publisher John Wiley and Sons Inc Abstract Background: Permanent pacemaker implantation is a common complication after transcatheter aortic valve replacement (TAVR). Leadless pacemakers (LPs) may reduce lead- and pocket-related complications, but their clinical outcomes after TAVR remain uncertain. This systematic review and meta-analysis evaluated the safety and effectiveness of LPs compared with transvenous pacemakers (TVPs). Method(s): PubMed, Scopus, and ScienceDirect were searched from inception to June 10, 2026. Randomized and observational studies were included. Random-effects meta-analyses pooled proportions, risk ratios (RRs), and mean differences (MDs). Reconstructed Kaplan-Meier data were used to estimate hazard ratios (HRs). Result(s): Ten studies involving 10,809 patients (1030 LP and 9779 TVP recipients) were included. The pooled procedural success rate of LP implantation was 98% (95% CI 95%-99%). Implantation success was comparable between LP and TVP (RR 1.00, 95% CI 0.98-1.02). Sensitivity analysis demonstrated a shorter hospital stay with LP (MD -1.37 days, 95% CI -2.33 to -0.41) and a lower risk of heart failure hospitalization (RR 0.37, 95% CI 0.14-0.96). Overall survival did not differ between groups (HR 1.05, 95% CI 0.44-1.23), although reconstructed survival curves showed late separation favoring LP. Device-related and vascular complications were comparable between LP and TVP. Conclusion(s): LP implantation after TAVR demonstrates excellent procedural success and clinical outcomes comparable to TVPs. LPs may reduce hospital stay and heart failure hospitalization, supporting their use as an alternative pacing strategy in appropriately selected patients. Copyright © 2026 Wiley Periodicals LLC. <82> Accession Number 652369537 Title SINGLE-STENT STRATEGY IN LEFT MAIN STENOSIS. Source Indonesian Journal of Cardiology. Conference: 10th Indonesian Society of Interventional Cardiology Annual Meeting. Jakarta Indonesia. 39(Supplement B) (pp 47), 2018. Date of Publication: 2018. Author Hp H.M. Publisher Indonesian Heart Association Abstract Significant LMCA (Left Main Coronary Artery) disease is considered as the lesion with the highest prognostic value in the coronary system because of the extent of jeopardised myocardium. Though CABG is considered as gold standard for treatment of left main stenosis, particularly distal left main, evidence is increasing to support the use of PCI with stenting in some cases. In this national government insurance era, most hospitals are facing budget tightening challenges in each procedures, including in the cath-lab when cardiologists dealing with complex coronary challenges. Some patients with complex lesion are not willing to undergo CABG as treatment option, so cardiologists are left with only few options of revascularization. We report two cases of patients with distal left main disease, one with critical stenosis of ostial LAD and the other was without bifurcation lesion. We performed a PCI of the distal left main through the transradial route. After the procedure the coronary blood flow were successfully restored into TIMI flow 3 with no residual stenosis. We performed coroangiography evaluation after 2 years post PCI and we found that the stent is still patent with no in-stent restenosis. The DK Crush V meta analyses of randomized controlled trials of bifurcation coronary stent strategies recommends a provisional single-stent strategy over upfront 2-stent strategy. This simpler option, as appropriate, may reduce fatal longterm sequelae associated with complex 2-stent bifurcation strategies. Our two cases prove that single-stent strategy remains to be an appropriate treatment of left main stenosis when we only have limited resources and options. <83> Accession Number 2050610077 Title Seven years is not a lifetime: long-term TAVR outcomes in an era of expanding indications. Source Trends in Cardiovascular Medicine. (no pagination), 2026. Date of Publication: 2026. Author Jacquemyn X.; Serna-Gallegos D. Institution (Jacquemyn, Serna-Gallegos) Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, United States (Jacquemyn, Serna-Gallegos) Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, United States Publisher Elsevier Inc. <84> [Use Link to view the full text] Accession Number 2050536874 Title Fresh Frozen Plasma versus Crystalloid Priming of Cardiopulmonary Bypass Circuit in Pediatric Surgery: A Randomized Clinical Trial. Source Anesthesiology. 132(1) (pp 95-106), 2020. Date of Publication: 01 Jan 2020. Author Dieu A.; Rosal Martins M.; Eeckhoudt S.; Matta A.; Kahn D.; Khalifa C.; Rubay J.; Poncelet A.; Haenecour A.; Derycke E.; Thiry D.; Gregoire A.; Momeni M. Institution (Dieu, Rosal Martins, Matta, Kahn, Khalifa, Momeni) From the Departments of Anesthesiology, United States (Eeckhoudt) Hematology, United States (Rubay, Poncelet) Cardiac Surgery, United States (Thiry, Gregoire) Perfusion Services, United States (Haenecour, Derycke) Pediatric Intensive Care Unit, United States (Haenecour, Derycke) University Hospital Saint Luc, Catholic University of Louvain (Cliniques Universitaires Saint Luc, Universite Catholique de Louvain), Brussels, Belgium Publisher Lippincott Williams and Wilkins Abstract Editor's Perspective - What We Already Know about This Topic - Fresh frozen plasma is often used to prime the cardiopulmonary bypass circuit for pediatric cardiac surgical patients to help offset dilutional coagulopathy that might result in increased perioperative bleeding and allogeneic blood transfusion Prior randomized trials of crystalloid versus fresh frozen plasma prime have reported conflicting results, but the vast majority of these studies were not blinded What This Article Tells Us That Is New - In this double-blind randomized controlled trial of patients undergoing pediatric cardiac surgery with cardiopulomonary bypass, postoperative bleeding and the need for allogeneic blood products does not differ significantly between patients for whom the cardiopulmonary bypass circuit was primed with crystalloid versus fresh frozen plasma Background - In congenital cardiac surgery, priming cardiopulmonary bypass (CPB) with fresh frozen plasma (FFP) is performed to prevent coagulation abnormalities. The hypothesis was that CPB priming with crystalloids would be different compared with FFP in terms of bleeding and/or need for blood product transfusion. Methods - In this parallel-arm double-blinded study, patients weighing between 7 and 15 kg were randomly assigned to a CPB priming with 15 ml . kg-1 PlasmaLyte or 15 ml . kg-1 FFP in addition to a predefined amount of packed red blood cells used in all patients. The decision to transfuse was clinical and guided by point-of-care tests. The primary endpoints included postoperative bleeding tracked by chest tubes, number of patients transfused with any additional blood products, and the total number of additional blood products administered intra- and postoperatively. The postoperative period included the first 6 h after intensive care unit arrival. Results - Respectively, 30 and 29 patients in the FFP and in the crystalloid group were analyzed in an intention-to-treat basis. Median postoperative blood loss was 7.1 ml . kg-1 (5.1, 9.4) in the FFP group and 5.7 ml . kg-1 (3.8, 8.5) in the crystalloid group (P = 0.219); difference (95% CI): 1.2 (-0.7 to 3.2). The proportion of patients additionally transfused was 26.7% (8 of 30) and 37.9% (11 of 29) in the FFP and the crystalloid groups, respectively (P = 0.355; odds ratio [95% CI], 1.7 [0.6 to 5.1]). The median number of any blood products transfused in addition to priming was 0 (0, 1) and 0 (0, 2) in the FFP and crystalloid groups, respectively (P = 0.254; difference [95% CI], 0 [0 to 0]). There were no study-related adverse events. Conclusions - The results demonstrate that in infants and children, priming CPB with crystalloids does not result in a different risk of postoperative bleeding and need for transfusion of allogeneic blood products. Copyright © 2019, the American Society of Anesthesiologists, Inc. All Rights Reserved. <85> Accession Number 2050489580 Title Recent advances in percutaneous coronary intervention for modernizing coronary physiology-guided and device-based strategies for coronary revascularization. Source Frontiers in Medicine. 13 (no pagination), 2026. Article Number: 1790673. Date of Publication: 2026. Author Tang D.; Mu W. Institution (Tang, Mu) Department of Cardiology, Gucheng District People's Hospital, Lijiang, China Publisher Frontiers Media SA Abstract Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide. Over the past three decades, percutaneous coronary intervention (PCI) has evolved from a anatomical revascularization technique into a precision-based, physiology- and imaging-guided therapeutic strategy capable of addressing increasingly complex coronary disease. This review aims to critically examine contemporary advances in PCI, with particular emphasis on the integration of coronary physiology, intravascular imaging, and next-generation device technologies. We synthesize evidence from landmark randomized trials, meta-analyses, and recent high-impact studies to evaluate how these advances have reshaped clinical decision-making, procedural optimization, and long-term outcomes in complex coronary artery disease. A comprehensive narrative review of the literature was conducted using PubMed, Google Scholar, and the National Library of Medicine databases. The review focuses on physiology-guided PCI, drug-eluting stent evolution, intravascular imaging, PCI in complex clinical settings (including left main disease and post-coronary artery bypass grafting anatomy), and emerging adjunctive technologies. Structural interventions are discussed selectively to contextualize the broader evolution of catheter-based cardiovascular therapies. Contemporary PCI has been transformed by physiology-guided lesion assessment, advanced intravascular imaging, and improved stent platforms, enabling safer and more effective treatment of complex coronary anatomy. Evidence from recent trials highlights both the strengths and limitations of physiology-guided PCI, particularly in multivessel and post-CABG disease, underscoring the need for integrated anatomy-physiology approaches. Advances in device engineering, robotic assistance, and adjunctive pharmacotherapy have further refined procedural precision and outcomes. Emerging technologies, including drug-coated balloons, resorbable scaffolds, and innovative biologic and cell-free therapeutic strategies, illustrate the expanding translational landscape of coronary intervention. The modernization of PCI reflects a paradigm shift toward precision-guided, evidence-based coronary revascularization. While technological advances have broadened the scope of PCI and improved procedural outcomes, optimal revascularization strategies must remain individualized and grounded in robust clinical evidence. Copyright © 2026 Tang and Mu. <86> Accession Number 2049374453 Title Combined epicardial and endocardial ablation for atrial fibrillation: An updated best practices guide to hybrid convergent procedures. Source Heart Rhythm O2. (no pagination), 2026. Date of Publication: 2026. Author Eldadah Z.A.; Celentano E.; Buch E.F.; Makati K.J.; Sherman A.J.; Agnino A.; Chan D.T.L.; Kerendi F.; Riley M.J.; Weerasooriya R.; Joshi P.; Kaba R.A.; Momin A.; Shults C.C.; Benharash P.; Cornella K.N.; Pan H.; Porta-Sanchez A.; Sonne K.; Osman F.; Stouffer C.W.; DeLurgio D.B.; Peterson S.M.; Morris K.E.; Mudd T.U.; Dunnington G.H.; Brodt C.R.; Hussein A.A.; Soltesz E.; Arghami A.; Killu A.M.; Sugrue A.; Martinelli K.; Merritt H.M.; Ahsan S.; Carranza C.L.; Fan K.Y.Y.; Gill J.; Hanke T.; Nisbet A.; Yap J.; Zannis K.; Kiankhooy A.; Lyons R.C. Institution (Eldadah) MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, DC, United States (Celentano) Department of Cardiac Electrophysiology, Humanitas Gavazzeni-Castelli, Bergamo, Italy (Celentano) Unit Translational Electrophysiology, Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands (Buch) University of California Los Angeles (UCLA) Cardiac Arrhythmia Center, UCLA, Los Angeles, CA, United States (Makati) St. Joseph's Hospital, Tampa, FL, United States (Sherman) BayCare Health Systems, Tampa, FL, United States (Agnino) Department of Cardiovascular Surgery, Humanitas Gavazzeni-Castelli, Bergamo, Italy (Chan) Department of Cardiothoracic Surgery, Queen Mary Hospital, Hong Kong SAR, China (Kerendi) St. David's Heart and Vascular, Austin, TX, United States (Riley, Martinelli) Wellstar Health System, Marietta, Georgia (Weerasooriya, Joshi) Heart Rhythm Clinic, Hollywood Private Hospital, Perth, WA, Australia (Weerasooriya, Joshi) University of Western Australia, Crawley, WA, Australia (Kaba) School of Health and Medical Sciences, City St George, University of London, London, United Kingdom (Kaba) Department of Biological Science, Royal Holloway, University of London, London, United Kingdom (Momin) Department of Cardiac Surgery, St George's University Hospitals NHS Foundation Trust, London, United Kingdom (Shults) Department of Cardiac Surgery, MedStar Washington Hospital Center, Washington, DC, United States (Benharash) Division of Cardiac Surgery, Department of Surgery, David Geffen School of Medicine, UCLA, Los Angeles, CA, United States (Cornella) Department of Thoracic Surgery and Interventional Radiology, St. Joseph Hospital of Orange, Orange, CA, United States (Pan) Biltmore Cardiology, Abrazo Medical Group, Phoenix, AZ, United States (Porta-Sanchez) Department of Cardiology, Hospital Clinic Cardiovascular Institute (ICCV), Universitat de Barcelona, Catalonia, Barcelona, Spain (Sonne) Clinic for Internal Medicine and Cardiology, MediClin Heart Center Lahr, Lahr, Germany (Osman) Institute for Cardio-Metabolic Medicine, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom (Stouffer) Cardiothoracic and Vascular Surgical Associates, Jacksonville, FL, United States (DeLurgio) Emory University Hospital, Atlanta, GA, United States (Peterson, Morris, Mudd) Norton Heart and Vascular Institute, Louisville, KY, United States (Dunnington) Department of Cardiothoracic Surgery, Adventist-Health Saint Helena, Saint Helena, CA, United States (Brodt) Sequoia Hospital, Palo Alto, CA, United States (Hussein) Cardiac Electrophysiology Section, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, United States (Soltesz) Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, United States (Arghami) Cardiovascular Surgery, Mayo Clinic, Rochester, MN, United States (Killu, Sugrue) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Merritt) Nebraska Methodist Health System, Omaha, NE, United States (Ahsan) Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (Carranza) Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (Fan) Kwok Tak Seng Heart Center, Grantham Hospital, Wong Chuk Hang, Hong Kong (Gill) Guy's and St. Thomas Hospital, London, United Kingdom (Hanke) Department of Cardiac Surgery, Heart and Vascular Centre Albertinen Krankenhaus, Hamburg, Germany (Nisbet) Bristol Heart Institute, Bristol, United Kingdom (Yap) Department of Cardiac Surgery, Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (Zannis) Unit of Cardiac Surgery, Institut Mutualiste Montsouris (IMM), Paris, France (Kiankhooy) Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States (Lyons) Trinity Health, Ypsilanti, MI, United States Publisher Elsevier B.V. Abstract Non-paroxysmal atrial fibrillation (NPAF) accounts for approximately 40%-50% of identified AF and is often accompanied by structural and functional atrial remodeling. Advanced disease can result in increased morbidity, mortality, and health care costs. Antiarrhythmic drugs or endocardial pulmonary vein isolation are less successful in NPAF. Hybrid epicardial-endocardial (convergent) ablation is a treatment for advanced AF supported by a randomized clinical trial for which best practices were published in 2020. With gained clinical experience and evidence, herein is an update to hybrid convergent best practices, with a focus on recommendations where possible. This includes the establishment of a multidisciplinary hybrid AF team, patient selection criteria, procedural logistics and protocols, intraoperative considerations, postoperative management, left atrial appendage closure, patient and provider education, adverse event mitigation, and follow-up patient outcomes. Future directions are explored, including the use of alternative ablation energy sources and robotic-assisted techniques. Copyright © 2026 Heart Rhythm Society. <87> Accession Number 2049682428 Title Efficacy and safety of prothrombin complex concentrate versus fresh frozen plasma in adult patients undergoing cardiac surgery: a systematic review and meta-analysis. Source Journal of Cardiothoracic Surgery. 21(1) (no pagination), 2026. Article Number: 776. Date of Publication: 01 Dec 2026. Author Hameed M.S.; Razzaq A.; Zia A.; Iftihar A.; Zaeem M.; Tariq A.; Javaid M.U.; Alvi S.; Munir I.; Truong V.T.; Hassan M.H.U.; Zaidi S.R.H.; Qaiser S.; Fatima R.; Naveed M.U. Institution (Hameed, Razzaq, Iftihar, Zaeem, Tariq) Department of Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan (Zia) Department of Medicine, Foundation University Medical College, Islamabad, Pakistan (Javaid) Department of Medicine, Faderal Medical and Dental College, Islamabad, Pakistan (Alvi) Department of Medicine, Ascension St.Joseph Hospital, Chicago, United States (Munir) Department of Medicine, UC Davis Medical Center, Sacramento, United States (Truong) Department of Cardiology, The Christ Hospital Health Network Ohio Heart and Vascular Center, Cincinnati, OH, United States (Hassan, Fatima) Department of Medicine, South Brooklyn Health, Brooklyn, United States (Zaidi) Department of Medicine, UC Health Parkview Medical Center, Pubelo, United States (Qaiser) Department of Medicine, Rutgers Health Community Medical Center, Toms River, United States (Naveed) Department of Medicine, Nangarhar Medical University, kab-ul-jalalabad highway, Jalalabad, Afghanistan Publisher BioMed Central Ltd Abstract Background: Postoperative bleeding is a common and potentially life-threatening complication following cardiac surgery, often exacerbated by multifactorial coagulopathy from cardiopulmonary bypass, hypothermia, and platelet dysfunction. While fresh frozen plasma (FFP) has traditionally been used for coagulation correction, it has significant limitations, including large volume requirements, slow onset, and increased risk of transfusion-related complications. Prothrombin complex concentrate (PCC) has emerged as a potential alternative, offering rapid coagulation correction with reduced volume load and no ABO compatibility requirements. This systematic review and meta-analysis compared the efficacy and safety of PCC versus FFP in managing coagulopathic bleeding in adult cardiac surgery patients. Method(s): We conducted a systematic review and meta-analysis following PRISMA guidelines. Electronic databases (MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials) were searched using MeSH terms and keywords related to "Cardiothoracic Surgery", "Prothrombin Complex Concentrate", and "Fresh Frozen Plasma", from inception to Jan 2026. Cohort studies and randomized controlled trials comparing PCC and FFP in patients aged > 18 years undergoing cardiac surgery complicated by bleeding or coagulopathy were included. Primary outcomes were RBC transfusion requirement, chest tube drainage, and thromboembolic events. Secondary outcomes included surgical re-exploration for bleeding, stroke, duration of mechanical ventilation, hospital and ICU stays, and acute kidney injury. Risk of bias was assessed using the Cochrane Risk of Bias Tool 2.0 for RCTs and the Newcastle-Ottawa Scale for observational studies. Statistical analysis was conducted using Review Manager (RevMan) version 5.4, applying risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes, both with 95% confidence intervals. The meta-analysis protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under protocol number CRD420251088737. Result(s): This meta-analysis included ten studies with 2,643 patients. PCC use moderately reduced RBC transfusion in the first 24 h (RR = 0.84; 95% CI: 0.76-0.93; p = 0.05; I2 = 47%), 12-24-h chest tube drainage (MD = - 188.89 mL; 95% CI: - 248.48 to - 125.30; p < 0.00001; I2 = 50%), and hospital stay (MD = - 1.19 days; 95% CI: - 2.21 to - 0.18; p = 0.004; I2 = 67%). No significant differences were observed for surgical re-exploration (RR = 0.81; 95% CI: 0.66-1.00; p = 0.05; I2 = 0%), mechanical ventilation (MD = - 0.08; 95% CI: - 0.34 to 0.19; p > 0.05; I2 = 73%), ICU stay (MD = - 0.07 days; 95% CI: - 0.59 to 0.45; p = 0.78; I2 = 59%), all-cause mortality (RR = 1.10; 95% CI: 0.82-1.50; p = 0.51; I2 = 0%), thromboembolic events (RR = 1.22; 95% CI: 0.80-1.85; p = 0.35; I2 = 0%), stroke (RR = 1.10; 95% CI: 0.75-1.63; p = 0.63; I2 = 0%), acute kidney injury (RR = 1.08; 95% CI: 0.74-1.56; p = 0.70; I2 = 77%), serious adverse events (RR = 0.78; 95% CI: 0.56-1.09; p = 0.15; I2 = 35%), and any adverse event (RR = 0.95; 95% CI: 0.81-1.11; p = 0.54; I2 = 53%). Moderate to high heterogeneity was noted in several outcomes, for which subgroup analyses were performed. Conclusion(s): This meta-analysis demonstrates that PCC is superior to FFP in reducing RBC transfusion requirements, 12-24-h chest tube drainage, and hospital length of stay in adult cardiac surgery patients, while maintaining a comparable safety profile. Further large-scale, high-quality RCTs are warranted to strengthen the evidence base and inform future guidelines. Copyright © The Author(s) 2026. <88> Accession Number 2050569823 Title Comment on "Rationale and design of a pilot randomized control trial of permissive hypotension after cardiac surgery: The PHACS trial". Source American Heart Journal Plus: Cardiology Research and Practice. 71 (no pagination), 2026. Article Number: 100948. Date of Publication: 01 Nov 2026. Author Kalpana T.; Silpa C.; Manukonda M.; Ponmani A. Institution (Kalpana) College of Nursing, Sri Padmavati Mahila Visvavidyalayam Women's University, Tirupati, India (Silpa) Department of Community Health Nursing, Apollo College of Nursing, Chittoor, India (Manukonda) (Ponmani) Vikram College of Nursing, Madurai, India Publisher Elsevier Inc. <89> Accession Number 2049457697 Title Early aortic valve replacement for asymptomatic severe aortic stenosis: an updated systematic review and meta-analysis. Source Progress in Cardiovascular Diseases. (no pagination), 2026. Date of Publication: 2026. Author Cannata F.; Del Torto A.; Stankowski K.; Fazzari F.; Mantegazza V.; Tassetti L.; Cosentino N.; Mushtaq S.; Baggiano A.; Muratori M.; Pontone G. Institution (Cannata, Del Torto, Stankowski, Fazzari, Mantegazza, Tassetti, Cosentino, Mushtaq, Baggiano, Muratori, Pontone) Department of Perioperative Cardiology and Cardiovascular imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy (Pontone) Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy Publisher W.B. Saunders Abstract Background The optimal timing of intervention in asymptomatic severe aortic stenosis remains debated. This updated meta-analysis evaluates the comparative effects of early surgical or transcatheter aortic valve replacement (AVR) versus conservative management by incorporating recent long-term randomized evidence. Methods We performed a systematic review and meta-analysis of randomized trials comparing early AVR with conservative management in asymptomatic severe AS. Hazard ratios and 95% confidence intervals were pooled using a random-effects model, and exploratory meta-regression analyses were conducted to identify potential treatment-effect modifiers. Results Across the included randomized trials, an early intervention strategy was associated with significant reductions in cardiovascular hospitalizations, heart failure hospitalizations, and stroke. Reductions in all-cause and cardiovascular mortality favored early intervention but did not achieve statistical significance. Treatment benefits varied according to clinical and hemodynamic profiles: greater baseline valve severity was associated with larger therapeutic effects, whereas increasing comorbidity burden (such as diabetes) tended to result in inferior clinical outcomes. Conclusions In asymptomatic severe AS, an early AVR strategy consistently reduces cardiovascular and heart failure hospitalizations and stroke compared with conservative surveillance, despite neutral effects on overall and cardiovascular mortality. These findings support a contemporary shift toward an individualized, phenotype-driven approach rather than universal early intervention. Integrating hemodynamic severity and comorbidity burden can help identify patients most likely to derive net clinical benefit from early valve replacement. Copyright © 2026 The Author(s). <90> Accession Number 2050563400 Title Comparative Long-Term Outcomes of Subcoronary Versus Full-Root Techniques in the Ross Procedure: A Meta-Analysis and Meta-Regression. Source Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery. (no pagination), 2026. Date of Publication: 2026. Author Cubas W.S.; Gundelach J.; Alfabeto A.; Kawaguchi Y.; Chu M.W.A. Institution (Cubas, Alfabeto, Kawaguchi, Chu) Division of Cardiac Surgery, Department of Surgery, Western University, London Health Sciences Centre, ON, Canada (Cubas) Southern Surgical Research Network, Universidad Cientifica del Sur, Lima, Peru (Gundelach) Department of Cardiac Surgery, Las Higueras Hospital, Talcahuano, Chile Publisher SAGE Publications Ltd Abstract Objective: The Ross procedure has demonstrated excellent results across various techniques. This meta-analysis compares subcoronary (SC) and full-root (FR) techniques, assessing long-term autograft failure, reintervention, and mortality to compare each approach and durability. Method(s): A literature search in PubMed, Embase, Scopus, and Cochrane identified studies (1970 to 2025) comparing SC versus FR Ross techniques with a minimum follow-up of 1 year. A random-effects meta-analysis assessed mortality, autograft failure, and reintervention. Meta-regression evaluated study-level covariate impact on long-term outcomes and durability. Result(s): Five observational studies were included (2,064 patients; 1,118 SC, 946 FR) with a mean age of 22.7 years and 12.8-year follow-up. SC patients were slightly older and had more congenital heart disease. FR was associated with longer cardiopulmonary bypass and cross-clamp times, with no differences in gender, valve morphology, or New York Heart Association class. Outcomes were comparable for mortality (relative risk [RR] = 0.95, 95% confidence interval [CI]: 0.72 to 1.25), reintervention (RR = 1.02, 95% CI: 0.42 to 2.46), and autograft failure (RR = 0.90, 95% CI: 0.36 to 2.23; hazard ratio = 0.88, 95% CI: 0.63 to 1.24). Meta-regression identified age and prior infective endocarditis as predictors of mortality, whereas longer follow-up modestly reduced reintervention risk, suggesting durable autograft performance or competing risks over time. Conclusion(s): This meta-analysis reveals comparable long-term outcomes between Ross procedure techniques. It likely reflects surgical expertise and preference, suggesting the approach should be patient tailored, as neither proves superior. Further research is needed to optimize individualized strategies. Copyright © The Author(s) 2026. 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 pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). <91> Accession Number 652358700 Title Design and Rationale of the CLASP II TR Randomized Trial for Severe Tricuspid Regurgitation. Source American heart journal. (pp 107627), 2026. Date of Publication: 09 Oct 2026. Author Ailawadi G.; Davidson C.J.; Anderson A.S.; Hahn R.T.; Willert P.; Gilmore S.Y.; Vinekar C.; Zhang B.; Muralidhar M.; Castro R.; Shi L.; Graham A.; Feldman T.; Mack M.J.; Leon M.B. Institution (Ailawadi) University of Michigan Medical School, Ann Arbor, MI, United States (Davidson) Northwestern University Feinberg School of Medicine, Chicago, IL, United States (Anderson) University of Texas at San Antonio, San Antonio, TX, United States (Hahn, Leon) Columbia University Medical Center, New York, New York; Cardiovascular Research Foundation, New York, New York (Willert, Gilmore, Vinekar, Zhang, Muralidhar, Castro, Shi, Graham, Feldman) Edwards Lifesciences, Irvine, CA, United States (Mack) Baylor Scott & White The Heart Hospital, Plano, TX, United States Abstract Severe tricuspid regurgitation (TR) is a progressive disease associated with mortality, heart failure hospitalization (HFH), impaired functional status, and reduced quality of life. Transcatheter tricuspid valve repair and replacement therapies have expanded treatment options for TR patients beyond medical therapy and surgery and improved their functional status and symptoms. The CLASP II TR trial is a prospective, multicenter, open-label randomized trial designed to test superiority of tricuspid transcatheter edge-to-edge repair (T-TEER) with the PASCAL transcatheter valve repair system+optimal medical therapy (device group) versus optimal medical therapy alone (control group) in symptomatic severe TR patients. A total of 450 patients with >=severe TR as assessed by an independent echocardiographic core laboratory are randomized following central screening committee assessment in a 2:1 ratio (device:control). The primary endpoint is a 6-month hierarchical composite combining key safety and efficacy outcomes (all-cause mortality, durable right ventricular assist device or heart transplant, elective or non-elective tricuspid valve surgery/intervention and number of HFH) with quality-of-life improvement assessed using Kansas City Cardiomyopathy Questionnaire Overall Summary score. Additionally, clinical, echocardiographic, functional, and quality-of-life parameters are also evaluated. Patients are assessed at baseline; 30 days; 3, 6, and 12 months; and annually through 5 years. Crossover of control patients is permitted either after the 2-year visit or when the last randomized patient completes 12-month follow-up. The CLASP II TR trial will inform the safety and effectiveness of the PASCAL system compared to medical therapy alone in the treatment of patients with symptomatic, severe tricuspid regurgitation. The trial has completed enrollment, and the report of primary results is expected. Trial Registration: Edwards PASCAL Transcatheter Valve Repair System Pivotal Clinical Trial (CLASP II TR); NCT04097145; https://clinicaltrials.gov/study/NCT04097145. Copyright © 2026 Elsevier Inc. All rights reserved. <92> Accession Number 2049685152 Title Adverse events in neonates with congenital heart disease after cardiovascular surgery: a systematic review and meta-analysis. Source BMC Pediatrics. 26(1) (no pagination), 2026. Article Number: 994. Date of Publication: 01 Dec 2026. Author Nunes E.; de Campos Pereira Silveira R.C.; Gimenes F.R.E.; Pereira R.A.; Gabiattia D. Institution (Nunes, de Campos Pereira Silveira, Gimenes, Pereira, Gabiattia) Ribeirao Preto College of Nursing, University of Sao Paulo, Avenida Bandeirantes, 3900, Monte Alegre, Ribeirao Preto, Sao Paulo, Brazil Publisher BioMed Central Ltd Abstract Introduction: Neonates with congenital heart disease (CHD) undergoing cardiovascular surgery are exposed to complex postoperative care and may experience adverse events. Method(s): A systematic review and meta-analysis was conducted. Searches were performed in the Cochrane Central Register of Controlled Trials, LILACS, CINAHL, EMBASE, PubMed, Web of Science Core Collection, and Scopus. Observational cohort studies evaluating adverse events in neonates were eligible for inclusion. Data extraction was performed independently by two reviewers; in the event of disagreement, a third reviewer was consulted. Search results were exported to the online reference management software EndNote Basic for duplicate removal and subsequently imported into the Rayyan platform. Result(s): Of the 60 articles identified, 20 studies comprising a total of 25,422 neonates with congenital heart disease in the postoperative period were included. The overall prevalence of adverse events was 14%. The most prevalent events were central venous catheter (CVC)-related incidents (14%), healthcare-associated infections (12%), and extubation failure (11%). Conclusion(s): The prevalence of adverse events in neonates with CHD undergoing cardiovascular surgery is substantial and likely underreported. Further studies are needed to improve the detection, mitigation, and reduction of these events. Copyright © The Author(s) 2026. <93> Accession Number 2049709465 Title Malignant Tracheal Stenosis: A Narrative Review of Current Diagnostic and Therapeutic Approaches. Source Journal of Clinical Medicine. 15(19) (no pagination), 2026. Article Number: 7638. Date of Publication: 01 Oct 2026. Author Savu C.F.; Sabha A.-A.; Tivadar M.-B.; Vlasceanu S.G.; Orghidan M.; Bobocea A.-C. Institution (Savu, Sabha, Tivadar, Vlasceanu, Orghidan, Bobocea) Department of Thoracic Surgery, "Marius Nasta" National Institute of Pneumology, Bucharest, Romania (Savu) Thoracic Surgery I, University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Malignant tracheal stenosis (MTS) is a rare, life-threatening condition caused by primary tracheal tumor, mainly adenoid cystic carcinoma (ACC) and squamous cell carcinoma (SCC), and more rarely other primary neoplasms such as lymphomas, or local extension/metastasis from adjacent malignancies (thyroid, esophageal, lung, or mediastinal cancers). Accounting for <0.1% of respiratory tumors, MTS presents with progressive respiratory failure, requiring urgent multidisciplinary care involving thoracic surgery, interventional pulmonology, oncology, and intensive care. Diagnosis relies on clinical evaluation, advanced imaging and endoscopy. Bronchoscopy (BC) remains the best investigation for direct visualization and biopsy or performing therapeutic maneuvers. Prognosis depends on histology, local extent, and achieving R0 resection. Tracheal resection with primary anastomosis remains the curative standard for resectable cases. Interventional procedures (debulking, laser, cryotherapy, stenting) are essential for palliative management and acute stabilization. Method(s): A structured (non-systematic) search of PubMed/MEDLINE, Embase, Scopus, and Web of Science (1965-2025) was performed using MeSH/Emtree terms and free-text keywords. Studies were included if they evaluated adult patients with malignant central airway stenosis, primary tracheal tumors, or secondary invasion undergoing surgical, bronchoscopic, or multimodal interventions, including ECMO support. Result(s): Malignant tracheal stenosis (MTS)-predominantly adenoid cystic and squamous cell carcinomas-imposes a critical clinical burden despite its low incidence. Complete surgical resection with negative margins remains the curative treatment for resectable disease. In unresectable cases, multimodal palliative interventions (stenting, laser/electrocautery ablation, and mechanical debulking) provide rapid airway restoration and quality-of-life improvements, whereas ECMO is an established rescue or adjunctive support strategy in selected critical airway procedures performed in experienced centers. Three-dimensional bioprinting and tissue-engineered reconstruction remain experimental or early clinical, and bioresorbable stents and artificial intelligence (AI)-based tools remain investigational; none is currently part of routine MTS management. Conclusion(s): R0 resection for appropriately selected resectable disease and interventional airway management for unresectable symptomatic disease are the best-supported strategies, although the evidence derives mainly from retrospective series from specialized centers. Emerging technologies require prospective validation before clinical adoption. Management should be individualized, multidisciplinary and centralized in experienced airway centers. Copyright © 2026 by the authors. <94> Accession Number 2049656132 Title Glucose control and clinical outcomes in surgical patients: A narrative review. Source Nutrition in Clinical Practice. (no pagination), 2026. Date of Publication: 2026. Author Kamel A.Y.; Vanzant E.; Munden A.; Kennedy H.; Rattanasuwan T.; Lemon S.J.; Thompson A.; Rosenthal M. Institution (Kamel, Rattanasuwan, Lemon) Department of Pharmacy, UF Health Shands Hospital, University of Florida College of Pharmacy, Gainesville, FL, United States (Vanzant, Munden, Thompson, Rosenthal) Department of Surgery, Division of Trauma and Acute Care Surgery, College of Medicine, University of Florida, Gainesville, FL, United States (Kennedy) Department of Endocrinology, Diabetes and Metabolism, UF Health Shands Hospital, University of Florida, Gainesville, FL, United States (Rattanasuwan) Department of Pharmacy Education and Practice, University of Florida College of Pharmacy, Gainesville, FL, United States Publisher John Wiley and Sons Inc Abstract Perioperative hyperglycemia occurs in up to 40% of noncardiac and 80% of cardiac surgery patients, frequently independent of a diabetes diagnosis; it is driven by the neuroendocrine stress response, inflammatory cytokine release, and postoperative insulin resistance. Elevated glucose promotes protein glycosylation, which impairs wound healing and immune function, and it has been consistently associated with surgical site infection, anastomotic leak, prolonged length of stay, and increased mortality across surgical subspecialties. This narrative review examines biochemical aspects of glycogen metabolism and stress-induced insulin resistance, synthesizes evidence linking hemoglobin A1c (HbA1c) thresholds to surgical outcomes, and summarizes contemporary guidelines from the American Diabetes Association, Endocrine Society, European Society of Cardiology, Society of Critical Care Medicine, and Surviving Sepsis Campaign. Current consensus favors moderate, protocolized glucose targets (generally 100-180 mg/dL) while avoiding iatrogenic hypoglycemia. Preoperative optimization toward an HbA1c near 7%, judicious carbohydrate loading, and avoidance of glycemic extremes offer meaningful, modifiable strategies to improve outcomes in surgical and critically ill surgical patients. Copyright © 2026 American Society for Parenteral and Enteral Nutrition. <95> Accession Number 2049452881 Title Serum biomarkers in structural deterioration of surgical bioprosthetic aortic valves: A systematic review and meta-analysis. Source Cardiovascular Revascularization Medicine. (no pagination), 2026. Date of Publication: 2026. Author Kholeif Z.; Doma M.; Rashwan R.; Mohamed A.E.; Ali A.E.; Abouelenein M.; Awashra A.; Goldsweig A.; Eleid M.; Bagameri G.; Leiner T.; Kietselaer B. Institution (Kholeif, Rashwan, Eleid, Leiner, Kietselaer) Department of Cardiology, Mayo Clinic, Rochester, MN, United States (Doma, Abouelenein) Faculty of Medicine, Alexandria University, Egypt (Mohamed) Faculty of Medicine, Tanta University, Egypt (Ali) Crestwood, Huntsville, AL, United States (Awashra) Department of Medicine, An Najah National University, Nablus, Palestine (Goldsweig) University of Massachusetts-Baystate Medical Center, CT, United States (Bagameri) Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, United States Publisher Elsevier Inc. Abstract Background Patients with surgically implanted bioprosthetic aortic valves remain at risk of structural valve deterioration (SVD), a progressive process that may compromise durability and clinical outcomes. In this study, we aimed to assess serum biomarkers in patients with versus without SVD following surgical aortic valve replacement (SAVR). Methods PubMed, Scopus, and Web of Science were systematically searched from inception through September 9, 2026 for studies comparing serum biomarkers in patients with versus without SVD following SAVR with a bioprosthetic aortic valve. Random-effects models were used to calculate pooled mean differences (MDs) with 95% confidence intervals (CIs). PROSPERO registration: CRD420250655746. Results Four studies with 819 patients (193 [23.6%] with SVD) were included. Patients with SVD had higher serum levels of low-density lipoprotein (LDL) (MD 0.23 mmol/L; 95% CI 0.05-0.41; p <0.01) compared to patients without SVD. Additionally, oxidized LDL levels (MD 3.86 U/L; 95% CI 1.14-6.58; p <0.01) as well as the concentration of small dense LDL-C (MD 0.14 mmol/L; 95% CI 0.03-0.25; p <0.01) were higher among patients with SVD. Furthermore, ApoB/ApoA-1 ratio was higher among SVD patients (MD 0.07; 95% CI 0.03-0.11; p <0.01) compared to patients without SVD. However, there were no significant differences between the groups in levels of triglycerides, high-density lipoprotein (HDL), creatinine, and fasting glucose. Conclusions In patients with surgically implanted bioprosthetic aortic valves, higher serum LDL, oxidized LDL, small dense LDL-C, and ApoB/ApoA-I ratio were associated with SVD. Given the small observational evidence base, these findings are hypothesis-generating and require validation before these biomarkers can be used for prediction or clinical decision-making. Copyright © 2026 Elsevier Inc. <96> Accession Number 2049661529 Title Updated systematic review and meta-analysis comparing Myval versus Sapien 3 transcatheter heart valves in severe aortic stenosis: focus on early and one-year mortality. Source Acta Cardiologica. (no pagination), 2026. Date of Publication: 2026. Author Yang L.; Yu G.; Pan M.; Liu Y.; Zhu Y.; Zhang M.; Yu H.; Pei Z. Institution (Yang, Yu, Pan, Zhu, Zhang) Jiangxi University of Chinese Medicine, Jiangxi, Nanchang, China (Yang, Pan, Liu, Yu, Pei) Nanchang People's Hospital, Jiangxi, Nanchang, China (Yu) Department of Traumatology and Orthopedics, Lishui People's Hospital, Zhejiang, Lishui, China Publisher Taylor and Francis Ltd. Abstract Background: Transcatheter aortic valve implantation (TAVI) is a guideline-recommended treatment for severe aortic stenosis (AS). While the balloon-expandable Edwards Sapien 3 valve has long been the benchmark, the newer Myval valve has emerged as a potential alternative. Comparative data on mid-term survival, specifically one-year all-cause mortality, are lacking but crucial for clinical evaluation. Method(s): This systematic review and meta-analysis synthesised direct comparative evidence on the Myval versus Sapien 3 valves in patients undergoing TAVI, searching PubMed, Embase, and Cochrane Central up to November 2025. The primary outcomes included all-cause mortality within 30 days and 1 year. Secondary outcomes were 30-day safety events and hemodynamic parameters. Result(s): Five studies (n = 2771) were included. The pooled analysis indicated no statistical difference in 30-day mortality (RR: 1.05, 95% CI: 0.53-2.07; p = 0.89; I2=0%) or in one-year all-cause mortality (RR: 0.93, 95% CI: 0.64-1.35; p = 0.70; I2=0%). Rates of stroke, major bleeding, pacemaker implantation, and other 30-day complications were also comparable (all p > 0.05). Hemodynamically, the Myval valve was superior at 30 days, with a lower mean gradient (MD: -2.37, 95% CI: -3.45 to -1.30; p < 0.0001) and larger effective orifice area (MD: 0.26, 95% CI: 0.17-0.35; p < 0.00001). Available one-year data from two randomised trials indicated this hemodynamic benefit was sustained. Conclusion(s): This updated meta-analysis demonstrates that the newer Myval valve offers comparable early safety and one-year survival to the established Sapien 3 valve, with superior and sustained hemodynamic performance. These findings support its role as a safe and effective alternative in the TAVI landscape. Copyright © 2026 Belgian Society of Cardiology. <97> Accession Number 2050530169 Title The effect of near-infrared spectroscopy guided intraoperative care on neurocognitive and functional outcomes after cardiac surgery: a systematic review and meta-analysis of randomised controlled trials. Source British Journal of Anaesthesia. (no pagination), 2026. Date of Publication: 2026. Author Abdali T.; Connelly E.; Belley-Cote E.; Sadeghirad B.; Lomivorotov V.; Couban R.; Shen M.; Usman A.; Brudney C.S.; Chander N.; Deschamps A.; Spence J. Institution (Abdali, Connelly, Sadeghirad, Couban, Spence) Department of Anesthesia, McMaster University, Hamilton, ON, Canada (Belley-Cote) Divisions of Cardiology and Critical Care, Department of Medicine, McMaster University, Hamilton, ON, Canada (Belley-Cote, Sadeghirad, Usman, Spence) Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada (Belley-Cote, Spence) Population Health Research Institute, Hamilton, ON, Canada (Belley-Cote, Spence) World Health Research Trust, Hamilton, ON, Canada (Lomivorotov) Department of Anesthesiology and Perioperative Medicine, Penn State Health, Hershey, PA, United States (Shen) Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada (Brudney) Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada (Brudney) Section of Critical Care Medicine, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada (Chander) Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada (Deschamps) Institut de cardiologie de Montreal, Montreal, QC, Canada (Deschamps) Departement d'anesthesiologie et de medecine de la douleur, Universite de Montreal, Montreal, QC, Canada (Spence) Division of Critical Care, Department of Medicine, McMaster University, Hamilton, ON, Canada Publisher Elsevier Ltd Abstract Background: Adverse neurocognitive and functional outcomes are common after cardiac surgery. Cerebral near-infrared spectroscopy (NIRS) monitors regional cerebral oxygen saturation, allowing clinicians to detect and reverse cerebral desaturation. We conducted a systematic review and meta-analysis of RCTs to evaluate whether intraoperative NIRS monitoring improves neurocognitive outcomes after cardiac surgery. Method(s): We searched CENTRAL, CINAHL, Embase, MEDLINE, PsycINFO, and Web of Science for RCTs comparing NIRS-guided intraoperative management with usual care in adults undergoing on-pump cardiac surgery, assessing the outcomes of postoperative cognitive decline, delirium, stroke, mortality, and functional recovery. We pooled data using random-effects meta-analysis and assessed certainty of evidence using GRADE methodology. Result(s): We included 17 RCTs (N=2288). NIRS-guided management probably reduces early postoperative cognitive decline (risk ratio [RR] 0.65, 95% CI 0.42-0.99; I2=65%, moderate certainty), may have little or no effect on stroke (RR 0.89, 95% CI 0.42-1.91; low certainty) or mortality (RR 0.84, 95% CI 0.47-1.52; low certainty), and may have no effect on delirium (RR 0.78, 95% CI 0.56-1.09; I2=32%, low certainty). Findings were primarily derived from small, single-centre trials with heterogenous NIRS thresholds and intervention algorithms. Few studies evaluated outcomes beyond 30 days, and none evaluated validated measures of quality of life or function. Conclusion(s): Although NIRS-guided intraoperative care shows promise for reducing early postoperative cognitive decline after cardiac surgery, evidence of benefit for other neurocognitive or clinical outcomes remains limited. Large multicentre studies are needed to confirm its utility, refine intervention thresholds, and determine its impact on long-term cognition, function, and quality of life.Systematic review protocol. PROSPERO (CRD42022336468). Copyright The Author(s) This is an open access article under the CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/ <98> Accession Number 2050436886 Title Artificial intelligence in paediatric cardiac critical care: from predictive analytics to continuous physiologic intelligence. Source Cardiology in the Young. (pp 1-7), 2026. Date of Publication: 2026. Author Savorgnan F.; Pilla P.; Loomba R.; Flores S. Institution (Savorgnan) Pediatrics, Baylor College of Medicine, United States (Pilla) Baylor College of Medicine, United States (Loomba) Northwestern University, United States (Flores) Pediatrics-Critical Care, Baylor College of Medicine, United States Publisher Cambridge University Press Abstract Objective: - Artificial intelligence is increasingly applied in paediatric cardiology and cardiac intensive care, where CHD, postoperative physiologic instability, and continuous bedside monitoring generate complex datasets. This review summarises current applications of artificial intelligence in paediatric cardiology and the cardiac ICU, focusing on cardiac imaging, electrocardiography, predictive analytics, waveform intelligence, and postoperative outcome prediction. Data sources: - A narrative review of PubMed, MEDLINE, and Scopus was performed for studies published from 2018 through 2026 evaluating artificial intelligence, machine learning, or deep learning in paediatric cardiology, CHD, congenital heart surgery, and cardiac critical care. Study selection: - Studies addressing paediatric or CHD-focused applications in echocardiography, cardiac MRI, electrocardiography, cardiac ICU monitoring, waveform analytics, or postoperative complication prediction were included, together with relevant reviews. Data extraction: - Information was extracted on study population, artificial intelligence method, clinical task, model inputs, outcomes, validation strategy, and major limitations. Data synthesis: - Artificial intelligence is most developed in imaging and electrocardiography, while paediatric and complex CHD evidence remains less mature. In cardiac ICU, models using electronic health record variables, high-frequency physiologic data, and risk indices have been evaluated for cardiac arrest, low cardiac output physiology, hyperlactatemia, extubation failure, and vasoactive de-escalation. External validation, prospective deployment, calibration, and workflow-safe implementation remain major gaps. Conclusion(s): - Artificial intelligence may improve diagnostic consistency, risk stratification, and early recognition of deterioration, but prospective validation and measurable clinical benefit are needed before autonomous use. Copyright © The Author(s), 2026. Published by Cambridge University Press <99> Accession Number 2049988204 Title Controlled low central venous pressure after cardiopulmonary bypass reduces acute kidney injury following cardiac surgery: a randomized controlled trial. Source Frontiers in Medicine. 13 (no pagination), 2026. Article Number: 1846773. Date of Publication: 2026. Author Chen L.; Hu L.; He Y.; Kong S.; Liu J.; Ding K.; Zhang C.; Zhu D.; Cheng Y.; Shi H.; Zhou J.; Ge Y. Institution (Chen, Hu, He, Liu, Ding, Zhang, Zhu, Shi, Ge) Department of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Jiangsu, Nanjing, China (Kong, Cheng, Zhou) School of International Business, China Pharmaceutical University, Jiangsu, Nanjing, China Publisher Frontiers Media SA Abstract Background - Postoperative acute kidney injury (AKI) is a serious complication of cardiac surgery. This study aimed to determine whether targeting central venous pressure (CVP) readings of <=10 mmHg using vasoactive drugs and reversing the Trendelenburg position was associated with a lower incidence of AKI than usual care in patients undergoing cardiac surgery requiring cardiopulmonary bypass (CPB). Methods - We conducted a randomized controlled trial. Patients were randomized in a 1:1 ratio to receive controlled low central venous pressure (CLCVP) or usual care. Patients in the CLCVP group received nitroglycerin and were placed in the reverse Trendelenburg position from 20 min after CPB until the end of surgery. The primary outcome was incidence of 7-day postoperative AKI defined by KDIGO criteria. Results - The trial included 505 subjects in the final analysis. There were fewer patients with postoperative AKI in the CLCVP group [114 (44.9%)] compared with the control group [150 (59. 8%)] [Absolute risk reduction (ARR): -14.9%; 95% confidence interval [CI]: (-23. 5%, -6. 3%); P = 0. 001]. Eight (3.1%) participants in the CLCVP group and 14 (5.6%) participants in the control group developed AKI of Stage 2 and above [ARR: -2. 4%; 95% CI: (-6. 0, 1. 1%); P = 0. 263]. This reduction was primarily driven by a lower incidence of Stage 1 AKI, whereas the incidence of Stage 2 or higher AKI did not differ significantly between groups. Median time-weighted CVP was lower in the CLCVP group (6.7 mm Hg vs. 8.1 mm Hg, P < 0. 001). Conclusion - This randomized clinical trial demonstrated that cardiac surgery patients with CLCVP exhibited lower CVP and fewer postoperative kidney injuries compared to those receiving usual care. Clinical Trial Registration - https://clinicaltrials.gov/study/NCT05855954, identifier NCT05855954. Copyright © 2026 Chen, Hu, He, Kong, Liu, Ding, Zhang, Zhu, Cheng, Shi, Zhou and Ge. <100> Accession Number 2049657550 Title Preoperative echocardiographic predictors of atrial fibrillation after coronary artery bypass graft surgery (CABG): a systematic review and meta-analysis. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 912. Date of Publication: 01 Dec 2026. Author Teimouri-Jervekani Z.; Samadi-Broujeni N.; Bahrani S.; Soleimani A. Institution (Teimouri-Jervekani, Soleimani) Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of (Samadi-Broujeni, Soleimani) Chamran Cardiovascular Research Hospital, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of (Bahrani) Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of Publisher BioMed Central Ltd Abstract Background: Postoperative atrial fibrillation (POAF) is a common complication after coronary artery bypass grafting (CABG), which is associated with increased morbidity, longer hospital stays, and higher healthcare costs. Preoperative echocardiographic parameters may play an important role in predicting the risk of POAF. Objective(s): To identify and evaluate preoperative echocardiographic parameters that can predict the development of POAF in patients undergoing CABG. Method(s): A systematic search was performed from January 2010 to October 2025 in PubMed, Scopus, Embase, and Web of Science. Risk of bias was assessed with ROBINS-I tool for observational studies. Result(s): Twenty-three studies (n = 2,983 patients) were included. POAF incidence ranged from 22% to 40%, with a pooled rate of 28.8% (95% CI: 21%-34%). Meta-analyses showed no significant pooled associations for left atrial volume index (LAVI) (OR 1.31; 95% CI: 0.92-1.87; I2 = 99.9%), peak atrial longitudinal strain (PALS) 0.65 (95% CI: 0.38-1.11); I2 = 99.9%), or LA contraction strain (LASRa) (OR 1.91; 95% CI: 0.83-4.41; I2 = 98.1%). Heterogeneity was substantial across all outcomes. Limited data suggested potential predictive value for right atrial indices and single-study parameters such as LA kinetic energy. Conclusion(s): Current echocardiographic markers including LAVI, PALS, and LASRa, do not demonstrate consistent or robust predictive value for POAF when pooled across heterogeneous studies. Standardized measurement protocols and larger prospective cohorts are needed to clarify the role of atrial structural and functional indices in POAF risk stratification. Copyright © The Author(s) 2026. <101> Accession Number 2050482012 Title Anticoagulation after transcatheter and surgical bioprosthetic aortic valve replacement: A narrative review. Source Perfusion (United Kingdom). (no pagination), 2026. Date of Publication: 2026. Author Arab S.; Chhatwal K.; Mizori R.; Rustogi A.; Fuad M.; Sokhal B.S.; Motairek I.; Al-Shakarchi N.; Ahmed R.; Showkat M.; Punjabi P. Institution (Arab, Chhatwal, Showkat) School of Medicine, Imperial College London, London, United Kingdom (Arab) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Chhatwal) National Heart and Lung Institute, Imperial College London, London, United Kingdom (Mizori) King's College London, GKT School of Medical Education, London, United Kingdom (Rustogi) University College London Medical School, London, United Kingdom (Fuad) Faculty of Biology Medicine and Health, The University of Manchester, Manchester, United Kingdom (Sokhal) School of Medicine, Keele University, Keele, United Kingdom (Sokhal) Royal Stoke University Hospital, University Hospitals North Midlands, Staffordshire, Stoke on Trent, United Kingdom (Motairek) Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, United States (Al-Shakarchi) Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States (Ahmed) Academic Clinical Lecturer, Newcastle University, Newcastle Upon Tyne, United Kingdom (Ahmed) Department of Cardiology, Freeman Hospital, Newcastle Upon Tyne, United Kingdom (Ahmed) Department of Cardiology, Royal Brompton Hospital, London, United Kingdom (Punjabi) Department of Cardiothoracic Surgery, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom Publisher SAGE Publications Ltd Abstract Background: Bioprosthetic aortic valve replacement, specifically surgical (SAVR) and transcatheter (TAVR), is among the most frequently performed cardiac interventions globally, yet anticoagulation strategies after implantation remain incompletely defined. Atrial fibrillation, notably prevalent pre- and post-operatively in these patients, substantially amplifies thromboembolic risk and complicates decision-making in an already elderly, frail, and comorbid population. Objective(s): To critically evaluate current anticoagulation strategies after bioprosthetic aortic valve replacement across sinus rhythm and atrial fibrillation in both SAVR and TAVR, and to identify evidence gaps and guideline inconsistencies. Method(s): We conducted a narrative review of major international guidelines (ESC/EACTS 2025, ACC/AHA 2020, and NICE 2021) and key clinical trials on antithrombotic therapy in valve replacement populations. Focus was placed on bioprosthetic aortic valve replacement, with mechanical and non-aortic valves excluded. Result(s): Aspirin monotherapy is the most consistently supported strategy after bioprosthetic TAVR in sinus rhythm, though guidelines diverge on duration and recommendation strength. In atrial fibrillation, all three guidelines apply uniform CHA<inf>2</inf>DS<inf>2</inf>-VASc-based frameworks irrespective of AF phenotype, procedural context, or detection modality, reflecting lacking evidence rather than deliberate clinical judgement. No trial has enrolled patients specifically with new-onset post-procedural AF or stratified by AF subtype, and subclinical AF after bioprosthetic AVR remains entirely uncharacterised. Conclusion(s): Guideline divergence reflects a structurally inadequate evidence base rather than genuine clinical equipoise. Individualised decisions informed by procedure type, AF phenotype, frailty, and bleeding risk are required to guide clinical practice, alongside an adequately powered stratified randomised trial incorporating mandatory continuous rhythm monitoring. Copyright © The Author(s) 2026 <102> Accession Number 2050372445 Title Bioprosthetic heart valve degeneration: new insights into structural remodeling and calcification. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1941295. Date of Publication: 2026. Author Levy S.; Weiss L.; Cahalane R.; Meuris B.; Aikawa E. Institution (Levy, Weiss, Cahalane, Aikawa) Center for Interdisciplinary Cardiovascular Sciences, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States (Cahalane) School of Engineering, Bernal Institute, Health Research Institute, University of Limerick, Limerick, Ireland (Meuris) Department of Cardiovascular Diseases, Research Unit of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium (Aikawa) Center for Excellence in Vascular Biology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States Publisher Frontiers Media SA Abstract Bioprosthetic heart valves (BHVs) are widely used to treat aortic valve disease, and their demand is rising. However, BHV lifespan remains limited by degeneration, with patients often requiring surgical or transcatheter reintervention within a decade. BHVs lack intrinsic remodeling capabilities, and the mechanisms contributing to their failure remain poorly understood. In this review, we summarize current knowledge of BHV degeneration by integrating findings from native aortic valve disease with studies of explanted bioprosthetic valves. We discuss the structural hallmarks of degeneration, including collagen remodeling, calcification, and inflammatory cell accumulation, and examine evidence that circulating blood-derived factors infiltrate BHV tissue and contribute to degeneration progression. Particular emphasis is placed on macrophages, which are consistently identified in explanted BHVs and may promote extracellular matrix (ECM) degradation. We also highlight extracellular vesicles (EVs) as potential mediators of cardiovascular calcification and propose that macrophage-derived EVs may promote ECM remodeling beyond sites of direct cellular accumulation. In addition, we review experimental approaches, including histological imaging, in vitro cell culture models, and proteomic analyses, that may help define molecular pathways underlying degeneration. Together, we hypothesize a model of BHV degeneration driven by interactions among host immune cells, circulating factors, and bioprosthetic tissue. Improved understanding of these mechanisms may facilitate the development of therapeutic strategies to improve BHV durability and long-term clinical outcomes. Copyright © 2026 Levy, Weiss, Cahalane, Meuris and Aikawa. <103> Accession Number 2049639544 Title Pooled Periprocedural and Short-Term Outcomes After Transcatheter Aortic Valve Replacement With Contemporary Self-Expanding Valves: A Systematic Review and Meta-Analysis. Source Structural Heart. (no pagination), 2026. Article Number: 101106. Date of Publication: 2026. Author Shaji S.; Saravanan P.B.; Sarkar R.; Kharsa C.; Aoun J.; Zaid S.; Kayani W.T.; Faza N.; Little S.H.; Atkins M.; Del Val F.R.; Kleiman N.S.; Reardon M.J.; Samimi S.; Goel S.S. Institution (Shaji) Department of Medicine, SRTR Government Medical College, Maharashtra, Ambajogai, India (Saravanan) Department of Medicine, KAP Viswanatham Government Medical College, Tamilnadu, Tiruchirappalli, India (Sarkar) Department of Medicine, Guangxi Medical University, Nanning, China (Kharsa, Aoun, Faza, Little, Kleiman, Goel) Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States (Zaid) Section of Cardiology, Baylor College of Medicine, Michael E DeBakey Veterans Affairs Medical Center, Houston, TX, United States (Kayani, Samimi) Department of Medicine, Baylor College of Medicine, Houston, TX, United States (Atkins, Del Val, Reardon) Department of Cardiovascular Surgery, Houston Methodist Hospital, Houston, TX, United States Publisher Cardiovascular Research Foundation Abstract Background Contemporary self-expanding transcatheter heart valves (SEVs) have incorporated design refinements to reduce paravalvular leak (PVL) and pacemaker implantation (PPI). We aimed to characterize clinical outcomes after transcatheter aortic valve replacement (TAVR) with contemporary SEVs in patients with severe aortic stenosis. Methods PubMed, EMBASE, and Scopus were searched through October 5, 2025, for studies reporting procedural, hemodynamic, and clinical outcomes for patients undergoing TAVR with the (1) Navitor or (2) Evolut PRO/PRO+/FX. Random-effects meta-analyses pooled single-arm event rates, stratified by SEV group, using the Freeman-Tukey double arcsine transformation. Between-platform differences were assessed using subgroup interaction testing. Results Fifty-two studies (n = 21,349; weighted mean age 82 years; mean Society of Thoracic Surgeons Predicted Risk of Mortality 4.8%) were included. At 30 days, all-cause mortality was low among Evolut and Navitor cohorts (1.4 and 1.5%; p = 0.63), and device success was high for both platforms (92.1 and 93.0%; p = 0.73). Moderate or greater PVL occurred in 2.5 and 1.1% of Evolut and Navitor cohorts, respectively ( p = 0.12), mild PVL occurred in 31.1 and 19.9% ( p = 0.046), and new PPI occurred in 13.4 and 15.3%, respectively. Mean gradients remained low among Evolut and Navitor cohorts at 1 year (7.7 and 7.3 mmHg; p = 0.65), whereas effective orifice area was higher among Evolut cohorts at 1 year (2.1 and 1.8 cm2; p < 0.001) ( p = p -interaction). Conclusions Navitor and Evolut PRO/PRO+/FX both demonstrated high device success, low mortality, favorable hemodynamic performance, and low rates of moderate or greater PVL at 1-year follow-up. Mild PVL and new PPI remained frequent. Observed comparative signals should be interpreted as indirect hypothesis-generating findings. Copyright © 2026 The Authors. <104> Accession Number 652355591 Title Effects of Preoperative Inspiratory Muscle Training on Right Ventricular Free Wall Longitudinal Strain and ICU Length of Stay in Patients Undergoing Heart Valve Replacement Surgery. Source Indonesian Journal of Cardiology. Conference: 29th Annual Scientific Meeting of the Indonesian Heart Association (ASMIHA) 2020. Virtual Indonesia. 41(Supplement A) (no pagination), 2020. Date of Publication: 2020. Author Satoto H.H.; Paramitha A.; Barata S.H.; Sugiri; Sofia S.N.; Wahyudati S. Institution (Satoto, Sugiri, Sofia) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Diponegoro University, Dr. Kariadi General Hospital, Semarang, Indonesia (Paramitha, Barata, Wahyudati) Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Diponegoro University, Dr. Kariadi General Hospital, Semarang, Indonesia Publisher Indonesian Heart Association Abstract Background: The reduction of right ventricular function after heart valve surgery was associated with mortality and morbidity after cardiac surgery, ICU length of stay, risk of nosocomial infection, postoperative pulmonary complications, and hospital cost. Inspiratory muscle training can be considered for improving right ventricular systolic function by optimalizing afterload dan cardiac contractility. The objective of this study was to investigate the effect of inspiratory muscle training on right ventricular systolic function by using right ventricular free wall longitudinal strain and it's impact on ICU length of stay in patients after heart valve surgery. Method(s): Thirty patients scheduled for elective heart valve surgery on August - November 2019 were randomized into conventional preoperative rehabilitation group and conventional preoperative rehabilitation added high intensity inspiratory muscle training at least 14 days before surgery. Echocardiography examination were performed before rehabilitation and after cardiac surgery. Result(s): The patients were randomized into 15 patients in control group and 15 patients in intervention group. There were 12 patients on each group completed the preoperative and postoperative echocardiography evaluations. Both groups had no significant differences on RV free wall longitudinal strain (-20.2 + 3.7% vs -20.6 + 4%; p=0.794) during the preoperative examination. By using independent t-test, we found significant differences on RV free wall longitudinal strain between intervention and control group (-17.7 + 3.0% and -14.4 + 4.0%; p=0.033) on postoperative evaluations. The ICU length of stay in intervention group was significantly shorter than control group (3.2 + 0.8 and 4.2 + 1.3 days; p=0.044). Conclusion(s): Patients underwent conventional preoperative rehabilitation added inspiratory muscle training had better right ventricular free wall longitudinal strain postoperatively and shorter ICU length of stay than patients in control group. <105> Accession Number 652355275 Title New Promises Mechanism of Colchicine for Prevention of Cardiovascular Events Induce by on-going Inflammation: Systematic Review and Metanalysis. Source Indonesian Journal of Cardiology. Conference: 29th Annual Scientific Meeting of the Indonesian Heart Association (ASMIHA) 2020. Virtual Indonesia. 41(Supplement A) (no pagination), 2020. Date of Publication: 2020. Author Arifin S.; Albaar T.M.; Christanto A.; Sishartami L.W.; Satrio B.; Rohman M.S. Institution (Arifin, Albaar, Christanto) Postgraduate School of Biomedicine Master, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia (Sishartami) Undergraduate School of Biomedicine Master, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia (Satrio, Rohman) Cardiology and Vascular Medicine, Universitas Brawijaya Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia Publisher Indonesian Heart Association Abstract Background: Inflammation is a key process implicated in the pathogenesis of cardiovascular disease at all stages and because colchicine has unique anti-inflammatory effect through NLRP3 inflammasome. We systematically reviewed cardiovascular benefits of colchicine in any population and specifically in patients with high cardiovascular risk. We evaluate the evidence supporting the potential role of colchicine in improving outcomes and reducing cardiovascular morbidity and mortality in patients with CVD. Method(s): A systematic computer-based search was conducted in PubMed, EMBASE, and Cochrane Database of Systematic Reviews. We include 4 trials with 2743 patients. Data on patients with AMI that undergo optimal medical therapy compared Colchicine versus others (non-used Colchicine) were retrieved. Primary outcomes were myocardial infarction, stroke, or urgent hospitalization for angina leading to coronary revascularization and adverse events. After testing for heterogenecity between studies, data were aggregated for random-effects models when necessary. Result(s): Our result showed insignificantly reduced risk of myocard reinfarction in colchicine group compared to control group (RR 0.46 [0.17, 1.24], p=0.1) and insignificantly reduced risk of rehospitalization in colchicine group compared to control group (RR 0.57 [0.29, 1.13], p=0.11) but significantly reduced risk of ischemic stroke in colchicine group compared to control group (RR 0.26 [0.10, 0.63], p=0.003). Conclusion(s): Colchicine may have substantial cardiovascular benefits although the meta-analysis result was not significant; however, there is sufficient uncertainty about its benefit to indicate the need for large-scale trials to further evaluate this inexpensive, promising treatment in cardiovascular disease. Further clinical trial evaluating the potential of colchicine for prevention of cardiovascular events would be of interest. <106> Accession Number 652355311 Title Comparison Between HeartMate II vs. HeartMate III in Left Ventricle Assisted Device Implantation in Patient With Advanced Heart Failure: A Systematic Review and Meta-Analysis. Source Indonesian Journal of Cardiology. Conference: 29th Annual Scientific Meeting of the Indonesian Heart Association (ASMIHA) 2020. Virtual Indonesia. 41(Supplement A) (no pagination), 2020. Date of Publication: 2020. Author Hanafy D.; Lintangella P.; Prasetyo P.; Pradipto S. Institution (Hanafy, Prasetyo, Pradipto) Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia (Hanafy, Lintangella) Department of Adult Cardiac Surgery, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia Publisher Indonesian Heart Association Abstract Introduction : Left Ventricle Assisted Devices (LVAD) is increasingly used as a treatment for patient with Advanced Heart Failure because of its availability, leaving heart transplantation as a last resource. This systematic review and meta analysis will be conducted to evaluate the advantages of this two devices. Methods : Journal searching from PubMed, Embase, Medline, Cochrane and ResearchGate for relevant published Randomized Controlled Trials (RCTs) between 2015 - 2020. Primary end point is to evaluate the overall survival and subgroup analysis will be performed in adverse events related to device implantation. Secondary end point is to provide reliability evidence for clinicians' decision-making. Result(s): in total 67 references were identified, 3 studies involving 2142 participants were included in this meta-analysis. There were statistically significant difference in overall survival with pooled OR 1.37 [1.13, 1.66] p<0.001 favoring Heartmate III, No heterogeneity I2 = 0%. means that HeartMate III have 1.37 times higher in overall survival compared to HeartMate II. Pooled analysis were also performed in a post operative outcomes such as pump thrombosis, gastrointestinal bleeding, re-operation and stroke [Pooled OR 10.59 [4.95, 22.68] p <0.001, I2 = 15%; OR 1.39 [1.05, 1.82] p= 0.02, I2 = 0%; OR 1.99 [1.05, 1.82] p <0.001, I2 = 0%; OR 2.69 [2.07, 3.50] p <0.001, I2 = 31% respectively] favoring HeartMate III. Conclusion(s): LVAD HeartMate III is statisticaly significant to have a good overall survival and reduced post-operative adverse events compared to HeartMate II. <107> Accession Number 2049678613 Title A bibliometric review of bibliometric studies published in cardiology journals. Source Current Problems in Cardiology. 52(1) (no pagination), 2027. Article Number: 103480. Date of Publication: 01 Jan 2027. Author Mohamed A.; Madkhaly F.M.; Ayish D.A.M.; Ayish F.; Ibrahim E.A.A.; Ibrahim W.; Abdalla A.; Awadlseid K.M.F.; Elsaman S.E.A.; Babiker Y.O.H.; Osman H.A.; Zafar M. Institution (Mohamed, Ayish) Department of Internal Medicine, College of Medicine, Jazan University, Jazan, Saudi Arabia (Madkhaly) Department of Basic Medical Sciences (Pathology), College of Medicine, Jazan University, Jazan, Saudi Arabia (Ayish) Department of Internal Medicine, Medical and Rheumatology Consultant, Head of Medical Department in Jazan General Hospital, Jazan, Saudi Arabia (Ibrahim) Department of Internal Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia (Ibrahim) Primary Healthcare, Ministry of Health, Riyadh, Saudi Arabia (Abdalla, Awadlseid) Department of Anatomy, College of Medicine, Jazan University, Jazan, Saudi Arabia (Elsaman) College of Nursing, Northern Border University, Arar, Saudi Arabia (Babiker) Department of Surgery, Collage of Medicine, Jazan University, Saudi Arabia (Osman) Department of Preventive Dental Science, College of Dentistry, Jazan University, Saudi Arabia (Zafar) Institute of Chemical Sciences, University of Peshawar, Khyber Pakhtunkhwa, Peshawar, Pakistan Publisher Elsevier Inc. Abstract Background Bibliometric research in cardiology has expanded alongside the growing volume and diversity of cardiovascular research. Objective To systematically map bibliometric studies published in cardiology journals and identify the major diseases, clinical areas, interventions, technologies, and emerging themes receiving bibliometric attention. Methods Scopus was searched in August 2026 using bibliomet in the Title field and cardio in the Source Title field, followed by selection of cardiology-related journals. Results A total of 203 publications were identified, comprising 136 articles (67.0%) and 67 reviews (33.0%). Output increased substantially after 2021, reaching a peak of 41 publications in 2023, followed by 38 in 2024 and 32 in 2026. Hu, Y. was the most prolific author (n=8), while the China Academy of Chinese Medical Sciences was the leading institution (n=35). China accounted for 148 publications, followed by the United States (17), Pakistan (8), Canada (6), India (5), Spain (5), and Turkey (5). Frontiers in Cardiovascular Medicine published the most studies (n=80), while the National Natural Science Foundation of China was the leading funding source (n=54). The identified literature covered diverse cardiovascular diseases, procedures, interventions, technologies, and emerging themes. Early studies emphasized productivity, citations, journals, research groups, and geographical patterns, whereas recent studies increasingly examined specific diseases, mechanisms, therapies, imaging, and surgery. Emerging areas included artificial intelligence, molecular research, genetics, exosomes, non-coding RNAs, and environmental factors. Conclusion Overall, bibliometric research has shifted toward specialized, technology-driven, molecular, and interdisciplinary cardiovascular topics. Copyright © 2026 Elsevier Inc. <108> Accession Number 2038742617 Title Comparison of inhaled iloprost and nitric oxide in the management of pulmonary hypertension post-cardiac surgery: A systematic literature review of randomized clinical trials. Source Critical Care and Shock. 29(4) (pp 115-128), 2026. Date of Publication: 01 Aug 2026. Author Silalahi D.M.R.; Setiawan P.; Perdhana F.; Husain T.; Kowara Y. Institution (Silalahi, Setiawan, Perdhana, Husain, Kowara) Department of Anesthesiology and Reanimation, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hos-pital, Surabaya, Indonesia Publisher The Indonesian Foundation of Critical Care Medicine Abstract Background: Pulmonary hypertension (PH) is a critical complication of cardiac surgery, particularly in patients undergoing pulmonary endarterectomy (PEA), heart transplantation, and lung transplantation. Inhaled iloprost and nitric oxide (NO) are widely used as pulmonary vasodilators; however, their comparative efficacy and safety are unclear. Objective(s): This systematic literature review aimed to compare the effectiveness and safety of inhaled iloprost and NO in managing PH after cardiac surgery, focusing on hemodynamic improvements and adverse effects. Method(s): A systematic search was conducted for randomized controlled trials (RCTs), randomized crossover studies, and open-label trials published until April 2025. Five relevant studies were included, encompassing 115 patients with various forms of post-cardiac surgery-related PH. The primary outcomes included reductions in mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR). In contrast, the secondary outcomes included hemodynamic parameters, oxygenation, incidence of pulmonary hypertensive crises (PHTC), and adverse events. Result(s): Both inhaled iloprost and NO effectively reduced mPAP and PVR across all studies, with no significant differences in the overall efficacy between the two treatments. However, iloprost demonstrated superior effects in improving cardiac output and reducing PVR compared with those of NO. Both therapies were associated with a significant reduction in PHTC and improvement in hemodynamic and oxygenation parameters. Iloprost also exhibited a better safety profile with fewer systemic side effects, such as throm-bocytopenia. The studies revealed that the incidence of adverse effects was generally low for both treatments, and no major complications were reported in either group. Conclusion(s): Inhaled iloprost provides superior hemodynamic improvements compared with NO, particularly in reducing PVR and increasing cardiac output. Both treatments were safe and effective in managing post-cardiac surgery PH. Iloprost may offer a better alternative to NO, especially for long-term management, given its sustained effects and fewer systemic side effects. Future studies should focus on larger multicenter trials to validate these findings and explore long-term outcomes. Copyright © 2026, The Indonesian Foundation of Critical Care Medicine. All rights reserved. <109> Accession Number 2049645443 Title Mortality predictors in cancer patients undergoing transcatheter aortic valve implantation for aortic stenosis: a systematic review and meta-analysis. Source Cardio-Oncology. 12(1) (no pagination), 2026. Article Number: 126. Date of Publication: 01 Dec 2026. Author Alizadehasl A.; Afsari Zonooz Y.; Mortaz Hejri G.; Hakimian H.; Bahramnejad A.; Amini-Salehi E.; Hashemi S.M.; Narimani-Javid R.; Hosseini Jebelli S.F.; Aliabadi A.Y. Institution (Alizadehasl, Afsari Zonooz, Hakimian, Bahramnejad, Hosseini Jebelli, Aliabadi) Cardio-Oncology Research Center, Rajaie Cardiovascular Institute, Tehran, Iran, Islamic Republic of (Mortaz Hejri) Cardiovascular Research Center, Rajaie Cardiovascular Institute, Tehran, Iran, Islamic Republic of (Amini-Salehi) School of Medicine, Guilan University of Medical Science, Rasht, Iran, Islamic Republic of (Hashemi) Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran, Islamic Republic of (Narimani-Javid) Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of Publisher BioMed Central Ltd Abstract Background: The coexistence of cancer and aortic stenosis is increasingly common in elderly patients, presenting unique challenges for management. Transcatheter aortic valve implantation (TAVI) offers a less invasive alternative to surgical valve replacement, but the impact of various clinical factors on post-TAVI mortality in cancer patients remains unclear. Objective(s): To systematically review and meta-analyze the predictors of mortality in cancer patients undergoing TAVI for aortic stenosis. Method(s): A comprehensive literature search was conducted in Scopus, PubMed, Web of Science, and Embase up to May 2025. Studies assessing mortality predictors in cancer patients post-TAVI were included. Data extraction and quality assessment were performed independently by two reviewers. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using random-effects models. Sensitivity analyses addressed within-study correlation assumptions, and heterogeneity was assessed using I2 and tau2 statistics. Result(s): Five high-quality case-control studies, encompassing over 7,000 patients, were included. Advanced NYHA class (III/IV), prior myocardial infarction, atrial fibrillation, COPD, diabetes mellitus, and higher STS scores were robustly associated with increased mortality. Active cancer conferred a significantly higher mortality risk (HR 1.64, 95% CI: 1.17-2.30), while preserved left ventricular ejection fraction and renal function were linked to improved survival. Most predictors remained stable across sensitivity analyses, although the impact of cancer status varied with correlation assumptions. Conclusion(s): Both traditional cardiovascular and cancer-specific factors significantly influence mortality in cancer patients undergoing TAVI. These findings underscore the need for individualized, multidisciplinary risk assessment and highlight the importance of further research to refine patient selection and optimize outcomes in this growing patient population. Copyright © The Author(s) 2026. <110> Accession Number 2049640248 Title Left Atrial Appendage Closure Versus Oral Anticoagulation for Prevention of Stroke or Systemic Embolism in Patients With Atrial Fibrillation: An Updated Meta-Analysis of 7004 Patients Across Six Randomized Trials. Source Journal of Cardiovascular Electrophysiology. (no pagination), 2026. Date of Publication: 2026. Author Ahmed A.; Paryani N.S.; Shakoor M.; Jaiswal V.; Golwala H.; Rosenberg J.R.; Metzl M.D.; Ricciardi M.J.; Lip G.Y.H.; Qamar A. Institution (Ahmed, Jaiswal, Ricciardi, Qamar) Section of Interventional Cardiology, Endeavor Center for Cardiovascular Intervention Outcomes Research and Evaluation (ECCORE), Endeavor Health Cardiovascular Institute, The University of Chicago Pritzker School of Medicine, Glenview, IL, United States (Paryani) Department of Medicine, HCA Healthcare Houston Clear Lake/University of Houston, Webster, TX, United States (Shakoor) Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan (Golwala) Division of Cardiovascular Medicine, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, United States (Rosenberg, Metzl) Department of Cardiology, Endeavor Health Cardiovascular Institute, The University of Chicago Pritzker School of Medicine, Glenview, IL, United States (Lip) Institute of Life Course and Medical Sciences, University of Liverpool, 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 Publisher John Wiley and Sons Inc Abstract Introduction: Left atrial appendage closure (LAAC) is an emerging alternative for stroke prevention in patients with atrial fibrillation (AF) who are unsuitable for long-term oral anticoagulants (OACs). However, its efficacy and safety relative to OACs remain uncertain. Method(s): Three databases were searched up to April 7, 2026, for randomized controlled trials comparing LAAC with OAC in patients with AF. Risk ratios with 95% confidence intervals were pooled using a random-effects model. Result(s): Six RCTs (n = 7004 patients) were analyzed. The risk of stroke or systemic embolism (SSE) did not differ significantly between the LAAC and OAC groups (RR: 1.10 [0.87-1.39]; p = 0.42). The risk of ischemic SSE was significantly increased with LAAC (RR: 1.41 [1.07-1.85]; p = 0.02) compared with OAC. No significant differences were observed in all-cause mortality (RR: 0.94 [0.81-1.09]), cardiovascular mortality (RR: 0.91 [0.69-1.21]), non-cardiovascular mortality (RR: 0.91 [0.75-1.12]), or hemorrhagic stroke (RR: 0.58 [0.29-1.17]). LAAC was associated with a similar risk of overall major bleeding (RR: 0.92 [0.77-1.09]) and low risk of non-procedural bleeding (RR: 0.61 [0.52-0.73]; p < 0.001) compared with OAC. Upon sensitivity analysis comparing LAAC with DOACs, the findings remained consistent across most clinical outcomes. Conclusion(s): LAAC demonstrates comparable risks of SSE and major bleeding to OACs, but is associated with a higher risk of ischemic SSE and reduced non-procedural bleeding, supporting its use in selected patients at high risk for long-term bleeding while emphasizing individualized shared decision-making. Copyright © 2026 Wiley Periodicals LLC. <111> Accession Number 2049657608 Title Robotic-assisted versus conventional coronary artery bypass grafting: a systematic review, meta-analysis, and trial sequential analysis of 39,918 patients. Source Journal of Cardiothoracic Surgery. 21(1) (no pagination), 2026. Article Number: 763. Date of Publication: 01 Dec 2026. Author Abdelsamad A.; Khalil I.; Hrebat M.; Abuawwad T.; Zetawi M.; Yassin B.M.; Amayre S.I.; Khazbak M.A.; Laouadi N.; Khatib S.; Atalla H.M.; Manasra L.A.; Qaraqe A.; Mansour B.; Abdeldaim T.M.A.; Ghazy T. Institution (Abdelsamad) Department of Surgery II, University of Witten/Herdecke, Witten, Germany (Abdelsamad) Chief, General and Gastrointestinal surgery, Helios Clinic Cuxhaven, Altenwalder Chaussee 10-12, 27474, Cuxhaven, Germany (Khalil) Faculty of Medicine, Alexandria University, Alexandria, Egypt (Hrebat) Faculty of Medicine, Tanta University, Tanta, Egypt (Abuawwad) Fujian Medical University, Fujian, China (Zetawi, Khatib, Atalla) Faculty of Medicine, An-Najah National University, Nablus, Palestine (Yassin) Faculty of Medicine, Kuwait University, Kuwait City, Kuwait (Amayre, Qaraqe) Faculty of Medicine, Al-Quds University, Jerusalem, Palestine (Khazbak) Ministry of Health, Muscat, Oman (Laouadi) Heart Center, King Abdulaziz Specialized Hospital, Al Jouf, Saudi Arabia (Manasra) Faculty of Medicine, Cairo University, Cairo, Egypt (Mansour) Faculty of Medicine, Ain Shams University, Cairo, Egypt (Abdeldaim) Omdurman Islamic University, Omdurman, Sudan (Ghazy) Department of Cardiac Surgery, Philipps University of Marburg, Marburg, Germany Publisher BioMed Central Ltd Abstract Background: Robotic-assisted coronary artery bypass grafting (RA-CABG) is an evolving minimally invasive alternative to conventional CABG (C-CABG), but comparative evidence remains fragmented. We conducted a comprehensive systematic review, meta-analysis, and trial sequential analysis to compare outcomes between RA-CABG and C-CABG. Method(s): Following PRISMA 2020 guidelines, we searched PubMed, Embase, Cochrane CENTRAL, and Web of Science through January 2026. Studies comparing RA-CABG to C-CABG reporting at least one outcome of interest were eligible. Random-effects meta-analyses using DerSimonian-Laird estimators were performed. Risk of bias was assessed using ROBINS-I. Trial sequential analysis evaluated the conclusiveness of cumulative evidence. Result(s): Nine studies comprising 39,918 patients (13,638 RA-CABG; 26,280 C-CABG) were included. All included studies were observational in design, and long-term outcome data were sparse. RA-CABG was associated with significantly lower mortality (OR 0.55, 95% CI 0.43-0.69; P < 0.001; I2=0%), atrial fibrillation (OR 0.53; P < 0.001), respiratory failure (OR 0.31; P < 0.001), blood transfusion (OR 0.28; P < 0.001), hospital length of stay (MD - 1.95 days; P < 0.001), and ICU stay (MD - 22.7 h; P < 0.001). Stroke showed a non-significant trend favoring RA-CABG (OR 0.76; P = 0.071). Trial sequential analysis confirmed conclusive evidence for mortality, atrial fibrillation, respiratory failure, and blood transfusion. Results were robust across sensitivity analyses. Conclusion(s): In this meta-analysis of observational studies, RA-CABG was associated with significantly improved short-term outcomes compared to C-CABG across multiple endpoints, with conclusive statistical evidence for four of seven binary outcomes. However, all included studies were observational, and these associations should be interpreted with caution given potential residual confounding and case-selection bias. Multicenter randomized trials with long-term follow-up are needed to confirm these findings. Copyright © The Author(s) 2026. <112> Accession Number 652349140 Title Effect of auricular acupressure as an adjunct to standard postoperative care on physical and psychological outcomes following coronary artery bypass graft surgery: protocol for a randomised, single-blind, sham-controlled trial. Source BMJ open. 16(10) (pp e126650), 2026. Date of Publication: 08 Oct 2026. Author Allahbakhshian A.; Farshbaf-Khalili A.; Ghasemi K.; Rahimi H.; Babaei L.; Radimaher F. Institution (Allahbakhshian) Department of Medical Surgical Nursing, Tabriz University of Medical Sciences, Tabriz, Iran, Islamic Republic of (Farshbaf-Khalili) Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran, Islamic Republic of (Ghasemi, Rahimi, Babaei, Radimaher) Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran, Islamic Republic of <113> Accession Number 652347938 Title Current status of minimally invasive surgery for thoracic esophageal diverticula: systematic review and meta-analysis. Source Surgical endoscopy. (no pagination), 2026. Date of Publication: 08 Oct 2026. Author Aiolfi A.; Tamburri G.; Cammarata F.; Bistagnino F.; Bonitta G.; Simic A.; Skrobic O.; Gutschow C.A.; Schoppmann S.F.; Ayazi S.; Elshafei M.; Popa C.; Bona D.; Bonavina L. Institution (Aiolfi, Tamburri, Cammarata, Bistagnino, Bonitta, Bona) Department of General Surgery, I.R.C.C.S. Ospedale Galeazzi - Sant'Ambrogio, Milan, Italy (Simic, Skrobic) Department of Surgery, School of Medicine University of Belgrade, Hospital for Digestive Surgery, University Clinical Center of Serbia, Belgrade, Serbia (Gutschow) Upper-GI Unit, Department of Visceral and Transplant Surgery, University Hospital Zurich, Zurich, Switzerland (Schoppmann) Surgical Oncology, Department of Surgery, Upper-GI-Service, Medical University of Vienna, Vienna, Austria (Ayazi) Department of Surgery, Drexel University, Philadelphia, PA, United States (Elshafei) Department of General and Visceral Surgery, Marien Hospital Mainz, Mainz, Germany (Popa) Regional Institute of Gastroenterology and Hepatology O. Fodor Cluj-Napoca, University of Medicine and Pharmacy Iuliu Hatieganu Cluj-Napoca, Cluj-Napoca, Croitorilor 19-21, Romania (Bona) Department of Biomedical Science for Health, University of Milan, Milan, Italy (Bonavina) Department of Pharmacy, Health and Nutrition Sciences, University of Calabria, Rende, Cosenza, Italy (Bonavina) Division of General and Foregut Surgery, Azienda Ospedaliera di Cosenza, University of Calabria, Cosenza, Italy Abstract INTRODUCTION: Thoracic esophageal diverticula, including epiphrenic and parabronchial types, are rare clinical entities representing about 30% of all esophageal diverticula. Thoracic diverticula of the pulsion type have traditionally been associated with motility disorders and treated by stapled diverticulectomy with or without myotomy/fundoplication in patients experiencing disabling symptoms of dysphagia, regurgitation or pulmonary aspiration. Purpose of this study was to review the existing literature and estimate outcomes of minimally invasive surgery. METHOD(S): Systematic review and meta-analysis. PubMed, MEDLINE, Scopus, Web of Science, Cochrane Central Library, and ClinicalTrials.gov were queried. The search was last updated on April 20, 2026. Outcomes were staple-line leak, overall complications, in-hospital mortality, and symptoms improvement. RESULT(S): Twenty-one observational studies including 390 patients were analyzed. The age of the patients ranged from 23 to 83 years. Dysphagia (86%), regurgitation (73.4%), and respiratory symptoms (31.2%) were common indications for surgery. The size of the diverticula ranged from 2 to 11 cm. Preoperative use of standard or high-resolution esophageal manometry was reported in 18 studies. Achalasia (49.2%) was the most commonly associated motility disorder. Laparoscopic (61.9%), thoracoscopic (30.6%), or combined (6.7%) minimally invasive approaches were described. Adjunctive procedures were esophagomyotomy (87%) and Dor (34.6%) or Toupet (17.7%) fundoplication. The estimated pooled prevalence of staple-line leak was 9.8% (95% CrI 7.1-13.4%; I2 = 0.0). Exploratory unadjusted subgroup analyses did not identify statistically supported differences in staple-line leak according to myotomy (RR = 0.67; 95% CrI 0.17-3.52) or surgical approach (RR = 0.72; 95% CrI 0.22-3.39). The estimated pooled prevalence of overall complications, in-hospital mortality, and study-reported symptom resolution/improvement was 21.6% (95% CrI 16.1-28.4%), 1.3% (95% CrI 0.5-2.9%), and 92.1% (95% CrI 87.7-95%), respectively. CONCLUSION(S): Current evidence reporting outcome for minimally invasive midesophageal and epiphrenic diverticulectomy is limited by study design and treatment heterogeneity. Future well-designed multicenter studies are required to assess the effect of surgical approach and esophageal myotomy on short-term morbidity, symptomatic outcomes, and recurrence rate. Copyright © 2026. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. <114> Accession Number 2050320582 Title The Impact of Renin-Angiotensin System Inhibitors on Postoperative Outcomes Following Coronary Artery Bypass Grafting: A Systematic Review. Source Cardiology in Review. (pp 1-8), 2026. Date of Publication: 2026. Author Mansour A.; Elazab A.; Elbataa A.; Shubietah A.; Elkasaby M.H.; Balbaa E.; Ali A.H.G.; Gadelmawla A.F.; Emara A.; Abdul-Hafez H.A.; Elbahloul M.A.; Hageen A.W.; Mhanna M.; Frishman W.H.; Aronow W.S. Institution (Mansour, Elbataa, Elkasaby, Emara) From the Department of Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Elazab) Department of Medicine, Faculty of Medicine, South Valley University, Qena, Egypt (Shubietah) Department of Medicine, Advocate Illinois Masonic Medical Center, Chicago, IL, United States (Balbaa) Department of Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt (Ali) Department of Medicine, National Research Ogarev Mordovia State University, Mordovia, Saransk, Russian Federation (Gadelmawla) Department of Medicine, Faculty of Medicine, Menoufia University, Menoufia, Egypt (Abdul-Hafez) Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine (Elbahloul) Department of Medicine, Faculty of Medicine, Kafr El-Shaikh University, Kafr El-Shaikh, Egypt (Hageen) Department of Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt (Mhanna) Division of Cardiovascular Medicine, Department of Medicine, University of Iowa, Iowa City, IA, United States (Frishman, Aronow) Departments of Medicine, New York Medical College and Westchester Medical Center, Valhalla, NY, United States Publisher Lippincott Williams and Wilkins Abstract Patients undergoing coronary artery bypass grafting (CABG) remain at high risk of major adverse cardiovascular events and death despite successful revascularization, and the role of renin-angiotensin system inhibitors (RASi), comprising angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, in this setting is not clearly defined. We systematically reviewed the effect of RASi initiated within 30 days after CABG on postoperative outcomes. PubMed, Web of Science, Scopus, and the Cochrane Library were searched through May 2025 for randomized controlled trials and observational studies comparing patients who received RASi after CABG, alone or with other cardiovascular medications, with those who did not. Five studies (3 RCTs and 2 retrospective cohorts) comprising 47, 821 patients (28, 917 RASi recipients and 18, 904 controls) were included. RASi use after CABG was generally associated with a lower rate of major adverse cardiovascular events, with the largest reductions observed in patients with heart failure. The effect on all-cause mortality was inconsistent: 2 studies reported a reduced risk, whereas 2 reported no significant difference. Cardiovascular mortality findings were similarly variable, with 1 study showing a marked reduction, 1 an early increase in the composite endpoint that attenuated over longer follow-up, and 1 no significant change. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <115> Accession Number 2050280413 Title Yoga Based Lifestyle Program in Improving Quality of Life after Coronary Artery Bypass Graft (CABG) Surgery: A Randomised Controlled Trial. Source Journal of Clinical and Diagnostic Research. 12(3) (pp YC05-YC09), 2018. Date of Publication: 01 Mar 2018. Author Eraballi A.; Raghuram N.; Ramarao N.H.; Pradhan B.; Rao P.V. Institution (Eraballi) Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Smasthana, Karnataka, Bangalore, India (Raghuram) Department of Yoga and Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Karnataka, Bangalore, India (Ramarao) Department of Yoga and Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Karnataka, Bangalore, India (Pradhan) Department of Yoga and Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Karnataka, Bangalore, India (Rao) Cardio Thoracic Surgeon, Department of Cardiology, Narayana Hrudayalaya Institute of Cardiac Sciences, Karnataka, Bangalore, India Publisher JCDR Research and Publications Pvt Ltd Abstract Introduction: The Quality of Life (QOL) after Coronary Artery Bypass Grafting (CABG) is an important contributor to morbidity and mortality. The addition of Yoga Based Lifestyle Program (YLSP) to conventional cardiac rehabilitation has found useful and effective in improving ejection fraction and reducing risk factor profiles. Aim(s): The aim of the present study was to evaluate the effect of add-on YLSP to conventional post-CABG rehabilitation and to compare the changes of QOL. MaterialsandMethods:Atotalof300patientspostedforelective CABG at Narayana Hrudayalaya Super Specialty Hospital, Bengaluru, India were randomised into two groups (150 each) i.e., Conventional Lifestyle Program (CLSP) and YLSP. Data on CLSP (95) and YLSP (102) was available for analysis at one year follow up. The YLSP Group practiced integrated yoga module including Yama, Niyama, Anasa, Pranayama and Meditation as an add-on to conventional lifestyle advice. Assessments were done before and one year after CABG on World Health Organization Quality of Life- Brief form questionnaire (WHOQOL-BREF) with four domains viz., 'Physical Health', 'Mental Health', 'Social relationships' and 'Environmental health'. As the data was not normally distributed, the non-parametric tests viz., Mann-Whitney Test and Wilcoxon signed ranks test for between group and within group comparisons were applied. Result(s): In YLSP group, significant (p<0.001; Wilcoxon's test) improvements were found within group after one year in all domains of WHOQOL-BREF, while there was significant improvement (p<0.05; Wilcoxon's test) only in the Social health domain, in the control (CLSP) group. There was significant differences between groups (p<0.05; Mann-Whitney test) in all domains with better improvement in the YLSP Group. Conclusion(s): Addition of integrated yoga program to conventional post-CABG rehabilitation leads to better improvement in all domains of quality of life after coronary artery bypass surgery. Copyright © 2018 JCDR Research and Publications Pvt Ltd. All rights reserved. <116> Accession Number 2049608134 Title Impact of Evolocumab on LDL-Cholesterol and Cardiovascular Outcomes in Patients With Established CVD: Systematic Review and Meta-Analysis. Source Endocrinology, Diabetes and Metabolism. 9(6) (no pagination), 2026. Article Number: e70355. Date of Publication: 01 Nov 2026. Author Goel A.; Naveed M.A.; Tandel H.; Mahmood A.; Mukhlis M.; Reddy K.S.V.; Maloth A.K.; Chauhan A.; Ashwara A.; Verma A.; Tahir H.B. Institution (Goel, Reddy, Maloth) Kakatiya Medical College, Telangana, Warangal, India (Naveed) Dow Medical College, Karachi, Pakistan (Tandel) C U Shah Medical College, Gujarat, Surendranagar, India (Mahmood) Shaikh Khalifa Bin Zayed Al Nahyan Medical and Dental College, Punjab, Lahore, Pakistan (Mukhlis) Ayub Medical College, Abbottabad, Pakistan (Chauhan) Maulana Azad Medical College, New Delhi, India (Ashwara) Department of Medicine, An-Najah National University, Nablus, Palestine (Verma) SR Sanjeevani Hospital, Siraha, Nepal (Verma) Dr. D. Y. Patil Medical College Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed-to-be-University), Maharashtra, Pune, India (Verma) Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth (Deemed-to-be-University), Maharashtra, Pune, India (Tahir) Lahore General Hospital, Lahore, Pakistan Publisher John Wiley and Sons Inc Abstract Background: Atherosclerotic cardiovascular disease is a leading cause of morbidity and mortality, and many high-risk patients fail to reach LDL-cholesterol (LDL-C) targets on statins alone. Evolocumab, a PCSK9 inhibitor, offers potent LDL-C lowering, but a synthesis of its lipid and clinical benefits in secondary prevention is needed. Method(s): We conducted a systematic review and meta-analysis of randomised controlled trials evaluating evolocumab in adults with established cardiovascular disease. PubMed, Embase, Scopus, Cochrane CENTRAL, and ClinicalTrials.gov were searched through April 2025. Outcomes included lipid parameters, major adverse cardiovascular events (MACE), individual cardiovascular endpoints, and safety, with pooled risk ratios (RR) and mean differences calculated using random-effects models. Result(s): Nine trials enrolling 67,662 patients were included. Evolocumab significantly reduced LDL-C (mean difference -57.73 mg/dL), total cholesterol (-52.27 mg/dL), triglycerides (-21.21 mg/dL), and lipoprotein(a) (-10.99 mg/dL), while increasing HDL-cholesterol (3.69 mg/dL). Evolocumab was associated with lower MACE (RR 0.53; 95% CI 0.40-0.71), though this estimate should be interpreted cautiously given heterogeneity in endpoint definitions and study designs. Myocardial infarction (RR 0.74) and coronary revascularisation (RR 0.80) were significantly reduced, while cardiovascular mortality and stroke showed no statistically definitive reduction. Serious adverse events and neurocognitive effects were comparable between groups, though injection-site reactions were more frequent with evolocumab. Conclusion(s): In patients with established cardiovascular disease, evolocumab provides substantial lipid lowering and reduces ischemic events without major safety concerns, supporting its use as an adjunct to statin therapy in secondary prevention. Copyright © 2026 The Author(s). Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd. <117> Accession Number 2049390835 Title Association between lipoprotein(a) and structural degeneration of bioprosthetic aortic valves: A systematic review and meta-analysis. Source Journal of Clinical Lipidology. (no pagination), 2026. Date of Publication: 2026. Author Echeverria-Ortegon E.; Torres-Chavez M.C.; Tejeda A.P.-T.; Caballero P.; Pastor-Cervantes J. Institution (Echeverria-Ortegon, Caballero) School of Health Sciences, Universidad Marista de Merida, (Echeverria-Ortegon and Caballero), Merida, Mexico (Torres-Chavez) Facultad de Medicina Mexicali, Universidad Autonoma de Baja California, (Torres-Chavez), Mexicali, Mexico (Tejeda) Memorial Healthcare System, (Tejeda), Hollywood, FL, United States (Pastor-Cervantes) Department of Cardiovascular Disease, Memorial Healthcare System, (Pastor-Cervantes), Hollywood, FL, United States Publisher Elsevier Ltd Abstract BACKGROUND Structural valve degeneration (SVD) remains a major limitation of bioprosthetic aortic valves (bAVs). Lipoprotein(a) [Lp(a)] is a genetically determined cardiovascular risk factor implicated in native aortic valve calcification, but its role in bioprosthetic valve degeneration remains incompletely understood. OBJECTIVE To systematically evaluate the association between elevated Lp(a) levels and structural degeneration of bAVs. METHODS A systematic review and meta-analysis were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, EBSCOhost, and Cochrane Library databases were searched for studies evaluating Lp(a) and structural degeneration of bAVs in patients undergoing surgical or transcatheter aortic valve replacement. Random-effects models were used to pool effect estimates. Cross-sectional outcomes were summarized using odds ratios (ORs), and longitudinal outcomes were pooled using hazard ratios (HRs), both with 95% CIs. RESULTS Five observational cohort studies, including 1227 patients, were included. In cross-sectional analyses (2 studies), elevated Lp(a) levels were significantly associated with SVD (OR 2.09, 95% CI 1.02-4.28; I2 = 0%). In longitudinal analyses (3 studies), elevated Lp(a) was associated with a higher risk of incident SVD or valve-related reintervention (HR 3.49, 95% CI 2.18-5.59; I2 = 0%). CONCLUSION Elevated Lp(a) levels are associated with an increased risk of structural degeneration in bAVs. Lp(a) may represent a useful biomarker for identifying patients at higher risk of valve deterioration and may have implications for surveillance strategies and emerging Lp(a)-lowering therapies. Copyright © 2026 National Lipid Association. <118> Accession Number 2050366470 Title Liposomal bupivacaine in thoracic surgery: a comprehensive review of current evidence and clinical implications. Source Frontiers in Medicine. 13 (no pagination), 2026. Article Number: 1917255. Date of Publication: 2026. Author Huang L.; He J.; Wei J.; Huang X.; Chen X.; Yang Q.; Zhong Y. Institution (Huang, Yang) School of Nursing, Guangxi University of Chinese Medicine, Guangxi Zhuang Autonomous Region, Nanning, China (Huang, He, Wei, Huang, Chen, Zhong) Department of Thoracic Surgery, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Guangxi Zhuang Autonomous Region, Nanning, China (Yang) Nursing Department, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Guangxi Zhuang Autonomous Region, Nanning, China Publisher Frontiers Media SA Abstract Liposomal bupivacaine (LB) is a prolonged-release formulation designed to provide postoperative analgesia for up to 72-96 h after a single injection. This comprehensive review evaluates the current evidence on LB in thoracic surgery, focusing on acute pain control, opioid consumption, hospital length of stay (LOS), functional recovery, comparative effectiveness across regional techniques, integration into Enhanced Recovery After Surgery (ERAS) protocols, chronic postsurgical pain (CPSP) reduction, and safety/cost considerations. The core critical finding of this review is that although meta-analyses show statistically significant reductions in pain scores and opioid consumption with LB, the clinical significance of these reductions is questionable-for example, the opioid-sparing effect at 24 h (-1.83 MME) is far below the threshold generally considered clinically meaningful (10-15 MME). Results vary by block type; benefits are more consistent with serratus anterior, erector spinae, and paravertebral blocks, while intercostal nerve block data are mixed. LB appears most effective when incorporated into ERAS protocols, although the independent contribution of LB within these multimodal pathways remains difficult to isolate. Emerging evidence suggests LB may reduce CPSP incidence by 30-58%, but these findings are preliminary and require confirmation in larger studies with longer follow-up. Safety profiles are favorable, with peak plasma concentrations well below toxicity thresholds. Methodological limitations of the existing evidence include small sample sizes, lack of blinding, and and heterogeneity across studies. Future large-scale RCTs with long-term follow-up are warranted. Copyright © 2026 Huang, He, Wei, Huang, Chen, Yang and Zhong. <119> Accession Number 2049627262 Title Current state of evidence for RATS lobectomy for NSCLC. Source Journal of Cardiothoracic Surgery. 21(1) (no pagination), 2026. Article Number: 737. Date of Publication: 01 Dec 2026. Author Galvaing G.; d'Ostrevy N.; Chadeyras J.-B.; Dupautet L.; Naamee A.; Filaire M. Institution (Galvaing, Chadeyras, Dupautet, Naamee, Filaire) Department of Thoracic and Endocrine Surgery, Jean Perrin Cancer Center, 58 rue Montalembert, Clermont-Ferrand, France (d'Ostrevy) Department of Cardiac Surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France Publisher BioMed Central Ltd Abstract Background: Robot-assisted thoracic surgery (RATS) has progressively been integrated into minimally invasive strategies for pulmonary lobectomy in patients with non-small cell lung cancer (NSCLC). Although video-assisted thoracic surgery (VATS) remains the most established minimally invasive approach, the clinical relevance and added value of robotic platforms continue to be debated. Method(s): This narrative review critically examines the existing literature on robot-assisted lobectomy for NSCLC. Emphasis is placed on comparative data evaluating oncological outcomes, lymph node assessment, perioperative results, technical considerations, learning curve, and economic implications in relation to VATS and open surgery. Result(s): Available evidence, predominantly derived from retrospective studies and large database analyses, indicates that RATS lobectomy is feasible and safe when performed in experienced centers. Long-term oncological outcomes, including overall and disease-free survival, appear broadly comparable across surgical approaches. While some studies suggest that robotic assistance may facilitate more extensive lymph node assessment, the clinical significance of these findings remains uncertain. Perioperative outcomes such as conversion rates, postoperative morbidity, and length of hospital stay are generally similar between RATS and VATS. Higher procedural costs associated with robotic platforms remain a consistent concern, with cost-effectiveness strongly influenced by institutional volume and resource allocation. Conclusion(s): Current evidence supports RATS lobectomy as a valid minimally invasive option for selected patients with NSCLC, offering outcomes comparable to those of established techniques. Despite clear technical advantages, definitive clinical superiority has not been demonstrated, highlighting the need for further prospective studies and standardized outcome reporting. Copyright © The Author(s) 2026. <120> Accession Number 2050341310 Title Surgical Artificial Intelligence Innovation Trends and Regulatory Insights: A Systematic Analysis of Food and Drug Administration-Approved Devices. Source Annals of Surgery. (no pagination), 2026. Date of Publication: 2026. Author Gandhewar R.; Guni A.; Tandon D.; Patel S.; Waldock W.; Dilaver N.; Zhang H.; Pandza K.; Darzi A.; Ashrafian H. Institution (Gandhewar, Guni, Waldock, Darzi, Ashrafian) Institute of Global Health Innovation (Gandhewar, Guni, Waldock, Darzi, Ashrafian) Department of Surgery and Cancer, Imperial College London, London, United Kingdom (Tandon) University Hospitals Coventry and Warwickshire, Coventry, United Kingdom (Patel, Dilaver) Department of General Surgery, Barking Havering and Redbridge University Hospitals NHS Trust (Zhang) King's College London, London, United Kingdom (Pandza, Ashrafian) Centre for Technology Innovation and Engagement (C-TIE), Leeds University Business School, Leeds, United Kingdom Publisher Wolters Kluwer Health Abstract Objective: - To characterise the landscape of surgical artificial intelligence (AI) devices approved by the US Food and Drug Administration (FDA). Background(s): - AI has the potential to improve surgical pathways, offering capability across screening, diagnosis, decision support, and intraoperative care. Despite this, real-world adoption remains limited. Regulatory approval serves as a key step in clinical translation but is influenced by challenges in evidence generation, safety, bias, transparency, and implementation. Consequently, the characteristics, evidence base, and functional roles of FDA-cleared surgical AI devices remain incompletely defined. Method(s): - FDA-cleared AI/machine learning medical devices were systematically screened for surgical relevance up to July 2025. Eligible devices were extracted for clinical application, underlying AI technology, evidence quality, and regulatory pathway. Devices were categorised using an adapted descriptive, diagnostic, predictive, prescriptive framework, and predicate networks were evaluated for risk of predicate creep. Analyses were performed in R. Result(s): - A total of 314 devices (25.1%) had surgical applications. Most were imaging-based devices and mapped to general surgery (24.8%), orthopaedic surgery (18.2%), neurosurgery (17.2%), and cardiac surgery (10.8%). The majority of devices were descriptive (50.6%) or diagnostic (40.4%), with relatively few predictive (1.3%) or prescriptive (7.6%) applications. Clinical validation was predominantly based on retrospective or bench studies, with only 5.1% supported by higher-quality prospective evidence. The premarket notification 510(k) pathway accounted for 95.2% of approvals. Among these, 37.5% demonstrated a high risk of predicate creep, reflecting substantial differences in intended use or technological characteristics compared with predicate devices. Conclusion(s): - FDA-approved surgical AI devices are currently dominated by imaging-based diagnostic tools. The widespread reliance on the 510(k) pathway and the observed prevalence of predicate creep highlight important considerations for regulatory evaluation. As AI applications expand toward predictive and interventional roles, improved evidence transparency and robust assessment of device equivalence will be essential to support safe clinical adoption. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <121> Accession Number 2049627261 Title Adjunctive hyperbaric oxygen therapy for poststernotomy deep sternal wound infection, mediastinitis, and sternal osteomyelitis after cardiac surgery: a scoping review. Source Journal of Cardiothoracic Surgery. 21(1) (no pagination), 2026. Article Number: 739. Date of Publication: 01 Dec 2026. Author Bahramnezhad F.; Montaseri M.; Jackson A.C. Institution (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 (Montaseri) Critical Care Nursing Department, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Montaseri) Student's Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Jackson) Australian Centre for Heart Health, Melbourne, Australia (Jackson) Faculty of Health, Deakin University, Geelong, Australia (Jackson) Centre on Behavioural Health, Hong Kong University, Pok Fu Lam, Hong Kong Publisher BioMed Central Ltd Abstract Introduction: Poststernotomy deep sternal wound infection (DSWI), mediastinitis, and sternal osteomyelitis are uncommon but serious complications of cardiac surgery. Hyperbaric oxygen therapy (HBOT) has been used as an adjunct in selected complex infections, but its incremental role within contemporary cardiac-surgery pathways is uncertain. Method(s): We conducted a scoping review according to JBI guidance and PRISMA-ScR reporting standards. MEDLINE, Embase, Cochrane CENTRAL, and CINAHL were searched from 1 January 1999 to 2 June 2026. We included adult and pediatric clinical sources and relevant experimental mediastinitis models. Two reviewers independently screened sources and charted data. Design-matched appraisal tools were used only to contextualize methodological limitations. Because populations, infection phenotypes, cointerventions, comparators, and endpoints differed substantially, findings were stratified and synthesized narratively; no meta-analysis was performed. Result(s): Eleven sources met the inclusion criteria: six adult cohorts/series, one pediatric cohort, two single-patient reports, and two MRSA rat models (179 adults in cohorts/series, 53 pediatric patients, two additional adult single-patient reports, and 103 animals). These sources represent distinct evidence strata and were not interpreted as one clinical entity. HBOT was always embedded within multimodal care, including surgery, antibiotics, NPWT, and/or reconstruction. Only two small adult studies provided direct nonrandomized HBOT-versus-non-HBOT comparisons. Li et al. compared sequential treatment eras and was analyzed separately. The evidence cannot isolate an incremental HBOT effect. Conclusion(s): Evidence for adjunctive HBOT remains sparse and highly heterogeneous. Current studies do not establish a causal or incremental benefit beyond surgery, source control, antibiotics, NPWT, and reconstruction. HBOT should not be routinely adopted or allowed to delay definitive surgical management. Its role, if any, is limited to carefully selected adjunctive use within multidisciplinary pathways and prospective evaluation. Copyright © The Author(s) 2026. <122> Accession Number 2048098803 Title Efficacy and Safety of CETP Inhibitors in Patients With Atherosclerotic Cardiovascular Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Source Journal of Cardiovascular Pharmacology. 88(4) (pp 290-298), 2026. Date of Publication: 01 Oct 2026. Author Rodriguez Milan R.; Jimenez Castellanos M.S.; Doniz Viveros A.D.; Yusufzai M.O.; Espinoza E.E.C.; Estela Fernandez C.A.; Machado D.A.; Sharjeel Abbas M.; Sah H.; Altamirano A.A.; Mahajan K. Institution (Rodriguez Milan, Altamirano) Universidad Autonoma Metropolitana, Unidad Xochimilco, Departamento de Atencion a la Salud, Ciudad de Mexico, Mexico (Jimenez Castellanos) Facultad de Medicina Humana, Universidad Autonoma de Chiapas, Tuxtla Gutierrez, Mexico (Doniz Viveros) Facultad Mexicana de Medicina, Universidad La Salle, Departamento de Medicina y Salud, Ciudad de Mexico, Mexico (Yusufzai) Bacha Khan Medical College, Mardan, Pakistan (Espinoza) Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru (Estela Fernandez) Universidad Cientifica del Sur, Lima, Peru (Machado) Universidad Catolica, Santa Cruz, Bolivia (Sharjeel Abbas) Goma Medical College, Khyber Medical University, Peshawar, Pakistan (Sah) Bahcesehir University Medical Park Goztepe, Istanbul, Turkey (Mahajan) Himachal Heart Institute, Mandi, India Publisher Lippincott Williams and Wilkins Abstract Atherosclerotic cardiovascular disease remains a leading cause of death globally. Cholesteryl ester transfer protein (CETP) inhibitors have been proposed as a novel strategy for cardiovascular risk reduction, yet evidence remains inconsistent. PubMed, EMBASE, and Scopus were searched for randomized controlled trials comparing CETP inhibitors with placebo in patients with atherosclerotic cardiovascular disease. Random-effects models were used to pool risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs). Heterogeneity was assessed using I2 statistics. Statistical analysis was performed using R software version 4.3.3. We included 5 RCTs involving 62, 565 participants, of whom 31, 698 (50.7%) received CETP inhibitors. Compared with placebo, CETP inhibitors showed no significant reduction in death from coronary heart disease (RR: 0.91; 95% CI, 0.82 to 1.01), unplanned coronary revascularization (RR: 0.91; 95% CI, 0.79-1.05), nonfatal myocardial infarction (RR: 0.94; 95% CI, 0.87-1.02), and stroke (RR: 1.02; 95% CI, 0.93-1.12). In addition, no excess risk of adverse events was observed (RR: 1.00; 95% CI, 0.99-1.02). Conversely, HDL-C (MD: +130.82%; 95% CI, 121.49-140.15), LDL-C (MD: -32.68%; 95% CI, -40.73 to -24.63), ApoA1 (MD: +45.04%; 95% CI, 40.51-49.57), and Apo B (MD: -17.26%; 95% CI, -20.51 to -14.00) showed significant improvement. CETP inhibitors produce substantial lipid modifications but do not reduce major adverse cardiovascular events, underscoring the limitations of surrogate lipid markers and the need for outcome-based validation of lipid-modifying therapies. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <123> Accession Number 2038742021 Title Regional Anesthesia for Patients Undergoing Cardiac Surgery: An Overview for the Bedside Nurse. Source Critical Care Nurse. 46(5) (pp 21-27), 2026. Date of Publication: 01 Oct 2026. Author Feldt Z.; McNeil J.; Parikh N.; Georgiana J.; Gallo P.D. Institution (Feldt, McNeil, Gallo) University of Virginia School of Medicine, Charlottesville, VA, United States (Parikh, Georgiana) UVA Health University Medical Center, cardio-thoracic intensive care unit, Charlottesville, VA, United States Publisher American Association of Critical-Care Nurses Abstract Background Regional anesthesia techniques are becoming increasingly used to reduce postoperative pain, reduce opioid use, and improve other outcomes in patients undergoing cardiac surgery. Objective To provide critical care nurses with an overview of regional anesthesia techniques for cardiac surgery patients and to discuss considerations for bedside nurses to ensure safe, effective, and patient-centered care. Methods A review of current literature was performed to provide a summary of fascial plane block techniques and the benefits, risks, and implications of their use for patients undergoing cardiac surgery. The role of bedside critical care nurses was examined. Results Regional anesthesia has been shown to improve postoperative pain scores, shorten intensive care unit and hospital stays, reduce several postoperative complications, and improve other patient-centered outcomes for cardiac surgery patients. Critical care nurses perform crucial roles during placement of the blocks, when monitoring patients for adverse effects of local anesthesia, and by providing patient education and managing patients' expectations. Discussion Regional anesthesia is an important tool in the care of patients undergoing cardiac surgery, and studies support its benefits for patient outcomes. However, further research is needed to develop and optimize evidence-based protocols for clinicians and perioperative care teams. Conclusion As regional anesthesia becomes a routine component of post-cardiac surgery care, critical care nurses must be familiar with block techniques (administration and implication), monitoring protocols, and management of potential adverse events to optimize patient outcomes. (Critical Care Nurse. 2026; 46[5]:21-27). Copyright © 2026 American Association of Critical-Care Nurses. <124> Accession Number 2050467830 Title The role of fibrinogen concentrate in the reduction of allogeneic blood product requirements: a systematic review and meta-analysis. Source British Journal of Anaesthesia. (no pagination), 2026. Date of Publication: 2026. Author Rahe-Meyer N.; Rodrigues R.; Fries D.; Steffen Schmidt D.; Faraoni D. Institution (Rahe-Meyer) Department for Anaesthesiology and Intensive Care Medicine, Franziskus Hospital, Bielefeld, Germany (Rodrigues) Department of Intensive Care, Hospital Israelita Albert Einstein, Sao Paulo, Brazil (Fries) Department of Anaesthesia and Critical Care Medicine, Hospital St. Vincent Zams, Zams, Austria (Fries) Department for Critical Care and Emergency Medicine, Medical University of Innsbruck, Innsbruck, Austria (Steffen Schmidt) CSL Behring GmbH, Marburg, Germany (Faraoni) Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, United States Publisher Elsevier Ltd Abstract Background: Fibrinogen concentrate (FC) has a well-established safety profile and is recommended for treating acquired fibrinogen deficiency. However, its comparative effectiveness vs other treatments regarding transfusions and patient outcomes remains uncertain. Method(s): Comparative studies from a range of clinical settings in which patients received FC for acquired hypofibrinogenaemia and that evaluated blood product needs, mortality, thromboembolic events, or hospital length of stay were included in a systematic literature review and meta-analysis (PROSPERO: CRD42024602804). Meta-analyses used pooled data to provide an estimate of the difference in outcome between FC and all other treatments; separate analyses were conducted for adult and paediatric patients. Result(s): Overall, 58 studies (N=13 530 patients) were analysed. Adult FC recipients received significantly fewer red blood cell, fresh frozen plasma, and platelet units than with other treatments: 28% (incidence rate ratio [IRR] 0.72; 95% confidence interval [CI] 0.59-0.89; P=0.002), 31% (IRR 0.69; 95% CI 0.54-0.89; P=0.004), and 44% less (IRR 0.56; 95% CI 0.33-0.95; P=0.03), respectively. These results were largely driven by cardiac surgery studies. In an RCT subanalysis, the use and quantity of blood products were significantly reduced with FC. No significant difference in mortality or thromboembolic events was found between treatments in adult patients or in any outcomes analysed in paediatric patients. Conclusion(s): This meta-analysis suggests FC administered for acquired hypofibrinogenaemia can reduce blood product transfusions in adults, with no obvious safety concerns, compared with other treatments. Copyright The Authors This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/ <125> Accession Number 2050446562 Title Intravenous Immunoglobulin Administration in Cardiac Surgery, Heart Transplantation and Infective Endocarditis: A Scoping Review. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Pilia E.; Derylo K.; Guarnieri M.; Marjanovic S.; Paternoster G.; Finco G.; Landoni G.; Belletti A. Institution (Pilia) Department of Anesthesia and Intensive Care, G. Brotzu Hospital, Cagliari, Italy (Pilia, Finco) Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy (Derylo) Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy (Guarnieri) Department of Anesthesia and Intensive Care, Centro Cardiologico Monzino IRCCS, Milan, Italy (Marjanovic) Faculty of Medicine, University of Belgrade, Belgrade, Serbia (Paternoster) Department of Health Sciences, Anaesthesia and ICU, School of Medicine, University of Basilicata San Carlo Hospital, Potenza, Italy (Landoni, Belletti) Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy (Landoni) School of Medicine, Vita-Salute San Raffaele University, Milan, Italy Publisher W.B. Saunders Abstract Perioperative infections are a common cause of morbidity in cardiac surgery. Intravenous immunoglobulin (IVIG) is increasingly used as a rescue treatment for septic shock. However, data on efficacy and safety in cardiac surgery patients are limited. A scoping review of available literature aimed at identifying studies investigating the use of IVIG in patients undergoing cardiac surgery or with infective endocarditis was performed. Studies reporting data on the use of IVIG in these populations were included, including case reports. Data on study design, population, control group, indications for IVIG therapy, and formulation and dose of IVIG were abstracted. Outcome data from randomized controlled trials (RCTs) were also abstracted. A total of 135 studies were identified, including 7 RCTs and 1 RCT study protocol. Most studies were performed in the setting of heart transplantation, followed by nontransplant cardiac surgery and infective endocarditis. The most common formulation was standard IVIG at a dose of 2 g/kg. Available data on the use of IVIG in cardiac surgery patients are mostly limited to the use of standard IVIG in heart transplantation recipients, and available evidence does not justify the routine use of IVIG in the cardiac surgery setting. However, in light of the strong scientific rationale supporting the use of IVIG, new high-quality RCTs enrolling a larger number of patients and following prospectively registered protocols are needed. Copyright © 2026 Elsevier Inc.

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