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Total documents retrieved: 139 Results Generated From: Embase <1980 to 2026 Week 44> Embase Weekly Updates (updates since 2026-10-23) - (139 records) <1> Accession Number 2046492130 Title Balancing the evidence with the SPAQI recommendations: from perioperative discontinuation towards continuation of SGLT2 inhibitors. Source British Journal of Anaesthesia. 137(2) (pp 413-419), 2026. Date of Publication: 01 Aug 2026. Author Garcia B.; Dixit A.A.; Legrand M. Institution (Garcia) Department of Intensive Care, Saint-Pierre University Hospital, Universite libre de Bruxelles (ULB), Brussels, Belgium (Garcia, Legrand) French Clinical Research Infrastructure Network-Cardiovascular and Renal Clinical Trialists (FCRIN INI-CRCT), Nancy, France (Dixit) Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States (Legrand) Department of Anesthesia & Perioperative Care, Division of Critical Care Medicine, University of California, San Francisco (UCSF), San Francisco, CA, United States Publisher Elsevier Ltd Abstract The Society for Perioperative Assessment and Quality Improvement consensus recommends a perioperative management strategy for sodium-glucose cotransporter 2 inhibitors based on surgical type, metabolic context, and underlying indication. This risk-stratified approach balances the low but real risk of euglycaemic ketoacidosis against established cardio-renal benefits. Current evidence is limited and suggests that euglycaemic ketoacidosis is driven more by metabolic context, particularly diabetes mellitus and fasting, than by drug continuation alone. Importantly, discontinuation could lead to a loss of cardiovascular benefit, whereas emerging data suggest potential perioperative benefits, although evidence remains limited. Overall, these recommendations shift toward a strategy based on euglycaemic ketoacidosis risk factors and careful metabolic monitoring rather than systematic discontinuation pending large randomised controlled trials. Copyright © 2026 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <2> Accession Number 2038777145 Title Comparing the Effect of Propofol Versus Isoflurane on Intraocular Pressure in Laminectomy Surgeries in Prone Position. Source Iranian Journal of Neurosurgery. 12 (no pagination), 2026. Article Number: e2. Date of Publication: 2026. Author Behboudi H.; Mohammdi M.J.; Jouryabi A.M.; Yousefzadeh-Chabok S.; Panah M.P.; Alijani B.; Haghighi M.; Khoshbakht-Pishkhani M.; Leyli E.K.; Ashraf A. Institution (Behboudi, Mohammdi, Panah) Department of Ophthalmology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran, Islamic Republic of (Jouryabi, Haghighi) Department of Anesthesiology, Anesthesiology Research Center, Alzahra Hospital, Guilan University of Medical Sciences, Rasht, Iran, Islamic Republic of (Yousefzadeh-Chabok) Department of Neurosurgery, Road Trauma Research Center, School of Medicine, Trauma Institute, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran, Islamic Republic of (Alijani) Department of Neurosurgery, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran, Islamic Republic of (Khoshbakht-Pishkhani) Department of Medical Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran, Islamic Republic of (Leyli) Department of Biostatistics, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran, Islamic Republic of (Ashraf) Clinical Research Development Unit, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran, Islamic Republic of Publisher Guilan University of Medical Sciences Abstract Background and Aim: Post-operative loss of vision is not a common but dramatic complication. This is most often reported after spinal and cardiac surgeries. Ischemic optic neuropathy is the primary cause, but its etiology remains unclear. Retinal blood perfusion depends on mean arterial pressure and intraocular pressure (IOP). In spinal surgery, both of these can be altered by the type of prone-position surgery. Because different anesthetic agents can be used for anesthesia in spine surgery, we conducted this randomized clinical trial to compare the effects of propofol and isoflurane as maintenance anesthesia on IOP during spinal surgery in the prone position. Methods and Materials/Patients: IOP was measured with the Tonopen Richert device in five steps before and after induction of anesthesia and during surgery every 30 minutes. A total of 72 patients were enrolled in this study. Result(s): IOP decreased after induction of anesthesia with propofol, but significantly increased in patients receiving isoflurane as maintenance of anesthesia in a prone position compared with the propofol group. Systolic and diastolic blood pressure and duration of surgery in a prone position were also associated with increased IOP. Conclusion(s): The present study showed that the group under anesthesia with propofol had significantly lower IOP than the group anesthetized with isoflurane. Copyright © 2026 Guilan University of Medical Sciences. Published by Guilan University of Medical Sciences. <3> Accession Number 2047458941 Title Complete Dacron reinforcement of Ross autograft does not increase neoaortic valve regurgitation: A systematic review and meta-analysis. Source JTCVS Techniques. 39 (no pagination), 2026. Article Number: 102490. Date of Publication: 01 Oct 2026. Author Wahba A.; Elmezayen Z.W.; Elbahy O.; Elshabrawi M.N.; Ehmidat M.; Said S.M. Institution (Wahba) Department of Cardiothoracic Surgery, Port Said University, Port Said, Egypt (Wahba, Said) Division of Pediatric and Adult Congenital Cardiac Surgery, Westchester Medical Center and Maria Fareri Children's Hospital, New York Medical College, Valhalla, NY, United States (Elmezayen) Department of Surgery, Kafr Elsheikh University, Kafr Elsheikh, Egypt (Elbahy, Elshabrawi) Department of Surgery, Port Said University, Port Said, Egypt (Ehmidat) Department of Surgery, Alexandria University, Alexandria, Egypt (Said) Department of Cardiothoracic Surgery, Alexandria University, Alexandria, Egypt Publisher Elsevier Inc. Abstract Objective The Ross procedure offers superior hemodynamics and growth potential for patients with unrepairable aortic valve disease, but pulmonary autograft dilation and progressive neoaortic valve regurgitation remain key limitations. Complete autograft reinforcement with Dacron has been proposed to enhance structural stability and prevent dilation. However, concerns persist regarding potential autograft distortion, impaired leaflet coaptation, and increased valve regurgitation. This systematic review and meta-analysis compares clinical outcomes of fully Dacron-supported versus unsupported or partially supported autografts in the Ross procedure. Methods A comprehensive literature search of PubMed, Web of Science, Cochrane, and Scopus databases was conducted from inception through March 30, 2026. Five retrospective comparative cohort studies including a total of 526 patients met inclusion criteria. Outcomes evaluated were early mortality (<=30 days), overall survival, freedom from autograft reoperation, and incidence of moderate or greater neoaortic valve regurgitation. Pooled risk ratios (RRs) with 95% CIs were calculated using random-effects meta-analysis. Results No significant differences were observed between fully supported and unsupported/partially supported groups for early mortality (RR, 2.52; 95% CI, 0.28-22.51; P = .41, I 2 = 0%), overall survival (RR, 0.99; 95% CI, 0.97-1.00], P = .14, I 2 = 0%), freedom from autograft reoperation (RR, 0.90; 95% CI, 0.76-1.07], P = .25, I 2 = 79.1%), or incidence of moderate or greater neoaortic valve regurgitation (RR, 2.00; 95% CI, 0.39-10.25; P = .41, I 2 = 73.5%). Conclusions Complete Dacron reinforcement of the pulmonary autograft does not increase the risk of neoaortic valve regurgitation or adversely affect clinical outcomes compared with unsupported or partially supported autografts. This technique offers a viable strategy to improve autograft durability and may enable the Ross procedure's application in patients previously deemed suboptimal candidates. Surgical technique should be tailored to individual patient profiles and institutional expertise, rather than standardized adoption of one technique. Copyright © 2026 The Author(s). <4> Accession Number 2049871374 Title Crystalloid vs colloid for Hemodynamics during Anesthesia INduction in TAVR patients (CHAIN-T): study protocol for a randomized controlled trial. Source Trials. 27(1) (no pagination), 2026. Article Number: 616. Date of Publication: 01 Dec 2026. Author Tuo X.; Wang F.; Chen Y.; Chen M.; Lu Z. Institution (Tuo, Wang, Chen, Chen, Lu) Department of Anesthesiology and Perioperative Medicine, Shaanxi Provincial Key Laboratory of Traditional Chinese Medicine, Xijing Hospital, Fourth Military Medical University, Changle West Rd. 127, Xi'an Shaanxi, China Publisher BioMed Central Ltd Abstract Objective: To assess whether preload with colloids could reduce hypotension during induction in patients undergoing transcatheter aortic valve replacement (TAVR) compared to crystalloids. Method(s): This study is a single-center, prospective, randomized, double-blind, parallel-controlled trial conducted at Xijing Hospital. A total of 116 patients scheduled for elective TAVR under general anesthesia will be randomly assigned in a 1:1 ratio to either the colloid group or the crystalloid group, receiving either 5 ml/kg of colloid or crystalloid solution before anesthesia induction infused over 15 min. The primary outcome is the area under curve (AUC) of the change in mean arterial pressure (MAP) from baseline during the induction period (until 15 min after induction). Secondary outcomes include the incidence of intraoperative hemodynamic instability, the use of intraoperative vasoactive drugs, the Sequential Organ Failure Assessment (SOFA) score on the first postoperative day, postoperative hospital length of stay, the rate of intensive care unit (ICU) admission postoperatively, all-cause mortality during hospitalization and by 30 days after surgery, and the incidence of renal replacement therapy by 30 days after surgery. Discussion(s): The results of this study will provide evidence on optimizing fluid preload to prevent hypotension during induction, reduce postoperative complications, and enhance recovery for patients undergoing TAVR. The findings are expected to promote anesthesia protocols in this patient population. Trial registration: The study protocol and statistical analysis plan were approved by the institutional Ethics Committee of Xijing Hospital, Fourth Military Medical University (XJLL-KY-20252560). The study was registered in ClinicalTrials.gov (NCT07329660) on December 29, 2025. Copyright © The Author(s) 2026. <5> Accession Number 2049870330 Title Fetal cardiac interventions versus expectant management in congenital heart disease: a systematic review and meta-analysis. Source BMC Pregnancy and Childbirth. 26(1) (no pagination), 2026. Article Number: 1193. Date of Publication: 01 Dec 2026. Author Ning P.; Liu J.; Lin S.; Zhao C.; Ji Z.; Pan S. Institution (Ning, Liu, Zhao, Ji, Pan) Heart Center, Women and Children's Hospital, Qingdao University, Qingdao, China (Lin) Department of Pediatric Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China Publisher BioMed Central Ltd Abstract Objectives: To evaluate biventricular circulation (BVC), live birth, and postnatal mortality after fetal cardiac intervention (FCI) compared with expectant management, and to examine outcomes according to technical success of FAV. Method(s): This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Embase, Web of Science, and Cochrane Library were searched from database inception through 31 December 2025 for observational FCI studiehis systematic review and meta-analysis followed PRISs. The primary analysis was limited to studies with an internal expectant-management comparator; eligible non-comparative FAV studies were considered only for the secondary technical-success analysis. Random-effects meta-analyses were performed in Stata, and heterogeneity was assessed using I2. Result(s): Eleven comparative reports representing 11 independent study populations were included in the primary FCI-versus-expectant-management synthesis, comprising 775 fetuses (418 interventions and 357 controls). Overall FCI estimates included both technically successful and unsuccessful procedures. Among cohorts with available live-birth data, live birth occurred in 271/315 (86.0%) FCI cases and 287/319 (90.0%) controls, with no significant difference between groups (OR 0.680, 95% CI 0.350-1.320; p = 0.256). Postnatal death among live-born infants with available postnatal outcome data occurred in 53/271 (19.6%) in the FCI group and 94/287 (32.8%) in the expectant-management group and was lower after FCI (OR 0.457, 95% CI 0.280-0.746; p = 0.002). For FAV, postnatal death among live-born infants was lower (OR 0.419, 95% CI 0.216-0.813; p = 0.010), whereas BVC showed a non-significant trend (OR 2.260, 95% CI 0.970-5.290; p = 0.060). Fetal pulmonary valvuloplasty (FPV) showed no significant association with BVC (OR 2.430, 95% CI 0.880-6.760; p = 0.088) or postnatal death among live-born infants (OR 0.432, 95% CI 0.098-1.909; p = 0.268). Technically successful FAV was associated with higher odds of BVC and live birth compared with unsuccessful FAV. Fetal atrial septal intervention (FASI) analyses included live birth and postnatal death among live-born infants only. No statistically significant difference was found for live birth (OR 0.480, 95% CI 0.110-2.060; p = 0.325) or postnatal death among live-born infants (OR 0.433, 95% CI 0.127-1.482; p = 0.183). Conclusion(s): FAV was associated with lower odds of postnatal death among live-born infants and showed a non-significant trend toward improved BVC, while technically successful FAV was associated with higher odds of BVC and live birth than unsuccessful FAV. In contrast, comparative evidence for FPV and FASI remains sparse, and these findings should be interpreted as exploratory. Copyright © The Author(s) 2026. <6> Accession Number 2049300670 Title Subvalvular Aortic Stenosis: Current Insights into an Often Overlooked Cause of Left Ventricular Outflow Tract (LVOT) Obstruction. Source Medical sciences. 14(5) (no pagination), 2026. Article Number: 515. Date of Publication: 01 Sep 2026. Author Leivaditis V.; Papatriantafyllou A.; Mulita F.; Androutsopoulou V.; Liolis E.; Tasios K.; Antzoulas A.; Litsas D.; Skoura T.; Nikolakopoulos K.; Papadoulas S.; Baikoussis N.G. Institution (Leivaditis, Papatriantafyllou) Westpfalz Klinikum, Department of Cardiothoracic and Vascular Surgery, Kaiserslautern, Germany (Mulita) Second Department of Surgery, Medical School, Democritus University of Thrace, Alexandroupolis, Greece (Androutsopoulou) Department of Cardiothoracic Surgery, Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece (Liolis) General University Hospital of Patras, Department of Oncology, Patras, Greece (Tasios) John Radcliffe Hospital Emergency Department, University Hospitals NHS Foundation Trust, Headley Way, Headington, Oxford, United Kingdom (Antzoulas) General University Hospital of Patras, Department of Surgery, Patras, Greece (Litsas) General Hospital of Lamia, Department of Surgery, Lamia, Greece (Skoura) Medical School, National and Kapodistrian University of Athens (NKUA), Aretaeion Hospital, Athens, Greece (Nikolakopoulos, Papadoulas) University of Patras, Department of Vascular Surgery, Patras, Greece (Baikoussis) Ippokrateio General Hospital of Athens, Department of Cardiac Surgery, Athens, Greece Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Subvalvular aortic stenosis (SAS) is an important cause of fixed left ventricular outflow tract obstruction and the second most common form of aortic stenosis. Although traditionally considered a congenital lesion, increasing evidence suggests that SAS often behaves as a progressive condition influenced by anatomical and hemodynamic factors. The disease may lead to significant complications, including left ventricular hypertrophy and progressive aortic regurgitation. Material(s) and Method(s): A narrative review of the current literature was performed to summarize contemporary knowledge regarding the epidemiology, pathophysiology, clinical presentation, diagnostic evaluation, and management of subvalvular aortic stenosis. Relevant studies were identified through searches of major medical databases and were critically analyzed to provide an overview of current concepts and clinical practice. Result(s): Subvalvular aortic stenosis demonstrates considerable anatomical and clinical heterogeneity, ranging from discrete subaortic membranes to fibromuscular tunnel-type obstruction. The condition often progresses over time, with increasing LVOT gradients and a high incidence of associated aortic regurgitation. Echocardiography remains the primary diagnostic modality, while advanced imaging techniques provide additional anatomical detail and assist in surgical planning. Surgical resection remains the cornerstone of treatment when significant obstruction or related complications develop. Conclusion(s): Subvalvular aortic stenosis is a complex and progressive disease requiring careful imaging assessment and timely surgical management. Although surgical outcomes are generally excellent, recurrence and progressive aortic valve involvement remain important long-term considerations. Ongoing research aimed at improving risk stratification and optimizing surgical strategies may further enhance patient outcomes. Copyright © 2026 by the authors. <7> Accession Number 2050640922 Title Latest findings on complications following trans- catheter aortic valve replacement: A literature review. Source American Heart Journal Plus: Cardiology Research and Practice. 71 (no pagination), 2026. Article Number: 100964. Date of Publication: 01 Nov 2026. Author Rezaei M.; Hekmatpou D.; Abbasi M.; Baghernezhad A.R.; Ahmadi N. Institution (Rezaei) Department of Medical and Surgical Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran, Islamic Republic of (Rezaei, Hekmatpou) Traditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran, Islamic Republic of (Abbasi) Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Baghernezhad) Department of Nursing, Khomein University of Medical Sciences, Khomein, Iran, Islamic Republic of (Ahmadi) Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Hekmatpou) School of Nursing, Arak University of Medical Sciences, Arak, Iran, Islamic Republic of Publisher Elsevier Inc. Abstract Background: Severe aortic stenosis (As) is the most common valvular heart disease in developed countries, and transcatheter aortic valve replacement (TAVR) has expanded across surgical risk groups. However, procedure-related complications remain clinically important, and their reported incidence and management have evolved with newer-generation devices and techniques. This review summarizes major TAVR complications, including their incidence and pathophysiology, risk factors, clinical impact, prevention and management, and outlines remaining knowledge gaps. Material(s) and Method(s): A structured narrative review of PubMed/MEDLINE, Scopus, and Web of Science was conducted for studies published between 2012 and 2026, including randomized trials, registries, cohort studies, and systematic reviews. Result(s): Major complications reviewed included Stroke, Delirium, Conduction disturbances (CD) and Arrhythmias, Bleeding/Vascular(access) site injuries/Paravalvular leak (PVL), Acute Kidney Injury (AKI), Structural valve degeneration and thrombosis, Infective Endocarditis (IE) and Coronary Obstruction (CO). Conclusion(s): TAVR complications remain multifactorial, and their incidence and management continue to shift with device evolution and procedural experience. Optimized patient selection, procedural refinement, frailty assessment, and individualized antithrombotic strategies remain important areas for improving outcomes. Copyright The Authors This is an open access article under the CC BY-NC license. http://creativecommons.org/licenses/by-nc/4.0/ <8> Accession Number 2049826321 Title Biomarker changes after surgical left atrial appendage occlusion: a substudy of the Left Atrial Appendage Occlusion Study III. Source Journal of Thrombosis and Haemostasis. (no pagination), 2026. Date of Publication: 2026. Author Lauw M.N.; Eikelboom J.W.; Yi Q.; Belley-Cote E.P.; Weitz J.I.; Whitlock R.P. Institution (Lauw) Department of Hematology, Erasmus University Medical Center, Rotterdam, Netherlands (Lauw, Eikelboom, Belley-Cote, Whitlock) Population Health Research Institute, Hamilton, ON, Canada (Eikelboom, Weitz) Thrombosis and Atherosclerosis Research Institute, Hamilton, ON, Canada (Eikelboom, Belley-Cote, Weitz) Department of Medicine, McMaster University, Hamilton, ON, Canada (Yi) School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada (Weitz) Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada (Weitz) Department of Medical Sciences, McMaster University, Hamilton, ON, Canada (Whitlock) Department of Surgery, McMaster University, Hamilton, ON, Canada Publisher Elsevier B.V. Abstract Background The Left Atrial Appendage Occlusion Study (LAAOS) III showed that surgical left atrial appendage occlusion (LAAO) reduced ischemic stroke or systemic embolism (SE) in patients with atrial fibrillation (AF) undergoing cardiac surgery. Objectives To explore whether LAAO changes levels of circulating biomarkers of coagulation activation, inflammation, hemodynamic stress, or myocardial injury after surgical LAAO. Methods In this single-center biomarker substudy of LAAOS III, D-dimer, C-reactive protein, interleukin-6, N-terminal pro-B-type natriuretic peptide, high-sensitivity cardiac troponin T, and heart-type fatty acid-binding protein were measured at baseline and at 30 days and/or 1 year in patients randomized to LAAO or no LAAO. Biomarker levels and changes from baseline were compared by treatment group. Exploratory landmark Cox models assessed associations between biomarker changes and subsequent stroke/SE after the 30-day and 1-year landmarks. Results Baseline samples were available for 208 participants, 30-day samples for 170, and 1-year samples for 123. Baseline biomarker levels were similar between groups. At 30 days, all measured biomarkers increased without between-group differences. At 1 year, most biomarkers had returned toward baseline. Too few events occurred after the 30-day and 1-year landmarks to support reliable analyses on biomarker changes and subsequent stroke/SE. Conclusion Despite its clinical benefit in patients with AF, surgical LAAO was not associated with consistent changes in circulating biomarkers over 1 year in this exploratory substudy. The lack of a detectable effect on the circulating biomarkers evaluated in this study does not provide a mechanistic explanation for the clinical benefit of surgical LAAO. Copyright © 2026 The Authors. <9> Accession Number 2050762321 Title Comparing the Long-term Outcomes of Coronary Artery Bypass Grafting (CABG) vs. Percutaneous Coronary Intervention (PCI) in Patients with Multivessel Disease- A Systematic Review and Meta-analysis. Source Current Cardiology Reviews. 22(7) (no pagination), 2026. Date of Publication: 2026. Author Ray R.; Singla S.; Virk G.S.; Hack S.; Abbas Z.; Murugesan H.A.; Mahmood A.; Shah M.; Khalid S.; Afzal S.; Izzat I. Institution (Ray) Bankura Sammilani Medical College, Bankura, India (Singla) Tidal Health, Salisbury, MD, United States (Virk) Avalon University School of Medicine, Willemstad, Curacao (Hack) St. George's University, St. George's, Grenada (Abbas) Quaid e Azam Medical College, Bahawalpur, Pakistan (Murugesan) Department of MBBS, Government Vellore Medical College, Vellore, India (Mahmood) Henry Ford Health System, Detroit, United States (Shah) King Edward Medical University, Lahore, Pakistan (Khalid) Department of MBBS, Jinnah Medical & Dental College, Karachi, Pakistan (Afzal) Department of MBBS, Lahore Medical and Dental College, Lahore, Pakistan (Izzat) Caribbean Medical University, Willemstad, Curacao Publisher Bentham Science Publishers Abstract Introduction: Coronary Artery Bypass Grafting (CABG) and Percutaneous Coronary Intervention (PCI) are standard treatments for Multivessel Coronary Artery Disease (MVD). Their long-term comparative effectiveness remains debated. Method(s): A systematic review and meta-analysis of randomized and observational studies was conducted, including patients with MVD followed for >=5 years. Data were pooled using random- or fixed-effects models, depending on the level of heterogeneity. Result(s): Thirteen studies met the inclusion criteria. CABG was associated with reduced all-cause mortality (RR 0.82, 95% CI 0.72-0.91) and fewer repeat revascularizations (RR 1.98, 95% CI 1.74-2.26) compared with PCI. Stroke risk was slightly higher after CABG. Discussion(s): Findings suggest CABG provides superior survival and event reduction in long-term follow-up, particularly in higher-risk subgroups. However, the modestly increased stroke risk highlights the need for individualized decision-making, taking into account patient comorbidities, anatomy, and surgical suitability. Conclusion(s): CABG offers long-term survival and durability advantages over PCI in MVD, while PCI remains suitable for patients with lower-risk anatomy or when surgery is contraindicated. Copyright 2026, Bentham Science Publishers <10> Accession Number 2044357345 Title The additive value of preprocedural cardiac computed tomography angiography (CCTA) planning in percutaneous left atrial appendage occlusion: a systematic review and meta-analysis. Source Journal of Interventional Cardiac Electrophysiology. 69(7) (pp 2071-2084), 2026. Date of Publication: 01 Oct 2026. Author Balbaa E.; Rakab M.S.; Gadelmawla A.F.; Amin A.M.; Tawfik A.M.; Elgendy A.; AL-Ihribat A.R.; Turkmani M.; Altobaishat O.; Elgendy M.S.; Shubietah A.; Abuelazm M. Institution (Balbaa, Tawfik) Faculty of Medicine, Alexandria University, Alexandria, Egypt (Rakab, Amin, Elgendy) Faculty of Medicine, Mansoura University, Mansoura, Egypt (Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia, Egypt (AL-Ihribat) Faculty of Medicine, Palestine Polytechnic University, Hebron, Palestine (Turkmani) Faculty of Medicine, Michigan State University, East Lansing, MI, United States (Turkmani) Division of Pulmonary and Critical Care, University of Toledo, Toledo, OH, United States (Altobaishat) Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan (Elgendy, Abuelazm) Faculty of Medicine, Tanta University, Tanta, Egypt (Shubietah) Department of Medicine, Advocate Illinois Masonic Medical Center, Chicago, IL, United States Publisher Springer Abstract Background: Cardiac computed tomography angiography (CCTA) is increasingly used to guide left atrial appendage occlusion (LAAO) by providing a detailed anatomical assessment. However, its incremental value over conventional planning methods, such as transesophageal echocardiography or fluoroscopy, remains uncertain. This study evaluated the additive value of CCTA-guided planning in percutaneous LAAO. Method(s): A systematic review and meta-analysis conducted using PubMed, Embase, CENTRAL, Scopus, and Web of Science, up to September 2024 (updated in July 2025). Dichotomous outcomes were pooled as risk ratios (RR), while continuous outcomes were pooled as mean differences (MD) along the corresponding 95% confidence intervals (CI). PROSPERO ID: CRD42024600363. Result(s): Six studies comprising 978 patients with follow-up periods of up to 90 days were included. The CCTA-guided group had significant higher device implantation success [RR: 1.06; 95% CI (1.01, 1.11), P = 0.028], a lower device resizing [RR: 0.42; 95% CI (0.26, 0.66), P = 0.0002], and a lower procedure time [MD: -13.29 min; 95% CI (-23.72, -2.86), P = 0.01]. There was no significant difference between the two groups in device-related embolization [P = 0.38], peri-device leakage [P = 0.16], radiation dose [P = 0.84], and contrast utilization [P = 0.96]. Conclusion(s): Adding CCTA to preoperative planning for LAAO as a complementary modality can increase implantation success rate, improve device selection accuracy, and shorten procedure time without increasing adverse events or contrast use with substantial heterogeneity and divergent subgroups. However, limited follow-up restricts long-term safety conclusions. Further large-scale, long-term randomized trials are needed to validate these findings. Copyright © The Author(s) 2026. <11> Accession Number 2049137074 Title 'Aspirin versus ticagrelor for the management after coronary revascularization - a systematic review and meta-analysis of randomised trials'. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 811. Date of Publication: 01 Dec 2026. Author Regmi D.R.; Regmi S.; Upreti S.; Gautam N. Institution (Regmi) Nepalese Army Institute of Health Sciences (NAIHS), Bhandarkhal, Syanobharyang, Kathmandu, Nepal (Regmi, Upreti) Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal (Gautam) Gulmi Durbar Basic Hospital, Gulmi, Nepal Publisher BioMed Central Ltd Abstract Objective: To compare the efficacy and safety of ticagrelor monotherapy versus aspirin monotherapy in patients with coronary artery disease undergoing coronary revascularization. Method(s): We conducted a systematic review and meta-analysis of RCTs comparing ticagrelor monotherapy with aspirin monotherapy after PCI or CABG. MEDLINE, Embase, Cochrane Central, Scopus, ClinicalTrials.gov and Google Scholar were searched up to 19th January 2026. The primary outcome was major adverse cardiovascular events (MACE), a composite of all-cause mortality, myocardial infarction and stroke. Secondary outcomes included all-cause mortality, myocardial infarction, stroke, major bleeding, repeat revascularization and stent thrombosis. Risk ratios (RRs) with 95% CIs were pooled using a random-effects model with restricted maximum likelihood estimation and Knapp-Hartung adjustment. Result(s): Five randomised trials involving 25,994 participants were included, of whom 12,998 received ticagrelor monotherapy and 12,996 received aspirin monotherapy. Ticagrelor monotherapy was associated with a significantly lower risk of MACE than aspirin monotherapy (RR 0.86, 95% CI 0.78 to 0.95; p = 0.012; I2 = 0%). All-cause mortality was also reduced with ticagrelor (RR 0.86, 95% CI 0.77 to 0.97; p = 0.023; I2 = 0%). No significant differences were observed for myocardial infarction (RR 0.87, 95% CI 0.70 to 1.07; p = 0.138; I2 = 0%), stroke (RR 1.01, 95% CI 0.85 to 1.19; p = 0.913; I2=0%), major bleeding (RR 1.00, 95% CI 0.84 to 1.20; p = 0.976; I2 = 0%), repeat revascularization (RR 0.89, 95% CI 0.58 to 1.37; p = 0.452; I2 = 45.8%) or stent thrombosis (RR 0.88, 95% CI 0.20 to 3.90; p = 0.481; I2 = 0%). Conclusion(s): Ticagrelor monotherapy was associated with a potential reduction in MACE and all-cause mortality compared with aspirin monotherapy after coronary revascularisation, without increasing major bleeding. However, these findings were driven primarily by PCI trials, particularly the GLOBAL LEADERS and GLASSY trial program, and should be interpreted cautiously because PCI and CABG populations were analyzed together. Trial registratrion: CRD420261286239 Copyright © The Author(s) 2026. <12> Accession Number 2041703974 Title Thoracic Ultrasound-Guided Regional Nerve Blockade for Pain Management Following Open Heart Surgery in Children: A Systematic Review and Network Meta-analysis of Analgesic Efficacy and Impact on Postoperative Opioid Requirements. Source Pediatric Cardiology. 47(8) (pp 3210-3222), 2026. Date of Publication: 01 Dec 2026. Author Abdelhady E.; Elmitwalli I.; Saber A.; Elhamrawy A.; Tobias J.D. Institution (Abdelhady, Tobias) Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, United States (Elmitwalli) Department of Pediatrics, University of Oklahoma Children's Hospital, Oklahoma City, OK, United States (Saber) Department of Cardiology, Minia Cardiothoracic University Hospital, New Minya, Egypt (Elhamrawy) Detroit Medical Center, Wayne State University, Detroit, MI, United States (Tobias) Department of Anesthesiology & Pain Medicine, The Ohio State University College of Medicine, Columbus, OH, United States Publisher Springer Abstract A new era of multimodal opioid-sparing pain management strategies has begun, aiming to control pain while limiting the use of opioids and their associated adverse effects. Peripheral nerve blockade, either single-shot or continuous catheter techniques, constitute an important cornerstone of these strategies. This systematic review and network meta-analysis aimed to compare and evaluate the effects of different single-shot ultrasound-guided regional anesthetic techniques on pain control following open cardiac surgical procedures in pediatric patients. A systematic review and comprehensive search were conducted to retrieve available randomized clinical trials focusing on the use of ultrasound-guided regional anesthesia nerve blockade as part of a multimodal analgesia approach in pediatric patients undergoing open cardiac surgery through median sternotomy. Our search was conducted in major databases, including MEDLINE, EMBASE, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials. The main outcomes of interest were perioperative opioid consumption and postoperative pain scores. A total of 1,511 articles were retrieved for the initial screening of titles, with 16 RCTs deemed eligible and included after full-text screening. Eleven different regional nerve blocks were assessed in the studies, including erector spinae plane block (ESPB), thoracic paravertebral block (PVB), deep parasternal block (DPB), superficial parasternal block (SPB), thoracic retrolaminar paravertebral block (TRLB), pectoral nerve block type II (PECS II), and multiple injection costotransverse block (MICB). Compared to no intervention, parasternal blocks particularly DPB and SPB were associated with a significant reduction in both intraoperative and 24-h postoperative fentanyl consumption. Postoperatively, fentanyl consumption was reduced by -4.92 microg/kg (95% CI: [-6.58 to -3.26]) with DPB, -2.54 microg/kg (95% CI: [-4.16 to -0.91]) with SPB, and -5.6 microg/kg (95% CI: [-8.31 to -2.89]) with TRLB. Intraoperatively, SPB reduced fentanyl use by -5.12 microg/kg (95% CI: [-6.8 to -3.43]) and DPB by -4.31 microg/kg (95% CI: [-5.9 to -2.71]). No significant postoperative opioid-sparing effect was observed with other blocks, such as ESPB, PVB, MICB, or PECS II. The pooled estimates showed considerable heterogeneity, with I2 values of 90.9% for intraoperative and 94.7% for postoperative fentanyl consumption. Ultrasound-guided regional anesthesia-particularly parasternal blocks-may offer superior opioid-sparing effects and enhanced recovery in children undergoing open-heart surgery, making them promising adjuncts to multimodal analgesia. In contrast, blocks such as ESPB, PVB, and MICB showed limited benefit for median sternotomy pain. Given the substantial heterogeneity in the current evidence, the routine use of these techniques should be guided by institutional experience and individualized patient factors. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2025. <13> Accession Number 2045082230 Title Mckeown Esophagectomy: Minimally Invasive Robot-Assisted vs Conventional Technique - Systematic Review and Meta-Analysis of Randomized Clinical Trial. Source Surgical Innovation. 33(6) (pp 628-636), 2026. Date of Publication: 01 Dec 2026. Author Neves A.D.; Comprido J.M.; Grillo I.T.C.; De Melo B.; Pompeu B.F. Institution (Neves) Department of Medicine, Ural State Medical University, Yekaterinburg, Russian Federation (Comprido) Department of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Brazil (Grillo) Department of Medicine, University of Buenos Aires, Buenos Aires, Argentina (De Melo) Department of Medicine, University of Santo Amaro, Sao Paulo, Brazil (Pompeu) Department of General Surgery, Heliopolis Hospital, Sao Paulo, Brazil (Pompeu) University of Sao Paulo Caetano do Sul, Sao Paulo, Brazil Publisher SAGE Publications Inc. Abstract Introduction: Currently, conventional minimally invasive esophagectomy (MIE) is the preferred surgical approach for esophageal cancer. Despite the increasing popularity of robot-assisted minimally invasive esophagectomy (RAMIE), its potential advantages over MIE are yet unknown. Method(s): We searched PubMed, Embase, and the Cochrane database for randomized controlled trials (RCTs) comparing RAMIE to MIE in patients with esophageal cancer that reported the outcomes of interest. Mean differences (MD) with 95% confidence intervals (CI) were collected. Statistical analysis was performed using Review Manager 5.4 (Cochrane Collaboration). Heterogeneity was assessed with I2 statistics. Result(s): We included three RCTs with 721 patients, of whom 364 (50,4%) underwent RAMIE. The number of dissected nodes increased in patients undergoing RAMIE (MD 3.72; 95% CI 1.07 to 6.37; P = 0.006). Similar results were observed in a subanalysis of the number of dissected thoracic nodes (MD 1.36 nodes; 95% Cl 0.12 to 2.61; P = 0.03), but not abdominal nodes (MD 0.30 nodes; 95% Cl -0.69 to 1.29; P = 0.55). RAMIE was associated with a reduction in blood loss (MD -47.76 mL; 95% Cl -70.06 to -25.46; P = <0.0001), thoracic operative time (MD -21.96 minutes; 95% Cl -33.82 to -10.10; P = 0.0003) and abdominal operative time (MD -15.10 minutes; 95% Cl -18.51 to -11.69; P = <0.00001) compared to MIE. Conclusion(s): This meta-analysis of RCTs found that, in patients with esophageal cancer, RAMIE increased the number of dissected nodes and reduced blood loss and operative time compared with MIE. Copyright © The Author(s) 2026 <14> Accession Number 2050610767 Title Coronary microvascular dysfunction in patients undergoing transcatheter aortic valve implantation: A systematic review and meta-analysis. Source PLOS One. 21(10 October) (no pagination), 2026. Article Number: e0360374. Date of Publication: 01 Oct 2026. Author Panyawongkhanti M.; Chintrakulchai P.; Tanking C.; Luangphiphat W. Institution (Panyawongkhanti, Chintrakulchai, Luangphiphat) Princess Srisavangavadhana Faculty of Medicine, Chulabhorn Royal Academy, Bangkok, Thailand (Tanking) Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand Publisher Public Library of Science Abstract Background: Coronary microvascular dysfunction (CMD) is a complication of severe aortic stenosis. Its prevalence after transcatheter aortic valve implantation (TAVI) and prognostic significance are understudied, as are the post-TAVI trajectories of microvascular indices. Aim(s): The aims of this study were to determine the pooled prevalence of CMD, the influence of the diagnostic modality, the post-TAVI coronary flow reserve (CFR) and microvascular resistance changes, and the prognostic impact of baseline CMD on major adverse cardiovascular events (MACE) in patients with severe aortic stenosis undergoing TAVI. Method(s): Five databases were searched from January 2010 to December 2025 for studies involving adults with severe aortic stenosis undergoing TAVI in which CMD was assessed by wire-based thermodilution, angiography-derived indices, Doppler measurements, or stress cardiac magnetic resonance. The risk of bias and certainty of evidence were assessed using the Newcastle-Ottawa Scale and GRADE, respectively. Random-effects meta-analyses (DerSimonian-Laird) pooled CMD prevalence (stratified by modality), CFR change (mean difference; before-after design), and prognostic hazard ratios (HRs). Change in microvascular resistance was synthesized narratively. The protocol was prospectively registered (PROSPERO: CRD42025143775) and reported per the PRISMA 2020 guidance. Result(s): Eleven primary studies were analyzed, 10 of which (n = 1,212) contributed to the prevalence analyses. An additional study (n = 126) was included in the sensitivity analyses only. CMD prevalence was 46.8% (95% confidence interval [CI] [34.0, 59.9]; I2 = 72%) and 38.4% (95% CI [35.3, 41.7]; I2 = 0%) when assessed using wire-based thermodilution (k = 6, n = 324) and angiographic (k = 4, n = 888) indices, respectively. CFR increased post-TAVI by a pooled mean difference of +0.49 (95% CI [+0.27, + 0.71]; I2 = 72%; k = 5, n = 103 paired observations). Reductions in microvascular resistance were confined to pressure-to-velocity and reserve ratio indices, and absolute minimal microvascular resistance was unchanged (k = 4, n = 85). The HR for MACE was 3.22 (95% CI [0.98, 10.60]; I2 = 78%; k = 2, n = 585). Substantial heterogeneity reflected non-equivalent CMD definitions. Conclusion(s): The prevalence of CMD pre-TAVI is influenced by the diagnostic method. CFR tends to improve after TAVI, likely due to reduced resting demand rather than structural repair. The CMD-MACE association should be viewed as hypothesis-generating due to limited studies, varied CMD definitions, and incompatible HR calculations. Prospective multicenter studies with standardized CMD definitions are required. Copyright © 2026, Panyawongkhanti 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. <15> Accession Number 2046549160 Title Which Non-pharmacological Sleep Interventions Are Most Effective After Cardiac Surgery?: A Network Meta-Analysis. Source Journal of Cardiovascular Nursing. 41(4) (pp 276-290), 2025. Date of Publication: 20 Oct 2025. Author Lee S.; Park C.G.; Chen P.; Saban K. Institution (Lee) Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, IL, United States (Park) College of Nursing, University of Illinois Chicago, United States (Chen) College of Nursing, University of Illinois Chicago, United States (Saban) Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, IL, United States Publisher Lippincott Williams and Wilkins Abstract Background: - Sleep disturbances are common after cardiac surgery. Although nonpharmacological interventions such as cognitive behavioral therapy (CBT), relaxation, and sleep hygiene practices have shown effectiveness for improving sleep, their relative impact remains unclear. Objective(s): - We applied network meta-analysis (NMA) to compare multiple nonpharmacological interventions and identify the most effective approach for improving sleep quality in patients after cardiac surgery. Method(s): - Following PRISMA-NMA guidelines, comprehensive searches across 6 databases were conducted in February 2025. Randomized controlled trials examining nonpharmacological interventions to improve sleep quality in postsurgical cardiac patients were included. All trials used the Pittsburgh Sleep Quality Index as the outcome measure. We performed NMA using STATA to determine the most effective intervention. Result(s): - Nineteen studies involving 1944 participants were examined. Interventions included education, relaxation, CBT, family-centered care, resistance exercise, aromatherapy, use of eye masks and earplugs, and combined therapies. Nonpharmacological interventions significantly improved sleep quality after cardiac surgery (standardized mean difference, 1.02; 95% confidence interval, -1.50 to -0.54). Among the interventions, CBT emerged as the most effective (surface under the cumulative ranking curve = 88.5%). Conclusion(s): - Our findings highlight the clinical value of CBT for postsurgical sleep management and support development of standardized guidelines for its implementation. Future research should explore a broader range of nonpharmacological interventions, assess their effectiveness across different types of cardiac surgeries, and investigate alternative CBT models such as online or shortened versions tailored to this population. Integrating CBT into routine postoperative care could enhance patient sleep, recovery, and well-being after cardiac surgery. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved. <16> Accession Number 2050716789 Title Comparing High-Flow Nasal Cannula Therapy and Conventional Oxygen Therapy in Adult Patients Post-Cardiac Surgery: A Systematic Review and Meta-Analysis. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Khan M.M.; Bacha Z.; Khan F.A.; Shahbaz H.; Rahman Q.H.U.; Habiba U.; Murad M.; Ali A.; Ahmed S.U.; Hamza A.; Sami I.; Muryem S.; Awais I.; Rehman M.U.; Ahmad S.; Kumar B. Institution (Khan, Bacha, Rahman, Habiba, Ali, Rehman) Khyber Medical College, Peshawar, Pakistan (Khan) Nowshera Medical College, Nowshera, Pakistan (Shahbaz, Hamza) Ayub Medical College, Abbottabad, Pakistan (Murad) Federal Medical and Dental College, Islamabad, Pakistan (Ali, Sami) Gomal Medical College, Dera Ismail Khan, Pakistan (Ahmed) Bolan Medical College, Quetta, Pakistan (Muryem) Peshawar Medical College, Peshawar, Pakistan (Awais) Faisalabad Medical University, Faisalabad, Pakistan (Ahmad) Sheikh Zayed Medical College, Rahim Yar Khan, Pakistan (Kumar) Jinnah Medical and Dental College, Karachi, Pakistan Publisher W.B. Saunders Abstract Background: Cardiac surgery with cardiopulmonary bypass structurally alters respiratory mechanics and carries a substantial risk of postoperative morbidity. Historically, patients have routinely received conventional oxygen therapy (COT) following extubation. High- flow nasal cannula (HCNC) therapy has emerged as an innovative respiratory support system. By synthesizing all currently available high-quality randomized controlled trials (RCTs), this study aimed to rigorously evaluate the efficacy and safety of HFNC compared to COT, focusing primarily on determining the need for escalation of respiratory support. Methodology: A thorough electronic search was carried out in the PubMed, Embase, and Scopus databases from their inception to May 2026. Only RCTs were considered for analysis. A random-effects model was applied to compute pooled estimates and 95% confidence intervals (CIs). Result(s): A total of 11 RCTs, comprising 2473 patients, were included in this systematic review and meta-analysis. HFNC had a statistically significant effect on reducing the requirement for escalation of respiratory support (risk ratio [RR] = 0.71; 95% CI, 0.55-0.93; p = 0.01). HFNC had a statistically significant effect on improving the arterial partial pressure of oxygen, as well as forced expiratory volume in 1 second, while also increasing delirium complications (RR = 3.63; 95% CI, 1.80-7.30; p = 0.0003). There were no statistically significant differences between the 2 approaches in the other secondary clinical and resource utilization outcomes, including intubation, overall mortality, hospital length of stay, intensive care unit length of stay, and postoperative atrial fibrillation. Conclusion(s): In adult patients recovering from cardiac surgery, HFNC therapy improves oxygenation and significantly curtails the need to escalate respiratory support compared to COT. However, these physiologic and intermediate clinical benefits do not translate into reductions in mortality, reintubation rate, or hospital length of stay and may come at the cost of increased postoperative delirium. Copyright © 2026 Elsevier Inc. <17> Accession Number 2050097847 Title Total Intravenous vs Volatile Inhalational Anesthesia for Major Noncardiac Surgery: A Randomized Clinical Trial. Source JAMA. 336(12) (pp 1039-1049), 2026. Date of Publication: 22 Sep 2026. Author Jhanji S.; Booth K.; Hiller L.; Braun J.; Dunn J.; Eggleston L.; Fenton-May L.; Frempong S.; Gilchrist K.; Jacques C.; Jefford M.; Kandiyali R.; Kaur D.; Mason J.; Moonesinghe S.R.; Pearse R.; Rao Baikady R.; Reynolds T.; Shelley B.; Sinclair R.C.F.; Teare T.; Vindrola-Padros C.; Yeung J. Institution (Jhanji, Rao Baikady) Department of Anesthesia, Perioperative Medicine and Critical Care, Royal Marsden NHS Foundation Trust, London, United Kingdom (Jhanji) Division of Radiotherapy and Imaging, Institute of Cancer Research, London, United Kingdom (Booth, Hiller, Braun, Dunn, Eggleston, Jacques, Jefford, Kaur, Yeung) Warwick Clinical Trials Unit, University of Warwick, Coventry, United Kingdom (Fenton-May) Cardiff and Vale University Health Board, Cardiff, United Kingdom (Frempong, Kandiyali, Mason) Centre for Health Economics at Warwick, University of Warwick, Coventry, United Kingdom (Gilchrist, Moonesinghe, Vindrola-Padros) University College London, London, United Kingdom (Pearse) Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom (Reynolds) Royal London Hospital, London, United Kingdom (Shelley) University of Glasgow, Glasgow, United Kingdom (Sinclair) Royal Victoria Infirmary, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle Upon Tyne, United Kingdom (Teare) Somerset NHS Foundation Trust, Somerset, United Kingdom (Yeung) University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom Publisher American Medical Association Abstract Importance Older adults undergoing major noncardiac surgery experience substantial postoperative morbidity and health care use. The comparative effectiveness of total intravenous anesthesia (TIVA) vs volatile-based inhalational anesthesia on recovery and safety remains uncertain. Objectives To determine whether TIVA improves days alive and at home at 30 days compared with inhalational anesthesia and to evaluate differences in patient-centered outcomes and recovery. Design, Setting, and Participants Pragmatic, multicenter, open-label randomized clinical trial conducted in 49 UK National Health Service hospitals from January 2022 to April 2024 (final follow-up, October 2024) among patients aged 50 years or older scheduled for elective major noncardiac surgery. Interventions Participants were randomized 1:1 to receive maintenance of general anesthesia with either TIVA (propofol infusion) (n = 1254) or volatile-based inhalational agents (n = 1254). All other perioperative care was at clinician discretion. Main Outcomes and Measures The primary outcome was days alive and at home at 30 days. Secondary outcomes included days alive and at home at 90 days; mortality at 30 days, 90 days, and 6 months; Quality of Recovery-15 score at day 3; patient satisfaction (Bauer Patient Satisfaction Questionnaire) at day 1; delirium (4 As Test [4AT]) at day 3; unintentional awareness under anesthesia; and major postoperative complications within 30 days. Results Among the 2508 randomized participants, the mean age was 67 (SD, 8.9) years, and 55% were male. Characteristics were balanced across randomized groups. Days alive and at home at 30 days were similar between groups (mean, 22.5 [SD, 6.8] days vs 22.4 [SD, 6.6] days for TIVA vs inhalational anesthesia, respectively; incidence rate ratio, 1.00; 95% CI, 0.99-1.02; adjusted P =.68). There were no differences in days alive and at home at 90 days; mortality at 30 days, 90 days, or 6 months; or Quality of Recovery-15 score at day 3. Lower rates of thirst, hoarseness, and nausea and vomiting were reported in the TIVA group. Levels of delirium were similar between groups, with the majority (87.6%) having no delirium at day 3. Major complications occurred in 12.4% of patients overall, with no significant between-group differences. Two cases of certain or probable unintentional awareness under anesthesia were reported, both in the TIVA group. Conclusions and Relevance Among older adults undergoing major noncardiac surgery, TIVA did not improve days alive and at home at 30 days compared with inhalational anesthesia. Copyright © 2026 American Medical Association. All rights reserved, including those for text and data mining, AI training, and similar technologies. <18> Accession Number 2045304706 Title Beyond the Average Effect: Identifying the Trauma Patients Who Benefit Most from Tranexamic Acid. Source Thrombosis and Haemostasis. 126(10) (pp 1014-1016), 2026. Date of Publication: 01 Oct 2026. Author Soler-Espejo E.; Roldan V. Institution (Soler-Espejo, Roldan) Department of Hematology, Instituto Murciano de Investigacion Biosanitaria (IMIB-Arrixaca), University of Murcia, Hospital Clinico Universitario Virgen de la Arrixaca, Murcia, Spain Publisher Georg Thieme Verlag <19> 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. <20> Accession Number 2049911946 Title Prevention of radial artery occlusion with rivaroxaban after interventional coronary interventions using transradial access: Results of a single-center randomized clinical trial. Source Journal of Vascular Access. 27(6) (pp 2907-2915), 2026. Date of Publication: 01 Nov 2026. Author Korotkikh A.; Babunashvili A. Institution (Korotkikh) Cardiac Surgery Clinic, Amur State Medical Academy, Blagoveshchensk, Russian Federation (Babunashvili) Department of Interventional Cardioangiology, Sechenov University, Moscow, Russian Federation Publisher SAGE Publications Ltd Abstract Background: Transradial access is the preferred approach for coronary angiography and percutaneous coronary intervention; however, radial artery occlusion (RAO) remains the most common vascular complication and may preclude repeat radial access, radiocephalic arteriovenous fistula creation, and use of the radial artery as a coronary bypass conduit. Most preventive strategies target procedural factors, whereas extended pharmacologic prophylaxis remains insufficiently studied. Objective(s): To evaluate the efficacy of rivaroxaban 2.5 mg twice daily for 3 months in preventing RAO after transradial coronary procedures and to assess bleeding events during follow-up. Method(s): This prospective, single-center, open-label randomized controlled trial enrolled 300 patients with chronic coronary syndrome undergoing coronary angiography or percutaneous coronary intervention via conventional transradial access. Patients were randomized (1:1) to rivaroxaban 2.5 mg twice daily for 3 months or standard therapy without additional anticoagulation. Duplex ultrasound, performed by a blinded assessor at 7 days, 1 month, and 3 months, evaluated the primary endpoint of complete RAO. Bleeding was classified according to Bleeding Academic Research Consortium criteria. Adjusted associations were assessed using Firth penalized logistic regression. Result(s): Rivaroxaban significantly reduced RAO at 7 days (0.7% vs 12.7%; p < 0.001), 1 month (3.3% vs 14.7%; p < 0.001), and 3 months (4.0% vs 13.3%; p = 0.004). At 3 months, the absolute risk reduction was 9.3%, corresponding to a number needed to treat of approximately 11. After adjustment for chronic kidney disease, radial artery diameter, and procedure duration, rivaroxaban remained independently associated with lower RAO (adjusted OR 0.22, 95% CI 0.08-0.61; p = 0.003). No BARC type 3-5 bleeding occurred; four BARC type 1 events were observed. Conclusion(s): In this selected single-center population, prolonged low-dose rivaroxaban was associated with a substantial reduction in ultrasound-detected RAO after transradial coronary procedures. These findings support further multicenter placebo-controlled trials but do not justify routine prophylactic use pending additional safety, cost-effectiveness, and comparative-effectiveness data. Copyright © The Author(s) 2026 <21> Accession Number 2049254544 Title Residual Atherosclerotic Cardiovascular Disease Risk in Statin Users: A Systematic Review and Meta-Analysis. Source Journal of the American Heart Association. 15(17) (no pagination), 2026. Article Number: e044840. Date of Publication: 20 Aug 2026. Author Watanabe A.H.; Bash L.D.; Westley T.; Garcia A.; Aiello E.; Bradbury J.; Garg J.; Telukuntla V.; Nanna M.G. Institution (Watanabe, Bash) Merck & Co, Inc, Rahway, NJ, United States (Westley, Aiello, Bradbury) Lumanity, Sheffield, United Kingdom (Garcia) Lumanity, Utrecht, Netherlands (Garg, Telukuntla) Lumanity, Gurugram, India (Nanna) Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, United States Publisher American Heart Association Inc. Abstract BACKGROUND: Statins are the cornerstone of lipid-lowering therapy, reducing low-density lipoprotein cholesterol in adults. However, residual atherosclerotic cardiovascular disease (ASCVD) risk among statin users remains unclear. This study estimated residual ASCVD risk in statin users in practice. METHOD(S): We conducted a systematic literature review and meta-analyses following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, including observational studies published January 1, 2013, to August 1, 2023, that reported ASCVD risk in adult statin users. Five outcomes were assessed: composite risk (major adverse cardiovascular events or all-cause death), myocardial infarction, ischemic stroke, cardiovascular-related death, and coronary revascularization. Meta-analysis methods were used to synthesize individual study estimates. For each outcome, forest plots present study-level estimates and the pooled incidence rate per 1000 person-years (PPY). RESULT(S): The meta-analysis of residual composite risk (major adverse cardiovascular events or all-cause death) in the overall population was 12.3 PPY (range, 0.2-72.0). Rates were lower in adults at risk of ASCVD (6.4 PPY [range, 3.7-9.8 PPY]) and higher in adults with prior ASCVD (15.8 PPY [range, 0.2-72.0 PPY]). Meta-analysis for myocardial infarction showed 8.23 PPY (range, 1.1-88.82 PPY) in the overall patient population, and a lower rate of ischemic stroke with a rate of 6.0 PPY (range, 1.4-18.8 PPY). A rate of 4.3 PPY (range, 0.4-22.9 PPY) was estimated for cardiovascular-related death, and 7.4 PPY for coronary revascularization (range, 3.1-27.6 PPY). CONCLUSION(S): Despite substantial between-study variability, this real-world meta-analysis indicates meaningful residual ASCVD risk among statin users, underscoring persistent treatment gaps and need for comprehensive, optimized risk management. Copyright © (2026), The Authors and Merck Sharp & Dohme LLC. 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. <22> Accession Number 2050081139 Title Letter to the editor regarding the article "Comparing perioperative heparin bridging strategies in mechanical heart valve patients undergoing surgery: A systematic review and Bayesian meta-analysis". Source Thrombosis Research. 266 (no pagination), 2026. Article Number: 109855. Date of Publication: 01 Oct 2026. Author Zhou J. Institution (Zhou) Department of Pharmacy, Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, China Publisher Elsevier Ltd <23> 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). <24> [Use Link to view the full text] Accession Number 2050099755 Title Staged Versus Concomitant TAVI and PCI for the Treatment of Coexisting Aortic Stenosis and Coronary Artery Disease. Source Cardiology in Review. 34(6) (pp 476-482), 2026. Date of Publication: 01 Dec 2026. Author Shirke M.M.; Wang W.; Welch J.; Faisal F.; Nguyen D.; Harky A. Institution (Shirke) Department of Medicine, University Hospitals NHS Trust, Nottingham, United Kingdom (Wang) Department of Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University Of London, London, United Kingdom (Welch) Department of General Surgery, Sandwell General Hospital, Sandwell and West Birmingham NHS Trust, Birmingham, United Kingdom (Faisal) Department of Medicine, New Vision University, Tbilisi, Georgia (Nguyen) Department of Cardiology, Massachusetts General Hospital, Corrigan Minehan Heart Center, Harvard Medical School, Boston, MA, United States (Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest, Liverpool, United Kingdom Publisher Lippincott Williams and Wilkins Abstract Aortic stenosis (AS) is one of the most common valvular pathologies. Severe coronary artery disease (CAD) often coexists with AS. Transcatheter aortic valve implantation (TAVI) and percutaneous coronary intervention (PCI) have been established as alternatives to open surgical interventions. The data on the timing for the treatment of the 2 conditions are scarce and depend on multiple factors. This review compares the clinical outcomes of the concomitant versus staged PCI and TAVI for the treatment of AS and CAD. A systematic, electronic search was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines to identify relevant articles that compared outcomes of the staged versus concomitant approaches for the TAVI and PCI. Seven studies were included involving 3745 patients. We found no statistically significant difference in primary outcomes such as 30-day mortality [odds ratio (OR) = 0.78; 95% confidence interval (CI): 0.39-1.57] and secondary outcomes including length of hospital stay (mean difference = -4.74, 95% CI: -10.96 to 1.48), new-onset renal failure (OR = 0.83, 95% CI: 0.22-3.13), cerebrovascular accidents (OR = 1.28, 95% CI: 0.64-2.57), and intraoperative blood loss (OR = 0.83, 95% CI: 0.32-2.12). New pacemaker insertion was statistically significant in favor of the concomitant approach (OR = 0.78, 95% CI: 0.63-0.96). This analysis suggests that while the 2 approaches are largely comparable in terms of most outcomes, patients at risk of requiring a pacemaker postprocedure may benefit from a concomitant approach. In conclusion, concomitant TAVI + PCI approach is nonsuperior to the staged approach for the treatment of CAD and AS. This review calls for robust trials in the field to further strengthen the evidence. Copyright © 2024 Wolters Kluwer Health, LLC. All rights reserved. <25> [Use Link to view the full text] Accession Number 2050158007 Title MYSTERY-HF: Myeloperoxidase Inhibition in Patients With Heart Failure and Reduced Ejection Fraction: A Phase II Randomized Controlled Trial. Source Circulation. 151(18) (pp 1372-1374), 2025. Date of Publication: 06 May 2025. Author Braumann S.; Macherey-Meyer S.; Polzin A.; Costard-Jackle A.; Morbach C.; Haring B.; Lapp H.; Ten Cate V.; Gieswinkel A.; Weliwitage J.; Hellmich M.; Michaelsson E.; Nelander K.; Ens-Jager N.; Rosenkranz S.; Geissen S.; Frey N.; Schulze P.C.; Aurell M.; Bohm M.; Frantz S.; Kelm M.; Rudolph V.; Shah S.J.; Wild P.S.; Baldus S. Institution (Braumann, Macherey-Meyer, Rosenkranz, Geisen, Baldus) Faculty of Medicine and University Hospital Cologne, Clinic III for Internal Medicine, University of Cologne, Germany (Weliwitage, Hellmich) Institute of Medical Statistics and Computational Biology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany (Polzin, Kelm) Department of Cardiology, Pulmonology, and Vascular Medicine, University Hospital Dusseldorf, Medical Faculty of the Heinrich Heine University Dusseldorf, Germany (Polzin, Kelm) Cardiovascular Research Institute Dusseldorf, Germany (Costard-Jackle) Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, University Hospital of the Ruhr-Universitat Bochum, Germany (Morbach, Frantz) Departments of Medicine I and Clinical Research and Epidemiology, Comprehensive Heart Failure Center, University Hospital Wurzburg, Germany (Haring, Bohm) Department of Medicine III, Saarland University Hospital, Homburg, Germany (Lapp) Department of Cardiology, Heart Center, Zentralklinik Bad Berka, Germany (Ten Cate, Gieswinkel, Wild) Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Germany (Michaelsson, Aurell) Early Clinical Development, Research and Early Clinical Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals Research and Development, AstraZeneca, Gothenburg, Sweden (Nelander) Cardiovascular, Renal and Metabolism Biometrics, Late Cardiovascular, Renal and Metabolism, BioPharmaceuticals Research and Development, AstraZeneca, Gothenburg, Sweden (Ens-Jager) Coordinating Center for Clinical Trials, Philipps-Universitat Marburg, Germany (Frey) Department of Cardiology, Angiology and Respiratory Medicine, University Hospital Heidelberg, Germany (Schulze) Department of Internal Medicine I, University Hospital Jena, Germany (Rudolph) Clinic for General and Interventional Cardiology/Angiology, Heart and Diabetes Center North Rhine-Westphalia, University Hospital of the Ruhr-Universitat Bochum, Germany (Shah) Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States (Ten Cate, Gieswinkel, Wild) German Center for Cardiovascular Research, Partner Site RhineMain, Mainz, Germany (Wild) Clinical Epidemiology and Systems Medicine, Center for Thrombosis and Hemostasis, University Medical Center Mainz, Germany (Wild) Institute of Molecular Biology, Mainz, Germany (Hellmich) Department of Medical Statistics, University Medical Center Gottingen, Germany Publisher Lippincott Williams and Wilkins <26> Accession Number 2049543300 Title Association of Sodium-Glucose Cotransporter 2 Inhibitor Use With Outcomes in Patients Undergoing Transcatheter Aortic Valve Implantation: A Systematic Review and GRADE-Assessed Meta-Analysis. Source Cardiovascular Therapeutics. 2026(1) (no pagination), 2026. Article Number: 8933859. Date of Publication: 2026. Author Mohamed A.A.; Husain B.H.; Dali T.K.; Ahmed M.E.; Al Shawawreh G.; Galal A.S.; Moussa M.A.; Hibysh A.M.; Shehata A.S.; Ramadan Y.; Aldeeb O.M.; Saeed T.Z.; Dibas M. Institution (Mohamed, Dali, Ahmed, Moussa) Faculty of Medicine, Zagazig University, Zagazig, Egypt (Husain) Faculty of Medicine, Cairo University, Cairo, Egypt (Al Shawawreh) Faculty of Medicine, Mansoura University, Al Mansurah, Egypt (Galal, Saeed) Faculty of Medicine, Assiut University, Assiut, Egypt (Hibysh) Faculty of Medicine, New Ismaila National University, Ismaila, Egypt (Shehata) Faculty of Medicine, South Valley University, Qena, Egypt (Ramadan) Faculty of Medicine, October 6 University, Giza, Egypt (Aldeeb) School of Medicine, The University of Jordan, Amman, Jordan (Dibas) Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine Publisher John Wiley and Sons Inc Abstract Background: Patients undergoing transcatheter aortic valve implantation (TAVI) remain at risk of adverse cardiovascular and renal outcomes despite procedural advancements. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated cardiovascular and renal benefits across various patient populations; however, their role in patients undergoing TAVI remains unclear. This study is aimed at evaluating the association between SGLT2 inhibitor use and clinical outcomes in this population. Method(s): We conducted a systematic review and meta-analysis comparing SGLT2 inhibitors versus non-SGLT2 inhibitors or standard care in patients undergoing TAVI. Major databases were searched through March 2026, with Embase updated through June 2026. Pooled analyses were performed using random-effects models to calculate risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs). Result(s): Five studies involving 6111 patients (SGLT2 inhibitors: n = 2933; control: n = 3178) were included. In primary random-effects models, SGLT2 inhibitors were associated with lower all-cause mortality (RR 0.68, 95% CI 0.48-0.97, p = 0.03), heart failure (HF) hospitalization (RR 0.62, 95% CI 0.42-0.90, p = 0.01), and major adverse cardiovascular events (RR 0.68, 95% CI 0.48-0.96, p = 0.03). However, in REML/Hartung-Knapp sensitivity analyses, CIs crossed the null for all-cause mortality, HF hospitalization, MACE, and pooled hazard ratios. Mortality benefits were absent at 6 and 12 months and in the randomized trial but persisted in low left ventricular ejection fraction (RR 0.56, 95% CI 0.35-0.89, p = 0.01). No significant differences occurred in acute kidney injury, urinary tract infections, or echocardiographic parameters. Conclusion(s): SGLT2 inhibitor use was associated with lower all-cause mortality and HF hospitalization after TAVI, but the evidence is limited by observational designs, heterogeneity, and low certainty for several outcomes. Further randomized trials are required. Copyright © 2026 Ahmed Adel Mohamed et al. Cardiovascular Therapeutics published by John Wiley & Sons Ltd. <27> 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 <28> Accession Number 2049129067 Title Incidence and risk factors of persistent postoperative pain after cardiac surgery: a systematic review and meta-analysis. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 570. Date of Publication: 01 Dec 2026. Author Yang Y.; Liu F.; Yao H. Institution (Yang) School of Nursing, Zhejiang Chinese Medical University, Zhejiang, Hangzhou, China (Yang) The Third People's Hospital of Chengdu, Sichuan, Chengdu, China (Liu) Department of Emergency division, Municipal Hospital, Shandong, Qingdao, China (Yao) Department of Intensive Care Unit, Zhejiang Provincial People's Hospital, Zhejiang, Hangzhou, China Publisher BioMed Central Ltd Abstract Background: Persistent postoperative pain after cardiac surgery (PPPCS) is a prevalent complication. This paper aims to appraise the incidence of PPPCS and analyze its related risk factors through systematic evaluation and Meta-analysis. Method(s): According to PRISMA guidelines, two researchers independently searched seven databases (PubMed, Cochrane Library, Web of Science, Scopus, China National Knowledge Infrastructure, Wanfang Database and China Biomedical Database) until October 5, 2024. Finally, 40 eligible studies were included. The quality of the included articles was evaluated by Newcastle-Ottawa Scale and Agency for Healthcare Research and Quality Agency Scale. The random-effect model was selected for Meta-analysis. Meta-regression analysis was conducted to test whether the publication time affected the incidence of PPPCS. Result(s): The incidence of PPPCS changed at different times after operation: 31.7% (27.2%, 36.2%) at 3 to 6 months, 25.1% (19.5%, 30.7%) at 6 to 12 months, 24.4% (18.1%, 30.7%) at 12 to 24 months, and 13.1% (7.6%, 18.6%) at more than 24 months. Meta-regression revealed that longer postoperative follow-up (12-24 months and beyond 24 months) was associated with a lower overall incidence of PPPCS.Significant risk factors included females, age < 69 years old, BMI>=28 kg/m2, poor wound healing, intraoperative remifentanil infusion, chronic pain history, and moderate-severe pain (day 0-5). Conclusion(s): The incidence of PPPCS ranged from 13.1% to 31.7%. Female sex, younger age, elevated BMI, poor wound healing, intraoperative remifentanil use, history of chronic pain, and severe acute postoperative pain were associated with higher odds of PPPCS. However, given the observational nature of the included studies, variable confounder adjustment, small numbers of studies for certain risk factors, and high heterogeneity, these associations should be interpreted cautiously and require confirmation in prospective studies with standardized definitions and more comprehensive adjustment. The identified factors may guide risk stratification but should not yet be regarded as definitively established causal determinants of PPPCS. Copyright © The Author(s) 2026. <29> Accession Number 2050514534 Title Ulinastatin Protects Cognition in Cardiac Surgical Patients. Source Annals of Thoracic and Cardiovascular Surgery. 32(1) (no pagination), 2026. Article Number: 26-00135. Date of Publication: 2026. Author Hu Y.; Zhou Y.; Ju H.; Lu X.; Shi Y.; Fang H. Institution (Hu, Zhou, Ju, Shi, Fang) Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, China (Hu) Department of Anesthesiology, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China (Lu) Department of Anesthesiology (High-Tech Branch), The First Affiliated Hospital of Anhui Medical University, Hefei, China (Shi) Department of Kidney Transplantation, Zhongshan Hospital, Fudan University, Shanghai, China (Shi) Shanghai Key Laboratory of Organ Transplantation, Zhongshan Hospital, Fudan University, Shanghai, China Publisher Japanese Association for Coronary Artery Surgery Abstract Purpose: This study aimed to investigate the incidence of postoperative cognitive dysfunction (POCD) in patients undergoing cardiac valve surgery and the potential protective effects of ulinastatin on POCD. Method(s): This was a prospective, multicenter, randomized, double-blind clinical trial. A total of 300 patients undergoing cardiac valve surgery were enrolled across the 3 hospitals and randomized to the control or ulinastatin treatment groups. The patients' cognition was evaluated using the Mini-Mental State Examination (MMSE). POCD was defined as a lower cognitive score after surgery than the baseline score. Serum levels of proinflammatory cytokines were measured by an enzyme-linked immunosorbent assay. Result(s): The incidence of POCD in the control group was significantly higher than those in the ulinastatin group (42/150 vs. 24/150, p <0.05). The MMSE score in the control group was significantly lower after the operation [D0 vs. D3: 27.72 (1.88) vs. 27.09 (2.61), p <0.05], but did not change in the ulinastatin group [D0 vs. D3: 27.63 (2.29) vs. 27.31 (2.47), p >0.05]. In the ulinastatin group, plasma levels of matrix metallopeptidase 9 (MMP9) and S100 calcium-binding protein B (S100beta) were significantly lower than those in the control group after the operation. Conclusion(s): The present study confirms that a transient proinflammatory state impairs cognition in patients undergoing cardiac surgery and indicates that perioperative administration of ulinastatin protects cognition. Copyright © 2026 The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery. This article is licensed under a Creative Commons Attribution 4.0 International License. <30> Accession Number 2048938691 Title Personalizing myocardial revascularization strategies in the setting of acute myocardial infarction. Source Expert Review of Cardiovascular Therapy. 24(9) (pp 763-777), 2026. Date of Publication: 2026. Author Mandala A.; Gabara L.; Curzen N.; Jabbour R.J. Institution (Mandala, Gabara, Curzen, Jabbour) Coronary & Structural Heart Research Group, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom (Curzen, Jabbour) Faculty of Medicine, University of Southampton, Southampton, United Kingdom (Jabbour) Imperial College London, London, United Kingdom Publisher Taylor and Francis Ltd. Abstract Introduction: Revascularization post myocardial infarction is a complex interplay of patient and anatomical factors. There is a growing number of interventional tools providing both physiological and anatomical delineation of disease burden which can help determine the method and extent of revascularization. A tailored approach is required taking into consideration shared decision making, co-morbidities, and evolving treatment options. Areas covered: This review article explores the wide array of revascularization techniques of both the culprit lesion and non-culprit lesions in the setting of acute myocardial infarction. A scoping literature review was undertaken of the PubMed database using keywordshighlighted below. Expert opinion: Prompt and durable revascularization of the infarct-related coronary artery remains the cornerstone of treatment for acute myocardial infarction. Specifically, timely restoration of normal flow and implantation of a DES during the index procedure remains the gold standard; however, deferred treatment and novel devices such as DCB may have an emerging role. Despite much evidence, complete revascularization of non-culprit coronary artery disease in acute myocardial infarction is still the subject of contention. Copyright © 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. <31> [Use Link to view the full text] Accession Number 2035513246 Title Comparison of Ultrasound-guided Single-injection Erector Spinae Plane Block, Retrolaminar Block, and Paravertebral Block for Postoperative Analgesia in Single-incision Video-assisted Thoracoscopic Surgery: A 3-arm, Double-blind, Randomized Controlled Noninferiority Trial. Source Clinical Journal of Pain. 41(1) (no pagination), 2025. Article Number: e1259. Date of Publication: 01 Jan 2025. Author Zhu Y.; Yang Y.; Zhang Q.; Li X.; Xue W.; Liu Y.; Zhao Y.; Xu W.; Yan P.; Li S.; Fang Y.; Huang J. Institution (Zhu, Yang, Zhang, Li, Xue, Liu, Zhao, Xu, Yan, Li, Fang, Huang) Department of Anesthesiology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China Publisher Lippincott Williams and Wilkins Abstract Objective: - Effective postoperative analgesia is critical for thoracic surgery. This study compares the analgesic efficacy of the erector spinae plane block (ESPB), retrolaminar block (RLB), and paravertebral block (TPVB) in single-incision video-assisted thoracoscopic surgery (SITS). Method(s): - Seventy-six patients underwent general anesthesia followed by ultrasound-guided nerve blocks with 20 mL of 0.5% ropivacaine. Primary outcomes included the area under the curve (AUC) of numeric rating scale (NRS) scores during rest and coughing over 24 hours. Secondary outcomes included perioperative opioid use, plasma biomarkers, and postoperative recovery measures. Result(s): - The AUC for NRS was 107.8+/-10.53 in the ESPB group, 104.8+/-8.05 in the RLB group, and 103.6+/-10.42 in the TPVB group, demonstrating noninferiority for ESPB (difference: 4.2+/-3.0, 95% CI: -1.82 to 10.22) and RLB (difference: 1.2+/-2.6, 95% CI: -3.97 to 6.37) compared with TPVB. No statistically significant differences were observed in opioid use, plasma biomarkers, QoR-15 scores, or adverse events. Discussion(s): - ESPB and RLB provide noninferior analgesia compared with TPVB in SITS patients and are effective alternatives that enhance safety. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved. <32> 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. <33> 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 (VO), 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 VO 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 <34> 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. <35> Accession Number 2048937940 Title TAVI in low-risk severe aortic stenosis: evidence, controversies, and lifetime treatment strategy. Source Expert Review of Cardiovascular Therapy. 24(9) (pp 805-816), 2026. Date of Publication: 2026. Author Wright K.; Rahman A.; Penny G.; Mohanarajan M.; Philip A.S.; Harky A. Institution (Wright) Acute Internal Medicine, Barnsley Hospital NHS Foundation Trust, Barnsley, United Kingdom (Rahman) School of Medicine, New Vision University, Tbilisi, GA, United States (Penny) Warrington and Halton Hospitals NHS Foundation Trust, Warrington, United Kingdom (Mohanarajan) School of Medicine, European Medical University, Dnipro, Ukraine (Philip) Barts and the London School of Medicine and Dentistry, School of Medicine, London, United Kingdom (Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom Publisher Taylor and Francis Ltd. Abstract Transcatheter aortic valve implantation (TAVI) has expanded from a treatment for inoperable and high-risk aortic stenosis to an established therapeutic option for selected patients at low surgical risk. This review focuses on the outcomes of major trials comparing TAVI to traditional surgical aortic valve replacement (SAVR), highlighting outcomes and potential complications when considering lifetime valve management as we move into the younger population. A literature search of PubMed using terms such as 'transcatheter aortic valve replacement' and 'low surgical risk' was used to identify relevant publications from within the last 10 years. Recent randomized trials and follow-up studies suggest that, in appropriately selected low-risk patients, TAVI and SAVR provide broadly comparable mid-term outcomes for cardiovascular mortality, stroke, and valve re-intervention. However, important differences remain. TAVI is consistently associated with lower rates of new-onset atrial fibrillation but higher rates of permanent pacemaker implantation and paravalvular aortic regurgitation. As TAVI moves into younger and asymptomatic populations, unresolved questions remain around valve durability, coronary access, redo strategies, and lifetime valve management, highlighting the central role of multidisciplinary heart-team assessment in selecting the optimal lifetime therapeutic strategy. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <36> 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. <37> 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. <38> 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/ <39> Accession Number 2048864609 Title Transcatheter tricuspid valve replacement for severe tricuspid regurgitation: current and future perspectives. Source Expert Review of Medical Devices. 23(10) (pp 1261-1273), 2026. Date of Publication: 2026. Author Calamita G.; Leone P.P.; Elsaid O.; Sturla M.; Rizvi S.; Lin J.; Sugiura T.; Scotti A.; Abelow A.; Assafin M.; Ho E.; Latib A. Institution (Calamita, Leone, Elsaid, Sturla, Rizvi, Lin, Sugiura, Scotti, Abelow, Assafin, Ho, Latib) Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, United States (Calamita) Department of Biomedical Sciences, Humanitas University, Milan, Italy (Calamita) IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy (Leone, Scotti, Assafin, Ho, Latib) Department of Cardiology, White Plains Hospital, White Plains, NY, United States Publisher Taylor and Francis Ltd. Abstract Introduction: Severe tricuspid regurgitation (TR) is common, undertreated, and associated with significant morbidity and mortality. Transcatheter tricuspid valve replacement (TTVR) has emerged as a promising option for patients unsuitable for surgical repair or transcatheter edge-to-edge repair. Areas covered: This review examines the innovation trajectory, current device landscape, patient selection, imaging guidance, procedure-specific challenges, and future perspectives of TTVR. A systematic literature search was performed using PubMed/MEDLINE, Embase, and ClinicalTrials.gov, covering publications from January 2015 to May 2025, using search terms including 'transcatheter tricuspid valve replacement,' 'TTVR,' 'tricuspid regurgitation,' and device-specific names. Expert opinion: TTVR offers near-complete regurgitation elimination but remains anatomy- and mechanism-dependent. Its role is best defined in patients with anatomy unfavorable for repair. Optimal timing, device selection, antithrombotic management, and long-term durability require prospective validation through dedicated trials and head-to-head comparisons with repair strategies. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <40> [Use Link to view the full text] Accession Number 2043042844 Title Left Ventricular Assist Device Implantation and Concomitant Tricuspid Valve Surgery: A Systematic Review and Meta-Analysis of Reconstructed Time-to-Event Data. Source ASAIO Journal. 72(10) (pp e296-e305), 2026. Date of Publication: 01 Oct 2026. Author Mastro F.; Gemelli M.; Gallo M.; Bortolato A.; Italiano E.G.; Lorusso R.; Tarzia V.; Slaughter M.; Gerosa G. Institution (Mastro, Gemelli, Bortolato, Italiano, Tarzia, Gerosa) From the Cardiac Surgery Unit, Cardio-Thoraco-Vascular and Public Health Department, Padova University Hospital, Louisville, Italy (Gallo, Slaughter) Department of Cardiovascular and Thoracic Surgery, University of Louisville, Kentucky, United States (Lorusso) Cardio-Thoracic Surgery Department, Maastricht University Medical Centre (MUMC), and Cardiovascular Research Institute Maastricht (CARIM), Maastricht, Netherlands Publisher Lippincott Williams and Wilkins Abstract Patients who undergo left ventricular assist device (LVAD) implantation may present with severe tricuspid regurgitation (TR), revealing underlying right heart failure. This study aims to evaluate the impact of concurrent tricuspid valve surgery (TVS) on LVAD implantation outcomes. Online electronic databases were systematically reviewed for studies including patients with advanced heart failure and TR treated by isolated LVAD implantation versus concomitant TVS and LVAD implantation. In-hospital outcomes were analyzed, and Kaplan-Meier (KM) curves presenting late survival by reconstruction of individual patient data. Sixteen studies were identified, comprising 2, 206 patients who underwent either isolated LVAD or LVAD implant with concomitant TVS. There was no significant difference in early mortality between the two groups (odds ratio [OR]: 1.18, 95% confidence interval [CI]: 0.85-1.65, p = 0.3, I2: 0%). The odds of right ventricular assist device (RVAD) implant were significantly higher in the LVAD + TVS group: (OR: 1.36 [95% CI: 1.0-1.86], p = 0.05). Analysis of late all-cause mortality showed a significantly higher risk of mortality in the LVAD + TVS group, hazard ratio (HR): 0.82 (0.69-0.98, p = 0.032) at each time-point. Tricuspid valve surgery at the same time as LVAD implant showed no difference in early operative mortality but jeopardized long-term survival. Future studies should aim to identify distinct patient subsets that could significantly benefit from TVS during the implantation of LVAD. Copyright © ASAIO 2025 <41> Accession Number 2049534733 Title Feasibility, acceptability, and preliminary estimates of a multimodal AKTIVER Heart Delirium Prevention Program in patients indicated for cardiac surgery: study protocol of a randomized controlled PREVENT POstoperative Delirium (PREVENT-POD) Pilot Study. Source Pilot and Feasibility Studies. 12(1) (no pagination), 2026. Article Number: 142. Date of Publication: 01 Dec 2026. Author Kuhnle J.; Dong M.T.; Heissenberg J.; Derad C.; Schettler E.; Neitzel C.; Itting P.T.; Botnariuc A.; Asendorf T.; Viehmeister B.; El-Essawi A.; Jebran A.-F.; Evertz R.; Badde J.C.; Steinmetz C.; Wuttke M.; David N.S.; Spank J.; Schafer D.A.; Kutschka I.; Baraki H.; Herrmann-Lingen C.; Thomas C.; von Arnim C.; Celano C.M.; Sadlonova M. Institution (Kuhnle, Dong, Heisenberg, Itting, Botnariuc, El-Essawi, Jebran, Evertz, Badde, Sadlonova) Department of Cardiothoracic and Vascular Surgery, University Medical Center Goettingen, Goettingen, Germany (Derad, Asendorf) Department of Medical Statistics, University Medical Center Goettingen, Goettingen, Germany (Schettler, Neitzel, Herrmann-Lingen, Sadlonova) Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany (Itting, Herrmann-Lingen, von Arnim, Sadlonova) DZHK (German Center for Cardiovascular Research), Partner Site Lower Saxony, Goettingen, Germany (Viehmeister) Department of Clinical Pharmacy, University Medical Center Goettingen, Goettingen, Germany (Steinmetz, von Arnim, Sadlonova) Department of Geriatrics, University Medical Center Goettingen, Goettingen, Germany (Wuttke, David) Department of Physical Therapy, University Medical Center Goettingen, Goettingen, Germany (Spank, Thomas) Department of Psychiatry and Psychotherapy for the Elderly, Klinikum Stuttgart, Stuttgart, Germany (Schafer, Celano, Sadlonova) Department of Psychiatry, Massachusetts General Hospital, Boston, United States (Schafer, Celano) Department of Psychiatry, Harvard Medical School, Boston, United States (Kutschka, Baraki) University Heart Center Basel, University Hospital Basel, Basel, Switzerland (Thomas) Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany Publisher BioMed Central Ltd Abstract Background: Postoperative delirium (POD) is a common complication in geriatric patients undergoing cardiac surgery. POD is associated with prolonged length of stay in the intensive care unit and hospital, increased mortality, institutionalization, distress, risk of cognitive impairment and dementia. The non-pharmacological, multimodal AKTIVER intervention from the multicenter PAWEL trial significantly reduced POD incidence and days with POD in older patients undergoing abdominal and orthopedic surgery. However, this positive effect on POD incidence has not yet been demonstrated in elderly patients undergoing cardiac surgery. Therefore, a specific AKTIVER Heart intervention with additional modules was developed. Method(s): In the randomized controlled PREVENT-POD pilot study, 60 patients aged 65 years or older undergoing elective cardiac surgery will be recruited and 2:1 randomized in either into the AKTIVER Heart intervention group (AKTIVER Heart) or treatment-as-usual plus (TAU+) group. In total, 40 patients will receive the non-pharmacological and modified AKTIVER Heart intervention, while the other 20 will receive TAU+ with preoperative education. The primary outcome is the feasibility and acceptability of the AKTIVER Heart intervention. Secondary outcomes include the preliminary estimates of the AKTIVER Heart on POD incidence, duration and severity, cognition, quality of life, sleep, treatment- and disease expectations, distress, depression, and anxiety symptoms. Discussion(s): This randomized controlled pilot study aims to evaluate the feasibility and acceptability of the non-pharmacological, multimodal AKTIVER Heart intervention in elderly patients undergoing elective cardiac surgery. This trial is designed to provide evidence on acceptability and feasibility of the AKTIVER Heart, and to perform a larger, well-powered multicenter POD prevention trial in cardiac surgery. Trial registration: German Clinical Trials Register (DRKS; http://www.drks.de; DRKS00035091, Registered prospectively on November 4, 2024 Copyright © The Author(s) 2026. <42> Accession Number 2050610256 Title Serratus Posterior Superior Intercostal Plane Block Versus Superficial Parasternal Intercostal Plane Block With Local Infiltration for Postoperative Analgesia in Open Cardiac Surgery: A Randomized Controlled Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Cevikkalp E.; Ulusoy E.; Ekinci M.; Ogur A.K.; Yilmaz C. Institution (Cevikkalp, Ulusoy, Ekinci, Ogur, Yilmaz) Department of Anesthesiology and Reanimation, University of Health Sciences Bursa City Hospital, Bursa, Turkey Publisher W.B. Saunders Abstract Objectives: Postoperative pain after open cardiac surgery arises from both sternotomy and chest drains and is often inadequately controlled by anatomically limited techniques. This study compared the serratus posterior superior intercostal plane block (SPSIPB, C3-T10 spread) with superficial parasternal intercostal plane block (PSIPB) plus chest drain-site infiltration. Design(s): Prospective, randomized, controlled trial with blinded outcome assessment. Setting(s): Single-center tertiary referral cardiac surgery center. Participant(s): Adults undergoing elective open cardiac surgery via median sternotomy; 80 assessed for eligibility, 76 randomized. Intervention(s): Bilateral SPSIPB (n = 35) or bilateral PSIPB plus local anesthetic infiltration at mediastinal and pleural chest drain sites (n = 41), performed preoperatively under ultrasound guidance. Measurements and Main Results: The primary outcome was cumulative 24-hour opioid consumption (morphine milligram equivalents, MME); the registered secondary outcomes were Numerical Rating Scale (NRS) pain scores at rest and on coughing and the Quality of Recovery-15 (QoR-15) at 24 hours. All other comparisons were exploratory. Twelve patients were excluded after randomization (2 SPSIPB, 10 control), leaving 33 and 31 for analysis. Opioid consumption was significantly lower in the SPSIPB group (36.6 +/- 17.5 v 56.7 +/- 16.1 mg of MME; mean difference 20.1 mg of MME; 95% CI, 11.7-28.5; p < 0.001). NRS scores were comparable during the first postoperative hour but lower in the SPSIPB group from 2 hours onward during coughing and at 4, 8, and 24 hours at rest (all p <= 0.019). QoR-15 scores were higher in the SPSIPB group (119 [112-126] v 108 [105-111.5]; median difference 10 points; 95% CI, 6-15; p < 0.001), exceeding the minimal clinically important difference of 6 points. Adverse events, including postoperative nausea and vomiting, did not differ between the groups. Conclusion(s): Compared with PSIPB plus drain-site infiltration-an active comparator targeting both the sternal and drain regions-SPSIPB reduced opioid consumption and improved quality of recovery and may be a valuable component of multimodal analgesia within Enhanced Recovery After Cardiac Surgery (ERACS) protocols. Copyright © 2026 Elsevier Inc. <43> Accession Number 2037688750 Title The Effect of Infusion of Dexmedetomidine to the Aortic Root before Aortic Cross-Clamp Removal on the Myocardial Protection in Patients Undergoing Mitral Valve Surgery; A Triple-Blinded Randomized Clinical Trial. Source Razavi Journal of Medicine. 14(1) (pp 22-32), 2026. Article Number: e1427. Date of Publication: 01 Jan 2026. Author Amini S.; Hajipour F.; Sistani M.R.N.; Zandi Z.; Yaghubi M. Institution (Amini) Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of (Hajipour) Department of Extra-Corporeal Circulation (ECC), Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Sistani) Pediatric and Congenital Cardiology Division, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of (Zandi) Department of Cardiovascular disease, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of (Yaghubi) Department of Extra-Corporeal Circulation (ECC), Razavi Hospital, Imam Reza International University, Mashhad, Iran, Islamic Republic of Abstract Background: Myocardial protection during cardiopulmonary bypass is a challenging dilemma. Some protective strategies have been introduced to ameliorate ischemic-reperfusion injury, although no optimal strategy has emerged. Objective(s): Herein, we evaluated the effect of aortic root infusion of Dexmedetomidine before cross-clamp removal on myocardial preservation. Method(s): This randomized, multicenter, triple-blinded controlled trial enrolled 56 patients who underwent mitral valve surgery. After randomization, the patients were allocated to the case group (Dexmedetomidine infusion in the aortic root before cross-clamp removal) and the control group (isotonic saline). Based on the study goals, Troponin-I and Creatinine kinase-MB were measured as primary outcomes at different time points during the study. Other clinical parameters were also measured as secondary outcomes. Statistical analysis was performed using SPSS software version 26.0 (Chicago, IL, USA). The significance level was considered as P<0.05. Result(s): A total of 54 patients in the case and control groups were included in the analysis. The main finding of this study was that troponin-I levels at all time points showed statistical differences between the two groups (P=0.001). Also, evaluation of CK-MB levels showed a significant decrease at 1 hour (P=0.001), 12 hours (P=0.001), and 24 hours (P=0.001) after ICU admission, in the case group compared with the control group. Conclusion(s): This study found that administering a Dexmedetomidine infusion before aortic cross-clamp removal can ameliorate ischemia-reperfusion injury-induced myocardial damage. Copyright © 2026 The Authors. <44> Accession Number 2044395174 Title Skeletonized vsPedicled LIMA in Diabetic Patients Undergoing CABG: A Meta-Analysis. Source Thoracic and Cardiovascular Surgeon. 74(7) (pp 570-576), 2026. Date of Publication: 01 Oct 2026. Author Onyeji P.; Momplaisir-Onyeji S.; Consoli L.; Dani S.; Passos F.S.; Doenst T.; Kirov H.; Caldonazo T. Institution (Onyeji) All Saints University School of Medicine, Saint George Parish, Roseau, Dominica (Momplaisir-Onyeji) American University of Barbados School of Medicine, Saint Michael, Saint Michael, Barbados (Consoli) Universidade Federal da Bahia, Bahia, Salvador, Brazil (Dani) GMERS Medical College and Hospital, Ahmedabad, Gujarat, Sola, India (Passos) Mater Dei Hospital, Salvador, Brazil (Doenst) Department of Cardiothoracic Surgery, University Hospital Jena, Jena, Germany (Kirov, Caldonazo) Department of Cardiothoracic Surgery, Friedrich-Schiller-University Jena, University Hospital, Jena, Germany Publisher Georg Thieme Verlag Abstract Background The left internal mammary artery (LIMA) remains the preferred conduit for coronary artery bypass grafting (CABG). However, diabetic patients face an increased risk of deep sternal wound infection (DSWI), particularly after pedicled LIMA harvesting, which may impair sternal perfusion. Skeletonized harvesting preserves sternal vascularity and may reduce infection risk, but current evidence remains limited and inconsistent. Methods Three different databases were assessed. The primary outcome was the occurrence of DSWI. Secondary outcomes were hospital length of stay (LOS), cardiopulmonary bypass (CPB) time, blood transfusion rates, and aortic cross-clamp time. A random effects model was performed. Results Three retrospective studies involving 400 diabetic patients were included, of whom 190 underwent skeletonized and 210 pedicled LIMA harvesting. Skeletonized harvesting was associated with significantly reduced risk of DSWI (odds ratio [OR]: 0.25; 95% confidence interval [CI]: 0.07-0.88; p = 0.031). CPB (mean difference [MD]: 3.03 minutes; 95% CI: 1.18-4.88; p = 0.001) and aortic cross-clamp times (MD: 3.06 minutes; 95% CI: 2.03-4.10; p < 0.001) were slightly longer in the skeletonized group. No significant differences were observed in hospital LOS (p = 0.159) or blood transfusion requirements (p = 0.959). Conclusion Skeletonized LIMA harvesting is associated with lower odds of DSWI in diabetic patients undergoing CABG, despite modestly longer operative times. Copyright © 2026. Thieme. All rights reserved. <45> [Use Link to view the full text] Accession Number 2043620788 Title Artificial intelligence in cardiothoracic monitoring and echocardiography. Source Current Opinion in Anaesthesiology. Publish Ahead of Print (no pagination), 2025. Date of Publication: 03 Dec 2025. Author Bryant J.M.; Jelly C.A.; Kertai M.D. Institution (Bryant, Jelly, Kertai) Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, United States Publisher Lippincott Williams and Wilkins Abstract Purpose of review - This review describes the recent advancements of artificial intelligence (AI) in cardiothoracic anesthesia monitoring. Recent findings - The application of AI in cardiothoracic anesthesia monitoring has potential to affect all phases of perioperative care - from preoperative testing and risk stratification to postoperative evaluation and advances in echocardiography image acquisition and interpretation. While these developments are promising, they remain in the early stages of clinical integration and validation. Summary - Advances in machine learning and natural language processing are expected to play an increasingly significant role in the monitoring and management of cardiothoracic surgery patients. As these technologies evolve, they hold the potential to enhance the precision, efficiency, and personalization of care. However, as AI becomes more integrated into clinical decision-making, it is imperative that care models remain grounded in the core principles of patient-centeredness and safety. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved. <46> [Use Link to view the full text] Accession Number 2043620841 Title Will prothrombin complex concentrate replace plasma in cardiac surgical bleeding in North America?. Source Current Opinion in Anaesthesiology. Publish Ahead of Print (pp 1-9), 2025. Article Number: 46031. Date of Publication: 04 Dec 2025. Author Bartoszko J.; Gabarin N.; Tanaka K.; Callum J. Institution (Bartoszko) Department of Anesthesia and Pain Management, University Health Network, Sinai Health, Women's College Hospital, University of Toronto, Canada (Bartoszko) Peter Munk Cardiac Centre and Toronto General Hospital Research Institute, University Health Network, Canada (Bartoszko) Departments of Anesthesiology and Pain Medicine, Canada (Gabarin) Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada (Tanaka) Department of Anesthesiology, University of Oklahoma Health, Oklahoma City, OK, United States (Callum) Department of Pathology and Molecular Medicine, Kingston Health Sciences Centre and Queen's University, Kingston, ON, Canada Publisher Lippincott Williams and Wilkins Abstract Purpose of review - There is increasing interest in four-factor prothrombin complex concentrate (4F-PCC) for treatment of acquired coagulopathic bleeding in cardiac surgery. Plasma, traditionally the treatment of choice, has a different composition compared with 4F-PCC. This review summarizes the current evidence. Recent findings - Because of its rapid reconstitution at the bedside and small administration volume, the use of 4F-PCC over plasma is rising - particularly with new clinical trial evidence suggesting 4F-PCC has efficacy and safety advantages. This is reinforced by mechanistic evidence supporting the role of 4F-PCC in normalizing or improving thrombin generation, an important aspect of secondary hemostasis often impacted in cardiac surgery. Four randomized controlled trials contribute to the human evidence base for the use of 4F-PCC in cardiac surgery. FARES-II, the largest study to date, demonstrated that 4F-PCC has improved hemostatic efficacy and a superior safety profile compared with plasma. Three additional studies are underway to confirm these findings. Summary - The use of 4F-PCC for the treatment of coagulopathic bleeding in cardiac surgery is supported by high-quality clinical evidence. Several unanswered questions remain regarding sex- and race-specific efficacy, the mechanism through which 4F-PCC may reduce serious adverse events, and its use in procedures that were under-represented in existing clinical trials. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved. <47> Accession Number 2044529695 Title Expert Consensus on Right Axillary Incision Approach for Open-Heart Surgery in Congenital Heart Disease. Source Structural and Congenital Heart Disease. 21(1) (no pagination), 2026. Article Number: 2. Date of Publication: 2026. Author Mo X.; Fan T.; Hua Z.; Haller C.; Oda S.; Luo S.; Liang W.; Yang Y.; Liu H.; Dong N.; Li S.; Chen X.; Chen J.; Shu Q.; Xing Q.; Zheng J.; Ming T.; An Q.; Wen P.; Wang Q.; Chen H.; Wen S.; Ye M.; Yang K.; Fang M.; Liu C.; Lin K.; Wu Z.; Fan X.; Pan Z.; Ding Y.; Pi M.; Li X.; Zou Y.; Tao S.; Chen R.; Ma L.; Zhang L.; You T.; Liao D.; Zhou C.; Li H.; Zhou G.; Gu C.; Li Z.; Li Y.; Zhang H.; He X.; Lu Y.; Hong H.; Zhang B.; Gong L.; Qi J.; Bai S.; Liu Y.; Zhao T. Institution (Mo, Yang, Qi) Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China (Fan, Liang) Department of Cardiovascular Surgery, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China (Hua, Liu) Department of Cardiothoracic Surgery, Shenzhen Children's Hospital, Shenzhen, China (Haller) Department of Cardiovascular Surgery, Sick Children Hospital Toronto Canada, Toronto, ON, Canada (Oda) Division of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan (Luo) Department of Cardiovascular Surgery, West China Second Hospital of Sichuan University, Chengdu, China (Dong) Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li, Yang, Zhang) Pediatric Cardiac Surgery Center, Fuwai Hospital, National Centre for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (Chen, Ma) Cardiovascular Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Chen) Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China (Zhang, Zhang, Zheng, Chen, He, Lu) Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (Shu, Fan) Department of Cardiac Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China (Xing) Heart Center, Qingdao Women and Children's Hospital, Qingdao, China (Li) Department of Cardiac Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China (Ming, Zou) Pediatric Heart Disease Treatment Center of Jiangxi Province, Jiangxi Provincial Children's Hospital, Nanchang, China (An, Lin) Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, China (Wen) Heart Center, Dalian Municipal Women and Children's Medical Center (Group), Dalian, China (Wang) Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (Wen) Department of Cardiovascular Surgery, Guangdong Provincial People's Hospital, Guangzhou, China (Chen) Department of Cardiovascular Surgery, Women and Children's Hospital of Qingdao University, Qingdao, China (Ye) Department of Cardiothoracic Surgery, Children's Hospital of Fudan University, Shanghai, China (Fang) Department of Cardiothoracic Surgery, General Hospital of Northern Theater Command, Shenyang, China (Liu) Department of Cardiology, Children's Hospital of Shanxi, Women Health Center of Shanxi, Taiyuan, China (Wu, Zhao) Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, China (Pan, Li) Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China (Ding) Department of Pediatric Cardiology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China (Pi, Gong) Department of Cardiothoracic Surgery, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li) Department of Cardiothoracic Surgery, Children's Hospital of Soochow University, Suzhou, China (Tao) Department of Cardiac Surgery, Children's Hospital in Hebei Province, Shijiazhuang, China (Chen) Department of Cardiothoracic Surgery, Hainan Women and Children's Medical Center, Haikou, China (Zhang) Department of Pediatric Surgery, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China (You) Department of Cardiothoracic Surgery, Gansu Provincial Hospital, Lanzhou, China (Liao) Department of Cardiothoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China (Zhou) Department of Cardiothoracic Surgery, Union Hospital Affiliated to Tongji, Medical College of Huazhong, University of Science and Technology, Wuhan, China (Li) Department of Cardiothoracic Surgery, Shandong Provincial Hospital Affiliated, Shandong First Medical University, Jinan, China (Zhou) Department of Cardiothoracic Surgery, The 7th Medical Center of Chinese PLA General Hospital, Beijing, China (Gu) Department of Cardiothoracic Surgery, Xijing Hospital, Xi'an, China (Li, Bai) Department of Cardiothoracic Surgery, Beijing Children's Hospital, Capital Medical University, Beijing, China (Zhang) Department of Cardiothoracic Surgery, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China (Hong) Department of Cardiothoracic Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China (Qi) Department of Cardiothoracic Surgery, Harbin Children's Hospital, Harbin Medical University, Harbin, China (Liu) Department of Cardiothoracic Surgery, Dalian municipal Women and Children's Medical Center, Dalian, China Abstract Congenital heart disease (CHD) is a common birth defect in children, and surgical intervention is the primary treatment. The traditional standard median sternotomy (MS) has drawbacks such as significant trauma and obvious scarring. The right axillary incision (RAI) has gradually become a conventional approach due to its advantages of preserving thoracic cage integrity, small incision size, rapid recovery, and hidden scarring. However, there is currently a lack of relevant guidelines and consensus for its application. This consensus adopts the international Delphi process, systematically searching domestic and foreign literature on CHD from 1982 to 2024. It uses the GRADE system for evidence grading and, through multidisciplinary expert discussions, clarifies the applicable CHD types, surgical techniques, establishment of extracorporeal circulation, organ protection strategies, management of special disease types, and approaches to common complications of RAI. Results show that RAI is strongly recommended for most simple congenital heart diseases (CHDs) (e.g., simple ventricular septal defect, atrial septal defect), weakly recommended for some complex CHDs (e.g., mild tetralogy of Fallot), and not recommended for complex CHDs such as transposition of the great arteries or in children with severe right thoracic deformity. Additionally, it standardizes key operational parameters: weight (5-30 kg as optimal), age (6 months-6 years as preferred), incision location, extracorporeal circulation cannulation, and organ protection measures. This consensus provides an evidence-based basis for standardizing the clinical application of RAI in open-heart surgery for CHD, ensuring surgical safety and efficacy. Copyright © 2026 The Authors. <48> Accession Number 2049042316 Title Continuous wound infiltration with local anesthetics in adult patients undergoing cardiac surgery: a PRISMA-compliant systematic review and meta-analysis. Source Chinese Medical Sciences Journal. 41(2) (pp 89-99), 2026. Date of Publication: 01 Jun 2026. Author Yao Y.-T.; More A.; Chao M.; Huang S. Institution (Yao, Huang) Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Yao, Huang) Evidence in Cardiovascular Anesthesia (EICA) Group, Beijing, China (Yao, More, Chao) Center of Outcomes Research, Department of Anesthesiology, Critical Care and Pain Medicine, University of Texas, Houston, TX, United States (Yao, More, Chao) Outcomes Research Consortium, Houston, TX, United States Publisher KeAi Communications Co. Abstract Background: Effective postoperative analgesia is critical to recovery after cardiac surgery. Continuous wound infiltration (CWI) with local anesthetics (LAs) has been proposed as an opioid-sparing adjunct, but its efficacy beyond pain control and its safety profile remain incompletely defined. Method(s): We conducted a PRISMA-compliant systematic review and meta-analysis of randomized controlled trials (RCTs) comparing CWI with control in adult cardiac surgery. PubMed, Embase, and Cochrane CENTRAL were searched from inception to August 30, 2025, and updated on April 2, 2026. Primary outcomes were postoperative Visual Analogue Scale (VAS) pain scores and cumulative morphine consumption. Secondary outcomes included mechanical ventilation duration, length of stay, mortality, complications, patient satisfaction, and adverse events. Risk of bias was assessed using the Cochrane RoB 2.0 tool, and certainty of evidence was evaluated using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Result(s): Twelve RCTs involving 2,117 patients were included. CWI significantly reduced VAS during mobilization at 24 h (MD=-0.93, 95% confidence interval [CI]: -1.53--0.33, P = 0.002) and 48 h (MD=-0.80, 95% CI: -1.17--0.44, P < 0.001), and decreased 48-hour morphine consumption (MD=-8.10 mg, 95% CI: -13.41--2.79, P = 0.003). No significant effects were observed on VAS at rest, mechanical ventilation duration, ICU or hospital length of stay, mortality, or major cardiovascular, pulmonary, renal, gastrointestinal complications, or postoperative infections. Patient satisfaction was higher with CWI. Technical complications were uncommon, and no clinically significant LA toxicity was reported. Conclusion(s): In adult cardiac surgery, CWI with LAs modestly improves analgesia during mobilization and reduces opioid requirements without clear improvement in major clinical outcomes or length of stay. CWI appears safe and feasible and may serve as an adjunct in multimodal, opioid-sparing analgesia strategies. Further adequately powered trials are warranted to define its comparative effectiveness within contemporary enhanced recovery after surgery (ERAS) pathways. Copyright © 2026 The Authors. Publishing Services by Elsevier B.V. on behalf of KeAi Communications Co. Ltd. This is an open access article under the CC BY-NC license. http://creativecommons.org/licenses/by-nc/4.0/ <49> 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. <50> Accession Number 2047862291 Title Sex-Related Differences in Outcomes and Thresholds for Intervention in Primary Mitral Regurgitation: A Systematic Review and Meta-Analysis. Source JACC: Cardiovascular Imaging. 19(10) (pp 1204-1218), 2026. Date of Publication: 01 Oct 2026. Author Long E.; Hahn R.T.; Gulati M.; Demetrescu C.; Shah B.N.; Bhattacharya S.; Moorjani N.; Lucchese G.; Bilkhu R.; Bosco P.; Patterson T.; Redwood S.; Pibarot P.; Prendergast B.; Rajani R.; Androshchuk V. Institution (Long, Lucchese, Redwood, Rajani, Androshchuk) Faculty of Life Sciences and Medicine, King's College London, United Kingdom (Long, Demetrescu, Lucchese, Bilkhu, Bosco, Patterson, Redwood, Rajani, Androshchuk) Cardiovascular Directorate, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (Hahn) Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States (Gulati) Department of Cardiology, The Davis Women's Heart Center, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States (Shah) Department of Cardiology, Wessex Cardiac Centre, Southampton General Hospital, Southampton, United Kingdom (Bhattacharya) Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (Bhattacharya, Prendergast) Cleveland Clinic London, London, United Kingdom (Moorjani) Department of Cardiothoracic Surgery, Royal Papworth Hospital, Cambridge, United Kingdom (Pibarot) Department of Medicine, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada Publisher Elsevier Inc. Abstract Background: Evidence on sex differences in outcomes after interventions for primary mitral regurgitation (PMR) remains conflicting. The authors performed a dedicated meta-analysis to examine whether guideline-recommended thresholds for intervention may contribute to these discrepancies. Method(s): Electronic databases were searched for studies reporting long-term outcomes of patients undergoing surgical or transcatheter interventions for PMR, stratified by sex. The primary endpoint was all-cause mortality, and the secondary endpoint was major adverse cardiovascular events. Reconstructed time-to-event individual patient data were used to derive frailty-adjusted Cox models and restricted mean survival time. To investigate whether sex-based differences in baseline characteristics had a modulating effect on differences in all-cause mortality, meta-regression was performed on individual patient data-derived HRs using a linear mixed-effects model. Result(s): Across 17 studies (N = 25,690), women comprised the minority (n = 9,632, 37.5%) and were significantly older (mean difference: 3.2 years, 95% CI: 2.2-4.3) with a greater proportion of heart failure symptoms (OR: 1.8; 95% CI: 1.6-2.1). At 15.7 years of follow-up, women had significantly greater risk of all-cause mortality compared with men (HR: 1.15; 95% CI: 1.07-1.24), corresponding to a survival deficit of 5.8 months (95% CI: 3.7-7.7). Similar results were observed in sensitivity analyses restricted to surgical intervention studies (HR: 1.18; 95% CI: 1.10-1.27). Female sex was also associated with significantly increased major adverse cardiovascular events (n = 2,775) (HR: 1.37; 95% CI: 1.11-1.70; DELTA restricted mean survival time: 8.5 months, 95% CI: 2.4-14.5). Age, >= moderate tricuspid regurgitation (TR), and concomitant tricuspid valve repair (TVr) emerged as significant moderators of sex differences in mortality after intervention for PMR (P < 0.001, P = 0.03, and P < 0.001, respectively). A greater proportion of >= moderate TR and TVr in women conferred increased mortality relative to men. Neither left ventricular nor left atrial parameters significantly moderated sex differences in all-cause mortality (all P > 0.05). Conclusion(s): At the time of PMR intervention, women are older, have more symptoms, and worse long-term outcomes compared with men. Older female age alongside higher prevalence of >= moderate TR and TVr explained a significant proportion of this heterogeneity in sex-related all-cause mortality, whereas differences in left ventricular and left atrial parameters had no significant influence. A careful appraisal of current guidelines to ensure equality of health care outcomes between sexes is warranted. Copyright © 2026 The Authors <51> Accession Number 2048399682 Title Final 2-Year Results of the REFORM Study: A Randomized Trial of Biolimus DCB Versus Paclitaxel DCB for In-Stent Restenosis. Source Catheterization and Cardiovascular Interventions. 108(4) (pp 1609-1616), 2026. Date of Publication: 01 Oct 2026. Author O'Callaghan D.; Coughlan J.J.; Alfonso F.; Hahn J.-Y.; Sabate M.; Toelg R.; Copt S.; Fitzgerald S.; Morice M.-C.; Trevelyan J.; Mylotte D.; Ortiz A.F.; Durand R.; Wohrle J.; Kleber F.X.; Stefanini G.; Rai H.; O'Kane P.; Byrne R.A. Institution (O'Callaghan, Coughlan, Rai, Byrne) School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland (O'Callaghan, Coughlan, Fitzgerald, Durand, Rai, Byrne) Cardiovascular Research Institute, Mater Private Network, Dublin, Ireland (Alfonso) Hospital Universitario de La Princesa, Centro de Investigacion Biomedica en Red Enfermedades Cardiovaculares, Universidad Autonoma de Madrid, IIS-IP, Madrid, Spain (Hahn) Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Sabate) Hospital Clinical de Barcelona, Cardiovascular Institute, Barcelona, Spain (Sabate) Institut d'Investigacions Biomediques August Pi i Sunyer, Centro de Investigacion Biomedica en Red Enfermedades Cardiovaculares, Barcelona, Spain (Toelg) Heart Center of Segeberger Kliniken, Bad Segeberg, Germany (Copt) Biosensors Europe, Morges, Switzerland (Morice) Institut Cardiovasculaire Paris-Sud, Ramsay, Centre Europeen de Recherche Cardiovasculaire, Massy, France (Trevelyan) Worcestershire Royal Hospital, Worcester, United Kingdom (Mylotte) University Hospital and National University of Ireland Galway, Galway, Ireland (Ortiz) Cardiovascular Institute, San Carlos University Hospital, Madrid, Spain (Wohrle) Department of Cardiology and Intensive Care, Medical Campus Lake Constance, Friedrichshafen, Germany (Kleber) PGS, Academic Teaching Hospital, University Halle-Wittenberg, Halle, Germany (Stefanini) Humanitas University, Milan, Italy (O'Kane) Royal Bournemouth Hospital, Bournemouth, United Kingdom Publisher John Wiley and Sons Inc Abstract Background: In the REFORM trial, treatment of coronary in-stent restenosis with a Biolimus A9TM drug-coated balloon (BCB) was found to be inferior with respect to in-segment percentage stenosis at 6-months in comparison to treatment with a standard paclitaxel coated paclitaxel-coated balloon (PCB). Aim(s): In this manuscript, the final prespecified 2-year clinical follow up follow-up of the REFORM trial is reported. Method(s): The Prospective, Randomized, Non-Inferiority Trial to Determine the Safety and Efficacy of the Biolimus A9TM Drug Coated Balloon for the Treatment of In-Stent Restenosis: First-in-Man Trial (REFORM) was a multicenter, single blind, non-inferiority, randomized controlled trial comparing the BCB and PCB in the treatment of coronary in-stent restenosis (ISR). The primary angiographic endpoint of the trial was in-segment % diameter stenosis (%DS) at 6 months, which has previously been reported. A total clinical follow-up duration of 2 years was planned. Prespecified clinical outcomes at 2 years were: target lesion failure (TLF), target vessel failure (TVF), and their individual components. Result(s): At 24 months, complete follow-up data was available for 93% (n = 188) of the intention to treat (ITT) population. The mean age was 68.7 years, and patients were predominantly male (80.2%). Comorbidities were well balanced between the 2 groups, including diabetes mellitus, which was present in 31% of the BCB group and 29.2% of the PCB group. ISR lesions were predominantly DES-ISR in both groups (BCB 80.7% vs. PCB 85.1%). Through to 2 year follow up, target lesion failure (TLF) occurred in 36 of 135 patients (27.8%) of patients in the BCB group and in 15 of 67 patients (23.5%) in the PCB group (HR: 1.25; 95% CI: 0.69-2.29). Clinically driven target lesion revascularization (CD-TLR) occurred in 31 of 135 patients (24.2%) in the BCB group versus 13 of 67 patients (20.4%) in the PCB group (HR: 1.26; 95% CI: 0.66-2.40). Target vessel myocardial infarction and cardiac death were comparable in both groups. Conclusion(s): In patients with coronary ISR, the final 2-year results from the REFORM study show that TLF rates were 27.8% in the biolimus-coated balloon BCB group and 23.5% in the paclitaxel-coated balloon PCB group. However, given the limited sample size and wide confidence intervals, the present analysis does not permit reliable inference regarding comparative event rates between treatment strategies. The results should be interpreted against the background of demonstrated inferior angiographic performance of the biolimus DCB at 6 months. Trial Registration: The trial was registered prospectively at www.clinicaltrials.gov (identifier: NCT04079192). Copyright © 2026 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. <52> [Use Link to view the full text] Accession Number 2048984680 Title Pooled Efficacy and Exploration of Effect Modifiers of Exercise Prehabilitation: A Systematic Review and Meta-regression Analysis of Randomized Controlled Trials. Source Anesthesia and Analgesia. 143(4) (pp 701-716), 2026. Date of Publication: 01 Oct 2026. Author Ramic L.; Branje K.; Al-Bayati M.; Kidd G.D.; Neilipovitz N.; Hutton B.; Wolfe D.M.; Fergusson D.; Fiore J.F.; Hladkowicz E.; McIsaac D.I.; Boland; Boland L.; Gill M.; Gillis C.; Aucoin S.; Auer R.; Beaule P.; Bryson G.; Carli F.; Eskander A.; Forster A.; Holroyd-Leduc J.; Khadaroo R.; Lalu M.; Martel G.; McCartney C.; Nantel J.; Poitras S.; Scheede-Bergdahl C.; Taljaard M.; Wijeysundera D.; Akhtar S.; Atkins M.; Basualdo-Hammond C.; Brindle M.; Gillam M.; Gramlich L.; Jackson T.; Love C.; McKeen D.; Meliambo A.; Moloo H.; Moore R.; Muscedere J.; Shorr R.; Wallace T.; Crawford A.; Li M.; Devine C.; Gilmore T.; Mor R.; LeBlanc J.; Schramm D.; Berrio Valencia M.I.; Kidd G.; Liang E. Institution (Ramic, Fergusson) Faculty of Medicine, The University of Ottawa, Ottawa, Ontario, Canada (Branje, Al-Bayati, Kidd, Neilipovitz, Hutton, Gillis, Hladkowicz, McIsaac) Department of Anesthesiology, The Ottawa Hospital/Ottawa Hospital Research Institute/University of Ottawa, Ottawa, Ontario, Canada (Hutton) School of Epidemiology and Public Health, The University of Ottawa, Ottawa, Ontario, Canada (Wolfe, Fergusson) Methodological and Implementation Research, The Ottawa Hospital Research Institute, Ottawa, Ottawa, Ontario, Canada (Fiore) Department of Surgery, McGill University, Montreal, Quebec, Canada Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - Low certainty evidence supports exercise prehabilitation's efficacy in reducing complications and length of stay in specific populations. Identification of procedural, participant, and program characteristics associated with greater prehabilitation efficacy is required to optimize effective application of prehabilitation programs. Our objectives were to (1) estimate the pooled efficacy of all approaches to exercise prehabilitation across all procedures, participants, and programs in reducing postoperative complications and length of stay, and (2) identify program, participant, and procedural characteristics associated with greater efficacy of exercise prehabilitation. METHOD(S): - A peer-reviewed search strategy was applied to Ovid Medline, Embase, CINAHL, PsycINFO, Web of Science, and the Cochrane CENTRAL Register of Controlled Trials (inception to March 1, 2022, and updated on October 25, 2023, and April 10, 2024). Randomized controlled trials addressing a population of adults (>=18 years) undergoing major elective surgery where participants were allocated to an exercise prehabilitation intervention were included. A multistage review of 6675 citations and 1220 full texts was completed independently in duplicate using DistillerSR. Data were pooled using random effects pairwise meta-analyses and meta-regression. Certainty of evidence and credibility of effect modifiers were evaluated. Critical outcomes were postoperative length of stay and the incidence of postoperative complications. Effect modifiers and hypotheses were identified a priori and published in the study's registered protocol (CRD42023487683). RESULT(S): - Across 99 included trials (n = 8222), pooled data suggested that exercise prehabilitation likely reduces complication rates (odds ratio [OR] = 0.54; 95% confidence interval [CI], 0.44-0.67; P < .01; I2 = 45%; moderate certainty) and length of stay (mean difference = -0.90 days; 95% CI, -1.23 to -0.58; P < .01; I2 = 78%; low certainty). Inspiratory muscle training was the only significant effect modifier for greater efficacy of exercise prehabilitation in reducing both complications (OR = 0.65; 95% CI, 0.44-0.97; low certainty) and length of stay (MD = -1.04; 95% CI, -1.75 to -0.32; low certainty). No other prespecified procedural, participant, or program factors were consistent or credible effect modifiers. CONCLUSION(S): - Exercise prehabilitation may reduce complications and LoS; however, well-reported multicenter trials synthesized using individual participant data are required to identify procedural, participant, and program factors associated with optimal exercise prehabilitation efficacy. Copyright © 2025 International Anesthesia Research Society <53> 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 <54> Accession Number 2048420414 Title Feasibility of Distal Radial Artery Interventions and Impact of Radial Artery Diameter on Puncture Failure. Source Catheterization and Cardiovascular Interventions. 108(4) (pp 1652-1661), 2026. Date of Publication: 01 Oct 2026. Author Du Y.; Li C.; Liu M.; Zhai J.; Liu H.; Liu D.; Dong Y.; Gong Y.; Wang L.; Wang H.; Cui C.; Song Y.; Chen J.; Gao Z.; Song L.; Yang W.; Wu Y.; Yuan J.; Li H.; Guo Y.; Gao L. Institution (Du, Li, Liu, Zhai, Wang, Cui, Song, Chen, Gao, Song, Yang, Wu, Yuan, Guo, Gao) Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Du, Guo) Cardiometabolic Medicine Center, Fuwai Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China (Du, Li, Liu, Zhai, Wang, Cui, Song, Chen, Gao, Song, Yang, Wu, Yuan, Guo, Gao) State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Beijing, China (Liu, Liu, Wang) Shihezi People's Hospital, The Third Affiliated Hospital of Shihezi University School of Medicine, Xinjiang, China (Song, Li, Dong, Li) State Key Laboratory of Cardiovascular Disease, Department of Ultrasound, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Gong) School of Biomedical Sciences, Harbin Medical University, Heilongjiang, Harbin, China Publisher John Wiley and Sons Inc Abstract Background: The widespread adoption of distal radial artery (DRA) interventions has been limited by the relatively higher puncture difficulty compared to conventional radial artery access. Aim(s): Evaluate the feasibility of DRA access and explore relationship between radial artery diameter and puncture failure. Method(s): A total of 733 patients proposed for DRA access were enrolled at the Department of Cardiology, Fuwai Hospital, between 2021 and 2024. All patients underwent preoperative ultrasound evaluation to measure the radial artery diameter at the snuffbox, and at 5 cm, 10 cm, and 15 cm proximal to the styloid process of the radius. The primary outcome was DRA puncture failure. Result(s): The overall DRA puncture success rate among these patients was 96.6%. PCI was performed in 74.0% of cases, with a procedural success rate of 92.7%. Multivariate logistic regression analysis showed that DRA diameter at the snuffbox was significantly associated with puncture failure (OR = 0.24; 95% CI: 0.09-0.61). Restricted cubic spline analysis (RCS) demonstrated a nonlinear association between DRA diameter at the snuffbox and puncture failure, with an increased risk observed as DRA diameter decreased below approximately 2.40 mm. Notably, segmented logistic regression identified an inflection point at 1.67 mm, below which the risk of puncture failure increased significantly. Conclusion(s): The feasibility of DRA access was demonstrated in our study. DRA diameter was identified as an important predictor of puncture success. These findings provide an anatomical consideration for patient selection and may assist clinicians in optimizing the use of DRA access in future interventions. Copyright © 2026 Wiley Periodicals LLC. <55> 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. <56> 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. <57> Accession Number 2038625716 Title Preoperative intra-aortic balloon pump use and clinical outcomes in patients undergoing surgery for mitral regurgitation. Source American Journal of Cardiovascular Disease. 16(4) (pp 277-288), 2026. Article Number: AJCD0173094. Date of Publication: 2026. Author Bahar A.R.; Bahar Y.; Elhussain M.; Jawadi M.H.; Hasan F.; Azimi N. Institution (Bahar, Bahar, Elhussain, Jawadi) Department of Medicine, Wayne State University School of Medicine, Detroit, MI, United States (Hasan) Department of Medicine, Division of Cardiology, Rush University Medical Center, Chicago, IL, United States (Azimi) Department of Medicine, Division of Cardiology, Sharp Grossmont Hospital, La Mesa, CA, United States Publisher E-Century Publishing Corporation Abstract Background: Mitral regurgitation (MR) requiring surgical correction poses significant perioperative challenges, particularly in hemodynamically compromised patients. Evidence supporting preoperative intra-aortic balloon pump (IABP) use in this setting remains scarce. This study evaluated the association between preoperative IABP use and clinical outcomes in patients undergoing surgical MR correction. Method(s): We conducted a retrospective cohort study utilizing the Nationwide Readmissions Database (NRD) from 2016 through 2020. Adult patients undergoing surgical mitral valve repair or replacement were identified using validated ICD-10-CM and ICD-10-PCS codes. Patients who received preoperative IABP were compared with those who did not through 1:1 propensity score matching, accounting for baseline clinical characteristics and illness severity. The primary outcome was major adverse cardiac and cerebrovascular events (MACCE). Secondary outcomes included in-hospital mortality, perioperative complications, 30-day readmissions, and length of stay. Result(s): Among 33,644 hospitalizations for surgical MR correction, 1,691 (5.0%) involved preoperative IABP use. Following propensity score matching, 964 pairs were analyzed. Preoperative IABP use was associated with significantly lower rates of MACCE (16.8% vs. 19.6%, P = 0.045), in-hospital mortality (4.7% vs. 6.5%, P = 0.028), ischemic stroke (1.5% vs. 2.3%, P = 0.040), and prolonged mechanical ventilation (7.9% vs. 10.2%, P = 0.014). Thirty-day readmission rates and length of stay were also lower among IABP recipients. Conclusion(s): Preoperative IABP use was associated with modestly improved in-hospital outcomes and lower short-term readmissions, with the most pronounced benefits among high-acuity patients. These hypothesis-generating findings support a selective, severity-guided role for preoperative IABP, warranting prospective validation. Copyright © 2026, E-Century Publishing Corporation. All rights reserved. <58> Accession Number 2038316985 Title Conduit Choice for Coronary Artery Bypass Grafting in Women. Source Journal of Updates in Cardiovascular Medicine. 14(2) (pp 33-35), 2026. Date of Publication: 01 Jun 2026. Author Bradshaw A.; Lawton J.S. Institution (Bradshaw, Lawton) Johns Hopkins University Faculty of Medicine, Department of Surgery, Division of Cardiac Surgery, MD, United States Publisher Heart and Health Foundation of Turkey (HHFT) <59> Accession Number 2029629675 Title Comparison of Postoperative Anxiety, Depression, Somatization, and Somatosensory Perception Levels of Patients After Off-Pump and On-Pump Coronary Artery Bypass Graft Surgery. Source Istanbul Medical Journal. 25(2) (pp 151-157), 2024. Date of Publication: 01 May 2024. Author Emir I.; Simsek M.H.; Isik N.A.; Onk O.A. Institution (Emir, Onk) Erzincan Binali Yildirim University, Faculty of Medicine, Department of Cardiovascular Surgery, Erzincan, Turkey (Simsek) Private Giresun Ada Hospital, Clinic of Psychiatry, Giresun, Turkey (Isik) Istanbul Medeniyet University, Faculty of Health Sciences, Department of Mental Health and Psychiatric Nursing, Istanbul, Turkey Publisher Galenos Publishing House Abstract Introduction: This study investigated the effect of coronary artery bypass grafting surgery performed using either the on-pump or off-pump technique on the levels of postoperative anxiety, depression, somatization, and somatosensory amplification in patients. Method(s): There were 100 participants in this cross-sectional study who completed the "Sociodemographic Data Form", the "Hospital Anxiety and Depression Scale", the "Somatization Scale (SS)", and the "Somatosensory Amplification Scale". Result(s): Compared with the off-pump group, the on-pump group had a higher mean SS score. Conclusion(s): Because the mean SS score was lower in patients after off-pump surgery, it may be more advantageous to perform off-pump surgeries in the future. Before the superiority of the off-pump over the on-pump can be definitively established, however, data from large, randomized trials are required. Copyright © 2024 by the University of Health Sciences Turkey, Istanbul Training and Research Hospital/Istanbul Medical Journal published by Galenos Publishing House. <60> 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 <61> Accession Number 2027793890 Title The Effect of Proton-Pump Inhibitors the on Development of Arrhythmia and Hypomagnesemia After Off-Pump Coronary Artery Bypass Surgery. Source Journal of Kerman University of Medical Sciences. 30(6) (pp 344-348), 2024. Date of Publication: 01 Nov 2024. Author Abbaspour H.; Yazdi A.P.; Vakili V.; Purafzali Firuzabadi S.J.; Abbasi Tashnizi M.; Amini S. Institution (Abbaspour, Yazdi, Amini) Department of Anesthesiology and Critical Care, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of (Vakili) Department of Family Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of (Purafzali Firuzabadi) Department of Anesthesiology and Critical Care and Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of (Abbasi Tashnizi) Department of Cardiac Surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of Publisher Kerman University of Medical Sciences Abstract Background: Long-term use of proton-pump inhibitors (PPI) can result in hypomagnesemia and arrhythmia. This study aimed to compare the effect of PPI and histamine 2-receptor antagonists (H<inf>2</inf> RA) on the incidence of hypomagnesemia and arrhythmia in patients following off-pump coronary artery bypass surgery (CABG). Method(s): In this randomized-controlled clinical trial 290 patients admitted to the ICU after off-pump CABG were randomly divided into two groups of H<inf>2</inf> RA (n = 145) and PPI (n = 145). For patients in the H<inf>2</inf> RA group, 50 mg intravenous ranitidine was prescribed every 8 hours after the nothing by mouth (NPO) period, followed by 40 mg famotidine tablets after starting the oral regimen (PO). The PPI group received 40 mg pantozol IV injections every 12 hours during the NPO period and 40 mg pantozol tablets once daily after becoming PO. The patients were investigated for the development of hypomagnesemia and associated arrhythmia. Result(s): In total 271 patients with a mean age of 59.3 +/- 10 years completed the study (female/male = 32.8%). Hypomagnesemia occurred in 60.1% of the patients, 76 (56.7%) in the H<inf>2</inf> RA group and 87 (63.5%) in the PPI group (P = 0.245), whereas arrhythmia had a prevalence of 12 (9.6%) and 15 (11.1%) cases, respectively (P = 0.690). The mean time of occurrence of hypomagnesemia and arrhythmia was 1.75 +/- 1.08 and 3.0 +/- 0.9 days after the operation in the H<inf>2</inf> RA group (P = 0.111) and 1.47 +/- 0.7 and 2.9 +/- 1.5 days in the PPI group (P = 0.897), respectively. Conclusion(s): Our study revealed that the short-term use of PPIs does not result in higher rates of hypomagnesemia and associated arrhythmia in comparison to H<inf>2</inf> RA consumption after off-pump CABG. Copyright © 2023 The Author(s). <62> Accession Number 2049503380 Title Outcomes after surgical management of anomalous aortic origin of a coronary artery (AAOCA): an up-to-date systematic review and meta-analysis. Source Translational Pediatrics. 15(8) (no pagination), 2026. Article Number: 300. Date of Publication: 2026. Author Imperatore G.; Rito M.L.; Scrascia G.; Giovannico L.; Savino L.; Fischetti G.; Meliota G.; Azzolina D.; Grani C.; Bottio T.; Padalino M.A. Institution (Imperatore) Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa, Italy (Rito) Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (Scrascia, Giovannico, Savino, Fischetti, Bottio) Cardiac Surgery and Transplant Unit, Department of Precision and Regenerative Medicine and Jonian Area, University of Bari "Aldo Moro", Bari, Italy (Meliota) Pediatric Cardiology Unit, Ospedale Pediatrico Giovanni XXIII, Bari, Italy (Azzolina) Department of Biostatistics, University of Naples Federico II, Naples, Italy (Grani) Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (Padalino) Pediatric and Congenital Cardiac Surgery Unit, Department of Precision and Regenerative Medicine and Jonian Area, University of Bari "Aldo Moro", Bari, Italy Publisher AME Publishing Company Abstract Background: Anomalous aortic origin of a coronary artery (AAOCA) is a rare congenital anomaly that represents a leading cause of sudden cardiac death (SCD) in children and young athletes. Risk is concentrated in specific anatomical phenotypes, particularly anomalous aortic origin of the left coronary artery from the right sinus (L-AAOCA), variants with interarterial and/or intramural proximal course, and anomalous coronary orifice (slit-like) and acute take-off angle. Despite advances in multimodal imaging, optimal risk stratification and management remain controversial, and no randomized trials comparing surgical and conservative strategies exist. This study aims to systematically evaluate contemporary evidence and quantitatively estimate pooled clinical outcomes to define procedural safety and durability. Method(s): A systematic search of PubMed/MEDLINE, Embase, Scopus, and the Cochrane Library was performed from database inception to March 2026. Eligible studies enrolled patients with AAOCA and reported management strategies and clinical outcomes. Original surgical series with fewer than 10 operated patients were excluded from the quantitative synthesis. A qualitative synthesis and random-effects meta-analysis of proportions were conducted to estimate pooled surgical incidence outcomes. Subjective postoperative symptoms and objectively documented residual ischemia were analysed as separate endpoints. For each outcome, study-specific evaluable denominators were used when follow-up populations differed from the baseline surgical cohort. Result(s): Twenty studies were included in the updated synthesis, substantially expanding the contemporary surgical evidence base. Pooled perioperative mortality was 0.85% [95% confidence interval (CI): 0.46-1.37%; I2=0%], and pooled coronary-related reintervention was 4.06% (95% CI: 3.07-5.36%; I2=0%). New or worsened postoperative aortic regurgitation (AR) occurred in 6.65% (95% CI: 3.75-11.53%; I2=67.7%), with higher rates in unroofing-dominant cohorts. When analysed as distinct endpoints, persistent postoperative symptoms remained relatively common (12.41%, 95% CI: 7.44-20.00%; I2=84.5%), whereas objective residual ischemia after repair was uncommon (3.86%, 95% CI: 1.80-8.07%; I2=68.7%). Conservative management, predominantly applied to lower-risk R-AAOCA phenotypes, showed low annualized mortality in selected series but non-negligible cumulative risk in registry data. Conclusion(s): This up-to-date systematic review and meta-analysis found low perioperative mortality and favorable mid-term outcomes after AAOCA repair, although reintervention and postoperative AR remain relevant and vary by surgical technique. Persistent symptoms exceeded objective residual ischemia, indicating that symptoms are not a direct surrogate of residual ischemic risk. Conservative management showed low event rates in selected lower-risk cohorts, but cumulative risk may not be negligible. These findings support individualized, anatomy-driven management with careful technique selection and standardized long-term outcome reporting. Copyright © AME Publishing Company. <63> Accession Number 2049329336 Title EECP intervention and coronary flow reserve in chronic coronary syndrome: a protocol of a multicentre, randomised controlled study in China (ECP-Core Trial). Source Trials. 27(1) (no pagination), 2026. Article Number: 583. Date of Publication: 01 Dec 2026. Author Leng Y.; Li Y.; Jia X.; Tian S.; Jiang Y.; Lin L.; Wang Y.; Pan W.; Liang J.; Wu F.; Zhou W.; Liao Z.; Zhang X.; Wu G. Institution (Leng, Li, Jia, Tian, Wang, Pan, Liang, Wu, Zhou, Liao, Zhang, Wu) Department of Cardiology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Guangdong, Shenzhen, China (Jiang, Lin) Department of Imaging, The Eighth Affiliated Hospital of Sun Yat-Sen University, Guangdong, Shenzhen, China Publisher BioMed Central Ltd Abstract Background: Few non-invasive approaches are available for improving coronary function in intermediate-risk chronic coronary syndrome (CCS) patients. Over the past 30 years, enhanced external counterpulsation (EECP) has been widely accepted and recommended for treating CCS in clinical guidelines. However, the effect of EECP on coronary function remains to be quantitatively validated in intermediate-risk CCS patients. Fractional flow reserve (FFR) is a gold standard (quantitative index) of coronary artery function, and FFR < 0.80 is regarded as an indicator for percutaneous coronary intervention (PCI) in clinical decision-making. However, FFR is invasive and cannot be performed repeatedly within a short time interval; therefore, FFR is not suitable for large-scale verification of the effect before and after EECP treatment. Conversely, with advancements in numerical theory and computation hardware, FFR derived from coronary computed tomography angiography (FFR<inf>CT</inf>) performs similarly to FFR used in coronary artery function measurement. Additionally, FFR<inf>CT</inf> is non-invasive and highly acceptable to patients. Therefore, in this study, we aim to explore whether EECP therapy can improve FFR<inf>CT</inf> in patients with intermediate-risk CCS and further enhance the long-term prognosis of CCS. Method(s): This prospective, multicentre, randomised controlled trial is blinded to the examination executors and analysts. One hundred four participants will be recruited, and they will be divided into the EECP and control groups. The primary outcome of this study is the between-group difference in FFR<inf>CT</inf> changes from baseline to follow-up. The secondary outcomes refer to between-group differences in DELTAFFR<inf>CT</inf>, wall shear stress, axial plaque stress, total exercise time, time to 1 mm ST-segment depression, Seattle Angina Questionnaire score, and cardiovascular-related composite endpoint events. Discussion(s): This is the first study to use the non-invasive coronary artery function index, FFR<inf>CT</inf>, to evaluate the efficacy of EECP in patients with CCS. It comprehensively evaluates the treatment efficacy from multiple dimensions, including exercise capacity, symptom changes, and prognosis. Therefore, this will potentially provide reliable evidence to inform treatment strategies for CCS. Trial registration: Trial registration number: ChiCTR2400079915. Registered on January 16, 2024 (retrospectively registered), https://www.chictr.org.cn/about.html. Copyright © The Author(s) 2026. <64> Accession Number 2049518233 Title Immediate Versus Staged Complete Revascularization in Multivessel Disease and STEMI. Source JACC: Cardiovascular Interventions. 19(19) (pp 2589-2600), 2026. Date of Publication: 12 Oct 2026. Author O'Callaghan D.; Rai H.; Giacoppo D.; Coughlan J.J.; Colleran R.; Durand R.; Spence M.S.; Kennedy M.; Blake G.J.; Hanratty C.G.; Kastrati A.; Byrne R.A. Institution (O'Callaghan, Rai, Giacoppo, Coughlan, Colleran, Durand, Spence, Kennedy, Blake, Hanratty, Byrne) Cardiovascular Research Institute, Mater Private Network, Dublin, Ireland (O'Callaghan, Rai, Giacoppo, Coughlan, Colleran, Spence, Kennedy, Byrne) School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland (Kastrati) TUM Klinikum Deutsches Herzzentrum, Munich, Germany Publisher Elsevier Inc. Abstract Background For patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease, complete revascularization is recommended. The timing of nonculprit lesion intervention, either immediately during the index procedure or staged at a later time, has been investigated in randomized controlled trials (RCTs). Objectives This study sought to perform a meta-analysis of RCTs comparing immediate vs staged complete revascularization in patients with multivessel disease presenting with STEMI. Methods We conducted a frequentist, pairwise meta-analysis. Studies were selected based on the following inclusion criteria: multicenter RCTs comparing immediate vs staged nonculprit revascularization in patients presenting with STEMI; exclusive use of second-generation (or newer) drug-eluting stents; a follow-up duration of >=1 year; and publication in a peer-reviewed journal. The primary outcome of interest was all-cause mortality, whereas secondary outcomes included myocardial infarction (MI), cardiac death, and unplanned revascularization. Summary estimates were computed using random-effects models with inverse-variance weighting based on trial-level HRs and 95% CIs. The study protocol was registered on PROSPERO (CRD420251124207). Results After a systematic search, 4 randomized trials comprising 2,651 patients were included in the meta-analysis. The risk of all-cause death at 1-year was higher with immediate complete revascularization (HR: 1.50; 95% CI: 1.02-2.21; P = 0.04; prediction interval [PI]: 0.80-2.81; I 2 = 0%; t 2 = 0). Immediate complete revascularization reduced the risk of recurrent MI when using the protocol specified definitions which included procedural MI (HR: 0.58; 95% CI: 0.36-0.94; P = 0.02; PI: 0.22-1.54; I 2 = 0%; t 2 = 0.034) but did not reduce risk of spontaneous MI (HR: 0.91; 95% CI: 0.55-1.48; P = 0.90; PI: 0.41-2.00; I 2 = 0%; tau2 = 0.00). The risk of cardiac death and unplanned revascularization was comparable between the treatment groups. Conclusions In STEMI and multivessel disease, immediate complete revascularization may be associated with an increased risk of all-cause death at 1-year when compared with staged complete revascularization. The treatment effect on mortality should be interpreted cautiously because of the relatively low number of deaths across the 4 trials and the statistical fragility of the findings. The findings from this analysis do not support an immediate complete revascularization strategy in these patients. Copyright © 2026 American College of Cardiology Foundation. <65> 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. <66> 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/ <67> 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. <68> Accession Number 2038638896 Title EFFECT OF GENERAL AND SPINAL ANESTHESIA ON POSTOPERATIVE MYOCARDIAL INJURY IN ELDERLY PATIENTS UNDERGOING HIP FRACTURE SURGERY: A RANDOMIZED STUDY. Source Turk Geriatri Dergisi. 29(3) (pp 358-367), 2026. Date of Publication: 2026. Author Ayik M.B.; Turk H.S.; Duymaz I.; Altinay M.; Kilinc L.; Sayin P.; Cinar A.S.; Oba S. Institution (Ayik, Turk, Duymaz, Altinay, Kilinc, Sayin, Cinar, Oba) Sisli Hamidiye Etfal Training and Research Hospital, Anesthesiology and Reanimation, Istanbul, Turkey Publisher Turkish Geriatrics Society Abstract Introduction: Postoperative myocardial injury following non-cardiac surgery is a clinically relevant complication in elderly patients and is related to worse postoperative outcomes. This study investigated whether anesthesia technique affects the development of myocardial injury after hip surgery in elderly patients. Material(s) and Method(s): This prospective randomized single-blind study included 100 patients older than 65 years with hip fractures who were scheduled for hip fracture surgery classified as American Society of Anesthesiologists physical status II-III who were scheduled for hip surgery. Patients received either general or spinal anesthesia according to group allocation. Age, sex, baseline hemodynamic parameters, intraoperative heart rate, and mean arterial pressure values were monitored at 10-minute intervals. Troponin T levels were assessed before surgery and repeatedly during the first 72 postoperative hours. Intensive care unit stay, hospital stay, postoperative complications, and 30-day mortality were also evaluated. Result(s): The general and spinal anesthesia groups showed no significant difference in MINS incidence, troponin changes, mortality, hospital stay, or ICU stay. Conclusion(s): General and spinal anesthesia were related to similar postoperative myocardial injury rates in elderly patients undergoing hip surgery. Copyright © 2026, Turkish Geriatrics Society. All rights reserved. <69> Accession Number 2049644118 Title Effects of cardiac telerehabilitation versus center-based cardiac rehabilitation on cardiorespiratory fitness in patients with coronary artery disease: a meta-analysis. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 902. Date of Publication: 01 Dec 2026. Author Zhong X.; Wu J.; Li L.; Feng P. Institution (Zhong, Wu, Li, Feng) Department of Rehabilitation Medicine, The Second Nanning People's Hospital, No.13, Dancun Road, Jiangnan District, Nanning, China Publisher BioMed Central Ltd Abstract Background: Cardiac telerehabilitation (CTR) has emerged as an alternative to center-based cardiac rehabilitation (CBCR) for patients with coronary artery disease (CAD), but its effectiveness in improving cardiorespiratory fitness remains uncertain. This meta-analysis aimed to compare the effects of CTR versus CBCR on maximal oxygen uptake (VO<inf>2max</inf>) in patients with CAD. Method(s): A systematic search of PubMed, Embase, Cochrane Library, Web of Science, Wanfang, and CNKI was conducted for relevant randomized controlled trials (RCTs). Pooled mean differences (MDs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Result(s): Ten RCTs involving 896 patients were included. Overall, CTR was not associated with a significant difference in VO<inf>2max</inf> compared with CBCR (MD: 0.02 mL/kg/min, 95% CI: -0.71 to 0.74; p = 0.97; I2 = 46%). Sensitivity analyses confirmed the robustness of the findings. Subgroup analyses showed consistent results across most factors. However, greater improvements were observed in studies with higher baseline VO<inf>2max</inf> (p for subgroup difference = 0.03) and longer follow-up (> 26 weeks) (MD: 0.90 mL/kg/min, 95% CI: 0.05 to 1.75; p for subgroup difference = 0.01). Meta-regression indicated that baseline VO<inf>2max</inf> and follow-up duration were positively associated with treatment effects. The certainty of evidence was rated as moderate due to imprecision, reflected by a pooled estimate close to null and CI crossing the line of no effect. Conclusion(s): CTR provides comparable improvements in VO<inf>2max</inf> to CBCR in patients with CAD. Potential benefits may be greater in patients with higher baseline fitness and with longer follow-up, although further high-quality trials are warranted. Copyright © The Author(s) 2026. <70> 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 <71> 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. <72> Accession Number 2050563334 Title Efficacy of Home-Based Telerehabilitation Versus Center-Based Cardiac Rehabilitation on Cardiopulmonary Function and Exercise Capacity in Patients After Coronary Artery Bypass Grafting: A RANDOMIZED CONTROLLED TRIAL. Source Journal of Cardiopulmonary Rehabilitation and Prevention. (no pagination), 2026. Date of Publication: 2026. Author Liu H.; Wang X.; Wang C.; Kong M.; Ma J.; Liu Y. Institution (Liu, Wang, Wang, Kong, Ma, Liu) The First Hospital of Hebei Medical University, Hebei, Shijiazhuang, China Publisher Lippincott Williams and Wilkins Abstract Purpose: - The objective is to compare the effects of a home-based telerehabilitation (HBTCR) program, traditional center-based cardiac rehabilitation (CBCR), and usual care on cardiopulmonary function and exercise capacity in patients after coronary artery bypass grafting (CABG). Method(s): - In this randomized controlled trial, 111 patients, 4 to 8 weeks after CABG surgery, were assigned to 12 weeks of HBTCR (n = 37), CBCR (n = 37), or to a control group (n = 37). The HBTCR group utilized wearable sensors and a mobile app for remote monitoring and coaching. The CBCR group underwent supervised on-site sessions. Primary outcomes were changes in peak oxygen uptake ((Formula presented)) and 6-minute walk distance. Secondary outcomes included left ventricular ejection fraction, psychological status, and quality of life. Result(s): - Among 101 completers, both HBTCR and CBCR groups showed significant improvements in (Formula presented) (HBTCR: +5.1; CBCR: +4.8 mL/kg/min) and 6-minute walk distance (HBTCR: +85.2 m; CBCR: +81.5 m) versus control (P < .001), with no difference between interventions. Significant improvements in left ventricular ejection fraction, psychological scores, and quality of life were also observed in both intervention groups compared with control (P < .05). Adherence was high (HBTCR: 92.1%; CBCR: 85.3%) with no major adverse events. Conclusion(s): - The findings suggest that an HBTCR program has similar efficacy as CBCR in improving cardiopulmonary function, exercise capacity, and patient-centered outcomes after CABG. An HBTCR program represents a viable, accessible alternative model for delivering comprehensive cardiac rehabilitation and secondary prevention. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <73> Accession Number 2049874518 Title Drug-Coated Balloons for In-Stent Restenosis and De Novo Coronary Lesions: State of the Art and Lessons Learned From Recent Trials. Source Journal of the Society for Cardiovascular Angiography and Interventions. (no pagination), 2026. Article Number: 105675. Date of Publication: 2026. Author Alfonso F.; Jeger R. Institution (Alfonso) Department of Cardiology. Hospital Universitario de La Princesa, Universidad Autonoma de Madrid and CIBER-CV IIS-IP, Madrid, Spain (Jeger) Department of Cardiology, Triemli Hospital, Zurich and University of Basel, Basel, Switzerland Publisher Elsevier B.V. Abstract Drug-coated balloons (DCB) have emerged as an important treatment modality in percutaneous coronary intervention by providing effective local antiproliferative drug delivery without leaving a permanent metallic implant. Robust evidence supports their use for the treatment of coronary in-stent restenosis (ISR), where DCB represent an established alternative to repeat drug-eluting stent (DES) implantation while avoiding additional stent layers. Contemporary data suggest that although repeat DES implantation may reduce target lesion revascularization in selected patients with DES-ISR, DCB remain particularly attractive in many patient subsets, including those with excellent predilation results, multiple stent layers, major side branches, and those with bare-metal ISR. Careful lesion preparation and increasing use of intracoronary imaging are critical determinants of procedural success. Beyond ISR, evidence supporting DCB in de novo coronary disease has expanded substantially, particularly in small-vessel disease, where randomized trials and patient-level meta-analyses demonstrate outcomes comparable or superior to contemporary DES. Growing data also support DCB use in selected complex anatomical and clinical scenarios, including bifurcation lesions, diabetes, acute coronary syndromes, and patients at high bleeding risk. Recent randomized trials evaluating DCB in broader all-comer populations have yielded mixed results, highlighting the absence of a class effect among DCB technologies and the importance of device choice, operator experience, and optimal patient selection. Ongoing randomized trials evaluating next-generation paclitaxel- and limus-based DCB are expected to better define patient selection and the complementary roles of DCB and DES. Rather than competing technologies, DCB and DES should be considered complementary tools that enable increasingly personalized coronary revascularization strategies. Copyright © 2026 The Author(s). <74> Accession Number 2038800693 Title Risk of Cardiovascular Events in Patients with Osteoporosis on Romosozumab Treatment Compared with Denosumab: A Multicenter Observational Cohort Study. Source Endocrinology and Metabolism. 41(3) (pp 442-451), 2026. Date of Publication: 01 Jun 2026. Author Ahn S.H.; Boo D.; Kim K.J.; Choi J.; Yoon H.; Jung C.Y.; You S.C.; Oh J.S.; Hong N. Institution (Ahn) Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, South Korea (Boo, You) Department of Biomedical Systems Informatics, Yonsei University College of Medicine, South Korea (Boo, You) Institute for Innovation in Digital Healthcare, Yonsei University, South Korea (Kim, Choi) Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, South Korea (Yoon) Big Data Research Center, Asan Institute of Life Science, Asan Medical Center, Seoul, South Korea (Jung) Biomedical Research Institute, Inha University Hospital, Incheon, South Korea (Oh) Department of Information Medicine, Asan Medical Center, South Korea (Hong) Department of Internal Medicine, Endocrine Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea Publisher Korean Endocrine Society Abstract Background: Romosozumab, a potent anabolic agent for osteoporosis, has been associated with an increased risk of adjudicated cardiovascular events compared with alendronate in postmenopausal women, although such an association was not observed in a placebo-controlled trial. Evidence from real-world clinical practice remains limited. Method(s): In this multicenter observational study, we analyzed patients aged >=50 years who were newly prescribed romosozumab 120 mg monthly or denosumab 60 mg every 6 months for osteoporosis at three tertiary hospitals in South Korea between January 1, 2020, and the end of each site's data collection period. The primary outcomes were major adverse cardiovascular events (MACE; acute myo-cardial infarction, ischemic stroke, or sudden cardiac death) and all cardiovascular adverse events (CVAEs; MACE, heart failure, peripheral artery disease, and non-coronary revascularization), assessed at 1-and 3-year follow-up. Large-scale 1:1 propensity score matching and Cox proportional hazards models were applied within a common data model framework with individual-level meta-analysis. Result(s): A total of 4,896 patients were included in the MACE analysis (4,758 in the CVAE analysis). At 1 year, the incidence rate of MACE did not differ significantly between the romosozumab and denosumab groups (9.20 per 1,000 person-years vs. 6.43 per 1,000 person-years; adjusted hazard ratio [aHR], 1.42; 95% confidence interval [CI], 0.64 to 3.19). The risk of CVAE was also similar between groups (16.23 per 1,000 person-years vs. 15.45 per 1,000 person-years; aHR, 1.05; 95% CI, 0.62 to 1.78). At 3 years, no significant differences were observed for MACE (aHR, 1.51; 95% CI, 0.79 to 2.88) or CVAE (aHR, 1.04; 95% CI, 0.69 to 1.58). Conclusion(s): In real-world clinical practice, romosozumab use was not associated with a statistically significant increase in cardiovascular risk compared with denosumab. Copyright © 2026 Korean Endocrine Society. <75> Accession Number 2050949123 Title Short-Term Anticoagulant Therapy and Subclinical Leaflet Thickening in Transcatheter Aortic Valves: The NOTION-4 Trial. Source Journal of the American College of Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Larsen A.F.; Jensen J.M.; Jensen R.V.; Willemen Y.; Phoksiri A.; Khokhar A.; Thuraiaiyah J.; Pedersen K.B.; Bieliauskas G.; Terkelsen C.J.; Sondergaard L.; Kofoed K.F.; Backer O.D.; Jorgensen T.H.; Norgaard B.L.; Fuchs A.; Kofoed K.; De Backer O. Institution (Jorgensen, Larsen, Willemen, Phoksiri, Khokhar, Thuraiaiyah, Bieliauskas, Kofoed, De Backer, Backer, Jorgensen, Norgaard, De Backer, Fuchs, Kofoed, De Backer) The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark (Larsen, Backer, Jorgensen, Norgaard, De Backer, Fuchs, Kofoed, De Backer) Department of Cardiology, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark (Jensen, Jensen, Pedersen, Terkelsen, Norgaard, Backer, Jorgensen, Norgaard, De Backer, Fuchs, Kofoed, De Backer) Department of Cardiology, Skejby, Aarhus University Hospital, Aarhus, Denmark (Sondergaard, Backer, Jorgensen, Norgaard, De Backer, Fuchs, Kofoed, De Backer) Abbott Structural Heart, Santa Clara, CA, United States Publisher Elsevier Inc. Abstract Background: Following transcatheter aortic valve replacement (TAVR), subclinical leaflet thrombosis-visualized on cardiac computed tomography (CT) as hypoattenuated leaflet thickening (HALT)-is common and might be associated with thromboembolic events. Objective(s): The NOTION-4 trial investigates different antithrombotic treatment strategies for the prevention of HALT. Method(s): NOTION-4 was a randomized controlled trial enrolling patients without an indication for oral anticoagulation shortly after successful TAVR. Patients were randomized to lifelong single antiplatelet therapy (SAPT) or 3 months of direct oral anticoagulant (DOAC) therapy followed by lifelong SAPT (DOAC-3m). The primary endpoint was HALT prevalence at 12 months. The trial was powered for superiority of the experimental strategy. Result(s): Of 352 patients randomized 1:1, 5 were screen failures or withdrew consent, leaving 176 in the SAPT group and 171 in the DOAC-3m group. At 3 months, HALT was observed in 31.8% of patients receiving SAPT compared with 12.1% of those receiving DOAC-3m. At 1 year, HALT occurred in 32.2% of SAPT patients and 28.3% of DOAC-3m patients with available CT scans (risk difference: -3.9%; 95% CI: -14.4% to 6.6%; P = 0.54). The combined risk of all-cause mortality, stroke, or major/life-threatening bleeding at 12 months was 2.3% in the SAPT group vs 8.2% in the DOAC-3m group (risk difference: 5.9%; 95% CI: 1.2% to 10.6%). Conclusion(s): Among TAVR patients without an indication for oral anticoagulation, 3 months of DOAC therapy significantly reduced the prevalence of HALT at 3 months compared with SAPT; however, this effect was attenuated by 9 months after discontinuation of DOAC therapy. (The Nordic Aortic Valve Intervention Trial 4 [NOTION-4]; NCT06449469). Copyright © 2026 by the American College of Cardiology Foundation. Published by Elsevier. <76> Accession Number 2049883615 Title Perioperative Blood Management in General Surgery: Recent Advances, Current Limitations, and the Emerging Role of Artificial Intelligence-A Narrative Review. Source International Journal of General Medicine. 19 (no pagination), 2026. Article Number: 640779. Date of Publication: 2026. Author Zhang L.; Liu G.; Guo S.; Wu Y.; Yu J.; Song X.; Jiang H. Institution (Zhang, Liu, Guo, Wu, Yu, Jiang) Department of General Surgery, Hongqi Hospital Affiliated to Mudanjiang Medical University, Heilongjiang, Mudanjiang, China (Song) Department of Pathology, Mudanjiang Cancer Hospital, Heilongjiang, Mudanjiang, China Publisher Dove Medical Press Ltd Abstract Patient blood management (PBM) is a patient-centered approach to blood use that aligns with modern medical practice. It is based on multidisciplinary collaboration and evidence-based medicine. Its aim is to improve clinical outcomes by correcting preoperative anemia, reducing perioperative blood loss, standardizing transfusion practices, and optimizing the management of coagulation function. Patients undergoing general surgery, particularly complex liver surgery or gastrointestinal cancer surgery, often face preoperative anemia, intraoperative bleeding, increased transfusion requirements, and postoperative coagulation abnormalities. These factors make perioperative blood management more complex. This narrative review searched PubMed, Web of Science, Google Scholar, and the China National Knowledge Infrastructure (CNKI) for relevant studies published over the past 10 years. It summarizes recent advances, current limitations, and challenges in the clinical translation of perioperative blood management in general surgery. This review focuses on the assessment and management of preoperative anemia, bleeding control and hemostatic strategies, transfusion management, coagulation monitoring, and thrombotic risk management. It also discusses recent advances and current limitations in the use of artificial intelligence (AI) and machine learning (ML) for risk prediction, clinical decision support, and individualized management. Current evidence suggests that PBM may help optimize perioperative care in general surgery. AI/ML may also support clinical decision-making by predicting bleeding risk, estimating transfusion requirements, and stratifying thrombotic risk. However, studies specifically focusing on general surgery patients remain limited. Most available evidence comes from cardiac surgery, orthopedics, or other surgical populations. In addition, current prediction models still have several limitations, including insufficient external validation, a lack of prospective evaluation, and limited interpretability. Therefore, these models should currently be used only as tools to support clinical judgment. Therefore, future studies should include more multicenter prospective research in general surgery populations. AI/ML-assisted decision support should also be further explored within standardized PBM pathways to improve the precision and standardization of perioperative blood management in general surgery. Copyright © 2026 Zhang et al. <77> Accession Number 2050834372 Title Cold and Room-Temperature Platelets in Cardiac Surgery: The CHIPS Randomized Clinical Trial. Source JAMA. 336(14) (pp 1216-1227), 2026. Date of Publication: 13 Oct 2026. Author Spinella P.C.; Zantek N.D.; VanBuren J.M.; Nicolson S.C.; Khanna A.K.; Klompas A.M.; Boisen M.L.; Williams T.M.; Monteleone M.; Bashir D.A.; Pavey W.; Smith B.B.; Ahmed M.I.; Niebler R.A.; Jeng E.; Flynn B.C.; Joshi R.V.; Preuss J.F.; Goswami D.; Yamada C.; Lewis C.; Cohn C.S.; Tint H.; Kwak J.; Sodha N.; Simon E.R.; Van P.Y.; Greilich P.E.; Booth F.V.McL.; Carter C.P.; Keegan A.; Cap A.P.; Matuk J.; McGlothlin A.; Berry N.S.; Lewis R.J.; Steiner M.E.; Hu P.; Hawkins J.; Jobes D.R.; Fadeyi E.A.; Reynolds A.M.A.; Bel C.G.; Smith M.M.; Gandhi M.J.; Montonye B.; Kaplan A.; Serna-Gallegos D.; Sultan I.; Kinney S.; Molony K.; Hensch L.; Resheidat A.; Malivers M.; Hahn R.; Le Viellez A.; Pepperell D.; Lu Q.; Downey F.X.; Haeger K.N.; Baltagi S.A.; Jaquiss R.D.B.; Noland D.K.; Cole R.; Duffin A.; Scott J.P.; Zeng L.; Ballew A.; Webb C.; Jessen M.; Hopson E.; Mickle P.; Kavanagh S.; Matzelle S.; Crowe L.; Mennie C.; Davenport R.; Chlebeck T.; Zenk E.; Lotz D.T.; Choi W.; Hobbs R.; Baptise A.; DeChristopher P.; Schoenecker N.; Rodheim D.; Connor J.; Griese D.J.; McGuire E.; VanSandt M.; Sera V.; O'Donovan J.; Marks D.; Johnson L.; Viele K.; Cholette J.M.; Levy J.H.; Selke F.; Silverman T.; Shea S.; Yazer M.; Young P.; Ness P.; Strandenes G.; Dean J.M.; Shaz B.; Stubbs J. Institution (Spinella) University of Pittsburgh, 3250 Fifth Ave, Ste 500, Pittsburgh, PA, United States (Spinella) Departments of Surgery and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, United States (Zantek, Cohn) Department of Laboratory Medicine and Pathology, Division of Transfusion Medicine, University of Minnesota, Minneapolis, United States (VanBuren, Carter) Department of Pediatrics, Division of Critical Care, University of Utah, Salt Lake City, United States (Nicolson) Department of Anesthesiology and Critical Care Medicine, Division of Cardiothoracic Anesthesiology, Children's Hospital of Philadelphia, Philadelphia, PA, United States (Khanna) Department of Anesthesiology, Division of Critical Care Medicine, Wake Forest University School of Medicine, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC, United States (Khanna) Outcomes Research Consortium, Houston, TX, United States (Klompas) Departments of Anesthesiology & Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States (Boisen) Department of Anesthesiology and Perioperative Medicine, Division of Cardiothoracic Anesthesiology, University of Pittsburgh, Pittsburgh, PA, United States (Williams) Department of Anesthesiology & Perioperative Medicine, Division of Cardiothoracic Anesthesiology, UCLA, Ronald Reagan UCLA Medical Center, Los Angeles, CA, United States (Monteleone) Department of Anesthesia, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States (Bashir) Department of Pediatrics, Division of Critical Care Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, United States (Pavey) Department of Anaesthesia and Perioperative Medicine, Division of Cardiothoracic Anaesthesia, Fiona Stanley Hospital, Perth, WA, Australia (Smith) Department of Anesthesiology and Perioperative Medicine, Division of Cardiovascular and Thoracic Anesthesiology, Mayo Clinic, Phoenix, AZ, United States (Ahmed) Department of Anesthesiology, Division of Pediatric Cardiac Anesthesiology, Children's Medical Center, University of Texas Southwestern Medical Center, Dallas, United States (Niebler) Department of Pediatrics, Medical College of Wisconsin and Herma Heart Institute, Children's Wisconsin, Milwaukee, United States (Jeng) Department of Surgery, Division of Cardiovascular Surgery, University of Florida, Gainesville, United States (Flynn) Department of Anesthesiology, Division of Critical Care, University of Kansas Medical Center, Kansas City, United States (Joshi, Greilich) Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, William P. Clements Jr University Hospital, Dallas, United States (Preuss) Department of Anesthesia, Sir Charles Gairdner Hospital, The University of Western Australia, Perth, WA, Australia (Goswami) Department of Anesthesia and Critical Care Medicine, Division of Pediatric Cardiac Critical Care and Anesthesia, Johns Hopkins Medical Center, Baltimore, MD, United States (Yamada) Department of Pathology, Division of Transfusion Medicine, University of Michigan, Ann Arbor, United States (Lewis) Department of Anesthesiology and Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, United States (Tint) Department of Pathology and Laboratory Medicine, Hemotherapy & Transfusion Medicine, University of Texas Health Science Center, Memorial Hermann Health System, Houston, United States (Kwak) Department of Anesthesiology and Perioperative Medicine, Division of Cardiothoracic Anesthesiology, Loyola University Medical Center, Maywood, IL, United States (Sodha) Department of Surgery, Division of Cardiac Surgery, Rhode Island Hospital, Providence, United States (Simon) Department of Anesthesiology, Division of Cardiothoracic and Vascular Anesthesia, University of Wisconsin School of Medicine and Public Health, Madison, United States (Van) Department of Surgery, Division of Trauma, Critical Care and Acute Care Surgery, Oregon Health & Science University, Portland, United States (Booth) HoustonTXUnited States (Keegan) Department of Hematology, King Edward Memorial Hospital, PathWest Laboratory Medicine, Perth, WA, Australia (Cap) Department of Medicine, Uniformed Services University, Bethesda, MD, United States (Matuk) School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States (McGlothlin, Berry, Lewis) Berry Consultants, Austin, TX, United States (Steiner) Department of Pediatrics, Divisions of Hematology/Oncology and Critical Care, University of Minnesota, Minneapolis, United States (Hu, Hawkins, Jobes) Children's Hospital of Philadelphia, Philadelphia, PA, United States (Fadeyi, Reynolds, Bel) Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC, United States (Smith, Gandhi, Montonye) Mayo Clinic, Rochester, MN, United States (Kaplan, Serna-Gallegos, Sultan) University of Pittsburgh Medical Center, Pittsburgh, PA, United States (Kinney, Molony) University of Cincinnati, Cincinnati, OH, United States (Hensch, Resheidat, Malivers) Texas Children's Hospital, Baylor, Houston, TX, United States (Hahn, Le Viellez, Pepperell) Fiona Stanley Children's Hospital, Perth, WA, Australia (Lu, Downey, Haeger) Mayo Clinic, Phoenix, AZ, United States (Baltagi, Jaquiss, Noland) University of Texas Southwestern Medical Center, Children's Medical Center, Dallas, TX, United States (Cole, Duffin, Scott) Children's Hospital of Wisconsin, Milwaukee, WI, United States (Zeng, Ballew) University of Kansas Medical Center, Kansas City, KS, United States (Webb, Jessen, Hopson) University of Texas Southwestern Clements Hospital, Dallas, TX, United States (Mickle, Kavanagh, Matzelle) Sir Charles Gairdner Hospital, Perth, WA, Australia (Crowe, Mennie) Johns Hopkins Medical Center, Baltimore, MD, United States (Davenport) University of Michigan, Ann Arbor, MI, United States (Chlebeck, Zenk, Lotz) University of Minnesota, Minneapolis, MN, United States (Choi, Hobbs, Baptise) Memorial Herman Health System, Houston, TX, United States (DeChristopher, Schoenecker, Rodheim) Loyola University Medical Center, Maywood, IL, United States (Connor, Griese, McGuire) University of Wisconsin School of Medicine and Public Health, Madison, WI, United States (VanSandt, Sera) Oregon Health & Science University, Portland, OR, United States (O'Donovan, Marks, Johnson) Australian Red Cross Lifeblood West, Melbourne, VIC, Australia (Viele) Berry Consultants, LLC, Austin, TX, United States (Cholette) CHIPS Steering Committee, Rochester, NY, United States (Levy, Shaz) CHIPS Steering Committee, Durham, NC, United States (Selke) CHIPS Steering Committee, Providence, RI, United States (Silverman) CHIPS Steering Committee, Bethesda, MD, United States (Shea, Yazer) CHIPS Steering Committee, Pittsburgh, PA, United States (Young) CHIPS Steering Committee, Nashville, TN, United States (Ness) CHIPS Steering Committee, Baltimore, MD, United States (Strandenes) CHIPS Steering Committee, Bergen, Norway (Dean) CHIPS Steering Committee, Salt Lake City, UT, United States (Stubbs) CHIPS Steering Committee, Jacksonville, FL, United States Publisher American Medical Association Abstract IMPORTANCE Patients undergoing cardiac surgery with cardiopulmonary bypass often require platelet transfusions for bleeding. Platelets are routinely stored at room temperature (20-24 degreeC) for up to 5 to 7 days; however, cold storage (1-6 degreeC) may allow for increased storage duration without loss of hemostatic function. OBJECTIVE To determine the maximum cold-storage duration, up to 21 days, for which cold-stored platelets (CSPs) are noninferior or superior in hemostatic efficacy to room-temperature platelets (RTPs) when transfused in actively bleeding patients undergoing cardiac surgery with cardiopulmonary bypass. DESIGN, SETTING, AND PARTICIPANTS A phase 3, multicenter, randomized, partially blinded, adaptive, noninferiority, storage duration-ranging trial conducted in pediatric and adult patients undergoing cardiac surgery with planned cardiopulmonary bypass at 27 sites in the US and Australia from December 2021 to March 2025. Statistical analysis was conducted from September 9 to October 3, 2025. INTERVENTION Patients were randomized 2:1 to receive CSPs with a maximum of 21 days of storage vs RTPs with a maximum of 7 days of storage. MAIN OUTCOMES AND MEASURES The primary outcome was a hemostatic efficacy score with values ranging from 1 to 5 and higher values indicating greater bleeding. The noninferiority margin was 1 point. The success criterion was met if at least 1 cold-storage duration of 7 days or more had a posterior probability of noninferiority of at least 97.5%. The secondary outcome was 24-hour chest tube output. RESULTS Of the 1000 patients who underwent platelet transfusion, 989 were included in the primary analysis (650 CSPs and 339 RTPs). The cohort had a mean (SD) age of 42.1 (30.1) years and 67.8% were male. CSPs were noninferior to RTPs for the primary outcome, with a probability of greater than 99.9% for all cold-storage durations. Pooled across storage durations, CSPs had a mean difference from RTPs of 0.09 (95% credible interval, -0.06 to 0.23). Median (IQR) chest tube output at 24 hours (8.9 mL/kg [5.2-15.4] for CSPs vs 8.4 mL/kg [5.5-15.9] for RTPs; difference in medians, 0.4 [95% CI, -1.0 to 1.5]) was not statistically different between study groups. In a post hoc analysis, as all storage durations were noninferior, considering the CSPs as a single group, the hemostatic efficacy score was similar between both groups: mean (SD) of 3.08 (1.15) CSPs vs 2.99 (1.10) RTPs. There were no differences in venous or arterial thrombotic events, transfusion-associated adverse events, acute respiratory distress syndrome, kidney failure, septic shock, and mortality between the study groups, except for increased reexploration rates in the CSP group. CONCLUSIONS AND RELEVANCE For patients undergoing cardiac surgery, CSPs stored up to 21 days are noninferior to RTPs for the control of active surgical bleeding. Use of CSPs may allow for increased availability of platelets by reducing wastage and shortages and may allow for incorporation of platelets into inventory at locations where platelets cannot be maintained due to the 5- to 7-day shelf life of RTPs. Copyright © 2026 American Medical Association. All rights reserved. <78> Accession Number 652446698 Title Comment on Hemostasis Using Prothrombin Complex Concentrate in Patients Undergoing Cardiac Surgery: Systematic Review with Meta-Analysis. Source Brazilian journal of cardiovascular surgery. 41(4) (no pagination), 2026. Date of Publication: 01 Jul 2026. Author Zwaag S.V.; Kukel I.; Fassl J. Institution (Zwaag, Kukel, Fassl) TUD Dresden University of Technology Institute of Cardiac Anesthesiology Dresden Germany Institute of Cardiac Anesthesiology, TUD Dresden University of Technology, Dresden, Germany <79> Accession Number 2050778842 Title Clinical Impact of Crossover Techniques for Primary Access Hemostasis in Transfemoral Transcatheter Aortic Valve Replacement Procedures. Source Journal of Invasive Cardiology. 33(4) (pp E302-E311), 2021. Date of Publication: 2021. Author Junquera L.; Urena M.; Latib A.; Munoz-Garcia A.; Nombela-Franco L.; Faurie B.; Alperi A.; Serra V.; Regueiro A.; Fisher Q.; Himbert D.; Mangieri A.; Colombo A.; Garcia E.M.; Urquiza R.V.; Jimenez-Quevedo P.; Pascual I.; del Blanco B.G.; Sabate M.; Mohammadi S.; Freitas-Ferraz A.B.; Muntane-Carol G.; Couture T.; Paradis J.-M.; Cote M.; Rodes-Cabau J. Institution (Junquera, Mohammadi, Freitas-Ferraz, Muntane-Carol, Couture, Paradis, Cote, Rodes-Cabau) Quebec Heart & Lung Institute, Laval University, Quebec City, QC, Canada (Urena, Fisher, Himbert) Assistance Publique-Hopitaux de Paris, Bichat Hospital, Paris, France (Latib, Mangieri, Colombo) San Raffaele Scientific Institute, Milan, Italy (Latib) Montefiore Medical Center, New York, NY, United States (Munoz-Garcia, Garcia) Hospital Universitario Virgen de la Victoria, Malaga, Spain (Nombela-Franco, Urquiza, Jimenez-Quevedo) Cardiovascular Institute. Hospital Clinico San Carlos, IdISSC, Madrid, Spain (Faurie) Groupe Hospitalier Mutualiste de Grenoble, Institut Cardiovasculaire, Grenoble, France (Alperi, Pascual) Hospital Universitario Central de Asturias, Oviedo, Spain (Serra, del Blanco) Hospital Universitari Vall d'Hebron, Barcelona, Spain (Regueiro, Sabate) Institut Clinic Cardiovascular, Hospital Clinic, Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain (Mangieri, Colombo) IRCCS Humanitas Research Hospital, Milan, Italy Publisher Cliggott Publishing Co. Abstract Objectives. To determine the occurrence of vascular complications (VCs) following transfemoral transcatheter aortic valve replacement (TAVR) with new-generation devices according to the use of a crossover technique (COT). Background. The use of a COT (with/without balloon) has been associated with a reduction of VCs in TAVR patients. However, scarce data support its use with second-generation devices. Also, its potential benefit in obese patients (at high-risk of VCs) has not been elucidated. Methods. A multicenter study including 2214 patients who underwent full percutaneous transfemoral TAVR (COT, 1522 patients; no COT, 692 patients). Thirty-day events were evaluated according to the use of a COT using a multivariate logistic regression model. A subanalysis was performed in obese patients. Results. Primary access major VCs (3.5% COT vs 3.9% no COT; P=.19), major/life-threatening bleeding (3.4% COT vs 2.0% no COT; P=.33), and mortality rates (2.4% COT vs 2.6% no COT; P=.23) were similar between groups. However, minor VCs (11.7% COT vs 5.9% no COT; P<.001) and postprocedural acute renal failure (8.9% COT vs 3.9% no COT; P<.001) were higher in patients undergoing the COT. In the overall cohort, percutaneous closure device failure was more frequent in obese patients (4.0% in the obese group vs 1.9% in the non-obese group; P<.01), but these differences were no longer significant in those undergoing a COT (3.4% in the obese group vs 2.0% in the non-obese group; P=.12). Indeed, in the subset of obese patients, the COT tended to be associated with fewer VCs (3.4% COT vs 5.9% no COT; P=.09). Conclusions. The use of a COT was not associated with a reduction of major VCs or improved outcomes. However, some patient subsets, such as those with higher body mass index, may benefit from the use of a COT. These findings would suggest the application of a tailored strategy, following a risk-benefit assessment in each TAVR candidate. Copyright © 2026 HMP Global. All Rights Reserved. <80> Accession Number 2049891386 Title Pneumothorax rates following cardiac surgery with versus without continuous serratus anterior plane catheters: a secondary analysis of trial data with propensity score matching to a historic cohort. Source Canadian Journal of Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Saeed H.; Kang S.; Uppal V.; Ho L.; Herman C.; Bailey J.G. Institution (Saeed) Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Saskatchewan, Saskatoon, SK, Canada (Kang, Uppal, Ho, Bailey) Department of Anesthesia, Pain Management & Perioperative Medicine, Dalhousie University, Halifax, NS, Canada (Herman) Division of Cardiac Surgery, Dalhousie University, Halifax, NS, Canada Publisher Springer Abstract Purpose: Moderate to severe pain is common after cardiac surgery, especially in the first two postoperative days. Inadequate pain control may prolong intensive care unit (ICU) stay, may increase cost, and contributes to chronic pain. Enhanced Recovery After Cardiac Surgery (ERACS) protocols prioritize multimodal analgesia, including regional anesthesia techniques. In a recent randomized trial with continuous serratus anterior plane (SAP) catheters, we found unexpectedly high pneumothorax rates. To address this, we aimed to design a propensity-score-matched comparison using patients from the same institution to control for institutional practice patterns, surgical techniques, and patient demographics that could confound comparisons with published literature rates from other centres. Method(s): We conducted a secondary analysis of RCT data with propensity score matching to a historic cohort. We compared the pneumothorax rates in patients receiving continuous SAP catheters in our previous Cardiac-Serratus Anterior Plane (Cardiac-SAP) trial with those in a retrospective institutional database cohort of patients receiving standard care undergoing cardiac surgery via sternotomy. The two groups were propensity score matched in a 1:20 ratio based on age, sex, smoking status, surgery type, and pre-existing respiratory disease. We analyzed univariate comparisons using Fisher's exact test or the percentile bootstrapping method. Result(s): We matched 50 patients from the Cardiac-SAP trial to 989 retrospective cohort patients. After matching, the SAP catheter group was associated with a significantly higher risk of pneumothorax (12% vs 3%; odds ratio, 5.3; 95% confidence interval, 2.1 to 13.6; P < 0.001). There were no significant differences for other outcomes, including ICU readmissions, length of ventilation, and length of ICU or hospital stay. Patients who developed a pneumothorax had longer ventilation time and longer hospital stays. Conclusion(s): Our data suggest that SAP catheter use as a part of a randomized trial for cardiac surgery was associated with a higher rate of pneumothorax in trial participants than in a historic cohort of a similar population, though causality is unclear. Differences in monitoring within the trial and the inherent risks in this population may have contributed. Copyright © Canadian Anesthesiologists' Society 2026. <81> Accession Number 652448039 Title Comparison of Pressure-Controlled and Volume-Controlled Ventilation During One-Lung Ventilation in Thoracic Surgery: A Randomized Clinical Trial. Source Asian journal of anesthesiology. 63(3) (pp 106-113), 2025. Date of Publication: 01 Sep 2025. Author Ghodraty M.R.; Salehi R.; Imani F.; Emami A.; Darvishnia S. Institution (Ghodraty, Salehi, Imani, Emami, Darvishnia) Department of Anesthesiology, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of Abstract Background: One-lung ventilation (OLV) is commonly required during thoracic surgery and is associated with significant changes in respiratory mechanics and hemodynamics. The optimal ventilation mode during OLV remains controversial. This trial compared pressure-controlled ventilation (PCV) and volume-controlled ventilation (VCV) with respect to respiratory mechanics and gas exchange during OLV. Method(s): In this single-blind randomized trial, 40 adult patients undergoing thoracic surgery requiring OLV were allocated to receive either PCV or VCV in two groups. During OLV, patients in the PCV group were ventilated with pressure adjustment to achieve a target tidal volume (VT) of 6 mL/kg, while the VCV group received a fixed VT of 6 mL/kg. Respiratory and hemodynamic parameters were recorded every 15 minutes, and arterial blood gas analysis was performed every 30 minutes. Result(s): Mean airway pressure (P-mean) during OLV was significantly lower in the PCV group compared with the VCV group (P < 0.05), while dynamic compliance (C-dyn) was significantly higher in the PCV group (P < 0.05). Expiratory VT was also higher in the PCV group (P < 0.05). Mean arterial pressure was consistently higher in the PCV group during OLV (P < 0.05). No significant differences were observed between the two groups in arterial oxygenation indices (P > 0.05). Conclusion(s): PCV improved respiratory mechanics during OLV in thoracic surgery by reducing P-mean and increasing C-dyn, without improving gas exchange. These findings reflect short-term intraoperative physiological differences and should not be extrapolated to postoperative clinical outcomes. <82> Accession Number 2050598052 Title Coronary Computed Tomography Angiography (CCTA) vs Functional Imaging in the Evaluation of Stable Ischemic Heart Disease. Source Journal of Invasive Cardiology. 33(5) (pp E349-E354), 2021. Date of Publication: 01 May 2021. Author Patel V.I.; Roy S.K.; Budoff M.J. Institution (Patel) St. Mary Medical Center, Long Beach, CA, United States (Patel, Roy, Budoff) Lundquist Institute Harbor-UCLA Medical Center, Torrance, CA, United States Publisher Cliggott Publishing Co. Abstract Background. Management of patients with stable ischemic heart disease remains challenging, in part due to the inability of non-invasive testing to accurately identify those who may benefit from coronary revascularization. For decades, use of functional testing,such as nuclear perfusion imaging, stress echocardiography, and exercise electrocardiography, has remained a pivotal componentof algorithms designed to evaluate anginal pain. Over the past several years, however, a growing body of evidence has developed tosupport anatomical imaging, with special attention given to coronary computed tomography angiography (CCTA) as the morediagnostically and prognostically accurate non-invasive testing modality. The results of several large randomized controlled trials, aswell as their subsequent post hoc analyses, have led to the escalation of CCTA as the first-line test in international guidelines for theevaluation of stable chest pain in patients with low-to-intermediate risk of coronary artery disease. Moreover, recognition of CCTAand its role in improving patient outcomes has driven key change in healthcare policy coverage, leading to streamlinedreimbursement and the elimination of prior authorization when utilized in the appropriate setting. Given the rapidly accumulatingsupportive evidence, the next iteration of the American College of Cardiology/American Heart Association guidelines for stableischemic heart disease should position CCTA as the first-line test in qualifying patients. Here, we review current literature evaluatinganatomical and functional imaging, and formulate a discussion on clinical implementation, limitations of currently available data, anddirection for CCTA-based future research. Copyright © 2026 HMP Global. All Rights Reserved. <83> Accession Number 2049894154 Title Perioperative Cerebral Metabolism in Patients Under General Anaesthesia With Sevoflurane or Propofol: Evaluation of the Arterial and Jugular Bulb Metabolome. Source Anesthesiology Research and Practice. 2026(1) (no pagination), 2026. Article Number: 8559251. Date of Publication: 2026. Author Wang C.; Ma S.; Xing X.; Liu Q.; Yang Y.; Lei Q.; Liao J.; Li P. Institution (Wang, Ma, Xing, Liu, Yang, Lei, Li) Department of Anesthesiology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China (Liu) Department of Anesthesiology, Wenjiang Hospital of Sichuan Provincial People's Hospital, Chengdu Wenjiang District People's Hospital, Chengdu, China (Liao) Department of Stomatology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China Publisher John Wiley and Sons Ltd Abstract Objective: Arterial serum was generally used to uncover shifts in the metabolic profile induced by surgery and anaesthesia. The specific perioperative metabolic alterations in the brain remain largely unknown. We aimed to detect perioperative changes in cerebral metabolism by arteriovenous gradients of circulating metabolites across the brain using liquid chromatography-tandem mass spectrometry (LC-MS) analysis. Method(s): The prospective study was conducted at Sichuan Provincial People's Hospital, China. Twenty patients with unilateral pulmonary lesion were recruited. Patients undergoing thoracic surgery were randomised to receive general anaesthesia with sevoflurane or propofol. Blood samples from radial artery and jugular bulb were collected before and after first anaesthetic administration, at the end of 60 min of maintenance of anaesthesia and 60 min after patients regained consciousness. LC-MS-based untargeted metabolomics strategies were used to determine the difference in abundance of circulating metabolites between artery and jugular bulb. Result(s): A total of 3900 metabolites were detected. Potential critical alterations of metabolites including phosphatidylcholine (PC), phosphatidylethanolamine (PE), choline, isocitrate and lactate and pathways were identified. Brain took up PC and PE in group sevoflurane but secreted these compounds in group propofol. Additionally, propofol was associated with the release of choline and isocitrate from brain. In both groups, lactic acid entered brain intraoperatively. Conclusion(s): This work may offer a comprehensive mapping of perioperative alterations of cerebral metabolism in patients under general anaesthesia and a new direction for further studies in pharmacology of general anaesthetics and pathogenesis of perioperative brain dysfunction. Trial Registration: Chinese Clinical Trial Registry: ChiCTR2500111204. Copyright © 2026 Chenghong Wang et al. Anesthesiology Research and Practice published by John Wiley & Sons Ltd. <84> Accession Number 2049774184 Title Rheumatic lesions of the pulmonary valve: A systematic review of the literature. Source Archives of Cardiovascular Diseases. (no pagination), 2026. Date of Publication: 2026. Author Nacanabo M.W.; Tall-Thiam A.; Seghda A.A.T.; Lengani E.H.; Thiombiano P.L.; Dah C.D.; Loya-Abouga M.; Yameogo A.A.; Ouattara-Zinge A.B.; Millogo G.C.R.; Kologo J.K.; Kambire Y.; Yameogo V.N.; Samadoulougou A.K.; Zabsonre P. Institution (Nacanabo, Tall-Thiam, Seghda, Thiombiano, Dah, Loya-Abouga, Samadoulougou) Department of Cardiology, Bogodogo University Hospital, Ouagadougou, Burkina Faso (Millogo, Kologo, Yameogo, Zabsonre) Department of Cardiology, Yalgado Ouedraogo University Hospital, Ouagadougou 01, Burkina Faso (Kambire) Department of Cardiology, Tengandogo University Hospital, Ouagadougou 11, Burkina Faso (Lengani, Yameogo) Department of Cardiology, Souro Sanou University Hospital, Bobo Dioulasso 01, Burkina Faso (Ouattara-Zinge) Department of Cardiology, Pala University Hospital, Bobo Dioulasso 01, Burkina Faso Publisher Elsevier Masson s.r.l. Abstract Background Rheumatic pulmonary valve disease accounts for < 1% of cases of rheumatic heart disease. Because of its rarity, this valvular disease is often overlooked and underdiagnosed. Aim To conduct a systematic review of reported cases of rheumatic pulmonary valve disease worldwide. Methods Studies reporting confirmed cases of rheumatic pulmonary valve disease, and providing sufficient clinical, diagnostic, therapeutic or follow-up data were included. Duplicate checking, selection, data extraction and quality assessment of the included studies were carried out by two reviewers, independently. The Joanna Briggs Institute critical appraisal tools were used for quality assessment. The process did not result in a meta-analysis because of significant heterogeneity and a lack of data. The review protocol is registered on the Prospective Registry of Systematic Reviews (CRD420261341732). Results We identified 909 publications across the six databases. Following deduplication and selection, we included a total of 30 studies involving 35 patients, published between 1931 and 2025. Case reports predominated, accounting for 87% of studies ( n = 26); case series accounted for 13% ( n = 4). Age ranged from 3 to 83 years (median 29 years). There was a female predominance ( n = 20; 57%). India accounted for 37% of cases ( n = 13), followed by the USA with 11% ( n = 4). Only 46% of patients ( n = 16) presented with acute rheumatic fever or pre-existing rheumatic heart disease on admission. Dyspnoea was a constant symptom in all patients. Seven patients (20%) presented with atrial fibrillation. A procedure was performed in 74% of cases ( n = 26): pulmonary valve replacement in 40% ( n = 14); balloon dilation in 11% ( n = 4); and intraoperative commissurotomy in 20% ( n = 7). The clinical outcome was favourable in 74% of the documented cases ( n = 26). Conclusions Rheumatic pulmonary valve disease is a rare condition, but is likely to be underdiagnosed and underreported; it most commonly forms part of a quadrivalent valve disease. This review highlights the need for increased clinical and paraclinical vigilance when assessing the pulmonary valve in rheumatic heart disease. Copyright © 2026 Elsevier Masson SAS. <85> Accession Number 2051003581 Title Effect of perioperative opioid-sparing multimodal analgesia on early postoperative sleep disturbance in adults undergoing elective non-cardiac, non-obstetric surgery under general anaesthesia: protocol for a systematic review and meta-analysis. Source BMJ Open. 16(10) (no pagination), 2026. Article Number: e121506. Date of Publication: 01 Oct 2026. Author Shi Y.; Cai H.; Du J.; Fu Z.; Zhao J.; Liu X. Institution (Shi, Cai, Du, Fu) Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Shi, Cai, Du, Fu, Zhao, Liu) Department of Anaesthesiology, China-Japan Friendship Hospital, Beijing, China Publisher BMJ Publishing Group <86> Accession Number 2038790630 Title Effect of Acapella versus Incentive Spirometry on Partial Pressure of Carbon Dioxide in Arterial Blood after Coronary Artery Bypass Graft Surgery: A Randomized Controlled Trial. Source Natural Resources for Human Health. 6(18S) (pp 137-148), 2026. Date of Publication: 30 Sep 2026. Author Naji B.A.; Jasim A.H. Institution (Naji, Jasim) Fundamentals of Nursing Department, College of Nursing, University of Baghdad, Baghdad, Iraq Publisher Visagaa Publishing House Abstract Background: Patients undergoing coronary artery bypass grafting (CABG) are at increased risk for postoperative pulmonary complications, which may include pneumonia, atelectasis, bronchospasm, exacerbation of chronic obstructive pulmonary disease (COPD), pneumothorax, pleural effusion, and various upper respiratory tract conditions. (1) The Acapella method is used to improve lung volume and airway patency in the early postoperative period in patients who have undergone coronary artery bypass grafting (CABG). Objective(s): to evaluate and compare the effect of acapella and incentive spirometry on Partial Pressure of Carbon Dioxide (PaCO2) after coronary artery bypass graft. Method(s): In a randomized controlled study, the effects of acapella versus incentive spirometry were compared in two cardiac centers (the Iraqi center of heart disease and Ibn Al-Bitar Specialized Center) from December 8th, 2025, to June 23rd 3, 2026. after getting the Ethical Approval Committee under No:37 on March 25, 2025.informed written agreement was gotten from all participant were involved in the study. The researchers' recruited volunteers who had undergone coronary artery bypass grafting (CABG) and randomly separated them into two groups: a study group and a control group. A total of 85 patients take part in the study. The main outcomes were measurements of PaCO2, were extracted from the patients' clinical records (ABGs), with the mean value calculated when the tests being conducted numerous times daily. PaCO2 measured 10 hours after extubation when patient is stable, one day after extubation, and day three after extubation after the procedure. The data were analyzed and interpreted by means of the statistical software SPSS (version 26.0). Qualitative variables such as age, sex, level of education, occupation, and place of residence were statistically analyzed using frequencies and percentages. Numerical variables were statistically analyzed using mean and standard deviation. A p-value below 0.05 was measured statistically significant. Result(s): The findings demonstrate significant reduction in PaCO2 levels over the three measurement periods in the control group (chi2= 15.630, p= 0.000) with moderate effect size (0.289); Incentive Spirometry group (chi2= 19.513, p= 0.000) with moderate effect size (0.325), and Acapella group (chi2= 27.214, p= 0.000) with large effect size (0.486). Conclusion(s): our study results showed that both Acapella and Incentive spirometry were associated with improved PaCo2 after Coronary Artery Bypass Graft, with Acapella showing the largest within-group effect. Recommendation: Join the acapella as adjunctive therapy with nursing practice care and rehabilitation of dyspnea for patients after coronary artery bypass grafting Surgery and conduct a clinical study to examine acapella with deep breathing and cough trials in patients who will undergo coronary artery bypass grafting surgery with lung problems such as chronic obstructive pulmonary disease and asthma. Copyright © 2026, Visagaa Publishing House. All rights reserved. <87> Accession Number 652445855 Title Individualized Cardiac Index-Guided Hemodynamic Therapy in High-Risk Patients Undergoing Elective Major Abdominal Surgery: The PELICAN Randomized Clinical Trial. Source JAMA. (no pagination), 2026. Date of Publication: 19 Oct 2026. Author Saugel B.; Meidert A.S.; Meyhoff C.S.; Sort R.; Aasvang E.K.; Bergholz A.; Serir A.; Schwartze E.; Thomsen K.K.; Zollner C.; Berthold S.; Borrmann M.; Esser J.; Laska A.; Scheiermann P.; Foss N.B.; Olsen J.W.; Madsen L.M.; Welling A.H.; Gaik C.; Roth S.; Schroder J.; Vives M.; Klimovic A.; Eichlseder M.; Goldmann S.; Renne T.; Hedrich H.; Vettorazzi E.; Zapf A.; Kouz K.; Flick M. Institution (Saugel, Bergholz, Serir, Schwartze, Thomsen, Zollner, Kouz, Flick) Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Saugel, Thomsen, Kouz) Outcomes Research Consortium, Houston, TX, United States (Meidert, Berthold, Borrmann, Esser, Laska, Scheiermann) Department of Anaesthesiology, LMU University Hospital, LMU Munich, Munich, Germany (Meyhoff, Madsen) Department of Anaesthesia and Intensive Care, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark (Meyhoff, Sort, Aasvang, Foss) Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark (Sort, Foss, Olsen) Department of Anaesthesia and Intensive Care, Hvidovre University Hospital, Copenhagen, Denmark (Aasvang, Welling) Department of Anesthesiology, Center for Cancer and Organ Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark (Gaik) Department of Anesthesiology and Intensive Care Medicine, University Hospital Giessen and Marburg, Campus Marburg, Marburg, Germany (Roth) Department of Anaesthesiology, Medical Faculty and University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Duesseldorf, Germany (Schroder) Department of Anesthesiology and Intensive Care, University Hospital Schleswig-Holstein, Campus Luebeck, Germany (Vives) Department of Anesthesia and Critical Care, Clinica Universidad de Navarra, Pamplona, Spain (Vives) School of Medicine, Universidad de Navarra, Pamplona, Spain (Vives) IdiSNA, Instituto de Investigacion Sanitaria de Navarra, Pamplona, Spain (Klimovic) Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine in Plzen, Charles University & University Hospital in Plzen, Czechia (Eichlseder) Division of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria (Goldmann) Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany (Renne) Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Renne) Irish Centre for Vascular Biology, School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland (Hedrich, Vettorazzi, Zapf) Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany Abstract Importance: It remains unclear if intraoperative hemodynamic therapy should be guided by cardiac index. Objective(s): To evaluate whether individualized cardiac index-guided hemodynamic therapy vs routine hemodynamic therapy improves outcomes in high-risk patients undergoing elective major abdominal surgery. Design, Setting, and Participant(s): This multicenter, single-blind, superiority randomized clinical trial enrolled high-risk patients undergoing elective major abdominal surgery between October 8, 2023, and October 25, 2025, at 12 university medical centers in Austria, the Czech Republic, Denmark, Germany, and Spain. The date of last follow-up was January 15, 2026. Intervention(s): Patients were randomized to individualized cardiac index-guided hemodynamic therapy targeting the patient's preoperative resting cardiac index vs routine hemodynamic therapy (with blinded cardiac index monitoring). Main Outcomes and Measures: The primary outcome was a composite of acute kidney injury, acute myocardial injury, severe infectious complications, nonfatal cardiac arrest, or death within the first 7 postoperative days. Secondary outcomes included the individual components of the primary outcome within the first 7 postoperative days. Result(s): Of the 1128 patients enrolled, 1111 were randomized and 1095 were included in the primary analysis (median age, 67 years [IQR, 59-74 years]; 49.4% were female). The primary outcome occurred in 243 of 549 patients (44.3%) in the individualized cardiac index-guided hemodynamic therapy group vs 256 of 546 patients (46.9%) in the routine hemodynamic therapy group (relative risk, 0.94 [95.1% CI, 0.83-1.08]; P = .38). There were no between-group differences for the incidence of the individual components of the primary outcome within the first 7 postoperative days. Conclusions and Relevance: Among high-risk patients undergoing elective major abdominal surgery, individualized cardiac index-guided hemodynamic therapy targeting the patient's preoperative resting cardiac index did not reduce the incidence of a composite outcome of acute kidney injury, acute myocardial injury, severe infectious complications, nonfatal cardiac arrest, or death within the first 7 postoperative days compared with routine hemodynamic therapy. Trial Registration: ClinicalTrials.gov Identifier: NCT05648279. <88> Accession Number 2049877146 Title Five-Year Follow-Up of Transcatheter Aortic Valve Replacement With Self-Expanding Intra-Annular Versus Commercially Available Valves. Source JACC: Cardiovascular Interventions. (no pagination), 2026. Date of Publication: 2026. Author Makkar R.R.; Cheng W.; Waksman R.; Chakravarty T.; Satler L.F.; Groh M.; Abernethy W.; Russo M.J.; Heimansohn D.; Hermiller J.; Worthley S.; Chehab B.M.; Matthews R.; Ramana R.K.; Yong G.; Chen C.; Asch F.M.; Nakamura M.; Jilaihawi H.; Sharma R.; Patel D.; Kapadia S.; Reardon M.J.; Bhatt D.L.; Fontana G.P. Institution (Makkar, Cheng, Chakravarty, Nakamura, Jilaihawi, Patel) Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States (Waksman, Satler) Washington Hospital Center, Washington, DC, United States (Groh, Abernethy) Mission Health and Hospitals, Asheville, NC, United States (Russo) Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, United States (Chen) Newark Beth Israel Medical Center, Newark, NY, United States (Heimansohn, Hermiller) St Vincent Heart Center, Indianapolis, IN, United States (Worthley) Royal Adelaide Hospital, Adelaide, SA, Australia (Worthley) Genesis Care, Sydney, NSW, Australia (Chehab) Ascension Via Christi Hospital, University of Kansas, Wichita, KS, United States (Matthews) University of Southern California, Los Angeles, CA, United States (Ramana) Advocate Christ Medical Center, Oak Lawn, IL, United States (Ramana, Yong) Heart Care Centers of Illinois, Palos Park, IL, United States (Asch) MedStar Health Research Institute, Washington, DC, United States (Sharma) Stanford University Medical Center, Stanford, CA, United States (Kapadia) Cleveland Clinic, Cleveland, OH, United States (Reardon) Houston Methodist Hospital, Houston, TX, United States (Bhatt) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, United States (Fontana) Cardiovascular Institute, Los Robles Regional Medical Center, Thousand Oaks, CA, United States Publisher Elsevier Inc. Abstract Background Long-term outcomes of the self-expanding intra-annular Portico transcatheter aortic valve are not known. Objectives This study aimed to report the 5-year outcomes of the PORTICO IDE randomized controlled trial. Methods This multicenter trial randomized (1:1) patients with severe symptomatic aortic stenosis at high/extreme surgical risk to transcatheter aortic valve replacement (TAVR) with the self-expanding intra-annular valve (study valve) or Food and Drug Administration-approved commercially available valves (CAVs; balloon-expandable or self-expanding supra-annular platforms). Assessments of the primary safety endpoint (30 days) and the primary efficacy endpoint (1 year) have been previously reported. Prespecified clinical outcomes and hemodynamic valve parameters are presented through 5 years. Results We randomized 750 eligible patients (mean age: 83 years, 52.7% female) to the study valve (n = 381) or CAV (n = 369). Compared with CAV, the study valve showed similar 5-year all-cause mortality or stroke (55.6% vs 51.3%, P = 0.42). Cardiovascular mortality was numerically higher in the study valve group compared with the CAV group (33.4% vs 25.8%; P = 0.06). Naive permanent pacemaker implantation was higher in the study valve group (36.6%) than the CAV group (20.3%; P < 0.0001) at 5 years. At 5 years, the study valve showed a lower mean transvalvular gradient (7.2 +/- 3.0 vs 9.5 +/- 6.5 mm Hg, P = 0.008), but similar valve area (1.78 +/- 0.45 vs 1.71 +/- 0.51 cm2, P = 0.40) compared to CAV. Conclusions In patients at high or extreme surgical risk, TAVR with the self-expanding intra-annular transcatheter heart valve had similar 5-year overall survival, stroke rates, and valve function compared with commercially available valves. Copyright © 2026 The Authors. <89> Accession Number 2049854314 Title 2026 Asia Pacific Heart Rhythm Society (APHRS) Guidelines (Part II) on Stroke Prevention in Atrial Fibrillation. Source Journal of Arrhythmia. 42(5) (no pagination), 2026. Article Number: e70491. Date of Publication: 01 Oct 2026. Author Chao T.-F.; Lip G.Y.H.; Chan Y.-H.; Lee S.-R.; Li M.; Kim D.; Kuo L.; Okumura K.; Tse H.-F.; Choi E.-K.; Chen M.; Joung B.; Krittayaphong R.; Middeldorp M.E.; Soejima K.; Pak H.-N. Institution (Chao, Kuo) Cardiovascular Center, Taipei Veterans General Hospital and National Yang Ming Chiao Tung University, Taipei, Taiwan (Republic of China) (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 (Chan) Cardiovascular Department, Chang Gung Memorial Hospital, Taoyuan, Taiwan (Republic of China) (Lee, Choi) Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (Lee, Choi) Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea (Li, Chen) Division of Cardiology, the First Affiliated Hospital With Nanjing Medical University, Nanjing, China (Kim, Joung, Pak) Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea (Kuo) Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan (Republic of China) (Okumura) Division of Cardiology, Saiseikai Kumamoto Hospital, Kumamoto, Japan (Tse) Cardiology Division, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, SAR, Hong Kong (Krittayaphong) Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand (Middeldorp) Centre for Heart Rhythm Disorders, Adelaide University, Adelaide, Australia (Soejima) Department of Cardiovascular Medicine, Kyorin University School of Medicine, Tokyo, Mitaka, Japan Publisher John Wiley and Sons Inc Abstract The 2026 Asia Pacific Heart Rhythm Society (APHRS) Guidelines represent the first comprehensive APHRS guidelines dedicated to the management of atrial fibrillation (AF) and comprise four parts covering epidemiology, detection/screening and integrated care; stroke prevention; rate and rhythm control; and lifestyle risk factor and comorbidity management. Part II focuses on stroke prevention in AF, integrating contemporary global evidence with data and clinical considerations specific to the Asia-Pacific region. It provides evidence-based and practical recommendations for stroke and bleeding risk assessment, oral anticoagulation, selection and appropriate dosing of direct oral anticoagulants, management of patients with special or complex clinical characteristics, and left atrial appendage occlusion. Particular attention is given to issues (and evidence) highly relevant to Asia-Pacific populations, including the evolving risk of ischemic stroke, appropriate anticoagulant dosing, renal function assessment, and balancing thromboembolic and bleeding risks. These recommendations aim to support individualized clinical decision-making, promote appropriate use of stroke-prevention strategies, and improve outcomes for patients with AF across the Asia-Pacific region. Copyright © 2026 The Author(s). Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society. <90> Accession Number 652422225 Title From bench to theatre: coronary anastomosis simulation in early UK cardiothoracic training - a review. Source Annals of the Royal College of Surgeons of England. (no pagination), 2026. Date of Publication: 15 Oct 2026. Author Mubarak F.S.; Haqzad Y.; Evans B. Institution (Mubarak, Haqzad, Evans) Leeds Teaching Hospitals NHS Trust, United Kingdom Abstract INTRODUCTION: Coronary anastomosis and artery bypass grafting remain fundamental components of cardiothoracic surgical practice. We review coronary anastomosis simulators, compare their educational evidence and practical trade-offs, and propose incorporation of simulation longitudinally into early UK cardiothoracic training. METHOD(S): A search of PubMed/MEDLINE and Google Scholar was undertaken for English-language publications from January 2000 to August 2026. Reference lists of relevant reviews were hand-searched. UK policy and programme material was identified from the Intercollegiate Surgical Curriculum Programme, the Society for Cardiothoracic Surgery in Great Britain and Ireland and associated professional sources. Studies describing a simulator, educational intervention, validation, assessment or transfer outcome were prioritised. FINDINGS: Low-fidelity models, including silicone tubes, foam-based vessels, and 3D-printed constructs, provide affordable and accessible opportunities for repetitive practice and early skills acquisition. High-fidelity simulators, such as beating-heart systems, offer enhanced realism suitable for advanced training levels. Biological models deliver superior anatomical fidelity but present logistical and cost limitations. Across modalities, simulation training consistently improves technical performance, including suture quality, procedural precision, OSATS scores and anastomosis time. Evidence demonstrating transfer of simulator-acquired skills to real operative performance remains sparse. Current UK training delivers simulation primarily through isolated short courses rather than structured longitudinal curricula. CONCLUSION(S): Simulation-based coronary anastomosis training is a valuable tool for front-loading technical skill acquisition in early cardiothoracic training. Educational impact is driven less by fidelity and more by structured curricula, deliberate practice and timely feedback. Future priorities include national standardisation, validation of clinical skill transfer and improving equitable access to simulation resources. <91> Accession Number 2049877499 Title Left atrial appendage occlusion for stroke prevention in atrial fibrillation: recent evidence, catheter ablation, and future trials. Source Expert Review of Cardiovascular Therapy. (no pagination), 2026. Date of Publication: 2026. Author Samaras A.; Nair D.G.; Nielsen-Kudsk J.E.; Tzikas A. Institution (Samaras) School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece (Nair) St. Bernards Healthcare & Arrhythmia Research Group, Jonesboro, AR, United States (Nielsen-Kudsk) Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (Tzikas) Second Department of Cardiology, General Hospital "Hippokration", Thessaloniki, Greece (Tzikas) Cardiology Department, European Interbalkan Medical Center, Thessaloniki, Greece Publisher Taylor and Francis Ltd. Abstract Introduction: Oral anticoagulation (OAC) remains the standard for stroke prevention in atrial fibrillation (AF), but bleeding, non-persistence and thromboembolism despite treatment create important unmet needs. Catheter ablation and left atrial appendage occlusion (LAAO) address distinct mechanisms and do not reproduce systemic anticoagulation. Areas covered: This narrative review covers randomized anticoagulation-withdrawal studies after ablation, trials and pooled evidence on LAAO, patients unable to sustain anticoagulation, procedural imaging and healing, post-implant antithrombotic therapy, and future trial design. Targeted searches of PubMed/MEDLINE and ClinicalTrials.gov were supplemented by citation screening and review of contemporary congress reports, for evidence spanning 2005-10 October 2026. Expert opinion: The completed randomized LAAO program mainly tests substitution where OAC remains feasible. Precision source control should be investigated as rescue when OAC cannot be sustained and as a potential dose-sparing complement in selected patients, while addressing residual ischemic risk and verifying durable closure. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <92> Accession Number 2049885983 Title Closed Versus Open Vent Port Techniques and the Disconnection Technique for Optimizing Lung Collapse With Bronchial Blockers in Video-Assisted Thoracoscopic Surgery: A Randomized Controlled Trial. Source Clinical Respiratory Journal. 20(10) (no pagination), 2026. Article Number: e70235. Date of Publication: 01 Oct 2026. Author Yao J.; Chen Y.-J.; Shen F.-M.; Xie J.; Yang J.-J.; Huang L.-X.; Tan X.-X.; Yang Y.; Sun J. Institution (Yao, Chen, Shen, Xie, Yang, Huang, Tan, Yang, Sun) Department of Anesthesiology, Surgery and Pain Management, Zhongda Hospital, Southeast University, Jiangsu, Nanjing, China (Sun) Jiangsu Provincial Key Laboratory of Critical Care Medicine, Jiangsu, Nanjing, China Publisher John Wiley and Sons Inc Abstract Introduction: For patients undergoing video-assisted thoracoscopic surgery (VATS) for lung cancer or other pulmonary lesions, effective one-lung ventilation (OLV) is essential to provide surgical exposure. Bronchial blockers (BBs) are increasingly used for OLV, but the optimal management of their vent port to accelerate lung collapse remains unclear. Method(s): In this prospective, randomized, controlled trial, 75 patients were allocated to three groups (n = 25 each): Group 1-BB with vent port closed; Group 2 (control)-BB with vent port open; Group 3-BB with the disconnection technique. Primary outcome was the time to complete lung collapse, which was scored according to the video clips obtained during the operation. Secondary outcomes included intraoperative hypoxemia, blood gas analysis, blocker malposition, perioperative complications, and surgeon satisfaction. Result(s): A total of 72 patients were included in the modified intention-to-treat analysis, with 24 patients in each group. Median time to complete lung collapse was 15 min (95% CI: 10-15) in Groups 1 and 3 but was not reached in Group 2 (15/24, 62.5% had not achieved complete collapse by 30 min). In an exploratory 30-min restricted mean survival time (RMST), complete collapse occurred on average 14.17 min earlier in Group 1 (95% CI: 11.10-17.23) and 12.50 min earlier in Group 3 (95% CI: 9.62-15.38) than in Group 2, with no difference between Groups 1 and 3 (1.67 min, 95% CI: -1.85 to 5.19); time-averaged hazard ratios were consistent (Group 1 vs. 2, 9.80 [4.22-22.73]; Group 3 vs. 2, 7.63 [3.36-17.31]; Group 1 vs. 3, 1.20 [0.67-2.16]). No significant differences were detected in hypoxemia, blocker malposition, or complications across groups; however, the trial was not powered for safety outcomes. Conclusion(s): In patients aged 18-65 years with ASA I-II and normal pulmonary function undergoing thoracic surgery, the closure of the BB vent port results in a more rapid lung collapse compared to maintaining the vent port open. However, there was no statistically significant difference observed between the vent port closure technique and the disconnection technique regarding the time required for complete lung collapse. Trial Registration: ChiCTR identifier: ChiCTR2000039896. Copyright © 2026 The Author(s). The Clinical Respiratory Journal published by John Wiley & Sons Ltd. <93> Accession Number 652424676 Title Mental Health Factors in Cardiothoracic Surgery Risk Prediction Models: A Systematic Review. Source Journal of the American Heart Association. (pp e052512), 2026. Date of Publication: 16 Oct 2026. Author Rios-Monterrosa J.; Artunduaga M.C.; Rasheed N.; Aguiar C.; Castro S.J.; Jaime M.; Lang E.; Woodward A.; Sun L.Y. Institution (Rios-Monterrosa, Rasheed, Castro, Sun) Division of Cardiothoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine Stanford University School of Medicine Stanford CA USA (Artunduaga) Universidad de los Andes Bogota Colombia, Colombia (Aguiar) California Northstate University College of Medicine Elk Grove CA USA (Jaime) Kaiser Permanente Bernard J. Tyson School of Medicine Pasadena CA USA (Lang) University of Central Florida College of Medicine Orlando FL USA (Woodward) Lane Medical Library Stanford University School of Medicine Stanford CA USA Abstract BACKGROUND: Mental health disorders are associated with substantial morbidity and death in cardiovascular disease, yet their role in perioperative risk stratification remains unclear in patients undergoing cardiothoracic surgery. We evaluated how mental health disorders are currently incorporated into cardiothoracic surgery risk prediction models. METHOD(S): We conducted a Preferred Reporting Items for Systemic Reviews and Meta-Analysis-concordant systematic review of PubMed and Embase on September 11, 2025 (International Prospective Register of Systematic Reviews: CRD420251274958). We included studies that developed or validated risk models predicting postoperative outcomes in adults undergoing cardiothoracic surgery that either included a mental health disorder as a covariate or validated a model in patients with such disorders. Model characteristics were extracted using the Checklist for Critical Appraisal and Data Extraction for Systemic Reviews of Prediction Modeling Studies, and risk of bias and applicability were assessed using the Prediction Model Risk of Bias Assessment Tool+Artificial Intelligence. Findings were synthesized qualitatively. RESULT(S): Of 17 986 articles screened, 9 studies met inclusion criteria and described 17 unique models. No study validated a model specifically in patients with mental health disorders. Depression was the most frequently included mental health covariate (8 models). When incorporated, mental health disorders had associations comparable to established clinical risk factors. The most frequently modeled outcomes were hospital readmission and postoperative depression. Three studies had a high risk of bias. Covariate selection and modeled outcomes varied substantially. CONCLUSION(S): Mental health disorders are rarely incorporated into cardiothoracic surgery risk models despite potentially important prognostic associations. Future studies should evaluate their incremental predictive value, validate models in patients with mental health disorders, and examine intersections with sociodemographic risk factors. <94> Accession Number 2049848970 Title Health-Related Quality of Life Following the Ross Procedure: A Systematic Review. Source Journal of Cardiac Surgery. 2026(1) (no pagination), 2026. Article Number: 5828872. Date of Publication: 2026. Author Dhakal S.; Jayabalan D.; Raguragavan A.; Saxena A. Institution (Dhakal, Jayabalan) Sir Charles Gardner Hospital, Nedlands, WA, Australia (Dhakal, Jayabalan, Raguragavan) Medical School, University of Western Australia, Nedlands, WA, Australia (Raguragavan) Fiona Stanley Hospital, Murdoch, WA, Australia (Saxena) Prince of Wales Hospital, Randwick, NSW, Australia Publisher John Wiley and Sons Inc Abstract The Ross procedure provides a living autologous aortic valve substitute and avoids lifelong anticoagulation, but its effect on health-related quality of life (HRQoL) relative to alternative aortic valve strategies remains incompletely defined. We conducted a systematic review of studies published from January 2000 to 17 September 2026 evaluating postoperative HRQoL after the Ross procedure using validated patient-reported outcome instruments. Twelve studies met the eligibility criteria. Six directly compared Ross recipients with mechanical aortic valve replacement (mAVR): three reported significantly better Ross outcomes in at least one SF-36 domain, one favoured the mechanical group in selected domains, and two found no significant difference. A randomised comparison with homograft aortic root replacement demonstrated higher physical functioning, general health and physical component scores after Ross at long-term follow-up. Comparisons with aortic valve repair were generally similar. Paediatric and young-adult studies demonstrated generally preserved HRQoL compared with healthy or relevant reference populations, although psychological concerns were identified in selected cohorts. Contemporary long-term data using PROMIS-10 and MacNew similarly demonstrated preserved physical and favourable mental and disease-specific HRQoL after Ross. Important limitations included substantial clinical and methodological heterogeneity, absence of preoperative HRQoL in most studies, residual confounding in observational comparisons and selection/non-response bias. Available evidence suggests that long-term HRQoL after the Ross procedure is generally preserved, with selected domain-level advantages reported against mAVR and homograft comparators. However, the heterogeneous and predominantly observational evidence base does not establish global HRQoL superiority of Ross over alternative aortic valve procedures. Copyright © 2026 Sugam Dhakal et al. Journal of Cardiac Surgery published by John Wiley & Sons Ltd. <95> Accession Number 652422744 Title Mechanical CPR - Assisted Percutaneous Coronary Intervention During Cardiac Arrest: Feasibility and Outcomes. Source Medical principles and practice : international journal of the Kuwait University, Health Science Centre. (pp 1), 2026. Date of Publication: 15 Oct 2026. Author Triantafyllis A.; Kotoulas S.C.; Aqeel I.; Karapedi E.; Antoniades K.; Pervana A.M.; Sotiris G.; Kolyda A.; Giannakopoulos A.; Poulimenos L.E. Abstract Cardiac arrest complicating acute coronary syndromes requires immediate coronary reperfusion; however, performing percutaneous coronary intervention (PCI) during active manual cardiopulmonary resuscitation (CPR) presents significant technical challenges. The Lund University Cardiac Arrest System (LUCAS) provides automated mechanical chest compressions and enables uninterrupted CPR during coronary angiography and PCI. Existing evidence is primarily limited to case reports and small observational studies, mechanical CPR has emerged as a practical adjunct in catheterization laboratories where manual compressions are unsafe or logistically challenging. We report two cases from our center in which LUCAS-assisted PCI was performed during ongoing cardiac arrest in the setting of cardiogenic shock and acute coronary syndromes, alongside a structured narrative synthesis of contemporary literature addressing feasibility, procedural considerations, and clinical outcomes. Mechanical chest compressions allowed uninterrupted angiography and successful revascularization in both cases, with return of spontaneous circulation achieved in one patient. Despite procedural success, survival remained poor, reflecting severe global ischemia and metabolic derangement. LUCAS-assisted PCI is a technically feasible strategy that facilitates coronary reperfusion in carefully selected patients. Evidence of survival benefit remains limited and derives predominantly from observational studies and case reports rather than randomized controlled trials. The role of extracorporeal CPR (ECPR) as a complementary or alternative strategy warrants explicit consideration at appropriately resourced centers. Improved patient selection and integration into structured resuscitation pathways may enhance clinical outcomes. Copyright © The Author(s) 2026. Published by S. Karger AG. <96> Accession Number 2049881146 Title Clinical prediction models in cardiac surgery-associated acute kidney injury: a systematic review and meta-analysis. Source Critical Care. 30(1) (no pagination), 2026. Article Number: 540. Date of Publication: 01 Dec 2026. Author Lasa-Berasain P.; Torrecilla Ugarte A.; Juarez-Vela R.; Ibanez-Beroiz B.; Ansotegui Hernandez A.; Sadaba R.; Barado Hualde J. Institution (Lasa-Berasain) Department of Intensive Care Medicine, Reina Sofia Hospital, Navarre, Tudela, Spain (Lasa-Berasain, Sadaba, Barado Hualde) Public University of Navarre (UPNA), Navarre, Pamplona, Spain (Torrecilla Ugarte) Department of Internal Medicine, Garcia Orcoyen Hospital, Navarre, Estella, Spain (Juarez-Vela) Faculty of Health Sciences, GRUPAC Research Group, University of La Rioja, La Rioja, Spain (Ibanez-Beroiz) Methodology Unit, Navarrabiomed-UPNA, Navarre, Spain (Sadaba) Cardiovascular Translational Research, Navarrabiomed (Fundacion Miguel Servet); Instituto de Investigacion Sanitaria de Navarra (IdiSNA); University Hospital of Navarre, Navarre, Spain (Ansotegui Hernandez, Barado Hualde) Department of Intensive Care Medicine, University Hospital of Navarre, Navarre, Pamplona, Spain Publisher BioMed Central Ltd Abstract Purpose: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a frequent postoperative complication associated with substantial morbidity and mortality. Clinical prediction models (CPM) may identify high-risk patients enabling targeted preventive interventions and improved outcomes. The objective of the study was to identify available CPMs for the risk of developing CSA-AKI and summarize their performance. Method(s): A systematic search of studies published in Pubmed, Scopus, the Chocrane Library and Web of Science was conducted, including studies that developed or validated CPMs for CSA-AKI in adult patients undergoing cardiac surgery with cardiopulmonary bypass. Data were extracted by two independent reviewers. Summary measures of diagnostic performance were calculated when feasible using random-effects models. Calibration and sensitivity analyses were also performed. Result(s): The pooled incidence of CSA-AKI was 26.3% (95% CI, 26.0-26.4), whereas CSA-AKI requiring renal replacement therapy (CSA-AKI RRT) occurred in 2.2% of patients (95% CI, 2.1-2.2). Among validated CPMs, Thakar 2005 demonstrated the best predictive performance for CSA-AKI RRT: pooled AUC 0.80 (95% CI, 0.77-0.82), sensitivity of 0.87, and a specificity of 0.49 at a threshold of >= 3 points. Calibration analyses indicated underestimation of risk. The Mehta 2006 and Wijeysundera 2007 models also demonstrated good discrimination. Discrimination for the prediction of milder stages of CSA-AKI was poorer, but newer models such as the Demirjian 2022 model showed promising performance. Conclusion(s): Accurate and well-validated CPMs can facilitate risk stratification for CSA-AKI which can influence clinical practice and research. Thakar 2005 demonstrated very good discrimination for predicting CSA-AKI RRT, whereas more validation studies for the prediction of milder stages of CSA-AKI are warranted. Copyright © The Author(s) 2026. <97> Accession Number 2049894657 Title Continuous-Flow Left Ventricular Assist Devices in Biventricular Configuration: A Systematic Review and Comparative Meta-Analysis of HeartMate 3 and HeartWare Biventricular Assist Devices. Source Artificial Organs. (no pagination), 2026. Date of Publication: 2026. Author Rahimov D.; Jones A.J.; Irondi C.O.; Nam Y.; Siddique F.; Storozynsky E.; Gibson G.T.; Joseph S.M.; Rajagopal K.; Hoopes C.W.; Tchantchaleishvili V. Institution (Rahimov, Jones, Irondi, Nam, Siddique, Rajagopal, Hoopes, Tchantchaleishvili) Department of Cardiac Surgery, Thomas Jefferson University, Philadelphia, PA, United States (Storozynsky, Gibson, Joseph) Division of Cardiology, Department of Medicine, Thomas Jefferson University, Philadelphia, PA, United States Publisher John Wiley and Sons Inc Abstract Background: Advanced biventricular heart failure may require durable biventricular assist device (BiVAD) support when heart transplantation is not immediately feasible or patients are ineligible for heart transplantation. We aimed to compare baseline characteristics, perioperative features, and clinical outcomes between patients supported with HeartMate 3-BiVAD (HM3-BiVAD) and HeartWare-BiVAD (HW-BiVAD). Method(s): A systematic search was performed in October 2025 across MEDLINE, Embase, Cochrane Library, Scopus, and CINAHL. We identified studies of adult patients supported with dual HeartMate 3 LVAD and HeartWare HVAD continuous-flow pumps in a BiVAD configuration. Study-level data were pooled to compare patients supported with HM3-BiVAD and those with HW-BiVAD. Result(s): The proportion of females was significantly lower among HM3-BiVAD patients [HM3: 4.8% (95% CI: 1.2, 17.1) vs. HW: 22.5% (16.8, 29.4), p = 0.02], whereas patient age was comparable between groups [HM3: 47 (43, 52) years vs. HW: 48 (45, 50) years, p = 0.9]. Chronic kidney disease [HM3: 57.1% (23, 85.6) vs. HW: 10.9% (4.6, 23.6), p = 0.01] was more common among HM3-BiVAD patients. Concomitant right ventricular assist device (RVAD) placement was the predominant approach across both groups [HM3: 66.2% (35.5, 87.4) vs. HW: 78.5% (70.1, 85), p = 0.36]. Right atrium was used more frequently as RVAD implantation site in the HM3-BiVAD group [HM3: 96.7% (63.4, 99.8) vs. HW: 33.9% (19, 52.9), p = 0.01], whereas the right ventricle predominated in the HW-BiVAD group [HM3: 3.2% (0.2, 36.6) vs. HW: 64.5% (45.2, 80.1), p = 0.01]. Overall survival was significantly higher among HM3-BiVAD patients [78.1% (49.3, 92.9)] compared to HW-BiVAD patients [48% (40.6, 55.4); p = 0.05]. The mean follow-up was 274 (200, 349) days in patients with HM3-BiVAD and 210 (143, 277) days in HW-BiVAD patients (p = 0.21). Conclusion(s): Patients with HW-BiVAD were characterized by a higher proportion of females and more frequent use of the RV as the RVAD implantation site, likely both due to the smaller device profile. HM3-BiVAD patients demonstrated higher post-implant survival despite a more severe preimplant clinical profile, suggesting a possible device-related advantage. Copyright © 2026 The Author(s). Artificial Organs published by International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC. <98> Accession Number 652423198 Title Topical Vancomycin for Prevention of Grade 2 or Higher Sternal Wound Infection After Cardiac Surgery: A Randomized Controlled Trial. Source The Annals of thoracic surgery. (no pagination), 2026. Date of Publication: 15 Oct 2026. Author Tsai M.-T.; Li C.-Y.; Chen Y.-W.; Hu Y.-N.; Kan C.-D.; Chou C.-H.; Roan J.-N. Institution (Tsai, Hu, Kan, Roan) Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan (Republic of China) (Li) Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan (Chen) Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan (Republic of China) (Chou) Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; School of Pharmacy, College of Medicine, National Cheng Kung University, Tainan, Taiwan Abstract BACKGROUND: To evaluate the efficacy and safety of topical vancomycin paste over the sternal edges in preventing sternal wound infection (SWI). METHOD(S): This single-center, prospective, single-blind controlled trial 1:1 randomized 360 adult patients undergoing elective full sternotomy cardiac surgery to receive either vancomycin paste or normal saline (NCT04500275). The primary endpoint was SWI within 90 postoperative days. The secondary endpoints included postoperative acute kidney injury, emergence of resistant pathogens and systemic vancomycin exposure. RESULT(S): The incidence of grade 2 or higher SWI within 90 days was significantly lower in the vancomycin group than in the placebo group (1 of 180, 0.6% vs. 7 of 180, 3.9%, p = .031). The subdistribution hazard ratio was 0.14 (p = .065). Deep SWI rate was 0.6% vs. 2.8% (p = .099). The incidence of acute kidney injury was comparable between the groups (31.7% vs. 28.9%, p = .251), even in patients with CKD stages >= 3. Systemic vancomycin concentrations were negligible and declined over time in non-dialysis patients. Levels above 10-20 mg/L persisted in some patients undergoing hemodialysis. Three cases of vancomycin-resistant Enterococcus from various sources were observed in the vancomycin group of patients with CKD stage >= 3 or undergoing hemodialysis. CONCLUSION(S): Topical vancomycin reduced grade 2 or higher SWI without increasing the risk of acute kidney injury. Systemic exposure was negligible, except in patients undergoing hemodialysis. While the emergence of VRE cannot be excluded, its incidence was negligible and does not outweigh the benefits of SWI reduction when using topical vancomycin. Copyright © 2026. Published by Elsevier Inc. <99> Accession Number 2050732994 Title Long-term outcomes of myocardial revascularization using I-graft and no-touch saphenous vein grafting: results of a randomized controlled trial. Source Clinical and Experimental Surgery. 14(3) (pp 23-32), 2026. Date of Publication: 2026. Author Makaev A.G.; Khvan D.S.; Sirota D.A.; Zhulkov M.O.; Agaeva K.A.; Bogachev-Prokophiev A.V.; Semagin A.A.; Aminov V.V.; Bazylev V.V.; Tungusov D.S.; Zotov A.S.; Sakharov E.R.; Shelest O.O.; Semchenko A.N.; Kovliakov V.A.; Rosseikin E.V. Institution (Makaev, Khvan, Sirota, Zhulkov, Agaeva, Bogachev-Prokophiev) Meshalkin National Medical Research Center, Ministry of Health of the Russian Federation, Novosibirsk, Russian Federation (Sirota) Novosibirsk State Medical University, Ministry of Health of the Russian Federation, Novosibirsk, Russian Federation (Semagin, Aminov) Federal Center for Cardiovascular Surgery, Ministry of Health of the Russian Federation, Chelyabinsk, Russian Federation (Bazylev, Tungusov) Federal Center for Cardiovascular Surgery, Ministry of Health of the Russian Federation (Penza), Penza, Russian Federation (Zotov, Sakharov, Shelest) Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies of the Federal Medical Biological Agency of Russia, Moscow, Russian Federation (Semchenko, Kovliakov, Rosseikin) Federal Center for Cardiovascular Surgery, Ministry of Health of the Russian Federation, Khabarovsk, Russian Federation Publisher Geotar Media Publishing Group Abstract Aim. To evaluate the long-term outcomes of myocardial revascularization using I-grafts and no-touch saphenous vein grafting within a randomized controlled trial, assessing graft patency, the incidence of major adverse cardiac and cerebrovascular events (major adverse cardiovascular and cerebrovascular events, MACCE), leg wound complications, and mortality at 6- and 12-month follow-up. Material and methods. This prospective multicenter randomized study included 106 patients with coronary artery disease who underwent elective coronary artery bypass grafting (CABG) at five federal centers between 2023 and 2024. Patients were randomized using the envelope method into two groups: in the first group (I-graft, n = 53), revascularization of the right coronary artery was performed using an I-composite graft based on the internal thoracic artery and a no-touch saphenous vein; in the second group (Conv, n = 53), a free no-touch saphenous vein graft with a proximal anastomosis to the aorta was used. The primary endpoint was graft patency at 12 months based on multislice computed tomography data. Secondary endpoints included MACCE incidence, mortality, and leg wound complications at 6 and 12 months of follow-up. Results. At 6 months post-CABG, no myocardial infarctions or repeat revascularizations were recorded. In the I-graft group, 2 strokes (4.3%) occurred, compared to none in the Conv group (p = 0.23); mortality was 0% in both groups. There were no statistically significant differences between groups regarding discomfort or numbness at the vein harvesting site. At 12 months, high graft patency rates were maintained: 91.9% in the Conv group and 89.1% in the I-graft group (p = 0.73). No myocardial infarctions or repeat revascularizations were identified. Mortality was 4.1% (n = 2) in the I-graft group and 2.3% (n = 1) in the Conv group (p = 1.0). The incidence of local complications at the vein harvesting site also showed no statistical difference between the studied groups. Conclusion. Within 12 months after surgery, the I-graft technique and the free no-touch saphenous vein graft demonstrated comparable clinical efficacy and high patency. Thus, the composite I-graft can be considered a safe and reliable alternative to traditional aortocoronary venous grafting for multivessel myocardial revascularization. Copyright All articles in our journal are distributed under the CC BY-NC-ND 4.0 (Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International) https://creativecommons.org/licenses/by/4.0/deed.en <100> Accession Number 2050621569 Title Abbreviated Dual Antiplatelet Therapy in Patients With High Bleeding Risk Undergoing PCI of Bifurcation Lesions: A Prespecified Substudy of the MASTER DAPT Trial. Source Circulation: Cardiovascular Interventions. 19(10) (pp e016222), 2026. Date of Publication: 01 Oct 2026. Author Chevalier B.; Cao D.; Smits P.C.; Brunel P.; Frigoli E.; Heg D.; Higuchi Y.; Kauer F.; Landi A.; Lopes R.D.; Mainar V.; Mamas M.; Mateev H.; McDonald J.; McFadden E.P.; Mulassari A.; Munir S.; Polad J.; Reimers B.; Sardella G.; Ungi I.; von Birgelen C.; Weidinger F.; Paradies V.; Valgimigli M. Institution (Chevalier) Institut Cardiovasculaire Paris-Sud, Hopital Prive Jacques Cartier, Ramsay-Sante, Massy, France (Cao) Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy (Cao) Department of Cardiology, Humanitas Gavazzeni, Bergamo, Italy (Smits, Paradies) Department of Cardiology, Maasstad Hospital, Rotterdam, Netherlands (Brunel) Cardiology Department, Hopital Prive Dijon-Bourgogne, Dijon, France (Frigoli, Landi, Valgimigli) Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland (Heg) Department of Clinical Research, University of Bern, Bern, Switzerland (Higuchi) Cardiovascular Division, Osaka Keisatsu Hospital, Japan (Kauer) Department of Cardiology, Albert Schweitzer Hospital, Dordrecht, Netherlands (Landi, Valgimigli) Faculty of Biomedical Sciences, University of Italian Switzerland, Lugano, Switzerland (Lopes) Duke University Medical Center, Durham, NC, United States (Mainar) Hospital General Alicante, Spain (Mamas) Keele Cardiovascular Research Group, School of Medicine, Keele University, United Kingdom (Mateev) Department of Interventional Cardiology, National Heart Hospital, Sofia, Bulgaria (McDonald) Department of Cardiology, East Lancashire Hospitals National Health Service Trust, Royal Blackburn Hospital, Lancashire, Blackburn, United Kingdom (McFadden) Interventional Cardiology, Cork University Hospital, Ireland (Mulassari) The Madras Medical Mission Hospital, Chennai, India (Munir) Royal Wolverhampton National Health Service Trust, Wolverhampton, United Kingdom (Polad) Department of Cardiology, Jeroen Bosch Hospital, Den Bosch, Netherlands (Reimers) Cardio Center, Humanitas Research Hospital Istituto di Ricovero e Cura a Carattere Scientifico, Rozzano-Milan, Italy (Sardella) Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Italy (Ungi) Division of Invasive Cardiology, Department of Internal Medicine, Center of Cardiology, University of Szeged, Hungary (von Birgelen) Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, Netherlands (von Birgelen) Department of Health Technology and Services Research, Faculty BMS, Technical Medical Centre, University of Twente, Enschede, Netherlands (Weidinger) 2nd Medical Department with Cardiology and Intensive Care Medicine, Klinik Landstrasse, Vienna, Austria (Valgimigli) University of Bern, Switzerland Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - Coronary stenting of bifurcation lesions has been associated with an increased risk of thrombotic events. However, the optimal duration of dual antiplatelet therapy (DAPT) after treatment of bifurcations, particularly among patients with high bleeding risk, is unknown. We aimed to evaluate the safety and efficacy of abbreviated DAPT in patients with high bleeding risk undergoing percutaneous coronary intervention (PCI) of bifurcation lesions. METHOD(S): - The MASTER DAPT trial (Management of High Bleeding Risk Patients Post Bioresorbable Polymer Coated Stent Implantation With an Abbreviated Versus Standard DAPT Regimen) randomized patients with high bleeding risk who were free from ischemic or bleeding events after 1 month of PCI to discontinue DAPT (abbreviated regimen) or continue DAPT for a minimum of 2 additional months (standard regimen). Coprimary outcomes were net adverse clinical outcomes events, major adverse cardiac and cerebral events, and BARC (Bleeding Academic Research Consortium) type 2, 3, or 5 bleeding at 335 days after randomization. This prespecified substudy evaluates the outcomes of abbreviated versus standard DAPT according to treatment of bifurcation lesions. RESULT(S): - Of the 4579 patients randomized, 976 (21.2%) underwent bifurcation PCI. Net adverse clinical event and major adverse cardiac and cerebral events did not differ between abbreviated and standard DAPT in both patients with (hazard ratio [HR], 0.98 [95% CI, 0.73-1.17] and HR, 0.92 [95% CI, 0.63-1.54], respectively) and without bifurcation PCI (HR, 1.14 [95% CI, 0.67-1.93] and HR, 0.96 [95% CI, 0.74-1.25]; P interaction=0.803 and 0.563, respectively). Abbreviated DAPT consistently reduced BARC 2, 3, or 5 bleeding in patients with (HR, 0.83 [95% CI, 0.53-1.30]) or without (HR, 0.65 [95% CI, 0.51-0.82]) bifurcation (P interaction=0.321). CONCLUSION(S): - Among patients with high bleeding risk with or without bifurcation PCI, abbreviated DAPT was associated with lower bleeding risk without an excess of ischemic or net adverse events compared with standard DAPT. REGISTRATION: - URL: https://www.clinicaltrials.gov; Unique identifier: NCT03023020. Copyright © 2026 American Heart Association, Inc. <101> Accession Number 2050852675 Title Catheter-Based Left Atrial Appendage Closure vs Oral Anticoagulation in Patients with Atrial Fibrillation: A Systematic Review and Meta-Analysis. Source JAMA Cardiology. 11(10) (pp 915-924), 2026. Date of Publication: 14 Oct 2026. Author Laudani C.; Bujak K.; Giacoppo D.; Finocchiaro S.; Cutore L.; Mauro M.S.; Redigolo P.; Mazzone P.M.; Di Leo G.; Nasisi F.; Spagnolo M.; Greco A.; Capodanno D. Institution (Laudani, Bujak, Giacoppo, Finocchiaro, Cutore, Mauro, Redigolo, Mazzone, Di Leo, Nasisi, Spagnolo, Greco, Capodanno) Division of Cardiology, Azienda Ospedaliero-Universitaria Policlinico Rodolico - San Marco, University of Catania, Catania, Italy (Bujak) Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland (Bujak) 3rd Department of Cardiology, Silesian Center for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland Publisher American Medical Association Abstract Importance: In patients with atrial fibrillation (AF), oral anticoagulation (OAC) is the gold standard for preventing ischemic stroke, at the expense of a higher risk of bleeding. Catheter-based left atrial appendage closure (LAAC) has been proposed as an alternative strategy to prevent stroke, but the efficacy and safety compared to OAC are uncertain. Objective(s): To evaluate the efficacy and safety of catheter-based LAAC compared to OAC in patients with AF at high risk of stroke. Data Sources: PubMed, Cochrane Central, and Web of Science were screened up to March 2026. The websites of leading cardiology societies, news outlets, and reference lists of each eligible study were also inspected. Study Selection: Studies enrolling patients with AF randomly assigned to catheter-based LAAC or OAC and reporting at least 1 outcome of interest were included. Data Extraction and Synthesis: Two investigators independently extracted data of interest and assessed data quality. Catheter-based LAAC vs OAC comparisons were pooled as incidence rate ratios (IRRs) using a frequentist random-effect model. Main Outcomes and Measures: Primary and coprimary outcomes were long-term stroke and major bleeding. Secondary outcomes included the composite of cardiovascular death, stroke, or systemic embolism, all-cause death, the single components of the composite end point, ischemic stroke, hemorrhagic stroke, and nonprocedural major bleeding. Periprocedural events (ie, stroke, major bleeding, death, device embolization, and pericardial effusion) were also combined. Result(s): Eight trials (7434 patients) were included in the meta-analysis. After a weighted mean follow-up of 37.9 months, no significant differences were detected for stroke (IRR, 1.08; 95% CI, 0.82-1.41) and major bleeding (IRR, 0.96; 95% CI, 0.81-1.14). However, catheter-based LAAC was associated with a higher risk of ischemic stroke (IRR, 1.34; 95% CI, 1.01-1.77) and a lower risk of nonprocedural major bleeding (IRR, 0.73; 95% CI, 0.58-0.92) compared with OAC. Periprocedural events per 1000 patients were 5 strokes, 9 episodes of bleeding, 1 death, 5 episodes of device embolization, and 9 pericardial effusions. Conclusions and Relevance: In patients with AF, at long-term follow-up, transcatheter LAAC was associated with similar rates of any type of stroke and major bleeding compared with OAC, while increasing the risk of ischemic stroke and lowering the risk of nonprocedure-related major bleeding. These findings do not support the routine use of LAAC as a first-line strategy for stroke prevention in patients with AF at moderate to high risk of stroke. Copyright © 2026 American Medical Association. <102> Accession Number 2050880348 Title Optimizing Saphenous Vein Grafts: From Workhorse to an Evidence-Based Conduit Strategy. Source Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery. (no pagination), 2026. Date of Publication: 2026. Author Zhou Z.; Zhao J.; Wang Y.; Wu W. Institution (Zhou, Zhao, Wang, Wu) Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, China Publisher SAGE Publications Ltd Abstract Objective: The saphenous vein graft (SVG) remains the most common conduit in coronary artery bypass grafting (CABG) but suffers from inferior long-term patency compared with arterial grafts. This review evaluates the concept of viewing the SVG not as an inherently flawed conduit but as one that can be systematically optimized through evidence-based strategies. Method(s): A narrative review was conducted to address the following clinical question: "In patients undergoing CABG, how do contemporary surgical harvesting techniques, intraoperative preservation methods, and postoperative pharmacologic strategies interact to optimize the long-term patency of saphenous vein grafts?" We synthesized evidence from recent landmark randomized controlled trials and meta-analyses to define a comprehensive optimization strategy. Result(s): SVG failure is a cascade initiated by surgical trauma and propagated by hemodynamic stress. The "no-touch" harvesting technique, which preserves protective perivascular tissue, has demonstrated superior long-term patency in classic trials, although recent evidence has sparked debate regarding its universal reproducibility. Intraoperative preservation with endothelial-sparing solutions and aggressive postoperative pharmacotherapy-including high-intensity statins and tailored antiplatelet strategies-provide crucial secondary protection. Notably, when graft failure occurs, recent randomized evidence challenges the dogma of a strict "native vessel first" approach, supporting instead an individualized, anatomy-driven strategy that balances early procedural hazard against long-term durability. Conclusion(s): The SVG is an optimizable conduit. A modern, integrated approach-combining meticulous harvesting, biological preservation, and aggressive secondary prevention-can substantially improve graft durability. By shifting focus from simple conduit selection to comprehensive conduit optimization and appropriate patient-specific target selection, the Heart Team can significantly improve long-term cardiovascular outcomes. Copyright © The Author(s) 2026 <103> Accession Number 2050879183 Title Comparison of oral and intravenous methadone for postoperative analgesia after cardiac surgery: a pilot randomized clinical trial. Source Regional Anesthesia and Pain Medicine. (no pagination), 2026. Article Number: rapm-2026-108588. Date of Publication: 2026. Author Ramanujan K.S.; Grate J.C.; Khan F.; Paul J.; D'Souza R.S.; Lemahieu A.M.; Wittwer E.D. Institution (Ramanujan, Grate, Paul, D'Souza, Wittwer) Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States (Khan) Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, United States (Lemahieu) Department of Quantitative Health Sciences, Mayo Clinic College of Medicine and Science, Rochester, MN, United States Publisher BMJ Publishing Group <104> Accession Number 2050839059 Title The effect of head and face massage on the severity of delirium following coronary artery bypass graft surgery: A clinical study. Source Advances in Integrative Medicine. 13(4) (no pagination), 2026. Article Number: 100730. Date of Publication: 01 Dec 2026. Author Tavangar H.; Abraghouei E.S.; Kalani Z.; Sadr F. Institution (Tavangar, Kalani, Sadr) Research Center for Nursing and Midwifery Care, Non-communicable Diseases Research Institute, Department of Nursing, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran, Islamic Republic of (Abraghouei) Critical care Nursing, Nursing Department, Nursing and Midwifery school, Shahid Sadoughi University of Medical Sciences, Yazd, Iran, Islamic Republic of Publisher Elsevier Australia Abstract Background: Coronary artery bypass graft (CABG) surgery is a commonly employed treatment for cardiovascular diseases. Postoperative delirium is a frequent and serious complication, particularly among older adults. In recent years, complementary therapies such as massage have attracted attention due to their simplicity, safety, and potential efficacy. This study aimed to evaluate the effect of head and face massage on postoperative delirium following CABG surgery. Method(s): In this RCT, 104 patients aged 60-75 years undergoing CABG surgery at [Blinded for peer review], were randomly assigned to an intervention or a control group. The intervention group received head and face massage using effleurage techniques in the postoperative phase. Data were collected and analyzed by using the NEECHAM confusion scale and SPSS. Result(s): Head and face massage significantly improved mean NEECHAM scores on postoperative days three and four, indicating reduced delirium severity in post-CABG patients. Although changes in categorical cognitive status were not statistically significant, an absolute difference of 15.3% in the proportion of patients classified as cognitively healthy on Day 4 corresponded to an estimated NNT of 7. This estimate suggests a potential clinical benefit but should be interpreted cautiously given the statistical uncertainty surrounding the categorical outcome. Conclusion(s): The findings support the potential of head and face massage as a non-pharmacological intervention to promote cognitive well-being in post-CABG patients. By enhancing relaxation, improving circulation, and reducing sympathetic nervous system activity, massage may mitigate risk factors associated with delirium. Its ease of implementation, low cost, and minimal risk make it a practical complementary therapy. Future studies should explore optimal frequency, duration, and combined interventions to maximize cognitive recovery. Copyright © 2026 Elsevier Ltd <105> Accession Number 2049737468 Title Diagnostic Yield and Incremental Value of 16S rRNA Gene PCR and Sequencing on Excised Heart-Valve Tissue in Infective Endocarditis: A Systematic Review and Meta-Analysis. Source Diagnostics. 16(19) (no pagination), 2026. Article Number: 3125. Date of Publication: 01 Oct 2026. Author Buzdug F.O.; Indries M.; Alexandru V.; Stanis C.E.; Manole F.; Calugar-Solea S.F.; Mocan C.-M.; Buzdug D.A.; Buzle A.M.; Csep A.N.; Caraman I.M.; Andronie-Cioara F.L.; Pasca G.; Daescu A.; Osiceanu G.A.; Osiceanu A.S.; Rus M. Institution (Buzdug, Alexandru, Stanis, Manole, Calugar-Solea, Buzle, Caraman, Rus) Doctoral School of Biomedical Sciences, University of Oradea, 1 University Street, Oradea, Romania (Buzdug, Indries, Alexandru, Stanis, Manole, Calugar-Solea, Buzle, Csep, Andronie-Cioara, Pasca, Osiceanu, Osiceanu, Rus) Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania (Buzdug, Indries, Stanis, Manole, Calugar-Solea, Buzle, Csep, Andronie-Cioara, Pasca, Osiceanu, Osiceanu, Rus) Clinical County Emergency Hospital Bihor, Oradea, Romania (Alexandru, Mocan) Clinical Hospital of Infectious Diseases and Pneumophthisiology "Dr. Victor Babes", Timisoara, Romania (Manole) Discipline of Otorhinolaryngology (ENT), Department of Surgery, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, Oradea, Romania (Buzdug, Caraman) Pelican Clinical Hospital, Oradea, Romania (Daescu) Doctoral School Department, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Broad-range bacterial 16S rRNA gene PCR followed by sequencing may improve the etiological diagnosis of infective endocarditis (IE), particularly when conventional cultures are negative. This systematic review and meta-analysis evaluated the overall molecular detection yield and incremental value of valve-tissue 16S molecular testing in surgically managed IE. Method(s): PubMed/MEDLINE, Scopus, Web of Science Core Collection, and Europe PMC were searched for Open Access studies published from 2016 to 2026. Eligible studies evaluated broad-range bacterial 16S PCR with sequence-based identification on excised native or prosthetic heart-valve tissue. Random-effects generalized linear mixed models were used to pool overall diagnostic yield, strict blood-culture-negative IE (BCNE) yield, and strict incremental etiologic yield beyond conventional microbiology. Diagnostic accuracy was summarized descriptively when complete 2 x 2 data were available. Result(s): Eight studies comprising 925 patients, surgical cases, or IE episodes contributed to the primary analysis, with 704 study-reported molecular-positive results. The pooled diagnostic yield was 75.9% (95% CI, 68.7-82.0%), with substantial heterogeneity (I2 = 81.8%) and a 95% prediction interval of 49.2-91.2%. In strict BCNE, the pooled yield was 53.7% (95% CI, 41.2-65.8%). The strict incremental etiologic yield was 8.8% (95% CI, 6.1-12.5%). Sensitivity analyses yielded similar estimates. Conclusion(s): Valve-tissue 16S PCR/sequencing can provide valuable etiological information, particularly in BCNE. However, the substantial between-study heterogeneity and wide prediction interval indicate that its expected molecular detection yield varies considerably across clinical settings and is influenced by patient selection, local diagnostic algorithms, laboratory methods, and reference standards. Copyright © 2026 by the authors. <106> Accession Number 2050566239 Title Expanding indications for transcatheter aortic valve implantation: time for valve-in-valve in mechanical prosthesis? A systematic review and meta-analysis. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1920900. Date of Publication: 2026. Author Ruiz-Ruiz J.; Jain A.; Garcia Gomez M.; Stepanenko A.; Pensotti F.; Rodriguez M.; Real C.; Cortes Villar C.; Galan-Arriola C.; De Prada Martin B.; Carrasco Moraleja M.; Alcantara R.W.A.; San Roman A.; Ibanez B.; Amat-Santos I. Institution (Ruiz-Ruiz, Jain, Garcia Gomez, Stepanenko, Pensotti, Rodriguez, Cortes Villar, Carrasco Moraleja, San Roman, Amat-Santos) Cardiology Department, University Clinic Hospital of Valladolid, Spain (Real, Galan-Arriola, Ibanez, Amat-Santos) Centro Nacional de Investigacion Cardiovascular (CNIC), Madrid, Spain (Cortes Villar, Galan-Arriola, San Roman, Ibanez, Amat-Santos) Centro de Investigacion Biomedica en Red (CIBERCV), Madrid, Spain (De Prada Martin) Anesthesiology Department, University Clinic Hospital of Valladolid, Spain (Alcantara) Clinica Aurus, Oliveira, Brazil (Alcantara) Interventional Cardiology Unit, Hospital Sao Judas Tadeu, Oliveira, Brazil (Ibanez) Cardiology Department, Fundacion Jimenez Diaz, Madrid, Spain Publisher Frontiers Media SA Abstract Aims - Following the recent first-in-human experience of Valve in Mechanical Valve (ViMech), interest has emerged in understanding how frequently such an approach might be required in clinical practice. We performed an exploratory meta-analysis to characterize the long-term burden of valve-related complications and reintervention after mechanical aortic valve replacement. Methods - Systematic literature search identified studies reporting outcomes of the five most used mechanical aortic valve models (Medtronic/ATS, St. Jude, Carbomedics, Bicarbon, On-X). Descriptive analysis and random-effects meta-analysis assessed late all-cause and valve-related mortality and complications (bleeding, thromboembolism, valve thrombosis, endocarditis, paravalvular leak, reintervention), expressed per 100 patient-years. Results - Thirty-two studies encompassing 24,960 patients undergoing mechanical valve replacement were assessed. Isolated mechanical aortic valve replacement was reported in all 32 studies (13,890 patients; 98,987 patient-years; mean follow-up 7.1 years); mean age at implantation was 57.9 years (95% CI 56.3-59.6) and 43% (38-49) were female. Pooled all-cause mortality was 2.39 per 100 patient-years (95% CI 1.92-2.99) and valve-related mortality was 0.55 (0.41-0.73) per 100 patient-years. Bleeding (0.22 [0.16-0.30]) and thromboembolic events (0.18 [0.12-0.25]) were the leading causes of valve-related death. Thromboembolic events (0.94 [0.77-1.14]) and bleeding (0.85 [0.65-1.10]) were the most frequent non-fatal complications, considerably more common than reintervention (0.36 [0.28-0.48] per 100 patient-years). All-cause mortality and complication rates were broadly similar across valve models. Conclusions - Mechanical aortic valves show excellent long-term durability with low reintervention rates. Nevertheless, valve-related complications, mainly bleeding and thromboembolism, suggest a small but clinically relevant population in whom redo surgery may carry substantial risk, providing epidemiological context for emerging Valve in Mechanical Valve strategies. Systematic Review Registration - https://www.crd.york.ac.uk/PROSPERO/view/CRD420251002419, identifier CRD420251002419. Copyright © 2026 Ruiz-Ruiz, Jain, Garcia Gomez, Stepanenko, Pensotti, Rodriguez, Real, Cortes Villar, Galan-Arriola, De Prada Martin, Carrasco Moraleja, Alcantara, San Roman, Ibanez and Amat-Santos. <107> Accession Number 652413167 Title Non-Pharmacological Management of Dental Anxiety in Individuals with Learning Disabilities: An Integrated Evidence Synthesis of Sensory-Adapted Dental Environments. Source Medicina Oral Patologia Oral y Cirugia Bucal. Conference: International Association for Disability and Oral Health 28th Scientific Conference 2026. Dublin Ireland. 31(Supplement 1) (pp 30), 2026. Date of Publication: 2026. Author Ibrahim S.; Mohd Yusof M.; Ade Chandra L.; Mohd F.; Ahmad M. Institution (Ibrahim, Ahmad) Special Care Dentistry Unit, Centre of Comprehensive Care Studies, Faculty of Dentistry, Universiti Teknologi MARA, Malaysia (Ibrahim, Mohd Yusof, Mohd) Special Care Dentistry Unit, Department of Oral Maxillofacial Surgery and Oral Diagnosis, Kulliyyah of Dentistry, International Islamic University of Malaysia, Malaysia (Ade Chandra) Department of Pharmacology and Therapy, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia Publisher Medicina Oral S.L. Abstract Objectives: Dental anxiety (DA) is common in dental care; however, evidence supporting non-pharmacological management of DA in individuals with learning disabilities (LD) remains limited. This study synthesised available evidence on non-pharmacological approaches for managing DA in LD populations, with specific focus on Sensory-Adapted Dental Environments (SADE). Method(s): An integrated, multi-stage evidence synthesis was prospectively registered with PROSPERO (CRD42023417578). A bibliometric analysis mapped global trends in DA research over the past 30 years, including the representation of individuals with LD. A scoping review was undertaken in accordance with PRISMA-ScR to identify and categorise non-pharmacological DA management strategies used. Subsequently, a systematic review following PRISMA 2020 guidelines evaluated the effectiveness of SADE. Risk of bias was assessed using RoB-2 for randomised controlled trials and ROBINS-I for non-randomised studies. Meta-analyses were conducted using a random-effects model where outcome data were sufficiently comparable. Result(s): Bibliometric analysis demonstrated a steady increase in DA-related publications, with persistently low inclusion of individuals with LD. Eleven studies examined non-pharmacological strategies for managing DA in LD populations, of which seven met inclusion criteria for the systematic review. Quantitative findings showed lower post-procedure heart rates among participants treated in SADE compared with regular dental environments. A primary meta-analysis of two randomised controlled trials demonstrated reduced heart rates under SADE, indicating lower physiological arousal (mean difference -17.76 bpm, 95% CI -24.25 to -11.28; I2 = 8.5%; p < .001). A secondary meta-analysis of four non-randomised studies found lower levels of behavioural distress during treatment under SADE (Hedges' g -0.69, 95% CI -1.03 to -0.35; I2 = 23%). Methodological quality varied across studies. Conclusion(s): Overall, the evidence suggests that SADE reduces physiological arousal and behavioural distress in individuals with LD; however, heterogeneity and the limited number of studies restrict certainty. Further well-designed trials are needed to inform inclusive practice and service-level implementation. <108> Accession Number 652410190 Title Bivalirudin Versus Heparin and Protamine in Adult Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis. Source Annals of cardiac anaesthesia. 29(4) (pp 494-502), 2026. Date of Publication: 01 Oct 2026. Author Cadd M.; Green S.; Puntis D.; Huellen H.V.; Seavill M.; Bullard S. Institution (Cadd, Green, Puntis, Huellen) Department of Anaesthesia, Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Sussex, United Kingdom (Seavill) Department of Anaesthesia, Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (Bullard) Department of Anaesthesia, St George's University Hospitals NHS Foundation Trust, London, United Kingdom Abstract OBJECTIVES: To summarize the evidence on the morbidity, mortality, and transfusion requirements of adult patients undergoing cardiac surgery using bivalirudin for anticoagulation compared to unfractionated heparin (UFH). MEASUREMENTS AND MAIN RESULTS: A total of 407 patients in three randomized controlled trial (RCTs) were included for pooled analysis. There was no significant difference in the primary outcome; reexploration for hemorrhage between groups (risk ratio: 1.38, 95% confidence interval: 0.42 to 4.48). There were no observable differences in any of the secondary outcomes; thromboembolic events (myocardial infarction, stroke, pulmonary embolism), mortality, or postoperative transfusion requirements (packed red cells (PRC), platelets, cryoprecipitate, fresh frozen plasma (FFP)). All studies included were assessed to have some concern for risk of bias. Interstudy heterogeneity was low across all comparisons. CONCLUSION(S): Bivalirudin has not been shown to have any significant difference to UFH on clinical outcomes in patients undergoing cardiac surgery, and as per current international guidelines, can be considered for safe use in those patients for whom UFH is contraindicated. The study is limited by the bias of the included studies and the variability of bivalirudin drug dosage and its therapeutic monitoring; further, well-powered RCTs are required. Copyright © 2026 Annals of Cardiac Anaesthesia. <109> Accession Number 652409626 Title Efficacy of Home-Based Telerehabilitation Versus Center-Based Cardiac Rehabilitation on Cardiopulmonary Function and Exercise Capacity in Patients After Coronary Artery Bypass Grafting: A RANDOMIZED CONTROLLED TRIAL. Source Journal of cardiopulmonary rehabilitation and prevention. (no pagination), 2026. Date of Publication: 14 Oct 2026. Author Liu H.; Wang X.; Wang C.; Kong M.; Ma J.; Liu Y. Institution (Liu) Author Affiliations: Department of Cardiac Surgery (Drs Liu, X. Wang, Kong, Ma, and Liu), and Department of Cardiac Function and Rehabilitation (Dr C. Wang), The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China Abstract PURPOSE: The objective is to compare the effects of a home-based telerehabilitation (HBTCR) program, traditional center-based cardiac rehabilitation (CBCR), and usual care on cardiopulmonary function and exercise capacity in patients after coronary artery bypass grafting (CABG). METHOD(S): In this randomized controlled trial, 111 patients, 4 to 8 weeks after CABG surgery, were assigned to 12 weeks of HBTCR (n = 37), CBCR (n = 37), or to a control group (n = 37). The HBTCR group utilized wearable sensors and a mobile app for remote monitoring and coaching. The CBCR group underwent supervised on-site sessions. Primary outcomes were changes in peak oxygen uptake () and 6-minute walk distance. Secondary outcomes included left ventricular ejection fraction, psychological status, and quality of life. RESULT(S): Among 101 completers, both HBTCR and CBCR groups showed significant improvements in (HBTCR: +5.1; CBCR: +4.8 mL/kg/min) and 6-minute walk distance (HBTCR: +85.2 m; CBCR: +81.5 m) versus control (P < .001), with no difference between interventions. Significant improvements in left ventricular ejection fraction, psychological scores, and quality of life were also observed in both intervention groups compared with control (P < .05). Adherence was high (HBTCR: 92.1%; CBCR: 85.3%) with no major adverse events. CONCLUSION(S): The findings suggest that an HBTCR program has similar efficacy as CBCR in improving cardiopulmonary function, exercise capacity, and patient-centered outcomes after CABG. An HBTCR program represents a viable, accessible alternative model for delivering comprehensive cardiac rehabilitation and secondary prevention. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <110> Accession Number 2050742088 Title Stepwise Airway Management Using an Airway Exchange Catheter for Lung Isolation in Odontogenic Descending Necrotizing Mediastinitis: A Case Report. Source Trends in Anaesthesia and Critical Care. Conference: EAC2026 Abstracts of the 9th European Airway Management Congress. Istanbul Turkey. 70(Supplement) (no pagination), 2026. Article Number: 101778. Date of Publication: 01 Oct 2026. Author Turk O.; Kacar C.; Cinar S.; Ildogan S. Institution (Turk, Kacar, Cinar, Ildogan) University of Health Sciences, Van Training and Research Hospital, Van, Turkey Publisher Churchill Livingstone Abstract Introduction / Purpose: Descending necrotizing mediastinitis (DNM) secondary to odontogenic infection is a rapidly progressive,life-threatening condition requiring prompt source control and, when thoracic surgery is indicated, lungisolation. Trismus, pharyngeal edema, and anatomical distortion may substantially increase the risk ofdifficult intubation and airway loss. Case: A 53-year-old woman with no known comorbidities was admitted to the intensive care unit (ICU) with severemandibulomaxillary swelling, trismus, and dysphonia due to a dental abscess. Computed tomographyrevealed deep neck space infection, paratracheal/paravertebral lymphadenopathy, bilateral pleuraleffusions, and suspected mediastinal involvement. Following multidisciplinary evaluation and intravenousmethylprednisolone, piperacillin-tazobactam, and vancomycin therapy, the patient was successfullyintubated with difficult-airway precautions. Anterior neck exploration with drainage of theretropharyngeal/parapharyngeal abscess was subsequently performed.On ICU day 5, video-assisted thoracoscopic surgery (VATS) was planned for mediastinal debridement. Toachieve one-lung ventilation while maintaining airway access, an airway exchange catheter (AEC) wasadvanced through the existing single-lumen tube (SLT). After SLT removal, a 37-Fr left-sided double-lumentube (DLT) was advanced over the AEC through its tracheal lumen. Correct bronchial positioning wasconfirmed by fiberoptic bronchoscopy. Following VATS and bilateral chest tube placement, the DLT wasexchanged back to an SLT over the AEC. The patient was successfully extubated on ICU day 11 andsubsequently transferred to the ward. Postoperative Cervical Drainage Following Deep Neck Space Infection [Formula presented] Postoperative clinical appearance following anterior neck exploration and drainage of the retropharyngeal/parapharyngeal abscess, demonstrating cervical drain placement for source control Posttoperative Cervical Drainage After Surgical Source Control [Formula presented] Postoperative appearance following anterior neck exploration and drainage of the retropharyngeal/parapharyngeal abscess, showing the cervical incision and drain placement. Discussion / Conclusion(s): DNM requires early multidisciplinary management and effective surgical source control [1]. In patients witha difficult airway requiring lung isolation, tube exchange may pose a substantial risk of losing an alreadysecured airway. Difficult-airway guidance emphasizes planning strategies that preserve airway access inhigh-risk patients [2]. AEC-guided exchange between DLTs and SLTs has been described, althoughexchange-related complications may occur and careful technique is essential [3]. In this patient, stagedSLT-DLT-SLT exchange over an AEC enabled one-lung ventilation while maintaining airway access. Thisapproach may represent a useful option in selected DNM patients when lung isolation is required and loss ofa secured difficult airway would carry substantial risk. Keywords: Airway exchange catheter, Descending necrotizing mediastinitis, Difficult airway, Double-lumen tube, Lung isolation References 1. Prado-Calleros HM, Jimenez-Fuentes E, Jimenez-Escobar I. Descending necrotizing mediastinitis: systematic review on its treatment in the last 6 years, 75 years after its description. Head Neck. 2016;38(Suppl 1):E2275-E2283. doi:10.1002/hed.24183. 2. Apfelbaum JL, Hagberg CA, Connis RT, et al. 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway. Anesthesiology. 2022;136(1):31-81. doi:10.1097/ALN.0000000000004002. 3. Wu HL, Tai YH, Wei LF, Cheng HW, Ho CM. Bronchial lumen is the safer route for an airway exchange catheter in double-lumen tube replacement: preventable complication in airway management for thoracic surgery. J Thorac Dis. 2017;9(10):E903-E906. doi:10.21037/jtd.2017.08.163. Copyright © 2026, Churchill Livingstone <111> Accession Number 652408958 Title The Effect of Intranasal Dexmedetomidine on Hemodynamic Responses during Double-Lumen Tube Insertion: A Randomized Controlled Trial. Source Annals of cardiac anaesthesia. 29(4) (pp 510-515), 2026. Date of Publication: 01 Oct 2026. Author Gilbert R.P.; Kumar S.N.; Panchanathan I.; Thomas A.K.; Dhanaboopathy K.; Kuppuswamy B.; Benjamin S.R.; Kuruvila K.T.; Rao V.M.; David N. Institution (Gilbert) Department of Anaesthesia, Christian Medical College, Vellore, Tamil Nadu, India (Kumar, Panchanathan, Kuppuswamy) Department of Cardiac Anaesthesia, Christian Medical College, Vellore, Tamil Nadu, India (Thomas, Dhanaboopathy) Department of Anaesthesia, Believers Church Medical College and Hospital, Kerala, India (Benjamin, Kuruvila, Rao, David) Department of Cardiothoracic Surgery, Christian Medical College, Vellore, Tamil Nadu, India Abstract BACKGROUND: Thoracic surgeries require controlled lung collapse for optimal visualization, achieved through Double-Lumen Tube (DLT) intubation for one-lung ventilation (OLV). DLT insertion triggers significant sympathetic activation, potentially causing cardiovascular complications and cerebrovascular events. This study aimed to investigate the efficacy of intranasally administered Dexmedetomidine in attenuating hemodynamic perturbations associated with laryngoscopy and DLT placement. METHOD(S): This randomized controlled study was done in a tertiary care center in South India. Patients coming for thoracic surgery requiring DLT insertion were recruited and randomized into Group A and Group B (n = 25). Group A received 1 mcg/kg Intranasal Dexmedetomidine, and Group B received Intranasal Normal saline 45 minutes prior to induction of anaesthesia using a mucosal atomizer device. Hemodynamic parameters, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR), were recorded at different time points up to 30 minutes after intubation. RESULT(S): Patients in the dexmedetomidine group had a lower heart rate before intubation (84.92 +/- 0.0349) than those in the placebo group (96.48 +/- 0.0349). A statistically significant reduction in heart rate was observed in Group A at intubation (T0) and at subsequent time points (T1, T2, T3, T20, T25, and T30). SBP and DBP decreased before intubation, after which subsequent readings showed a statistically significant difference (P = 0.000). Patients in Group A required significantly less Propofol to maintain BP within 20% of baseline. CONCLUSION(S): Administering a single dose of intranasal dexmedetomidine at 1 mcg/kg before induction effectively manages the hemodynamic response during laryngoscopy. Copyright © 2026 Annals of Cardiac Anaesthesia. <112> Accession Number 652403143 Title Effect of transcutaneous auricular vagus nerve stimulation on perioperative psychological symptoms in patients undergoing elective thoracoscopic lung resection: A randomized controlled trial. Source Chinese medical journal. (no pagination), 2026. Date of Publication: 13 Oct 2026. Author Sun Z.; Zhang S.; Liu H.; Tao M.; Wang Y.; Chen J.; Xiong X.; Deng Q.; Yu Y.; Lin Y.; Ma T.; Zhou M.; Li P.; Guo X.; Liu J.; Hang C.; Wang M.; Han Y.; Zhang H.; Cao J. Institution (Sun, Liu, Tao, Wang, Chen, Xiong, Deng, Yu, Lin, Ma, Zhou, Li, Guo, Liu, Hang, Wang, Zhang, Cao) Jiangsu Province Key Laboratory of Anesthesiology and Brain Science & Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, China (Sun, Tao, Wang, Xiong, Yu, Lin, Ma, Zhou, Li, Guo, Liu, Hang, Wang, Cao) Department of Anesthesiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China (Zhang) Department of Anesthesiology, Renji Hospital School of Medicine, Shanghai Jiao Tong University, Shanghai, China (Liu) Department of Anesthesiology & Clinical Research Center for Anesthesia and Perioperative Medicine & Key Laboratory of Anesthesia and Analgesia Application Technology, Huzhou Central Hospital & The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University & The Affiliated Huzhou Hospital, Huzhou, Zhejiang, China (Chen) Department of Anesthesiology, Suzhou Municipal Hospital, Suzhou, Jiangsu, China (Han) Department of Anesthesiology, Eye & ENT Hospital of Fudan University, Shanghai, China Abstract BACKGROUND: Perioperative anxiety is highly prevalent in patients undergoing thoracoscopic lung resection, adversely affecting postoperative recovery. Transcutaneous auricular vagus nerve stimulation (taVNS) has emerged as a promising noninvasive neuromodulatory intervention with demonstrated efficacy in various psychiatric and stress-related conditions. This study aimed to evaluate the efficacy and safety of taVNS in reducing perioperative anxiety in this population. METHOD(S): This single-center, parallel-group, randomized, double-blind, superiority trial was conducted at the Department of Anesthesiology and Thoracic Surgery, the Affiliated Hospital of Xuzhou Medical University between October 10, 2024, and April 30, 2025. A total of 176 eligible patients aged >=18 years with ASA physical status I-III and scheduled for elective thoracoscopic lung resection were enrolled. Patients with neuropsychiatric disorders, auricular lesions, severe cardio-cerebrovascular diseases, implanted electronic devices, Mini-Mental State Examination (MMSE) score <15, long-term psychotropic medication use or postural tachycardia syndrome were excluded. All participants were randomly allocated to receive four sessions of either active taVNS or sham taVNS. Stimulation was delivered via the auricular branch of the vagus nerve at the cymba conchae of the left ear at four predefined perioperative time points: the afternoon before surgery, the morning of surgery, immediately after tracheal extubation, and the afternoon of the first postoperative day. The primary outcome was the incidence of perioperative anxiety, assessed from the initiation of the first taVNS session through 3 days postoperatively. All participants, healthcare providers, outcome assessors and data analysts were blinded to group assignment during the whole study. RESULT(S): A total of 176 patients were randomly assigned, with 88 participants in the active taVNS group and 88 in the sham taVNS group. After excluding 2 patients (1 patient from each group) who were transferred to the ICU postoperatively, a total of 174 patients (median age, 58 years; 105 women [60.4%]) completed the study and were analysed for the primary outcome, including 87 patients in each group. The incidence of perioperative anxiety was significantly lower in the active taVNS group than in the sham taVNS group (50.6% vs. 73.6%; relative risk [RR], 0.59; 95% confidence interval [CI], 0.41-0.85; chi2 = 9.76; P = 0.002). Compared with sham stimulation, active taVNS was associated with reductions in anxiety and depression scores, postoperative pain intensity, and physiological stress indices and improvement in sleep quality and overall postoperative recovery. No severe adverse events were observed in either group. The main mild adverse reactions included nausea, vomiting, local tingling, dizziness and headache, and the incidence of adverse events was similar between the two groups. CONCLUSION(S): Four perioperative sessions of taVNS applied to the left cymba conchae significantly reduced the incidence of perioperative anxiety in patients undergoing thoracoscopic lung resection and were additionally associated with improvements in depressive symptoms, stress burden, sleep quality, and pain outcomes. TRIAL REGISTRATION: Chinese Clinical Trial Register Identifier: ChiCTR2400090542 (http://www.chictr.org.cn). Copyright © 2026 The Chinese Medical Association, produced by Wolters Kluwer Health, LLC. under the CC-BY-NC-ND license. <113> Accession Number 2038778947 Title Comparative Study of Hemodynamic Response to Etomidate Versus Ketofol Anesthetic Induction in Patients with Reduced Ejection Fraction Undergoing Coronary artery bypass grafting (CABG). Source International Journal of Medical Science in Clinical Research and Review. 9(5) (pp 1515-1521), 2026. Date of Publication: 01 Sep 2026. Author Kr M.; Patel M.D.; Sn N. Institution (Kr, Patel, Sn) Department of Cardiac Anesthesia, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Karnataka, Mysore, India Publisher International Journal of Medical Science in Clinical Research and Review (IJMSCRR) Abstract Background: Coronary artery bypass grafting surgery is the commonest surgery done in patients with various cardiovascular diseases. Doing the CABG surgery in patients with reduced ejection fraction is associated with mortality. Anesthesia used in the CABG surgery in patients with reduced ejection fraction plays major role in surgical outcome. The present study aimed to evaluate the hemodynamic response to etomidate versus ketofol anesthetic induction in patients with reduced ejection fraction undergoing CABG surgery. Material(s) and Method(s): This study was conducted in a total of 70 patients selected in the based on the inclusion and exclusion criteria. Patients were divided in to two groups, group-I received Etomidate and group-II Ketofol respectively. For all the patients demographic data, systolic blood pressure, diastolic blood pressure, mean arterial pressure and heart rate were recorded at different time periods (at baseline, after 1 min of induction, before laryngoscopy (BL), after laryngoscopy(AL), 2min following lscopy )and the data was enter in excel sheet used for analysis. Statistical Package for Social Sciences (SPSS 20.0) version used for analysis. Result(s): Maximum number of patients had age between 51-60 years in both groups. Comparison of mean between the groups not showed any significant difference. Group-I and II had similar gender distribution. Mean weight between the group-I and II not showed any significant difference. Comparison of mean systolic blood pressure at baseline, After Laryngoscopy (AL) and 2 min following laryngoscopy not showed significant difference, but at 1 min and Before Laryngoscopy (BL) values showed significant difference. Baseline, 1 min, BL and AL diastolic blood pressure showed significant difference compared between group-I and II not at 2 min. Mean arterial pressure showed significant difference compared between group-I and II at 1 min and BL and no other time periods. Comparison of heart rate between the groups at baseline and 1 min showed significant difference with p value 0.05. Conclusion(s): These study observations concluded that patients received etomidate showed better hemodynamic stability at all the time periods compared to ketofol in patients undergoing CABG surgery with reduction ejection fraction. Copyright © 2026 The Author(s). <114> Accession Number 652410425 Title Impact of Erector Spinae Block on Postoperative Analgesia and Hospital Recovery in Coronary Artery Bypass Surgery: A Systematic Review with Meta-analysis, Meta-Regression, and Sequential Trial Analysis. Source Annals of cardiac anaesthesia. 29(4) (pp 481-493), 2026. Date of Publication: 01 Oct 2026. Author Aureliano de Carvalho J.P.; Dos Reis Requiao H.; Vieira R.M.; de Sousa Ferreira P.; da Silva Neto E.B.; Torres de Araujo Azi L.M.; Modolo N.S.P.; Alves R.L. Institution (Aureliano de Carvalho, Dos Reis Requiao, de Sousa Ferreira, da Silva Neto, Torres de Araujo Azi, Alves) Federal University of Bahia, Salvador, Brazil (Vieira, Modolo, Alves) Botucatu School of Medicine, Paulista State University, Botucatu, Brazil Abstract ABSTRACT: The erector spinae plane block (ESPB) is a promising regional technique for cardiac surgery. We evaluated the efficacy of ESPB regarding analgesia and in-hospital outcomes in patients undergoing coronary artery bypass grafting (CABG). We conducted a systematic review and meta-analysis comparing ESPB versus control in adults undergoing CABG (CRD42025645045). Primary outcomes were opioid consumption (24 h/48 h) and pain intensity. Secondary outcomes included extubation time and intensive care unit (ICU) length of stay. Data were pooled using random-effects models. Meta-regression and trial sequential analysis (TSA) were used to assess sources of heterogeneity and robustness, respectively, while the Grading of Recommendations, Assessment, Development, and Evaluations framework provided the certainty of the evidence for each outcome. Twelve studies (704 patients) were analyzed. ESPB significantly reduced the morphine milligram equivalent consumption at 24 h (mean difference (MD) -19.05 mg; 95% confidence interval (CI) [-22.50 to -15.61]; P < 0.001; high certainty) and 48 h (MD -19.42 mg; 95% CI [-28.75 to -10.09]; P < 0.001; moderate certainty). Pain scores, by the Numerical Rating Scale, were lower within 12 h (MD -0.93; P < 0.001; moderate certainty) and at 24 h (MD -0.58; P = 0.016; low certainty). ESPB shortened extubation time (MD -2.50 h; high certainty) and ICU stay (MD -12.55 h; moderate certainty). TSA confirmed robust evidence for opioid reduction, early pain relief, and extubation benefits. ESPB provides effective early analgesia, reduces perioperative opioid requirements, and accelerates recovery in CABG, representing a fundamental complement to conventional isolated intravenous analgesia. Future research should investigate continuous techniques. Copyright © 2026 Annals of Cardiac Anaesthesia. <115> Accession Number 652403168 Title Enhanced Recovery After Surgery Pathways in Pediatric Thoracic Surgery: A Scoping Review. Source Journal of pediatric surgery. (pp 163540), 2026. Date of Publication: 13 Oct 2026. Author Yildiz G.A.; Taylan S.; Aslan F.E. Institution (Yildiz) Faculty of Health Sciences, Nursing Department Bahcesehir University, Istanbul, Turkey (Taylan) Faculty of Health Sciences, Nursing Department Mediterrenian University, Antalya, Turkey (Aslan) Faculty of Health Sciences, Nursing Department Bahcesehir University, Istanbul, Turkey Abstract BACKGROUND: Pediatric thoracic surgery is a field with a high risk of postoperative complications and a complex recovery process, requiring effective care models that support rapid and safe patient recovery. OBJECTIVE(S): This study aims to systematically map the existing literature on ERAS (Enhanced Recovery After Surgery) protocols in pediatric thoracic surgery, to identify the reported protocol components and outcome measures, and to determine knowledge gaps for future research. METHOD(S): A scoping review was conducted according to the six-stage framework of the Joanna Briggs Institute and reported in line with the PRISMA-ScR guidelines. A comprehensive literature search was performed in PubMed, Web of Science, and Scopus databases in February 2026. Studies examining ERAS protocols in pediatric thoracic surgery and reporting clinical and psychosocial outcomes were included. Two researchers independently extracted the data and synthesized them using thematic analysis. RESULT(S): A total of 7 studies were included in the scoping review. The most frequently evaluated components of ERAS protocols were early mobilization, multimodal analgesia, and early feeding, and these practices were important for shortening hospital length of stay, optimizing pain control, and supporting clinical efficiency without increasing complication rates. Although most studies were retrospective and single-center, ERAS was shown to be feasible when implemented through multidisciplinary teams and safe in terms of short-term clinical outcomes. However, patient-reported and long-term psychosocial outcomes remain limited. CONCLUSION(S): ERAS protocols in pediatric thoracic surgery are feasible and safe in terms of short-term clinical outcomes and can be effective with multidisciplinary team coordination. Future multicenter, prospective, and standardized studies are needed to evaluate patient-reported and long-term outcomes. Copyright © 2026. Published by Elsevier Inc. <116> Accession Number 2050643225 Title Transcatheter aortic valve replacement in failed transcatheter versus failed surgical bioprostheses: a systematic review with exploratory meta-analysis. Source Frontiers in Cardiovascular Medicine. 13 (pp 1-16), 2026. Article Number: 1870804. Date of Publication: 18 Sep 2026. Author Ghannam M.; Abomohsen M.; Idries I.Y.; Shamoon F.; Ghallab M.; Zghyer F.; Gonzalez A.V.; Ahmad A.; Habib H.A.; Vasudev R. Institution (Ghannam, Abomohsen, Idries) Brookdale University Hospital and Medical Center, Brooklyn, NY, United States (Shamoon, Ahmad, Habib, Vasudev) St. Joseph's University Medical Center, Paterson, NJ, United States (Ghallab) Department of Cardiovascular Medicine, Creighton University, Omaha, NE, United States (Zghyer) Heart, Vascular and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, OH, United States (Gonzalez) Department of Cardiology, Heart Failure Division, University of Alabama at Birmingham, Birmingham, AL, United States Publisher Frontiers Media SA Abstract Background - With the expanding use of transcatheter aortic valve replacement (TAVR) in younger patients, the need for reintervention on failed bioprostheses is rising. Comparative evidence between redo TAVR for failed transcatheter valves (TAV-in-TAV) and TAVR for failed surgical valves (TAV-in-SAV) is limited. Objective - To systematically review and meta-analyse the clinical, haemodynamic, and safety outcomes of TAV-in-TAV versus TAV-in-SAV. Methods - PubMed, Scopus, Web of Science, Cochrane CENTRAL, and Embase were searched from inception to April 2026. Studies directly comparing TAV-in-TAV with TAV-in-SAV and reporting original data with >=10 patients per group were included. Risk of bias was assessed using ROBINS-I and the Newcastle-Ottawa Scale. Random-effects meta-analyses were performed for 30-day mortality, 1-year mortality, mean transvalvular gradient at 30 days, and new permanent pacemaker (PPM) implantation. Results - Four observational studies, including 705 patients in the extracted comparative cohorts, met the inclusion criteria. Two full-text studies contributed to the primary quantitative analyses. TAV-in-TAV was not associated with a statistically significant difference in 30-day mortality compared with TAV-in-SAV (OR 0.71, 95% CI 0.25-2.00), nor in 1-year mortality (OR 1.02, 95% CI 0.47-2.18). TAV-in-TAV was associated with lower mean transvalvular gradients at 30 days (MD -2.71 mmHg, 95% CI -4.07 to -1.34). A non-significant trend toward higher new permanent pacemaker implantation was observed after TAV-in-TAV (OR 1.85, 95% CI 0.94-3.65). Conclusion - Current comparative evidence between TAV-in-TAV and TAV-in-SAV remains limited and observational. No definitive mortality difference was identified, but clinically meaningful benefit or harm cannot be excluded. TAV-in-TAV shows a consistent early haemodynamic signal with lower gradients, while the possible increase in pacemaker implantation remains exploratory. These findings should be considered hypothesis-generating and require confirmation in larger prospective studies with longer follow-up. Systematic Review Registration - https://www.crd.york.ac.uk/PROSPERO/view/CRD420261369410, PROSPERO CRD420261369410. Copyright © 2026 Ghannam, Abomohsen, Idries, Shamoon, Ghallab, Zghyer, Gonzalez, Ahmad, Habib and Vasudev. <117> Accession Number 652409305 Title Comparison of Effectiveness of Caudal Dexmedetomidine vs. Caudal Fentanyl with Bupivacaine during Pediatric Cardiac Surgery with regards to Hemodynamic Fluctuations and Postoperative Pain. Source Annals of cardiac anaesthesia. 29(4) (pp 594-599), 2026. Date of Publication: 01 Oct 2026. Author Manwani R.N.; Wadaskar D.; Panbude P.; Mankhair S.; Kanakam S. Institution (Manwani) Department of Anaesthesia, Datta Meghe Medical College, Nagpur, Maharashtra, India (Wadaskar, Panbude, Mankhair) Department of Anaesthesia, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India (Kanakam) Department of Anaesthesia, Fortis Hospital, Kolkata, West Bengal, India Abstract BACKGROUND: Optimum analgesia, reflecting into attenuation of stress response, is pertinent in pediatric cardiac surgery. Narcotics are still the mainstay in providing analgesia, and they are a common adjunct in caudal epidural analgesia. Unwanted effects of narcotics warrant a constant search for nonopioid analgesics. OBJECTIVE(S): To compare dexmedetomidine vs. fentanyl as an adjuvant in caudal anesthesia in pediatric cardiac surgery. MATERIALS AND METHODS: Sixty patients, 1 to 8 years of age, with acyanotic congenital heart disease were divided into two groups randomly: group A received caudal dexmedetomidine 0.5 microg/kg with 2 mg/kg bupivacaine diluted to 1.6 ml/kg with normal saline. Group B received caudal fentanyl 1 microg/kg with 2 mg/kg bupivacaine diluted to 1.6 ml/kg with normal saline. RESULT(S): Stress response assessed by surge in heart rate and blood pressure after induction was significantly lower in group A (Dexmedetomidine group). The mean time to successful discontinuation of mechanical ventilation was significantly lower in the dexmedetomidine group (1.2 +/- 0.4 vs. 1.73 +/- 0.58 h). Children in the dexmedetomidine group had lower FLACC pain scores at 4 hours postextubation (2.93 +/- 1.04 vs. 3.83 +/- 0.83), implying better pain control. The time to need for rescue analgesia was longer in the dexmedetomidine group (6.1 +/- 1.21 vs. 3.96 +/- 0.96 h). CONCLUSION(S): Caudal dexmedetomidine gave better control of hemodynamic parameters when compared with fentanyl and was associated with earlier extubation postoperatively. It also has superior and prolonged analgesia compared to caudal fentanyl as an adjunct. Copyright © 2026 Annals of Cardiac Anaesthesia. <118> Accession Number 2050726858 Title From animal behavior to human perioperative neurocognitive disorders: Translational boundaries of the gut-brain axis. Source Behavioural Brain Research. 517 (no pagination), 2027. Article Number: 116533. Date of Publication: 04 Feb 2027. Author Zhu C.; Wei J. Institution (Zhu, Wei) Department of Anesthesiology, Huadong Hospital, Fudan University, Shanghai, China Publisher Elsevier B.V. Abstract Perioperative neurocognitive disorders (PND), including postoperative delirium (POD), delayed neurocognitive recovery (DNR), and postoperative neurocognitive disorder, are common after surgery in older adults, and the gut-brain axis has been proposed as a contributing pathway. Most mechanistic support rests on rodent behavioral assays, yet these endpoints and human clinical diagnoses are routinely treated as interchangeable. This critical narrative review examines that translational boundary. PND is used here as a clinically consequential test case for a broader behavioral-neuroscience problem: how animal behavioral phenotypes, microbiome-associated signals, and intervention effects should be translated into human diagnostic constructs. A structured search identified and appraised the principal evidence rather than an exhaustive synthesis; no formal risk-of-bias or certainty-of-evidence assessment was performed. Evidence was separated into human perioperative studies reporting a neurocognitive outcome with either a measured gut-brain exposure or a gut-directed intervention; those reporting gut-brain change without a cognitive outcome; perioperative preclinical evidence; and indirect non-perioperative evidence. The retrieved human perioperative evidence spans observational cohorts across gastric, orthopedic, spinal and cardiac surgery, multi-omic and metabolomic cohorts, and randomized perioperative probiotic trials reporting lower rates of study-defined cognitive outcomes. It nonetheless remains heterogeneous and largely single-center, with modest event numbers, inconsistent sampling and assessment, and limited external validation. Mechanistic support still comes mainly from perioperative rodent models using water maze, fear-conditioning, recognition-memory, and delirium-like readouts, which measure narrow, species-specific capacities and are not diagnostic equivalents of POD, DNR, or postoperative neurocognitive disorder. Microbiome-mediated causation is unproven, and cross-species endpoint alignment remains a central route to improved translation. Copyright © 2026 <119> Accession Number 652411050 Title Response to Comments on Comparison of Analgesic Efficacy of Intrathecal Morphine and Ultrasound - Guided Bilateral Erector Spinae Plane Block in Patients Undergoing Open Heart Surgery with Midline Sternotomy: An Open Label Randomized Control Trial. Source Annals of cardiac anaesthesia. 29(4) (pp 661-662), 2026. Date of Publication: 01 Oct 2026. Author Karuppiah V.; Kumar R.; Mohammed S.; Chouan A.; Chhabra S.; Kamal M.; Sharma A. Institution (Karuppiah) Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India (Kumar, Mohammed, Chouan, Chhabra, Kamal) Department of Anesthesia and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India (Sharma) Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India <120> Accession Number 652409022 Title Comparative Efficacy of Pecto-Intercostal Facial Plane Block vs Transversus Thoracic Facial Plane Block Combined with Rectus Sheath Block for Post-Sternotomy Analgesia: A Prospective Randomized Controlled Trial. Source Annals of cardiac anaesthesia. 29(4) (pp 577-586), 2026. Date of Publication: 01 Oct 2026. Author Gupta P.; Pula R.; Polapally V.; Gooty S.; Krosuri V.; Thakur N.; Gopinath R. Institution (Gupta) Department of Anaesthesiology and Critical Care, ESIC Medical College and Super Speciality Hospital, Sanathnagar, Hyderabad, Telangana, India Abstract BACKGROUND: Ultrasound-guided facial plane blocks are central to enhanced recovery after cardiac surgery (ERACS) protocols, yet evidence comparing pecto-intercostal facial plane block (PIFB) and transversus thoracic facial plane block (TTPB) with rectus sheath block (RSB) remains limited. METHOD(S): This prospective, randomized, controlled trial enrolled 100 adult patients (ASA II-III) undergoing elective median sternotomy at a tertiary care hospital in South India. Patients received standardized general anesthesia and were randomized to bilateral PIFB or TTPB (20 mL 0.25% bupivacaine + 4 mg dexamethasone per side) with RSB after cardiopulmonary bypass. The primary outcome was 24-hour postoperative fentanyl consumption. Secondary outcomes included visual analog scale (VAS) pain scores at 0, 3-, 6-, 12-, and 24-hours post-extubation, rescue analgesia, extubation timing, ICU/hospital stay, and complications. RESULT(S): A total of 96 patients completed analysis (PIFB: n = 47; TTPB: n = 49). Mean 24-hour fentanyl consumption was 267.23 +/- 92.54 microg (PIFB) vs 297.18 +/- 88.09 microg (TTPB), mean difference - 29.95 microg (95% confidence interval: -66.60 to 6.70; P = 0.108). VAS scores showed no significant between-group differences (P > 0.05). Rescue analgesia rates were similar, with 84% and 90% not requiring additional opioids. Four PIFB patients (8%) stayed intubated >24 hours due to cardiac issues, vs none in the TTPB group (P = 0.121). CONCLUSION(S): This trial found no significant difference in opioid consumption or pain scores between PIFB + RSB and TTPB + RSB for post-sternotomy analgesia. Both techniques were safe within ERACS protocols. Larger noninferiority trials are needed before establishing equivalence or recommending one technique over another. Copyright © 2026 Annals of Cardiac Anaesthesia. <121> Accession Number 2050742092 Title The Use of VivaSight Single Lumen Tube With Endobronchial Blocker in MIDCAB Surgery - a Feasibility Study. Source Trends in Anaesthesia and Critical Care. Conference: EAC2026 Abstracts of the 9th European Airway Management Congress. Istanbul Turkey. 70(Supplement) (no pagination), 2026. Article Number: 101761. Date of Publication: 01 Oct 2026. Author Subrtova K.; Lips M.; Kunstyr J.; Soltes J.; Michalek P. Institution (Subrtova, Lips, Kunstyr, Soltes, Michalek) General University Hospital in Prague, Czechia Publisher Churchill Livingstone Abstract Introduction / Purpose:: The VivaSight Single Lumen is a single-use endotracheal tube with integrated camera providing continuous visualization of the main carina. We evaluated the feasibility of its use for tracheal intubation and endobronchial blocker placement in patients undergoing minimally invasive direct coronary artery bypass (MIDCAB) surgery requiring left lung collapse. Material(s) and Method(s): We retrospectively analysed 65 patients (54 males [83.1%], 11 females [16.9%]) undergoing elective MIDCAB surgery between January 2021 and February 2026. Mean age was 65.6 years +/- 11.3, mean BMI was 28.1 +/- 4.8; 24 patients (36.9%) had at least one predictor of difficult intubation. Airway was secured using the VivaSight Single Lumen tube with an endobronchial blocker by 22 anaesthesiologists. Primary outcome was correct visualization of the main carina with successful insertion of an endobronchial blocker, secondary outcomes included lung isolation quality, perioperative respiratory complications, and operator satisfaction. Finding(s): Direct laryngoscopic intubation was successful in 64 patients (98.5%); one patient (1.5%) required fiberoptic intubation through an i-gel due to a difficult airway. The commonest Cormack-Lehane grades were 1 and 2a; three patients (4.6%) had grade 3. Successful visualization of the main carina was achieved in 62 cases (95.4%), two patients (3%) required additional flexible bronchoscopy. Adequate lung collapse was achieved in 64 patients (98.5%); in one patient (1.5%) it was suboptimal but sufficient for surgery. One patient (1.5%) experienced difficult left lung re-expansion. Postoperative atelectasis occurred in 24 patients (36.9%), two patients (3.1%) required non-invasive ventilation, one patient (1.5%) developed a pneumothorax. All anaesthesiologists rated device manipulation and blocker placement favourably; 93% rated carinal visualization as good or very good, all indicated a preference for VivaSight over a conventional endotracheal tube with flexible bronchoscopy. Discussion / Conclusion(s): The use VivaSight Single Lumen tube is feasible for tracheal intubation and endobronchial blocker placement for MIDCAB surgery. A prospective randomized controlled trial is planned at our institution. Keywords: one lung ventilation, airway management, minimally invasive cardiac surgery, endobronchial blocker, tracheal intubation References Oh SK, Lim BG, Kim YS, Lee JH, Won YJ. ETView VivaSight single lumen vs. conventional intubation in simulated studies: a systematic review and meta-analysis. J Int Med Res. 2020 Jun;48(6):300060520925653. doi: 10.1177/0300060520925653. Copyright © 2026, Churchill Livingstone <122> Accession Number 2049812957 Title Post-treatment risks of transcatheter aortic valve implantation: should we be increasing preventative measures?. Source Expert Review of Cardiovascular Therapy. (no pagination), 2026. Date of Publication: 2026. Author Theofilis P.; Vlachakis P.K.; Koutsopoulos G.; Kachrimanidis I.; Iliakis P.; Ktenopoulos N.; Patsalis P.C.; Toutouzas K.; Tsioufis K. Institution (Theofilis, Vlachakis, Koutsopoulos, Kachrimanidis, Iliakis, Ktenopoulos, Toutouzas, Tsioufis) First Department of Cardiology, "Hippokration" General Hospital, University of Athens Medical School, Athens, Greece (Iliakis, Patsalis) Department of Medicine, Division of Cardiology, Angiology and Internal Emergency Medicine, Ruhr University Bochum, Knappschaft Kliniken University Hospital Bochum, Bochum, Germany Publisher Taylor and Francis Ltd. Abstract Introduction: Transcatheter aortic valve implantation (TAVI) has become an established treatment for severe aortic stenosis across an expanding risk spectrum. As indications extend to younger and lower-risk patients, post-treatment complications with implications for survival, quality of life, and valve durability require attention. Areas covered: This narrative review discusses major post-TAVI complications with direct implications for procedural planning and lifetime management, including cerebrovascular events, conduction abnormalities, coronary obstruction and aortic root injury, bioprosthetic valve dysfunction, valve thrombosis, residual regurgitation, and TAVI-associated infective endocarditis. Evidence was reviewed from pivotal randomized trials, contemporary registries, consensus documents, systematic reviews, and mechanistic studies addressing incidence, pathophysiology, predictors, prognosis, prevention, diagnosis, and management of these complications. Expert opinion: Post-TAVI risk reduction should move beyond reactive complication management toward individualized prevention. Meticulous computed tomography-based planning, optimized valve selection and implantation technique, rational antithrombotic therapy, structured rhythm and valve surveillance, selective use of cerebral embolic protection, timely correction of clinically or hemodynamically significant residual regurgitation, and infection-prevention pathways are central components of contemporary care. Future progress will depend on better risk stratification, longer-term durability data, and targeted preventive strategies adapted to lower-risk patients with longer life expectancy. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <123> Accession Number 652412531 Title Safety and Efficacy of Acute Normovolemic Hemodilution in Female Patients: A Secondary Analysis of the ANH Trial. Source JAMA surgery. (no pagination), 2026. Date of Publication: 14 Oct 2026. Author Pruna A.; Scandroglio A.M.; Lei C.; Oriani A.; Di Fazio A.; Pontillo D.; Santonocito C.; Bonizzoni M.A.; Comis M.; Calabro M.G.; Kadantseva K.; Barucco G.; Guarracino F.; Giardina G.; Ajello V.; Di Prima A.L.; Osinsky R.; Oliva F.M.; Efremov S.; Mucchetti M.; Vandyck K.B.; Franco A.; Arangino C.; Nardelli P.; Ranucci M.; D'Amora M.; Wang L.; Zhang H.; Lorsomradee S.; Hajjar L.A.; Ti L.K.; McNeil J.S.; Pieri M.; Bove T.; Gurcu M.E.; Rocco M.; Landoni G.; Paternoster G.; Zangrillo A.; Monaco F. Institution (Pruna, Scandroglio, Oriani, Pontillo, Bonizzoni, Calabro, Barucco, Giardina, Di Prima, Oliva, Mucchetti, Franco, Nardelli, Pieri, Landoni, Zangrillo) Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy (Lei, Wang, Zhang) Department of Anesthesiology and Perioperative Medicine, Anesthesia Clinical Research Center, Xijing Hospital, Xi'an, China (Di Fazio) Regional Complex Intercompany Institute of Legal Medicine, San Carlo Hospital, Potenza, Italy (Santonocito) Anesthesia and Intensive Care Medicine III, Policlinico University Hospital G. Rodolico - San Marco, Catania, Italy (Comis) S.C. Anestesia e Rianimazione Cardiovascolare, A.O. Ordine Mauriziano Umberto I, Turin, Italy (Kadantseva) Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russian Federation (Kadantseva) A. Loginov Moscow Scientific Clinical Center, Moscow, Russian Federation (Guarracino) University Gabriele d'Annunzio Chieti Pescara, Department of Medical, Dental and Biotechnological Sciences, Chieti, Italy (Ajello) Department of Cardiothoracic and Vascular Surgery, Tor Vergata University Hospital, Rome, Italy (Osinsky) Department of Anesthesiology and Intensive Care, E. Meshalkin National Medical Research Center, Novosibirsk, Russian Federation (Efremov) Saint Petersburg State University Hospital, Saint Petersburg, Russian Federation (Vandyck) Department of Anesthesiology, University of Oklahoma, Oklahoma City, United States (Arangino) Anestesia e Terapia Intensiva Cardiochirurgica, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy (Ranucci) Department of Cardiac Anesthesia and ICU, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (D'Amora) Department of Cardiac, Thoracic and Vascular Anaesthesia, University Hospital San Giovanni Di Dio e Ruggi D Aragona, Salerno, Italy (Lorsomradee) Chiang Mai University, Chiang Mai, Thailand (Hajjar) Hospital das Clinicas, HCFMUSP, Faculdade de Medicina da USP, Sao Paulo, Brazil (Ti) Department of Anaesthesia, National University Hospital, Italy (McNeil) University of Virginia School of Medicine, Charlottesville, United States (Pieri, Landoni, Zangrillo) School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (Bove) Department of Basic Biotechnological Sciences, Universita Cattolica del Sacro Cuore, Rome, Italy (Bove) Department of Emergency, Anesthesiological and Reanimation Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy (Gurcu) Kosuyolu Heart Center, Istanbul, Turkey (Rocco) Department of Medical and Surgical Science and Translational Medicine, Sapienza University of Rome, Rome, Italy (Rocco) UOC Anestesia e Rianimazione, Rome, Italy (Paternoster) Department of Health Sciences, University of Basilicata, Potenza, Italy (Paternoster) Anaesthesia and ICU, San Carlo Hospital, Potenza, Italy (Monaco) Cardiothoracic and Vascular Anesthesia and Intensive Care, Bologna, Italy (Monaco) Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum - University of Bologna, Bologna, Italy Abstract Importance: Female patients undergoing cardiac surgery have a higher transfusion burden, yet they remain underrepresented in randomized clinical trials. Although the ANH trial showed no significant reduction in the proportion of patients receiving allogeneic blood transfusions with acute normovolemic hemodilution, evidence regarding its efficacy and safety specifically in female patients remains limited. Objective(s): To evaluate the efficacy and safety of acute normovolemic hemodilution (ANH) compared with usual care in female patients undergoing elective cardiac surgery with cardiopulmonary bypass. Design, Setting, and Participant(s): This was a post hoc secondary analysis of the multicenter, randomized ANH trial, which was conducted at 32 centers in 11 countries from April 2019 to December 2024. Of 2010 patients in the original ANH trial, 405 were women and were included in this analysis; 219 had been randomized to receive ANH and 186 to usual care. This secondary analysis was conducted from August 2025 to January 2026. Intervention(s): Withdrawal of at least 650 mL whole blood with crystalloids replacement and reinfusion after cardiopulmonary bypass. Main Outcomes and Measures: The primary outcome was the occurrence of at least 1 allogeneic packed red blood cell (pRBC) transfusion during the index hospitalization. Safety outcomes included intraoperative hypotension, intensive care unit (ICU) length of stay, hospital length of stay, mortality, and other perioperative complications. Result(s): The median (IQR) age of the participants was 62 (54-69) years. The occurrence of allogeneic pRBC transfusion was similar in the ANH and usual care groups (38.8% vs 44.6%, respectively; relative risk [RR], 0.87; 95% CI, 0.69-1.10; P = .24). Intraoperative hypotension occurred more frequently with ANH (16.0% vs 4.8% in usual care; RR, 3.30; 95% CI, 1.62-6.74; P = .02). Patients receiving ANH also had longer ICU stays (mean difference, 21.13 hours; 95% CI, 1.89-40.38; P = .03) and hospital stays (mean difference, 1.92 days; 95% CI, 0.14-3.70; P = .04). No significant differences were observed in mortality or other postoperative complications. Conclusions and Relevance: In this post hoc secondary analysis of a randomized clinical trial, ANH was not associated with a reduction in allogeneic pRBC transfusion among women undergoing cardiac surgery and was associated with more frequent intraoperative hypotension and longer ICU and hospital stay. These exploratory findings warrant confirmation in adequately powered studies specifically designed to evaluate female patients undergoing cardiac surgery. Trial Registration: ClinicalTrials.gov Identifier: NCT03913481. <124> Accession Number 2050537696 Title Summary of the best evidence for dyadic disease management in patients who have undergone coronary stenting and their family caregivers. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1871242. Date of Publication: 23 Sep 2026. Author Wang H.; Zhu J.; Wei K.; Luo B.; Wan S.; Wang J.; Yu S. Institution (Wang, Zhu, Wei, Luo, Wan, Wang, Yu) School of Nursing, Beihua University, Jilin City, China (Yu) Affiliated Hospital of Beihua University, Jilin City, China Publisher Frontiers Media SA Abstract Objective - To systematically synthesize the best available evidence on dyadic disease management for patients and their family caregivers following coronary stent implantation and to develop actionable evidence-based recommendations for clinical practice. Methods - This evidence summary used the 6S evidence pyramid to guide the prioritization and retrieval of evidence sources. Chinese and international databases and relevant professional society websites were systematically searched from inception to February 28, 2026, using terms related to percutaneous coronary intervention/coronary stenting, caregivers/dyadic care, and self-management/disease management/cardiac rehabilitation. Two reviewers independently screened eligible evidence sources, assessed methodological quality using design-appropriate appraisal tools, and extracted and synthesized the evidence. Results - A total of 18 evidence sources were included, comprising 4 guidelines, 4 expert consensus statements, 2 systematic reviews, 1 evidence summary, 3 randomized controlled trials, and 4 quasi-experimental studies. Evidence synthesis yielded 27 evidence-based recommendations across five domains: assessment and planning, education and decision-making, self-management and rehabilitation, psychosocial support, and continuity of care. Key recommendations emphasized dyadic assessment of patient and caregiver needs, psychological status, caregiver burden, and readiness for collaboration; joint education and shared decision-making; caregiver-supported medication management, lifestyle modification, rehabilitation, symptom monitoring, and emergency response; psychosocial support for both members of the dyad; and coordinated discharge transition and follow-up. Conclusion - The synthesized evidence integrates previously dispersed caregiver-related findings into a structured, consent-based dyadic management pathway for post-stenting care. Clinicians should identify and assess the caregiver selected by the patient, clarify collaborative roles and goals, provide joint education and targeted skills training, and integrate caregiver support into self-management, rehabilitation, psychosocial care, discharge transition, and follow-up. This pathway offers a practical approach to incorporating caregiver participation into post-stenting secondary prevention while preserving patient autonomy and addressing the needs of both members of the dyad. Copyright © 2026 Wang, Zhu, Wei, Luo, Wan, Wang and Yu. <125> Accession Number 2050565812 Title From rejection to vasculopathy: a review of non-invasive biomarkers in alloimmune responses in heart transplantation. Source Frontiers in Medicine. 13 (no pagination), 2026. Article Number: 1923304. Date of Publication: 01 Oct 2026. Author Majo Ribera P.; Bates L.; Scott W.; Fisher A.; Gonzalez-Fernandez O. Institution (Majo Ribera, Bates, Scott, Fisher, Gonzalez-Fernandez) Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom (Majo Ribera, Bates, Fisher, Gonzalez-Fernandez) Institute of Transplantation, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom Publisher Frontiers Media SA Abstract Background - Heart transplantation is the gold standard treatment for end-stage heart failure. Despite immunosuppression as the cornerstone therapy for post-transplant management, the presence of immunological complications including acute cellular rejection (ACR), antibody-mediated rejection (AMR), and cardiac allograft vasculopathy (CAV)-remain major barriers to long-term graft survival. Graft monitoring largely remains dependent on protocolized endomyocardial biopsy (EMBx), an invasive, risky procedure. Scope - This narrative review focuses on aggregating the published evidence, summarizing key clinical complications, and presenting the available tools to date. Furthermore, we discuss key limitations which must be addressed to improve patient care, including the need for non-invasive biomarkers in cardiac allograft vasculopathy Key findings - Significant progress in the development and promising use of non-invasive biomarkers for the detection of graft rejection has emerged over the last decade; particularly for monitoring ACR and AMR. Donor-derived cell-free DNA and gene expression profiling of circulating immune cells have both emerged as promising tools to aide post-transplant management of graft health and reduce EMBx frequency. Soluble protein biomarkers-including hs-cTn, BNP, and NT-proBNP-provide supplementary information on graft stress and injury but lack specificity. In contrast, evidence supporting non-invasive biomarker use in CAV remains sparse. Conclusions - Non-invasive biomarkers have meaningfully advanced rejection surveillance in heart transplantation and hold promise for reducing procedural burden on patients. However, their role in detecting and monitoring CAV remains underdeveloped, and represents the most critical unmet need in the field. Copyright © 2026 Majo Ribera, Bates, Scott, Fisher and Gonzalez-Fernandez. <126> Accession Number 652400920 Title Direct oral anticoagulants vs dual antiplatelet therapy after left atrial appendage occlusion: a meta-analysis of trials. Source European heart journal. (no pagination), 2026. Date of Publication: 13 Oct 2026. Author Badran A.S.; Stone G.W. Institution (Badran) Faculty of Medicine, Ain Shams University, Cairo, Egypt (Stone) Icahn School of Medicine, Mount Sinai Fuster Heart Hospital, New York, NY, United States <127> Accession Number 652401012 Title Perioperative Outcomes of Acute Normovolemic Hemodilution in Cardiac Surgery: Evidence From Randomized Controlled Trials. Source Cardiology in review. (no pagination), 2026. Date of Publication: 14 Oct 2026. Author Hassan J.; Azam H.; Kumar P.; Nasir W.; Ahmed I.; Chatta S.E.; Jadoon M.S.K.; Laiba F.; Zafar S.; Sufian M.; Bukhari S.M.H.; Khan K.A.; Bashir A.M.D.; Kumari K. Institution (Hassan) From the Department of Medicine, Abu Umara Medical and Dental College/ Green International University, Lahore, Punjab, Pakistan (Azam) Department of Medicine, Jinnah Sindh Medical University, Karachi, Sindh, Pakistan (Kumar) Department of Medicine, Bilawal Medical College, Liaquat University of Medical and Health Sciences, Sindh, Pakistan (Nasir) Department of Medicine, Faisalabad Medical University, Faisalabad, Punjab, Pakistan (Ahmed, Jadoon) Department of Medicine, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Punjab, Pakistan (Chatta) Department of Medicine, King Edward Medical University, Lahore, Punjab, Pakistan (Laiba) Department of Internal Medicine, Capital Health Regional Medical Center, Trenton, NJ, United States (Zafar) Department of Medicine, Al-Aleem Medical College, Lahore, Pakistan (Sufian, Khan) Department of Medicine, Aga Khan University, Karachi, Sindh, Pakistan (Bukhari) Department of Medicine, Gujranwala Medical College, Gujranwala, Punjab, Pakistan (Bashir) Department of Clinical Pharmacology, Shalamar Medical & Dental College, Lahore, Punjab, Pakistan (Kumari) Department of Medicine, Islamabad Medical and Dental College, Islamabad, Punjab, Pakistan Abstract Acute normovolemic hemodilution (ANH) is a blood conservation strategy used in cardiac surgery, but its efficacy in reducing allogeneic blood transfusion remains debated. This systematic review and meta-analysis updates the existing evidence by incorporating recent randomized controlled trials (RCTs) to provide a contemporary assessment of ANH's impact on perioperative transfusion outcomes. We searched PubMed/MEDLINE, Scopus, and Cochrane Central up to August 2025 for RCTs comparing ANH to standard care in adult cardiac surgery. Primary outcomes were the number of allogeneic red blood cell units transfused, the rate of allogeneic blood transfusion, and estimated total blood loss. Data were pooled using random-effects models, and subgroup analyses were performed by type of surgery. Thirty-one RCTs involving 4426 patients (ANH = 2242, control = 2184) were included. ANH significantly reduced the rate of allogeneic blood transfusion (risk ratio 0.75, 95% confidence interval [CI] 0.66-0.87; P < 0.0001), the number of allogeneic red blood cell units transfused (standardized mean difference -0.42, 95% CI -0.64 to -0.20; P = 0.0001), and estimated total blood loss (standardized mean difference -0.42, 95% CI -0.63 to -0.21; P < 0.0001). Substantial heterogeneity was observed. Subgroup analysis demonstrated that benefits were most consistent in patients undergoing coronary artery bypass grafting. In patients undergoing cardiac surgery, particularly coronary artery bypass grafting, ANH reduces exposure to allogeneic blood transfusion and decreases perioperative blood loss. Despite significant heterogeneity across studies, these findings support the inclusion of ANH within multimodal blood management protocols. Further large, high-quality RCTs with standardized protocols are warranted to confirm its role in modern practice. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <128> Accession Number 2038742620 Title Risk of Short-Term Stroke in Non-High-Risk Patients Undergoing Transcatheter Aortic Valve Replacement vs Surgical Aortic Valve Replacement: A Systematic Review and Meta-Analysis. Source Reviews in Cardiovascular Medicine. 27(10) (no pagination), 2026. Article Number: 49672. Date of Publication: 01 Oct 2026. Author Liu H.; Xiao Z.; Zou J.; Peng X. Institution (Liu, Zou, Peng) Department of Cardiology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China (Liu, Zou, Peng) Jiangxi Hypertension Research Institute, Nanchang, China (Xiao) Jiangxi Medical College, Nanchang University, Nanchang, China Publisher IMR Press Limited Abstract Background: To compare the incidence of stroke at 1 and 2 years following transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR), aiming to inform clinical decision-making regarding the safety and effectiveness of these interventions. Method(s): A random-effects meta-analysis was conducted including 9 randomized controlled trials (RCTs) with a total of 9865 patients. The primary endpoint was the incidence of stroke at 1 and 2 years post-procedure. Result(s): At 1 year, TAVR was associated with a lower incidence of stroke compared with SAVR (odds ratio (OR), 0.77; 95% confidence interval (CI), 0.61-0.98; p = 0.03). No significant difference was observed at 2 years (OR, 0.87; 95% CI, 0.65-1.17; p = 0.37). Conclusion(s): TAVR significantly reduces the risk of stroke within 1 year post-procedure compared with SAVR; however, this effect was not maintained at 2 years. These findings highlight the early benefit of TAVR, while the long-term advantage requires further investigation. The PROSPERO Registration: This study has been registered with PROSPERO, registration number: CRD42025636191, https://www.crd.york.ac.uk/PROSPERO/view/C RD42025636191. Copyright © 2026 The Author(s). <129> Accession Number 2049830828 Title The Effect of Sodium Bicarbonate on Renal Injury in Patients Undergoing Major Surgery: Evidence Predominantly from Cardiac Surgery. Source Current Anesthesiology Reports. 16(1) (no pagination), 2026. Article Number: 38. Date of Publication: 01 Dec 2026. Author Han Z.; Zhang T.; Zhu N.; Yang Y.; Zheng Q.; Chandler C.; Zhang Y. Institution (Han, Zhang) Department of Anesthesiology, the Second Affiliated Hospital of Anhui Medical University, Hefei, China (Han, Zhang) Key Laboratory of Anesthesiology and Perioperative Medicine of Anhui Higher Education Institutes, Anhui Medical University, Hefei, China (Zhang, Zhu, Yang, Zheng, Zhang) Anhui Medical University, Hefei, China (Chandler) Department of Anesthesiology and Pain Medicine, University of California Davis Health, Sacramento, CA, United States Publisher Springer Abstract Background: Acute kidney injury (AKI) is a common postoperative complication with no established pharmacologic prevention. Sodium bicarbonate (NaHCO3) has been studied extensively for its renoprotective potential, but evidence is conflicting. Its influence depends on the patient's prior renal function and the type of renal injury. We performed an updated meta-analysis to evaluate the efficacy and safety of perioperative intravenous NaHCO3 for preventing renal injury after major surgery. Method(s): We searched PubMed, Embase, Web of Science, and Cochrane Library for randomized controlled trials comparing perioperative NaHCO3 with control in adult patients undergoing major surgery (9 cardiac surgery trials and 1 orthotopic liver transplantation trial). Primary outcome was AKI incidence; secondary outcomes included serum creatinine change at 48 h, need for renal replacement therapy (RRT), and all-cause mortality. Random-effects models were used. Result(s): Ten randomized controlled trials involving 1,544 patients were included. Perioperative NaHCO3 did not reduce AKI incidence compared with control therapy (RR = 1.02, 95% CI 0.86-1.21, P = 0.81) or improve 48-h serum creatinine change (MD = - 0.66 micromol/L, 95% CI - 15.53 to 14.21). No significant effects were observed on RRT requirement or all-cause mortality. Subgroup analyses showed no consistent effect modification by surgical type, timing, or infusion duration, although high-dose NaHCO3 showed a borderline signal of potential harm. Conclusion(s): Perioperative intravenous sodium bicarbonate was not associated with a reduction in AKI incidence. The confidence interval does not exclude a small benefit or harm. Routine use solely for AKI prophylaxis is not supported. Copyright © The Author(s) 2026. <130> Accession Number 652399744 Title Left Atrial Appendage Closure or Medical Therapy in Atrial Fibrillation: A Systematic Review and Meta-analysis. Source Cardiology. (pp 1), 2026. Date of Publication: 12 Oct 2026. Author Al-Abdouh A.; Obeidat O.; Alabdallah K.; Yilmaz M.; Mortada I.; Eldawud D.; Mhanna M.; Alhuneafat L.; Ghanem F.; Kundu A.; Jabri A.; Anouti K.; Staloch D.; Narayanan A.; Sabayon M.D. Abstract BACKGROUND: The use of anticoagulation in patients with atrial fibrillation is often limited by the significant risk of bleeding, and difficulties maintaining consistent adherence over time. These challenges have led to the development of left atrial appendage closure (LAAC) as an alternative stroke prevention strategy in this patient population. Our study aimed to evaluate LAAC versus medical therapy in patients with atrial fibrillation. METHOD(S): A comprehensive search was conducted using PubMed, Embase, and Cochrane Library from database inception through April 1, 2026. The predefined endpoints were composite outcome of systemic embolism, cardiovascular mortality, or stroke in addition to other endpoints including all-cause mortality, cardiovascular mortality, strokes, and major bleeding. All outcomes were pooled using a random effect Mantel-Haenszel model. The between-study variance (tau2) was estimated using the Paul Mendel method, which is the preferred method when the number of included studies is small. RESULT(S): A total of five randomized controlled trials, 5,404 patients were analyzed; 2,878 underwent LAAC and 2,526 received medical therapy. The median follow-up across studies was 4 years. LAAC met noninferiority compared with medical therapy in atrial fibrillation for major bleeding (RR 0.86; 95% CI 0.59-1.26) and all-cause mortality (RR 0.93; 95% CI 0.71-1.22). In contrast, noninferiority was not met for the composite outcome (RR 0.97; 95% CI 0.64-1.47), cardiovascular mortality (RR 0.86; 95% CI 0.51-1.42), systemic embolism (RR 1.93; 95% CI 0.21-17.5), and all stroke (RR 1.11; 95% CI 0.73-1.67). CONCLUSION(S): This meta-analysis showed that LAAC was noninferior to anticoagulation for all-cause mortality and major bleeding, but it did not meet noninferiority for the other assessed outcomes, including stroke, cardiovascular mortality, and/or systemic embolism. Copyright © The Author(s) 2026. Published by S. Karger AG. <131> [Use Link to view the full text] Accession Number 2050538467 Title Update on Direct Oral Anticoagulants in Atrial Fibrillation Patients Undergoing Cardiac Interventional Procedures: From Clinical Trials to Real-World Evidence. Source Journal of Cardiovascular Pharmacology. 75(3) (pp 185-199), 2020. Date of Publication: 01 Mar 2020. Author Melillo E.; Carbone A.; Rago A.; Papa A.A.; D'. Onofrio A.; Nigro G.; Golino P.; Russo V. Institution (Melillo, Carbone, Rago, Papa, Nigro, Golino, Russo) Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli, Naples, Italy (D'. Onofrio) Departmental Unit of Electrophysiology, Evaluation and Treatment of Arrhythmias, Monaldi Hospital, Naples, Italy Publisher Lippincott Williams and Wilkins Abstract Direct oral anticoagulants (DOACs) are considered a first-line therapy for long-term stroke prevention in patients with nonvalvular atrial fibrillation (AF) and high thromboembolic risk. The potential role of DOACs in cardiac interventional procedures is a pressing clinical question, considering the increasing number of procedures and the growing prevalence of patients in DOAC therapy. The aim of this review is to provide an update on available evidence about the clinical performance of DOACs in AF patients undergoing different interventional procedures (AF cardioversion and ablation, and percutaneous coronary and structural heart disease interventions) and to explore the possible role of DOACs as an alternative therapeutic strategy in cardiac interventional procedures among non-AF patients. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. <132> Accession Number 2038774395 Title BIETTIER LONG-TIERM OUTSOMIES AFTIER SORONARY ARTIERY BYPASS GRAFTING SOMPARIED WITH PIERSUTANIEOUS SORONARY INTIERVIENTION IN ISSHIEMIS HIEART DISIEASIE WITH RIEDUSIED LIEFT VIENTRISULAR FUNSTION: A SYSTIEMATIS RIEVIIEW. Source Central Asian Journal of Medical Hypotheses and Ethics. 7(3) (pp 285-296), 2026. Date of Publication: 30 Sep 2026. Author Yessaliyev N.; Tuleutayev R.; Adenov M.; Akhmetov V.; Turysbekuly A.; Kairatova G.; Kauysheva A.; Sydykova B. Institution (Yessaliyev, Tuleutayev) Department of Cardiac Surgery, Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan (Adenov, Kauysheva) Director of the National Scientific Center of Phthisiopulmonology of the Republic of Kazakhstan, Kazakhstan (Akhmetov, Sydykova) Department of Healthcare Management, Kazakhstan Medical University "KSPH", Almaty, Kazakhstan (Turysbekuly) Department of Cardiovascular Surgery, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan (Kairatova) Department of Public Health, Semey Medical University, Semey, Kazakhstan Publisher South Kazakhstan Medical Academy Abstract The choice of the optimal myocardial revascularization strategy in patients with coronary artery disease, multivessel coronary artery disease, and reduced left ventricular function remains one of the most pressing and controversial issues in modern cardiology and cardiovascular surgery. Despite significant progress in the development of percutaneous coronary intervention techniques and the refinement of coronary artery bypass grafting (CABG) surgical technologies, the preferred method for restoring coronary blood flow in this patient population remains actively debated. Evaluation of long-term clinical outcomes, including survival, the risk of cardiovascular complications, and the need for repeat revascularization procedures, is particularly important. The aim of this study was to conduct a comparative analysis of the efficacy and safety of percutaneous coronary intervention and CABG in adult patients with coronary artery disease, including those with reduced left ventricular function, based on current scientific evidence. A systematic literature review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Publications were searched in the international databases PubMed, Scopus, Web of Science, and Embase from January 2020 to May 2026. The review included randomized controlled trials and prospective and retrospective cohort studies that reported direct comparisons of percutaneous coronary intervention and coronary artery bypass grafting in adult patients with coronary artery disease. Due to significant clinical and methodological heterogeneity among the studies, a qualitative data synthesis was conducted rather than a quantitative meta-analysis. Results. Analysis of the included studies showed that both revascularization strategies had comparable rates of all-cause and in-hospital mortality during short-and medium-term follow-up periods. However, in the long term, coronary artery bypass grafting demonstrates more favorable outcomes, characterized by a reduced incidence of major adverse cardiovascular and cerebrovascular events, myocardial infarction, and repeated coronary interventions. The most pronounced benefit of surgical revascularization is observed in patients with three-vessel coronary disease, left main coronary artery disease, and a marked reduction in left ventricular ejection fraction. Percutaneous coronary intervention (PCI) retains its importance as a less invasive treatment option in patients with less complex coronary artery disease anatomy and a high risk of surgical intervention. Conclusion. Current data indicate that CABG remains the preferred revascularization strategy for most patients with extensive coronary atherosclerosis and reduced left ventricular function due to its superior long-term clinical outcomes, while PCI is an effective alternative in carefully selected clinical situations. A personalized approach to treatment selection, taking into account the anatomical features of the coronary artery, the degree of left ventricular dysfunction, and surgical risk, can improve treatment efficacy and patient prognosis. PROSPERO registration: The systematic review was registered with PROSPERO under registration number CRD420261437422. Copyright © 2026, South Kazakhstan Medical Academy. All rights reserved. <133> Accession Number 2050642132 Title Effects of dexmedetomidine on postoperative outcomes in adult non-cardiac surgical patients admitted to the intensive care unit: a systematic review and network meta-analysis of randomized controlled trials. Source Anaesthesia Critical Care and Pain Medicine. 46(1) (no pagination), 2027. Article Number: 101907. Date of Publication: 01 Jan 2027. Author Shin C.C.Y.; Karigowda L.; Zhang B.; Sadanandan D.; Shehabi Y.; Wong S.; Subramaniam A.; Deshpande K. Institution (Shin, Karigowda, Zhang) Department of Intensive Care Medicine, Fairfield Hospital, NSW, Australia (Shin, Karigowda) Department of Intensive Care Medicine, Liverpool Hospital, NSW, Australia (Karigowda) Department of Intensive Care Medicine, Westmead Hospital, NSW, Australia (Sadanandan) Research Scientist and Biostatistician, Women's & Children's Health Research Unit, Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research, Karnataka, Belagavi, India (Shehabi, Wong) Department of Intensive Care Medicine, Prince of Wales Hospital, NSW, Australia (Shehabi, Subramaniam) Centre for Outcome and Resource Evaluation, Australian and New Zealand Intensive Care Society, Melbourne, VIC, Australia (Subramaniam) Department of Intensive Care Medicine, Dandenong Hospital, Monash Health, Dandenong, Vic, Australia (Subramaniam) Department of Intensive Care Medicine, Epworth Healthcare, Richmond, Vic, Australia (Subramaniam) Peninsula Clinical School, Monash University, Frankston, VIC, Australia (Subramaniam) Department of Intensive Care Medicine, Epworth Hospital, Richmond, Vic, Australia (Deshpande) Department of Intensive Care Medicine, St George Hospital, NSW, Australia (Deshpande) Clinical School of Medicine, University of New South Wales, New South Wales, Australia Publisher Elsevier Masson s.r.l. Abstract Background: The role of dexmedetomidine in patients admitted to the intensive care unit (ICU) following non-cardiac surgery remains unclear. While dexmedetomidine is widely used for its sedative and potential delirium-sparing properties, its pooled effects on clinically relevant postoperative outcomes in this population are not well established. This systematic review and network meta-analysis evaluated the comparative effectiveness and safety of dexmedetomidine compared with other sedative strategies in postoperative non-cardiac surgical ICU patients. Method(s): We systematically searched PubMed, Cochrane CENTRAL, and Embase from inception to 26 May 2026 for randomised controlled trials (RCTs) comparing postoperative dexmedetomidine with normal saline or other sedatives in adults (>=18 years) admitted to the ICU after non-cardiac surgery. The primary outcome was incidence of delirium during the ICU stay. Secondary outcomes were time to extubation, ICU length of stay, duration of mechanical ventilation, and haemodynamic adverse events. Effect estimates were expressed as relative risks (RRs) or mean differences (MDs) using random-effects models. Risk of bias was assessed using the Cochrane RoB 2 tool, and certainty of evidence was evaluated using the GRADE framework. Interventions were ranked using the surface under the cumulative ranking curve (SUCRA) for each outcome. Result(s): Twenty-four RCTs involving 2,777 patients were included in the systematic review, of which 22 RCTs involving 2,544 patients contributed to the network meta-analysis. Compared with midazolam (RR 0.11, 95% CI 0.02 to 0.80; very low certainty) and normal saline (RR 0.46, 95% CI 0.36 to 0.59; low certainty), dexmedetomidine may reduce the risk of delirium. Evidence is insufficient to determine whether propofol differs from dexmedetomidine in its effect on delirium. There were no differences in time to extubation, duration of mechanical ventilation, or ICU length of stay across sedative strategies. Dexmedetomidine probably increases the risk of bradycardia compared with propofol (RR 3.03, 95% CI 1.39-6.25; low certainty), but the evidence is insufficient to determine whether the two agents differ in their effects on hypotension. In safety rankings, dexmedetomidine performed least favourably for bradycardia (SUCRA 0.03) and hypotension (SUCRA 0.13). Conclusion(s): Dexmedetomidine may reduce postoperative delirium in non-cardiac surgical ICU patients but does not appear to improve ventilatory recovery or ICU length of stay and is associated with higher bradycardia risk. Its principal benefit lies in delirium prevention, supporting an individualised approach to sedative selection. Copyright © 2026 Societe Francaise d'Anesthesie et de Reanimation (SFAR). Published by Elsevier Masson SAS. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <134> [Use Link to view the full text] Accession Number 2050629901 Title Impact of Virtual Reality on Transcatheter Aortic Valve Implantation: A Prospective Randomized Controlled Trial. Source Circulation: Cardiovascular Imaging. 19(10) (pp e018922), 2026. Date of Publication: 01 Oct 2026. Author Kanschik D.; Steinhoff D.; Klein K.; Lichtenberg A.; Ballazs C.; Stadnik D.; Scherner M.; Antoch G.; Kelm M.; Zeus T.; Jung C. Institution (Kanschik, Steinhoff, Klein, Kelm, Zeus, Jung) Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Germany (Lichtenberg, Ballazs, Stadnik, Scherner) Department of Cardiac Surgery, Medical Faculty, University Hospital and Heinrich-Heine University, Germany (Antoch) Department of Diagnostic and Interventional Radiology, Medical Faculty, University Hospital and Heinrich-Heine University, Germany (Lichtenberg, Kelm, Zeus, Jung) Cardiovascular Research Institute Duesseldorf (CARID), Medical Faculty, Heinrich-Heine University, Germany Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - Accurate preprocedural planning is crucial for a successful transcatheter aortic valve implantation to ensure patient safety and valve longevity. Through 3-dimensional visualization, virtual reality (VR) offers the potential to enhance this process. The study investigated whether the inclusion of VR in preprocedural planning can improve the procedural preparation, impact intraprocedural parameters, and improve short-term patient outcomes. METHOD(S): - This randomized, prospective, controlled study included 140 patients who underwent transcatheter aortic valve implantation at the University Hospital Duesseldorf between April and August 2024. In the control group, preprocedural planning was based on multislice computed tomography data using 3mensio software, while in the intervention group, it was supplemented with VR software. In addition, interventionalists assessed both tools via a structured questionnaire. RESULT(S): - The evaluation did not reveal any relevant differences in patient characteristics. VR was superior to 3mensio software with respect to the 3-dimensional understanding (P<0.001). Similarly, depth perception, visualization of atherosclerotic plaques, and iliofemoral tortuosity were better in the VR group. Both methods were found to be useful and helpful in preparing for the procedure. There were no significant differences in procedural data between the 2 groups. However, the VR group had a lower rate of bleeding at the access site (P<0.05). There was no significant difference in the length of hospital stay or postprocedural transthoracic echocardiography data evaluations. CONCLUSION(S): - The data show that VR visualization can optimize preparation for the procedure by improving the 3-dimensional understanding of the aortic valve and adjacent structures. The detailed visualization of the access routes can lead to a reduction in periprocedural complications. Copyright © 2026 American Heart Association, Inc. <135> Accession Number 2050626217 Title Efficacy and safety of liposomal bupivacaine for thoracic paravertebral block in adult thoracic surgery: A systematic review and meta-analysis. Source Asian Journal of Surgery. (no pagination), 2026. Date of Publication: 2026. Author Yan L.; Huai Z.; Zhang W. Institution (Yan, Huai, Zhang) Department of Anesthesiology, The Second Affiliated Hospital of Shandong First Medical University, Shandong, Tai'an, China Publisher Elsevier (Singapore) Pte Ltd Abstract Liposomal bupivacaine (LB) has been used for thoracic paravertebral block (TPVB) to prolong analgesia after thoracic surgery, but its clinical benefit remains uncertain. We conducted a systematic review and meta-analysis of randomized controlled trials comparing LB-based TPVB with non-liposomal local-anesthetic regimens in adults undergoing thoracic surgery. PubMed, Embase, the Cochrane Library/CENTRAL, and Web of Science were searched from inception to 12 April 2026. Six trials involving 589 patients were included. LB was associated with lower resting pain scores at 24 and 48 h, although heterogeneity was substantial and both findings were sensitive to the omission of one study. No statistically significant differences were observed in resting pain at 72 h, evoked pain during coughing or activity at 24 h, or opioid consumption at 24-72 h. Lower-risk signals were observed for postoperative vomiting, dizziness, and study-defined chronic postsurgical pain at 3 months; however, these outcomes were based on few studies and limited events. The certainty of evidence was low or very low. LB-TPVB may reduce resting pain during the first 48 h, but the clinical relevance and robustness of these findings remain uncertain. Evidence for opioid sparing, evoked pain, safety outcomes, and chronic postsurgical pain remains insufficient for definitive conclusions. Copyright Asian Surgical Association and Taiwan Society of Coloproctology This is an open access article under the CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/ <136> Accession Number 2049761245 Title Endoscopic versus open radial artery harvesting for coronary artery bypass grafting: an updated systematic review, meta-analysis, and GRADE assessment. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 925. Date of Publication: 01 Dec 2026. Author Qazi T.I.; Malik A.A.; Khan M.; Yahya M.; Asad Y.; Idrees S.; Gull M.U.; Khan A.; Munir F.; Khan A.S.; Sadaqat A.; Amjad M.M.; Kotak P.; Rauf M.A.A.; Rehman S.; Yasir M.; Khattak M.H.; Batool A.; Khan H.W.; Khan B.W. Institution (Qazi, Yahya, Gull, Khan, Amjad, Khattak, Khan) Department of Medicine, Khyber Medical College, KPK, Peshawar, Pakistan (Malik, Khan, Asad) Department of Medicine, United Medical and Dental College, Sindh, Karachi, Pakistan (Idrees) Department of Medicine, Rawalpindi Medical University, Punjab, Rawalpindi, Pakistan (Munir) Department of Medicine, Shaheed Mohtarma Benazir Bhutto Medical College, Lyari, Sindh, Karachi, Pakistan (Khan) Department of Medicine, Plovdiv Medical University, Plovdiv, Bulgaria (Sadaqat) Department of Curative Medicine, Faculty of Medicine, Kateb University, Kabul, Afghanistan (Kotak) Department of Medicine, Liaquat University of Medical and Health Sciences, Sindh, Jamshoro, Pakistan (Rauf) Department of Medicine, Abbottabad International Medical College, KPK, Abbottabad, Pakistan (Rehman) Department of Medicine, Government General Hospital Faisalabad, Punjab, Faisalabad, Pakistan (Yasir) Department of Medicine, Ayub Medical College, KPK, Abbottabad, Pakistan (Khan) Department of Surgery, King Edward Medical University, Punjab, Lahore, Pakistan (Batool) Department of Medicine, Sir Syed College of Medical Sciences, Sindh, Karachi, Pakistan (Khan) Department of Surgery, Ayub Teaching Hospital, KPK, Abbottabad, Pakistan Publisher BioMed Central Ltd Abstract Background: Endoscopic radial artery harvesting (ERAH) is a minimally invasive alternative to open radial artery harvesting (ORAH) for coronary artery bypass grafting (CABG), though concerns persist regarding graft patency and neurological outcomes. Method(s): PubMed, Embase, Cochrane Library, and ClinicalTrials.gov were searched through February 21, 2026. Randomized controlled trials and propensity-matched observational studies were included. Risk of bias was assessed using ROB 2 and the Newcastle-Ottawa Scale; certainty of evidence was evaluated using GRADE. Pooled risk ratios and mean differences with 95% confidence intervals were calculated using a random-effects model. Result(s): ERAH significantly reduced wound complications (RR = 0.61, 95% CI: 0.39-0.96) and wound infections (RR = 0.57, 95% CI: 0.35-0.93), though this benefit did not persist in RCT-only analysis. Neurological complications were reduced after sensitivity analysis (RR = 0.44, 95% CI: 0.34-0.57). Graft patency was comparable (RR = 1.01, 95% CI: 0.90-1.14), with no significant differences in mortality, MACCE, or myocardial infarction. Observational data showed modest reductions in cardiopulmonary bypass time and hospital stay. Conclusion(s): ERAH demonstrates comparable graft patency and major clinical outcomes to ORAH. Donor-site benefits suggested by observational studies are not consistently supported by randomized evidence. Large trials with standardized outcomes and long-term follow-up are needed. Trial registration: PROSPERO, CRD420261334767. Copyright © The Author(s) 2026. <137> Accession Number 652386554 Title The Impact of Statin Therapy on Postoperative Short- and Long-term Mortality and Morbidity After Non-Cardiac Surgery. Source European journal of preventive cardiology. (no pagination), 2026. Date of Publication: 12 Oct 2026. Author Bell M.; Bremberg A.; Mellbin L.; Valadkhani A. Institution (Bell, Valadkhani) Function Perioperative Medicine and Intensive Care (PMI), Karolinska University Hospital, Stockholm, Sweden (Bell, Bremberg, Valadkhani) Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (Mellbin) Department of Medicine, Karolinska Institutet, Solna, Stockholm, Sweden (Mellbin) Heart, Vascular and Neuro Theme, Karolinska University Hospital, Stockholm, Sweden Abstract AIMS: Statins' anti-inflammatory and endothelial-stabilising effects suggest perioperative value, but trials of de novo initiation were discredited following research misconduct. Whether established preoperative statin therapy lowers postoperative mortality dose-dependently remains unclear. METHOD(S): We studied 56,362 patients aged >=45 years undergoing non-cardiac surgery at two university hospitals (2016-2023). Preoperative statin exposure was assessed as status (any vs none), intensity (high vs low/intermediate), and regimen (high vs low/intermediate vs none). Primary outcomes were 30- and 365-day mortality. Inverse probability of treatment weighting, using random forest-estimated propensity scores targeting the average treatment effect in the treated, was applied to balance measured confounders. Associations were estimated with weighted Cox regression. RESULT(S): Overall, 372 patients (0.6%) died within 30 days and 3,735 (6.6%) within 365 days. After weighting, all covariates were balanced. Statin therapy showed a directionally consistent but non-significant association with lower 30-day mortality (HR 0.78; 95% CI 0.57-1.07), and was associated with lower 365-day mortality (HR 0.81; 95% CI 0.73-0.90; ARD -1.2 percentage points; number needed to treat 83). A dose-response relationship was evident: versus no statin, high-intensity therapy showed a 29% lower hazard (HR 0.71; 95% CI 0.60-0.83; ARD -2.3 points) and low/intermediate-intensity a 16% lower hazard (HR 0.84; 95% CI 0.74-0.96). Findings were consistent across sensitivity analyses. CONCLUSION(S): Among adults undergoing non-cardiac surgery, established preoperative statin therapy was associated with dose-dependent lower 365-day mortality. These findings suggest perioperative statin continuation as a preventive strategy and warrant confirmation in a randomised trial. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. <138> Accession Number 652389018 Title Impact of Extent of Coronary Artery Disease in Transcatheter Aortic Valve Replacement: A PRO-TAVI Substudy. Source JACC. Cardiovascular interventions. 19(19) (pp 2619-2630), 2026. Date of Publication: 12 Oct 2026. Author Broeze G.M.; Aarts H.M.; da Silva Voorham J.; Hemelrijk K.I.; Jan van Ginkel D.; Versteeg G.A.A.; Grundeken M.J.; Claessen B.E.P.M.; Tonino P.A.L.; Schotborgh C.E.; Meuwissen M.; van Houwelingen G.K.; Wykrzykowska J.J.; Amoroso G.; Vossenberg T.N.; Vriesendorp P.A.; van Royen N.; Ten Berg J.M.; Tijssen J.G.P.; Voskuil M.; Delewi R. Institution (Broeze, da Silva Voorham, Hemelrijk, Grundeken, Claessen, Tijssen, Delewi) Department of Cardiology, Amsterdam University Medical Centres, Amsterdam, Netherlands (Aarts) Department of Cardiology, Amsterdam University Medical Centres, Amsterdam, the Netherlands; Department of Cardiology, University Medical Centre Utrecht, Utrecht, the Netherlands (Jan van Ginkel) Department of Cardiology, St. Antonius Hospital, Nieuwegein, Netherlands (Versteeg, van Royen) Department of Cardiology, Radboud University Medical Centre, Nijmegen, Netherlands (Tonino) Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, the Netherlands; Department of Biomedical Engineering, Technical University Eindhoven, Eindhoven, the Netherlands (Schotborgh) Department of Cardiology, Haga Hospital, The Hague, Netherlands (Meuwissen) Department of Cardiology, Amphia Hospital, Breda, Netherlands (van Houwelingen) Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, Netherlands (Wykrzykowska) Department of Cardiology, Groningen UMC, Groningen, Netherlands (Amoroso) Department of Cardiology, OLVG, Amsterdam, Netherlands (Vossenberg) Department of Cardiology, Medical Centre Leeuwarden, Leeuwarden, Netherlands (Vriesendorp) Department of Cardiology, Maastricht University Medical Centre, Maastricht, Netherlands (Ten Berg) Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands (Voskuil) Department of Cardiology, University Medical Centre Utrecht, Utrecht, Netherlands Abstract BACKGROUND: Coronary artery disease is present in one-half of patients undergoing transcatheter aortic valve replacement (TAVR). The recent randomized controlled PRO-TAVI (Percutaneous Coronary Intervention Before Transcatheter Aortic Valve Implantation) trial indicated that deferral of percutaneous coronary intervention (PCI) is safe in patients with concomitant coronary artery disease at 1-year follow-up. The SYNTAX (Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery) score quantifies the extent of coronary artery disease, which may guide individualized revascularization strategies. OBJECTIVE(S): The aim of this study was to evaluate the association between SYNTAX score (SS) and clinical outcomes in patients undergoing TAVR. METHOD(S): This study was a substudy of the PRO-TAVI trial, including 466 patients with significant coronary artery disease undergoing TAVR randomized to deferral of PCI or PCI before TAVR. SS was calculated from preprocedural coronary angiograms, and patients were stratified by SS quartiles. The primary outcome was a composite of all-cause mortality, myocardial infarction, stroke, and major bleeding at 1 year. An ischemic composite outcome of all-cause mortality, myocardial infarction, and stroke was also assessed. RESULT(S): The primary composite outcome did not differ across SS categories between the deferral and PCI groups at 1-year follow-up, which was completed by all but 1 patient. In patients with SS >17, the ischemic composite outcome occurred more often in the deferral group (30.9% vs 14.8%; adjusted HR: 2.43; 95% CI: 1.04-5.64; P = 0.04), driven primarily by all-cause mortality and stroke. Bleeding events were less frequent in the deferral group across all SS subgroups. CONCLUSION(S): In patients with concomitant coronary artery disease undergoing TAVR, deferral of PCI reduced bleeding risk and appeared safe across all SS categories. Deferral of PCI in patients with more complex coronary artery disease (SS >17) was associated with higher risk for the ischemic composite outcome. These post hoc findings require confirmation in randomized trials. (Percutaneous Coronary Intervention Before Transcatheter Aortic Valve Implantation [PRO-TAVI]; NCT05078619). Copyright © 2026 The Authors. Published by Elsevier Inc. All rights reserved. <139> Accession Number 2049768590 Title Valve-specific structural vulnerability in infective endocarditis: a narrative review of surgical complexity and outcomes. Source Journal of Cardiothoracic Surgery. 21(1) (no pagination), 2026. Article Number: 800. Date of Publication: 01 Dec 2026. Author Abd Rani N.H.; Mohamed A.; Md Isa Z.; Kadiman S.; Kamarudin T.A. Institution (Abd Rani) Non-Invasive Cardiovascular Laboratory, National Heart Institute, Kuala Lumpur, Malaysia (Mohamed) Centre for Diagnostic, Therapeutic & Investigative Studies (CODTIS), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia (Md Isa) Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia (Kadiman) Department of Anaesthesiology and Critical Care, National Heart Institute, Kuala Lumpur, Malaysia (Abd Rani, Kamarudin) Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia Publisher BioMed Central Ltd Abstract Background: Infective endocarditis (IE) carries in-hospital mortality of 15-20% and 1-year mortality approaching 40%, with surgery required in 40-50% of cases. IE is not uniformly distributed across cardiac valves aortic 30-45%, mitral 25-30%, tricuspid 5-10%, pulmonary < 2%, PVE 10-30% and this distribution reflects valve-specific anatomical determinants governing surgical complexity and outcomes. Despite the 2023 ESC Guidelines, a unified structural framework linking anatomical vulnerability to surgical decision-making remains absent. Objective(s): To propose a valve-specific structural vulnerability framework and examine its implications for surgical complexity, perioperative outcomes, and re-surgery risk across all cardiac valve types. Method(s): A narrative review of peer-reviewed literature (2015-2025) was conducted across PubMed, Scopus, and MEDLINE. Systematic reviews, meta-analyses, multicentre registries, and guideline documents were synthesised narratively. Key Findings: A structural vulnerability gradient (prosthetic valves > aortic > mitral > tricuspid > pulmonary) is proposed as a conceptual model of valve-specific disease behaviour. Aortic IE carries maximal vulnerability through peri-annular extension, 30-40% of cases, requiring radical root reconstruction with elevated operative mortality. Mitral IE exhibits conditional vulnerability; repair yields superior outcomes over replacement. Tricuspid IE is predominantly IVDU-associated with comparatively lower operative mortality. PVE carries the highest operative risk, with prolonged operative times and significant reoperation rates. Conclusion(s): IE is best understood as a valve- and substrate-specific disease in which anatomical determinants drive surgical complexity and clinical prognosis. This proposed vulnerability hierarchy may enable preoperative risk stratification, inform valve-specific surgical planning, and provide a mechanistic framework for understanding differential outcomes across valve types. Prospective outcome registries and standardised complexity metrics are needed to validate and refine this conceptual model. Copyright © The Author(s) 2026.

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